Eight-month-old twins from Hayward Heath, West Sussex, recently met the surgeon who saved their lives even before they were born. The BBC reports how their mother, Katerina Ahouansou, at six months pregnant, during a routine scan, uncovered a serious issue with their development and blood supply.

Doctors diagnosed the twins with twin-to-twin transfusion syndrome or TTTS. It is a condition where one twin received more blood and nourishment than the other due to uneven blood vessel distribution in the placenta. In case there is no medical intervention, it could be fatal for both the twins.

A Specialist Steps In

This is when Ahouansou was referred to Professor Kypros Nicolaides at King’s College Hospital in London. Professor Nicolaides is a pioneer in fetal medicine and he specializes in a laser procedure that redistributes blood supply between twins in cases of TTTS.

When Ahouansou was scanned, Nicolaides observed that one of the twins were significantly smaller than the other. "There was a very high chance that if we did not intervene, both twins could die," he recalled.

An Operation No Less Than A Miracle

The life-saving laser surgery was performed and within a week the doctors saw an improvement with the twin who was smaller in size. When the twins were born, they weighed 1.5kg and 1.7kg. To recognize the efforts by the surgeon, Ahouansou named them Kai Kypros and Asher Nicolas after Professor Kypros Nicolaides.

Ahouansou also expressed deep gratitude for the professor's expertise and called him "proof that miracles can be performed by people who are devotees to their profession."

Professor Kypros Nicolaides has been at King’s College Hospital since 1980 and is widely regarded as a leader in fetal medicine. His groundbreaking research and development of screening and surgical techniques have saved countless lives.

Through his dedication, Professor Nicolaides has given many families hope, demonstrating how medical advancements continue to improve survival rates for complex fetal conditions like TTTS.

More about Twin-to-twin Transfusion Syndrome

As per the John Hopkins Medicine, TTTS is a rare pregnancy condition that affects identical twins or other multiples. It happens in pregnancies where twins share one placenta and a network of blood vessels that supply oxygen and nutrients essential for development in the womb. These pregnancies are known as monochorionic.

Sometimes, the blood vessels in the placenta are unevenly distributed, causing an imbalance in blood flow between the twins. The donor twin loses more blood than it receives, leading to malnutrition and potential organ failure. Meanwhile, the recipient twin gets an excess of blood, putting strain on the heart and increasing the risk of cardiac complications.

Impact on the Donor Twin

The donor twin loses blood volume (hypovolemia), reducing kidney function and urine production. This leads to low amniotic fluid levels (oligohydramnios) or, in severe cases, a complete absence (anhydramnios). Without proper blood circulation, the donor twin faces cardiovascular issues, increasing the risk of death.

Impact on the Recipient Twin

The recipient twin experiences excess blood volume (hypervolemia), causing increased urination and excessive amniotic fluid (polyhydramnios). The overworked heart struggles to handle the surplus blood, leading to cardiovascular dysfunction, heart failure, and, in extreme cases, death.

The World Health Organization has issued its first global guidelines for tackling obesity in children and adolescents. Prioritising lifestyle changes, it has placed diet, physical activity and behavioural support ahead of clinical weight-loss treatments like GLP-1 drugs.

The guidelines come as obesity poses a greater threat to children and adolescents. In 2024, around 400 million children and adolescents aged 5 to 19 were overweight, including 170 million living with obesity. The rate of obesity in this age group has quadrupled since 1990, jumping from 2% to 8%.

The WHO's recommendations come amid growing use of GLP-1 drugs like Wegovy and Saxenda among younger patients in some countries.

The use of GLP-1 medications weight-loss medications among children under 12 in the US has risen in recent years. According to a recent research data, in 2019, only about 0.03% of children had been prescribed a GLP-1 drug like Wegovy and Saxenda, made by Novo Nordisk, and Eli Lilly's Zepbound. By June 2026, that figure had risen to 9.3%.

WHO Does Not Recommend GLP-1s For Children Under 10

Also read: Are GLP-1 Drugs Safe for Children? Study Finds Nutritional Deficiency in Nearly 17% Within a Year

WHO does not recommend weight-loss medicines, bariatric surgery or weight-management devices for treating obesity for children aged 0 to 9 years.

Instead, it recommends lifestyle interventions, including dietary changes, physical activity and behavioural programmes for children and their caregivers. WHO's guidelines are linked to the limited evidence available on the long-term safety and effectiveness of obesity medicines in younger children.

The guidance is more nuanced for adolescents aged 10 to 19, the. Approved obesity medicines, including GLP-1 therapies, may be considered when a supervised, structured lifestyle programme fails to achieve the desired results.

This means the WHO is not ruling out medication for teenagers but does not place it ahead of lifestyle changes.

“The foundation of obesity care for children and adolescents is not medicine or surgery, but access to comprehensive support that enables healthy eating, physical activity and sustainable behaviour change,” said Luz María De Regil, director of WHO's Department of Nutrition and Food Safety.

Why Is WHO Cautious About GLP-1 Drugs For Children?

Also read: Wegovy & Zepbound Are Not Approved By US FDA For Children Under 12: So Why Are Prescriptions Rising?

GLP-1 medicines like Ozempic, Mounjaro and Wegovy have transformed obesity treatment in adults, but the evidence base in children and adolescents is limited. De Regil said there is currently insufficient evidence on GLP-1 drugs in younger populations. The WHO director also said that research is in progress to study their effectiveness and safety, which could revise the health body's position.

Questions around long-term safety, how treatment affects growth and development, how long medication needs to be continued and what happens after stopping treatment remain important areas of research. It's crucial as children may have to be on GLP-1 treatment for a long time.

Some GLP-1 drugs are already approved for certain younger patients. In the US and European Union, Wegovy and Saxenda can be used for weight management in some adolescents aged 12 and older, while the EU also permits Saxenda for certain children aged 6 to 11.

Even though evidence is limited about side-effects of GLP-1 drugs in children, a new study found that nearly 1 in 6 children, or 17%, treated with GLP-1 medications developed a diagnosed nutritional deficiency within one year.

The research, conducted by scientists at Northwestern University and Ann & Robert H. Lurie Children’s Hospital of Chicago, found that vitamin D deficiency was the most common nutritional deficiency, identified in 12.4% of children within one year of starting GLP-1 treatment.

WHO Wants Obesity Treatment To Go Extend Weight Loss

The new guidelines also emphasise that treating childhood obesity should not be reduced to the weighing scale. WHO recommends addressing diet, physical activity, sedentary behaviour, sleep and behavioural factors, while tailoring interventions to the child and family.

Mental health also forms part of the guidance as anxiety, depression, low self-esteem and social withdrawal can both contribute to unhealthy behaviours and be consequences of living with obesity. Children with obesity can also face stigma and bullying, making psychological and social support an crucial part of obesity care.

“Our priority must be to ensure that every child and adolescent can access quality care and supportive environments from an early age, helping them achieve and maintain a healthy weight and laying the foundation for lifelong health and well-being,” De Regil said.

Timely care during pregnancy, delivery, the newborn period and early childhood can help reduce some risks associated with cerebral palsy, a group of lifelong neurological disorders affecting movement, muscle tone and posture, experts said on the occasion of World Cerebral Palsy Day.

Observed annually on October 6, World Cerebral Palsy Day aims to raise awareness, advocate for equal rights and support the more than 50 million people living with cerebral palsy (CP) worldwide.

Speaking to HealthandMe, experts said preventing cerebral palsy may not always be possible, but appropriate care before and after birth and early recognition of developmental concerns can help reduce some risks and ensure timely support.

"While cerebral palsy cannot always be prevented, reducing avoidable risks around pregnancy and childbirth, recognizing complications such as reduced oxygen supply promptly, and providing appropriate newborn and developmental care can make a meaningful difference to a child’s health and functioning," Dr Neelam Suri, Senior Consultant, Obstetrics & Gynaecology, Indraprastha Apollo Hospital, Delhi, told HealthandMe.

Pregnancy and Birth: How Can The Risk Be Reduced?

Also read: Rare Pregnancy Infections Linked To 3-Fold Higher Autism Risk: What Is TORCH?

Dr Suri stressed the importance of regular antenatal care to identify and manage infections, high blood pressure, diabetes, fetal growth problems and other pregnancy complications.

Preventing or appropriately managing preterm birth is also important, as premature babies have a higher risk of developing cerebral palsy.

"One important concern around birth is birth asphyxia, where there is reduced oxygen supply to the baby’s brain, particularly during labor or delivery," Dr Suri said.

Timely recognition of fetal distress and appropriate intervention during childbirth can help reduce complications associated with reduced oxygen to the brain. Monitoring the baby during labor and having access to timely obstetric and newborn care are therefore important.

Dr Gurneet Singh Sawhney, Director, Stereotactic & Functional Neurosciences and Senior Consultant, Department of Neurosurgery & Spinal Surgery, Fortis Hospital, Mumbai, said the risk can also be lowered through regular antenatal check-ups, controlling diabetes and blood pressure, getting the rubella vaccine, treating infections promptly and avoiding smoking and alcohol.

"If a baby is likely to be born early, delivering at a well-equipped center makes a real difference. So does quickly treating newborn jaundice or breathing [problems]," he added.

After Birth: What Should Parents Watch For?

Read More: Unsafe Sleep Factors Linked To 73% Of Sudden Unexpected Infant Deaths In US: CDC

Premature or medically vulnerable babies may need closer monitoring for breathing difficulties, infections, seizures and other problems that can affect the developing brain. Babies who experienced complications around birth may also require neurological and developmental follow-up.

Parents should pay attention to developmental milestones rather than waiting for delays to resolve on their own.

Early Warning Signs Parents Should Not Ignore

READ: World Meningitis Day: Why 1 In 3 Meningitis Deaths Occur In Children Under 5

"Parents are often told their child is just a late bloomer, but some signs need a doctor's attention," Dr Sawhney, told HealthandMe.

Parents should consult a doctor if their baby:

• Cannot hold up their head by four months

• Is not sitting by nine months

• Feels unusually stiff or floppy when picked up

• Favors one hand before the first birthday

• Has legs that cross like scissors

• Shows persistent toe-walking

Why Early Intervention Matters

"The first two to three years are when a child's developing brain adapts most easily. Starting physiotherapy, occupational therapy and speech therapy early helps children build healthy movement patterns. It also stops muscles from tightening into permanent contractures," Dr Sawhney said.

Regular hip and spine monitoring, bracing and, where needed, corrective surgery can also support mobility and independence.

"With regular hip and spine monitoring, bracing and, where needed, corrective surgery, many children go on to walk, play and attend school independently," he added.

The focus, experts said, should be on timely care from pregnancy through early childhood, with developmental concerns assessed as early as possible.

The World Health Organization (WHO) says meningitis still remains a major public health challenge, especially when it comes to children younger than five as they face the highest mortality.

Meningitis is inflammation of the membranes surrounding the brain and spinal cord. It can be caused by bacteria, viruses, fungi, and other pathogens. Bacterial meningitis is among the most severe forms which can lead serious complications and even death.

Meningitis is notorious for progressing at an alarming rate. Capable of deteriorating within hours, meningitis may not look the same in infants as it does in adults. Doctors explain why young children are vulnerable, the warning signs parents should not miss, and how vaccination can prevent some of the deadliest forms of the disease.

More than one-third of people who die from meningitis globally are children under five, according to recent estimates from the Global Burden of Disease Study 2023. In 2023, meningitis caused an estimated 259,000 deaths worldwide, with around 86,600 deaths occurring among children younger than five.

On World Meningitis Day, Healthandme looked at those figures to analyse what drives the likelihood of complications among children with the help of two experts - Dr. Praveen Gupta, Chairman - Marengo Asia International Institute for Neuro and Spine, Marengo Asia Hospitals, Gurugram and Dr. Prabhudev Hiremath, Consultant – Paediatric Neurology, Ramaiah Institute of Neurosciences, Ramaiah Memorial Hospital.

Children Under Five More Are Vulnerable To Meningitis

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Health experts stress that meningitis is not only preventable but also a medical emergency in which delays can have devastating consequences. According to Dr. Praveen Gupta, the developing immune system of young children is one of the key reasons why they are vulnerable to the infection.

He explained, "Children below five years of age and infants especially have a developing immune system that makes them susceptible to infections. There are different organisms that tend to be responsible depending on age groups. New-borns are prone to group B streptococcus, meningococcus, pneumococcus, and H.influenzae is a common cause among children."

Dr Prabhudev Hiremath explained that the vaccination gaps among infants make them more susceptible to complications. He also said that children may not present classic symptoms of meningitis as seen in adults. He added that the this difficulty in recognising meningitis in babies is particularly concerning because the disease can progress rapidly.

He said, "Their protective antibody levels are also lower, especially before the completion of the primary vaccination schedule. Certain bacteria can therefore enter the bloodstream and reach the coverings of the brain and spinal cord more easily. Meningitis in babies may not present with classical symptoms as we see in adults, which can delay recognition and treatment."

Meningitis Risk & Vaccination

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A significant proportion of bacterial meningitis is preventable by vaccination. WHO's global plan aims to reduce vaccine-preventable bacterial meningitis by 50% and deaths by 70% by 2030.

Vaccines targeting major bacterial causes, including pneumococcus, meningococcus and Haemophilus influenzae, have helped reduce meningitis in populations with high vaccination coverage.

Dr Gupta said, "A major portion of bacterial meningitis is vaccine-preventable, particularly for meningitis from H.influenzae type B (Hib), pneumococcus, and meningococcus. Though vaccination does not prevent all cases of meningitis, which is caused by viruses or other organisms, this method remains one of the best tools we have in order to prevent it."

He added, "Parents need to ensure that age-specific vaccinations are administered and discuss additional vaccines with their pediatrician depending on their child's risk. Pentavalent vaccine with Hib component and pneumococcal vaccination are included in the national immunization schedule of India."

Dr Hiremath also cautioned against assuming that vaccination eliminates all meningitis risk. He said, "Routine childhood immunization has dramatically reduced meningitis in countries with high vaccine coverage. However, vaccination cannot prevent every form of meningitis, so parents should not dismiss concerning symptoms simply because a child is fully vaccinated."

Meningitis Symptoms In Babies

Also read: Russia Plague Outbreak: Lab Worker Dies Of 'Unknown Infection' After Suspected Exposure; CDC Monitors The Situation

One of the biggest challenges for parents is that an infant cannot say that they have a severe headache or a stiff neck. This means parents need to watch for changes in feeding, behaviour, alertness and crying, rather than waiting for the classic symptoms seen in adults.

Dr Gupta said, "Do not wait for the symptoms of headache with neck stiffness in babies. Look out for high fever, unusual drowsiness or lethargy, irritability, continuous or unusual crying, poor feeding, repeated vomiting, convulsions, unusual behavior, or bulging fontanelle. Older children may present with fever, severe headaches, vomiting, neck stiffness, photophobia, confusion, and increased lethargy."

Meningitis Can Become Life-Threatening Within Hours

Bacterial meningitis is a medical emergency. WHO notes that clinical deterioration can be rapid, with death potentially occurring within 24 hours without prompt treatment. Dr Gupta stressed how quickly a child's condition can change. He said that bacterial meningitis and meningococcal infection deteriorate very fast, progressing from flu-like symptoms to severe illness within hours.

He explained, "When a child presents with fever with altered behavior, extreme lethargy, convulsions, breathing difficulties, persistent vomiting, severe headaches, neck stiffness, cold hands and feet, or a rapidly developing dark or purplish rash, parents should never opt for a wait-and-watch approach. If you suspect meningitis, every minute counts. It's an emergency."

Dr Hiremath explains how a peculiar meningitis-related rash can appear, which is considered to be a major warning sign.

He said, "A non-blanching, purple or reddish rash is another major warning sign, particularly with meningococcal infection. Parents should not wait for every classical symptom to appear.

Treatment Does Not Signify A Child Has Fully Recovered

The doctors caution against assuming that after an infection is treated, the child recovers completely. WHO estimates that about one in five people affected by bacterial meningitis develop long-term complications, which can include neurological and sensory disabilities.

For children, these complications may become more apparent only as they grow and developmental or academic demands increase.

Dr Gupta said, "About one-fifth of people who have experienced the disease end up having some kind of complication. The complications may range from hearing loss, seizures, weakness and neurological issues, and intellectual disabilities. Children will have to be observed for possible speech and language problems, cognitive and learning disabilities, memory, attention, behavioral and developmental delays."

Dr Hiremath stressed that some problems may not be immediately obvious after discharge.

He said, "Not all these complications are obvious when a child leaves the hospital. Some may become apparent months later, particularly as developmental and academic demands increase. That is why regular follow-up is important after meningitis."

Dr. Gupta lists necessary tests and evaluations that must children exposed to meningitis should undergo to get timely treatment and necessary care.

"Hearing tests, neurological assessment, developmental or cognitive evaluation need to be done based on the disease and recovery. Early intervention and proper education may prove to be very important. WHO particularly emphasizes care, support and aftercare of those who have been through meningitis as a part of its 2030 strategy," explains Dr. Gupta.

The 2023 analysis estimated 259,000 meningitis deaths worldwide. Children under five accounted for more than one-third of them. Doctors urge that vaccination remains one of the strongest tools for preventing serious bacterial meningitis, but recognising symptoms early remains crucial.