World Prematurity Day: Smog in India can be venom for your preemie

(Representational image)

New Delhi: The nip in the air is pleasant, but what happens if it starts suffocating you? The atmosphere suddenly grows translucent and you start coughing and feel choked. This is nothing but being trapped in an envelope of smog. Residents are facing a tough time due to smog engulfing the town and its surrounding areas. It is harmful for those who are suffering from cardiovascular and pulmonary diseases such as bronchitis and asthma, besides rhinitis, conjunctivitis and dermatitis but it is the deadliest for premature infants.

One out of every four premature deaths in India in 2015, or some 2.5 million, was attributed to pollution, according to the study released in October by The Lancet Medical Journal. China’s environment was the second deadliest, with more than 1.8 million premature deaths, or one in five, blamed on pollution-related illness.

Traps preemies in its cob-web

Premature birth is a birth that happens too soon – before 37 weeks of pregnancy and is one of the leading causes of neonatal mortality and morbidity in India. Babies born this early face complications that are inversely related to gestation. The younger the babies, more likely the problems. Chronic lung disease is the most common in premature babies and pollution worsens their ability to breathe.

Studies conducted from time to time have revealed that towns and cities with higher level of air pollution have higher incidence of respiratory diseases. New-borns have virgin (immature) lungs and they are at a very high risk of contracting respiratory ailments in environmental condition like smog, causing a surge in preterm deaths.

Time and again experts have also expressed apprehensions that exposure to high level of pollution can affect the life span of preemies.

Dr Raghuram Mallaiah, Director Neonatology, Fortis la Femme says that pollution is a major risk factor especially for premature babies. Although most of the organs are formed in premature babies at birth, a major portion of development of these organs happen only after birth. Lungs in a very premature baby doubles in volume over the first 2-3 months of life and pollution casts a very severe negative impact on this and thereby has long term effects for the entire future of these babies. Similarly, other organs such as brain and heart also suffer long term implications due to pollution. Pollution also has a negative impact on the physical and mental growth of premature babies.

Smog is emitting poison in air as it leads to the onset of allergies or aggravates existing allergies and decreases lung immunity within infants. Neonates themselves are susceptible to breathing problems due to early birth, but exposure to such circumstances aggravate their lung diseases. Pollutants can damage not only the respiratory system but also other organs of newborns. Neither their immune systems nor their different organ systems are developed enough to fight the harmful environment we find ourselves in.

Hold on it affects your pregnancy too!

Yes, exposure to air pollution during pregnancy can increase your risk of premature birth and low birth weight. A new mother’s exposure to air pollution during pregnancy causes stress for mother and further affects child’s health (especially breathing) and learning skills later in life. Situations like such impacts the foetal growth leading to preterm deliveries.

Studies have also found that high air pollution levels can have an impact on the body’s absorption of vitamin D, which promotes calcium absorption that is vital for bone growth and also plays an important role in boosting immunity.

This "pollution emergency" prevailing in Delhi is an alarming state of medical emergency and like virtually sitting on a time bomb which is likely to explode in 5-10 years, if we do not act fast.

Consuming toxic air triggers health complications for both mother and baby and here the intervention of skin-to-skin contact is utmost needed. Breastfeeding is the best form of nutrition for a preterm baby. Breast milk is easily digested and provides the best immunization for preemies. The best way of doing so is through Kangaroo care, which is a method of holding a baby that involves skin-to-skin contact and is known to enhance breast milk production and more willingness to breast feed. KMC (Kangaroo Mother Care) is known to regulate heart rate, breathing patterns and temperatures in preterm babies. Babies under KMC experience less pain therefore less crying and establish better sleeping pattern. It reduces the risk of infections and allows better, faster overall development of the baby shortening the length of hospital stay, says Dr Anita Sharma, Infant and young child feeding counsellor, BPNI(India) and UNICEF WHO Doula, Child Birth Educator, Lamaze international, USA.

The situation is turning murkier day by day and hence it is our responsibility to ensure that children have access to one of the most basic elements for existence – clean air. While policy interventions can play an important role in improving the overall public health scenario, experts suggest that parents should take their own measures to ensure their children’s health is not affected because of pollution as the only motive is to protect babies and infants from environmental hazards at all costs.

(This article has been curated and written by Dr Raghuram Mallaiah, Director neonatology, Fortis la femme, GK-2, and Founder Amaara Human Milk Bank and Dr Anita Sharma, Infant and young child feeding counsellor, BPNI(India) and UNICEF WHO Doula, Child Birth Educator, Lamaze international, USA)