This week is my first week back at work after maternity leave. Being a built environment professional specialising in health and well-being, I thought I’d share what I’d learned during this time about how buildings and products affect our children’s health, what to avoid, and what to look out for.
Young children are considered particularly sensitive to chemical exposure due to their high surface area vs body weight ratio, rapid metabolic rate and fast growth of organs and tissues (1,2). For this reason, it is incredibly important to create a healthy, non-toxic environment for them. This includes the air quality in our homes, nurseries and schools, and the products that babies and children come into contact with. In addition, as their body clocks calibrate and start to develop their circadian rhythm, we can be mindful of how we design and use our buildings, outdoor spaces and electric lighting in order to help support this.
While some of these things do come at a premium, and healthier options can come be more costly, there are still small changes in terms of lifestyle and behaviour that we can all practice in order to support infant health and well-being.
In the coming months, I’m hoping to join forces with universities, research organisations, nurseries, schools and hopefully even hospitals to take some of these interests and research further. There are still huge gaps to fill in terms of research best practice, so please do get in touch if this is an area you wish to collaborate in!
Light
For babies, a daily pattern of greater sleep at night and being more awake in the day is not typically established until 12 to 16 weeks of age (3), but the establishment of a circadian rhythm can be hindered if a newborn does not receive appropriate day/night light exposure (4, 5). Some studies show that ‘abnormal’ light during the newborn period may even cause long- term health problems (5) and one study suggested that too low a level of daylight for newborns may even influence the onset of bipolar disorder (6). Therefore, most research in this field recommends that infants (much like adults) should be exposed to as much light as possible during the day and essentially no light exposure at night, in order to promote normal circadian rhythm development (5). With this in mind, we need to encourage parents to take babies outside as much as possible during the day, despite our cooler climate. This is common practice in the Nordic countries, where they create sheltered outdoor environments and spaces that allow for this in rainy weather. Perhaps more importantly, however, is that we use light correctly in the evenings and at night – limiting any blue light such as that from televisions, phone screens and bright overhead lights. Warm red tones are best, especially for those night feeds! A warm, dimly lit red Himalayan salt lamp can be good for evenings and nights, giving just enough light for a change and feed.
Air
The British Lung Foundation (BLF) recognises that babies and children are especially vulnerable to air pollution as their lungs are still growing and developing and that exposure to air pollution can harm normal growth and lung function in the womb, during childhood and right up to the late teens. However, it is not only external air pollution, but also indoor air quality that we need to be mindful of. Children are more vulnerable when breathing in polluted air as their airways are smaller, still developing, and they breathe more rapidly than adults (7). Moreover, their immune systems are still developing. Being exposed to high levels of air pollution over a long period may put them at risk of developing asthma during childhood, or as an adult, of infections such as pneumonia, and even lung cancer later in life (7). Pollution in the home can come from a range of sources, such as nearby roads, the use of chemical indoor cleaning products, cooking, decorating, smoking and excess dust. Opening windows helps to keep homes well ventilated (if not located in a polluted area) and home air purifiers are now widely available, but be mindful to look out for high quality ones with HEPA and carbon filters, and a high Clean Air Delivery Rate (CADR). We have a Philips air purifier (Philips AC3033/30 Expert Series 3000i) which contains a HEPA and carbon filter and a CADR of 520 m³/h. Philips have tested the 3-layer filter to show that it eliminates 99.97% of ultra-fine particles, which prevents these from being inhaled. We noticed it always kicked into turbo mode when we cooked, dusted or plumped cushions!
Furniture and Paints
Although child-safe paints are regulated under BS EN 71-3:1995 for children’s toys, it is also important to ensure furniture and wall paints used around children are safe. It is my strong view that we should avoid painting nurseries and children’s bedrooms in paints that are not certified to emissions standards, as poor air quality due to the presence of volatile organic compounds (VOCs) can directly impact respiratory health, with prenatal exposure to air pollutants being significantly associated with the alteration of lung function in preschool children (9). You could choose natural mineral paints by brands such as Airlite and Graphenstone, which are both Cradle to Cradle Gold certified (among several other emission certifications) for ensuring good air quality through a low VOC content. We found them slightly more difficult to use as they are mineral based, but worth it for the air quality benefit!
There aren’t many furniture brands certified for toxicity or low VOC content. We opted for a Boori cot and changing table (the latter second-hand, which can also be a good choice for reducing VOCs, while being budget friendly) as Boori products are not only FSC certified (for sustainable timber) but Boori were also the first nursery brand to achieve Greenguard GOLD certification for nursery-friendly paint finishes, ensuring they don’t emit toxic chemicals. For mattresses, we wanted to avoid foam due to VOCs and potentially harmful gasses, which have been detected in studies of children’s foam mattresses (8), opting for a Naturalmat mattress made from coir, organic cotton and organic lambswool. It’s chemical free, non-toxic, naturally fire retardant and OEKO-TEX® certified, ensuring harmful chemicals are avoided. It also feels super comfy!
Textiles
Children’s skin is highly sensitive and only considering ‘natural’ fibres as sufficient does not factor in what the fabric is dyed with, how the product is made, transported and packaged to ensure safe limits of harmful materials are not breached. Helpful labels to look out for are GOTS, Oeko-Tex and ‘organic’. GOTS – The Global Organic Textile Standard – ensures both environmental and socially responsible production, limits environmentally hazardous substances prohibited by chemical inputs and requires an evaluation of toxicity and biodegradability for chemical inputs. The Oeko-Tex STANDARD 100 label ensures that every component of a clothing article i.e., every thread, button and other accessories, have “been tested for harmful substances and that the article therefore is harmless for human health”. The test takes into account numerous regulated and non-regulated substances, which may be harmful to human health and in many cases, the limits go beyond national and international requirements. The criteria catalogue used is updated annually (as a minimum) with new scientific knowledge or statutory requirements.
Certified products are helpfully stocked by high-street suppliers such as Marks & Spencer and John Lewis and we also found Tots Bots Oeko-Tex certified washable nappies great, as well as ‘Eco by Naty’ disposables which are also Oeko-Tex certified (we used a combination). This ensures harmful chemicals aren’t coming into contact with baby’s sensitive skin and is also more sustainable, reducing plastic waste.
Bottles
A final quick note on bottles – some studies have found a comparatively high (when compared with adults) number of microplastics in baby’s faeces, which can be seen as a health hazard, due to some studies of laboratory animals finding that microplastic exposure can cause cell death, inflammation and metabolic disorders of cells (10). To avoid this, we can look to use silicone instead. We like ‘Nanobebe’ silicone bottles. These are free from BPA, phthalates, lead, PVCs and have a 100% silicone interior, but there are also several other brands that use either silicone or glass to avoid exposure to plastics.
Concluding views
While it is not always possible to get outside every day, to live in a home with big windows, painted in entirely healthy paints and with natural furnishings, as well as buying certified products, we can all make lifestyle changes, such as spending more time outdoors and limiting the use of bright lights, televisions and phones in the evenings, and take some of these steps in order to reduce infant exposure to toxins and improve their health and well-being. Much research is still needed in this area, and more best practice examples in the built environment, particularly on how we build better schools, homes and hospitals, and I’m looking forward to contributing towards this research in the coming months and years.
References
1. Ionas AC, et al. ‘Children’s exposure to polybrominated diphenyl ethers (PBDEs) through mouthing toys.’ Environ Int. 2016;87:101–7.
2. Turner A. ‘Concentrations and migratabilities of hazardous elements in second-hand children’s plastic toys.’ Environ Sci Technol. 2018;52:3110–6.
3. Sheldon SH. ‘Development of Sleep in Infants and Children.’ In: Sheldon SH, et al., eds. Principles and Practice of Pediatric Sleep Medicine. 2nd ed. Elsevier Saunders; 2014:17–23.
4. Eventov-Friedman S, et al. ‘The red reflex examination in neonates: an efficient tool for early diagnosis of congenital ocular diseases.’ Isr Med Assoc J. 2010;12(5):259–261.
5. Yates J. ‘The long-term effects of light exposure on establishment of newborn circadian rhythm.’ J Clin Sleep Med. 2018;14(10):1829–1830.
6. Bauer M, et al. ‘Influence of light exposure during early life on the age of onset of bipolar disorder.’ J Psychiatr Res. 2015;64:1–8.
7. BLF (https://www.blf.org.uk/support-for-you/risks-to-childrens-lungs/air-pollution)
8. Boor BE, et al. ‘Infant exposure to emissions of volatile organic compounds from crib mattresses.’ Environ Sci Technol. 2014 Mar 18;48(6):3541-9. doi: 10.1021/es405625q. Epub 2014 Mar 3. PMID: 24548111.
9. Gutiérrez-Delgado RI, et al. ‘Prenatal exposure to VOCs and NOx and lung function in preschoolers.’ Pediatr Pulmonol. 2020 Aug;55(8):2142-2149. doi: 10.1002/ppul.24889. Epub 2020 Jun 25. PMID: 32510180; PMCID: PMC7485223.
10. Junjie Zhang, et al. ‘Occurrence of Polyethylene Terephthalate and Polycarbonate Microplastics in Infant and Adult Feces.’ Environmental Science & Technology Letters, 2021; DOI: 10.1021/acs.estlett.1c00559
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