Extreme Heat Threatens Pregnancies, Exposing Gaps in Climate Adaptation Plans
Extreme heat is emerging as a growing threat to pregnancy and childbirth. Research from India and an international survey highlight the risks to maternal and newborn health, underscoring the need for stronger healthcare protections and climate adaptation plans.
Rising temperatures are increasing concerns about maternal and newborn health, highlighting the need to protect pregnant women from extreme heat.Image credit:Pexels
Evidence from Tamil Nadu and a new international survey shows how rising temperatures threaten maternal and newborn health, with outdoor workers and rural women facing particular risks.
Extreme heat is emerging as a growing threat to pregnancy and childbirth, but climate adaptation plans risk overlooking the women and newborns most vulnerable to its effects. New international survey findings, alongside research from Tamil Nadu, point to a widening public-health challenge as rising temperatures threaten maternal health and expose inequalities in access to safe healthcare.
At least 73% of maternal healthcare professionals surveyed across five countries reported an increase in heat-related cases or complications affecting pregnant women over the past five years, according to a survey commissioned by global charitable foundation Wellcome. Meanwhile, 76% reported an increase in heat-related complications affecting foetal or newborn health.
The findings were highlighted by Simon Stiell, executive secretary of the United Nations Framework Convention on Climate Change (UNFCCC), at an event organised by Wellcome during the Pre-COP ministerial meeting in Fiji on October 5, ahead of the COP31 climate conference in Türkiye in November.
“Rising temperatures mean rising danger in pregnancy,” Stiell said, pointing to links between extreme heat during pregnancy and premature birth, stillbirth, low birth weight and maternal complications.
The survey covered 1,000 maternal healthcare professionals working in Australia, Brazil, India, the United Kingdom and Zimbabwe. It found that 81% were concerned that extreme heat would increasingly threaten maternal, foetal and newborn health without further action. Nearly all respondents had cared for a pregnant woman or baby whose health they believed had been affected by extreme heat, while 92% wanted more training and resources to protect pregnant women.
The findings highlight a critical gap in climate preparedness: although heat-health warnings are becoming increasingly important, pregnancy and newborn care are not always adequately incorporated into plans for responding to extreme temperatures.
Evidence from India highlights unequal risks
Research from Tamil Nadu adds to the growing evidence that occupational heat exposure can have serious consequences for pregnancy.
A prospective cohort study published in BJOG: An International Journal of Obstetrics & Gynaecology examined 800 pregnant women engaged in moderate to heavy physical work in Tamil Nadu. Researchers found that 47.3% experienced high occupational heat exposure. Among heat-exposed women, 29.6% experienced moderate dehydration, while 17.4% recorded an increase in core body temperature.
The study found that women exposed to high occupational heat had 2.4 times the adjusted odds of miscarriage and 2.3 times the adjusted odds of an adverse pregnancy outcome. The latter included outcomes such as miscarriage, preterm birth, low birth weight and stillbirth.
Children are attending school in temporary learning centres following the devastating floods in Nuwakot, Nepal, where climate change and glacial ice melt have played a significant factor.Image credit: UNICEF/Laxmi Prasad Ngakhusi
The researchers also found that high occupational heat exposure was associated with twice the adjusted odds of an adverse outcome at birth. Although the study establishes an association rather than proving that heat alone caused each outcome, it provides evidence of the risks faced by pregnant women working in hot conditions.
A separate observational cohort study involving 680 pregnant women across six Tamil Nadu districts examined differences between rural and urban populations. Researchers found that 55% of rural participants experienced heat exposure above the study’s permissible limit, compared with 45% of urban participants.
Rural women were also more likely to report heat-strain symptoms, including excessive thirst, fatigue, headaches and dizziness. After accounting for potential confounding factors, heat-exposed rural women had nearly twice the risk of adverse pregnancy outcomes and three times the risk of adverse birth outcomes compared with the study’s urban comparison group.
The study also found a fourfold higher risk of miscarriage among heat-exposed rural women during the first trimester compared with urban women. The researchers identified socioeconomic disadvantage, limited awareness of heat risks and reduced access to welfare facilities as factors that could contribute to rural women’s greater vulnerability.
Evidence from a separate study of 126,273 pregnancies recorded in India and Pakistan reinforces the concern. Researchers found that higher average maximum temperatures during the second trimester were associated with an increased risk of preterm birth. The relative risk was 1.05 for the study’s five-degree temperature contrast, indicating a 5% relative increase in risk—not a five-percentage-point increase in the absolute risk of premature birth.
Together, these studies suggest that heat exposure is not simply an environmental inconvenience during pregnancy. It can coincide with dehydration, physically demanding work and barriers to healthcare, creating risks that are unevenly distributed across communities.
From warnings to protection
Stiell warned that the effects of extreme heat are not shared equally. Pregnant women who work outdoors, live in poorly ventilated housing, travel long distances to clinics or depend on healthcare facilities without reliable electricity, water or cooling cannot be protected through public advice alone.
“Staying cool” is not a realistic option for families without access to cool spaces, he argued. Without targeted intervention, extreme heat could deepen existing inequalities in maternal healthcare, making a safe pregnancy increasingly dependent on income, geography and access to medical services.
Stiell outlined three priorities for governments: integrating pregnancy and newborn care into climate adaptation and heat-health planning; translating evidence into practical protection through healthcare-worker training, heat alerts and safer facilities; and improving data to identify where risks are growing and which interventions are effective.
For India, the findings have implications for heat-action plans, occupational safety and maternal healthcare. Measures could include heat-risk guidance during antenatal visits, better protection for pregnant outdoor workers, improved ventilation and cooling in maternity facilities, and reliable access to water and electricity during extreme heat.
The UN climate chief also called for adaptation-finance commitments agreed at COP30 in Belém, Brazil, to be delivered and for countries to work towards mobilising $1.3 trillion annually for developing countries.
Health is expected to remain a key priority in preparations for COP31, scheduled for November 9–20, 2026, in Türkiye’s Antalya province, under the Turkish presidency and with Australia leading negotiations.
The emerging evidence makes the policy challenge clear: protecting pregnant women and newborns must become part of climate resilience, rather than an afterthought. As temperatures rise, governments will need to assess climate action not only by emissions targets and financial commitments, but also by whether healthcare systems can protect people during pregnancy and give newborns a safe start to life.
Jishnu P is an Editorial Associate and Reporter at EdPublica. He holds a Master’s degree in Communication and Journalism from Pondicherry University, India, and a Bachelor’s degree in Physics.
FSSAI Moves to Restrict Added Sugars in Infant Foods, Citing Need for Stronger Nutritional Safeguards
FSSAI has proposed restricting the addition of sucrose and fructose to infant foods for babies up to six months. The draft amendment aims to strengthen nutritional safeguards.
FSSAI has proposed prohibiting the addition of sucrose and fructose to food products intended for infants up to six months of age. Representational image. Image credit: Pragyan Bezbaruah/ Pexels
The first months of life leave little room for nutritional guesswork. An infant’s food must supply the energy and nutrients needed for growth, making the composition of commercial infant nutrition products a matter of public health. Whether manufacturers need to add particular sugars to these products is therefore an important regulatory question.
Research published in recent years has begun examining how added sugars enter infants’ diets, including through formula milk, and whether early exposure is associated with subsequent eating patterns and weight gain. Although the evidence does not establish that added sucrose or fructose in infant formula directly causes obesity, it has raised questions about the nutritional value of adding sugars when alternative carbohydrate sources are available.
Against this backdrop, the Food Safety and Standards Authority of India (FSSAI) has proposed prohibiting the addition of sucrose and fructose to food products intended for infants up to six months of age. The draft amendment, published in the Gazette of India on 16 October 2026, would tighten the existing rules governing the composition of these products.
Early Exposure to Added Sugars
An Indian study published in the Indian Journal of Community Medicine in 2021 examined the sugar and salt content of 114 commercially available infant formulas and baby foods. The researchers found that around 28% of the products had a high-sugar profile, while approximately 51% listed sugar or related ingredients among their first four ingredients.
The study covered products intended for children aged up to 24 months, including infant formulas and complementary foods. Its findings offer evidence that sugar content warrants scrutiny in India’s infant and young-child food market. However, the assessment relied on product labels and did not establish whether the products caused adverse health outcomes. It also did not demonstrate that infant formulas intended specifically for babies under six months routinely contained added sucrose or fructose.
Research elsewhere has examined possible links between added sugars in infant formula and early growth. A 2025 study published in The Journal of Nutrition followed 234 infants from predominantly low-income households in the United States. Researchers assessed dietary intake at six, nine and 12 months and found an association between higher added-sugar intake from formula and higher weight-for-length scores.
For every additional 10 grams of added sugar consumed daily through formula, weight-for-length scores increased by an average of 0.060. The study was observational, so it cannot establish that sugar caused the difference. Its findings also cannot be directly generalised to Indian infants.
A separate study published in Frontiers in Nutrition in 2023 examined dietary data from 95 infants and toddlers aged nine to under 16 months. It found an association between added sugars consumed through infant formula and sugar-sweetened beverage consumption later in infancy. The researchers did not establish a significant association between formula-derived added sugars and added-sugar intake from table foods. The small sample and cross-sectional design limit the conclusions that can be drawn.
These studies examine different aspects of early sugar exposure: the composition of products available in India, associations with infant weight and possible links with later dietary patterns. None establishes that the proposed restriction will prevent childhood obesity. They do, however, provide grounds for examining whether particular sugars need to be added to products intended for very young infants.
Infant’s Food: Why the First Six Months Matter
The World Health Organization (WHO) and UNICEF recommend exclusive breastfeeding during the first six months of life, followed by the introduction of appropriate complementary foods at around six months while breastfeeding continues.
FSSAI has proposed restricting the addition of sucrose and fructose to food products intended for infants up to six months, as part of efforts to strengthen infant nutrition standards in India. Representational image. Image credit: hartono subagio/ Pexels
For infants who require an alternative to breast milk, appropriately formulated infant formula can provide essential nutrition. Its carbohydrate composition must meet nutritional requirements for growth and development. The question for regulators is whether adding particular sugars serves a necessary nutritional purpose in products designed for this age group.
WHO’s 2023 guideline on complementary feeding recommends that children aged six to 23 months should not consume foods high in sugar, salt and trans fats. Its evidence review identified associations between sugar-sweetened beverage consumption during infancy and later obesity in some studies, although the certainty of the evidence was low. The recommendation concerns the broader diet of children aged six months and older; it does not specifically establish the effects of sucrose or fructose in infant formula.
The distinction between naturally occurring sugars and added sugars is equally important. Milk naturally contains lactose, which provides energy. Sucrose and fructose may instead be introduced as ingredients during product formulation. Their use needs to be assessed against the nutritional requirements of the intended age group.
What the FSSAI Amendment Proposes
Under the Food Safety and Standards (Foods for Infant Nutrition) Regulations, 2020, lactose and glucose polymers are the preferred carbohydrate sources in infant nutrition products. The existing rules permit sucrose and/or fructose when required as a carbohydrate source, subject to prescribed limits.
The draft Food Safety and Standards (Foods for Infant Nutrition) Amendment Regulations, 2026, proposes prohibiting the addition of sucrose and fructose to products intended for infants up to six months of age. This would remove the existing allowance for these two sugars in products for this age group. FSSAI has invited objections and suggestions from stakeholders within 60 days from the date on which copies of the relevant Gazette notification are made available to the public. The submissions will be considered before the amendment is finalised.
NMC Directs Medical Colleges to Set Up Patient Safety Committees
The National Medical Commission has directed medical colleges and medical institutions to establish patient safety committees, designate nodal officers and strengthen procedures to prevent avoidable harm.
Medical professionals review documents during a meeting, highlighting the importance of coordinated safety practices in healthcare institutions. Representational image. Image credit: Dave Gracia/ Pexels
The National Medical Commission (NMC) has directed medical colleges and medical institutions across India to establish Patient Safety Committees or Cells and designate Patient Safety Nodal Officers to strengthen safety practices and reduce preventable harm in healthcare settings.
The Commission asked the heads of medical institutions to share the composition of their committees and the details of the designated nodal officers with the National Patient Safety Secretariat (NPSS) under the Directorate General of Health Services (DGHS).
The directive follows a communication dated May 8, 2026, from the Additional Director General of Health Services in the Union Ministry of Health and Family Welfare. It seeks to strengthen the adoption of patient safety protocols and standard operating procedures across medical institutions.
NMC’s Multidisciplinary Oversight
The proposed committee will be chaired by the director, head of the institution or medical superintendent. Its membership must include representatives from relevant medical specialties and the patient safety domains identified by the NPSS. Institutions are also advised to designate a nodal officer with sufficient seniority and authority to coordinate safety initiatives.
The framework covers 11 patient safety domains, including medication safety, surgical safety, blood transfusion safety, medical device safety, laboratory and diagnostic safety, infection prevention and control, healthcare-associated infections, antimicrobial resistance, patient and family engagement, vaccine and injection safety, and facility safety. It also encompasses operational research in patient safety and safety in AYUSH services.
The scope extends beyond clinical treatment to areas such as biomedical waste management, fire safety, structural safety and environmental safety. Nursing, hospital administration and other relevant professionals can contribute to the committee’s work.
From Protocols to Institutional Accountability
The directive places responsibility for patient safety within an organised institutional framework. Rather than leaving safety measures to individual departments or healthcare professionals, the proposed mechanism brings clinical, diagnostic and administrative functions under coordinated oversight.
The committee’s terms of reference include reviewing patient safety incidents and near misses, analysing their causes, promoting reporting and recommending corrective and preventive measures. Such reviews can help institutions identify weaknesses in procedures and address risks before they result in further harm.
The effectiveness of these committees will depend on how consistently institutions implement safety protocols, review incidents and act on their findings. Establishing a committee is an administrative step; sustained monitoring and corrective action are essential to translating the framework into safer care.
World Food Day: India’s Childhood Obesity Burden Raises Concerns Over Diabetes Risk
More than 41 million Indian children and adolescents aged 5–19 were living with overweight or obesity in 2025, according to the World Obesity Atlas 2026. The growing burden raises concerns about long-term health risks, including type 2 diabetes, and highlights the need for healthier food environments, better nutrition and stronger school-based interventions.
Children’s food environments and dietary habits are increasingly important in discussions about childhood obesity and long-term health risks.Image credit:Pexels
With more than 41 million Indian children and adolescents living with overweight or obesity, experts warn that unhealthy food environments could increase future risks of type 2 diabetes. New national guidance on childhood diabetes and proposed restrictions on junk food sales near schools highlight the need for preventive action.
As the world observes World Food Day on October 16, childhood nutrition is emerging as a challenge that extends beyond hunger and undernutrition. The growing prevalence of overweight and obesity among children is raising concerns about their long-term health, including their risk of developing type 2 diabetes.
India faces a particularly significant challenge. The World Obesity Atlas 2026 estimates that approximately 14.9 million children aged five to nine and 26.4 million children and adolescents aged 10–19 in India were living with overweight or obesity in 2025. Together, these figures amount to more than 41 million young people.
The report also estimates that around 1.39 million Indian children aged five to 19 had hyperglycaemia attributable to high body mass index in 2025. Hyperglycaemia refers to elevated blood glucose levels and is a health indicator associated with metabolic risk; it should not be interpreted as a count of children diagnosed with diabetes.
The figures highlight the importance of addressing childhood obesity early, before associated health risks become more difficult to manage.
Food environments and the risk of early-onset diabetes
The World Health Organization (WHO) reported in September 2026 that 400 million children and adolescents aged five to 19 worldwide were overweight in 2024, including 170 million living with obesity. The prevalence of overweight in this age group increased from 8% in 1990 to 20% in 2024.
Childhood obesity is influenced by a combination of biological, social, economic and environmental factors. Diets high in energy but low in essential nutrients, limited opportunities for physical activity and the easy availability of heavily marketed processed foods can contribute to unhealthy weight gain.
Obesity can increase insulin resistance, in which the body’s cells respond less effectively to insulin. This can raise the risk of type 2 diabetes, a condition that is increasingly important to consider in children and adolescents.
However, the relationship between food and diabetes requires an important distinction. Type 1 diabetes is an autoimmune condition in which the body’s immune system attacks insulin-producing cells in the pancreas. It is not caused by eating sugary foods or being overweight. Type 2 diabetes develops through different mechanisms and is associated with factors including excess body weight, genetics and physical inactivity.
The two conditions require different approaches to prevention and treatment.
India introduces a national childhood diabetes framework
In a significant policy development, the Union Ministry of Health and Family Welfare released a comprehensive guidance document on diabetes mellitus in children on May 3, 2026.
The framework outlines a structured approach to screening, diagnosis, treatment and long-term management, linking community-level identification with district hospitals and medical colleges. It also provides for free-of-cost care at public health facilities, including insulin therapy, blood glucose monitoring supplies and follow-up services.
The guidance promotes awareness of the early warning signs of type 1 diabetes through the “4Ts”: Toilet, Thirsty, Tired and Thinner. These refer to frequent urination, excessive thirst, unusual tiredness and unexplained weight loss.
The initiative is important because timely diagnosis and access to insulin can be lifesaving for children with type 1 diabetes. It also highlights the need for health systems to identify and manage diabetes before complications develop.
Schools become a focus of food policy
India is also considering measures to improve the food environments surrounding schools. A Reuters report published on September 24, 2026, said the country was moving towards restrictions on the sale of foods high in fat, salt and sugar within a 50-metre radius of schools.
The proposed measures would affect vendors and shops selling products such as sugary drinks and packaged snacks near educational institutions. The proposal reflects growing concern about the availability of unhealthy foods in places where children spend much of their day.
If implemented effectively, school-focused measures could form part of a wider strategy that includes healthier school meals, accessible drinking water, nutrition education, physical activity and clearer food labelling.
However, restrictions alone cannot address the problem. Families also need affordable access to fruits, vegetables, pulses and other nutritious foods. Public-health measures must account for household budgets and the realities of food access in different communities.
Beyond calories
World Food Day 2026, themed “Innovate today. Nourish tomorrow,” offers an opportunity to reconsider what food security means for children. Access to sufficient calories is essential, but the nutritional quality of food also matters.
Reducing the future burden of type 2 diabetes requires action across healthcare, education, food policy and community environments. At the same time, children living with type 1 diabetes need timely diagnosis, uninterrupted insulin supplies and long-term medical support