As Delhi-NCR battles air quality levels in the ‘severe’ range, doctors caution that the damage begins long before birth. Anuja Jaiswal speaks with Dr Kana Ram Jat, professor of paediatrics at AIIMS, New Delhi, about the hidden impact of pollution on unborn and young children.
Does air pollution affect children only after birth, or earlier?
The harm starts in the womb. Pollutants inhaled by the mother enter her bloodstream and reach the fetus, which relies entirely on maternal blood for oxygen and nutrients.
What long-term effects does fetal exposure to pollution have?
Air pollutants trigger inflammation, oxidative stress and reduced oxygen supply to the fetus. This disrupts organ development, particularly in the lungs, increasing the chances of a newborn having a compromised respiratory system and needing longer stays in neonatal care.
Babies exposed to high levels of pollution are more likely to have low birth weight, develop allergies, wheezing and asthma, and face a higher risk of developmental delays.
Why are infants and young children more vulnerable than adults?
Their lungs are still growing and much smaller in capacity. The same amount of polluted air therefore causes disproportionately greater irritation — like adding the same amount of chilli powder to a small bowl of curd versus a large one.
Are respiratory illnesses increasing in young children? What are the most common ones?
While the number of infections hasn’t risen sharply, infants and toddlers show more severe symptoms because of narrower airways and lower lung capacity.
The most common problems in children under five include frequent colds, pneumonia and wheezing episodes after viral infections. Pollution aggravates asthma, worsens infections and leads to disturbed sleep, increased wheezing, missed school and more hospital visits. Hospitals routinely report a surge in paediatric breathing emergencies during high-pollution spells.
Why is diagnosing asthma difficult in very young children?
Because several conditions mimic asthma — congenital airway abnormalities, aspiration of feeds, or even a foreign object in the airway. Parents should seek urgent medical care for breathing distress, noisy breathing, bluish lips or nails, poor feeding, lethargy, seizures or reduced responsiveness.
What should parents know about bronchiolitis? How serious is pneumonia?
Bronchiolitis, common in children under two, begins like a cold but can lead to breathing trouble within a few days. Most children recover, but some require ICU care.
Pneumonia varies in severity, and any concerning symptoms should prompt immediate medical attention.
Are antibiotics and nebulisers always the right treatment?
Most respiratory infections in children are viral, and antibiotics offer no benefit. Nebulisers too are frequently overused. In many cases — particularly asthma — metered dose inhalers (MDIs) with spacers are highly effective and safe. Parents should always consult their paediatrician to choose the appropriate device.
Should parents worry about steroids in inhalers?
Inhaled steroids are safe for children with asthma when used under medical supervision. However, unnecessary or unsupervised use can be harmful.
How can parents protect their child’s lungs long-term?
Exclusive breastfeeding for the first six months, routine vaccinations, avoiding self-medication, reducing outdoor exposure during high-pollution days, and timely consultation with a paediatrician are essential. Air purifiers can help indoors — especially for infants and the elderly — but offer only partial protection.
Can repeated lung infections in early childhood cause long-term issues?
Yes. Since lungs continue developing through early childhood, recurrent infections can increase the risk of persistent wheezing or asthma later in life.
What myths do parents commonly believe?
Some widespread misconceptions include:
• Children cannot have asthma
• Inhaled steroids are addictive
• Asthma is a social stigma
• Every infection needs antibiotics
• Self-medication is sufficient
Timely paediatric guidance, Dr Jat stresses, is the key to preventing complications.
