The cost of air pollution: ‘Healthy babies developing pneumonia within weeks, some are born asthmatic’

Although Aahan’s mother Jaya Shroff was distraught that both her children had become asthmatic, their doctor, Dr Rahul Sharma, additional director of Pulmonology at Fortis Noida, wasn’t. “Over the last few years, asthma and allergies have become common among children and pre-teens,” he says. Aahan needed injectable steroids. “In fact, it was while attending to our son in hospital that we found our daughter, too, was wheezing slightly. That’s when she was also diagnosed with asthma,” says Shroff.

It all begins in the womb

Dr Kana Ram explains the problem begins from the time when the child is inside a mother’s womb and has a risk of being born with a compromised respiratory system, a reason why newborns have to be kept longer in the neonatal units these days. “A foetus exposed to pollutants is usually born with a low birth weight. Such babies are prone to allergies and asthma as they grow up,” he says.

The foetus, he explains, is entirely dependent on the mother’s blood supply for oxygen and nutrients. “So, when pollutants enter the maternal bloodstream, the foetus is indirectly exposed too. This can cause inflammation, oxidative stress, and reduced oxygen delivery, all of which interfere with healthy growth and organ development even before birth.”

Low birth weight and premature delivery can lead to a higher risk of infant mortality, developmental delays and chronic conditions later in life, such as diabetes and heart disease. Studies have shown that pollutants can lead to DNA sequence changes and chromosomal aberrations, which can increase susceptibility to certain diseases. In fact, the cumulative effect of air pollutants can delay developmental milestones.

About 30 km from AIIMS Delhi, Dr Manish Mannan, Head of Paediatrics and Neonatology at Paras Hospital, Gurugram, has been studying his patients for patterns of respiratory behaviour. “Infants with compromised lung capacity need longer stays in the NICU and extended oxygen support. The long-term risk is worrying because it can predispose them to chronic respiratory illnesses in adulthood,” he says.

How do air pollutants impact child health?

Toxic particles breathed in by the pregnant woman can cross the placenta, which is a temporary organ that connects the baby to the mother via an umbilical cord, and interfere with the baby’s development process. “First, the placenta gets inflamed, so there is a resistance to blood flow. Then the blood vessels get damaged and there is reduced blood flow and nutrients to the foetus. Fine particulate matter like PM2.5, nitrogen dioxide, carbon monoxide can impair organ development in the foetus. Lung development starts early in pregnancy but continues till the very end. Chronic exposure to pollutants can lead to smaller lung volumes, immature airways and compromised immune function. In essence, these babies may be born with lungs that aren’t ready for the outside world, leading to respiratory distress right after birth,” says Dr Mannan.

Studies show a link between maternal exposure to air pollution and an increased risk of stillbirth, particularly during the third trimester. Microplastics floating in the air and emanating from sources like synthetic clothing, car tyres and breakdown of plastic waste are endocrine disruptors. They play around with hormones. They have been found in the human placenta, umbilical cord and umbilical cord blood, indicating they can pass from mother to foetus, where they hamper organ development and the central nervous system.

Over the past decade, Dr Mannan says, the change has been unmistakable. “Previously, most neonatal infections were due to delivery complications or hospital-acquired pathogens. Now we see healthy babies developing respiratory distress and pneumonia within weeks. Pollution weakens both the mother’s and the baby’s immunity, especially among those in cities and industrial zones. More babies now require respiratory assistance at birth. Low birth weight, preterm delivery and persistent cough in infants were exceptions a decade ago. Now, they’re routine,” he adds.

What should be the preventive steps then?

Both pregnant women and children need good air quality at home using air purifiers. Both should limit indoor smoke from incense and mosquito coils as well as outdoor exposure, keep windows shut during peak pollution hours and stay indoors. “Nutrition matters too, including foods rich in antioxidants like vitamins C and E, which help counter oxidative stress. Regular follow-ups help track lung and developmental milestones in infants,” says Dr Mannan. Parents like Shroff are adding house plants, buying air purifiers and even crowd-funding for purifiers at school.

But on a larger scale, Dr Mannan emphasises, urban planning and public policy are just as crucial. “Cleaner fuels, stricter emission controls and better air monitoring systems aren’t luxuries. Air quality isn’t just an environmental issue — it’s a neonatal health crisis,” he says.