The research findings have been published in the renowned journal Nature Communications: Dual human milk oligosaccharide-fibre utilisation is a selection cue for the weaning gut microbiome.

“We have long known that breastfeeding is important for infants’ health. What is new is that we can now explain how the sugars in breast milk, HMOs, also help to select the bacterial communities associated with a healthy gut microbiota later in life. This underlines the importance of combining breastfeeding with solid baby food at this stage of child’s development,” says Maher Abou Hachem, professor at DTU Bioengineering and senior author of the study.

The study reveals a previously unknown mechanism that gives specific gut bacteria an advantage in the competition to inhabit the infant’s gut during weaning, because they are endowed to metabolise both HMOs from breast milk and fibres from plant-based foods.

The results suggest that the weaning period is a crucial developmental window, during which the combination of breast milk and solid food, promotes the maturation of the gut microbiota to the adult-like community that is maintained during adulthood. On the long term, this new knowledge may contribute to the development of better nutritional solutions for infants and strengthen our understanding of how early nutrition affects health later in life.

“The findings are important in daily clinical practice as an additional justification to the already strong emphasis on promoting the mother’s own milk production and breastfeeding when infants and young children are admitted to a neonatal intensive care unit due to preterm birth or critical illness,” says Consultant Lise Aunsholt from the Department of Intensive Care for Newborns and Young Children at Rigshospitalet.

“It is encouraging to know that when we advise a mother to continue breastfeeding after discharge – and for as long as possible during the transition to solid foods – this will potentially have a positive impact on the child for the rest of their life,” she says.

According to the researchers, the study shows that breast milk not only supports the infant’s nutrition during infancy but also helps to select the bacteria that become a permanent part of the gut microbiota later in life.

Close collaboration between DTU and TUH

The study was carried out in close collaboration between researchers from DTU and clinical research environments at the Technical University Hospital (TUH – see fact box)

The researchers analysed the changes in bacteria and their genes over the weaning phase. This gave them insight into which bacteria were present and what the bacteria were doing. At the same time, the researcherscultured the bacteria in the laboratory under conditions resembling the environment in the human gut. In this way, they were able to identify the bacteria capable of metabolising both HMOs from breast milk and dietary fibres from solid food.

“The collaboration between DTU’s technological and biological expertise and the clinical environments at TUH has been crucial in enabling us to link knowledge about the bacteria’s functions to the development of the gut microbiota in children. This provides unique insight into how early dietary choices affect health later in life,” says Maher Abou Hachem.

Could pave the way for new nutritional solutions

The researchers believe that this new knowledge sets the stage for the development of future nutritional solutions for infants and targeted interventions that support the establishment of healthy gut bacterial community.

The results also suggest that the weaning period may be a crucial time for preventive measures against diseases that are later in life associated with disturbances in the gut microbiota.

The analysis found that while healthy behaviour and lifestyle interventions remain an essential foundation of any effective weight management programme — delivering meaningful weight loss and improvements in body composition on their own — adding pharmacotherapy produced the strongest outcomes. Crucially, the study’s authors characterise medication not merely as a supplementary tool, but as a core component of treatment when combined with lifestyle change.

The review assessed short-term outcomes typically measured over six to twelve months, tracking improvements in body mass index (BMI) and BMI z score, a metric used to contextualise weight relative to age and sex in children and adolescents. Long-term sustainability and safety were also monitored across the included studies.

The findings come as obesity rates in children and adolescents continue to rise globally, placing growing pressure on clinicians and health systems to identify effective, evidence-based treatment approaches. The results suggest a shift in how pharmacotherapy should be framed in paediatric obesity care — not as a last resort or add-on, but as an integral element of a combined strategy.

The study was led by corresponding author Bjorn T. Tam, PhD, and is published in JAMA Pediatrics (doi:10.1001/jamapediatrics.2026.2248). The full text is freely accessible here.

Chile ranks among the highest countries globally for rates of childhood overweight and obesity [1]. To combat this issue, in 2016 Chile implemented one of the world’s most comprehensive and ambitious food policies, the Food Labelling and Advertising Law (FLAL) [2].

The FLAL targets foods and drinks high in sugars, saturated fats, salt, or calories through three core measures: mandatory front-of-package warning labels in the form of black octagons (images available here), restrictions on the sale of such products in schools, and limits on food marketing directed at children.

Prof Guillermo Paraje, Professor of Economics, Universidad Adolfo Ibáñez Business School (Chile), says, “Although individual national measures like sugar taxes on soft drinks have been associated with improved health outcomes, this is the first study to plausibly demonstrate that a package of policies can reduce early childhood overweight/obesity risk at the national level.

“These results offer strong evidence for policymakers around the world. They support mandatory front-of-pack nutrition warning labels, restrictions on unhealthy food in schools, and marketing bans as effective, practical ways to tackle the childhood obesity epidemic.”

National data on more than 300,000 schoolchildren aged four to six in Chile was used to compare children’s weight from the years before the introduction of FLAL with the weight and size of children in the same school grades after the first phase of the law came into place in 2016.

The study found that children who had been at school for 18 months after the introduction of FLAL Phase 1 were less likely to be overweight or have obesity than those in the same grades before FLAL. Girls had a 2.9% lower risk of overweight or obesity (a reduction of 1.4 percentage points from a pre-FLAL rate of 47.7%) while boys had a 2.4% lower risk (a reduction of 1.2 percentage points from a pre-FLAL rate of 52%.)

The study also found a plausible causal impact in the cohort of schoolchildren aged four to six after only six months of the FLAL Phase 1; girls had a 1.9% lower risk of overweight or obesity (a reduction of 0.9 percentage points from a pre-FLAL prevalence of 47.4%) and boys a 2.2% lower risk (a reduction of 1.2 percentage points from a pre-FLAL prevalence of 52%).

Phases 2 and 3 of FLAL set stricter limits on sugars, saturated fats, salt, or calories. These phases were introduced in 2018 and 2019, so they did not impact the study’s results.

Dr Nieves Valdes, Associate Professor of Economics, Universidad Adolfo Ibáñez Business School (Chile), says, “Although the reduction in obesity and overweight risk among young school children may seem modest, it is likely that the further tightening of the law in later years will have increased the impact, especially given evidence that there was a greater drop in sales of labelled food products during Phase 2 of the FLAL compared to Phase 1.”

“Additionally, even a small weight reduction for children who have overweight or obesity is likely to bring meaningful long-term health benefits, given the strong links between childhood obesity and later risk of obesity, diabetes, hypertension, and cardiovascular disease, as well as evidence that early prevention can substantially lower these risks.”

The researchers note some limitations of their studies, including that the plausible causality of the relationship relies on the assumption that, if the FLAL hadn’t been introduced, the two cohorts of school children would have followed the same nutrition trends, which cannot be tested although support for the assumption was provided through pre-policy trends. Additionally, the children’s weight was collected by school staff who, although trained for this task, may not achieve the same precision typically found in primary health care settings.

Writing in a linked Comment, Professor Simone Pettigrew and Dr Daisy Coyle, The George Institute for Global Health (Australia), who were not involved in the study, say, “In a policy environment where industry opposition constitutes a formidable obstacle to the implementation of health-promoting policies, high-quality, real-world evidence is critical. […] the research results strengthen the case for governments to move beyond incremental, single-policy approaches and to instead implement comprehensive, integrated strategies to improve food environments. In particular, the results highlight the potential for policy suites including mandatory warning labels and marketing restrictions on unhealthy foods and school food minimum standards to produce meaningful outcomes.”

The researchers say the drops led to small but significant reductions in myopia progression compared with placebo, and are “a worthwhile addition to currently available optical interventions for the treatment of myopia in children in the UK.”

Rates of myopia in children are increasing worldwide, and are linked to higher healthcare costs and long term eye-related complications

Atropine eye drops are used worldwide to treat myopia in children, but are not currently available in the NHS, so their effectiveness and safety in children in the UK is uncertain.

To address this knowledge gap, researchers recruited 289 children with myopia aged 6-12 years (average age 9.3 years; 72% reported white ethnicity; 56% were girls) from five NHS hospital eye services and academic institutions between June 2019 and February 2022. All children wore standard spectacles to correct myopia.

A total of 192 children received daily 0.01% atropine eye drops and 97 received placebo for two years, in addition to standard spectacles. Myopia progression, eye growth, safety, and tolerability were monitored every six months.

Final results were available for 230 children (151 in the atropine group and 79 in the placebo group).

After accounting for factors such as age, ethnicity, and history of myopia in at least one parent, children who used atropine eye drops experienced a small decrease in myopia progression and eye growth compared with those using placebo drops.

Specifically, atropine treatment led to an average reduction of 0.38 D (diopter) in refractive error and 0.14 mm in central axial length – two key measures of myopia – compared with placebo.

Pupil diameter was the only other outcome with a notable difference (0.36 mm greater in the atropine group). No differences were seen in the frequency of adverse events or in tolerability measures, such as sore eyes, blurry vision, itchiness, or difficulty reading and writing.

The researchers acknowledge several trial limitations, such as the generalisability of results outside of a clinical trial environment and the potential influence of the covid-19 pandemic, which occurred during the trial period.

Nevertheless, they conclude: “The findings suggest that a low concentration atropine eye drop product would be a worthwhile addition to currently available optical interventions for the treatment of myopia in children in the UK.”

These results will help inform policymakers in the UK, they add.

“In the United States, that’s hundreds of thousands, if not a million cases of flu that we can avoid each year,” said senior study author Anupam Jena, the Joseph P. Newhouse Professor of Health Care Policy in the Blavatnik Institute at HMS. “That’s a huge effect size.”

The findings provide additional support for the flu vaccine at a time when childhood vaccines have come under scrutiny in the United States. This January, the U.S. Centers for Disease Control and Prevention removed the annual influenza vaccine, as well as several others, from its childhood schedule of recommended vaccines. That change, which was widely condemned by medical societies and public health organizations, was blocked by a U.S. District Court in March.

“The federal government cited an absence of evidence that they want to see, and so we have provided that,” said Christopher Worsham, HMS assistant professor of medicine at Massachusetts General Hospital and first author on the study. “We have randomized data, and it shows that flu vaccines are effective for these young children.”

Sorting by birthday

Young children typically have an annual visit to the doctor scheduled around their birthday. For children born in the fall, those visits are a convenient time to get the flu vaccine. But children born in the summer will likely have appointments before the flu vaccine becomes available — they need an additional appointment to get vaccinated.

In previous research, Jena and Worsham found that the additional burden on caretakers results in lower flu vaccination rates in summer-born children. This creates a natural experiment, randomly sorting children into more- or less-vaccinated groups based on the happenstance of when they were born.

The researchers compared insurance claims data for summer-born and fall-born children between the ages of 2 and 5 over five flu seasons between 2016 and 2023. (They skipped the 2020-2021 and 2021-2022 seasons because of confounding factors from COVID-19.)

In each season, fall-born children were more likely to be vaccinated and less likely to catch the flu.

The vaccination rates for children with fall birthdays were between 8.6 and 12.5 percentage points higher than those with summer birthdays and the influenza diagnosis rates were 1.0 to 1.4 percentage points lower.

“Across these five seasons, we see that for every hundred kids who are randomly vaccinated because of when their birthday falls, somewhere between nine and 14 of them avoid a case of the flu that they otherwise would have caught,” said Jena, who is also a professor of medicine at Mass General.

For other illnesses that do not have vaccines, such as the common cold or gastrointestinal viruses, there was no difference in the infection rates of the two groups.

“It comes down to: vaccines work,” Worsham said.

More natural experiments

As children get older, birthdays and doctor’s appointments stop being so closely aligned. The researchers note that after about age five, the influenza diagnosis rates between fall- and summer-born children start to even out.

“The randomized data we have is limited to these very young children because their doctor appointments are tied to their birthday,” Worsham said.

That doesn’t mean that the vaccine isn’t effective in older children, teenagers, or adults — it definitely is, Worsham said. But after a certain age, birthdays are no longer good indicators of whether someone is more or less likely to have received the flu vaccine, so this experiment can’t capture vaccine effectiveness in older groups.

This work is just one example of a randomized experiment that can be found in existing data — there are many similar opportunities across different fields of medicine, the researchers said. Jena and Worsham are frequent collaborators and have co-authored a book, Random Acts of Medicine, on the subject.

“It is impossible to do a randomized controlled trial for every single thing that we want to know and understand,” Jena said. “But we have an incredible amount of data out there and there are randomized experiments like this sitting in that data, waiting to be uncovered.”

Authorship, funding, disclosures

Charles F. Bray, HMS hourly research assistant in health care policy and master’s student at Havard T.H. Chan School of Public Health, is co-author of the study.

This research was not directly supported by any funders.

The authors report no conflicts of interest related to this work. A full list of disclosures can be found in the paper.

Hip dysplasia is the most common cause of hip arthritis for people under 50, according to the International Hip Dysplasia Institute. It occurs when a hip socket is too shallow to support the ball of the thigh bone. In young children, this can cause problems ranging from a mildly wiggly hip to complete dislocation. In adults, it can affect how people walk, lead to early-onset arthritis, and cause pain and mobility issues.

Late diagnosis of DDH remains a public health issue worldwide, leading to problems for adults later in life. More comprehensive ultrasound screening of infants during community-based public health services could help catch these missed cases without requiring hospital resources to conduct the initial screening, researchers said.

The methods used to screen newborns for DDH vary around the world. Most countries, including North America, South Korea, Taiwan and Japan, have a selective screening programme based first on a physical exam or family history. Only a small number of countries, including Austria, Switzerland and Mongolia, provide ultrasound screening for all newborns, which is more accurate.

Associate Professor Kyoko Yoshioka-Maeda from the Graduate School of Medicine at the University of Tokyo wanted to explore ways to catch these missed cases earlier. It was also vital to limit the burden on Japan’s medical system which has a declining number of paediatric orthopaedic surgeons.

‘I wanted to find out if these [ultrasound] devices could be successfully used in a community setting to screen infants for DDH as part of the maternal child and health programme,’ Yoshioka-Maeda explained. ‘Based on our nationwide survey, approximately 2% of municipalities use ultrasound screening because of workforce constraints. There is also a disparity between the availability of paediatric orthopaedic surgeons and hospitals in rural areas compared to urban areas.’

In Japan, about a month or two after a mother has given birth, she is visited by a public health nurse or midwife to check her recovery and the baby’s development. Public health nurses can offer guidance and community-based preventative care but differ from midwives and registered nurses in hospitals, and do not commonly use ultrasound.

Public health nurses and midwives from two rural municipalities in the island prefecture of Okinawa in southern Japan, and one in central Japan’s Aichi Prefecture participated in the study. Participants completed an e-learning module and hands-on seminar for the portable ultrasound device and the Graf method (used to diagnose DDH).

Ultrasound images were remotely reviewed by paediatric orthopaedic surgeons or an experienced senior surgeon. In total, 349 infants were screened out of a target 365, giving an overall coverage of 95.6%. Of these community-based examinations, 85.8% of the images were successfully classified by the surgeons.

Based on the ultrasound findings and other risk factors, 42 infants were referred, and of these, 41 attended hospital visits. Overall, 23 infants (54.8%) required follow-up and 2 (4.8%) treatment. However, only 6 of the 42 children (14.3%) would have previously met the criteria for a referral without ultrasound screening, demonstrating its effectiveness to support early detection of DDH.

‘We received strong support from caregivers, municipal administrators, hospitals, public health centres and paediatric orthopaedic surgeons, which was key for the success of this study,’ said Yoshioka-Maeda. ‘In order to roll this out across Japan, the first hurdle is the budget to purchase the equipment and train and support the staff. The other bottleneck is image interpretation, as there is a very limited number of paediatric orthopaedic surgeons in Japan. Developing an AI-based system could help us with that.’

Previous meta-analyses looking at the use of antidepressants during pregnancy and risk of neurodevelopmental disorders in children were conducted nearly a decade ago and limited by small study numbers and a lack of controlling for additional factors. This new meta-analysis provides the best evidence to date that the small increase in risk of autism or ADHD in the children of women who used antidepressants when pregnant identified in many studies is not caused by the medication.

“We know many parents-to-be worry about the potential impact of taking medication during pregnancy; our study provides reassuring evidence that commonly used antidepressants do not increase the risk of neurodevelopmental disorders such as autism and ADHD in children. While all medications carry risks, so too does stopping antidepressants during pregnancy due to an increased risk of relapse. Therefore, for women with moderate-severe depression, doctors and patients must carefully weigh the potential risks and benefits of continuing antidepressant treatment during pregnancy against the potential harms of untreated depression,” says author Dr Wing-Chung Chang, University of Hong Kong.

He continues, “Although our study found a small increase in the risk of autism and ADHD in the children of women who had used antidepressants during pregnancy, it also found that this risk disappeared when we accounted for other factors. The increased risk was also seen in the children of fathers who took antidepressants and of mothers with antidepressant use before, but not during, pregnancy. Together, this suggests that it is not the antidepressants themselves causing an increased risk in autism and ADHD but it is more likely to be due to other factors, including genetic predisposition to conditions such as ADHD, autism, and mental health conditions.”

Authors pooled data from 37 studies which included more than 600,000 pregnant women taking antidepressants and almost 25 million pregnancies with no antidepressant use.

Before controlling for key factors such as mental health conditions, the analysis found that antidepressant use by the mother during pregnancy was associated with a 35% increased risk of ADHD and a 69% increased risk of autism. However, this became greatly reduced or non-significant in analyses that better controlled for confounding factors. Use of antidepressants during pregnancy by the father was associated with a 46% increase in the risk of ADHD and a 28% increase in the risk of autism.

Among studies with analyses restricted to mothers with mental health disorders, all selective serotonin reuptake inhibitors (SSRIs) were found to not be associated, only amitriptyline/nortriptyline remained associated with increased ADHD and autism risk. Amitriptyline/nortriptyline are currently considered second or third options as treatments for depression and are often prescribed for treatment-resistant depression. Therefore, women treated with these may have more severe, chronic, or complex underlying mental health conditions than those receiving more common antidepressants, which could be influencing the association between amitriptyline/nortriptyline and increased ADHD and autism risk.

The study found no difference in risk between high and low doses of antidepressants.

“The evidence suggests a link between either parent having a mental health condition and a slightly higher risk of ADHD or autism. In addition to genetic factors, this link could be explained by the home and social environment as ongoing family stress, changes in how the family functions, and differences in how parents behave and care for their children may influence neurodevelopment. There is a need to ensure both parents have access to support and treatment for mental health conditions; for their own sake and to support neurodevelopment of their child,” says Dr. Joe Kwun-Nam Chan, University of Hong Kong.

The researchers note some limitations of their study, including that data on important factors such as socioeconomic status, lifestyle risk factors and low birth weight was lacking in the studies. Additionally, there was only a small number of studies looking at antidepressant use in specific trimesters or exact doses and dose changes, which makes it harder to draw conclusions about these. Finally, women who are prescribed antidepressants tend to have more severe depression than those who are not, so some bias may remain even after controlling for mental health status.

Writing in a linked Comment, Lisa Vitte, Emmanuel Devouche and Gisele Apter from University Rouen Normandy (France), who were not involved in the study, say, “Chang and colleagues’ study adds knowledge and confirms some of the pre-existing knowledge on the use of antidepressants during pregnancy: that they should continue to be taken as they protect maternal mental health and do not harm fetal development. This result is of considerable impact after many contradictory and controversial studies.”

There was no funding source for this study. The study was conducted by researchers from the University of Hong Kong.

The labels have been added to this press release as part of a project run by the Academy of Medical Sciences seeking to improve the communication of evidence. For more information, please see: http://www.sciencemediacentre.org/wp-content/uploads/2018/01/AMS-press-release-labelling-system-GUIDANCE.pdf. If you have any questions or feedback, please contact The Lancet press office at pressoffice@lancet.com

Quotes from Authors cannot be found in the text of the Article but have been supplied for the press release. The Comment quote is taken directly from the linked Comment.

https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(26)00089-1/fulltext

The paper, “Economic evaluation of delaying the infant hepatitis B vaccination schedule,” is under embargo until 11am EST on April 27, 2026 in JAMA Pediatrics.

The longer the delay, the study found, the higher the cost in human life and health care, with costs ranging from $16 million to $370 million depending on the age at first vaccination and adherence to vaccination schedules.

Chronic hepatitis B is a leading cause of cirrhosis, liver failure, liver cancer and death, affecting 2.4 million people in the United States. Newborns have the highest risk: 90% of newborns who contract hepatitis B virus (HBV) will develop chronic infections and 25% will die prematurely from cirrhosis or liver cancer.

“Preventing HBV transmission at birth is a cornerstone of hepatitis B elimination efforts,” said Noele Nelson, professor of practice in the Department of Public and Ecosystem Health, the senior author of the study.

In December 2025, the federal Advisory Committee on Immunization Practices (ACIP) voted to delay the first dose of HBV vaccine for infants whose birth parent tests negative for the virus – a reversal of a 2018 recommendation to administer the vaccine to all infants within 24 hours of birth.

In this study, Nelson and her team used probabilistic models built on published scientific data about hepatitis B vaccine efficacy, transmission rates and disease progression to estimate the number of infections and health care costs various vaccine scenarios would incur.

Nelson compared models where vaccination is given at birth or delayed to age 2 months, 7 months, 4 years or 12 years, in children of HBV-negative birth parents, unknown birth parent infection status or both. Their models also consider cases where all children received all three recommended doses, or incomplete vaccination.

All projections showed that, in unvaccinated groups, more individuals progressed to chronic infection or serious complications like cirrhosis and liver cancer. This effect was amplified in scenarios where children do not receive all three doses as prescribed.

“Importantly, our study underestimates the costs and health outcomes associated with delays to administering the hepatitis B vaccine birth dose,” Nelson said. “Our model assumptions were conservative. For example, we didn’t include the increasing risk of getting HBV infection from members of their household or community, which could happen if the number of people with HBV infection increases.”

The latest ACIP recommendation was, in part, based on low HBV infections. Nelson argues that the low incidence of HBV infection in the United States is a direct result of the successful vaccination programs.

“Multiple studies have shown that the later children receive their first hepatitis B vaccination, the lower the probability they will complete their routine vaccination course,” Nelson said. “This policy may reverse this progress towards hepatitis B elimination.”

The recent ACIP decision also cited concerns about the safety of the hepatitis B vaccine and speculation that harms might outweigh the benefits of vaccination. Reviewing four decades of studies, including recent comprehensive safety reviews, Nelson did not find any evidence of serious adverse reactions such as seizures, other neurological disorders, infections or mortality.

“We found that over 35 years of data demonstrate long-term immunogenicity and likely lifetime protection from hepatitis B vaccines,” Nelson said. “We don’t find any advantage in delaying the first dose of this vaccine, and our findings favor maintaining a policy of universal hepatitis B vaccination at birth.”

Additional authors include Eric W. Hall of Oregon Health & Science University; Prabhu Gounder of the Los Angeles County Department of Public Health; and Heather Bradley of Emory University.

Their study, published in JAMA Network Open, was the first to assess trends in young children’s nicotine exposures across all types of products.

Researchers at the New Jersey Poison Control Center, based at Rutgers New Jersey Medical School, used the National Poison Data System to analyze more than 92,000 reported nicotine exposures in children ages 5 and younger between 2016 and 2023 to understand how the rise of newer products – specifically disposable e-cigarettes and nicotine pouches – has changed the risks for young children.

They found that while tobacco exposures from conventional products such as cigarettes decreased by 43%, electronic cigarette-related incidents have increased 243% over the past eight years and often involved children who inhaled the vapors directly from the devices. They also found children exposed to e-cigarettes were more likely to require a visit to a health care facility compared with those exposed to cigarettes.

“This significant spike in children breathing in these substances tells us the risk has changed: It’s no longer just about a toddler swallowing something they found on the floor,” said Perry Rosen, lead author who conducted the research at the New Jersey Poison Control Center before becoming a medical student at New York Institute of Technology College of Osteopathic Medicine. “Many recent cases involve children actively using e-cigarette devices after gaining access to them.”

Young children naturally mimic the behaviors they see around them. “When children see caregivers or older family members vaping, they may copy that behavior—bringing the device to their mouth and inhaling—without any understanding they are exposing themselves to a harmful substance,” said Diane Calello, executive and medical director of the New Jersey Poison Control Center. Unlike cigarettes, these devices are often ready to use, brightly colored, require little effort to activate, and appear more like toys than a harmful product.

Even moderate ongoing exposure among users of vaping products—which can include adolescents—has been associated with lasting health effects on developing lungs, including increased  risk of bronchitis and worsening asthma, although such effects have not yet been reported in young children.

Despite federal laws passed in 2019 and 2020 to raise the minimum purchase age and restrict certain flavors, the upward trend in childhood poisonings has continued.

In New Jersey, liquid nicotine can only be sold in child‑resistant containers under the New Jersey Liquid Nicotine Child-Resistant Container Act (N.J.S.A. 2A:170‑51.9), which adopts federal safety standards requiring packaging that young children cannot easily open. This state law aligns with the federal Child Nicotine Poisoning Prevention Act of 2015, which mandates child‑resistant “special packaging” for all liquid nicotine products nationwide. However, while these may prevent a child from swallowing the liquid, children may still be lured by an enticing device and mimic the behavior they see – inhaling the nicotine.

She emphasized that existing protections focus largely on liquid nicotine ingestion, not behavioral exposure. “Child-resistant packaging may prevent a toddler from swallowing liquid nicotine, but it does nothing to stop a child from copying what they see an adult do,” Rosen said. That’s why we need safety standards that address the device itself, not just the container.”

“Current laws which focus on child-resistant packaging for nicotine liquids, are no longer enough,” Calello said. “This study underscores the need for safety regulations at the device level. For example, manufacturers should be required to include flow restrictors or designs that make it more difficult for a child to activate a device.”

Persistent inequalities remain a major barrier to achieving universal protection against life-threatening infections – reflecting findings from the UK Heath Security Agency National Immunisation Programme Health Equity Audit 2025.

The findings from an interdisciplinary research team including data scientists, infectious disease epidemiologists and physicians from the University of Liverpool are published today (1 April 2026) in the journal The Lancet Regional Health – Europe. 

By performing a data analysis, researchers from the Institute of Population Health and the Institute of Infection, Veterinary & Ecological Sciences at the University of Liverpool have examined the trends in timely vaccine uptake before and after England changed its PCV dose schedule in  January 2020 – transitioning from a “2+1” PCV schedule (two primary doses at 8 and 16 weeks, with a booster dose at 12 months) to a “1+1” PCV schedule (single primary dose at 12 weeks and a booster dose at 12 months).

In a longitudinal study, the researchers analysed Pneumococcal Conjugate Vaccine (PCV) uptake data from 2013-2025 for children aged 1 and 2 years from the Cover of Vaccination Evaluated Rapidly (COVER) programme. COVER collects quarterly and annual data on childhood immunisation coverage in England for children at 1, 2 and 5 years of age.

Looking at pattens for upper-tier local authorities in England linked to 2019 Index of Multiple Deprivation quintiles, the study found that PCV booster retention has dropped in England since the schedule change, which coincided with the start of the COVID-19 pandemic. This deterioration disproportionately affected children in more deprived areas, risking avoidable disease burden concentrated in the most disadvantaged communities and widening health inequalities. The findings agree with evidence from a BMJ article by the wider research team and the UK Heath Security Agency National Immunisation Programme Health Equity Audit 2025, reporting immunisation inequity in England is not only persistent but it is worsening in critical areas.

The number of required clinic visits may be insufficient to overcome the systemic barriers to vaccination faced by marginalised communities. Immunisation system strengthening, targeted, equity-focused interventions and enhanced call-recall systems for post-infant vaccine delivery could help address the identified PCV coverage gaps. These outputs are timely as the House of Lords – Childhood Vaccinations Committee is holding an inquiry to examine childhood vaccination coverage in England, why there has been a gradual decline in coverage over the past decade and what the Government should do to reverse this decline and reduce inequalities in childhood vaccination coverage.

Dr Edward Hill from the University of Liverpool is the corresponding author on the paper. He said: “National averages and patterns can often mask local vulnerabilities. This research highlights the importance of using granular data to identify exactly which groups are falling behind in intervention uptake. Public health interventions can then be more precisely targeted.”

Lead author Praise Ilechukwu from the University of Liverpool commented: “Our study shows that while the UK’s move to a 1+1 schedule was evidence-based and efficient, we are still seeing a consistent lag in protection for children in deprived areas. These deprivation-associated inequalities in pneumococcal vaccine coverage in children leaves children in deprived areas more vulnerable to pneumococcal diseases like pneumonia and meningitis.”

Co-author Professor Neil French from the University of Liverpool commented: “Addressing the PCV booster retention issues can be aided by establishing routine monitoring of booster gaps as a key performance indicator for the vaccination programme. This should include regular reporting by deprivation and place to enable early identification of emerging problems.”

Co-author Dr Dan Hungerford from the University of Liverpool commented: “Inequalities persist even with fewer required vaccination appointments for PCV. We need to look at the wider social determinates of inequalities in child health and structural access factors—like flexible vaccination access points and tailored community outreach—to ensure every child is protected regardless of their background.”

The research, published today in The Lancet Regional Health – Europe, was supported by the NIHR Health Protection Research Unit in Emerging and Zoonotic Infections.

The paper Inequalities in childhood pneumococcal conjugate vaccine uptake in England before and after the change from a 2+1 to 1+1 schedule: a longitudinal study is available here: https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(26)00079-7/fulltext

Research led by the University of Southampton and King’s College London examined the experiences of parents navigating waiting lists for ADHD diagnosis with Child and Adolescent Mental Health Services (CAMHS) in the UK.

NHS data for the end of September 2025 shows that of those children (up to 17 years old) waiting for an assessment with the service, over 63 percent spent more than a year on the list, and a third of these were waiting over two years.

“CAMHS are experiencing  enormous demand to offer timely support to young people. Staff working in these services are under huge pressure, and in-turn, parents and their children, are also suffering – with some concern that long wait times could exacerbate ADHD symptoms,” explains lead author Dr Ellen Hedstrom.

She adds: “Through our study, we wanted to better understand how parents experience the time between their child’s referral, an ADHD assessment, and a diagnostic outcome. Also, what impact this has on them and their child.”

Study findings are published in the journal Health Expectations.

The researchers conducted anonymised interviews with a total of 41 parents of children aged between five and 11 years old. Their wait times ranged between seven months and over two years. Thirty percent of participants fell between an 18 and 24 month wait, and ten percent over two years. About 50 percent of children hadn’t had their initial ADHD assessment at the time of interview.

Strong feedback was given to the research team by parents. Many of felt that:

• Communication about wait time status was either non-existent or unsatisfactory.

• Lengthy wait times negatively impacted the mental health and wellbeing of both themselves and their child.

• Uncertainty led them to feelings of powerlessness, anxiety and being forgotten.

• Finding a crisis care contact was a struggle, or that support they’d accessed was inadequate.

• There’s pressure to get a diagnosis because it can be essential to access support or treatment, for example at school.

Many parents believed there was a disparity between the support they felt they needed and the support they received.

As one parent, Jayne, put it: “It’s hard because there is no support, at the moment, until you get that diagnosis and you’re forever in limbo.”

Another, Jaz, said: “We’ve wasted over 2 years of her education, it is a huge percentage. And in that time, she was just getting further and further behind.”

Others were grappling with whether they should try and find the money to go private, as in the case of Sarah: “We are struggling a bit and it would be nice to know whether we should be trying to save up to get him seen privately, if it’s gonna be years and years, then that’s what we’d do. If it’s gonna be another 6 months, then we’ll wait.”

At the same turn, there was also empathy for health care staff and understanding that clinical services are under enormous strain. Some parents said they wanted to place as few demands as possible on staff, due to this.

Parents’ suggestions for improvement included regular updates of their status on the waiting list, including confirmation of wait times; a digitised system where parents could logon, check any progress, or book appointments; also, the idea of a named key-worker who they could turn to for help and support while waiting. Parents also expressed the need for help with skills and strategies for themselves to manage the behaviour of their children.

Meanwhile, the authors of the study point to a recent successful local authority scheme which piloted a neurodiversity tool – offering early profiling from trained professionals. This gave parents and schools  knowledge for early intervention to help children while they wait for formal diagnosis.

“Many tools and platforms already exist, or could be developed to meet the needs of CAMHS,” concludes Dr Hedstrom. “This would not only give parents more autonomy in the way that they manage their time on a wait list and how they access much-needed information, but also alleviate the burden on mental health services, resulting in a more efficient service.”

1. The paper, ‘Until You Get the Diagnosis You’re Forever in Limbo’—Parents’ Experiences of Waiting for an Attention-Deficit/Hyperactivity Disorder Assessment With Child and Adolescent Mental Health Services, is published in the journal Health Expectations – DOI: 10.1111/hex.70569 and can be read here: https://onlinelibrary.wiley.com/doi/10.1111/hex.70569
2. For interviews contact, Steve Williams, Media Manager, University of Southampton. +44 23 80593 212
3. The University of Southampton drives original thinking, turns knowledge into action and impact, and creates solutions to the world’s challenges. We are among the top 100 institutions globally (QS World University Rankings 2026). Our academics are leaders in their fields, forging links with high-profile international businesses and organisations, and inspiring a 25,000-strong community of exceptional students, from over 135 countries worldwide. Through our high-quality education, the University helps students on a journey of discovery to realise their potential and join our global network of over 300,000 alumni. www.southampton.ac.uk
4. For more about KCL visit: https://www.kcl.ac.uk/

Previous research suggested a potential link between paracetamol use in the first year of life and later eczema, asthma and other diseases.

“Our study found that paracetamol and ibuprofen are incredibly safe to use in young children,” says lead researcher Professor Stuart Dalziel, Cure Kids Chair of Child Health Research at Waipapa Taumata Rau, University of Auckland, and Paediatrician at Starship Children’s Hospital.

Dalziel says paracetamol and ibuprofen are the most common medicines prescribed or bought over the counter for babies worldwide.

“These results give parents and health professionals high confidence to continue to use these important medications.”

Almost 4,000 babies across New Zealand participated from birth, with half randomised to ensure their parents provided paracetamol and half to ensure their parents  provided ibuprofen when the infants required medication for fever or pain relief in the first year of life.

The researchers asked parents at regular intervals whether their children had eczema or asthma symptoms, or bronchiolitis. They also checked prescribing and hospital records.

The results for the first year of data have now been analysed and published in the leading journal The Lancet Child & Adolescent Health.

Eczema affected about 16 percent of babies given paracetamol and 15 percent of those given ibuprofen. Bronchiolitis occurred in about five percent of babies in both groups. These differences were not significant. Serious side effects were rare, and none was caused by the medications.

The study found no association between either medication and eczema or bronchiolitis and confirmed that both drugs were safe to use.

It is the first randomised controlled trial – considered the gold standard for research – to address this question.

This paper is part of a longer project dubbed the ‘Paracetamol and Ibuprofen in the Primary Prevention of Asthma in Tamariki (PIPPA Tamariki) study’.

PIPPA Tamariki is the largest trial ever conducted in children in New Zealand, and participants are being followed from birth to age six.

The researchers will soon publish findings on the same children at age three, and later at age six.

The long-term objective of the study is to test whether there are any links between paracetamol and specific conditions that can only be accurately diagnosed once children reach school age.

“We know that two‑thirds of children who are wheezy at age three years don’t develop asthma by age six,” says Dalziel.

“Thus we need to wait until school age to ultimately test if paracetamol in the first year of life causes asthma.”

Similarly, developmental disorders such as autism and attention deficit hyperactivity disorder (ADHD) are more accurately diagnosed as children get older.

Lead author Dr Eunicia Tan, a senior lecturer at the University of Auckland and emergency physician at Middlemore Hospital, says, “Ultimately, the study will provide important evidence regarding the link between paracetamol use and asthma, eczema, hay fever, and developmental disorders, such as autism and ADHD.”

The study was funded by the Health Research Council of New Zealand and Cure Kids and run by the University of Auckland and the Medical Research Institute of New Zealand, Wellington.