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How To Keep Babies & Kids Safe When The AQI Soars

A pediatrician shares how to keep everyone breathing easy when wildfire smoke descends.

Over the past few years, many of us in the United States have grown accustomed to thinking of summer — and often well into fall — as wildfire season. We play close attention to rain fall and snow pack in winter, hoping it’ll be enough to keep our forests safe and our skies clear. We’ve downloaded apps (yes, plural) that tell us what the air quality is that day in our area, and even give air quality forecasts. Increasingly, thanks to these apps that now live permanently on our phones, many of us have realized that air quality can dip into an “unhealthy” range for many reasons, and not just because of wildfire smoke, as air pollution persists as a global issue. In fact, according to the World Health Organization (WHO), 99% of people on earth live in places where the air pollution levels exceed the limit of what is considered healthy. Most of all, as parents of young kids, we worry about what toll all of this takes on our children’s physical and mental health, and how we can care for our kids when the air quality is unhealthy.

What are AQI levels & what air quality is unhealthy for children?

If you’re unfamiliar with the acronym “AQI,” it simply means “air quality index,” and is a numerical system that assigns the quality of the air on any given day a number and a color associated with that number. The Environmental Protection Agency (EPA) uses it with the goal of making it easy for people to understand easily whether the air quality where they live is healthy or unhealthy, and make choices about the day accordingly.

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But what do those AQI numbers really mean? And when should parents worry? “Generally above 150, you’ve got my attention,” explains Dr. Hina Talib, Pediatrician and Adolescent Medicine specialist at the Atria Institute in New York and spokesperson for American Academy of Pediatrics. On a day with an AQI of 150 or higher, she says, “I’m gonna take precautions. If you are somebody who would potentially be at more risk from the harmful effects of wildfire smoke or air pollution, then you may take more precautions at lower levels.”

She encourages parents to keep a little perspective when it comes to checking air quality numbers. “The air quality index is meant to be helpful to us, and not meant to add more anxiety, although it does for some people,” Talib explains. If you have an awareness of what precautions you can take to keep your family safe and healthy, try to think of an AQI tracker as just another tool.

How to keep babies and kids safe when the air quality is unhealthy

You may feel powerless to protect your child from something like wildfire smoke, but there are many precautions you can take to keep them as safe that are known to be quite effective, Talib says. They include:

  • Wearing a high-quality N95 mask.
  • Avoiding the outdoors.
  • Wearing sunglasses, which can curb eye irritation.
  • Running the best air purifier you have access to. “Prioritize placing it in the bedroom(s) rather than in open areas,” Talib advises.
  • Keeping all doors and windows closed.
  • In the car, run the air on the recirculation option rather than pulling in air from the outside.

Make time to care for kids & teens mental health, too

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For kids and teenagers, Talib encourages parents to consider mental health during an air quality event, as well as physical health. “When I hear from tweens and middle schoolers, they seem to be asking me less about how to stay safe in the moment, but more about if it’s going to get worse. Older teens will talk about climate change, and climate anxiety. Having time and space to address those concerns and worries is an important part of how parents can support their kids during this time.” Having the sky turn orange with wildfire smoke, and not being able to go outside can be scary to kids of all ages, Talib reminds, encouraging parents to make time to listen to your kids, and answer questions that may arise.

It can be hard to know where to start, though, particularly if you are also feeling anxious or overwhelmed yourself. Keep it simple and age-appropriate, Talib advises. Even a small conversation can make the moment less scary. “Take a moment to explain that there are a lot of helpers working on this problem, and a lot of scientists working on this problem, and that what we are doing to keep them safe is going to help keep them safe.” It’s essential to talk about what’s going on, and to be mindful of what you say in front of your kids, too. Reassure them, and remember that “even though they’re little people, they have very big ears. They see a lot and they hear a lot,” Talib says. So, while you’re naturally focused on keeping their body safe, try to address their feelings, too, and try to be careful of what you say when they’re in earshot.

How does air quality affect kids?

Babies, toddlers and young kids are at higher risk during an air quality event, which means parents really do need to take an air quality alert seriously and take any precautions they are able to take. “Our youngest children, our infants and our toddlers — their lungs are really still developing. So, they are more susceptible to the harmful effects of air pollution, with the particles directly affecting their lungs and their breathing,” Talib explains. Children of any age with asthma, allergies, or other lung disease also more susceptible.

Why are children so vulnerable to air pollution? “Because their lungs are more immature and still developing, their airway tracks are smaller, and they breathe in more air and ventilate more than than adults do.” Basically, because babies and kids breathe faster and deeper than grown ups, there is more of a chance for them to get pollutants into their lungs. Or “more air per minute for their body size,” as Talib puts it.

How to protect babies from wildfire smoke and air pollution

Babies under 1 year old are particularly vulnerable when the air quality is unhealthy, and Talib recommends being mindful of them in particular. “We want parents to take more precaution for them, even not like the darkest red zones of the air quality index, but just to be mindful about when they’re outside, and what is necessary versus notm,” she says.

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A few extra precautions she suggests parents of infants take during an air quality event, like poor air quality from wildfire smoke, are:

  • Change clothes when you come home from spending any time outside. “You can have particulate matter from the air pollution on your body, in your hair, on your clothes, and you don't want to transfer that to your infant,” Talib explains.
  • Shower and wash your hair before holding your baby
  • Run an air purifier in the baby’s bedroom
  • Keep the baby inside as much as possible

How can parents of kids with asthma prepare for wildfire season and air pollution?

Air quality events are a good reason to keep up with prescriptions and make plans with your child’s pediatrician. Refilling prescriptions on schedule (especially controller medications) and checking expiration dates is something that Talib urges families who deal with asthma to do. She recommends reaching out to your pediatrician with the following three questions:

  1. Do I have an up-to-date asthma action plan?
  2. Do I know what I'm supposed to be doing every day?
  3. Do I know what I'm supposed to be doing when I feel symptoms? “There's a good chance you will feel symptoms when you experience like an air pollution event.”

When to call the doctor

Per Talib, check in with your child’s healthcare provider if the AQI in your area is high and your child is:

  • Breathing fast
  • Coughing
  • Wheezing
  • Struggling to speak at their usual pace
  • Unable to count to 10 without gasping or having to take a deep breath of air
  • Showing signs of respiratory distress (which includes breathing faster at the belly or through the nose)
  • Has a sore or itchy throat, or itchy or runny eyes

Of course, if you are ever concerned about your child’s immediate wellbeing, then you shouldn’t hesitate to seek emergency care.


Dr. Hina Talib, Pediatrician and Adolescent Medicine specialist at the Atria Institute in New York and spokesperson for American Academy of Pediatrics.