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.

Infants who do not receive the recommended vitamin K injection at birth face a significantly higher risk of dangerous bleeding, including bleeding in the brain, according to a new study.

The findings, published in JAMA Pediatrics, reinforce the importance of the routine newborn vitamin K shot in preventing Vitamin K Deficiency Bleeding (VKDB), a rare but potentially life-threatening condition.

Higher Risk of Bleeding in Babies Without Vitamin K

Researchers from the Karolinska Institutet in Sweden analyzed data from more than 2 million live births between 2003 and 2021.

The study found that babies who did not receive an intramuscular vitamin K injection had:

• 1.52 times higher odds of any bleeding episode during the first six months of life.
• 2.91 times higher odds of intracranial (brain) bleeding during the same period.

"Our findings have important clinical implications, highlighting the ongoing need for communication between healthcare practitioners and parents about the vital role of vitamin K prophylaxis in preventing potentially life-threatening bleeding in newborns," said lead researcher Eleni Simatou of the Karolinska Institutet.

Why Is Vitamin K Important For Newborns?

Also read: 13.5 Million Children Remain Zero-Dose In 2025 Despite Global Vaccination Gains: UN Report

Vitamin K is a fat-soluble vitamin essential for normal blood clotting and bone health. Newborns naturally have very low vitamin K levels, putting them at risk of Vitamin K Deficiency Bleeding (VKDB).

The American Academy of Pediatrics (AAP) has recommended a vitamin K injection for all newborns since 1961. The shot is highly effective in preventing VKDB, which can cause severe internal bleeding, including bleeding in the brain, and may lead to permanent brain damage or death.

Importantly, the vitamin K shot is not a vaccine. It is a one-time supplement given shortly after birth to provide babies with adequate vitamin K.

Growing Concern Over Refusal of Vitamin K Shot

The researchers noted that parental refusal of vitamin K injections has been increasing in several countries.

A separate JAMA analysis of US electronic health records, published earlier this year, found that refusal rates rose from 2.92% in 2017 to 5.18% in 2024. In Sweden, however, only 1.5% of newborns did not receive the vitamin K shot in 2021.

"Vitamin K at birth is safe and effective," said study author Kate Semidey of Florida International University.

"Our review found that babies who do not get the vitamin K injection are 81 times more likely to develop vitamin K deficiency bleeding."

In addition to the US, the refusal is also growing in countries like Canada, New Zealand , and Scotland.

The authors noted that refusal also appears to be more common in home births, where reporting may also be less complete.

Read More: Cyclosporiasis Outbreak: US Probes Taco Bell Link; CDC Reviews Over 5,100 Cases

Breastfed Babies Remain at Higher Risk

Breast milk contains relatively low levels of vitamin K. As a result, babies who are exclusively breastfed remain vulnerable to VKDB until they begin eating solid foods if they do not receive the birth injection.

The study also found a higher use of oral vitamin K, which is considered less effective than the intramuscular injection in preventing VKDB, particularly the late-onset form that can occur weeks after birth.

Delhi's air quality has slipped into the 'poor' category for the first time in more than 85 days, even as the monsoon season sets in. While rainfall is often expected to clear the air, doctors warn that a combination of lingering pollution, high humidity, mold, allergens, and seasonal viral infections can significantly increase the risk of respiratory illnesses in children. Experts say children are especially vulnerable because their lungs and immune systems are still developing, making it easier for polluted air and environmental triggers to affect their breathing and long-term lung health.

After weeks of relatively clean air, Delhi's air quality deteriorated sharply on July 12, with the city's overall Air Quality Index (AQI) slipping into the 'poor' category at 261—the highest level recorded in more than 85 days.

According to Central Pollution Control Board (CPCB) data, this was the city's highest AQI since April 17, when it stood at 263.

Repeated exposure to polluted air during childhood can impair lung development and increase the risk of long-term respiratory diseases.

"Air pollution affects children more because their lungs are still developing, and they breathe faster than adults, inhaling more polluted air relative to their body weight," Dr. Narendra Kumar Jha, Director and Head of Pediatrics at Yashoda Medicity, told HealthandMe.

He added that inhaled pollutants irritate and inflame the airways, weakening the body's natural defense mechanisms. This can lead to chronic cough, wheezing, breathing difficulties, throat irritation, and worsening of conditions such as asthma and allergic rhinitis.

Why Children Are More Vulnerable

Children are not simply "small adults," said Dr. Nikhil Rajvanshi, Consultant, Pediatric Pulmonology, Madhukar Rainbow Children's Hospital, Delhi.

Because their lungs and immune systems are still developing, children breathe faster and inhale more air per kilogram of body weight than adults, making them more susceptible to pollution, infections, and environmental triggers.

How Air Pollution Affects Children's Lungs

According to Dr. Rajvanshi, pollutants such as PM2.5, PM10, nitrogen dioxide, and ozone penetrate deep into the lungs, triggering inflammation.

Even short-term exposure can cause:

• Coughing
• Wheezing
• Chest tightness
• Reduced exercise tolerance
• Increased emergency visits in susceptible children

Over time, repeated exposure can impair lung growth, reduce lung function, worsen asthma control, and increase the risk of chronic respiratory diseases later in life.

Why Respiratory Illnesses Increase During the Monsoon

Despite occasional rainfall clearing pollutants, the monsoon creates conditions that favor respiratory illnesses.

Dr. Rajvanshi explained that high humidity promotes indoor mold growth, damp conditions increase exposure to fungal spores, viral infections spread more easily, and sudden weather changes can trigger asthma. Periods of stagnant air between rainfall spells may also allow pollutants to accumulate.

As a result, pediatric clinics are reporting more cases of:

• Viral upper respiratory tract infections
• Persistent cough after viral illness
• Wheezing, especially in preschool-aged children
• Acute asthma attacks
• Allergic rhinitis with nasal blockage and sneezing
• Breathing difficulties linked to humidity, mold exposure, and fluctuating air quality

Children with asthma or allergies are particularly vulnerable, as viral infections combined with poor air quality can significantly worsen their symptoms.

How Parents Can Protect Their Children

Dr. Jha advised parents not to ignore persistent cough, breathing difficulty, or sleep disturbances caused by respiratory symptoms.

On days when pollution levels are high, children should avoid prolonged outdoor activities and strenuous exercise. Parents should also keep indoor air as clean as possible, ensure children stay hydrated, and continue prescribed asthma medications if needed.

Other preventive measures include:

• Monitor the daily AQI before outdoor activities.
• Keep children away from tobacco smoke, incense, mosquito coils, and indoor biomass smoke.
• Prevent dampness and mold inside the home.
• Clean regularly to reduce dust accumulation.
• Encourage frequent hand hygiene.
• Ensure adequate sleep, hydration, and a balanced diet.
• Continue prescribed controller medication and maintain an updated asthma action plan for children with asthma.
• Ensure eligible children, particularly those with chronic respiratory diseases, receive an annual influenza vaccination.

When Should Parents Seek Medical Care?

Parents should consult a pediatrician if a child develops:

• Fast or difficult breathing
• Wheezing or noisy breathing
• A cough lasting longer than two to three weeks
• Recurrent nighttime coughing
• Fever accompanied by breathing difficulty
• Poor feeding or lethargy in infants
• Bluish lips or fingertips
• Asthma symptoms that do not improve with prescribed reliever medication

Dr. Rajvanshi stressed that early medical evaluation can help distinguish between viral infections, asthma, allergies, pneumonia, and other lung conditions.

"Not every cough requires antibiotics, and not every episode of wheezing means a child has asthma. However, recurrent cough, persistent wheezing, exercise limitation, or breathing difficulty should never be ignored. Early diagnosis and appropriate treatment can prevent complications and improve long-term lung health," he told HealthandMe.

The adolescent stage is a crucial milestone in one’s life due to various developments experienced by teenagers at this stage. Adolescents must get access to comprehensive reproductive health education because it is instrumental in educating them on various health concerns, enabling them to develop healthy lifestyles.

Nonetheless, due to social taboos, myths, and insufficient information, adolescents find themselves in a situation where they are not conversant with health concerns.

Creating Awareness About PCOS and Menstrual Health

Among some of the things that need to be discussed in relation to adolescent reproductive health is the issue of Polycystic Ovary Syndrome (PCOS) and menstruation. Today, there is a higher prevalence of PCOS among girls and young women than before, which is related to various complications, including irregular menstruation, acne, excess body hair, and obesity problems in the future. It is important to know the first signs of PCOS to make a quick diagnosis of the disease and bring about lifestyle changes.

Another aspect that should be taken into account is the promotion of menstrual hygiene among girls. Girls need to understand that menstruation is a natural phenomenon that, therefore, nothing should prevent them from practicing good menstrual hygiene practices, including the use of sanitary products and appropriate methods of changing their pads.

The Importance Of HPV Vaccination

Reproductive health education must include HPV vaccination information, which would be the most effective way to prevent cervical cancer. HPV vaccination is something that many parents and young people don't know much about, including its benefits and recommended vaccination age. Therefore, educating people about how important it is to be vaccinated against HPV will help reduce the occurrence of cervical cancer in the future.

Encouraging Responsible Reproductive Health

The responsibilities regarding reproductive health also refer to the understanding of the process of puberty, but additionally include educating young people with regard to responsible behavior, respecting limits, practicing consent, and the importance of making informed decisions.

Building a Healthier Generation

Educating teenagers is very important in order to have a healthy generation in the future. Everybody should work together to create a supportive environment that encourages discussions regarding reproductive health problems. The promotion of awareness regarding PCOS, HPV vaccinations, and other reproductive health problems would also enable our children to become proactive in taking care of their health.

(Dr. Priya Gupta, Senior Consultant - Obstetrics and Gynecology, Cocoon Hospital, Jaipur)