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What is the real starter pack for a newborn in Nairobi? It's obviously not diapers, warm blankets or milk.

Experts say it is the first air they breathe, which contains exhaust fumes, road dust, and smoke from rubbish fires drifting through the window.

Researchers from the University of Nairobi say the air many babies breathe in their homes in Nairobi is three times above WHO safe pollution limits.

The air is bad even where families use clean fuels such as LPG, ethanol or electricity instead of charcoal and firewood.

“Both the indoor and outdoor PM2.5 concentrations we measured were often above WHO Air Quality Guidelines, including in homes using clean fuels. These findings highlight the importance of improving indoor air quality, given that caregivers and infants spend much of their time indoors, which increases their exposures and potential health risks,” the authors said.

Vincent Kipter from the UoN’s Department of Chemistry helped monitor air pollution inside and outside 48 homes in Nairobi’s Eastlands area as part of his PhD studies.

Kipter and his colleagues visited homes with babies and placed air monitors inside cooking areas and just outside the houses for 24 hours.

Half of the homes were one-room with only one external door, and nearly all were located in multi-storey flats.

They then measured levels of PM2.5 and carbon monoxide, a poisonous gas produced during burning.

PM2.5 refers to extremely tiny particles released from smoke, dust and fuel combustion. The tiny particles can travel deep into the lungs and bloodstream and are linked to asthma, pneumonia and poor brain development in children.

Mothers were also interviewed about cooking fuels, rubbish burning, nearby traffic, smoking and ventilation in the home.

The researchers found that babies are not safe in and outside their homes. They found 97 per cent of indoor air samples had levels of the PM2.5 particle pollution thrice above the WHO safety guideline. Outside the homes, 79 per cent of air samples also exceeded safe limits.

“Our results indicate that indoor air quality is a concern for infant health in Nairobi despite the use of clean household fuels. Most of the homes we sampled were only one or two rooms, where the infants likely spend much of their time, which may lead to high exposures and health burden.”

The findings have been published in PLOS Global Public Health in a paper titled, “Indoor and outdoor fine particulate matter and carbon monoxide concentrations in homes of infants in Nairobi, Kenya.”

During the study period, 67 per cent of mothers reported using LPG for cooking, 19 per cent used ethanol and 10 per cent used electricity. Yet dirty air remained a major problem.

The study found that even homes using electricity alone still recorded pollution above WHO guidelines. “The three homes who reported using electricity and no other fuels during sampling had lower indoor PM2.5 compared to homes burning solid or liquid fuels,” the researchers wrote. “However, their geometric mean still exceeded the WHO air quality guidelines.”

Carbon monoxide (CO) levels were also worrying in some homes, especially during cooking times. Although average levels were generally low, several homes recorded dangerous spikes that exceeded WHO limits.

The findings come as Kenyan doctors increasingly warn about respiratory illnesses linked to Nairobi’s poor air quality.

Paediatric lung specialist Dr Justus Simba warned that breathing dirty air at a young age can increase the risk of pneumonia, asthma, coughing and other breathing problems, while long-term exposure has also been linked to poor brain development and learning difficulties.

Dr Simba, also a senior lecturer at the Department of Child Health and Paediatrics at Jomo Kenyatta University of Science and Agriculture, attributed the higher risk to prolonged exposure to air pollution in the city.

“There is a lot of global evidence showing that children’s lungs are affected when they live in polluted environments. Studies have also looked at patients, and as a lung specialist, I can say that the key change needed is either reducing pollution or moving them to cleaner areas,” he said during last year’s Clean Air Forum in Nairobi.

“From a clinical perspective as a paediatrician, I’ve seen cases where simply relocating a child from one side of the city, especially from more polluted areas, leads to an improvement in symptoms.”