Emily Oster

3 min Read Emily Oster

Emily Oster

Can I Take My Kids Outside When There’s Wildfire Smoke?

Q&A on feeling trapped

Emily Oster

3 min Read

There is wildfire smoke here; I have a baby and a toddler. We are trapped inside — or are we? Can we go to the playground? Is there some air quality cutoff I should be paying attention to?

—Want to breathe easier

I asked Christopher Worsham to jump in and respond to your questions about wildfires and air quality. Chris is a pulmonologist and critical care physician at Massachusetts General Hospital and a public-health researcher at Harvard Medical School. He is the co-author (along with Anupam Jena) of the forthcoming book Random Acts of Medicine: The Hidden Forces That Sway Doctors, Impact Patients, and Shape Our Health (preorder it now!) and the Random Acts of Medicine newsletter on Substack. —Emily


This question recently came up with other parents while I was at the playground with my two toddlers, as we looked up at the sky, a bit hazy from wildfire smoke that was blown our way. 

With short-term exposure to poor air quality and young children, the biggest concern is that small particles in the air might irritate their little lungs, causing shortness of breath or coughing, or trigger an asthma attack in a child with asthma — a condition that is very common in this age group. The challenge here is that every child has a different threshold of sensitivity, and in very young kids, a parent may not yet be aware that their child even has asthma.

The EPA has developed color-based standards, with different colors representing different levels of risk to sensitive groups (like those with asthma or other lung disease) and the general population. The air quality index (AQI) is a number between 0 and 500, and it’s calculated by combining measurements of a number of different air pollutants, including small particles such as those from wildfire smoke. The colors are meant to indicate the level of risk when the AQI hits a certain threshold. This color-based system can be handy because it’s simple and easy to remember — green is good, red (and purple and maroon) is bad, and orange is somewhere in between.

Chart explaining air quality index levels.

What’s important to remember, however, is that every child is different. For a particular child, the same AQI level may or may not lead to coughing, shortness of breath, or an asthma attack. So while it’s reasonable to start with these guidelines and follow them when it’s clear-cut by staying inside if the air quality is red and above (or orange and above for a child with asthma), the most important thing to do is keep an eye on the child’s symptoms even when the air quality is below one of these AQI thresholds. 

Biologically speaking, there’s nothing magical that happens at an AQI of 150 — it’s just that the EPA had to draw a line in the sand somewhere when developing these systems. So a child might be sensitive at an AQI of 140, 132, 94, or 76, and that number could even change from year to year as they grow. If a parent sees that their child is coughing or is uncharacteristically winded after playing, that’s a sign they should go home, take it easy (to the extent that toddlers are capable of this), use an inhaler if the child has asthma, and call their pediatrician for specific advice. —Chris

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👉Comment “Link” for a DM to an article that summarizes all of the best potty training advice we collected.

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☀️ If you want to add a little sunscreen on their hands and feet? Go for it! But be mindful as baby skin tends to more prone to irritation.

Comment “Link” for a DM to an article on the data around sun and heat exposure for babies.

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OUT NOW: My new book “The Unexpected: Navigating Pregnancy During and After Complications” is available on April 30th. All of my other books came out of my own experiences. I wrote them to answer questions I had, as a pregnant woman and then as a new parent. “The Unexpected” is a book not to answer my own questions but to answer yours. Specifically, to answer the thousands of questions I’ve gotten over the past decade from people whose pregnancies were more complicated than they had expected. This is for you. 💛 Order now at my link in bio! ...

OUT NOW: My new book “The Unexpected: Navigating Pregnancy During and After Complications” is available on April 30th. All of my other books came out of my own experiences. I wrote them to answer questions I had, as a pregnant woman and then as a new parent. “The Unexpected” is a book not to answer my own questions but to answer yours. Specifically, to answer the thousands of questions I’ve gotten over the past decade from people whose pregnancies were more complicated than they had expected. This is for you. 💛 Order now at my link in bio!

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Is side sleeping important during pregnancy? Comment “Link” for a DM to an article on whether sleep position affects pregnancy outcomes.

Being pregnant makes you tired, and as time goes by, it gets increasingly hard to get comfortable. You were probably instructed to sleep on your side and not your back, but it turns out that advice is not based on very good data.

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Sources:
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📈 Robert M. Silver et al., “Prospective Evaluation of Maternal Sleep Position Through 30 Weeks of Gestation and Adverse Pregnancy Outcomes,” Obstetrics and Gynecology 134, no. 4 (2019): 667–76.

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While doctors have long said Tylenol was safe, confusing studies, panic headlines, and even a lawsuit have continually stoked fears in parents. As a result, many pregnant women have chosen not to take it, even if it would help them.

This is why good data is so important! When we can trust the data, we can trust our choices. And this study shows there is no blame to be placed on pregnant women here. So if you have a migraine or fever, please take your Tylenol.

#tylenol #pregnancy #pregnancyhealth #pregnancytips #parentdata #emilyoster
...