When I met my friend Aishwarya's daughter, Aanya, on a Sunday afternoon, she was building an entire world in her backyard using only sticks, leaves, and her imagination. In her eyes, a stick became a magic wand, leaves turned into currency for her "shop," and an old cardboard box was her fortress. Aishwarya admitted that this was Aanya’s “free play” time—a period without gadgets, instructions, or adult guidance, which made me curious.

To put this to rest, we had a word with Dr Kushal Agrawal, Neonatologist and Head of the Department of Neonatology and Paediatrics at KVR Hospital Kashipur, "Unstructured play is much more than just frivolous fun. It is an integral part of child development. Today, children do not have much scope for free play. With the academic system, straddled by extracurricular activities and digital entertainment, the scope for unstructured play is getting smaller and smaller.". On the contrary, research reveals that unstructured plays hold a lot of benefits for children that structured activities may not have in store.

What are the Physical Benefits of Unstructured Play?

According to Dr Agrawal, "free time plays" are a great way for kids to get involved in physical activities meant for their growth. "When children are left to play freely, their movements become more varied and spontaneous," he says. Science behind this practice does support this because free play increases the levels of physical activity, which is moderately vigorous in children; this is essential in preventing childhood obesity and promoting health in general.

Other than these, the outdoor environments provide opportunities and challenges for natural development outside. While children run, jump, climb, and look around the outdoors, they can become able to develop strength, coordination, and endurance for a healthy and active lifestyle by exercising. Otherwise, structured activities often restrict children to specific movements or instructions.

How Play helps in Social and Emotional Growth of Kids?

Except for physical fitness, disorganized play lays the foundation for basic social and emotional capabilities. During unorganized play, children invent their games, negotiate roles, settle disputes, and collaborate to attain some common objectives. According to Dr. Agrawal, "such interactions build empathy, cooperation, and communication skills as children learn to express themselves, listen to others and adapt to group dynamics.".

Research indicates that children learn emotional resilience through unstructured play, navigating minor setbacks in a low-stakes environment. If the game goes sour, kids learn to solve the problem on the spot; this builds up their self-confidence as well as independence. This is a kind of play that gives children the freedom to learn by themselves and try new things without having the fear of being prohibited by others or the fear of failure.

How Parents can Encourage Creativity and Problem-Solving in Children

Freedom in play helps unlock a child's creativity and the problem-solving aspects. Most structured activities have predetermined tasks or instructions that do not develop creative thought. According to Dr Agrawal, "When children are allowed to be free, they can explore and create their own scenarios, which are meant for developing unique solutions based on critical thinking.".

Unstructured play provides children with a number of materials for play—blocks, sand, or leaves, for example—without script, so that they invent games, build imaginary worlds, and, in a very real sense, answer their natural curiosity. It has been proven that this type of play helps children to make decisions, adaptability, and innovations, qualities useful throughout life.

Is Play Holistic Approach to Child Development?

Dr Agrawal believes that unstructured play is a very important factor of all-rounded child development. "Nowadays, children's lives are very scheduled, so it's very important for the parents to remember how necessary play is", he further adds. Being freely playful would be a great support to their healthy physical development as well as social, emotional, and cognitive development.

As parents, we can encourage free play by creating an environment that encourages exploration and curiosity. What can be very impactful is giving the child a safe outdoor space and setting aside gadgets to allow for uninterrupted time to play. As these spaces tend to be counterintuitive to everything that can be seen as a hallmark of productivity and measurable progress, unstructured play allows the children to build resilience, independence, and joy.

Giving Children the Freedom to Play

More than just being childhood, unstructured play confers a wide range of benefits since children learn to manage social dynamics, solve problems independently, and bring their creativity into life which puts them better prepared for the challenges of adulthood. In this natural form of play, people lay down a foundation for lifelong skills to achieve balanced wellbeing and success.

The next time you catch your child playing carefree—maybe using a stick as a wand or a rock as a pet—take the time to be thankful for the developmental steps.

Nearly 76,805 children and adolescents in India are estimated to develop cancer each year. At the same time, childhood cancer can be highly treatable when diagnosed early and managed appropriately, with survival exceeding 80% in settings where timely diagnosis and comprehensive treatment are available.

When people think about preventive healthcare for children, the conversation usually centers on vaccinations, good nutrition, physical activity, sleep and regular health check-ups. These are important for a child’s overall health. But prevention also involves something that is often overlooked: recognizing when a child’s health is changing and seeking medical advice at the right time.

Childhood cancer is different from many cancers seen in adults. In most cases, there is no clear lifestyle-related cause that parents could have avoided. A child developing cancer is therefore not usually linked to something the parents did or did not do. This is important because there is no particular diet, exercise routine or supplement that can guarantee protection against childhood cancer.

The Importance of Recognizing a Pattern

For doctors, one of the more practical ways to improve outcomes is to recognize when a seemingly common symptom is not following its usual course. Fever, tiredness, headaches, loss of appetite or body pain are frequent childhood complaints. But when they persist, keep returning or occur alongside other changes, they should not simply be treated repeatedly without evaluation.

• Unexplained weight loss

• Unusual bruising or bleeding

• Persistent bone or abdominal pain

• A growing lump or swelling

• Repeated headaches

• Changes in vision

These are some signs that may require further assessment. These symptoms are not specific to cancer, but their persistence warrants attention.

Why Early Diagnosis Matters

Most childhood cancers do not have a routine screening test for healthy children. Diagnosis therefore often depends on noticing an unusual pattern and investigating it appropriately.

A delay does not necessarily mean that cancer has been missed, but prolonged delays can allow some cancers to progress before treatment begins. For this reason, awareness among parents and healthcare providers, timely evaluation and appropriate referral are important parts of childhood cancer care.

Prevention Is Not Just About Avoiding Cancer

Vaccination still has a place in the broader cancer-prevention conversation. Hepatitis B vaccination helps reduce the risk of liver cancer linked to chronic hepatitis B infection, while HPV vaccination can help prevent HPV-related cancers later in life. However, these vaccines do not prevent most cancers that occur during childhood.

Similarly, nutrition should be viewed in the right context. A balanced diet supports growth and recovery, including during cancer treatment, but there is no specific food or diet that can prevent a cancer.

The Cost of Childhood Cancer

Childhood cancer can place a significant financial and practical burden on families. Treatment costs may be accompanied by expenses related to travel, accommodation, food and time away from work.

At the same time, families today have more avenues of support than before. Government health schemes, public healthcare facilities and non-government organizations can help with treatment costs and other practical needs. The challenge is ensuring that families are aware of these resources and can access them early enough.

Looking Beyond Treatment

Children who survive cancer may need long-term monitoring for possible effects of treatment on growth, development and other aspects of health.

For childhood cancer, therefore, prevention is less about finding a way to eliminate risk and more about reducing what can be changed: delayed diagnosis, interruptions in treatment and avoidable long-term complications..

(Dr Amita Mahajan, Senior Consultant, Pediatric Oncology, Indraprastha Apollo Hospital, Delhi)

Globally, one in six people of reproductive age experiences infertility at some point in their lifetime. Smoking is one of the key reasons for infertility among men and women worldwide, according to a new World Health Organization (WHO) knowledge summary.

The report, the 12th in a series of Tobacco Knowledge Summaries, highlights evidence linking tobacco use to infertility in women, harmful effects on sperm and sexual function in men, and potentially lower chances of success with some fertility treatments. It also warns that second-hand smoke may affect reproductive health.

Infertility is defined as the failure to achieve pregnancy after 12 months or more of regular unprotected sex.

What Does the WHO Report Say?

Infertility can have multiple causes. However, cigarette smoking and exposure to second-hand tobacco smoke are associated with infertility in women.

The harmful effects of cigarette smoking on women’s reproductive health are well documented, while evidence on other tobacco products, including waterpipe and smokeless tobacco, as well as nicotine products such as e-cigarettes, is still emerging.

Current data suggest potential risks to fertility, but further research is needed to fully understand these effects. Among

men, cigarette smoking is associated with harmful effects on semen and sperm, as well as sexual function, which can contribute to infertility.

On the other hand, women who quit smoking may have a lower risk of infertility compared with women who continue to smoke.

WHO recommends that healthcare providers inform individuals and couples planning pregnancy about the reproductive risks of tobacco use and offer evidence-based support to help them quit.

How Smoking Affects Fertility?

“Smoking is an important fertility consideration for both men and women. It can affect the quality of both eggs and sperm, and the concern is not limited to people who smoke themselves,” Dr Neelam Suri, Senior Consultant, Obstetrics & Gynecology, Indraprastha Apollo Hospital, Delhi, told HealthandMe.

Smoking also accelerates follicular depletion, which may contribute to an earlier onset of menopause compared with women who do not smoke.

Second-hand smoke can expose individuals to harmful substances that may affect reproductive health. Eggs and sperm are rapidly developing cells, and exposure to tobacco smoke can increase the risk of DNA damage and other cellular changes that may affect fertility and reproductive outcomes.

Dr Shalu , Senior Clinical Director, Cloudnine Group of Hospitals, Gurugram, told HealthandMe that while passive smoking may not directly cause infertility in every individual, regular exposure to tobacco smoke can affect reproductive health and have significant implications during pregnancy.

These include ectopic pregnancy, miscarriage, preterm birth, pre-eclampsia, fetal growth restriction, low birth weight, stillbirth, placental complications and neonatal complications.

Regular exposure to second-hand smoke may also potentially influence the chances of success with fertility treatments such as IVF.

“This is particularly relevant for couples undergoing IVF, where egg and sperm quality can influence the chances of successful treatment,” Dr Suri said.

What Should Couples Planning Pregnancy Do?

For couples planning a pregnancy or undergoing fertility treatment, avoiding tobacco smoke is an important step towards protecting reproductive health.

This means quitting smoking and maintaining a smoke-free environment at home to reduce regular exposure to cigarette smoke.

At the same time, fertility depends on multiple factors. Exposure to second-hand smoke does not necessarily mean a couple will experience infertility or IVF failure. However, reducing preventable risk factors can be beneficial when trying to conceive.

Ideally, couples should create a smoke-free environment before conception rather than waiting until fertility difficulties emerge.

Tylenol is one of the most commonly used pain killers. That’s why a study on the drug’s long-term effect on reproductive health of unborn girl children is concerning.

Researchers in Denmark found that girls exposed to paracetamol, also known as acetaminophen or Tylenol in the US, during fetal development had smaller ovaries, fewer ovarian follicles and smaller uteruses in infancy compared to girls who were not exposed to the component.

It’s essential to understand that study does not show that girls exposed to the drug will certainly have fertility problems later in life.

The researchers say it is still too early to know whether the changes observed during infancy and adolescence will translate into reduced fertility or earlier menopause.

What Did The Study Find?

Published in Human Reproduction Open, the study involved 302 girls from the Copenhagen Analgesic Study, or COPANA.

The researchers tracked mothers' paracetamol use during pregnancy through repeated questionnaires and also measured the drug in urine samples.

The girls were examined at around three months of age, during a period known as minipuberty, when the reproductive hormone system becomes temporarily active.

Of the 302 girls, 92 had first been exposed to paracetamol before 17 weeks of pregnancy; 67 were first exposed from 17 weeks onward and 143 had no reported prenatal exposure.

The researchers found that girls exposed during early fetal development had an approximately 40% smaller ovarian volume and a 13% smaller uterine volume compared to girls who were not exposed.

Girls exposed during mid-to-late fetal development stage had about 23% fewer ovarian follicles. These follicles contain immature eggs that can potentially develop and mature over a woman's reproductive life.

Additionally, girls exposed exclusively during early pregnancy also had lower levels of anti-Müllerian hormone (AMH), a hormone produced by ovarian follicles that is commonly used as a marker of ovarian reserve.

Also read: Tylenol, Other Medications Linked To 400% Rise In Liver Injuries In US

Changes From Infancy To Adolescence

Researchers also examined an independent group of 1,210 girls who had been followed from infancy through adolescence.

In this group, prenatal paracetamol exposure was associated with a smaller uterus at puberty and smaller ovaries during adolescence.

Study leader Margit Bistrup Fischer of Rigshospitalet in Copenhagen stressed that the long-term implications remain unknown. Whether these early reproductive differences affect fertility or the timing of menopause will require long-term follow-up.

Also read: Lower Doses Of CBD Could Also Cause Liver Damage: FDA Study Finds

Tylenol And Infertility

This was an observational study, which means that researchers looked at an association between prenatal exposure to paracetamol and changes in future reproductive health.

They did not randomly assign pregnant women to take paracetamol, so the study cannot establish that the drug itself caused the changes.

The authors also say that external factors cannot be completely excluded. Women who took paracetamol because they must have been pain and discomfort due to headaches, fever or other illnesses. These underlying conditions could also influence fetal development.

Also, the women used relatively low to moderate amounts of paracetamol. According to COPANA cohort, the most common reasons were headaches or migraines, musculoskeletal pain, illness or cold and fever.

The study also found that increased reported paracetamol exposure, meaning high dose, was too associated with lower ovarian and uterine volumes.

Also read: Paracetamol Is Not Safe For Older People, Finds Study

Earlier Studies That Raised Similar Concerns About Tylenol

It's not the first time that Tylenol has sparked safety concerns. In 2025, new studies by Mount Sinai and Harvard T.H. Chan School of Public Health raised an concerning question: is prenatal exposure to acetaminophen associated with neurodevelopmental disorders including autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) in children?

A study led by Andrea Baccarelli, dean of Harvard T.H. Chan School of Public Health’s faculty of environmental health in BMC Environmental Health, systematically reviewed 46 previous studies encompassing data from more than 100,000 participants.

The aim was to investigate whether acetaminophen use during pregnancy correlates with neurodevelopmental disorders in children.

Applying the Navigation Guide Systematic Review method—a strict, gold-standard approach to assessing environmental health evidence—the study team evaluated the quality, risk of bias, and strength of evidence of all included research.

By doing so, it was possible to conduct a solid synthesis of available scientific literature, and what emerged was a pattern: better-quality studies showed a more pronounced association between prenatal acetaminophen exposure and offspring increased risk of ADHD and autism.

Another recent study observed that liver injuries reported to US poison centres increased by nearly 400% between 2000 and 2024, due to acetaminophen, sold under brand names like Tylenol.

The study also found that exposures involving acetaminophen-containing combination drugs decreased by 60%-85% after the US Food and Drug Administration capped the amount of acetaminophen allowed in combination prescription products.

However, harmful exposures to acetaminophen alone increased steadily over the 24 years. The findings suggest that regulatory action reduced liver injuries linked to combination products, while acetaminophen alone remained a leading contributor to poison-centre-reported liver injuries.