Kids love going around places, playing, and exploring new things. While all of this is fun, it can expose them to diseases. When they come from school, they are exposed to various germs through air and transmission or direct contact. They also touch surfaces a lot, then their face, then their mouths. This makes it easy for illness to spread. While it is impossible to prevent illness completely, there could be several measures that can reduce the risk and support recovery.

Vaccination

Vaccination is a critical step in preventing severe illnesses. The Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics (AAP) recommend following an established vaccine schedule. Vaccines protect against life-threatening infections, including those that disproportionately affect infants and young children.

Good Hygiene

While no vaccine can prevent one from common cold, good hygiene practices can significantly reduce germ transmission. Parents must therefore encourage their children to wash their hands after touching toys, hard surfaces, and other people. What is more important is proper hand hygiene, as handwashing with soap and water is the most effective way to eliminate germs.

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The Hygiene Hypothesis: Does Exposure to Germs Strengthen Immunity?

There are several research that suggests that early exposure to germs may help develop a child’s immune system, a concept known as the "hygiene hypothesis." However, many immunologists argue against this theory, noting that children naturally encounter enough germs to build immunity without unnecessary exposure to unsanitary conditions. A balanced approach ensures children develop a strong immune response without increased risk of illness.

Cleaning and Sanitizing Children’s Belongings

Regular cleaning of toys, school supplies, and frequently touched objects is essential. Understanding the difference between cleaning, sanitizing, and disinfecting can help:

• Cleaning removes visible dirt and debris.
• Sanitizing reduces germs to safer levels.
• Disinfecting kills germs completely, offering the highest level of protection.

It is important to read product labels carefully, use child-safe cleaning products, and rinse toys thoroughly after disinfection, especially those that go into a child’s mouth.

Choosing Effective Sanitizing Products

To minimize germ exposure, parents should clean objects with soap and water first and then use a sanitizer for everyday items. Disinfectants, which are stronger, should be used on objects that a sick person has touched. The Environmental Protection Agency (EPA) provides a list of approved sanitizers and disinfectants that effectively kill germs.

Encouraging Good Hygiene Without Causing Anxiety

Teaching children proper hygiene without creating fear is essential. Make handwashing engaging by incorporating songs or counting games. Explaining the benefits of hygiene in a positive way helps children understand that washing hands protects them and others. Parents can reinforce these habits by leading by example.

Boosting Immunity Through Nutrition

A strong immune system helps children fight infections more effectively. Proper nutrition plays a crucial role in immune support. A balanced diet should include:

• Proteins
• Vegetables
• Fruits
• Healthy fats
• Carbohydrates
• Adequate hydration

Multivitamins are generally unnecessary for well-nourished children, but if supplements are used, they should be free of added sugars and taken under supervision to prevent choking hazards.

Teaching Respiratory Etiquette

Proper respiratory hygiene reduces the spread of illness. Parents should model behaviors such as covering their mouths with an elbow when coughing or sneezing. Using tissues and disposing of them immediately is also a good practice. Reinforcing these habits through positive encouragement makes children more likely to adopt them.

Riya and Karan (name changed), both working professionals from Indirapuram, Ghaziabad, often unwind at night by watching reels after putting their 6-year-old son, Aarav, to bed. What began as “just 20 minutes” regularly stretched to 1–2 hours. Over time, Aarav started asking for the phone at dinner. Soon, he insisted on watching reels before sleeping. Tantrums increased when the phone was taken away.

Within months, Aarav’s sleep was delayed by 1–1.5 hours. He woke up cranky and tired for school, and schoolteachers noticed a reduced attention span. He became impatient and easily irritable. His parents realized he was not just watching — he was hooked on fast-paced short videos.

What Is Happening?

Do you know that our children mirror parental behavior? Fast, high-stimulation reels overstimulate the brain. Night screen exposure disrupted melatonin and sleep cycles. Reduced parent-child interaction impacted emotional regulation. We need to understand that sleep is not a passive state of rest; it is an active biological process that is essential for physical growth, brain development, emotional regulation, and overall well-being. In children, adequate and high-quality sleep is as important as proper nutrition and immunization. Unfortunately, pediatric sleep is often neglected, misunderstood, or sacrificed in modern lifestyles.

What Is Normal Pediatric Sleep?

Normal sleep varies with age and follows predictable developmental patterns.

• Newborns (0–3 months): 14–17 hours per day, fragmented into multiple sleep periods.
• Infants (4–12 months): 12–16 hours, with gradual consolidation of night sleep.
• Toddlers (1–2 years): 11–14 hours, including 1–2 daytime naps.
• Preschool children (3–5 years): 10–13 hours, often with one nap.
• School-age children (6–12 years): 9–12 hours, usually no naps.
• Adolescents (13–18 years): 8–10 hours, with a natural tendency toward later sleep and wake times.

Normal sleep is regular, age-appropriate in duration, refreshing, and uninterrupted, allowing the child to wake up alert and active during the day.

How To Promote Normal Sleep In Children

Healthy sleep habits, often referred to as sleep hygiene, are the cornerstone of normal pediatric sleep.

Key strategies include:

• Maintaining a fixed bedtime and wake-up time, even on weekends.
• Establishing a calm and predictable bedtime routine (bath, reading, prayer, or quiet conversation).
• Ensuring the sleep environment is dark, quiet, cool, and comfortable.
• Avoiding screen exposure (mobile phones, tablets, television) at least 1–2 hours before bedtime.
• Encouraging daytime physical activity and exposure to natural daylight.
• Avoid heavy meals, caffeine, or sugary drinks close to bedtime.
• Consistency is critical. Children thrive on routine, and predictable sleep schedules reinforce the body’s internal clock.

Home Remedies to Support Better Sleep

Simple, non-pharmacological measures at home can significantly improve sleep quality:

• Warm bath or gentle massage before bedtime to promote relaxation.
• Storytelling or reading can help transition from stimulation to calmness.
• Soft music or white noise for children who have difficulty settling.
• Comfort objects (a favorite toy or blanket) for younger children.
• Teaching relaxation techniques such as deep breathing to older children.
• Limiting late-evening academic pressure or emotionally charged discussions.

Importantly, sleeping pills or sedatives should never be used without medical advice.

Why Sleep Is Crucial for Growth and Development

Sleep plays a central role in nearly every aspect of child development:

• Growth hormone secretion peaks during deep sleep, directly influencing height and physical development.
• Brain maturation and learning depend on sleep for memory consolidation and neural connectivity.
• Immune function is strengthened during sleep, reducing infection risk.
• Emotional regulation improves with adequate sleep, reducing irritability and mood swings.
• Metabolic health is protected, lowering the risk of obesity and insulin resistance.

Chronic sleep deprivation disrupts these processes, with long-term consequences.

Common Pediatric Sleep Disorders

Pediatric sleep disorders are common and often under-recognized. They include:

• Behavioral insomnia of childhood (difficulty falling or staying asleep due to habits).
• Sleep-disordered breathing, including obstructive sleep apnea.
• Parasomnias such as night terrors, sleepwalking, and confusional arousals.
• Restless sleep disorders, including restless legs syndrome.
• Circadian rhythm disorders are particularly prevalent in adolescents.
• Early recognition and treatment are essential to prevent secondary behavioral and academic problems.

Relationship Between Sleep and Behavioral Disturbance

There is a strong and well-established link between poor sleep and behavioral issues in children.

Sleep-deprived children may present with:

• Hyperactivity and impulsivity (often mimicking ADHD)
• Inattention and poor academic performance
• Irritability, aggression, and emotional outbursts
• Anxiety and depressive symptoms
• Poor social interaction and reduced empathy

Future Consequences: Sleep, Aggression, and Crime

The long-term consequences of untreated sleep disorders extend beyond childhood:

• Chronic sleep deprivation affects impulse control, judgment, and emotional regulation.
• Adolescents with persistent sleep problems show higher rates of risk-taking behavior, substance use, and aggression.
• Longitudinal studies suggest associations between poor childhood sleep, antisocial behavior, and later involvement in violence or crime.
• Sleep deprivation impairs moral reasoning and increases reactive aggression, particularly in socially vulnerable populations.

Healthy sleep is a foundational pillar of pediatric health, equal in importance to nutrition, education, and emotional security. Promoting normal sleep from early childhood can improve behavior, academic success, mental health, and even societal outcomes in adulthood. Parents, schools, and healthcare providers must work together to recognize sleep as a priority—not a luxury—for every child.

Early investment in healthy sleep is an investment in healthier individuals and a safer society.

(By Dr Tanuj Kumar Verma, Consultant, Pediatric Intervention Pulmonologist and Intensivist at Cloudnine Group of Hospitals, Indirapuram)

A new study published in The Lancet Obstetrics, Gynaecology, & Women's Health has revealed an alarming rise in infertility rates among women aged 35 years and older.

The analysis, based on the Global Burden of Disease Study 2023, found that global female infertility could affect nearly 80 million women aged 35–49 by 2036 if current trends continue.

In 2023, an estimated 53.60 million women aged 35–49 were affected by infertility. Nearly 54 million women in this age group sought fertility care, including fertility testing and assisted reproductive technologies such as in vitro fertilization (IVF).

Asia Bears Highest Burden

According to the study, Asia has the highest need for fertility care particularly East Asia reported the highest regional burden, while Australasia has the lowest. At country level, the Central African Republic had the highest reported burden, while Nepal had the lowest.

Although disparities between low- and high-income regions have narrowed, the burden is shifting toward high-income settings, where women are more likely to delay pregnancy and seek fertility testing and treatment.

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The researchers said, "This shift reflects broader social and economic changes, including delayed family planning and greater access to fertility services in some affluent regions".

"Advanced-age female infertility represents a growing global health challenge. Despite improved regional equity, low-SDI countries continue to face significant burdens. This necessitates implementing tailored public health strategies and prioritizing resource allocation to mitigate future burdens," said the researchers from China, Hong Kong, and Singapore in the paper.

To address the rising demand, the authors called for

• expanding and integrating fertility services into primary health care, reducing financial barriers to treatment,
• using innovative delivery methods,
• mobile health tools,
• improve equitable access to fertility care.

Infertility A Growing Global Health Concern

The World Health Organization defines infertility as the failure to achieve a clinical pregnancy after 12 months of regular unprotected intercourse.

Approximately 8–12 per cent of reproductive-aged couples worldwide experience infertility, with the burden disproportionately affecting women aged 35–49 years.

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The study noted that this higher risk is largely biological, driven by age-related declines in ovarian reserve and oocyte quality, which reduce natural fertility, increase miscarriage risk, and lower the success rates of assisted reproductive technologies (ART).

As populations age and socioeconomic transitions continue, the number of women exposed to advanced-age infertility risk is increasing, making it an increasingly important public health issue.

How Was The Study Conducted?

The researchers analyzed data from the Global Burden of Disease (GBD) 2023 study to provide what they describe as the first comprehensive assessment of infertility among women aged 35–49 across 204 countries and territories.

Since 1990, both the age-standardized prevalence rate and disability-adjusted life years (DALYs) attributable to infertility have risen steadily, by 0.45 per cent and 0.47 per cent every year, respectively.

The study projects that infertility cases in women aged 35–49 will continue to rise, reaching nearly 80 million by 2036 in the absence of targeted interventions.

The researchers also found a 23.10% reduction in the relative disparity in infertility-related DALYs between low- and high-Socio-demographic Index (SDI) regions since 1990, indicating progress in equity while highlighting persistent structural gaps in access to care.

A 20-month-old toddler from West Bengal who suffered from recurring urinary tract infections (UTIs) for six months was eventually diagnosed with cystinuria, a rare inherited metabolic disorder that causes recurrent kidney stone formation.

About The Case

The diagnosis came after the toddler experienced persistent UTIs over a period of six months. After multiple episodes of infection couldn’t be solved despite treatment, the doctors discovered the rare condition.

Initially, the doctors believed that it could be vesicoureteral reflux, a condition in which urine flows backward from the bladder towards the kidneys.

However, more investigations revealed an unusual kidney stone caused by cystinuria, an inherited disorder that leads to excessive amounts of the amino acid cystine in urine.

As cystine dissolves poorly in urine, it can crystallise and form stones, which may block urine flow, trigger recurrent UTIs, and damage the kidneys if left untreated for a long time. Doctors at a Bengaluru hospital treated the child using a minimally invasive procedure to remove the stone.

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What Is Cystinuria?

Usually, the kidneys reabsorb cystine after filtering blood. In individuals with cystinuria, this process does not work well.

Large amounts of cystine pass into the urine. As cystine does not dissolve in urine, it forms crystals and eventually stones in the kidneys.

The condition is caused when the child inherits one faulty gene from each parent. Parents who carry one altered gene usually have no symptoms themselves.

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Symptoms & Treatment

Unlike most kidney stones, which are more common in adults, cystinuria presents during childhood or adolescence. Parents must look out for the following symptoms in their children:

• Recurrent urinary tract infections

• Pain while passing urine

• Blood in urine

• Abdominal or flank pain

• Kidney stones at an unusually young age

• Difficulty passing urine if stones obstruct the urinary tract

Although cystinuria has no cure, effective treatment and management can reduce stone formation and protect kidney function. It includes:

• Drinking large amounts of water to dilute urine and reduce the formation of stones

• Reducing salt intake

• Limiting consumption of excessive animal protein

• Medications that make urine less acidic (urine alkalinisation)

• Drugs that reduce cystine stone formation in severe cases

• Surgical or minimally invasive procedures to remove stones when necessary

Parents must seek medical attention when the child faces the following:

• Two or more UTIs within six months or repeated infections over a year

• Recurrent fever without an obvious cause

• Intense pain during urination

• Blood in the urine

• Difficulty in gaining weight

• Persistent irritability

• Recurrent abdominal or back pain

While most recurrent UTIs are caused by common anatomical or behavioural factors, persistent or unusual infections can occasionally point to rare inherited disorders like cystinuria that warrant medical attention.

Early diagnosis and timely treatment can help prevent permanent kidney damage and significantly reduce the frequency of stone formations.