Coffee has always been a crowd favorite drink among all age groups. But we all know that caffeine has a different effect on everyone. Doctors often express how young kids and teens should be careful about caffeine but new guidelines regarding this set a firm boundary when it comes to teen health and caffeine. Health experts, working with the Robert Wood Johnson Foundation, have new advice on healthy drinks for kids and teens in the age group of 5-18. The guidelines say that water and milk are the best drinks for them. They want kids to get into good drinking habits early so they can stay healthy. They're also worried about kids drinking too many sugary and caffeinated drinks. This new guide helps parents know what's good for their kids to drink.

How Did Caffeine Become So Popular Among Teens?

The new guidelines are especially relevant because caffeinated drinks have become increasingly popular among teenagers. Coffee shops, like Starbucks, are popular hangouts for teens, and energy drinks, often packed with caffeine and promoted by social media influencers, are widely available. And a very popular theme on social media is coffee, people enjoy having different varieties of it, making to a very affordable and trendy thing to enjoy! There are accounts dedicated to coffee consumption and often kids and teens partake in these trends.

A recent poll by the C.S. Mott Children's Hospital found that nearly a quarter of parents say their teens consume caffeine almost every day. The most common sources are sodas, followed by coffee and tea, and then energy drinks. Even chocolate contributes to caffeine intake. The amount of kids who consume coffee raises concerns about the potential health effects of caffeine on young people, whose bodies and brains are still developing. The easy access to these beverages and the marketing strategies targeting young audiences contribute to the problem.

Could The Lack Of Guidelines Be A Reason?

Right now, there aren't any official rules about how much caffeine kids can have. This makes it hard for parents and doctors to know what to tell kids about caffeine. The new report tries to fix this by giving some advice based on research. Experts are worried about how caffeine affects kids' sleep, mood, and health. Kids are more sensitive to caffeine than adults. Caffeine can keep them awake, make them anxious, and might even affect their hearts. Because there aren't any rules, it's important to have experts telling us what's safe.

How Caffeine Affects Kids

Caffeine is something that makes your body speed up. Adults can usually handle some caffeine, but it's different for kids and teens. Their bodies are smaller, and their brains are still growing, so caffeine can affect them more. It can make it hard for them to sleep, make them nervous, and even give them headaches or stomachaches. It can also raise their blood pressure and heart rate. Caffeine can also change their mood, making them cranky or unable to focus. We don't know all the ways caffeine affects kids in the long run, and that's another reason to be careful.

The report says that plain water and plain milk are the healthiest drinks for kids and teens. They say it's okay to have a little bit of 100% juice, plant-based milk, or flavored milk, but not too much. They also say kids should stay away from sugary drinks like soda, sports drinks, and lemonade. And, very importantly, they shouldn't drink caffeinated drinks or other things that give you a jolt. This advice is based on what we know about how these drinks affect kids' health. Sugary drinks can cause weight gain and other problems, and caffeine can mess with sleep and other things.

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.

Hypertension or high blood pressure is an increasingly common problem among children and adolescents; many children may not have any obvious signs or symptoms in the early phase. It is said that hypertension in children is a “silent condition,” and therefore, it is of paramount importance that doctors, parents, and teachers are aware of it to detect the condition early.

Symptoms Of High Blood Pressure In Children

While some kids might not have any symptoms at all, there are some signs that shouldn't be overlooked. Recurrent headaches or morning headaches, especially headaches in the back of the head, may occasionally be a sign of high blood pressure. Symptoms can be dizziness, blurred vision, flashers, loss of energy for no known reason, nausea, vomiting, difficulty breathing during exercise, chest pain, palpitations, or frequent nosebleeds for no obvious reason.

There can also be changes in a child's behaviour or physical appearance in the school environment that teachers might observe. Children with high blood pressure often experience headaches, frequent visits to the sick room for weak or dizzy spells and ask to go out of class to rest. Sometimes, symptoms such as difficulty in concentration, sudden drop in school performance, irritability, changes in mood or appearing unusually withdrawn are associated with underlying health problems, such as hypertension.

Some children may be more tired, winded or unwell from sports or physical activity than others and avoid it. These symptoms can be missed and dismissed as stress, poor sleep or lack of interest in studies or sports. Such symptoms may be overlooked and blamed on stress, sleep deprivation or low interest in studies or sports.

Leading Causes & Prevention

Doctors think obesity, poor diet, excessive salt intake, poor sleep, low exercise, and watching too much screen time are all factors that are driving up hypertension rates in kids and teens. Other kidney disease, heart disease, hormone imbalances, or family history can also contribute in some children.

Regular blood pressure checks on children's routine visits are very significant because many children with hypertension may be asymptomatic, experts say. Prompt diagnosis and treatment can prevent complications with the heart, kidneys, brain and eyes in the long term.

It is important that parents and teachers do not shrug off repeated complaints of headaches, fatigue, dizziness or vision problems as insignificant. Early medical assessment can be important in safeguarding a child's long-term health.

By Dr Vaibhav Meshram, Paediatrician, Ruby Hall Clinic