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href="https://web.archive.org/web/20220713235156/https://www.bbc.co.uk/bitesize"><svg class="product-icon" version="1.1" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" x="0px" y="0px" viewbox="0 0 512 512" enable-background="new 0 0 512 512" xml:space="preserve" focusable="false" aria-hidden="true"><g><path fill="#6100A8" d="M134,400H78c-0.552,0-1.052-0.224-1.414-0.586S76,398.552,76,398V162c0-0.552,0.224-1.052,0.586-1.414 S77.448,160,78,160h56c0.552,0,1.052,0.224,1.414,0.586S136,161.448,136,162v236c0,0.552-0.224,1.052-0.586,1.414 S134.552,400,134,400z"></path><path fill="#7222C6" d="M254,400h-92c-0.552,0-1.052-0.224-1.414-0.586S160,398.552,160,398V114c0-0.552,0.224-1.052,0.586-1.414 S161.448,112,162,112h92c0.552,0,1.052,0.224,1.414,0.586S256,113.448,256,114v284c0,0.552-0.224,1.052-0.586,1.414 S254.552,400,254,400z"></path><path fill="#963CE1" d="M444.77,373.863l-85.829,26.232c-0.529,0.162-1.073,0.093-1.526-0.148s-0.812-0.655-0.973-1.184 L273.901,126.63c-0.16-0.528-0.091-1.07,0.149-1.521c0.241-0.451,0.653-0.811,1.18-0.972l85.829-26.232 c0.529-0.162,1.073-0.093,1.526,0.148s0.812,0.655,0.973,1.184l82.542,272.133c0.16,0.528,0.091,1.07-0.149,1.521 C445.71,373.342,445.297,373.702,444.77,373.863z"></path></g></svg><span>Bitesize</span></a></li><li class="orb-nav-cbeebies"><a href="https://web.archive.org/web/20220713235156/https://www.bbc.co.uk/cbeebies"><span>CBeebies</span></a></li><li class="orb-nav-cbbc"><a href="https://web.archive.org/web/20220713235156/https://www.bbc.co.uk/cbbc"><span>CBBC</span></a></li><li class="orb-nav-food"><a href="https://web.archive.org/web/20220713235156/https://www.bbc.co.uk/food"><span>Food</span></a></li></ul></nav><nav class="orbit-header-links international"><ul><li class="orb-nav-homedotcom"><a href="https://web.archive.org/web/20220713235156/https://www.bbc.com/"><span>Home</span></a></li><li class="orb-nav-newsdotcom"><a 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id="orbit-drawer-container" class="orbit-drawer-container"></div><section class="orbit-more-drawer geo orbit-default orbit-language-en b-r b-g-p" id="orbit-more-drawer"><div class="orbit-more-drawer-content"><ul class="more-domestic"><li class="orb-nav-home"><a href="https://web.archive.org/web/20220713235156/https://www.bbc.co.uk/"><span>Home</span></a></li><li class="orb-nav-news"><a href="https://web.archive.org/web/20220713235156/https://www.bbc.co.uk/news"><svg class="product-icon" version="1.1" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" x="0px" y="0px" viewbox="0 0 512 512" enable-background="new 0 0 512 512" xml:space="preserve" focusable="false" aria-hidden="true"><g><path fill="#B80000" d="M302,424h-68c-0.552,0-1.052-0.224-1.414-0.586S232,422.552,232,422V306c0-0.552,0.224-1.052,0.586-1.414 S233.448,304,234,304h68c0.552,0,1.052,0.224,1.414,0.586S304,305.448,304,306v116c0,0.552-0.224,1.052-0.586,1.414 S302.552,424,302,424z"></path><path fill="#EB0000" d="M422,280H234c-0.552,0-1.052-0.224-1.414-0.586S232,278.552,232,278V90c0-0.552,0.224-1.052,0.586-1.414 S233.448,88,234,88h188c0.552,0,1.052,0.224,1.414,0.586S424,89.448,424,90v188c0,0.552-0.224,1.052-0.586,1.414 S422.552,280,422,280z"></path><path fill="#D30000" d="M206,328H90c-0.552,0-1.052-0.224-1.414-0.586S88,326.552,88,326V210c0-0.552,0.224-1.052,0.586-1.414 S89.448,208,90,208h116c0.552,0,1.052,0.224,1.414,0.586S208,209.448,208,210v116c0,0.552-0.224,1.052-0.586,1.414 S206.552,328,206,328z"></path></g></svg><span>News</span></a></li><li class="orb-nav-sport"><a href="https://web.archive.org/web/20220713235156/https://www.bbc.co.uk/sport"><svg class="product-icon" version="1.1" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" x="0px" y="0px" viewbox="0 0 512 512" enable-background="new 0 0 512 512" xml:space="preserve" focusable="false" aria-hidden="true"><g><path fill="#FFD230" d="M90,184h332c0.552,0,1.052-0.224,1.414-0.586S424,182.552,424,182V90c0-0.552-0.224-1.052-0.586-1.414 S422.552,88,422,88H90c-0.552,0-1.052,0.224-1.414,0.586S88,89.448,88,90v92c0,0.552,0.224,1.052,0.586,1.414S89.448,184,90,184z"></path><path fill="#FFA100" d="M306,424h116c0.552,0,1.052-0.224,1.414-0.586S424,422.552,424,422v-92c0-0.552-0.224-1.052-0.586-1.414 S422.552,328,422,328H306c-0.552,0-1.052,0.224-1.414,0.586S304,329.448,304,330v92c0,0.552,0.224,1.052,0.586,1.414 S305.448,424,306,424z"></path><path fill="#FFBA00" d="M210,304h212c0.552,0,1.052-0.224,1.414-0.586S424,302.552,424,302v-92c0-0.552-0.224-1.052-0.586-1.414 S422.552,208,422,208H210c-0.552,0-1.052,0.224-1.414,0.586S208,209.448,208,210v92c0,0.552,0.224,1.052,0.586,1.414 S209.448,304,210,304z"></path></g></svg><span>Sport</span></a></li><li class="orb-nav-weather"><a href="https://web.archive.org/web/20220713235156/https://www.bbc.co.uk/weather"><svg class="product-icon" version="1.1" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" x="0px" y="0px" viewbox="0 0 512 512" enable-background="new 0 0 512 512" xml:space="preserve" focusable="false" aria-hidden="true"><g><path fill="#067EB3" d="M316.234,368.56l52.326-52.326c0.391-0.391,0.586-0.902,0.586-1.414c0-0.512-0.195-1.024-0.586-1.414 L252.594,197.44c-0.391-0.391-0.902-0.586-1.414-0.586s-1.024,0.195-1.414,0.586l-52.326,52.326 c-0.391,0.391-0.586,0.902-0.586,1.414s0.195,1.024,0.586,1.414L313.406,368.56c0.391,0.391,0.902,0.586,1.414,0.586 C315.332,369.146,315.844,368.95,316.234,368.56z"></path><path fill="#1969A6" d="M90,424h74c0.552,0,1.052-0.224,1.414-0.586S166,422.552,166,422V258c0-0.552-0.224-1.052-0.586-1.414 S164.552,256,164,256H90c-0.552,0-1.052,0.224-1.414,0.586S88,257.448,88,258v164c0,0.552,0.224,1.052,0.586,1.414 S89.448,424,90,424z"></path><path fill="#149EDC" d="M258,166h164c0.552,0,1.052-0.224,1.414-0.586S424,164.552,424,164V90c0-0.552-0.224-1.052-0.586-1.414 S422.552,88,422,88H258c-0.552,0-1.052,0.224-1.414,0.586S256,89.448,256,90v74c0,0.552,0.224,1.052,0.586,1.414 S257.448,166,258,166z"></path></g></svg><span>Weather</span></a></li><li class="orb-nav-iplayer"><a href="https://web.archive.org/web/20220713235156/https://www.bbc.co.uk/iplayer"><svg class="product-icon" version="1.1" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" x="0px" y="0px" viewbox="0 0 512 512" enable-background="new 0 0 512 512" xml:space="preserve" focusable="false" aria-hidden="true"><g><path fill="#DC2878" d="M182,358h-68c-0.55,0-1.05-0.225-1.412-0.587C112.225,357.05,112,356.55,112,356V156 c0-0.552,0.224-1.052,0.586-1.414S113.448,154,114,154h68c0.55,0,1.05,0.225,1.413,0.587C183.775,154.95,184,155.45,184,156v200 c0,0.552-0.224,1.052-0.586,1.414S182.552,358,182,358z"></path><path fill="#FF4C98" d="M372.106,248.243l34-58.89c0.275-0.476,0.33-1.022,0.197-1.517c-0.133-0.495-0.453-0.94-0.93-1.215 l-173.205-100c-0.478-0.276-1.023-0.332-1.518-0.2c-0.494,0.132-0.938,0.454-1.214,0.932l-34,58.89 c-0.275,0.476-0.33,1.022-0.197,1.517c0.133,0.495,0.453,0.94,0.93,1.215l173.205,100c0.478,0.276,1.023,0.332,1.518,0.2 C371.386,249.042,371.83,248.721,372.106,248.243z"></path><path fill="#AF0D5B" d="M372.106,263.757l34,58.89c0.275,0.476,0.33,1.022,0.197,1.517c-0.133,0.495-0.453,0.94-0.93,1.215 l-173.205,100c-0.478,0.276-1.023,0.332-1.518,0.2c-0.494-0.132-0.938-0.454-1.214-0.932l-34-58.89 c-0.275-0.476-0.33-1.022-0.197-1.517c0.133-0.495,0.453-0.94,0.93-1.215l173.205-100c0.478-0.276,1.023-0.332,1.518-0.2 C371.386,262.958,371.83,263.279,372.106,263.757z"></path></g></svg><span>iPlayer</span></a></li><li class="orb-nav-sounds"><a href="https://web.archive.org/web/20220713235156/https://www.bbc.co.uk/sounds"><svg class="product-icon" version="1.1" xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" x="0px" y="0px" viewbox="0 0 512 512" enable-background="new 0 0 512 512" xml:space="preserve" focusable="false" aria-hidden="true"><g><path fill="#A13104" d="M122,304H78c-0.552,0-1.052-0.224-1.414-0.586S76,302.552,76,302v-92c0-0.552,0.224-1.052,0.586-1.414 S77.448,208,78,208h44c0.552,0,1.052,0.224,1.414,0.586S124,209.448,124,210v92c0,0.552-0.224,1.052-0.586,1.414 S122.552,304,122,304z"></path><path fill="#D24712" d="M230,376h-80c-0.552,0-1.052-0.224-1.414-0.586S148,374.552,148,374V138c0-0.552,0.224-1.052,0.586-1.414 S149.448,136,150,136h80c0.552,0,1.052,0.224,1.414,0.586S232,137.448,232,138v236c0,0.552-0.224,1.052-0.586,1.414 S230.552,376,230,376z"></path><path fill="#FA6400" d="M422,424H258c-0.552,0-1.052-0.224-1.414-0.586S256,422.552,256,422V90c0-0.552,0.224-1.052,0.586-1.414 S257.448,88,258,88h164c0.552,0,1.052,0.224,1.414,0.586S424,89.448,424,90v332c0,0.552-0.224,1.052-0.586,1.414 S422.552,424,422,424z"></path></g></svg><span>Sounds</span></a></li><li class="orb-nav-bitesize"><a 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href="https://web.archive.org/web/20220713235156/https://www.linkedin.com/shareArticle?mini=true&url=https%3A%2F%2Fwww.bbc.com%2Ffuture%2Farticle%2F20220315-how-eco-anxiety-affects-childrens-minds%3Focid%3Dww.social.link.linkedin&title=How%20can%20we%20help%20kids%20cope%20with%20'eco-anxiety'?" class="linkedin-icon gelicon--linkedin" target="_blank" rel="noopener noreferrer" id=""><span class="screen-reader-only">Share on Linkedin</span><div id="LinkedInIcon"></div></a></div></div><div class="copyright__text b-reith-sans-font">(Image credit: Getty Images)</div><div class="hero-image"><picture><source media="(min-width:1200px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/1600x900/p0c2nf82.webp" type="image/webp"/><source media="(min-width:1200px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/1600x900/p0c2nf82.jpg" type="image/jpeg"/><source media="(min-width:880px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/1280x720/p0c2nf82.webp" type="image/webp"/><source media="(min-width:880px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/1280x720/p0c2nf82.jpg" type="image/jpeg"/><source media="(min-width:576px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/976x549/p0c2nf82.webp" type="image/webp"/><source media="(min-width:576px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/976x549/p0c2nf82.jpg" type="image/jpeg"/><source media="(min-width:224px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/624x351/p0c2nf82.webp" type="image/webp"/><source media="(min-width:224px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/624x351/p0c2nf82.jpg" type="image/jpeg"/><img draggable="false" title="Girl holding "save our earth" sign at climate change protest (Credit: Getty Images)" src="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/976x549/p0c2nf82.jpg" alt="Girl holding "save our earth" sign at climate change protest (Credit: Getty Images)" id=""/></picture></div></div><div class="article__container"><div class="article__main"><div class="article__subcontainer"><article class="article__body"><div class="article__author-unit"><div class="author-unit"><div class="author-unit__container author-unit__container--desktop"><a class="author-unit__text b-font-family-serif" target="" rel="" id="">By Josie Glausiusz</a><span class="b-font-family-serif b-font-weight-300">22nd April 2022</span></div><div class="author-unit__line"><div class="styled-line styled-line--dark-grey styled-line--large"></div></div></div></div><div class="article__body-content"><div class="article__intro b-font-family-serif">More and more children are experiencing "eco-anxiety": a chronic fear of environmental doom. But some are converting their panic into a force for good.</div><div><div class="body-text-card b-reith-sans-font"><div class="drop-capped b-reith-sans-font" style="border-color:#005a5a">S</div><div class="body-text-card__text body-text-card__text--future body-text-card__text--drop-capped body-text-card__text--flush-text"><div><p>Striding onto the streets of Glasgow, 16-year-old Amy O'Brien joined tens of thousands of other marchers last November for a <a href="https://web.archive.org/web/20220713235156/https://cop26coalition.org/gda/">Global Day of Action for Climate Justice</a>. O'Brien is an activist with <a href="https://web.archive.org/web/20220713235156/https://www.fridaysforfuture.ie/">Fridays for Future Ireland</a>, a youth movement that uses school strikes to campaign for climate justice. She had taken the train and ferry from her home town of Mitchelstown in County Cork to Glasgow to attend the 26th UN Climate Change Conference of the Parties (COP26). But while the journey was motivated by her activism, it also had a deeply personal side effect: it gave her hope.</p> <p>O'Brien had spent half her life worrying about the impact of global climate change, to the point of feeling an intense fear over the planet's future – an <a href="https://web.archive.org/web/20220713235156/https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3918955">increasingly common phenomenon among children</a> and teenagers. Now the sight of so many diverse banner-carrying campaigners, of all ages, offered her "a glimmer of the future that is possible".</p> <p>"It was a really colourful scene, and there was music and there were people dancing," O'Brien recalls. "At one point it started lashing with rain, and so you would think it would dampen the scene, but actually there was such a bright, hopeful and exuberant protest. Everyone seemed so happy to be together, showing up for the world we want to see."</p> <p>O'Brien has been acutely aware of the climate crisis since the age of eight, when she first learned in primary school about the impact of <a href="https://web.archive.org/web/20220713235156/https://www.nature.com/articles/s41558-020-0818-9">melting Arctic ice on polar bears</a>.</p> <p>"Even at the start, I was upset for animals and that nature was having to change because of us," she says. "I felt a bit powerless." By age 13 or 14, "fear kicked in" as she witnessed <a href="https://web.archive.org/web/20220713235156/https://www.corkbeo.ie/news/local-news/cop26-areas-cork-could-underwater-22044750">increased flooding of Cork's River Lee</a>, and learned how extreme weather was displacing people in countries <a href="https://web.archive.org/web/20220713235156/https://www.aljazeera.com/economy/2021/5/25/bbin-2020-more-people-displaced-by-extreme-climate-than-conflict#:~:text=Densely%20populated%20countries%20like%20China,Atlantic%20hurricane%20season%20on%20record.">like India and the Philippines</a>. "Their lives are torn apart, and these are the same people who contributed the least to this crisis," O'Brien says. "I started to feel fear and hurt for what they were already going through."</p> <p>The intense feeling that O'Brien experiences in the midst of the climate crisis, has a name: eco-anxiety, defined by the American Psychological Association as "<a href="https://web.archive.org/web/20220713235156/https://www.apa.org/news/press/releases/2017/03/mental-health-climate.pdf">a chronic fear of environmental doom</a>".</p> <p>Eco-anxiety can be caused by the stressful and frightening experience of "watching the slow and seemingly irrevocable impacts of climate change unfold, and worrying about the future for oneself, children and later generations", according to a report published by the association and two other organisations, Climate for Health and Eco-America. It may come with "feelings of loss, helplessness, and frustration", and guilt, as the sufferers feel they are unable to stop climate change.</p></div></div></div></div><div class="article-body__image-text article-body__image-text--landscape"><div id="future/article/20220315-how-eco-anxiety-affects-childrens-minds-p0bvgzfc"><div><picture><source media="(min-width:1200px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/1600x900/p0bvgzfc.webp" type="image/webp"/><source media="(min-width:1200px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/1600x900/p0bvgzfc.jpg" type="image/jpeg"/><source media="(min-width:880px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/1280x720/p0bvgzfc.webp" type="image/webp"/><source media="(min-width:880px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/1280x720/p0bvgzfc.jpg" type="image/jpeg"/><source media="(min-width:576px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/976x549/p0bvgzfc.webp" type="image/webp"/><source media="(min-width:576px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/976x549/p0bvgzfc.jpg" type="image/jpeg"/><source media="(min-width:224px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/624x351/p0bvgzfc.webp" type="image/webp"/><source media="(min-width:224px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/624x351/p0bvgzfc.jpg" type="image/jpeg"/><img draggable="false" title="A protester in Buenos Aires, Argentina, shows a message on her hand saying "our future" (Credit: Muhammed Emin Canik/Anadolu Agency/Getty Images)" src="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/976x549/p0bvgzfc.jpg" alt="A protester in Buenos Aires, Argentina, shows a message on her hand saying "our future" (Credit: Muhammed Emin Canik/Anadolu Agency/Getty Images)" id=""/></picture><div class="inline-image__description b-reith-sans-font inline-image__description--desktop"><div class="text-summary"><p class="text-summary__text text-summary__text--grey text-summary__text--left">A protester in Buenos Aires, Argentina, shows a message on her hand saying "our future" (Credit: Muhammed Emin Canik/Anadolu Agency/Getty Images)</p></div></div></div></div></div><div><div class="body-text-card b-reith-sans-font"><div class="body-text-card__text body-text-card__text--future body-text-card__text--flush-text"><div><p>As a broader form of environmental fear, eco-anxiety isn't exactly new – in the 19th century, the Victorians worried about <a href="https://web.archive.org/web/20220713235156/https://theconversation.com/air-pollution-in-victorian-era-britain-its-effects-on-health-now-revealed-87208">growth-stunting, lung-choking black smoke from coal-burning in the UK</a>. But as human activity <a href="https://web.archive.org/web/20220713235156/https://www.carbonbrief.org/mapped-how-climate-change-affects-extreme-weather-around-the-world">increases the risk of </a><a href="https://web.archive.org/web/20220713235156/https://www.carbonbrief.org/mapped-how-climate-change-affects-extreme-weather-around-the-world">extreme weather</a>, including heatwaves, droughts and flooding, and as the United Nations warns of a "<a href="https://web.archive.org/web/20220713235156/https://www.bbc.com/news/science-environment-58130705">code red for humanity</a>", surveys show that kids are suffering from climate anxiety at <a href="https://web.archive.org/web/20220713235156/https://www.theguardian.com/society/2020/nov/20/half-of-child-psychiatrists-surveyed-say-patients-have-environment-anxiety">even higher rates than adults</a> – including feelings of worry, fear, anger, grief, despair, guilt and shame. These often <a href="https://web.archive.org/web/20220713235156/https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3918955">fluctuating moods and feelings</a> can include positive sensations as well, such as hope.</p> <p>"Children are infinitely more informed than their parents think, a lot of the time," says Caroline Hickman, a psychotherapist at the University of Bath in the UK. She led a 2021 <a href="https://web.archive.org/web/20220713235156/https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3918955">global online survey</a> of climate anxiety in 10,000 teenagers and young adults aged 16-25 in 10 countries, including the UK, US, Brazil, India and the Philippines.</p> <p>Close to 60% of the young people who responded to the survey said that they felt "very" or "extremely" worried about climate change while 75% said that "the future is frightening", 56% believe that "humanity is doomed" and 39% were hesitant to have children. Fifty-eight percent of respondents felt that governments were betraying them or future generations.</p></div></div></div></div><div class="article-body__pull-quote"><blockquote class="inline-quote b-font-family-serif b-font-weight-300" style="border-left:3px solid #005a5a"><h2 class="simple-header b-reith-sans-font b-font-family-serif b-font-weight-300 simple-header--serif-light-italic simple-p-tag--medium simple-p-tag--quote">Parents instinctively want to protect their kids from painful, scary, traumatic stuff</h2></blockquote></div><div><div class="body-text-card b-reith-sans-font"><div class="body-text-card__text body-text-card__text--future body-text-card__text--flush-text"><div><p>Offering children honest answers to their questions about climate catastrophe isn't always easy, though. Parents instinctively want to protect their kids from "painful, scary, traumatic stuff", Hickman says. But although climate anxiety is distressing, it's also rational, she and her co-authors contend. So when a 10-year-old child asks, "is it true that in 100 years the Earth will be burned to a crisp?" it's "not pure fantasy", Hickman says. "It's not, 'Mummy, can sharks fly?' The question is grounded in reality."</p> <p>If a child asks questions about climate change, first find out what they have learned about the topic, Hickman advises, including whether they are reading scaremongering stories online. Then, "tell her it's a brilliant question", she says, and add: "I want you to feel proud of those feelings. Because you only feel that anxiety or worry because you care about the planet."</p></div></div></div></div><div class="article-body__image-text article-body__image-text--landscape"><div id="future/article/20220315-how-eco-anxiety-affects-childrens-minds-p0bvh15y"><div><picture><source media="(min-width:1200px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/1600x900/p0bvh15y.webp" type="image/webp"/><source media="(min-width:1200px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/1600x900/p0bvh15y.jpg" type="image/jpeg"/><source media="(min-width:880px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/1280x720/p0bvh15y.webp" type="image/webp"/><source media="(min-width:880px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/1280x720/p0bvh15y.jpg" type="image/jpeg"/><source media="(min-width:576px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/976x549/p0bvh15y.webp" type="image/webp"/><source media="(min-width:576px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/976x549/p0bvh15y.jpg" type="image/jpeg"/><source media="(min-width:224px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/624x351/p0bvh15y.webp" type="image/webp"/><source media="(min-width:224px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/624x351/p0bvh15y.jpg" type="image/jpeg"/><img draggable="false" title="School children demonstrate in Jakarta, Indonesia. Fear of climate change has united young people all over the world (Credit: Ed Wray/Getty Images)" src="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/976x549/p0bvh15y.jpg" alt="School children demonstrate in Jakarta, Indonesia. Fear of climate change has united young people all over the world (Credit: Ed Wray/Getty Images)" id=""/></picture><div class="inline-image__description b-reith-sans-font inline-image__description--desktop"><div class="text-summary"><p class="text-summary__text text-summary__text--grey text-summary__text--left">School children demonstrate in Jakarta, Indonesia. Fear of climate change has united young people all over the world (Credit: Ed Wray/Getty Images)</p></div></div></div></div></div><div><div class="body-text-card b-reith-sans-font"><div class="body-text-card__text body-text-card__text--future body-text-card__text--flush-text"><div><p>Hickman enthusiastically endorses "lots of conversations" with kids around climate change. But parents also need to calibrate their responses to children at different ages, advises climate educator Harriet Shugarman, executive director of Climate Mama, an advocacy organisation for parents.</p> <p>In her book <a href="https://web.archive.org/web/20220713235156/https://www.climatemama.com/author-page">How to Talk to Your Kids About Climate Change</a>: Turning Angst into Action, Shugarman offers advice to parents of kids from nursery school age to late-teen years on how they can mitigate anxiety and take action on climate change.</p> <p>"When kids are coming to you with questions directly, we have to tell the truth, whatever age they're at," she says. But we should also strengthen their own sense of agency. "Kids do have power, and we want to try to work to build that up at each age," she advises.</p> <p>With very young children, the first step is to create "a sense of wonder in nature" – watching ants in the grass on outings to city parks, or sharing stories and songs. Include your five-to-six-year-old kids in climate marches, take photos of the protests, and have kids send their own drawings or letters to local officials, she suggests.</p> <p>By the time kids reach the ages of 10-13 years old, they are probably learning about climate change in school. Encourage them to discuss climate change with teachers, neighbours and family, Shugarman says. Also, "we can remind them that there are so many scientists, businesspeople, organisations, elected officials, working on the climate crisis all over the world."</p> <p>By ages 14-16 years old, teenagers are approaching the age at which they'll be able to vote. "Their elected officials are interested in what they have to say because they are future voters," Shugarman says. Political engagement for older teens is crucial. "So many young people seem so disillusioned, rightly so, perhaps, with our democracies. But they are very fragile and we need them to be participatory." </p></div></div></div></div><div class="article-body__image-text article-body__image-text--landscape"><div id="future/article/20220315-how-eco-anxiety-affects-childrens-minds-p0bvh1z8"><div><picture><source media="(min-width:1200px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/1600x900/p0bvh1z8.webp" type="image/webp"/><source media="(min-width:1200px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/1600x900/p0bvh1z8.jpg" type="image/jpeg"/><source media="(min-width:880px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/1280x720/p0bvh1z8.webp" type="image/webp"/><source media="(min-width:880px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/1280x720/p0bvh1z8.jpg" type="image/jpeg"/><source media="(min-width:576px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/976x549/p0bvh1z8.webp" type="image/webp"/><source media="(min-width:576px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/976x549/p0bvh1z8.jpg" type="image/jpeg"/><source media="(min-width:224px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/624x351/p0bvh1z8.webp" type="image/webp"/><source media="(min-width:224px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/624x351/p0bvh1z8.jpg" type="image/jpeg"/><img draggable="false" title="Young activists in Durban, South Africa. Africa is vulnerable to climate change, yet contributes only 3.8% to global emissions (Credit: Darren Stewart/Gallo Images/Getty Images)" src="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/976x549/p0bvh1z8.jpg" alt="Young activists in Durban, South Africa. Africa is vulnerable to climate change, yet contributes only 3.8% to global emissions (Credit: Darren Stewart/Gallo Images/Getty Images)" id=""/></picture><div class="inline-image__description b-reith-sans-font inline-image__description--desktop"><div class="text-summary"><p class="text-summary__text text-summary__text--grey text-summary__text--left">Young activists in Durban, South Africa. Africa is vulnerable to climate change, yet contributes only 3.8% to global emissions (Credit: Darren Stewart/Gallo Images/Getty Images)</p></div></div></div></div></div><div><div class="body-text-card b-reith-sans-font"><div class="body-text-card__text body-text-card__text--future body-text-card__text--flush-text"><div><p>Action and participation may also help temper one of the societal risks of eco-anxiety: as well-founded as the fear of the environmental crisis may be, when taken too far, it could actually hinder positive change.</p> <p>Ilan Kelman, professor of disasters and health at University College London Institute for Risk and Disaster Reduction in the UK, fears that eco-anxiety in young people may be feeding a state of "<a href="https://web.archive.org/web/20220713235156/https://www.urmc.rochester.edu/behavioral-health-partners/bhp-blog/march-2020/coping-with-climate-change-anxiety.aspx#:~:text=%22Eco%2Dparalysis%22%20refers%20to,(e.g.%20denial)%20become%20activated.">eco-paralysis</a>" where they feel unable to take action because their emotional distress is overwhelming.</p></div></div></div></div><div class="article-body__pull-quote"><blockquote class="inline-quote b-font-family-serif b-font-weight-300" style="border-left:3px solid #005a5a"><h2 class="simple-header b-reith-sans-font b-font-family-serif b-font-weight-300 simple-header--serif-light-italic simple-p-tag--medium simple-p-tag--quote">We should also be incredibly inspired by how far humanity has come – Ilan Kelman</h2></blockquote></div><div><div class="body-text-card b-reith-sans-font"><div class="body-text-card__text body-text-card__text--future body-text-card__text--flush-text"><div><p>"There's no claim whatsoever that it's all good news," Kelman says of the state of the planet. The increase in heat and humidity will lead to very high mortality, he stresses, and "a lot of people are going to have no option but to be forced to move or to die". Furthermore, "if the Antarctica and Greenland ice sheets go, then that is extremely concerning. We're looking at a major reconfiguration of the world's shore lines."</p> <p>Even so, "the doomsday scenarios, the calamity, the utter destruction: I cannot find any scientific support for that," Kelman says. "Even in the worst case scenarios, 'Earth burnt to a crisp' is not a feasible outcome," he notes. "I've yet to find a scenario which within the next hundred years, or in fact the next thousand or ten thousand years, a scenario in which humans become extinct because of climate change."</p> <p>"We should also be incredibly inspired by how far humanity has come," Kelman emphasises. He advises climate-anxious youngsters to "focus on the science, and balance the real worries with all the wonderful inspiration, wisdom and success which humanity has shown over decades and centuries".</p> <p>He includes among these successes the <a href="https://web.archive.org/web/20220713235156/https://www.business-standard.com/article/markets/investors-in-fossil-fuels-announce-plans-to-divest-39-2-trillion-121102600666_1.html#:~:text=About%201%2C500%20investment%20institutions%20overseeing,report%20issued%20Tuesday%20by%20DivestInvest.">divestment </a>by pension funds and foundations in fossil fuels, localised energy systems such as small wind turbines or solar roof panels,<a href="https://web.archive.org/web/20220713235156/https://farmingbase.com/what-is-guerilla-gardening-and-what-are-seed-bombs/"> guerilla gardening</a> in neglected spaces, <a href="https://web.archive.org/web/20220713235156/https://www.cseindia.org/rainwater-harvesting-1272">rainwater harvesting</a>, accessible science on the internet, as well as broader social progress that has improved the lives of many, such as laws outlawing discrimination and oppression and granting people equal rights.</p> <p>Kelman notes that action on climate isn't limited to public protests. Young people can consider a career in journalism, science and technology, medicine and health, or standing for political office. "A lot of youth activists have been amazing in taking governments to court," he says, referring to the <a href="https://web.archive.org/web/20220713235156/https://www.bbc.com/future/article/20211207-the-legal-battle-against-climate-change">increasing number of campaigners suing governments and companies to take action against climate change</a>. "That has been inspirational, that has been successful. Put your energies into the legal system, to end fossil fuel subsidies, to make governments legally adhere to the pledges that they're making."</p></div></div></div></div><div class="article-body__image-text article-body__image-text--landscape"><div id="future/article/20220315-how-eco-anxiety-affects-childrens-minds-p0bvh3pk"><div><picture><source media="(min-width:1200px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/1600x900/p0bvh3pk.webp" type="image/webp"/><source media="(min-width:1200px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/1600x900/p0bvh3pk.jpg" type="image/jpeg"/><source media="(min-width:880px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/1280x720/p0bvh3pk.webp" type="image/webp"/><source media="(min-width:880px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/1280x720/p0bvh3pk.jpg" type="image/jpeg"/><source media="(min-width:576px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/976x549/p0bvh3pk.webp" type="image/webp"/><source media="(min-width:576px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/976x549/p0bvh3pk.jpg" type="image/jpeg"/><source media="(min-width:224px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/624x351/p0bvh3pk.webp" type="image/webp"/><source media="(min-width:224px)" srcset="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/624x351/p0bvh3pk.jpg" type="image/jpeg"/><img draggable="false" title="Many young people find hope in campaigning, like these children at a climate march in Amsterdam (Credit: Ana Fernandez/SOPA Images/LightRocket/Getty Images)" src="https://web.archive.org/web/20220713235156im_/https://ychef.files.bbci.co.uk/976x549/p0bvh3pk.jpg" alt="Many young people find hope in campaigning, like these children at a climate march in Amsterdam (Credit: Ana Fernandez/SOPA Images/LightRocket/Getty Images)" id=""/></picture><div class="inline-image__description b-reith-sans-font inline-image__description--desktop"><div class="text-summary"><p class="text-summary__text text-summary__text--grey text-summary__text--left">Many young people find hope in campaigning, like these children at a climate march in Amsterdam (Credit: Ana Fernandez/SOPA Images/LightRocket/Getty Images)</p></div></div></div></div></div><div><div class="article-body__callout-box"><div class="callout-box-card" style="width:342px"><div class="callout-box-card__container"><h3>Family Tree</h3><h4></h4><div class="body"><div><p>This article is part of <a href="https://web.archive.org/web/20220713235156/https://www.bbc.com/future/family-tree"><strong>Family Tree</strong></a>, a series of features from the BBC that explore the issues and opportunities that parents, children and families face all over the world. You might also be interested in some other stories about children, teenagers and the environment:</p> <p><a>Asia's new love of forest schools</a></p> <p><a href="https://web.archive.org/web/20220713235156/https://www.bbc.com/future/article/20211206-how-climate-change-has-altered-christmas">How climate change altered Christmas</a></p> <p><a href="https://web.archive.org/web/20220713235156/https://www.bbc.com/future/article/20220105-the-arctic-parenting-style-that-fosters-resilience">How Arctic kids learn resilience</a></p> <p>You can also climb new branches of the Family Tree on <a href="https://web.archive.org/web/20220713235156/https://www.bbc.com/worklife/family-tree"><strong>BBC Worklife</strong></a>.</p></div></div></div></div></div></div><div><div class="body-text-card b-reith-sans-font"><div class="body-text-card__text body-text-card__text--future body-text-card__text--flush-text"><div><p>Many of the young people campaigning against climate change are driven as much by anger as anxiety, Hickman says.</p> <p>"I started research with children and young people around climate change 10 years ago – children as young as five, up to mid-20s, in the Maldives, Nigeria, Bangladesh, Brazil, France, the UK and America," she says. "What I started hearing over and over again from children, was, 'it's not the environmental problems that are frightening me; yes, they are upsetting; what really frightens me is government failure to act on this'."</p> <p>That anger at government inertia is familiar for <a href="https://web.archive.org/web/20220713235156/https://www.linkedin.com/in/rosekobusinge/?originalSubdomain=uk">Rose Kobusinge</a>, a 26-year-old climate justice activist and PhD student at the University of Coventry in the UK. Born in Western Uganda, Kobusinge says her "real understanding" of climate change came in her early-20s. She was motivated to act when she saw how droughts in her home in the Kabarole and Ntoroko districts of Uganda were drying crops and killing livestock, and <a href="https://web.archive.org/web/20220713235156/https://www.bbc.com/news/world-africa-56526631">receding glaciers</a> in the <a href="https://web.archive.org/web/20220713235156/https://whc.unesco.org/en/list/684/">Rwenzori mountains</a> were triggering "massive floods and landslides in Kasese and Bundibugyo in Western Uganda, my closest neighbouring districts".</p> <p>The African continent is vulnerable to climate change, she notes, yet its contribution to global greenhouse gas emissions is the smallest – j<a href="https://web.archive.org/web/20220713235156/https://www.cdp.net/en/research/global-reports/africa-report">ust 3.8%</a> of the total.</p> <p>"Children and young people, we are taking climate change as a real threat, because we know it's the future of the children that is at stake," Kobusinge says. At COP26, which she attended, she saw how world leaders <a href="https://web.archive.org/web/20220713235156/https://www.euronews.com/green/2022/02/17/vanessa-nakate-african-and-eu-leaders-are-already-breaking-cop26-promises">made big promises</a>, yet <a href="https://web.archive.org/web/20220713235156/https://www.unep.org/news-and-stories/story/cop26-ends-agreement-falls-short-climate-action">fell short on action</a>.</p> <p>"I feel that there is limited time," Kobusinge says. "Our global leaders are supposed to care about the most vulnerable, to care about the poor, to care about the children and the youth, [but] are not doing what they should be doing. It makes me feel uncertain about the future." Even so, "when I look at young people, civil societies and indigenous communities coming together to ask for climate justice, that gives me a little bit of hope", she says. She encourages activists to support one another and create safe spaces, online or in-person, to share feelings.</p> <p>Using your anxiety positively "is like a blessing in disguise", she says, because it can prompt action and motivation.</p> <p>That's advice that Amy O'Brien has taken to heart. Using Telegram and Zoom, she connects with MAPA activists (<a href="https://web.archive.org/web/20220713235156/https://fridaysforfuture.org/newsletter/edition-no-1-what-is-mapa-and-why-should-we-pay-attention-to-it/">Most Affected People and Areas</a>, or communities in Africa, Latin America, and the Pacific Islands, that suffer most from the effects of climate change). Together with five other young activists, she hosts the late-night <a href="https://web.archive.org/web/20220713235156/https://anchor.fm/sustainablesleepoverclub">Sustainable Sleepover Club</a> podcast, where participants talk about "anything and everything", including "movies and chocolates, climate justice, gender equality and trans rights." To "educate and empower", she writes for the Fridays for Future international newsletter, as well as her local newspaper.</p> <p>"Through activism, I've met so many other activists who really care about the climate crisis," O'Brien says, and that gives her hope: "Hope is also now my driving force, like a little light pushing me to act."</p> <p>Seeing the numbers of diverse protesters on the coalition day of action at COP26, "really emphasised to me that I'm not alone; there are so many people who care about this, and we will win, because we're fighting together," she says. "We were dancing to protests, we laughed when it rained, a rainbow started shining… and it was just really beautiful. From the whole experience, I learned about the power of my voice as well."</p> <p><em>--</em></p> <p><em>Join one million Future fans by liking us on </em><a href="https://web.archive.org/web/20220713235156/https://www.facebook.com/BBCFuture/"><strong><em>Facebook</em></strong></a><em>, or follow us on </em><a href="https://web.archive.org/web/20220713235156/https://twitter.com/BBC_Future"><strong><em>Twitter</em></strong></a><em> or </em><a href="https://web.archive.org/web/20220713235156/https://www.instagram.com/bbcfuture_official/"><strong><em>Instagram</em></strong></a><em>.</em></p> <p><em>If you liked this story, </em><a href="https://web.archive.org/web/20220713235156/http://pages.emails.bbc.com/subscribe/?ocid=fut.bbc.email.we.email-signup"><strong><em>sign up for the weekly bbc.com features newsletter</em></strong></a><em>, called "The Essential List" – a handpicked selection of stories from BBC </em><a 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night","creationDateTime":"0001-01-01T00:00:00Z","entity":"image","guid":"","id":"p0by4c4d","modifiedDateTime":"0001-01-01T00:00:00Z","project":"","slug":"","url":"https:\u002F\u002Fweb.archive.org\u002Fweb\u002F20220713235156\u002Fhttps:\u002F\u002Fychef.files.bbci.co.uk\u002F$recipe\u002Fp0by4c4d.jpg","cacheLastUpdated":1657756319031},"p0by4cjv":{"urn":"urn:external:nitro:image:p0by4cjv","_id":"62b41f131f4b7b1a3f008504","copyright":"Getty Images","fileSizeBytes":0,"mimeType":"image\u002Fjpeg","sourceHeight":1080,"sourceUrl":"https:\u002F\u002Fweb.archive.org\u002Fweb\u002F20220713235156\u002Fhttps:\u002F\u002Fs3-eu-west-1.amazonaws.com\u002Flive-galileo-interface-mt-resources-imagebucket-1a92e5tj3b5d6\u002Fp0\u002Fby\u002F4c\u002Fp0by4cjv.jpg","sourceWidth":1920,"synopsisLong":"","synopsisMedium":"While some books suggest a form of controlled crying even for newborns, most sleep researchers caution against it (Credit: Getty Images)","synopsisShort":"A newborn baby cries alone in a cot","templateUrl":"https:\u002F\u002Fweb.archive.org\u002Fweb\u002F20220713235156\u002Fhttps:\u002F\u002Fychef.files.bbci.co.uk\u002F$recipe\u002Fp0by4cjv.jpg","title":"While some books suggest a form of controlled crying for newborns, most sleep researchers caution against it","creationDateTime":"0001-01-01T00:00:00Z","entity":"image","guid":"","id":"p0by4cjv","modifiedDateTime":"0001-01-01T00:00:00Z","project":"","slug":"","url":"https:\u002F\u002Fweb.archive.org\u002Fweb\u002F20220713235156\u002Fhttps:\u002F\u002Fychef.files.bbci.co.uk\u002F$recipe\u002Fp0by4cjv.jpg","cacheLastUpdated":1657756319031},"p0by4f0v":{"urn":"urn:external:nitro:image:p0by4f0v","_id":"62b41f031f4b7b393765d807","copyright":"Getty 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crying","creationDateTime":"0001-01-01T00:00:00Z","entity":"image","guid":"","id":"p0by4f0v","modifiedDateTime":"0001-01-01T00:00:00Z","project":"","slug":"","url":"https:\u002F\u002Fweb.archive.org\u002Fweb\u002F20220713235156\u002Fhttps:\u002F\u002Fychef.files.bbci.co.uk\u002F$recipe\u002Fp0by4f0v.jpg","cacheLastUpdated":1657756319031},"p0by4lhv":{"urn":"urn:external:nitro:image:p0by4lhv","_id":"62b41eef1f4b7b110a3fbbaf","copyright":"Getty Images","fileSizeBytes":0,"mimeType":"image\u002Fjpeg","sourceHeight":1080,"sourceUrl":"https:\u002F\u002Fweb.archive.org\u002Fweb\u002F20220713235156\u002Fhttps:\u002F\u002Fs3-eu-west-1.amazonaws.com\u002Flive-galileo-interface-mt-resources-imagebucket-1a92e5tj3b5d6\u002Fp0\u002Fby\u002F4l\u002Fp0by4lhv.jpg","sourceWidth":1920,"synopsisLong":"","synopsisMedium":"Frequent wakes may be tough on parents, but they play an important role in keeping babies safe and healthy (Credit: Getty Images)","synopsisShort":"A young baby looks at the camera with his eyes wide open","templateUrl":"https:\u002F\u002Fweb.archive.org\u002Fweb\u002F20220713235156\u002Fhttps:\u002F\u002Fychef.files.bbci.co.uk\u002F$recipe\u002Fp0by4lhv.jpg","title":"Frequent wakes may be tough on parents","creationDateTime":"0001-01-01T00:00:00Z","entity":"image","guid":"","id":"p0by4lhv","modifiedDateTime":"0001-01-01T00:00:00Z","project":"","slug":"","url":"https:\u002F\u002Fweb.archive.org\u002Fweb\u002F20220713235156\u002Fhttps:\u002F\u002Fychef.files.bbci.co.uk\u002F$recipe\u002Fp0by4lhv.jpg","cacheLastUpdated":1657756319031},"p0by4gn9":{"urn":"urn:external:nitro:image:p0by4gn9","_id":"62b41eff1f4b7b1ce400a0d9","copyright":"Getty Images","fileSizeBytes":0,"mimeType":"image\u002Fjpeg","sourceHeight":1080,"sourceUrl":"https:\u002F\u002Fweb.archive.org\u002Fweb\u002F20220713235156\u002Fhttps:\u002F\u002Fs3-eu-west-1.amazonaws.com\u002Flive-galileo-interface-mt-resources-imagebucket-1a92e5tj3b5d6\u002Fp0\u002Fby\u002F4g\u002Fp0by4gn9.jpg","sourceWidth":1920,"synopsisLong":"","synopsisMedium":"Throughout infancy and toddlerhood, the brain relies on \"co-regulation\" – the aid of a soothing caregiver – to calm down (Credit: Getty Images)","synopsisShort":"An adult with a tattooed arm puts their arms around a baby crying in a cot","templateUrl":"https:\u002F\u002Fweb.archive.org\u002Fweb\u002F20220713235156\u002Fhttps:\u002F\u002Fychef.files.bbci.co.uk\u002F$recipe\u002Fp0by4gn9.jpg","title":"Throughout infancy and toddlerhood, the brain relies on \"co-regulation\"","creationDateTime":"0001-01-01T00:00:00Z","entity":"image","guid":"","id":"p0by4gn9","modifiedDateTime":"0001-01-01T00:00:00Z","project":"","slug":"","url":"https:\u002F\u002Fweb.archive.org\u002Fweb\u002F20220713235156\u002Fhttps:\u002F\u002Fychef.files.bbci.co.uk\u002F$recipe\u002Fp0by4gn9.jpg","cacheLastUpdated":1657756319031},"p0by4h2v":{"urn":"urn:external:nitro:image:p0by4h2v","_id":"62b41eed1f4b7b11001f2871","copyright":"Getty Images","fileSizeBytes":0,"mimeType":"image\u002Fjpeg","sourceHeight":1080,"sourceUrl":"https:\u002F\u002Fweb.archive.org\u002Fweb\u002F20220713235156\u002Fhttps:\u002F\u002Fs3-eu-west-1.amazonaws.com\u002Flive-galileo-interface-mt-resources-imagebucket-1a92e5tj3b5d6\u002Fp0\u002Fby\u002F4h\u002Fp0by4h2v.jpg","sourceWidth":1920,"synopsisLong":"","synopsisMedium":"Warm, responsive caregiving has been associated with a range of benefits for babies and children, including more secure attachment (Credit: Getty Images)","synopsisShort":"A father holds his newborn baby in his arms and smiles into his eyes","templateUrl":"https:\u002F\u002Fweb.archive.org\u002Fweb\u002F20220713235156\u002Fhttps:\u002F\u002Fychef.files.bbci.co.uk\u002F$recipe\u002Fp0by4h2v.jpg","title":"Warm, responsive caregiving has been associated with a range of benefits for babies and children","creationDateTime":"0001-01-01T00:00:00Z","entity":"image","guid":"","id":"p0by4h2v","modifiedDateTime":"0001-01-01T00:00:00Z","project":"","slug":"","url":"https:\u002F\u002Fweb.archive.org\u002Fweb\u002F20220713235156\u002Fhttps:\u002F\u002Fychef.files.bbci.co.uk\u002F$recipe\u002Fp0by4h2v.jpg","cacheLastUpdated":1657756319031},"p0by4hhw":{"urn":"urn:external:nitro:image:p0by4hhw","_id":"62b41eed1f4b7b037f503033","copyright":"Getty Images","fileSizeBytes":0,"mimeType":"image\u002Fjpeg","sourceHeight":1080,"sourceUrl":"https:\u002F\u002Fweb.archive.org\u002Fweb\u002F20220713235156\u002Fhttps:\u002F\u002Fs3-eu-west-1.amazonaws.com\u002Flive-galileo-interface-mt-resources-imagebucket-1a92e5tj3b5d6\u002Fp0\u002Fby\u002F4h\u002Fp0by4hhw.jpg","sourceWidth":1920,"synopsisLong":"","synopsisMedium":"A baby's personality plays a part in whether they put themselves to sleep independently, or need a caregiver's help and reassurance (Credit: Getty Images)","synopsisShort":"A young baby lies in a cot with a parent looking over","templateUrl":"https:\u002F\u002Fweb.archive.org\u002Fweb\u002F20220713235156\u002Fhttps:\u002F\u002Fychef.files.bbci.co.uk\u002F$recipe\u002Fp0by4hhw.jpg","title":"A baby's personality plays a part in whether they put themselves to sleep independently","creationDateTime":"0001-01-01T00:00:00Z","entity":"image","guid":"","id":"p0by4hhw","modifiedDateTime":"0001-01-01T00:00:00Z","project":"","slug":"","url":"https:\u002F\u002Fweb.archive.org\u002Fweb\u002F20220713235156\u002Fhttps:\u002F\u002Fychef.files.bbci.co.uk\u002F$recipe\u002Fp0by4hhw.jpg","cacheLastUpdated":1657756319031},"p0by4j9q":{"urn":"urn:external:nitro:image:p0by4j9q","_id":"62b41eef1f4b7b06274b0898","copyright":"Kathryn O'Donnell","fileSizeBytes":0,"mimeType":"image\u002Fjpeg","sourceHeight":1080,"sourceUrl":"https:\u002F\u002Fweb.archive.org\u002Fweb\u002F20220713235156\u002Fhttps:\u002F\u002Fs3-eu-west-1.amazonaws.com\u002Flive-galileo-interface-mt-resources-imagebucket-1a92e5tj3b5d6\u002Fp0\u002Fby\u002F4j\u002Fp0by4j9q.jpg","sourceWidth":1920,"synopsisLong":"","synopsisMedium":"Some experts suggest bedsharing, or cosleeping, to low-risk families (Credit: Kathryn O'Donnell)","synopsisShort":"A woman lies in the protective C-curl position with her newborn next to her","templateUrl":"https:\u002F\u002Fweb.archive.org\u002Fweb\u002F20220713235156\u002Fhttps:\u002F\u002Fychef.files.bbci.co.uk\u002F$recipe\u002Fp0by4j9q.jpg","title":"Some experts suggest bedsharing, or cosleeping, to low-risk families","creationDateTime":"0001-01-01T00:00:00Z","entity":"image","guid":"","id":"p0by4j9q","modifiedDateTime":"0001-01-01T00:00:00Z","project":"","slug":"","url":"https:\u002F\u002Fweb.archive.org\u002Fweb\u002F20220713235156\u002Fhttps:\u002F\u002Fychef.files.bbci.co.uk\u002F$recipe\u002Fp0by4j9q.jpg","cacheLastUpdated":1657756319031},"p0by4jnm":{"urn":"urn:external:nitro:image:p0by4jnm","_id":"62b41eef1f4b7b037f503034","copyright":"Alamy","fileSizeBytes":0,"mimeType":"image\u002Fjpeg","sourceHeight":1080,"sourceUrl":"https:\u002F\u002Fweb.archive.org\u002Fweb\u002F20220713235156\u002Fhttps:\u002F\u002Fs3-eu-west-1.amazonaws.com\u002Flive-galileo-interface-mt-resources-imagebucket-1a92e5tj3b5d6\u002Fp0\u002Fby\u002F4j\u002Fp0by4jnm.jpg","sourceWidth":1920,"synopsisLong":"","synopsisMedium":"(Credit: Alamy)","synopsisShort":"A baby sleeping soundly","templateUrl":"https:\u002F\u002Fweb.archive.org\u002Fweb\u002F20220713235156\u002Fhttps:\u002F\u002Fychef.files.bbci.co.uk\u002F$recipe\u002Fp0by4jnm.jpg","title":"A baby sleeping soundly","creationDateTime":"0001-01-01T00:00:00Z","entity":"image","guid":"","id":"p0by4jnm","modifiedDateTime":"0001-01-01T00:00:00Z","project":"","slug":"","url":"https:\u002F\u002Fweb.archive.org\u002Fweb\u002F20220713235156\u002Fhttps:\u002F\u002Fychef.files.bbci.co.uk\u002F$recipe\u002Fp0by4jnm.jpg","cacheLastUpdated":1657756319031}},"articles":{"future\u002Farticle\u002F20211011-covid-19-should-we-vaccinate-children":{"urn":"urn:pubpipe:wwverticals:article:future\u002Farticle\u002F20211011-covid-19-should-we-vaccinate-children","_id":"62b41ff51f4b7b6e9616e9a8","ambientVideo":"","articleType":"story","assetVideo":null,"author":[],"bodyIntro":"In Israel, more than half of those over 12 years old and some younger children have had a single dose of Covid-19 vaccine – with a few already onto booster jabs. What can we learn from this?","businessUnit":"worldwide","cards":[{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EIn late August 2021, Talia Shmuel took her five-year-old son to their local health clinic in Jerusalem, Israel, for his first vaccine against Covid-19. He was born with a heart defect, and as a side-effect has a severely narrowed windpipe, which makes him particularly vulnerable to the disease. \"Any time he gets sick, it generally turns into pneumonia,\" Shmuel says. \"And he gets sick a lot.\"\u003C\u002Fp\u003E\n\u003Cp\u003EShmuel, a mother of three, needed \u003Ca href=\"https:\u002F\u002Fwww.gov.il\u002FBlobFolder\u002Fnews\u002F27072021-03\u002Fen\u002FNEWS_Corona_27072021.pdf\"\u003Especial \u003C\u002Fa\u003E\u003Ca href=\"https:\u002F\u002Fwww.gov.il\u002FBlobFolder\u002Fnews\u002F27072021-03\u002Fen\u002FNEWS_Corona_27072021.pdf\"\u003Eauthorisation\u003C\u002Fa\u003E by Israel's Ministry of Health to have her son vaccinated, because of his young age. She felt excited, and confident that it was the right choice. \"My husband and I are both research analysts, and we look at every single number that comes across; we are tracking everything,\" she says. \"We check multiple different sources. From the numbers, yes, there are possible side-effects [of the vaccine]. However, the side-effects of Covid-19 are significantly worse for him.\"\u003C\u002Fp\u003E\n\u003Cp\u003EAs more and more countries \u003Ca href=\"https:\u002F\u002Fwww.rki.de\u002FDE\u002FContent\u002FKommissionen\u002FSTIKO\u002FEmpfehlungen\u002FPM_2021-08-16.html\"\u003Earound the \u003C\u002Fa\u003E\u003Ca href=\"https:\u002F\u002Fwww.rki.de\u002FDE\u002FContent\u002FKommissionen\u002FSTIKO\u002FEmpfehlungen\u002FPM_2021-08-16.html\"\u003Eworld\u003C\u002Fa\u003E are beginning \u003Ca href=\"https:\u002F\u002Fwww.canada.ca\u002Fen\u002Fpublic-health\u002Fservices\u002Fvaccination-children\u002Fcovid-19.html\"\u003Eto offer\u003C\u002Fa\u003E \u003Ca href=\"https:\u002F\u002Fwww.cdc.gov\u002Fcoronavirus\u002F2019-ncov\u002Fvaccines\u002Frecommendations\u002Fadolescents.html#:~:text=CDC%20recommends%20everyone%2012%20years,did%20prior%20to%20the%20pandemic.\"\u003ECovid-19 vaccines\u003C\u002Fa\u003E for \u003Ca href=\"https:\u002F\u002Fwww.england.nhs.uk\u002F2021\u002F09\u002Fnhs-rolls-out-covid-19-jab-to-children-aged-12-to-15\u002F\"\u003Echildren over 12\u003C\u002Fa\u003E, Israel offers a glimpse of what the future may hold. The country rapidly vaccinated a large part of its adult population earlier this year. In June, it \u003Ca href=\"https:\u002F\u002Fwww.gov.il\u002Fen\u002Fdepartments\u002Fnews\u002F21062021-02\"\u003Erecommended vaccinating children over 12\u003C\u002Fa\u003E, after outbreaks in schools – and is now already offering \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20210916-covid-19-how-effective-is-a-third-vaccine-dose\"\u003Ethird doses\u003C\u002Fa\u003E as \u003Ca href=\"https:\u002F\u002Fwww.gov.il\u002Fen\u002Fdepartments\u002Fnews\u002F24082021-03\"\u003Ebooster shots for that\u003C\u002Fa\u003E\u003Cspan\u003E age group\u003C\u002Fspan\u003E. Since July, it has also offered vaccinations for children aged 5-11 \u003Ca href=\"https:\u002F\u002Fwww.gov.il\u002Fen\u002Fdepartments\u002Fnews\u002F27072021-03\"\u003E\"in exceptional circumstances\",\u003C\u002Fa\u003E including severe chronic lung illnesses and congestive heart failure. But while the Pfizer-BioNTech vaccine has been \u003Ca href=\"https:\u002F\u002Fwww.pfizer.com\u002Fnews\u002Fpress-release\u002Fpress-release-detail\u002Fpfizer-and-biontech-announce-positive-topline-results\"\u003Eshown to be safe\u003C\u002Fa\u003E for children, the decision can be more complex than for adults. Since children tend to be less affected by Covid-19, even a small number of adverse reactions to the vaccine can make it harder to justify the jab.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20211011-covid-19-should-we-vaccinate-children-0"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":[],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20211011-covid-19-should-we-vaccinate-children-1"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003E\"The vaccine works,\" says \u003Ca href=\"https:\u002F\u002Fdkf.unibas.ch\u002Fen\u002Fresearch-groups\u002Ffocal-areas\u002Fimmunology-infectious-diseases\u002Fresearch-group-ritz-n\u002F\"\u003ENicole Ritz\u003C\u002Fa\u003E\u003Cspan\u003E, a specialist in paediatric infectious diseases\u003C\u002Fspan\u003E at University Children's Hospital Basel in Switzerland. \"But same as we have done for 12 to 18-year-olds, you need even more caution as you [decrease] in age. Potentially, this is going to be a vaccine which we give in the first year of life, as we do with many other vaccines. The more you [decrease] in age, the more you need data which shows you that this is a safe vaccine. And it's going to be more difficult [to collect that data] because a five-year-old is much less likely to tell you, 'I have a strange feeling in my heart, I don't feel happy today', than a 16-year-old.\"\u003C\u002Fp\u003E\n\u003Cp\u003EIsrael's roll-out of the vaccine for children has been relatively smooth. To date, it has vaccinated more than half of 12 to 15-year-olds. A very small number of people have taken to the streets for sporadic protests. Most Israeli parents, however, appear willing to vaccinate their older children: By October 2021, 53.7% of children aged 12 to 15, and 84% of 16 to 19-year-olds, had received a first shot, according to the Ministry of Health's Covid-19 dashboard.\u003C\u002Fp\u003E\n\u003Cp\u003EAsked how they felt about the vaccine for younger children, including those without background illnesses, several parents showed enthusiasm. They cited their fear of their kids getting infected, anxiety about incipient lockdowns, burn-out over frequent quarantines and home-schooling, unease about their kids falling behind in school, or the inability of their kids to learn remotely – whether because they find it difficult to focus or due to lack of screens that enable kids to access Zoom. (\u003Cem\u003EFind out more about \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fworklife\u002Farticle\u002F20200421-why-zoom-video-chats-are-so-exhausting\" target=\"_blank\"\u003Ewhy Zoom calls are so exhausting\u003C\u002Fa\u003E.\u003C\u002Fem\u003E)\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20211011-covid-19-should-we-vaccinate-children-2"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":[],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20211011-covid-19-should-we-vaccinate-children-3"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EThe rise of the highly contagious \u003Ca href=\"https:\u002F\u002Fwww.cdc.gov\u002Fcoronavirus\u002F2019-ncov\u002Fvariants\u002Fdelta-variant.html\"\u003EDelta variant\u003C\u002Fa\u003E has fuelled such fears of future lockdowns.\u003C\u002Fp\u003E\n\u003Cp\u003EIn mid-June 2021, Israel lifted its indoor mask mandate, citing a successful campaign to fully vaccinate about 60% of its total population. Among the elderly, who are most at risk from Covid-19, that proportion is even higher – almost 90% of Israelis over 70 are vaccinated. Ten days later, as the Delta variant spread, the indoor mask mandate was back in place. By late summer, the \u003Ca href=\"https:\u002F\u002Fwww.medrxiv.org\u002Fcontent\u002F10.1101\u002F2021.08.29.21262798v1\"\u003EDelta variant was dominant\u003C\u002Fa\u003E in Israel.\u003C\u002Fp\u003E\n\u003Cp\u003EAfter Israeli public schools opened on 1 September, the number of children testing positive for Covid-19 began to rise dramatically. Over the course of the month, slightly more than 54% of positive tests in Israel were in children aged zero to 19, according to the Israeli Ministry of Health's \u003Ca href=\"https:\u002F\u002Fdatadashboard.health.gov.il\u002FCOVID-19\u002Fgeneral\"\u003ECovid-19 dashboard\u003C\u002Fa\u003E. Some children were quarantined after a single day of school. For the second year in a row, Israelis who had planned to observe the Jewish New Year indoors in synagogue found themselves organising impromptu outdoor prayer services in local parks. They blew the traditional ram's horn, or shofar, under the trees as passing joggers paused to listen.\u003C\u002Fp\u003E\n\u003Cp\u003EVaccinating children could help break that cycle of optimistic re-openings followed by Covid-19 surges and setbacks, some experts say.\u003C\u002Fp\u003E\n\u003Cp\u003E\"I believe – and I've said it all along – that we need to vaccinate children in order to control the pandemic, from as early an age as possible,\" says epidemiologist \u003Cspan\u003EManfred Green\u003C\u002Fspan\u003E, professor in the School of Public Health at the University of Haifa in Israel. Very early in the pandemic, he explains, \"we knew that this was a very transmissible disease; now it's become more transmissible with Delta.\" Public health officials had hoped that if 60% to 70% of the population had immunity, the pandemic could be controlled, he says. They now realise that that percentage has to be much higher. Vaccinating children would \"diminish that pool\" of non-immune people in the population.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20211011-covid-19-should-we-vaccinate-children-4"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":[],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20211011-covid-19-should-we-vaccinate-children-5"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EAs children congregate in schools, they can spread the disease, Green adds. If infected, they are likely to be \u003Ca href=\"https:\u002F\u002Fwww.imperial.ac.uk\u002Fnews\u002F209273\u002Fmost-children-experience-mild-covid-19-show\u002F\"\u003Easymptomatic or experience only mild symptoms\u003C\u002Fa\u003E, but that does not mean all children brush off the disease easily. In the United States, hospitalisations of children and adolescents rose nearly five-fold during late June to mid-August 2021, as Delta was becoming dominant, \u003Ca href=\"https:\u002F\u002Fwww.cdc.gov\u002Fmmwr\u002Fvolumes\u002F70\u002Fwr\u002Fmm7036e2.htm\"\u003Eaccording to data from the US Centers for Disease Control\u003C\u002Fa\u003E. In Israel, of all patients in a serious condition in October, between 0.2 and 0.5% were children aged zero to 19. A total of 12 children aged zero to 19 in Israel have died of Covid-19 since the start of the pandemic, according to the \u003Ca href=\"https:\u002F\u002Fdatadashboard.health.gov.il\u002FCOVID-19\u002Fgeneral\"\u003EMinistry of Health's Covid-19 dashboard\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003EChildren are also at some risk of prolonged symptoms after infection, mostly headaches and fatigue, known as \"Long Covid\". Although reports vary, \u003Ca href=\"https:\u002F\u002Fwww.thelancet.com\u002Fjournals\u002Flanchi\u002Farticle\u002FPIIS2352-4642(21)00198-X\u002Ffulltext?utm_campaign=lancetcovid21&utm_content=175048732&utm_medium=social&utm_source=twitter&hss_channel=tw-27013292\"\u003Ea recent \u003C\u002Fa\u003Estudy of 258,790\u003Ca href=\"https:\u002F\u002Fwww.cidrap.umn.edu\u002Fnews-perspective\u002F2021\u002F08\u002Flong-covid-19-rare-children-study-says\"\u003E children aged five to 17\u003C\u002Fa\u003E found that, in the UK, between 2% and 4% of 1,734 children who tested positive for Covid-19 experienced such longer-term symptoms. In Israel, a similar study found that 11% of 13,864 children aged three to 18 who had recovered from Covid-19 reported long-term symptoms including \u003Ca href=\"https:\u002F\u002Fwww.timesofisrael.com\u002Fmore-than-10-of-israeli-kids-who-got-virus-now-suffer-from-long-covid-study\u002F\"\u003Edisturbed sleep and problems concentrating\u003C\u002Fa\u003E. Some of these effects, the study's authors say, could result from prolonged lockdowns and school closures.\u003C\u002Fp\u003E\n\u003Cp\u003EGiven these factors, \"it makes a lot of sense\", Green says, to vaccinate children aged 5 to 11, and possibly at even younger ages, even without underlying conditions. From Israel's experience of vaccinating children aged 12 to 15, \"the lesson is that the vaccine has a good safety record. There are not a significant number of severe adverse effects\", he adds.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20211011-covid-19-should-we-vaccinate-children-6"},{"bodyHtml":{"assets":[]},"calloutBodyHtml":"\u003Cp\u003EThis article is part of \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Ffamily-tree\" target=\"_blank\"\u003EFamily Tree\u003C\u002Fa\u003E, a new series of features from the BBC that examine the issues and opportunities that parents, children and families face all over the world. It examines the role that families have in today’s society and how they will be part of the world tomorrow.\u003C\u002Fp\u003E","calloutTitle":"Family Tree","cardType":"CalloutBox","iFrameType":"","id":"future\u002Farticle\u002F20211011-covid-19-should-we-vaccinate-children-7"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EBetween one in 3,000 and one in 6,000 males aged 16 to 24 who received the Pfizer-BioNTech vaccine in Israel developed a rare \u003Ca href=\"https:\u002F\u002Fwww.science.org\u002Fnews\u002F2021\u002F06\u002Fisrael-reports-link-between-rare-cases-heart-inflammation-and-covid-19-vaccination\"\u003Eheart muscle inflammation\u003C\u002Fa\u003E called myocarditis, but Green insists that it is \"almost always\" a treatable condition, although it may require hospitalisation. That side effect may also have to be seen in the context of the dangers of a Covid-19 infection. An \u003Ca href=\"https:\u002F\u002Fwww.nejm.org\u002Fdoi\u002Ffull\u002F10.1056\u002FNEJMoa2110475\"\u003EIsraeli study of adults aged 16 years and older\u003C\u002Fa\u003E found that the risk of myocarditis was \"substantially increased\" after infection with Covid-19, compared with its incidence after vaccination.\u003C\u002Fp\u003E\n\u003Cp\u003EOther Israeli public health officials express more caution.\u003C\u002Fp\u003E\n\u003Cp\u003E\"Vaccinating children under the age of 12 years raises difficult medical, ethical and social issues and questions,\" Adi Niv-Yagoda, an expert in health policy at Tel Aviv University and a member of the Israeli Health Ministry’s Covid-19 advisory panel, wrote in an email. \"On the one hand, vaccinating children between the ages of five and 12 years can be very helpful in dealing with the spread of Covid-19 morbidity and reducing the dimensions of the corona epidemic,\" he says. \"On the other hand, the natural concern [is] about possible future health consequences.\"\u003C\u002Fp\u003E\n\u003Cp\u003EThose concerns are echoed by Nicole Ritz of University Children's Hospital Basel. \"Do you vaccinate the younger kids to protect themselves or do you vaccinate them to protect society?\" asks Ritz, a pediatric infectious disease specialist who has treated between 20 and 30 children and adolescents with PIMS (\u003Ca href=\"https:\u002F\u002Fwww.thelancet.com\u002Fjournals\u002Flanchi\u002Farticle\u002FPIIS2352-4642(21)00138-3\u002Ffulltext#:~:text=Paediatric%20inflammatory%20multisystem%20syndrome%20temporally,CoV%2D2%20infection%20in%20children.\"\u003Epaediatric inflammatory multisystem syndrome\u003C\u002Fa\u003E), a rare and severe syndrome which occurs in \u003Ca href=\"https:\u002F\u002Fwww.rcpch.ac.uk\u002Fresources\u002Fpims-covid-19-linked-syndrome-affecting-children-information-families\"\u003Eless than 0.5% of children\u003C\u002Fa\u003E who have (or who have had) Covid-19.\u003C\u002Fp\u003E\n\u003Cp\u003EIf the disease remains benign in most children, then only a small group of them prone to severe illness – those with risk factors \u003Ca href=\"https:\u002F\u002Fjournals.lww.com\u002Fpidj\u002Ffulltext\u002F2021\u002F04000\u002Frisk_factors_for_severe_covid_19_in_children.2.aspx\"\u003Elike obesity, diabetes or lung diseases\u003C\u002Fa\u003E – will potentially benefit directly from vaccination, Ritz explains. But if the only benefit of immunising kids is to protect their grandparents, then \"that vaccine has to be extremely safe\", she says.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20211011-covid-19-should-we-vaccinate-children-8"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":[],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20211011-covid-19-should-we-vaccinate-children-9"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003ERitz points to a recent \u003Ca href=\"https:\u002F\u002Fwww.cdc.gov\u002Fmmwr\u002Fvolumes\u002F70\u002Fwr\u002Fmm7031e1.htm\"\u003ECDC report\u003C\u002Fa\u003E on Covid-19 safety in adolescents aged 12 to 17, which followed up on 8.9 million US adolescents who had received the Pfizer-BioNTech vaccine. Their Vaccine Adverse Event Reporting System (Vaers) received 9,246 reports of adverse events following vaccination, \u003Ca href=\"https:\u002F\u002Fwww.aafp.org\u002Fnews\u002Fhealth-of-the-public\u002F20210819mmwrcovidvacc.html\"\u003Ea rate of one out of every thousand patients vaccinated\u003C\u002Fa\u003E. More than 90% of these adverse events were \"non-serious\" events like dizziness and headache. The remainder, or 9.3%, were for serious adverse events, including chest pain, vomiting, fever and myocarditis. \"\u003Ca href=\"https:\u002F\u002Fwww.cdc.gov\u002Fmmwr\u002Fvolumes\u002F70\u002Fwr\u002Fmm7031e1.htm\"\u003ENo reports of \u003C\u002Fa\u003E\u003Ca href=\"https:\u002F\u002Fwww.cdc.gov\u002Fmmwr\u002Fvolumes\u002F70\u002Fwr\u002Fmm7031e1.htm\"\u003Edeath\u003C\u002Fa\u003E to Vaers were determined to be the result of myocarditis,\" the CDC report notes.\u003C\u002Fp\u003E\n\u003Cp\u003EYet the rise of the Delta variant has also prompted some researchers to change their position on vaccinating children.\u003C\u002Fp\u003E\n\u003Cp\u003E\"Given the rise of the Delta variant, it is now more urgent to vaccinate children 5 to 11 when those [clinical] trials are complete and the vaccine is shown to be safe and effective,\" infectious diseases physician Monica Gandhi of the University of California, San Francisco, told the BBC in an email. Earlier this year, she had not seen the need to vaccinate that age group, but Delta had changed the picture: \"With its higher transmissibility, I would favour vaccinating younger children to help protect those in the household and especially older adults.\"\u003C\u002Fp\u003E\n\u003Cp\u003EGreen concurs. \"I know that some people will say, 'why should children get a vaccine that's not going to help them individually and only going to help society?' The answer is that children are not some kind of species that live outside of society. They are part of society. If their parents get ill, or their grandparents, or their neighbours, that affects them as well.\"\u003C\u002Fp\u003E\n\u003Cp\u003EFor parents, it can be difficult to make a confident decision amid the slew of studies and statistics. But some simply feel relief – and a growing sense of hope. \u003C\u002Fp\u003E\n\u003Cp\u003E\"I would get my under-12s vaccinated in a hot second if I could,\" says Gila Rose, a freelance writer and editor in the Israeli town of Modiin. She has an 18-year-old and a 15-year-old (both of whom are vaccinated) as well an 11-year-old and almost-seven-year-old twins. Rose cites the rise of the Delta variant, as well as repeated lockdowns and quarantines, as reasons for speeding up vaccinations of younger children. \u003C\u002Fp\u003E\n\u003Cp\u003ESchool closures are taking their toll, as well. \"Kids are really suffering,\" she says. \"It was one thing when we thought it would be a few months, or a year. But now we're heading into our third messed-up school year.\"  \u003C\u002Fp\u003E\n\u003Cp\u003ERose has \"no qualms\" about vaccinating her younger children, seeing the jab as a \"get out of quarantine free\" card: \"I will be first in line with my children. Maybe this is the thing that is finally needed, to turn the tide,\" she says.  \u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003E--\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EJoin one million Future fans by liking us on \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.facebook.com\u002FBBCFuture\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EFacebook\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, or follow us on \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Ftwitter.com\u002FBBC_Future\"\u003E\u003Cstrong\u003E\u003Cem\u003ETwitter\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E or \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.instagram.com\u002Fbbcfuture_official\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EInstagram\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E. \u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EIf you liked this story, \u003C\u002Fem\u003E\u003Ca href=\"http:\u002F\u002Fpages.emails.bbc.com\u002Fsubscribe\u002F?ocid=fut.bbc.email.we.email-signup\"\u003E\u003Cstrong\u003E\u003Cem\u003Esign up for the weekly bbc.com features newsletter\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, called \"The Essential List\" – a handpicked selection of stories from BBC \u003Cstrong\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002F\"\u003EFuture\u003C\u002Fa\u003E\u003C\u002Fstrong\u003E, \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fculture\u002F\" target=\"_blank\"\u003E\u003Cstrong\u003E\u003Cem\u003ECulture\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fworklife\u002F\" target=\"_blank\"\u003E\u003Cstrong\u003E\u003Cem\u003EWorklife\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ftravel\u002F\" target=\"_blank\"\u003E\u003Cstrong\u003E\u003Cem\u003ETravel\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E and \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Freel\"\u003E\u003Cstrong\u003E\u003Cem\u003EReel\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E delivered to your inbox every Friday.\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003E \u003C\u002Fem\u003E\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"infographic","imageAlignment":"centre","imageOrientation":"landscape","pullQuoteImageAlignment":"centre","videoImageAlign":"centre","id":"future\u002Farticle\u002F20211011-covid-19-should-we-vaccinate-children-10"}],"collection":[],"disableAdverts":false,"displayDate":"2021-10-12T00:01:00Z","embeddedCustomHtml":"","embeddedInfographicUrl":"","embeddedType":"infographic","headlineLong":"What we know about Covid-19 jabs for kids","headlineShort":"Should young kids get the Covid-19 jab?","image":[],"imageAlignment":"centre","imageAltText":"","isSyndicated":true,"latitude":"","longitude":"","mpsVideo":"","option":[],"partner":null,"primaryVertical":"future","promoAlignment":"centre","promoAltText":"","promoImage":null,"relatedStories":null,"relatedTag":null,"summaryLong":"In Israel, more than half of those over 12 years old and some younger children have had a single dose of Covid-19 vaccine – with a few already onto booster jabs.","summaryShort":"Israel is vaccinating vulnerable kids as young as five against Covid-19","tag":[],"textToSpeech":false,"creationDateTime":"2021-10-11T23:05:33.079733Z","entity":"article","guid":"97b1d8ea-9a39-4912-8593-a267bc2b85a5","id":"future\u002Farticle\u002F20211011-covid-19-should-we-vaccinate-children","modifiedDateTime":"2022-02-24T19:29:28.904468Z","project":"wwverticals","slug":"future\u002Farticle\u002F20211011-covid-19-should-we-vaccinate-children","cacheLastUpdated":1657756317506},"future\u002Farticle\u002F20220225-are-children-at-risk-of-long-covid":{"urn":"urn:pubpipe:wwverticals:article:future\u002Farticle\u002F20220225-are-children-at-risk-of-long-covid","_id":"62b41ff81f4b7b0907499450","ambientVideo":"","articleType":"story","assetVideo":null,"author":[],"bodyIntro":"While Covid-19 causes relatively mild disease in most children, previously healthy youngsters are showing signs of longer-term issues related to the virus.","businessUnit":"worldwide","cards":[{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EBefore they fell ill, the children being seen by Danilo Buonsenso at the Gemelli University Hospital in Rome, Italy, had been lively and active. Most played sports and took part in activities after school. But then they caught Covid-19.\u003C\u002Fp\u003E\n\u003Cp\u003EMonths after they had apparently recovered from the initial viral infection, the children continued to struggle with a wide range of symptoms that left them unable to return to their normal lives.\u003C\u002Fp\u003E\n\u003Cp\u003E\"Most of the children I've seen were completely healthy before Covid, they were doing sport, extra-school activities,\" says Buonsenso. \"And then they were not able to return to their normal school routine because they were getting headaches or had difficulty concentrating after a few hours.\"\u003C\u002Fp\u003E\n\u003Cp\u003EA paediatrician at the Gemelli University Hospital, Buonsenso was the first doctor to survey whether children were vulnerable to long Covid. Like many paediatricians, he has seen children with lingering symptoms of fatigue, insomnia, joint pain, respiratory issues, skin rashes and heart palpitations, which can remain months after the infection has passed.\u003C\u002Fp\u003E\n\u003Cp\u003EBuonsenso says it is vital that children are not left behind in studies of post-Covid illness. He points out that just as in adults, even children who are asymptomatic or mildly infected can develop persistent problems.\u003C\u002Fp\u003E\n\u003Cp\u003EChildren have generally been thought to be less vulnerable to the longer-term effects of Covid-19, with the risk decreasing the younger they are. It was thought this might be because younger children do not have \u003Ca href=\"https:\u002F\u002Fadc.bmj.com\u002Fcontent\u002Farchdischild\u002Fearly\u002F2020\u002F11\u002F30\u002Farchdischild-2020-320338.full.pdf\"\u003Eas many ACE2 receptors\u003C\u002Fa\u003E – the keyhole the virus targets to invade our cells in their nose and respiratory tract.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"infographic","imageAlignment":"centre","imageOrientation":"landscape","pullQuoteImageAlignment":"centre","videoImageAlign":"centre","id":"future\u002Farticle\u002F20220225-are-children-at-risk-of-long-covid-0"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":[],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220225-are-children-at-risk-of-long-covid-1"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EHowever, the emergence of the \u003Ca href=\"https:\u002F\u002Fcovariants.org\u002Fvariants\u002F21K.Omicron\"\u003EOmicron variant\u003C\u002Fa\u003E – which is \u003Ca href=\"https:\u002F\u002Fhealth.ucdavis.edu\u002Fnews\u002Fheadlines\u002Fomicron-10-things-to-know-about-the-very-contagious-covid-19-variant\u002F2022\u002F01\"\u003Emore infectious\u003C\u002Fa\u003E than previous forms of Covid-19 – and its \u003Ca href=\"https:\u002F\u002Fcovariants.org\u002Fvariants\u002F21L.Omicron\"\u003Enew subvariant BA.2\u003C\u002Fa\u003E, has now led to a much higher proportion of children becoming infected with the virus.\u003C\u002Fp\u003E\n\u003Cp\u003EAccording \u003Ca href=\"https:\u002F\u002Fwww.cdc.gov\u002Fmmwr\u002Fvolumes\u002F71\u002Fwr\u002Fmm7107e4.htm\"\u003Eto a report\u003C\u002Fa\u003E from the Centers for Disease Control and Prevention in the US, Covid-19 hospital admission rates among children and adolescents under the age of 17 increased rapidly in late December 2021, as the Omicron variant began to take off. This was particularly notable among children aged 0-4 years who were not yet eligible for vaccination.\u003C\u002Fp\u003E\n\u003Cp\u003ESimilar findings have been reported in the UK, with \u003Ca href=\"https:\u002F\u002Fwww.nature.com\u002Farticles\u002Fd41586-022-00309-x\"\u003Ereports\u003C\u002Fa\u003E in early February 2022 noting there has been an increase in the proportion of children admitted to hospital with Covid-19 during the Omicron wave, especially those under the age of one.\u003C\u002Fp\u003E\n\u003Cp\u003EWhile the vast majority of children recover quickly, specialists are still concerned about early signs which indicate that the rates of those with long Covid could be rising.\u003C\u002Fp\u003E\n\u003Cp\u003E\"We are currently seeing an uptick in the number of children being diagnosed with post-Covid conditions,\" says Carlos Oliveira, a paediatrician who runs the \u003Ca href=\"https:\u002F\u002Fwww.ynhh.org\u002Fchildrens-hospital\u002Fservices\u002Fpulmonology\u002Fpost-covid-care-program?__cf_chl_rt_tk=1_IvbuweAB5HEvkm01wj3EWCWaO3FTtT_X9Qvzh.KzM-1643644204-0-gaNycGzNCJE\"\u003Epost-Covid care program\u003C\u002Fa\u003E at Yale New Haven Children's Hospital, in Connecticut, US. \"In our hospital for example, the number of children and adolescents who were diagnosed with a post-Covid condition this month [January] is already more than three times higher than what we experienced in the summer months. Other countries are seeing similar trends.\"\u003C\u002Fp\u003E\n\u003Cp\u003EThis is backed up by the latest data from the UK's Office of National Statistics which found that the number of children under 16 with self-reported Long Covid of any duration 'increased from \u003Ca href=\"https:\u002F\u002Fwww.ons.gov.uk\u002Fpeoplepopulationandcommunity\u002Fhealthandsocialcare\u002Fconditionsanddiseases\u002Fdatasets\u002Falldatarelatingtoprevalenceofongoingsymptomsfollowingcoronaviruscovid19infectionintheuk\" target=\"_blank\"\u003E77,000\u003C\u002Fa\u003E in October 2021, to \u003Ca href=\"https:\u002F\u002Fwww.ons.gov.uk\u002Fpeoplepopulationandcommunity\u002Fhealthandsocialcare\u002Fconditionsanddiseases\u002Fbulletins\u002Fprevalenceofongoingsymptomsfollowingcoronaviruscovid19infectionintheuk\u002F3march2022\"\u003E119,000\u003C\u002Fa\u003E in January 2022.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220225-are-children-at-risk-of-long-covid-2"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"The apparently heightened risk of long Covid in children has also been used as an argument to vaccinate more children against the disease","id":"future\u002Farticle\u002F20220225-are-children-at-risk-of-long-covid-3"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003ETo deal with this steadily rising influx of patients, the UK has now established \u003Ca href=\"https:\u002F\u002Fwww.england.nhs.uk\u002F2021\u002F06\u002Fnhs-sets-up-specialist-young-peoples-services-in-100-million-long-covid-care-expansion\u002F\"\u003E15 specialist paediatric hubs\u003C\u002Fa\u003E designed to provide post-Covid care, while the US and many other countries are making similar investments. The Children's Hospital Los Angeles has been awarded \u003Ca href=\"https:\u002F\u002Fwww.chla.org\u002Fpress-release\u002Fchildren-s-hospital-los-angeles-awarded-83-million-study-long-term-effects-covid\"\u003Ean $8.3m grant\u003C\u002Fa\u003E (£6.2m) specifically to study Long Covid in children and young adults, as part of a national initiative called Recover which aims to unlock the mysteries surrounding the aftermath of Covid-19 infection.\u003C\u002Fp\u003E\n\u003Cp\u003EThe apparently heightened risk of long Covid in children has also been used as an argument to vaccinate more children against the disease. \u003Ca href=\"https:\u002F\u002Fwww.medrxiv.org\u002Fcontent\u002F10.1101\u002F2021.10.26.21265508v3?ijkey=88d23a3aa74089808609ae770b7ffc6df3ae5d0d&keytype2=tf_ipsecsha\"\u003EStudies in adults\u003C\u002Fa\u003E have suggested Covid-19 vaccination is associated with a lower risk of developing long Covid symptoms. However, while the UK, US and many other European countries such as France and Spain, are now vaccinating 5-to-11-year-olds, vaccines are still awaiting authorisation for use in children under five.\u003C\u002Fp\u003E\n\u003Cp\u003EBut one of the major questions remains trying to figure out just how common long Covid is in children. Scientists at University College London recently unveiled the \u003Ca href=\"https:\u002F\u002Fwww.ucl.ac.uk\u002Fnews\u002F2022\u002Ffeb\u002Ffirst-research-definition-long-covid-children-and-young-people\"\u003Efirst standardised definition of the condition\u003C\u002Fa\u003E – symptoms which impact childrens’ physical, mental or social wellbeing and persist for a minimum of 12 weeks after initial Covid-19 testing. It is hoped that this will make it easier for researchers to \u003Ca href=\"https:\u002F\u002Fadc.bmj.com\u002Fcontent\u002F107\u002F3\u002Fe2\"\u003Estudy the disease course\u003C\u002Fa\u003E, its various outcomes, and understand precisely how many children are affected by it.\u003C\u002Fp\u003E\n\u003Cp\u003ELast September, researchers at University College London and Public Health England unearthed some of the \u003Ca href=\"https:\u002F\u002Fwww.researchsquare.com\u002Farticle\u002Frs-798316\u002Fv1\"\u003Efirst concrete answers\u003C\u002Fa\u003E after surveying 3,065 11-to-17-year-olds who tested positive for Covid between January and March.\u003C\u002Fp\u003E\n\u003Cp\u003ESomewhere between \u003Ca href=\"https:\u002F\u002Fwww.ucl.ac.uk\u002Fnews\u002F2021\u002Fsep\u002Ffirst-findings-worlds-largest-study-long-covid-children\"\u003E2% and 14%\u003C\u002Fa\u003E of teenagers were found to still experience fatigue, shortness of breath and persistent headache, 15 weeks after reporting a positive PCR test, and at a higher rate than a control group who tested negative for the virus. Around the same time, the Israeli Health Ministry released a survey showing \u003Ca href=\"https:\u002F\u002Fwww.gov.il\u002Fen\u002Fdepartments\u002Fnews\u002F13092021-01\"\u003Ethat 11.2% of children\u003C\u002Fa\u003E reported some symptoms of long Covid as part of their recovery, and 1.8-4.6% of them continued to experience symptoms six months later.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220225-are-children-at-risk-of-long-covid-4"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":[],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220225-are-children-at-risk-of-long-covid-5"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EPaediatricians running post-Covid clinics \u003Ca href=\"https:\u002F\u002Fwww.salon.com\u002F2022\u002F01\u002F22\u002Fthe-kids-are-not-alright-data-suggests-10-of-children-with-19-become-long-haulers\u002F\"\u003Ebelieve that\u003C\u002Fa\u003E the true prevalence lies in the region of 10%. Other scientists, however, \u003Ca href=\"https:\u002F\u002Fwww.bmj.com\u002Fcontent\u002F376\u002Fbmj.o143\"\u003Epoint out\u003C\u002Fa\u003E that the data is clouded by the fact that more than half of children without Covid-19 have also suffered from headaches, fatigue, sleep disturbances and issues with concentration during the pandemic. Many surveys of persistent post-Covid symptoms in children do not compare children infected with Covid-19 with uninfected controls, which could lead to over-representation of symptom prevalence.\u003C\u002Fp\u003E\n\u003Cp\u003EAs such many scientists feel that there remains an ongoing need for more rigorous studies to accurately determine the true risk of long Covid, particularly in the wake of Omicron. And it is likely that as more children are vaccinated against Covid-19, the numbers affected will change.\u003C\u002Fp\u003E\n\u003Cp\u003EFor Buonsenso, whatever the true prevalence of long Covid across adolescents and younger children transpires to be, the sheer numbers being infected with the virus means significant numbers are suffering. \u003C\u002Fp\u003E\n\u003Cp\u003E\"Even if the long Covid prevalence turns out to be say 2%, given the hundreds of thousands of children who are get Covid, it is still a very massive number,\" he says.\u003C\u002Fp\u003E\n\u003Cp\u003EExactly why children develop long Covid symptoms is still a mystery too.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220225-are-children-at-risk-of-long-covid-6"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"The hypothesis that is mostly talked about currently is inflammatory changes to small blood vessels that then will lead to organ dysfunction – Jakob Armann","id":"future\u002Farticle\u002F20220225-are-children-at-risk-of-long-covid-7"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EOliveira told the BBC that in some cases children can sustain organ damage from the virus that causes Covid-19, Sars-CoV-2. It can invade the heart or the pancreas, causing conditions such as pericarditis or pancreatitis where that particular organ becomes inflamed – which can lead to breathing problems and other long-term complications, but this is relatively rare.\u003C\u002Fp\u003E\n\u003Cp\u003EThere are series of \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20210609-how-long-will-long-covid-last\"\u003Etheories for why long Covid occurs in adults\u003C\u002Fa\u003E, ranging from the reactivation of a dormant virus, to lingering viral fragments within the body, to a viral-induced autoimmune reaction with so-called autoantibodies binding to cells in different tissues. The same may be true for children, but another idea being considered as a possible mechanism for long Covid in both children and adults is that the \u003Ca href=\"https:\u002F\u002Fwww.thelancet.com\u002Fjournals\u002Flancet\u002Farticle\u002FPIIS0140-6736(20)30937-5\u002Ffulltext\"\u003Evirus induces damage to the circulatory system\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003E\"The hypothesis that is mostly talked about currently is inflammatory changes to small blood vessels that then will lead to organ dysfunction,\" says Jakob Armann, a paediatrician at Dresden University of Technology in Germany, who has been collecting blood samples from secondary school children to try to identify possible causes of long Covid. \"But there is no reliable data in kids at the moment that proves this.\"\u003C\u002Fp\u003E\n\u003Cp\u003EBut Oliveira is not convinced that processes driving long Covid in children are always the same as in adults. For one thing, the symptom profiles are subtly different. Many adults experience brain fog and other neurological issues, symptoms which are thought to be driven in some cases by the presence of autoantibodies, antibodies which attack the body’s own tissue. However, Oliveira says that the dominant long Covid symptoms in children tend to be fatigue, headaches, dizziness, pain in muscles and joints.  \u003C\u002Fp\u003E\n\u003Cp\u003E\"Let's say autoantibodies are the main driving cause of this disease, then those autoantibodies should be produced irrespective of age,\" he says. \"So the prevalence of long Covid should then be the same at all ages. But we don't see that, the prevalence is lower in children.\"\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220225-are-children-at-risk-of-long-covid-8"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":[],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220225-are-children-at-risk-of-long-covid-9"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EInstead, Oliveira points to \u003Ca href=\"https:\u002F\u002Fwww.jci.org\u002Farticles\u002Fview\u002F149633\"\u003Eone study\u003C\u002Fa\u003E which found that young children who present to doctors with post-Covid inflammation tend to have a biomarker in their blood which is associated with a leaky gut – a digestive condition which can allow microbes from the gut to seep into the bloodstream. He suggests that while Covid-19 is predominantly a respiratory disease in adults, in a proportion of susceptible children it could be more of a gastrointestinal issue, with viral particles residing in the gut before getting reabsorbed into the blood and causing problems.\u003C\u002Fp\u003E\n\u003Cp\u003E\"We know that both kids and adults can shed the DNA of the virus \u003Ca href=\"https:\u002F\u002Flink.springer.com\u002Farticle\u002F10.1007\u002Fs10875-021-01132-1\"\u003Ein their stools for months and months\u003C\u002Fa\u003E, so it's a reasonable idea that getting re-exposed to dead virus due to a leaky gut will trigger a sudden inflammatory process,\" he says. \"If this pans out to be true, then we can test infected children for a leaky gut and see if we can predict who's likely to have problems, which would be huge.\"\u003C\u002Fp\u003E\n\u003Cp\u003EBut just as in adults, there is likely to be more than one explanation. Buonsenso is currently collaborating with the Karolinska Institute to see whether children with long Covid seem to have any obvious genetic dysfunction. Daniel Munblit, a paediatrics specialist at Sechenov University in Moscow, Russia, has been investigating whether there is a connection between susceptibility to allergies and vulnerability to long Covid.\u003C\u002Fp\u003E\n\u003Cp\u003EOver the past two decades, one of the main theories behind allergies has been \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F14758340\u002F\"\u003Ean imbalance\u003C\u002Fa\u003E in the body's white blood cells, namely Th1 and Th2 cells. Th1 cells act as the first line of defence against external invaders, and generate inflammation in response to pathogens. Th2 cells are the second line response and produce antibodies.\u003C\u002Fp\u003E\n\u003Cp\u003EIn a well-functioning immune system, both groups of these cells work together to keep the system balanced. But in some susceptible individuals, one group becomes too dominant, which can lead to excessive reactions to a virus or other external stimulus, resulting in allergies and other autoimmune diseases. Munblit believes this could be one possible cause of post-Covid symptoms.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220225-are-children-at-risk-of-long-covid-10"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"So far I'd say that between two-thirds and three-quarters of children with long Covid recover after three months – Danilo Buonsenso","id":"future\u002Farticle\u002F20220225-are-children-at-risk-of-long-covid-11"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003E\"We have found that children with a history of allergies are \u003Ca href=\"https:\u002F\u002Ferj.ersjournals.com\u002Fcontent\u002F59\u002F2\u002F2101341\"\u003Emore prone\u003C\u002Fa\u003E to develop long Covid,\" he says. \"But I'm approaching it with caution before we have more evidence because unfortunately parents tend to over-report allergic diseases in their children, so this requires more studies.\"\u003C\u002Fp\u003E\n\u003Cp\u003EWhile the realisation long Covid can affect children has frightened parents around the world, Buonsenso is keen to reassure families that in the vast majority of cases, they recover within a few months, meaning that there is no long-term impact on their education and development.\u003C\u002Fp\u003E\n\u003Cp\u003EThere are cases of children, however, who remain ill more than six months after the initial infection. Specialists at the Schneider Children's Medical Center of Israel \u003Ca href=\"https:\u002F\u002Fwww.reuters.com\u002Fbusiness\u002Fhealthcare-pharmaceuticals\u002Fdoctors-weigh-covid-19-impact-children-vaccine-drives-ramp-up-2021-12-09\u002F\"\u003Erecently reported\u003C\u002Fa\u003E cases of children with long Covid going on to develop chronic problems such as asthma and hearing loss, and toddlers who have reverted in their development, going from walking back to crawling because of muscle pains.\u003C\u002Fp\u003E\n\u003Cp\u003E\"So far I'd say that between two-thirds and three-quarters of children with long Covid recover after three months, but there are a subset, around 10-20% that have not recovered spontaneously,\" Buonsenso says. \"And we don't know yet if any of these children will go on to suffer longer term sequelae like we see with measles or other viral infections.\"\u003C\u002Fp\u003E\n\u003Cp\u003EThe National Institutes of Health have launched \u003Ca href=\"https:\u002F\u002Fwww.nih.gov\u002Fnews-events\u002Fnews-releases\u002Flong-term-study-children-covid-19-begins\"\u003Ea study\u003C\u002Fa\u003E which will track up to 1,000 children and young adults who tested positive for Covid-19, and follow them for up to three years to investigate any long-term consequences on their health and quality of life.\u003C\u002Fp\u003E\n\u003Cp\u003EDoctors are also investigating whether administering Covid-19 vaccines to children suffering from long Covid can help reduce the symptoms, as has been \u003Ca href=\"https:\u002F\u002Fwww.theguardian.com\u002Fsociety\u002F2021\u002Fmay\u002F18\u002Flong-covid-symptoms-ease-after-vaccination-survey-finds\"\u003Eseen in adults\u003C\u002Fa\u003E. Oliveira says that this has proven to be a successful treatment approach with some children where there are still viral particles lingering somewhere in their body.\u003C\u002Fp\u003E\n\u003Cp\u003E\"The idea is that if there are remaining parts of the virus there, the vaccine may lead to clearing of them,\" he says. \"I've had several kids who have had lingering symptoms, and not all of them have improved. But most of them have had either complete or partial resolution of their symptoms. I had one child who had severe abdominal pain for months, and other symptoms like headaches and fevers. And after they got the vaccine, their abdominal pain and headaches completely went away, but their fever remained. Two of the three symptoms going away, for me it's a victory.\"\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220225-are-children-at-risk-of-long-covid-12"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":[],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220225-are-children-at-risk-of-long-covid-13"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EApart from that, it remains a matter of trying to alleviate the problems as best as possible. Some symptoms such as dizzy spells can be treated with medications to reduce heart rate, while Oliveira refers children with chronic pain to cognitive behavioural specialists to try to help them find ways to cope with it.\u003C\u002Fp\u003E\n\u003Cp\u003EOther specialists hope the increasing amounts of research being devoted to long Covid in children could help shed light on the long-term complications which can result from other childhood viral infections. It is known, for example, that RSV can \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC3215509\u002F\"\u003Elead to asthma\u003C\u002Fa\u003E, while \u003Ca href=\"https:\u002F\u002Fwww.contemporarypediatrics.com\u002Fview\u002Fneurologic-complications-influenza-children\"\u003Einfluenza\u003C\u002Fa\u003E and the \u003Ca href=\"https:\u002F\u002Fbmcfampract.biomedcentral.com\u002Farticles\u002F10.1186\u002Fs12875-019-0954-3\"\u003EEpstein-Barr virus\u003C\u002Fa\u003E can also lead to chronic illness in a small proportion of children. Henry Balfour, a pediatrics specialist at the University of Minnesota Medical School believes that all of these post-viral conditions may stem from a similar weakness within the genetic code.\u003C\u002Fp\u003E\n\u003Cp\u003E\"I think all of these problems are related to various forms of immune dysregulation, that may have a common ancestor in our genes, and that's really worth looking into,\" says Balfour.\u003C\u002Fp\u003E\n\u003Cp\u003EBut for many parents such as Sammie McFarland, who founded Long Covid Kids after her 15-year-old daughter Kitty developed prolonged long Covid symptoms, it has been reassuring to see a greater number of policymakers and doctors taking the problem more seriously in recent months. In an interview with the BBC last year, McFarland says that when her daughter's illness was first described to a nurse, she was accused of attention seeking, and many other parents have been told that their child's problems are psychological.\u003C\u002Fp\u003E\n\u003Cp\u003E\"This has been a concern since the Royal College of Paediatrics and Child Health published an article stating families were reporting symptoms to GPs, with a discussion on fabricated illness,\" says McFarland. \"Then there is the toxic positivity brigade who think that a positive approach will cure long Covid. While of course positivity plays an important role in any recovery, that doesn't cure damaged organs.\"\u003C\u002Fp\u003E\n\u003Cp\u003EWhile long Covid may only affect a relatively small proportion of children, Buonsenso says that the numbers are still so substantial that the world cannot afford to ignore their plight.\u003C\u002Fp\u003E\n\u003Cp\u003E\"I know that in children it's less frequent but I think it's very difficult to close your eyes in front of so many patients reporting this,\" he says. \"This is starting to create problems for national health systems, because it's very complicated and expensive to care for children with such multiple comorbidities. We have experienced a long-term problems in the past with Epstein-Barr and other viral infections, but the main difference now is that it's thousands and thousands of patients fighting to get their lives back on track.\"\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003E* This article was updated on 7 March 2022 to reflect the latest estimates for long Covid from the UK's Office of National Statistics.\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp dir=\"ltr\"\u003E\u003Cem\u003E--\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp dir=\"ltr\"\u003E\u003Cem\u003EJoin one million Future fans by liking us on \u003Ca href=\"https:\u002F\u002Fwww.facebook.com\u002FBBCFuture\u002F\"\u003EFacebook\u003C\u002Fa\u003E, or follow us on \u003Ca href=\"https:\u002F\u002Ftwitter.com\u002FBBC_Future\"\u003ETwitter\u003C\u002Fa\u003E or \u003Ca href=\"https:\u002F\u002Fwww.instagram.com\u002Fbbcfuture_official\u002F\"\u003EInstagram\u003C\u002Fa\u003E.\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp dir=\"ltr\"\u003E\u003Cem\u003EIf you liked this story, \u003Ca href=\"http:\u002F\u002Fpages.emails.bbc.com\u002Fsubscribe\u002F?ocid=fut.bbc.email.we.email-signup\"\u003Esign up for the weekly bbc.com features newsletter\u003C\u002Fa\u003E, called \"The Essential List\" – a handpicked selection of stories from BBC \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\"\u003EFuture\u003C\u002Fa\u003E, \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fculture\"\u003ECulture\u003C\u002Fa\u003E, \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fworklife\"\u003EWorklife\u003C\u002Fa\u003E, \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fculture\"\u003ETravel\u003C\u002Fa\u003E and \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fculture\"\u003EReel\u003C\u002Fa\u003E delivered to your inbox every Friday.\u003C\u002Fem\u003E\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220225-are-children-at-risk-of-long-covid-14"}],"collection":null,"disableAdverts":false,"displayDate":"2022-03-01T01:00:00Z","embeddedCustomHtml":"","embeddedInfographicUrl":"","embeddedType":"infographic","headlineLong":"How children are being affected by long Covid","headlineShort":"How long Covid is affecting children","image":[],"imageAlignment":"centre","imageAltText":"","isSyndicated":true,"latitude":"","longitude":"","mpsVideo":"","option":[],"partner":null,"primaryVertical":"future","promoAlignment":"centre","promoAltText":"","promoImage":null,"relatedStories":null,"relatedTag":null,"summaryLong":"While Covid-19 causes relatively mild disease in most children, previously healthy youngsters are showing signs of longer-term issues related to the virus.","summaryShort":"Some doctors fear the pandemic is creating a long-term health burden in children","tag":[],"textToSpeech":false,"creationDateTime":"2022-03-01T01:00:53.877461Z","entity":"article","guid":"a06e3411-f5a3-4666-9e1a-6f6f63de0b37","id":"future\u002Farticle\u002F20220225-are-children-at-risk-of-long-covid","modifiedDateTime":"2022-03-18T14:32:46.803447Z","project":"wwverticals","slug":"future\u002Farticle\u002F20220225-are-children-at-risk-of-long-covid","cacheLastUpdated":1657756317506},"future\u002Farticle\u002F20211025-how-face-masks-affect-young-children":{"urn":"urn:pubpipe:wwverticals:article:future\u002Farticle\u002F20211025-how-face-masks-affect-young-children","_id":"62b41ff71f4b7b7f6237ba57","ambientVideo":"","articleType":"story","assetVideo":null,"author":[],"bodyIntro":"In Singapore and many other countries around the world, it's common for young children to wear masks against Covid-19 – but aside from the protection they provide against the virus, might they pose a risk to their longer-term development?","businessUnit":"worldwide","cards":[{"bodyHtml":{"assets":[],"html":"\u003Cp\u003ELike many children his age, three-year-old Eshan Evans is energetic and boisterous. But as soon as he has to put on a face mask at school, something changes. \"You can see he's a different boy, much tamer and quieter,\" says his mother Herne.\u003C\u002Fp\u003E\n\u003Cp\u003EIn Singapore, where Eshan and his family live, children aged six and above are legally required to wear masks. But many kindergartens and pre-schools also strongly encourage the practice for younger children. It means that for roughly eight hours every weekday, except while eating, drinking, or napping, Eshan wears a disposable three-ply mask. \u003C\u002Fp\u003E\n\u003Cp\u003EThe moment he's let out, however, he rips off his mask, shoving it into his pocket or thrusting into his grandmother's hands. Once, on a particularly bad day in July, he threw his mask on the ground and ran out the school gates.\u003C\u002Fp\u003E\n\u003Cp\u003E\"He hates it,\" says his mother, who doesn't make her son wear a mask outside of school. \"I have nothing against masks... but we don't want to force it on him and know he's uncomfortable.\"\u003C\u002Fp\u003E\n\u003Cp\u003EThe decision of whether to mask young children is one that many parents and regulators around the world are facing as they try to prevent new waves of Covid-19, while also allowing children to develop, socialise and thrive emotionally. \u003C\u002Fp\u003E\n\u003Cp\u003EFrom a regulatory standpoint, as of early October, countries fall largely into three camps. Singapore and European countries such as \u003Ca href=\"https:\u002F\u002Fwww.service-public.fr\u002Fparticuliers\u002Factualites\u002FA14422\"\u003EFrance\u003C\u002Fa\u003E and \u003Ca href=\"https:\u002F\u002Fwww.salute.gov.it\u002Fportale\u002Fnuovocoronavirus\u002FdettaglioFaqNuovoCoronavirus.jsp?lingua=italiano&id=235\"\u003EItaly\u003C\u002Fa\u003E recommend masking up from the age of six. This is in line the World Health Organization's \u003Ca href=\"http:\u002F\u002Fwho.int\u002Fpublications\u002Fi\u002Fitem\u002FWHO-2019-nCoV-IPC_Masks-Children-2020.1\"\u003Eguidelines\u003C\u002Fa\u003E, which recommend that children over six wear masks in certain circumstances, for example when there is \u003Ca href=\"https:\u002F\u002Fwww.who.int\u002Fnews-room\u002Fq-a-detail\u002Fq-a-children-and-masks-related-to-covid-19\"\u003Ewidespread transmission\u003C\u002Fa\u003E in their area. Some only apply the rule to specific indoor settings, such as school.  \u003C\u002Fp\u003E\n\u003Cp\u003EOther regulatory bodies, including the \u003Ca href=\"https:\u002F\u002Fwww.cdc.gov\u002Fcoronavirus\u002F2019-ncov\u002Fcommunity\u002Fschools-childcare\u002Fk-12-guidance.html\"\u003ECenters for Disease Control and Prevention\u003C\u002Fa\u003E in the United States, recommend mask-wearing for those aged two and older. And then there are those countries that have dropped requirements for in-classroom face coverings – for instance, in the UK, \u003Ca href=\"https:\u002F\u002Fwww.gov.uk\u002Fgovernment\u002Fpublications\u002Factions-for-schools-during-the-coronavirus-outbreak\u002Fschools-covid-19-operational-guidance\"\u003Eneither children nor their teachers\u003C\u002Fa\u003E are advised to wear masks to school.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"infographic","imageAlignment":"centre","imageOrientation":"landscape","pullQuoteImageAlignment":"centre","videoImageAlign":"centre","id":"future\u002Farticle\u002F20211025-how-face-masks-affect-young-children-0"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":[],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20211025-how-face-masks-affect-young-children-1"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EThe only globally accepted consensus is that babies and children under two \u003Ca href=\"https:\u002F\u002Fwww.cdc.gov\u002Fcoronavirus\u002F2019-ncov\u002Fprevent-getting-sick\u002Fabout-face-coverings.html\"\u003Eshould not wear masks\u003C\u002Fa\u003E, due to the risk of suffocation.\u003C\u002Fp\u003E\n\u003Cp\u003E\"The age limit for the use of masks by children is not yet a scientific definition,\" says Adamos Hadjipanayis, president of the European Academy of Paediatrics.\u003C\u002Fp\u003E\n\u003Cp\u003EThere have been \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F33533522\u002F\"\u003Erelatively few studies\u003C\u002Fa\u003E investigating mask-wearing in children, due to ethical and logistical challenges. Those few studies, which focused on the physical impact of masks on breathing, did not find any harmful effects. But the debate around the wider pros and cons has been heated.\u003C\u002Fp\u003E\n\u003Cp\u003EProponents of mask-wearing argue that masks protect the wearer and those around them from Covid-19, and that the risk factors of the disease for young children should not be overlooked. Most countries do not vaccinate children under 12, or only in exceptional cases, which leaves them comparatively exposed. Serious cases of Covid-19 in young children are still \u003Ca href=\"https:\u002F\u002Fwww.cdc.gov\u002Fcoronavirus\u002F2019-ncov\u002Fcovid-data\u002Finvestigations-discovery\u002Fhospitalization-death-by-age.html\"\u003Erelatively rare \u003C\u002Fa\u003E– according to a \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fnews\u002Fhealth-57766717\"\u003Elarge UK study\u003C\u002Fa\u003E published this July, roughly one in 50,000 children with Covid end up in intensive care, and two in a million die. But the rapidly spreading \u003Ca href=\"https:\u002F\u002Fwww.bmj.com\u002Fcontent\u002F373\u002Fbmj.n1513\"\u003EDelta variant\u003C\u002Fa\u003E, which is at least \u003Ca href=\"https:\u002F\u002Fwww.cdc.gov\u002Fcoronavirus\u002F2019-ncov\u002Fvariants\u002Fdelta-variant.html#:~:text=The%20Delta%20variant%20is%20more,previous%20variants%20in%20unvaccinated%20people.\"\u003Etwice as contagious\u003C\u002Fa\u003E compared with previous strains, is putting pressure on countries to contain and prevent outbreaks, \u003Ca href=\"https:\u002F\u002Fdownloads.aap.org\u002FDOFA\u002FAAP%20Letter%20to%20FDA%20on%20Timeline%20for%20Authorization%20of%20COVID-19%20Vaccine%20for%20Children_08_05_21.pdf\"\u003Eincluding among children\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003E\"Delta makes the situation far worse,\" says Deepti Gurdasani, a clinical epidemiologist at Queen Mary University of London. \"Post-Delta, we're seeing a lot of outbreaks in schools all over the world.\"\u003C\u002Fp\u003E\n\u003Cp\u003EThe good news is that mask-wearing has been linked to lower rates of Covid-19 in schools. For example, in the US state of North Carolina, where masking is compulsory for students above six, schools reported \u003Ca href=\"https:\u002F\u002Fabcsciencecollaborative.org\u002Fwp-content\u002Fuploads\u002F2021\u002F06\u002FABCs-Final-Report-June-2021.06-esig-DB-KZ-6-29-21.pdf\"\u003Eextremely low transmission rates\u003C\u002Fa\u003E – although more than 7,000 children and staff attended school while carrying the virus between March and June 2021, only 363 Covid-19 cases were found to have been caused as a result.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20211025-how-face-masks-affect-young-children-2"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"Masks provide an additional layer of protection against Covid-19 and have been shown to decrease the risk of getting the disease – Annabelle de St. Maurice","id":"future\u002Farticle\u002F20211025-how-face-masks-affect-young-children-3"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EIn another survey involving 169 elementary schools in Georgia, researchers found that when teachers and staff were required to wear masks, reported \u003Ca href=\"https:\u002F\u002Fjamanetwork.com\u002Fjournals\u002Fjama\u002Ffullarticle\u002F2781847\"\u003ECovid-19 cases were 37% lower\u003C\u002Fa\u003E compared to schools without a mask mandate.\u003C\u002Fp\u003E\n\u003Cp\u003E\"Masks provide an additional layer of protection against Covid-19 and have been shown to decrease the risk of getting the disease,\" says Annabelle de St. Maurice, an assistant professor of paediatrics at the University of California, Los Angeles. \u003C\u002Fp\u003E\n\u003Cp\u003EOf course, masking may not solely be responsible for reducing transmission. Other protective factors such as \"personal hand hygiene, safe distancing, and whether an area is well-ventilated may play a part,\" says Mark Ng, the clinical lead of the infection prevention and infectious diseases workgroup at Singhealth Polyclinics in Singapore.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20211025-how-face-masks-affect-young-children-4"},{"bodyHtml":{"assets":[]},"calloutBodyHtml":"\u003Cp\u003EThis article is part of \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Ffamily-tree\" target=\"_blank\"\u003E\u003Cstrong\u003EFamily Tree\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E, a new series of features from the BBC that examine the issues and opportunities that parents, children and families face all over the world. It examines the role that families have in today's society and how they will be part of the world tomorrow.\u003C\u002Fp\u003E\n\u003Cp\u003EYou might also be interested in some other stories about how the pandemic is affecting children:\u003C\u002Fp\u003E\n\u003Cul\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20211011-covid-19-should-we-vaccinate-children\"\u003EShould we vaccinate young children?\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20210913-the-little-known-virus-that-surged-in-children-this-summer\"\u003EHow Covid-19 led a children's virus to surge\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20200603-how-covid-19-is-changing-the-worlds-children\"\u003EHow the pandemic is changing children\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003C\u002Ful\u003E","calloutTitle":"Family Tree","cardType":"CalloutBox","iFrameType":"","id":"future\u002Farticle\u002F20211025-how-face-masks-affect-young-children-5"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EBut masks are an efficient and effective preventive measure, which is probably why many parents of young children in Singapore still stuck to it even after the island state \u003Ca href=\"https:\u002F\u002Fwww.straitstimes.com\u002Fsingapore\u002Flegal-cut-off-age-for-children-to-wear-masks-to-be-raised-to-6-years-old-and-above\"\u003Eraised the legal mask-wearing age to six\u003C\u002Fa\u003E last September. The initial ruling, imposed half a year earlier, required children over two to be masked. (\u003Cem\u003ERead more about \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20200504-coronavirus-what-is-the-best-kind-of-face-mask\"\u003Ehow face masks reduce transmission\u003C\u002Fa\u003E.\u003C\u002Fem\u003E)\u003C\u002Fp\u003E\n\u003Cp\u003EFor Mimi Zainal, mother to two children aged three and five years old, the change in ruling made no difference. \"I prefer the kids to wear masks... it gives me a peace of mind to know they are more protected,\" she says. \u003C\u002Fp\u003E\n\u003Cp\u003EThe children struggled with wearing masks at first, Zainal admits, but she and her husband \"hyped it up\" into a fun activity that the family would do together before heading out. She bought a variety of patterns – astronauts, unicorns, and other colourful prints – for the children to choose from. Within a matter of weeks, the kids got used to their masks, she says.\u003C\u002Fp\u003E\n\u003Cp\u003ESome argue that even the jolliest pattern can't change one fundamental problem with masks: they hide half the face, and may make it harder to decode people's moods and feelings.\u003C\u002Fp\u003E\n\u003Cp\u003EChildren begin to recognise basic emotions – happiness, sadness, fear, anger, and so on – from as early as 10 months of age, with development peaking around five or six years, says Kang Lee, a developmental psychologist at the University of Toronto.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20211025-how-face-masks-affect-young-children-6"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":[],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20211025-how-face-masks-affect-young-children-7"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EBeing able to see faces in their entirety is a key part of such development and masking can hinder that process, he says: \"We learn emotions mostly through the face.\" (\u003Cem\u003ERead more about \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20200603-how-covid-19-is-changing-the-worlds-children\"\u003Ehow the pandemic might be changing the world's children\u003C\u002Fa\u003E.\u003C\u002Fem\u003E)  \u003C\u002Fp\u003E\n\u003Cp\u003EBut other experts are skeptical of how much of an impediment masks really are. \"Faces aren't necessarily the only or the most important cue to someone else's emotions,\" says Ashley Ruba, a postdoctoral researcher at the University of Wisconsin-Madison's Child Emotion Lab. There are other vital signals too, she says, \"things like tone of voice, body posture, and overall social situation\".\u003C\u002Fp\u003E\n\u003Cp\u003EA \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F22892280\u002F\"\u003E2012 study\u003C\u002Fa\u003E found that children under the age of nine could still correctly pinpoint the emotions of the faces they were viewing, even if they couldn't see their mouths. And in an experiment conducted last year, Ruba and her colleague discovered that while masks slightly impaired children's ability to recognise sadness, anger, and fear, the \u003Ca href=\"https:\u002F\u002Fjournals.plos.org\u002Fplosone\u002Farticle?id=10.1371\u002Fjournal.pone.0243708\"\u003Eoverall effect was the same with sunglasses\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003E\"This is another piece of evidence to suggest that masks may not have such a negative impact on children's emotional development,\" she says. After all, people usually don't worry about wearing sunglasses around kids.\u003C\u002Fp\u003E\n\u003Cp\u003EEva Chen, a developmental psychologist at the Hong Kong University of Science and Technology, points out that in any case, people are not wearing masks or sunglasses all the time: \"So children are not 100% deprived of facial information.\" And in places like China, South Korea, and Japan, where \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fnews\u002Fworld-52015486\"\u003Emasking was commonplace\u003C\u002Fa\u003E even before the pandemic struck, children have developed normally, she adds.\u003C\u002Fp\u003E\n\u003Cp\u003EOne potentially greater area of concern may be the impact of masks on children's language development. Here, experts too are somewhat divided in their views, but they agree on one thing: there's a lot parents can do to bridge any budding problems.\u003C\u002Fp\u003E\n\u003Cp\u003E\"Children learn through observation,\" says Lynette Teo, who teaches childhood language and literacy development at Singapore's Ngee Ann Polytechnic. \"They look at the movement of the mouth, and see the lips and tongue move. If you just think about the 'th' sound, the placement of the tongue is so important.\"\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20211025-how-face-masks-affect-young-children-8"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":[],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20211025-how-face-masks-affect-young-children-9"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EBut parents shouldn't worry too much, says Lee. \"Kids are very adaptable to the environment. If one channel is blocked, they will go to another channel.\" To help kids understand, he suggests teachers and parents enhance their speech, posture, body movement and gestures when speaking with them.\u003C\u002Fp\u003E\n\u003Cp\u003EThe situation for children with special needs is different, however, says Stephen Camarata, a professor of hearing and speech sciences at Vanderbilt University in Tennessee, who works extensively with such kids. \"Children with disabilities, especially hearing loss, use facial features to fill in the information they're not hearing,\" he says. \"They really need that visual information to understand what you're saying. With masks on, they're just not getting access to those cues.\"\u003C\u002Fp\u003E\n\u003Cp\u003EHe also expects masks to generally make it harder for young children to learn new words: \"In the short term, in terms of comprehending new words and vocabulary, [masks are] going to have an attenuating effect.\"      \u003C\u002Fp\u003E\n\u003Cp\u003EZainal, the Singaporean mother of two, noticed such a potential lag in her own son, but was able to solve through additional support. Worried that the five-year-old \"was a bit slow in learning his phonics,\" she sent him for extra classes at a tuition centre earlier this year. \"I found that even though teachers had masks on, he was still able to pick up the sounds and learn.\"\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20211025-how-face-masks-affect-young-children-10"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"In the long run, I don't see any negative psychological effects on children – Kang Lee","id":"future\u002Farticle\u002F20211025-how-face-masks-affect-young-children-11"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003ETammy Lim, a consultant with the Child Development Unit at Singapore's National University Hospital, agrees. She highlights how a local study found that two-year-olds were \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC8236912\u002F\"\u003Estill able to learn and recognise words\u003C\u002Fa\u003E even when spoken from behind a mask. In her view, the impact of masks on children is negligible compared to the other ways in which Covid-19 has disrupted their lives. She's more worried about how increased screen time, for example, has displaced exercise, playtime, and other activities. Already, her unit has seen an increase in young patients with developmental delays and behavioural issues, which she partly ascribes to the lack of opportunities for free play and socialising.\u003C\u002Fp\u003E\n\u003Cp\u003EBy comparison, the lasting effects of masking, if any, may be trivial. \"In the long run, I don't see any negative psychological effects on children,\" says Lee.\u003C\u002Fp\u003E\n\u003Cp\u003EChen takes a similar view. \"Kids acclimatise surprisingly easily,\" she says. If parents are worried, she suggests the best solution is to spend as much time as possible with their kids. \"There's plenty of research to show that it's really important to have a child feel securely attached to their parents – to have their parents listen to them and reflect their emotions back to them, and to communicate extensively with one another.\"\u003C\u002Fp\u003E\n\u003Cp\u003ECreating those warm family moments may be the best way to weather the upheaval of pandemic-induced rules and disruptions.\u003C\u002Fp\u003E\n\u003Cp\u003EFor Zainal, that involved coming up with creative ways for her kids to have fun at home, such as picnicking on the balcony, having an indoor scavenger hunt, and doing weekly craft activities. Masks are annoying, she says, but there's still fun to be had indoors. And when they do venture out, masks provide \"a sense of assurance to know that the kids are at least protected in a way, and can continue going to school and interacting with their friends\".\u003C\u002Fp\u003E\n\u003Cp\u003E--\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EAll content within this article is provided for general information only, and should not be treated as a substitute for the medical advice of health care professionals. The BBC encourages anyone interested in further information to seek advice from their health care provider.\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EDisclaimer: The BBC is not responsible or liable for any diagnosis or actions taken by a user based on the content of this site. The BBC is not liable for the contents of any external internet sites listed, nor does it endorse any commercial product or service mentioned or advised on any of the sites. Always consult your own GP if you're in any way concerned about your health or the health of your child.\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E -- \u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EJoin one million Future fans by liking us on \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.facebook.com\u002FBBCFuture\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EFacebook\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, or follow us on \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Ftwitter.com\u002FBBC_Future\"\u003E\u003Cstrong\u003E\u003Cem\u003ETwitter\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E or\u003Cstrong\u003E \u003C\u002Fstrong\u003E\u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.instagram.com\u002Fbbcfuture_official\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EInstagram\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E.\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EIf you liked this story, \u003C\u002Fem\u003E\u003Ca href=\"http:\u002F\u002Fpages.emails.bbc.com\u002Fsubscribe\u002F?ocid=fut.bbc.email.we.email-signup\"\u003E\u003Cstrong\u003E\u003Cem\u003Esign up for the weekly bbc.com features newsletter\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, called \"The Essential List\". A handpicked selection of stories from BBC Future, Culture, Worklife, and Travel, delivered to your inbox every Friday.\u003C\u002Fem\u003E\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20211025-how-face-masks-affect-young-children-12"}],"collection":[],"disableAdverts":false,"displayDate":"2021-10-25T14:50:40.217Z","embeddedCustomHtml":"","embeddedInfographicUrl":"","embeddedType":"infographic","headlineLong":"Should young children be made to wear face masks?","headlineShort":"How face masks affect young children","image":[],"imageAlignment":"centre","imageAltText":"","isSyndicated":true,"latitude":"","longitude":"","mpsVideo":"","option":[],"partner":null,"primaryVertical":"future","promoAlignment":"centre","promoAltText":"","promoImage":null,"relatedStories":null,"relatedTag":null,"summaryLong":"In many countries, it's common for young children to wear masks against Covid-19 – but do the benefits of protection against the virus pose a risk to their long term development?","summaryShort":"Should youngsters wear face masks to help curb the spread to Covid-19?","tag":[],"textToSpeech":false,"creationDateTime":"2021-10-26T00:00:22.496249Z","entity":"article","guid":"51403b48-ec2a-4d1c-8f5f-19c8bf650941","id":"future\u002Farticle\u002F20211025-how-face-masks-affect-young-children","modifiedDateTime":"2022-02-24T19:30:31.09828Z","project":"wwverticals","slug":"future\u002Farticle\u002F20211025-how-face-masks-affect-young-children","cacheLastUpdated":1657756317506},"future\u002Farticle\u002F20210913-the-little-known-virus-that-surged-in-children-this-summer":{"urn":"urn:pubpipe:wwverticals:article:future\u002Farticle\u002F20210913-the-little-known-virus-that-surged-in-children-this-summer","_id":"62b41ff51f4b7b7aba74bb80","ambientVideo":"","articleType":"story","assetVideo":null,"author":[],"bodyIntro":"Doctors used to know RSV as a seasonal virus that emerged in the winter, but in the last few months in the Northern Hemisphere there has been a surprising surge in cases.","businessUnit":"worldwide","cards":[{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EIn early 2021 staff at Maimonides Children's Hospital in Brooklyn, New York, were starting to feel a cautious sense of relief. Covid-19 cases in the city were falling. As a side effect of social distancing, mask-wearing and hand-washing, they had also seen far fewer other viral infections, \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20201009-could-social-distancing-make-the-flu-extinct\"\u003Esuch as the flu\u003C\u002Fa\u003E. But then in March a growing number of coughing children and babies arrived at the hospital, some of them struggling to breathe.\u003C\u002Fp\u003E\n\u003Cp\u003EThey'd been infected with RSV, short for respiratory syncytial virus, a common winter bug that can cause lung problems. At this time of the year, RSV cases should have been dwindling. Instead, \u003Ca href=\"https:\u002F\u002Fpediatrics.aappublications.org\u002Fcontent\u002F148\u002F3\u002Fe2021052089\"\u003Ethey were soaring\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003EOver the months that followed, out-of-season RSV surges would disrupt summers in places as far afield as the \u003Ca href=\"https:\u002F\u002Femergency.cdc.gov\u002Fhan\u002F2021\u002Fhan00443.asp\"\u003Esouthern US\u003C\u002Fa\u003E, \u003Ca href=\"https:\u002F\u002Fwww.paediatrieschweiz.ch\u002Fnews\u002Fepidemiologie-von-rsv-infektionen-2\u002F\"\u003ESwitzerland\u003C\u002Fa\u003E, \u003Ca href=\"https:\u002F\u002Fwwwnc.cdc.gov\u002Feid\u002Farticle\u002F27\u002F11\u002F21-1565_article\"\u003EJapan\u003C\u002Fa\u003E and \u003Ca href=\"https:\u002F\u002Fwww.gov.uk\u002Fgovernment\u002Fnews\u002Fhealth-chiefs-issue-warning-as-childhood-respiratory-infections-rise-ahead-of-winter\"\u003Ethe UK\u003C\u002Fa\u003E. The virus's strange behaviour appears to be an indirect consequence of the Covid-19 pandemic, doctors say. Last year, lockdowns and hygiene measures \u003Ca href=\"https:\u002F\u002Facademic.oup.com\u002Fcid\u002Farticle\u002F72\u002F12\u002F2199\u002F5912591\"\u003Esuppressed the spread of coronavirus, but also other viruses such as RSV\u003C\u002Fa\u003E. As a result, children \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC8299745\u002F\"\u003Edid not have the opportunity to build up immunity\u003C\u002Fa\u003E against them.\u003C\u002Fp\u003E\n\u003Cp\u003EOnce the measures were loosened, RSV found a large pool of susceptible babies and children to infect, leading to sudden surges at unexpected times. A previously fairly predictable bug turned into one that could surprise hospitals and families at any time of the year. The unseasonal outbreaks stretched wards to their limits, put \u003Ca href=\"https:\u002F\u002Fwww.gov.uk\u002Fgovernment\u002Fnews\u002Fhealth-chiefs-issue-warning-as-childhood-respiratory-infections-rise-ahead-of-winter\"\u003Efamilies on alert\u003C\u002Fa\u003E, and showed just how deeply Covid-19 and the associated measures had reshaped the world.\u003C\u002Fp\u003E\n\u003Cp\u003EFor staff on the ground, the experience was dramatic.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"infographic","imageAlignment":"centre","imageOrientation":"landscape","pullQuoteImageAlignment":"centre","videoImageAlign":"centre","id":"future\u002Farticle\u002F20210913-the-little-known-virus-that-surged-in-children-this-summer-0"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":[],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20210913-the-little-known-virus-that-surged-in-children-this-summer-1"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003E\"Our ICU (intensive care unit) again became overwhelmed, this time not with Covid, but with another virus,\" recalls Rabia Agha, the director of the division of paediatric infectious diseases at Maimonides Children's Hospital. At the peak of the outbreak, in early April, the majority of children admitted into the ICU were being admitted for RSV.\u003C\u002Fp\u003E\n\u003Cp\u003EAround the world, the virus ripped through populations of young children who had been shielded from infectious diseases for months, and were now suddenly exposed to them.\u003C\u002Fp\u003E\n\u003Cp\u003E\"It surprised us. We knew that it was something to look out for, but we didn't think it would be that many,\" says Christoph Berger, head of the department of infectious diseases and hospital epidemiology at the University Children's Hospital in Zurich.\u003C\u002Fp\u003E\n\u003Cp\u003EAt his hospital, RSV cases usually peak in January, and hover around zero in the summer months of June to August. This year, there were no cases in winter. Instead, they began to rise steeply in June, then soared to 183 infections in July, higher than in previous winter seasons.\u003C\u002Fp\u003E\n\u003Cp\u003E\"We were full, every single bed was occupied, and that's a challenge,\" Berger recalls of the height of the outbreak in July. His hospital had to transfer sick babies and children with RSV to other hospitals that still had space. Several other \u003Ca href=\"https:\u002F\u002Fwww.paediatrieschweiz.ch\u002Fnews\u002Fepidemiologie-von-rsv-infektionen-2\u002F\"\u003ESwiss hospitals\u003C\u002Fa\u003E experienced the same.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20210913-the-little-known-virus-that-surged-in-children-this-summer-2"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"If you skip one season, then you are not producing antibodies against it, and mothers are not producing antibodies that can then be passed on to babies – Rabia Agha","id":"future\u002Farticle\u002F20210913-the-little-known-virus-that-surged-in-children-this-summer-3"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003ERSV posed a bigger problem for them than the coronavirus during the summer in Switzerland. \"We had almost no Covid cases during that period,\" says Berger. The few children who came to the hospital with Covid recovered relatively quickly. \"Those with RSV stayed longer,\" he says.\u003C\u002Fp\u003E\n\u003Cp\u003EAn RSV infection is not in itself a cause for alarm. According to the US \u003Ca href=\"https:\u002F\u002Fwww.cdc.gov\u002Frsv\u002Fhigh-risk\u002Finfants-young-children.html\"\u003ECenters for Disease Control and Prevention\u003C\u002Fa\u003E, most children will have had one by the time they are two years old. The majority will experience it as a cold-like illness, with a \u003Ca href=\"https:\u002F\u002Fwww.gov.uk\u002Fgovernment\u002Fpublications\u002Frespiratory-syncytial-virus-rsv-symptoms-transmission-prevention-treatment\u002Frespiratory-syncytial-virus-rsv-symptoms-transmission-prevention-treatment#transmission\"\u003Erunny nose and cough\u003C\u002Fa\u003E, and recover by themselves. But in some babies and young children, it can cause \u003Ca href=\"https:\u002F\u002Fwhat0-18.nhs.uk\u002Fparentscarers\u002Fworried-your-child-unwell\u002Fwheeze-and-breathing-difficulties\"\u003Ebronchiolitis\u003C\u002Fa\u003E, an inflammation of the lower parts of the lung. They may struggle to breathe and feed.\u003C\u002Fp\u003E\n\u003Cp\u003EAbout 1-2% of babies under 6 months old with RSV have to be taken to hospital and given \u003Ca href=\"https:\u002F\u002Fwww.nhs.uk\u002Fconditions\u002Fbronchiolitis\u002Ftreatment\u002F\"\u003Eextra oxygen\u003C\u002Fa\u003E through a mask or tubes in their nose to help them recover. Some may also require a \u003Ca href=\"https:\u002F\u002Fwww.nhs.uk\u002Fconditions\u002Fbronchiolitis\u002Ftreatment\u002F\"\u003Efeeding tube\u003C\u002Fa\u003E. With that support, most will get better within a few days.\u003C\u002Fp\u003E\n\u003Cp\u003EBefore the coronavirus pandemic, hospitals routinely prepared for RSV surges ahead of winter. The most at-risk patients, such as premature babies and those with existing lung and heart problems, can be protected with \u003Ca href=\"https:\u002F\u002Fwww.ouh.nhs.uk\u002Fpatient-guide\u002Fleaflets\u002Ffiles\u002F45436Ppalivizumab.pdf\"\u003Epalivizumab\u003C\u002Fa\u003E, a shot of antibodies that helps fight off the virus. The shot needs to be given every month throughout the months when RSV is active, another reason why preparing for surges is so crucial.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20210913-the-little-known-virus-that-surged-in-children-this-summer-4"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":[],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20210913-the-little-known-virus-that-surged-in-children-this-summer-5"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EThe pandemic has disrupted that seasonal rhythm, and its role in the usual development of children's immunity.  \u003C\u002Fp\u003E\n\u003Cp\u003E\"With the measures we had for Covid, people were not meeting, people were not travelling, and people were being very careful with masking and distancing,\" says Agha. \"And that truly helped to keep Covid as well as all other viruses at bay. So, one season of this RSV was completely missed. And if you skip one season, then you are not producing antibodies against it, and mothers are not producing antibodies that can then be passed on to babies.\"\u003C\u002Fp\u003E\n\u003Cp\u003EAs a result, those babies may then be particularly vulnerable to RSV when the world re-opens. Data from different countries \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC8299745\u002F\"\u003Esupports that idea\u003C\u002Fa\u003E of an immunity gap due to a skipped season. \"The greatest relative increase in cases are in children aged one, who 'missed' an RSV season last autumn\u002Fwinter\", officials at Public Health England said in an email to the BBC, describing the \u003Ca href=\"https:\u002F\u002Fwww.gov.uk\u002Fgovernment\u002Fstatistics\u002Fnational-flu-and-covid-19-surveillance-reports-2021-to-2022-season\"\u003Esurges seen in parts of England\u003C\u002Fa\u003E over the summer there.\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EYou might also be interested in:\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cul\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20210609-how-long-will-long-covid-last\"\u003EWhat long Covid is revealing about disease\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20200603-how-covid-19-is-changing-the-worlds-children\"\u003EHow Covid-19 is changing the world's children\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20210222-the-unusual-ways-western-parents-raise-children\"\u003EIs the Western way of raising kids weird?\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003C\u002Ful\u003E\n\u003Cp\u003EA skipped season increases the pool of susceptible babies and children, since it includes those who were shielded during the winter, as well as those born since then. That may make viral surges more powerful when they eventually hit. In Tokyo, researchers have reported the \u003Ca href=\"C:\\Users\\Zaria%20Gorvett\\Downloads\\National%20Center%20for%20Global%20Health%20and%20Medicine\"\u003Elargest annual rise in RSV cases\u003C\u002Fa\u003E since monitoring began in 2003. They suggest the build-up of susceptible people during the pandemic may have contributed to the unusually big outbreak this year.\u003C\u002Fp\u003E\n\u003Cp\u003EOther aspects of the new viral landscape are still unclear, such as the question of why RSV surged once anti-Covid measures were loosened, but not \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20201009-could-social-distancing-make-the-flu-extinct\"\u003Ethe flu\u003C\u002Fa\u003E, which has remained fairly subdued. The precise pattern of the out-of-season RSV surges has also varied somewhat from country to country. Agha and her team in Brooklyn observed that their surge was unusually severe, affecting much \u003Ca href=\"https:\u002F\u002Fpediatrics.aappublications.org\u002Fcontent\u002F148\u002F3\u002Fe2021052089\"\u003Eyounger children\u003C\u002Fa\u003E than usual and sending a higher proportion into intensive care. But in \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC7929151\u002F\"\u003EAustralia\u003C\u002Fa\u003E, for example, it affected an older age group than before. Berger says that the Swiss summer outbreaks had been no more severe than typical winter surges.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20210913-the-little-known-virus-that-surged-in-children-this-summer-6"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":[],"imageAlignment":"centre","imageOrientation":"portrait","id":"future\u002Farticle\u002F20210913-the-little-known-virus-that-surged-in-children-this-summer-7"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EOne big question is what this new pattern means for the coming months. A summer surge does not necessarily mean there won't be more cases when the weather turns cold. And in some areas, cases are only beginning to rise now, in early autumn.\u003C\u002Fp\u003E\n\u003Cp\u003E\"RSV, and the bronchiolitis that it causes, is definitely the key thing that at the moment the children's hospitals are planning for, expecting, beginning to see and looking after,\" says Sophia Varadkar, deputy medical director and consultant paediatric neurologist at Great Ormond Street Hospital for Children in London.\u003C\u002Fp\u003E\n\u003Cp\u003EAt her hospital, cases have started rising, and she expects to see more in the coming weeks. For those caring for babies, RSV can be a greater worry than Covid-19, says Varadkar. \"Covid for children, in general, was not a significant illness. It did not make many children really unwell. RSV is a potentially bigger illness, [affecting] many more children, and we definitely know that it can make those small babies unwell,\" she says.\u003C\u002Fp\u003E\n\u003Cp\u003EWith schools reopening, viruses including RSV will have more opportunities to spread. But adults' behaviour may be even more crucial. In Switzerland, nurseries and playgroups remained open throughout the winter, and young children did not wear masks. Yet almost no children came down with viral infections such as RSV and the flu that winter, presumably because the adults' hygiene measures helped protect them.\u003C\u002Fp\u003E\n\u003Cp\u003E\"People always say that the children infect the adults, but if you think about it, that wasn't the case at all here, it was the other way round,\" says Berger. \"When adults and older children wear masks, observe social distancing and wash their hands, we see neither flu nor RSV. And when they loosen their measures, the virus circulates again, and more young children end up in hospital.\"\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20210913-the-little-known-virus-that-surged-in-children-this-summer-8"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"Hand-washing, and keeping vulnerable babies away from people with runny noses and coughs, can help the spread of infection","id":"future\u002Farticle\u002F20210913-the-little-known-virus-that-surged-in-children-this-summer-9"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EEven after the summer surge, his hospital remains on guard. \"I have no idea how this will continue, and whether those were all the cases, or whether we'll see another wave in winter – I don't know.\"\u003C\u002Fp\u003E\n\u003Cp\u003EHand-washing, and keeping vulnerable babies away from people with runny noses and coughs, can help the spread of infection. It can also flatten the peak of an RSV epidemic, ensuring hospitals have the capacity to look after every child who needs help.  \u003C\u002Fp\u003E\n\u003Cp\u003E\"For most of the children, it will be a mild illness, they can be looked after by their parents, they just need comfort, more frequent feeds, a quiet time, some paracetamol if they have a temperature, and that's all that they need,\" says Varadkar in London. But if the baby is struggling to breathe or feed, or parents feel \u003Ca href=\"https:\u002F\u002Fwhat0-18.nhs.uk\u002Fparentscarers\u002Fworried-your-child-unwell\u002Fwheeze-and-breathing-difficulties\"\u003Esomething is just not right\u003C\u002Fa\u003E, they should seek help, she says.\u003C\u002Fp\u003E\n\u003Cp\u003EAt Maimonides Children's Hospital in Brooklyn, the peak of the RSV surge has passed. But Agha sees a broader lesson for hospitals adjusting to a post-Covid-19 world.\u003C\u002Fp\u003E\n\u003Cp\u003E\"What it taught us was that you have to be prepared,\" says Agha. \"These are not the same times as two years ago. Life has changed, the world has changed, and these viruses are evolving and behaving in unexpected ways.\"\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003E--\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EJoin one million Future fans by liking us on \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.facebook.com\u002FBBCFuture\u002F\"\u003E\u003Cem\u003E\u003Cstrong\u003EFacebook\u003C\u002Fstrong\u003E\u003C\u002Fem\u003E\u003C\u002Fa\u003E\u003Cem\u003E, or follow us on \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Ftwitter.com\u002FBBC_Future\"\u003E\u003Cem\u003E\u003Cstrong\u003ETwitter\u003C\u002Fstrong\u003E\u003C\u002Fem\u003E\u003C\u002Fa\u003E\u003Cem\u003E or \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.instagram.com\u002Fbbcfuture_official\u002F\"\u003E\u003Cem\u003E\u003Cstrong\u003EInstagram\u003C\u002Fstrong\u003E\u003C\u002Fem\u003E\u003C\u002Fa\u003E\u003Cem\u003E.\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EIf you liked this story, \u003C\u002Fem\u003E\u003Ca href=\"http:\u002F\u002Fpages.emails.bbc.com\u002Fsubscribe\u002F?ocid=fut.bbc.email.we.email-signup\"\u003E\u003Cem\u003E\u003Cstrong\u003Esign up for the weekly bbc.com features newsletter\u003C\u002Fstrong\u003E\u003C\u002Fem\u003E\u003C\u002Fa\u003E\u003Cem\u003E, called \"The Essential List\". A handpicked selection of stories from \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002F\" target=\"_blank\"\u003E\u003Cem\u003E\u003Cstrong\u003EBBC Future\u003C\u002Fstrong\u003E\u003C\u002Fem\u003E\u003C\u002Fa\u003E\u003Cem\u003E, \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fculture\u002F\" target=\"_blank\"\u003E\u003Cem\u003E\u003Cstrong\u003ECulture\u003C\u002Fstrong\u003E\u003C\u002Fem\u003E\u003C\u002Fa\u003E\u003Cem\u003E, \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fworklife\u002F\" target=\"_blank\"\u003E\u003Cstrong\u003E\u003Cem\u003EWorklife\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ftravel\u002F\" target=\"_blank\"\u003E\u003Cem\u003E\u003Cstrong\u003ETravel\u003C\u002Fstrong\u003E\u003C\u002Fem\u003E\u003C\u002Fa\u003E\u003Cem\u003E and \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Freel\"\u003E\u003Cstrong\u003E\u003Cem\u003EReel\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E delivered to your inbox every Friday.\u003C\u002Fem\u003E\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20210913-the-little-known-virus-that-surged-in-children-this-summer-10"}],"collection":[],"disableAdverts":false,"displayDate":"2021-09-14T01:00:00Z","embeddedCustomHtml":"","embeddedInfographicUrl":"","embeddedType":"infographic","headlineLong":"The little-known virus that surged in children this year","headlineShort":"How Covid-19 boosted a children's virus","image":[],"imageAlignment":"centre","imageAltText":"","isSyndicated":true,"latitude":"","longitude":"","mpsVideo":"","option":[],"partner":null,"primaryVertical":"future","promoAlignment":"centre","promoAltText":"","promoImage":null,"relatedStories":null,"relatedTag":null,"summaryLong":"Doctors used to know RSV as a seasonal virus that emerged in the winter, but in the last few months there has been a surge in the Northern Hemisphere.","summaryShort":"Before the coronavirus pandemic, RSV was mostly a winter problem","tag":[],"textToSpeech":false,"creationDateTime":"2021-09-14T00:00:11.285529Z","entity":"article","guid":"fad46d62-30d5-4164-8f97-6cf366fe00e4","id":"future\u002Farticle\u002F20210913-the-little-known-virus-that-surged-in-children-this-summer","modifiedDateTime":"2022-02-28T13:38:21.750907Z","project":"wwverticals","slug":"future\u002Farticle\u002F20210913-the-little-known-virus-that-surged-in-children-this-summer","cacheLastUpdated":1657756317506},"future\u002Farticle\u002F20200603-how-covid-19-is-changing-the-worlds-children":{"urn":"urn:pubpipe:wwverticals:article:future\u002Farticle\u002F20200603-how-covid-19-is-changing-the-worlds-children","_id":"62b41ff31f4b7b09003af075","ambientVideo":"","articleType":"story","assetVideo":null,"author":[],"bodyIntro":"From their academic success to their social skills and mental health, the pandemic is a crisis for today’s children – and the fallout may follow them for the rest of their lives.","businessUnit":"worldwide","cards":[{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EWhen today’s children and adolescents grow up, will they see themselves as a “\u003Ca href=\"https:\u002F\u002Fen.wikipedia.org\u002Fwiki\u002FLost_Generation\"\u003Elost generation\u003C\u002Fa\u003E”, whose lives will forever fall in the shadow of a global pandemic?\u003C\u002Fp\u003E\n\u003Cp\u003EThe school closures are one of the most visible – and controversial – means by which Covid-19 is affecting young people. According to Unesco, \u003Ca href=\"https:\u002F\u002Fen.unesco.org\u002Fnews\u002Freopening-schools-when-where-and-how\"\u003Ethe education of nearly 1.6 billion pupils in 190 countries has so far been affected\u003C\u002Fa\u003E – that’s 90% of the world’s school-age children. And at the time of writing, there are still no definite plans for opening the schools of around half of these children.\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003EThere has been much \u003Ca href=\"https:\u002F\u002Fwww.sciencedirect.com\u002Fscience\u002Farticle\u002Fpii\u002FS2468266720300827\"\u003Edebate\u003C\u002Fa\u003E over the exact role that school closures have played containing the overall spread of the virus. It is just over five months since the novel coronavirus was first reported in Wuhan, meaning that the data describing its transmission and the effects of any particular measure are still patchy.\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003EBut according to Richard Armitage, in the division of public health and epidemiology at the University of Nottingham, those legitimate scientific questions about the effectiveness of school closures \u003Ca href=\"https:\u002F\u002Fwww.thelancet.com\u002Fjournals\u002Flanglo\u002Farticle\u002FPIIS2214-109X(20)30116-9\u002Ffulltext\"\u003Eshould not be taken as a justification\u003C\u002Fa\u003E for re-opening them prematurely. “An absence of evidence is not necessarily evidence of absence,” he says.\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003EWe know, after all, that transmission is higher in densely-packed, indoor spaces, and although the danger to children may not be as high as the risk to the adults teaching them, the virus does seem to evoke an \u003Ca href=\"https:\u002F\u002Fwww.who.int\u002Fnews-room\u002Fcommentaries\u002Fdetail\u002Fmultisystem-inflammatory-syndrome-in-children-and-adolescents-with-covid-19\"\u003Eextreme reaction in a very small number of paediatric cases\u003C\u002Fa\u003E. Crucially, children may become carriers who transmit the virus to the most vulnerable members of society, such as their grandparents. After all, they’re not exactly known for their fastidious hygiene.\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003EAll of which may make a full return to normality unlikely for most children in the next few months. And when that is combined with the other stresses of living in isolation under quarantine, it may have some serious consequences – delaying their cognitive, emotional and social development. For those in the most critical periods of adolescence, it may even increase the risk of mental illness.\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003ESince the poorest will be hardest hit by all of these effects, lockdowns are expected to widen the existing inequalities across the globe, with repercussions for years to come. “It’s disadvantaged children who pay the greatest price here, as they will fall the furthest behind, and have the fewest resources available to ‘catch up’ once the pandemic threat has passed,” says Armitage.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"infographic","imageAlignment":"centre","imageOrientation":"landscape","pullQuoteImageAlignment":"centre","videoImageAlign":"centre","id":"future\u002Farticle\u002F20200603-how-covid-19-is-changing-the-worlds-children-0"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":[],"imageAlignment":"centre","imageAltText":"Children wearing plastic face visors attend a class in Japan. (Credit: Getty Images)","imageOrientation":"landscape","id":"future\u002Farticle\u002F20200603-how-covid-19-is-changing-the-worlds-children-1"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003ESome experts, such as Wim Van Lancker, a sociologist at the University of Leuven in Belgium, go as far as to describe it at as “\u003Ca href=\"https:\u002F\u002Fwww.thelancet.com\u002Fjournals\u002Flanpub\u002Farticle\u002FPIIS2468-2667(20)30084-0\u002Ffulltext\"\u003Ea social crisis in the making\u003C\u002Fa\u003E”.\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003ESo what are the facts? And what can be done to mitigate these problems before it is too late?\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003EThe attainment gap\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003ELet’s first consider the consequences for the child’s intellectual development.\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003ESome clues to these effects come from studies of \u003Ca href=\"http:\u002F\u002Fftp.iza.org\u002Fdp2923.pdf\"\u003Eshort-term school closures due to snow\u003C\u002Fa\u003E. In 2007, Dave Marcotte, a professor in public affairs at American University in Washington DC, examined the standardised test scores of third, fifth and eighth graders in Maryland. The effects of school closures were greatest for the youngest children, with each lost day resulting in around 0.57% fewer children reaching the expected grades in reading and maths. The average school lost around 5 days, in total, due to bad weather – resulting in around a 3% drop in the overall pass rate – equivalent to roughly one child in a classroom of 30.\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EYou might also like:\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cul\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20200527-coronavirus-how-covid-19-could-redesign-our-world\" target=\"_blank\"\u003EHow Covid-19 could redesign our world\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20200520-why-lockdown-life-feels-like-its-going-faster\" target=\"_blank\"\u003EWhy time seems to be going faster while we are in lockdown\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20200528-why-most-covid-19-deaths-wont-be-from-the-virus\" target=\"_blank\"\u003EWhy most Covid-19 deaths won't be from the virus\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003C\u002Ful\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003EClearly, even relatively brief periods of time out of education can have a lasting impact. It’s not just the missed opportunities for learning that need to be considered during the current crisis, however. The more serious concern is that, when schools are closed for long periods, many children will begin to forget what they already know – a regression that will be much harder to remedy.\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003EMarcotte points to studies of children’s progress over the school year. As you might expect, most children show steady improvements throughout the terms, but \u003Ca href=\"https:\u002F\u002Fjournals.sagepub.com\u002Fdoi\u002F10.3102\u002F00346543066003227\"\u003Ethis can regress – sometimes radically – during the long summer school holiday\u003C\u002Fa\u003E, particularly in subjects such as maths. “In the United States, about 25% of what is gained during the academic year is lost over the course of the summer,” Marcotte says.\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003EIf schools don’t reopen until September, many children will have spent more than 20 weeks in a row away from school – an unprecedented amount of time away from education, meaning we can’t simply extrapolate from the existing data. “We just don't know if it's a linear increase in learning loss, or if it may be something even larger that sort of compounds on itself,” says Marcotte. Given that \u003Ca href=\"https:\u002F\u002Fwww.bbc.co.uk\u002Fnews\u002Fhealth-16320306\"\u003Etime spent in education appears to shape adult IQ\u003C\u002Fa\u003E – this could result in serious, lifelong effects on their cognitive ability.\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003EMarcotte hopes that attempts at remote learning may help to prevent that set-back, but he is sceptical that it can fully make up the difference. “Making real-world connections and spending time with peers, and focusing on lessons, is so much easier when you're in the same room and engaged,” he says.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20200603-how-covid-19-is-changing-the-worlds-children-2"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":[],"imageAlignment":"centre","imageAltText":"A seesaw covered in official tape at a closed playground in Moscow (Credit: EPA)","imageOrientation":"landscape","id":"future\u002Farticle\u002F20200603-how-covid-19-is-changing-the-worlds-children-3"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EIn the worst-case scenario, some students may actually regress even more than they would during a normal school break, he says, since they will also lack the opportunity for intellectually nourishing activities like music lessons, trips to the museum and library, or summer camps. Children will be missing the regular reinforcement of what they’ve learned at school and all these chances to expand their general knowledge and understanding of the world.\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003EWidening inequalities\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003ENot all children will be affected in the same way – leading some experts to fear that this will widen the (already highly significant) gap in educational achievement between richer and poorer families.\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003EWe know, for example, that the learning loss during the US summer vacations depends on the child’s background. Some studies have found that richer children actually \u003Cem\u003Eimprove\u003C\u002Fem\u003E their reading performance over the period, while it is the poorer families who tend to show the greater losses, since they have fewer educational resources over the holidays.\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003EWhile governments are trying to encourage home schooling, it relies on a good computer and reliable internet connection to be able to access the school’s resources, and a quiet room to study. Home schooling also assumes that the parents themselves are sufficiently educated, and have enough time, to be able to help with the lessons. “This assumption unfortunately does not [always] hold, meaning many children’s academic development will grind to a halt during school closures, especially those from underprivileged backgrounds, further widening the attainment gap,” says Armitage. A recent study from the UK found that \u003Ca href=\"https:\u002F\u002Fwww.ifs.org.uk\u002Fpublications\u002F14848\"\u003Echildren from richer families are spending about 30% more time on home learning than those from poorer families\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003EVan Lancker agrees that access to a quiet study area, with an internet connection, is a huge issue for many people. “Those are the circumstances which are not very likely for children living in poverty and over-crowded households,” he says. “We're facing a very, very long period of several months in which groups of disadvantaged children may not have been able to learn very much, and so the gap will have widened when school starts again next term.”\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003EThe lockdown may disproportionately affect the children of first-generation immigrants, since they may have fewer opportunities to learn and practice their second language outside of the home.\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003ENor will these inequalities end once the schools start to re-open. Research by Alison Andrew, Sarah Cattan, Monica Costa Dias and colleagues at the Institute for Fiscal Studies, a think tank in London, UK, shows that \u003Ca href=\"https:\u002F\u002Fwww.ifs.org.uk\u002Fpublications\u002F14848\"\u003Epoorer families are less willing to allow their children to return to education\u003C\u002Fa\u003E. “We know from the evidence that’s coming out, on who’s been most affected health-wise by the coronavirus, that individuals from poorer backgrounds are more likely to have been exposed,” says Alison Andrew. “And this might be increasing concern among individuals in poorer households.”\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20200603-how-covid-19-is-changing-the-worlds-children-4"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":[],"imageAlignment":"centre","imageAltText":"A student having a virtual lesson using a tablet (Credit: EPA)","imageOrientation":"landscape","id":"future\u002Farticle\u002F20200603-how-covid-19-is-changing-the-worlds-children-5"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EIt’s worth bearing in mind that the economic effects of the virus – such as job losses – are expected to increase poverty in general. If nothing is done to make up these amplified class divides, the effects may linger for years. “The younger you are, the more likely it is that there will be consequences well into your adult life,” says Van Lancker. “We know these effects accumulate over time.”\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003EMental health\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EWhile the child’s intellectual development may be the most obvious victim of these shutdowns, it’s by no means the only thing at risk. Teachers are often the first people to notice deteriorating mental health among their students and to encourage them to seek treatment, and many schools provide counselling and psychotherapy on site. In the US, for instance, around \u003Ca href=\"https:\u002F\u002Fjamanetwork.com\u002Fjournals\u002Fjamapediatrics\u002Ffullarticle\u002F2764730\"\u003E13% of adolescents receive mental healthcare from their schools\u003C\u002Fa\u003E. Indeed, for a sizeable chunk – 35% – of vulnerable adolescents being treated for mental health issues, schools are the \u003Cem\u003Eonly \u003C\u002Fem\u003Esource of support for their problems.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20200603-how-covid-19-is-changing-the-worlds-children-6"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"In general, children with more siblings appear to develop social skills at a quicker rate, so it may be that it’s only children who are worst affected.","id":"future\u002Farticle\u002F20200603-how-covid-19-is-changing-the-worlds-children-7"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EIt is possible to provide some help remotely, but so-called “telemental health services” are far from ideal – since they face exactly the same barriers that make distance learning difficult. “Mental health services also involve a degree of privacy, and not all families have the living arrangements to allow for that,” explains Ezra Golberstein at the University of Minnesota’s School of Public Health. Once again, it will probably be the poorest families who suffer the most.\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003EWithout regular contact with students, teachers and counsellors will also be unable to report suspected cases of abuse. “For many children, home is an unpleasant, undesirable, and unsafe place to be, and school provides a much-needed shelter,” says Armitage.\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003EGolberstein pointed me to one recent analysis of data from Florida, which found a \u003Ca href=\"https:\u002F\u002Fpapers.ssrn.com\u002Fsol3\u002Fpapers.cfm?abstract_id=3601399\"\u003E27% \u003Cem\u003Ereduction\u003C\u002Fem\u003E in alleged cases of abuse during March and April 2020\u003C\u002Fa\u003E. It seems highly unlikely that abusers have mended their ways during this period, suggesting that a large number of cases are going unreported as a result of the closures.\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003EThe sad truth is that the amount of child abuse – and indeed all kinds of domestic abuse – will have probably increased throughout the pandemic. “If people are confined to overcrowded households and living in deprived circumstances, this is already associated with the high likelihood for domestic abuse,” says Van Lancker. And at least for the moment, many of these crimes can be hidden by the pandemic.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20200603-how-covid-19-is-changing-the-worlds-children-8"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":[],"imageAlignment":"centre","imageAltText":"A demonstration in NYC for equality in all schools (Credit: Alamy)","imageOrientation":"landscape","id":"future\u002Farticle\u002F20200603-how-covid-19-is-changing-the-worlds-children-9"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EAdolescence is considered to be a critical period for the development and treatment of mental health issues – and if those problems are left untreated, they may be much harder to remedy in later life.\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003EArrested development\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003EThe broader consequences of the outbreak – including the anxiety of growing up during a global pandemic, and the fear for family members – remain to be seen. But children are highly perceptive of their parents’ and carers’ worries and it \u003Ca href=\"https:\u002F\u002Fwww.thelancet.com\u002Fjournals\u002Flanchi\u002Farticle\u002FPIIS2352-4642(20)30097-3\u002Ffulltext\"\u003Eseems likely that they will absorb some of this angst\u003C\u002Fa\u003E – whether it’s worry about the disease itself, the job losses, or the strains of isolation.\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003EAs a comparison, Louise Dalton and Elizabeth Rapa in the department of psychiatry at the University of Oxford point to research on the children of people with HIV or cancer. Often, young children engage in “magical thinking” – believing that their own thoughts or behaviours are the cause of the event. “They end up blaming themselves unnecessarily, and sometimes feel incredibly guilty,” Dalton says – which may also happen during this crisis. For children or adolescents of any age, the uncertainty and the loss of their own freedom will be hard to process and could lead to long-term behavioural problems.\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003EUnfortunately, Dalton and Rapa feel that parents have not been given enough information about these issues and the way to deal with them. “Children's emotional needs are completely being neglected at the moment,” Rapa says. So although children have been given abundant material on the physical effects of the disease and the ways to avoid contagion, government health campaigns have provided very little guidance on how to cope with the stress. “[Children] are now experts on viral transmission, but they're not being taught how we can talk about this and deal with such important things.”\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003EIt’s also unclear how the isolation and physical distancing may influence the development of socioemotional skills, like regulating your feelings, exercising self-control and managing conflicts with your peers. It’s now known that time in education is essential for helping children to mature – particularly if their parents aren’t modelling those skills at home – and the time out may delay their progress. In general, \u003Ca href=\"https:\u002F\u002Fjournals.sagepub.com\u002Fdoi\u002Fabs\u002F10.1177\u002F0265407502193001\"\u003Echildren with more siblings appear to develop social skills at a quicker rate\u003C\u002Fa\u003E, so it may be that it’s only children who are worst affected. (Though only children may benefit in other ways – their parents can probably spend more time helping them personally with home schooling, for instance.)\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20200603-how-covid-19-is-changing-the-worlds-children-10"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":[],"imageAlignment":"centre","imageAltText":"A group of Japanese students walking into a museum (Credit: Alamy)","imageOrientation":"landscape","id":"future\u002Farticle\u002F20200603-how-covid-19-is-changing-the-worlds-children-11"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003E“We don't have any truly similar experience that we can look to in the past to try to see what happened,” says Golberstein. “But kids are sensitive and responsive to their environments, and stressors early in life have consequences for child development, mental health, and human capital development, so I am quite concerned.”\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003ENo easy answers\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003EThere are no easy solutions for these issues. To prevent the widening inequalities in education, teachers need to provide alternatives for work that requires a computer or internet connection, for example. “Teachers need to be sure that children are able to fulfil their tasks, even in deprived conditions,” says Van Lancker.\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003EGovernments can also implement schemes like mobile libraries that will ensure children can get the reading materials they need. “These are small things, but they can really make a difference in keeping the learning going,” he adds. In the long term, schools will need to look carefully at the children who have been hit hardest by the crisis and consider special measures that could help to make up for the losses.\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003EMore generally, Rapa and Dalton argue that parents and carers need to have open and honest conversations with their children about the emotions the whole family are feeling as a result of the pandemic. The temptation may be to put a brave face on the situation, but simply ignoring the underlying tensions will only backfire, they say. For this reason, they’ve recently created a video \u003Ca href=\"https:\u002F\u002Fblackpoolbetterstart.org.uk\u002Fcovid19-update\u002F\"\u003Eoutlining the most constructive ways to have those conversations\u003C\u002Fa\u003E.  “Once everyone starts talking about [the stresses], things do get better,” says Rapa.\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003EOnly with a concerted effort from parents, teachers, social workers, psychiatrists and politicians can we be sure that children of all classes can emerge from the crisis ready to cope and thrive in the post-Covid-19 world.\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003E* David Robson is the author of \u003C\u002Fem\u003E\u003Cem\u003E\u003Ca href=\"http:\u002F\u002Fwww.davidrobson.me\u002Fthe-intelligence-trap\"\u003EThe Intelligence Trap: Revolutionise Your Thinking and Make Wiser Decisions\u003C\u002Fa\u003E\u003C\u002Fem\u003E\u003Cem\u003E, which examines evidence-based ways to improve learning, creativity and problem solving. He is \u003C\u002Fem\u003E\u003Ca href=\"http:\u002F\u002Fwww.twitter.com\u002Fd_a_robson\"\u003E\u003Cem\u003E@d_a_robson\u003C\u002Fem\u003E\u003C\u002Fa\u003E\u003Cem\u003E on Twitter.\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E--\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EAs an award-winning science site, BBC Future is committed to bringing you evidence-based analysis and myth-busting stories around the new coronavirus. You can read more of our \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Ftags\u002Fcovid-19\"\u003E\u003Cem\u003ECovid-19 coverage here\u003C\u002Fem\u003E\u003C\u002Fa\u003E\u003Cem\u003E.\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E--\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EJoin one million Future fans by liking us on \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.facebook.com\u002FBBCFuture\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EFacebook\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, or follow us on \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Ftwitter.com\u002FBBC_Future\"\u003E\u003Cstrong\u003E\u003Cem\u003ETwitter\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E or \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.instagram.com\u002Fbbcfuture_official\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EInstagram\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E.\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EIf you liked this story, \u003C\u002Fem\u003E\u003Ca href=\"http:\u002F\u002Fpages.emails.bbc.com\u002Fsubscribe\u002F?ocid=fut.bbc.email.we.email-signup\"\u003E\u003Cstrong\u003E\u003Cem\u003Esign up for the weekly bbc.com features newsletter\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, called “The Essential List”. A handpicked selection of stories from BBC \u003C\u002Fem\u003E\u003Ca href=\"http:\u002F\u002Fwww.bbc.com\u002Ffuture\"\u003E\u003Cstrong\u003E\u003Cem\u003EFuture\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, \u003C\u002Fem\u003E\u003Ca href=\"http:\u002F\u002Fwww.bbc.com\u002Fculture\"\u003E\u003Cstrong\u003E\u003Cem\u003ECulture\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, \u003C\u002Fem\u003E\u003Ca href=\"http:\u002F\u002Fwww.bbc.com\u002Fworklife\"\u003E\u003Cstrong\u003E\u003Cem\u003EWorklife\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, and \u003C\u002Fem\u003E\u003Ca href=\"http:\u002F\u002Fwww.bbc.com\u002Ftravel\"\u003E\u003Cstrong\u003E\u003Cem\u003ETravel\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, delivered to your inbox every Friday.\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20200603-how-covid-19-is-changing-the-worlds-children-12"}],"collection":null,"disableAdverts":false,"displayDate":"2020-06-04T01:00:00Z","embeddedCustomHtml":"","embeddedInfographicUrl":"","embeddedType":"infographic","headlineLong":"How Covid-19 is changing the world’s children","headlineShort":"How Covid-19 is changing children","image":[],"imageAlignment":"centre","imageAltText":"A girl on a balcony poses with a picture she drew (Credit: Reuters)","isSyndicated":true,"latitude":"","longitude":"","mpsVideo":"","option":[],"partner":null,"primaryVertical":"future","promoAlignment":"centre","promoAltText":"","promoImage":null,"relatedStories":null,"relatedTag":[],"summaryLong":"From their academic success to their social skills and mental health, the pandemic is a crisis for today’s children – and the fallout may follow them for the rest of their lives.","summaryShort":"We may witness the consequences for years to come","tag":[],"textToSpeech":false,"creationDateTime":"2020-06-04T02:22:32.619974Z","entity":"article","guid":"cdf9cdb9-946d-4636-8dd1-24babcb18668","id":"future\u002Farticle\u002F20200603-how-covid-19-is-changing-the-worlds-children","modifiedDateTime":"2022-02-24T18:56:28.330617Z","project":"wwverticals","slug":"future\u002Farticle\u002F20200603-how-covid-19-is-changing-the-worlds-children","cacheLastUpdated":1657756317507},"future\u002Farticle\u002F20200330-coronavirus-are-children-immune-to-covid-19":{"urn":"urn:pubpipe:wwverticals:article:future\u002Farticle\u002F20200330-coronavirus-are-children-immune-to-covid-19","_id":"62b420171f4b7b1b17544749","ambientVideo":"","articleType":"story","assetVideo":null,"author":[],"bodyIntro":"The evidence so far suggests that children are less vulnerable to the effects of the coronavirus, but they can still be infected. Why does the virus seem to affect children differently?","businessUnit":"worldwide","cards":[{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EThere is much debate about the credibility of a \u003Ca href=\"https:\u002F\u002Fwww.bbc.co.uk\u002Fnews\u002Ftechnology-51975377\"\u003Erecent tweet\u003C\u002Fa\u003E by entrepreneur Elon Musk suggesting children are \"essentially immune\" to the coronavirus. So far, the narrative has been that while the coronavirus may cause severe, or even fatal, disease in the elderly, the outcomes for children are reassuring.\u003C\u002Fp\u003E\n\u003Cp\u003ENevertheless, there have been a few concerning reports of young people being seriously affected by the virus. These, together with school closures implemented last week in many countries around the world alongside strict social distancing measures, have made many parents worry about the effect it could have on their children.\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003ECan children be infected with the coronavirus?\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EYes. Just as with adults, children exposed to the coronavirus can be infected with it and display signs of Covid-19. “At the beginning of the pandemic, it was thought that children are not getting infected with the coronavirus, but now it is clear that the amount of infection in children is the same as in adults,” explains Andrew Pollard, professor of paediatric infection and immunity at the University of Oxford. “It’s just that when they do get the infection they get much milder symptoms.”\u003C\u002Fp\u003E\n\u003Cp\u003EData from the Chinese Center for Disease Control and Prevention reported that children under 19 years of age comprised \u003Ca href=\"https:\u002F\u002Fjamanetwork.com\u002Fjournals\u002Fjama\u002Ffullarticle\u002F2762130\"\u003E2% of the 72,314 Covid-19 cases\u003C\u002Fa\u003E logged by February 20th, while \u003Ca href=\"https:\u002F\u002Fwww.cdc.gov\u002Fmmwr\u002Fvolumes\u002F69\u002Fwr\u002Fmm6912e2.htm?s_cid=mm6912e2_w\"\u003Ea US study of 508 patients\u003C\u002Fa\u003E, reported no case fatalities among children, with this group accounting for less than 1% of the patients in hospital.\u003C\u002Fp\u003E\n\u003Cp\u003E“It could be that the virus has preferentially affected adults at the moment because there has been workplace transmission and transmission during travel,” says Sanjay Patel, a paediatric infectious diseases consultant at Southampton Children’s Hospital. “Now that adults are spending more time with their children we might see a rise in infection in children, but we might not.”\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EYou might also like:\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E• \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20200317-covid-19-how-long-does-the-coronavirus-last-on-surfaces\" target=\"_blank\"\u003EHow long does coronavirus last on surfaces?\u003C\u002Fa\u003E\u003Cbr \u002F\u003E• \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20200324-covid-19-how-social-distancing-can-beat-coronavirus\" target=\"_blank\"\u003EWhy social distancing might last for some time\u003C\u002Fa\u003E\u003Cbr \u002F\u003E• \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20200323-coronavirus-will-hot-weather-kill-covid-19\" target=\"_blank\"\u003EWill hotter weather kill the coronavirus?\u003C\u002Fa\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EOverall global trends seem to suggest children are less likely to be infected than adults, especially older adults, but it is very possible the data is biased by the fact that, in some countries, testing is only offered to those who show up in hospital with severe symptoms of Covid-19, very few of whom are children.\u003C\u002Fp\u003E\n\u003Cp\u003E“Clearly, more children are infected than we think,” says Patel. “We are not testing every child in the country.”\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003EHow does the coronavirus affect children differently from adults?\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E“It is a remarkable observation, in the global literature that we have for coronavirus already, that even children with very serious medical conditions, who are on immunosuppressive therapies or on cancer treatments, are much less affected than adults, especially older adults,” says Andrew Pollard, head of the Oxford Vaccine Group, whose researchers have recently identified a \u003Ca href=\"https:\u002F\u002Fwww.ovg.ox.ac.uk\u002Fnews\u002Fcovid-19-vaccine-development\"\u003Evaccine candidate for Covid-19\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003EIn general, children with Covid-19 experience milder symptoms than adults. But a \u003Ca href=\"https:\u002F\u002Fwww.bbc.co.uk\u002Fnews\u002Flive\u002Fworld-52101615?ns_mchannel=social&ns_source=twitter&ns_campaign=bbc_live&ns_linkname=5e833bd26d8c9806657fed4e%26Girl%20of%2012%20is%20%27Europe%27s%20youngest%20victim%27%262020-03-31T12:53:06.279Z&ns_fee=0&pinned_post_locator=urn:asset:dddb2af2-c6c4-44e0-8ed8-84dc9d7131b7&pinned_post_asset_id=5e833bd26d8c9806657fed4e&pinned_post_type=share\" target=\"_blank\"\u003E12-year-old girl from Belgium\u003C\u002Fa\u003E and a \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fnews\u002Fuk-52114476\" target=\"_blank\"\u003E13-year-old boy from London\u003C\u002Fa\u003E, UK, have both died in recent days, making them the youngest victims in Europe. A 14-year-old in China has also been reported to have died after being infected with the virus. \u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"infographic","imageAlignment":"centre","imageOrientation":"landscape","pullQuoteImageAlignment":"centre","videoImageAlign":"centre","id":"future\u002Farticle\u002F20200330-coronavirus-are-children-immune-to-covid-19-0"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":[],"imageAlignment":"centre","id":"future\u002Farticle\u002F20200330-coronavirus-are-children-immune-to-covid-19-1"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EData from a \u003Ca href=\"https:\u002F\u002Fpediatrics.aappublications.org\u002Fcontent\u002Fpediatrics\u002Fearly\u002F2020\u002F03\u002F16\u002Fpeds.2020-0702.full.pdf\"\u003EChinese study of Covid-19 in children\u003C\u002Fa\u003E confirmed slightly more than half showed mild symptoms of fever, cough, sore throat, runny nose, body aches and sneezing; while around a third showed signs of pneumonia, with frequent fever, a productive cough and wheeze but without the shortness of breath and difficulty breathing seen in more severe cases.\u003C\u002Fp\u003E\n\u003Cp\u003EGraham Roberts, an honorary consultant paediatrician at the University of Southampton, explains: “Children (with Covid-19) are predominantly affected in their upper airways (nose, mouths, and throats) so they get cold-like features rather than the virus managing to access their lower airways, ie lungs, and giving the pneumonia and life-threatening Sars picture that we see with adult patients.”\u003C\u002Fp\u003E\n\u003Cp\u003EThe proportion of children who went on to develop severe or critical Covid-19 illness with breathlessness, acute respiratory distress syndrome (ARDS), and shock was much lower (6%) than \u003Ca href=\"https:\u002F\u002Fjamanetwork.com\u002Fjournals\u002Fjama\u002Ffullarticle\u002F2762130\"\u003Eamong Chinese adults\u003C\u002Fa\u003E (19%) – especially older adults with chronic cardiovascular or respiratory conditions. A small proportion of children (1%) did not show any signs of infection at all, despite harbouring the virus. In comparison, only 1% of infected adults remained asymptomatic.\u003C\u002Fp\u003E\n\u003Cp\u003E“The million dollar question is whether the majority of infected children just have very mild symptoms, or whether children are actually not getting infected with the virus, certainly not as much as adults are,” says Patel.\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003EWhy do children infected with the coronavirus fare better than adults?\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E“The virus is so new that we don’t really know”, says Roberts, who is also director of the David Hide Asthma and Allergy Research Centre, in Newport, UK.\u003C\u002Fp\u003E\n\u003Cp\u003E“One of the likely reasons is that the virus needs a protein on the surface of a cell (a receptor) to get into the inside of a cell and start causing problems,” he says. “The coronavirus seems to use the Angiotensin converting enzyme II (ACE-2) receptor for this purpose. It may be that children have less ACE-2 receptors in their lower airways (lungs) than in their upper airways, which is why it is their upper airways (nose, mouths and throats) that are predominantly affected.”\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20200330-coronavirus-are-children-immune-to-covid-19-2"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"It is not so much that children are not being as affected, but that something changes as a person gets much older that makes one more likely to be affected – Andrew Pollard","id":"future\u002Farticle\u002F20200330-coronavirus-are-children-immune-to-covid-19-3"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EThis may explain why children infected with the coronavirus seem to get more of a cold rather than a pneumonia or the life threatening Sars picture that is seen in adults. The coronavirus’s affinity for the ACE-2 receptor was demonstrated in cell lines and in mouse models in \u003Ca href=\"https:\u002F\u002Fwww.nature.com\u002Farticles\u002Fnm1267\"\u003Elaboratory studies\u003C\u002Fa\u003E as early as 2003, and in \u003Ca href=\"https:\u002F\u002Fwww.nature.com\u002Farticles\u002Fnature12711\"\u003Egenome studies\u003C\u002Fa\u003E of novel coronaviruses RsSHC014 and Rs3367 (related, but not identical, to the SARS coronavirus) isolated from Chinese horseshoe bats in 2013.\u003C\u002Fp\u003E\n\u003Cp\u003EPollard says there may be another explanation. “It is not so much that children are not being as affected, but that something changes as a person gets much older that makes one more likely to be affected.”\u003C\u002Fp\u003E\n\u003Cp\u003EHe puts this down to the ageing of the immune system (immunosenescence), which makes the body less able to fight off new infections. “However, we don’t see immunosenescence in young adults, and it’s very clear that even young adults have a higher risk of severe disease than children do so that is probably not the whole answer,” adds Pollard.\u003C\u002Fp\u003E\n\u003Cp\u003EThere are many ways in which the immune system of a child differs from that of an adult, not least because the immune system of children is still very much a work in progress: children, especially those in nursery or school, are exposed to a large number of novel respiratory infections and this might result in them having higher baseline levels of antibodies against viruses than adults.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20200330-coronavirus-are-children-immune-to-covid-19-4"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":[],"imageAlignment":"centre","id":"future\u002Farticle\u002F20200330-coronavirus-are-children-immune-to-covid-19-5"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003E“Children seem to mount more intense responses (to viral infections) than adults, such as high fevers that you just don’t see very often in adults,” says Roberts. “It is very possible that the children’s immune systems are better able to control the virus, localise it to their upper airways without it causing too many other problems and eliminate the virus”. \u003C\u002Fp\u003E\n\u003Cp\u003E“It might also be that children previously infected with the other four types of coronavirus might experience cross protection from previous infections,” adds Patel.\u003C\u002Fp\u003E\n\u003Cp\u003EAdditionally, the authors of the study of childhood cases in \u003Ca href=\"https:\u002F\u002Fwww.medrxiv.org\u002Fcontent\u002F10.1101\u002F2020.03.19.20027078v1.full.pdf\"\u003EChina\u003C\u002Fa\u003E suggest that because children have fewer chronic cardiovascular and respiratory conditions, they are more resilient to severe coronavirus infection than elderly adults.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20200330-coronavirus-are-children-immune-to-covid-19-6"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"Children, with immature immune systems, appear to be less capable of mounting cytokine storms to fight off viral infections","id":"future\u002Farticle\u002F20200330-coronavirus-are-children-immune-to-covid-19-7"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003E“Very few children have severe Covid-19 infection,” says Pollard. “That does suggest that there is something fundamentally different about the way they are handling the virus.”\u003C\u002Fp\u003E\n\u003Cp\u003EThere is a third reason as to why children don’t seem to be getting severely ill with Covid-19. In critically ill adults, an overzealous immune response to fight off the virus – termed a \u003Ca href=\"https:\u002F\u002Fwww.thelancet.com\u002Fjournals\u002Flancet\u002Farticle\u002FPIIS0140-6736(20)30628-0\u002Ffulltext\"\u003Ecytokine storm\u003C\u002Fa\u003E – appears to do more harm than good, causing multi-organ failure. Children, with immature immune systems, appear to be less capable of mounting cytokine storms to fight off viral infections.\u003C\u002Fp\u003E\n\u003Cp\u003EWhile this hypothesis is yet to be proved in Covid-19, \u003Ca href=\"https:\u002F\u002Fpediatrics.aappublications.org\u002Fcontent\u002F113\u002F1\u002Fe7.long\"\u003Estudies of immune responses in children during the 2003 Sars outbreak\u003C\u002Fa\u003E proved that, unlike adults, children did not mount an overtly elevated cytokine response.\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003ECan children, with mild or no illness, transmit the Coronavirus to others?\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EYes, they can.\u003C\u002Fp\u003E\n\u003Cp\u003E“This is the big issue,” says Roberts. “Many think that children are at low risk and we don’t need to worry about them, and yes, that is true for children who don’t have chronic medical conditions like immunodeficiencies. What people are forgetting is that children are probably one of the main routes by which this infection is going to spread throughout the community.” \u003C\u002Fp\u003E\n\u003Cp\u003EThe coronavirus is transmitted from an infected person to a non-infected person through direct contact with the respiratory droplets of an infected person (generated through coughing and sneezing), and touching surfaces contaminated with the virus. This means that children infected with the coronavirus, with very mild or no illness, can transmit the infection to others, especially family members and elderly relatives.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20200330-coronavirus-are-children-immune-to-covid-19-8"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":[],"imageAlignment":"centre","id":"future\u002Farticle\u002F20200330-coronavirus-are-children-immune-to-covid-19-9"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003E“Children with very mild disease are probably going to be one of the major contributors to spreading the virus across the population,” says Roberts. “This is why schools closing are crucial to reducing the rate at which the pandemic spreads across the UK.” \u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003EHave we seen a similar pattern, with other viruses, where children experience milder illness than adults but are important spreaders of the infection?\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EYes, influenza is one such virus that most of us are familiar with.\u003C\u002Fp\u003E\n\u003Cp\u003E“Influenza is often just a runny nose in a child, in the older members of the population it can lead to hospitalisation, intensive care, or can be fatal,” says Roberts. He has an important message: “A few years ago the government (in the UK) brought in flu vaccinations for children. That wasn’t particularly to protect children in the population, that was to stop children from passing influenza to their elderly relatives who can be much more affected by it.”\u003C\u002Fp\u003E\n\u003Cp\u003EThe principle holds true for the coronavirus. The risk of Covid-19 to children themselves is low, the risk of them transmitting it to vulnerable elderly or ailing relatives, is high.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20200330-coronavirus-are-children-immune-to-covid-19-10"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"Chinese data suggests that young children, particularly infants, are more vulnerable to Covid-19 than other age groups","id":"future\u002Farticle\u002F20200330-coronavirus-are-children-immune-to-covid-19-11"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EAnother example is the swine flu (H1N1) virus, responsible for the flu pandemic of 2009 and 2010. “H1N1 infection was preferentially much worse in pregnant women and the elderly, with children having some tummy symptoms but much milder than in adults,” says Patel.\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003EDoes Covid-19 affect children of different ages differently?\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EIt appears so. The Chinese data suggests that young children, particularly infants, are more vulnerable to Covid-19 than other age groups. While severe or critical illness was reported in one in 10 infants, these rates decreased dramatically as children grew older so that in children aged five years or older, only three or four in 100 developed severe or critical illness.\u003C\u002Fp\u003E\n\u003Cp\u003E“There is a predilection for preschoolers,” says Roberts. “They have small airways, and they are less robust that older children in fighting off the infection. They are also more likely to be admitted to hospital because they are so young.”\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003EWhat about teenagers? \u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E“At some stage children turn into adults,” says Roberts. “In teenagers, we see a maturation in the immune system into a more adult pattern, which may be less effective at controlling this virus. It is important to remember, however, that we know very little about this virus, we are really speculating in terms of trying to understand why we are seeing the epidemiology that we are seeing.”\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Ca href=\"https:\u002F\u002Fjamanetwork.com\u002Fjournals\u002Fjama\u002Ffullarticle\u002F2762130\"\u003EIn the Chinese study\u003C\u002Fa\u003E, no deaths were reported among children aged nine years and younger, while the \u003Ca href=\"https:\u002F\u002Fpediatrics.aappublications.org\u002Fcontent\u002Fpediatrics\u002Fearly\u002F2020\u002F03\u002F16\u002Fpeds.2020-0702.full.pdf\"\u003Eonly death in children under 19\u003C\u002Fa\u003E occurred in a 14-year-old. On 23 March, the UK also reported a Covid-19 related death in an 18-year-old with an underlying health condition before a 13-year-old was reported to have died on 1 April in London.\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003ECan Covid-19 affect newborns?\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EYes.\u003C\u002Fp\u003E\n\u003Cp\u003EWhile the pandemic is still unfolding in many parts of the world, there are at least two cases of confirmed infection in newborns – \u003Ca href=\"https:\u002F\u002Fwww.bbc.co.uk\u002Fnews\u002Fworld-asia-china-51395655\"\u003Eone in Wuhan, China\u003C\u002Fa\u003E and \u003Ca href=\"https:\u002F\u002Fwww.theguardian.com\u002Fworld\u002F2020\u002Fmar\u002F14\u002Fnewborn-baby-tests-positive-for-coronavirus-in-london\"\u003Eone in London in the UK\u003C\u002Fa\u003E. It is not yet known whether these babies contracted the infection in the womb, or after being born. In both cases, their mothers tested positive for the virus.\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003EWhat do we know about how the coronavirus affects babies in the womb?\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003ENot much.\u003C\u002Fp\u003E\n\u003Cp\u003EWhile coronaviruses responsible for severe acute respiratory syndrome (Sars) and Middle East respiratory syndrome (Mers) can affect the pregnant woman as well as her baby, causing miscarriages, premature delivery, and poor growth of the baby, similar patterns have as yet not been reported for mothers with Covid-19.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20200330-coronavirus-are-children-immune-to-covid-19-12"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":[],"imageAlignment":"centre","id":"future\u002Farticle\u002F20200330-coronavirus-are-children-immune-to-covid-19-13"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EHowever, these findings are based on \u003Ca href=\"https:\u002F\u002Fwww.thelancet.com\u002Fjournals\u002Flaninf\u002Farticle\u002FPIIS1473-3099(20)30192-4\u002Ffulltext\"\u003Etwo small studies\u003C\u002Fa\u003E and national guidelines about the risks of Covid-19 in pregnancy, to the mother and to the baby, are being constantly updated. Nevertheless, \u003Ca href=\"https:\u002F\u002Fwww.gov.uk\u002Fgovernment\u002Fpublications\u002Fcovid-19-guidance-on-social-distancing-and-for-vulnerable-people\u002Fguidance-on-social-distancing-for-everyone-in-the-uk-and-protecting-older-people-and-vulnerable-adults\"\u003EPublic Health England\u003C\u002Fa\u003E advises that pregnant women are at increased risk of severe illness from coronavirus (Covid-19) and recommends them to be particularly stringent in following social distancing measures for up to 12 weeks.\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003EHow can families protect children from being infected with the coronavirus?\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EGood hand washing, social distancing and disinfecting surfaces and objects which may harbour germs are the cornerstones of limiting the spread of the virus. The “catch it, bin it, kill it” practise is as important to decreasing the spread of Covid-19 as flu. “Do the basics properly,” says Patel. “If you’re in a communal area, if you touch anything, don’t touch your face before washing your hands well.” \u003C\u002Fp\u003E\n\u003Cp\u003EThe NHS website contains \u003Ca href=\"https:\u002F\u002Fwww.nhs.uk\u002Fconditions\u002Fcoronavirus-covid-19\u002F\"\u003Einformation about the measures families can take to protect themselves\u003C\u002Fa\u003E from Covid-19. Unicef has produced guidance for parents on \u003Ca href=\"https:\u002F\u002Fwww.unicef.org\u002Fstories\u002Fnovel-coronavirus-outbreak-what-parents-should-know\"\u003Ehow to protect their children\u003C\u002Fa\u003E from catching the coronavirus.\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003ECan families protect elderly and vulnerable relatives from being infected by children?\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EYes, but it will not be easy. Of the three measures – good hand-washing, social distancing and disinfecting surfaces and objects – distancing is the only failsafe method to protect elderly and vulnerable relatives from being infected, either by children or by anyone else.\u003C\u002Fp\u003E\n\u003Cp\u003E“Looking at family interactions on mother’s day, I saw loads of families with grandparents, parents and children together,” says Patel. “I think that is absolutely terrifying – the data is very clear about the high risk for severe disease in the elderly, especially those with preexisting medical conditions. Keeping children away from grandparents is just the right thing to do – why take the risk.”\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20200330-coronavirus-are-children-immune-to-covid-19-14"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"In almost all circumstances, children are safe from severe Covid-19 disease – Andrew Pollard","id":"future\u002Farticle\u002F20200330-coronavirus-are-children-immune-to-covid-19-15"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EThe separation of apparently healthy children from elderly relatives may seem an unnecessarily stoic measure, however it is important to remember that while most children infected with the coronavirus show only mild signs of illness, or no signs at all, they can still transmit the virus to others.\u003C\u002Fp\u003E\n\u003Cp\u003ELimiting the spread of the coronavirus and containing the Covid-19 pandemic will depend as much on the success of social and behavioural changes, as on modern medicine and scientific advances.\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003EWhy it’s important to talk to children about Covid-19\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E“With so much of the narrative about Covid-19 taking place at the societal level, one thing we really need parents to do is reassure their children that children are not going to die from Covid-19. It’s really important that we get this message out,” says Patel. “We know, as paediatricians, that children fear the worst but they don’t often articulate that with us.”\u003C\u002Fp\u003E\n\u003Cp\u003EPollard agrees. He suggests that parents should reassure their children that “in almost all circumstances, children are safe from severe Covid-19 disease”.\u003C\u002Fp\u003E\n\u003Cp\u003E“Children and teenagers are worried for their families,” says Linnea Karlsson, a professor and child psychiatrist at the University of Turku, Finland. “We need to explain to children and teenagers that these are exceptional circumstances, and that we wouldn’t be asking them to make exceptions to their normal routines if it wasn’t.\u003C\u002Fp\u003E\n\u003Cp\u003E“We need to explain to them that in situations like these we need to think about taking care of everyone, not just ourselves and our families.”\u003C\u002Fp\u003E\n\u003Cp\u003E* \u003Cem\u003EThe \u003Ca href=\"https:\u002F\u002Fwhat0-18.nhs.uk\u002Fpopular-topics\u002Fcoronavirus\"\u003EHealthier Together\u003C\u002Fa\u003E\u003C\u002Fem\u003E\u003Cem\u003E network contains advice for parents on how to talk to children about COVID-19.\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E--\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EAs an award-winning science site, BBC Future is committed to bringing you evidence-based analysis and myth-busting stories around the new coronavirus. You can read more of our \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Ftags\u002Fcovid-19\"\u003E\u003Cstrong\u003E\u003Cem\u003ECovid-19 coverage here\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E.\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E--\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EJoin one million Future fans by liking us on \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.facebook.com\u002FBBCFuture\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EFacebook\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, or follow us on \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Ftwitter.com\u002FBBC_Future\"\u003E\u003Cstrong\u003E\u003Cem\u003ETwitter\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E or\u003Cstrong\u003E \u003C\u002Fstrong\u003E\u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.instagram.com\u002Fbbcfuture_official\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EInstagram\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E.\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EIf you liked this story, \u003C\u002Fem\u003E\u003Ca href=\"http:\u002F\u002Fpages.emails.bbc.com\u002Fsubscribe\u002F?ocid=fut.bbc.email.we.email-signup\"\u003E\u003Cstrong\u003E\u003Cem\u003Esign up for the weekly bbc.com features newsletter\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, called “The Essential List”. A handpicked selection of stories from BBC Future, Culture, Worklife, and Travel, delivered to your inbox every Friday.\u003C\u002Fem\u003E\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20200330-coronavirus-are-children-immune-to-covid-19-16"}],"collection":null,"disableAdverts":false,"displayDate":"2020-04-01T01:00:00Z","embeddedCustomHtml":"","embeddedInfographicUrl":"","embeddedType":"infographic","headlineLong":"Why children are not immune to Covid-19","headlineShort":"Why children are not immune to Covid-19","image":[],"imageAlignment":"centre","imageAltText":"","isSyndicated":true,"latitude":"","longitude":"","mpsVideo":"","option":[],"partner":null,"primaryVertical":"future","promoAlignment":"centre","promoAltText":"","promoImage":null,"relatedStories":null,"relatedTag":[],"summaryLong":"The evidence so far suggests that children are less vulnerable to the effects of the coronavirus. But they can still be infected by the virus.","summaryShort":"Most young people are less severely affected, but they can still catch the virus","tag":[],"textToSpeech":false,"creationDateTime":"2020-04-01T00:00:08.7298Z","entity":"article","guid":"4d25a3ec-a3b0-4c1b-b236-408e67ba5514","id":"future\u002Farticle\u002F20200330-coronavirus-are-children-immune-to-covid-19","modifiedDateTime":"2022-02-24T18:50:58.176724Z","project":"wwverticals","slug":"future\u002Farticle\u002F20200330-coronavirus-are-children-immune-to-covid-19","cacheLastUpdated":1657756317507},"future\u002Farticle\u002F20220315-how-eco-anxiety-affects-childrens-minds":{"urn":"urn:pubpipe:wwverticals:article:future\u002Farticle\u002F20220315-how-eco-anxiety-affects-childrens-minds","_id":"62b41ff81f4b7b035129a3f9","ambientVideo":"","articleType":"story","assetVideo":null,"author":["future\u002Fauthor\u002Fjosie-glausiusz"],"bodyIntro":"More and more children are experiencing \"eco-anxiety\": a chronic fear of environmental doom. But some are converting their panic into a force for good.","businessUnit":"worldwide","cards":[{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EStriding onto the streets of Glasgow, 16-year-old Amy O'Brien joined tens of thousands of other marchers last November for a \u003Ca href=\"https:\u002F\u002Fcop26coalition.org\u002Fgda\u002F\"\u003EGlobal Day of Action for Climate Justice\u003C\u002Fa\u003E. O'Brien is an activist with \u003Ca href=\"https:\u002F\u002Fwww.fridaysforfuture.ie\u002F\"\u003EFridays for Future Ireland\u003C\u002Fa\u003E, a youth movement that uses school strikes to campaign for climate justice. She had taken the train and ferry from her home town of Mitchelstown in County Cork to Glasgow to attend the 26th UN Climate Change Conference of the Parties (COP26). But while the journey was motivated by her activism, it also had a deeply personal side effect: it gave her hope.\u003C\u002Fp\u003E\n\u003Cp\u003EO'Brien had spent half her life worrying about the impact of global climate change, to the point of feeling an intense fear over the planet's future – an \u003Ca href=\"https:\u002F\u002Fpapers.ssrn.com\u002Fsol3\u002Fpapers.cfm?abstract_id=3918955\"\u003Eincreasingly common phenomenon among children\u003C\u002Fa\u003E and teenagers. Now the sight of so many diverse banner-carrying campaigners, of all ages, offered her \"a glimmer of the future that is possible\".\u003C\u002Fp\u003E\n\u003Cp\u003E\"It was a really colourful scene, and there was music and there were people dancing,\" O'Brien recalls. \"At one point it started lashing with rain, and so you would think it would dampen the scene, but actually there was such a bright, hopeful and exuberant protest. Everyone seemed so happy to be together, showing up for the world we want to see.\"\u003C\u002Fp\u003E\n\u003Cp\u003EO'Brien has been acutely aware of the climate crisis since the age of eight, when she first learned in primary school about the impact of \u003Ca href=\"https:\u002F\u002Fwww.nature.com\u002Farticles\u002Fs41558-020-0818-9\"\u003Emelting Arctic ice on polar bears\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003E\"Even at the start, I was upset for animals and that nature was having to change because of us,\" she says. \"I felt a bit powerless.\" By age 13 or 14, \"fear kicked in\" as she witnessed \u003Ca href=\"https:\u002F\u002Fwww.corkbeo.ie\u002Fnews\u002Flocal-news\u002Fcop26-areas-cork-could-underwater-22044750\"\u003Eincreased flooding of Cork's River Lee\u003C\u002Fa\u003E, and learned how extreme weather was displacing people in countries \u003Ca href=\"https:\u002F\u002Fwww.aljazeera.com\u002Feconomy\u002F2021\u002F5\u002F25\u002Fbbin-2020-more-people-displaced-by-extreme-climate-than-conflict#:~:text=Densely%20populated%20countries%20like%20China,Atlantic%20hurricane%20season%20on%20record.\"\u003Elike India and the Philippines\u003C\u002Fa\u003E. \"Their lives are torn apart, and these are the same people who contributed the least to this crisis,\" O'Brien says. \"I started to feel fear and hurt for what they were already going through.\"\u003C\u002Fp\u003E\n\u003Cp\u003EThe intense feeling that O'Brien experiences in the midst of the climate crisis, has a name: eco-anxiety, defined by the American Psychological Association as \"\u003Ca href=\"https:\u002F\u002Fwww.apa.org\u002Fnews\u002Fpress\u002Freleases\u002F2017\u002F03\u002Fmental-health-climate.pdf\"\u003Ea chronic fear of environmental doom\u003C\u002Fa\u003E\".\u003C\u002Fp\u003E\n\u003Cp\u003EEco-anxiety can be caused by the stressful and frightening experience of \"watching the slow and seemingly irrevocable impacts of climate change unfold, and worrying about the future for oneself, children and later generations\", according to a report published by the association and two other organisations, Climate for Health and Eco-America. It may come with \"feelings of loss, helplessness, and frustration\", and guilt, as the sufferers feel they are unable to stop climate change.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"infographic","imageAlignment":"centre","imageOrientation":"landscape","pullQuoteImageAlignment":"centre","videoImageAlign":"centre","id":"future\u002Farticle\u002F20220315-how-eco-anxiety-affects-childrens-minds-0"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0bvgzfc"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220315-how-eco-anxiety-affects-childrens-minds-1"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EAs a broader form of environmental fear, eco-anxiety isn't exactly new – in the 19th century, the Victorians worried about \u003Ca href=\"https:\u002F\u002Ftheconversation.com\u002Fair-pollution-in-victorian-era-britain-its-effects-on-health-now-revealed-87208\"\u003Egrowth-stunting, lung-choking black smoke from coal-burning in the UK\u003C\u002Fa\u003E. But as human activity \u003Ca href=\"https:\u002F\u002Fwww.carbonbrief.org\u002Fmapped-how-climate-change-affects-extreme-weather-around-the-world\"\u003Eincreases the risk of \u003C\u002Fa\u003E\u003Ca href=\"https:\u002F\u002Fwww.carbonbrief.org\u002Fmapped-how-climate-change-affects-extreme-weather-around-the-world\"\u003Eextreme weather\u003C\u002Fa\u003E, including heatwaves, droughts and flooding, and as the United Nations warns of a \"\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fnews\u002Fscience-environment-58130705\"\u003Ecode red for humanity\u003C\u002Fa\u003E\", surveys show that kids are suffering from climate anxiety at \u003Ca href=\"https:\u002F\u002Fwww.theguardian.com\u002Fsociety\u002F2020\u002Fnov\u002F20\u002Fhalf-of-child-psychiatrists-surveyed-say-patients-have-environment-anxiety\"\u003Eeven higher rates than adults\u003C\u002Fa\u003E – including feelings of worry, fear, anger, grief, despair, guilt and shame. These often \u003Ca href=\"https:\u002F\u002Fpapers.ssrn.com\u002Fsol3\u002Fpapers.cfm?abstract_id=3918955\"\u003Efluctuating moods and feelings\u003C\u002Fa\u003E can include positive sensations as well, such as hope.\u003C\u002Fp\u003E\n\u003Cp\u003E\"Children are infinitely more informed than their parents think, a lot of the time,\" says Caroline Hickman, a psychotherapist at the University of Bath in the UK. She led a 2021 \u003Ca href=\"https:\u002F\u002Fpapers.ssrn.com\u002Fsol3\u002Fpapers.cfm?abstract_id=3918955\"\u003Eglobal online survey\u003C\u002Fa\u003E of climate anxiety in 10,000 teenagers and young adults aged 16-25 in 10 countries, including the UK, US, Brazil, India and the Philippines.\u003C\u002Fp\u003E\n\u003Cp\u003EClose to 60% of the young people who responded to the survey said that they felt \"very\" or \"extremely\" worried about climate change while 75% said that \"the future is frightening\", 56% believe that \"humanity is doomed\" and 39% were hesitant to have children. Fifty-eight percent of respondents felt that governments were betraying them or future generations.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220315-how-eco-anxiety-affects-childrens-minds-2"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"Parents instinctively want to protect their kids from painful, scary, traumatic stuff","id":"future\u002Farticle\u002F20220315-how-eco-anxiety-affects-childrens-minds-3"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EOffering children honest answers to their questions about climate catastrophe isn't always easy, though. Parents instinctively want to protect their kids from \"painful, scary, traumatic stuff\", Hickman says. But although climate anxiety is distressing, it's also rational, she and her co-authors contend. So when a 10-year-old child asks, \"is it true that in 100 years the Earth will be burned to a crisp?\" it's \"not pure fantasy\", Hickman says. \"It's not, 'Mummy, can sharks fly?' The question is grounded in reality.\"\u003C\u002Fp\u003E\n\u003Cp\u003EIf a child asks questions about climate change, first find out what they have learned about the topic, Hickman advises, including whether they are reading scaremongering stories online. Then, \"tell her it's a brilliant question\", she says, and add: \"I want you to feel proud of those feelings. Because you only feel that anxiety or worry because you care about the planet.\"\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220315-how-eco-anxiety-affects-childrens-minds-4"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0bvh15y"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220315-how-eco-anxiety-affects-childrens-minds-5"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EHickman enthusiastically endorses \"lots of conversations\" with kids around climate change. But parents also need to calibrate their responses to children at different ages, advises climate educator \u003Cspan data-mce-mark=\"1\"\u003EHarriet Shugarman\u003C\u002Fspan\u003E, executive director of Climate Mama, an advocacy organisation for parents.\u003C\u002Fp\u003E\n\u003Cp\u003EIn her book \u003Ca href=\"https:\u002F\u002Fwww.climatemama.com\u002Fauthor-page\"\u003EHow to Talk to Your Kids About Climate Change\u003C\u002Fa\u003E: Turning Angst into Action, Shugarman offers advice to parents of kids from nursery school age to late-teen years on how they can mitigate anxiety and take action on climate change.\u003C\u002Fp\u003E\n\u003Cp\u003E\"When kids are coming to you with questions directly, we have to tell the truth, whatever age they're at,\" she says. But we should also strengthen their own sense of agency. \"Kids do have power, and we want to try to work to build that up at each age,\" she advises.\u003C\u002Fp\u003E\n\u003Cp\u003EWith very young children, the first step is to create \"a sense of wonder in nature\" – watching ants in the grass on outings to city parks, or sharing stories and songs. Include your five-to-six-year-old kids in climate marches, take photos of the protests, and have kids send their own drawings or letters to local officials, she suggests.\u003C\u002Fp\u003E\n\u003Cp\u003EBy the time kids reach the ages of 10-13 years old, they are probably learning about climate change in school. Encourage them to discuss climate change with teachers, neighbours and family, Shugarman says. Also, \"we can remind them that there are so many scientists, businesspeople, organisations, elected officials, working on the climate crisis all over the world.\"\u003C\u002Fp\u003E\n\u003Cp\u003EBy ages 14-16 years old, teenagers are approaching the age at which they'll be able to vote. \"Their elected officials are interested in what they have to say because they are future voters,\" Shugarman says. Political engagement for older teens is crucial. \"So many young people seem so disillusioned, rightly so, perhaps, with our democracies. But they are very fragile and we need them to be participatory.\" \u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220315-how-eco-anxiety-affects-childrens-minds-6"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0bvh1z8"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220315-how-eco-anxiety-affects-childrens-minds-7"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EAction and participation may also help temper one of the societal risks of eco-anxiety: as well-founded as the fear of the environmental crisis may be, when taken too far, it could actually hinder positive change.\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cspan\u003EIlan Kelman\u003C\u002Fspan\u003E, professor of disasters and health at University College London Institute for Risk and Disaster Reduction in the UK, fears that eco-anxiety in young people may be feeding a state of \"\u003Ca href=\"https:\u002F\u002Fwww.urmc.rochester.edu\u002Fbehavioral-health-partners\u002Fbhp-blog\u002Fmarch-2020\u002Fcoping-with-climate-change-anxiety.aspx#:~:text=%22Eco%2Dparalysis%22%20refers%20to,(e.g.%20denial)%20become%20activated.\"\u003Eeco-paralysis\u003C\u002Fa\u003E\" where they feel unable to take action because their emotional distress is overwhelming.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220315-how-eco-anxiety-affects-childrens-minds-8"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"We should also be incredibly inspired by how far humanity has come – Ilan Kelman","id":"future\u002Farticle\u002F20220315-how-eco-anxiety-affects-childrens-minds-9"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003E\"There's no claim whatsoever that it's all good news,\" Kelman says of the state of the planet. The increase in heat and humidity will lead to very high mortality, he stresses, and \"a lot of people are going to have no option but to be forced to move or to die\". Furthermore, \"if the Antarctica and Greenland ice sheets go, then that is extremely concerning. We're looking at a major reconfiguration of the world's shore lines.\"\u003C\u002Fp\u003E\n\u003Cp\u003EEven so, \"the doomsday scenarios, the calamity, the utter destruction: I cannot find any scientific support for that,\" Kelman says. \"Even in the worst case scenarios, 'Earth burnt to a crisp' is not a feasible outcome,\" he notes. \"I've yet to find a scenario which within the next hundred years, or in fact the next thousand or ten thousand years, a scenario in which humans become extinct because of climate change.\"\u003C\u002Fp\u003E\n\u003Cp\u003E\"We should also be incredibly inspired by how far humanity has come,\" Kelman emphasises. He advises climate-anxious youngsters to \"focus on the science, and balance the real worries with all the wonderful inspiration, wisdom and success which humanity has shown over decades and centuries\".\u003C\u002Fp\u003E\n\u003Cp\u003EHe includes among these successes the \u003Ca href=\"https:\u002F\u002Fwww.business-standard.com\u002Farticle\u002Fmarkets\u002Finvestors-in-fossil-fuels-announce-plans-to-divest-39-2-trillion-121102600666_1.html#:~:text=About%201%2C500%20investment%20institutions%20overseeing,report%20issued%20Tuesday%20by%20DivestInvest.\"\u003Edivestment \u003C\u002Fa\u003Eby pension funds and foundations in fossil fuels, localised energy systems \u003Cspan\u003Esuch as small wind turbines or solar roof panels,\u003C\u002Fspan\u003E\u003Ca href=\"https:\u002F\u002Ffarmingbase.com\u002Fwhat-is-guerilla-gardening-and-what-are-seed-bombs\u002F\"\u003E guerilla gardening\u003C\u002Fa\u003E in neglected spaces, \u003Ca href=\"https:\u002F\u002Fwww.cseindia.org\u002Frainwater-harvesting-1272\"\u003Erainwater harvesting\u003C\u002Fa\u003E, accessible science on the internet, as well as broader social progress that has improved the lives of many, such as laws outlawing discrimination and oppression and granting people equal rights.\u003C\u002Fp\u003E\n\u003Cp\u003EKelman notes that action on climate isn't limited to public protests. Young people can consider a career in journalism, science and technology, medicine and health, or standing for political office. \"A lot of youth activists have been amazing in taking governments to court,\" he says, referring to the \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20211207-the-legal-battle-against-climate-change\"\u003Eincreasing number of campaigners suing governments and companies to take action against climate change\u003C\u002Fa\u003E. \"That has been inspirational, that has been successful. Put your energies into the legal system, to end fossil fuel subsidies, to make governments legally adhere to the pledges that they're making.\"\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220315-how-eco-anxiety-affects-childrens-minds-10"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0bvh3pk"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220315-how-eco-anxiety-affects-childrens-minds-11"},{"bodyHtml":{"assets":[]},"calloutBodyHtml":"\u003Cp\u003EThis article is part of \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Ffamily-tree\"\u003E\u003Cstrong\u003EFamily Tree\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E, a series of features from the BBC that explore the issues and opportunities that parents, children and families face all over the world. You might also be interested in some other stories about children, teenagers and the environment:\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Ca href=\"about:blank\"\u003EAsia's new love of forest schools\u003C\u002Fa\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20211206-how-climate-change-has-altered-christmas\"\u003EHow climate change altered Christmas\u003C\u002Fa\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20220105-the-arctic-parenting-style-that-fosters-resilience\"\u003EHow Arctic kids learn resilience\u003C\u002Fa\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EYou can also climb new branches of the Family Tree on \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fworklife\u002Ffamily-tree\"\u003E\u003Cstrong\u003EBBC Worklife\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E.\u003C\u002Fp\u003E","calloutTitle":"Family Tree","cardType":"CalloutBox","iFrameType":"","id":"future\u002Farticle\u002F20220315-how-eco-anxiety-affects-childrens-minds-12"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EMany of the young people campaigning against climate change are driven as much by anger as anxiety, Hickman says.\u003C\u002Fp\u003E\n\u003Cp\u003E\"I started research with children and young people around climate change 10 years ago – children as young as five, up to mid-20s, in the Maldives, Nigeria, Bangladesh, Brazil, France, the UK and America,\" she says. \"What I started hearing over and over again from children, was, 'it's not the environmental problems that are frightening me; yes, they are upsetting; what really frightens me is government failure to act on this'.\"\u003C\u002Fp\u003E\n\u003Cp\u003EThat anger at government inertia is familiar for \u003Ca href=\"https:\u002F\u002Fwww.linkedin.com\u002Fin\u002Frosekobusinge\u002F?originalSubdomain=uk\"\u003ERose Kobusinge\u003C\u002Fa\u003E, a 26-year-old climate justice activist and PhD student at the University of Coventry in the UK. Born in Western Uganda, Kobusinge says her \"real understanding\" of climate change came in her early-20s. She was motivated to act when she saw how droughts in her home in the Kabarole and Ntoroko districts of Uganda were drying crops and killing livestock, and \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fnews\u002Fworld-africa-56526631\"\u003Ereceding glaciers\u003C\u002Fa\u003E in the \u003Ca href=\"https:\u002F\u002Fwhc.unesco.org\u002Fen\u002Flist\u002F684\u002F\"\u003ERwenzori mountains\u003C\u002Fa\u003E were triggering \"massive floods and landslides in Kasese and Bundibugyo in Western Uganda, my closest neighbouring districts\".\u003C\u002Fp\u003E\n\u003Cp\u003EThe African continent is vulnerable to climate change, she notes, yet its contribution to global greenhouse gas emissions is the smallest – j\u003Ca href=\"https:\u002F\u002Fwww.cdp.net\u002Fen\u002Fresearch\u002Fglobal-reports\u002Fafrica-report\"\u003Eust 3.8%\u003C\u002Fa\u003E of the total.\u003C\u002Fp\u003E\n\u003Cp\u003E\"Children and young people, we are taking climate change as a real threat, because we know it's the future of the children that is at stake,\" Kobusinge says. At COP26, which she attended, she saw how world leaders \u003Ca href=\"https:\u002F\u002Fwww.euronews.com\u002Fgreen\u002F2022\u002F02\u002F17\u002Fvanessa-nakate-african-and-eu-leaders-are-already-breaking-cop26-promises\"\u003Emade big promises\u003C\u002Fa\u003E, yet \u003Ca href=\"https:\u002F\u002Fwww.unep.org\u002Fnews-and-stories\u002Fstory\u002Fcop26-ends-agreement-falls-short-climate-action\"\u003Efell short on action\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003E\"I feel that there is limited time,\" Kobusinge says. \"Our global leaders are supposed to care about the most vulnerable, to care about the poor, to care about the children and the youth, [but] are not doing what they should be doing. It makes me feel uncertain about the future.\" Even so, \"when I look at young people, civil societies and indigenous communities coming together to ask for climate justice, that gives me a little bit of hope\", she says. She encourages activists to support one another and create safe spaces, online or in-person, to share feelings.\u003C\u002Fp\u003E\n\u003Cp\u003EUsing your anxiety positively \"is like a blessing in disguise\", she says, because it can prompt action and motivation.\u003C\u002Fp\u003E\n\u003Cp\u003EThat's advice that Amy O'Brien has taken to heart. Using Telegram and Zoom, she connects with MAPA activists (\u003Ca href=\"https:\u002F\u002Ffridaysforfuture.org\u002Fnewsletter\u002Fedition-no-1-what-is-mapa-and-why-should-we-pay-attention-to-it\u002F\"\u003EMost Affected People and Areas\u003C\u002Fa\u003E, or communities in Africa, Latin America, and the Pacific Islands, that suffer most from the effects of climate change). Together with five other young activists, she hosts the late-night \u003Ca href=\"https:\u002F\u002Fanchor.fm\u002Fsustainablesleepoverclub\"\u003ESustainable Sleepover Club\u003C\u002Fa\u003E podcast, where participants talk about \"anything and everything\", including \"movies and chocolates, climate justice, gender equality and trans rights.\" To \"educate and empower\", she writes for the Fridays for Future international newsletter, as well as her local newspaper.\u003C\u002Fp\u003E\n\u003Cp\u003E\"Through activism, I've met so many other activists who really care about the climate crisis,\" O'Brien says, and that gives her hope: \"Hope is also now my driving force, like a little light pushing me to act.\"\u003C\u002Fp\u003E\n\u003Cp\u003ESeeing the numbers of diverse protesters on the coalition day of action at COP26, \"really emphasised to me that I'm not alone; there are so many people who care about this, and we will win, because we're fighting together,\" she says. \"We were dancing to protests, we laughed when it rained, a rainbow started shining… and it was just really beautiful. From the whole experience, I learned about the power of my voice as well.\"\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003E--\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EJoin one million Future fans by liking us on \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.facebook.com\u002FBBCFuture\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EFacebook\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, or follow us on \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Ftwitter.com\u002FBBC_Future\"\u003E\u003Cstrong\u003E\u003Cem\u003ETwitter\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E or \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.instagram.com\u002Fbbcfuture_official\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EInstagram\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E.\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EIf you liked this story, \u003C\u002Fem\u003E\u003Ca href=\"http:\u002F\u002Fpages.emails.bbc.com\u002Fsubscribe\u002F?ocid=fut.bbc.email.we.email-signup\"\u003E\u003Cstrong\u003E\u003Cem\u003Esign up for the weekly bbc.com features newsletter\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, called \"The Essential List\" – a handpicked selection of stories from BBC \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EFuture\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fculture\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003ECulture\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fworklife\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EWorklife\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ftravel\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003ETravel\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E \u003Cem\u003Eand \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Freel\"\u003E\u003Cstrong\u003E\u003Cem\u003EReel\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E delivered to your inbox every Friday.\u003C\u002Fem\u003E\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220315-how-eco-anxiety-affects-childrens-minds-13"}],"collection":["future\u002Fpremium-collection\u002Ffamily-tree"],"disableAdverts":false,"displayDate":"2022-04-22T10:22:00Z","embeddedCustomHtml":"","embeddedInfographicUrl":"","embeddedType":"infographic","headlineLong":"How can we help kids cope with 'eco-anxiety'?","headlineShort":"The rise of 'eco-anxiety' in kids","image":["p0c2nf82"],"imageAlignment":"centre","imageAltText":"","isSyndicated":true,"latitude":"","longitude":"","mpsVideo":"","option":[{"Content":{"Description":"Apple News Publish: Select to publish, remove to unpublish. (Do not just delete or unpublish the story)","Name":"publish-applenews-system-1"},"Metadata":{"CreationDateTime":"2016-02-05T14:32:31.186819Z","Entity":"option","Guid":"13f4bc85-ae27-4a34-9397-0e6ad3619619","Id":"option\u002Fpublish-applenews-system-1","ModifiedDateTime":"2022-02-27T22:52:24.455144Z","Project":"wwverticals","Slug":"option\u002Fpublish-applenews-system-1"},"Urn":"urn:pubpipe:wwverticals:option:option\u002Fpublish-applenews-system-1","_id":"62b420921f4b7b5d34253c8b"}],"partner":null,"primaryVertical":"future","promoAlignment":"centre","promoAltText":"","promoImage":null,"relatedStories":null,"relatedTag":null,"summaryLong":"More and more children are experiencing \"eco-anxiety\": a chronic fear of environmental doom. But some are converting their panic into a force for good.","summaryShort":"Is climate change causing a mental health crisis?","tag":["tag\u002Fpsychology"],"textToSpeech":false,"creationDateTime":"2022-04-22T10:25:05.806438Z","entity":"article","guid":"02f31d43-191d-4774-9c55-305a5b8d84c1","id":"future\u002Farticle\u002F20220315-how-eco-anxiety-affects-childrens-minds","modifiedDateTime":"2022-04-22T10:25:05.806438Z","project":"wwverticals","slug":"future\u002Farticle\u002F20220315-how-eco-anxiety-affects-childrens-minds","cacheLastUpdated":1657756319030},"future\u002Farticle\u002F20220704-why-childhood-sunburns-are-so-dangerous":{"urn":"urn:pubpipe:wwverticals:article:future\u002Farticle\u002F20220704-why-childhood-sunburns-are-so-dangerous","_id":"62c4d0c61f4b7b344e70be97","ambientVideo":"","articleType":"story","assetVideo":null,"author":["future\u002Fauthor\u002Fjessica-mudditt"],"bodyIntro":"Five simple steps helped Australia bring down high skin cancer rates – and could help others stay safe in the sun.","businessUnit":"worldwide","cards":[{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EWhen it comes to lowering the risk of developing skin cancer, childhood and adolescence are critical periods. The amount of sun exposure a person has in the first 20 years of their life determines to a \u003Ca href=\"https:\u002F\u002Fwww.ajpmonline.org\u002Farticle\u002FS0749-3797(16)30022-8\u002Ffulltext\"\u003Esubstantial degree\u003C\u002Fa\u003E the likelihood of developing skin cancer, research shows. Just one case of blistering sunburn as a child or teenager has been found to \u003Ca href=\"https:\u002F\u002Fwww.skincancer.org\u002Fskin-cancer-information\u002Fskin-cancer-facts\u002F#:~:text=On%20average%2C%20a%20person's%20risk,developing%20melanoma%20later%20in%20life.\"\u003Edouble the risk\u003C\u002Fa\u003E of developing melanoma, which is the most serious form of skin cancer, later in life.\u003C\u002Fp\u003E\n\u003Cp\u003EAustralia has one of the \u003Ca href=\"https:\u002F\u002Fwww.aimatmelanoma.org\u002Fabout-melanoma\u002Fmelanoma-stats-facts-and-figures\u002F\"\u003Ehighest rates\u003C\u002Fa\u003E of \u003Ca href=\"https:\u002F\u002Fwww.wcrf.org\u002Fcancer-trends\u002Fskin-cancer-statistics\u002F\"\u003Eskin cancer in the world\u003C\u002Fa\u003E, with a prevalence roughly double that of the UK and United States, due to its intense sun. In fact, melanoma is the most \u003Ca href=\"https:\u002F\u002Fmelanoma.org.au\u002Fabout-melanoma\u002Fmelanoma-facts\u002F\"\u003Ecommon cancer\u003C\u002Fa\u003E for Australians aged 20 to 39, and is so common that it has come to be known as Australia's \"national cancer\" (in the US, it is the \u003Ca href=\"https:\u002F\u002Fwww.aimatmelanoma.org\u002Ffacts-statistics\u002F\"\u003Ethird most common cancer\u003C\u002Fa\u003E in that age group). But in response to that threat, the country has also developed some of the world's most effective measures for skin cancer prevention – which hold powerful lessons for other countries dealing with ever-hotter summers.\u003C\u002Fp\u003E\n\u003Cp\u003ESince early sun protection can make such a big difference, one key message from Australian experts is for families to be aware of the danger of ultraviolet (UV) radiation from the Sun, and take a few simple protective steps.\u003C\u002Fp\u003E\n\u003Cp\u003E\"The UV sort of 'zaps' the DNA in healthy cells,\" says Justine Osborne, programme manager at Cancer Council Victoria in southeastern Australia. \"The cells will repair themselves when the UV exposure disappears, but if you're constantly hitting them with UV there's no chance for them to repair. That is when skin cancer develops.\" Globally, skin cancer was \u003Ca href=\"https:\u002F\u002Fwww.arpansa.gov.au\u002Fnews\u002Farpansa-boosts-uv-protection-globally#:~:text=Research%20in%202019%20estimates%20around,cancer%20in%20the%20same%20year.\"\u003Ediagnosed\u003C\u002Fa\u003E in 6.7 million people in 2019, and it killed 118,000.\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003EThin skin needs protection\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EWhile most of the guidance around sunscreen is applicable to both adults and children, protecting infants from sunburn requires a different approach. Sunscreen should never be used on a baby who is six months or younger, and a child under one year should not be directly exposed to UV rays, according to the Cancer Council. Instead, appropriate protections for babies include lightweight, loose-fitting clothes that allow airflow, dense shade and a soft hat that will not become a choking hazard.\u003C\u002Fp\u003E\n\u003Cp\u003E\"A baby's skin is very thin and sensitive, and babies tend to suck on things, which means they could ingest the sunscreen,\" says Osborne. \"Babies and young children are particularly susceptible to UV damage, so it's really important that they are well protected whenever the UV index is three or more.\" The World Health Organization's UV index measures the strength of the ultraviolet radiation from the sun on a given day and place, and ranges from 0 (low) to over 11 (extreme). A higher number means the potential damage to the skin and eye increases, and also, that it can occur more quickly.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"infographic","imageAlignment":"centre","imageOrientation":"landscape","pullQuoteImageAlignment":"centre","videoImageAlign":"centre","id":"future\u002Farticle\u002F20220704-why-childhood-sunburns-are-so-dangerous-0"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0cgtldl"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220704-why-childhood-sunburns-are-so-dangerous-1"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003ESunburn in children can be particularly dangerous, also because they are more likely to suffer from \u003Ca href=\"https:\u002F\u002Fwww.sunsmart.com.au\u002Fabout-sunsmart\u002Fmedia-and-communications\u002Fmedia-releases\u002F2020\u002Falarming-number-of-minors-presenting-at-victorian-hospital-emergency-department-with-sunburn.html\"\u003Erelated conditions such as heat stroke\u003C\u002Fa\u003E. Experts recommend using sunscreen formulas designed for children, and testing the cream on a small patch of skin first. \"True allergies to sunscreen are \u003Ca href=\"https:\u002F\u002Fwww.everydayhealth.com\u002Fallergies\u002Fare-you-allergic-to-sunscreen.aspx\"\u003Every rare\u003C\u002Fa\u003E, but when they occur it is usually caused by the extra ingredients in a sunscreen [such as fragrance], rather than the sun-protective properties,\" says Osborne.\u003C\u002Fp\u003E\n\u003Cp\u003EShe points out that sunscreen should be stored below 30C (86F) because if it overheats, the ingredients will start to separate and lose efficacy. \"If you're at the beach, keep sunscreen in the cooler box with your drinks. Don't keep it in the glove box of your car. Treat it as a precious thing.\"\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003EHow much suncream should you use?\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EWhile darker pigmented skin generally takes longer to sunburn, \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fbooks\u002FNBK534837\u002F\"\u003Eall skin types can be damaged by the sun\u003C\u002Fa\u003E. Depending on factors such as the UV index and a person's skin type, sunburn can occur in just 10 minutes. UV exposure can raise the risk of skin cancer \u003Ca href=\"https:\u002F\u002Fwww.cancer.org\u002Fhealthy\u002Fbe-safe-in-sun\u002Fsun-damage.html\"\u003Eeven when it doesn't cause sunburn\u003C\u002Fa\u003E. In recent years, research has also shown that sun exposure can cause \u003Ca href=\"https:\u002F\u002Fwww.manchester.ac.uk\u002Fdiscover\u002Fnews\u002Fsun-damages-skin-of-older-black-people-finds-research\u002F\"\u003Epremature ageing in different skin types\u003C\u002Fa\u003E, \u003Ca href=\"https:\u002F\u002Fwww.jidonline.org\u002Farticle\u002FS0022-202X(18)32790-8\u002Ffulltext\"\u003Eincluding skin of colour\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003E\"UV is not related to temperature. It is possible to get sunburnt on a cold but clear day. You can also get sunburnt on a cloudy day. You don't feel it until it is too late,\" says Stuart Henderson, a radiation scientist at the Australian Radiation Protection and Nuclear Safety Agency (ARPNSA). He has co-authored \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F35290998\u002F\"\u003Ea review of the effectiveness and use of sunscreen\u003C\u002Fa\u003E in Australia that found that sunscreen is safe for the skin, but the amount of sunscreen and the way it is applied varies considerably between individuals.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220704-why-childhood-sunburns-are-so-dangerous-2"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"Sunscreen should be the last resort – Stuart Henderson","id":"future\u002Farticle\u002F20220704-why-childhood-sunburns-are-so-dangerous-3"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003ESunscreen is an \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20190722-sunscreen-safe-or-toxic\"\u003Eeffective way to help prevent sunburn\u003C\u002Fa\u003E in children over six months of age. However, there is widespread \u003Ca href=\"https:\u002F\u002Fwww.cancer.org.au\u002Fmedia-releases\u002F2017\u002Falmost-half-of-australians-confused-about-sunscreen\"\u003Econfusion about its correct use\u003C\u002Fa\u003E. Along with \u003Ca href=\"https:\u002F\u002Fwww.cancercouncil.com.au\u002Fnews\u002F10-myths-about-sun-protection\u002F?utm_source=google&utm_content=1gsCCNSWAO2021&utm_medium=cpc&&utm_source=google&utm_content=1gsCCNSWAO2021&gclid=Cj0KCQjwntCVBhDdARIsAMEwAClfbpGoQXyIImdVZbRjcw4Wk2BtkI2mtiQ_B8rbQlQVwDsYtGw9Jh8aAikREALw_wcB&gclsrc=aw.ds\"\u003Edamaging myths\u003C\u002Fa\u003E (such as a fake tan providing protection against sunburn), studies have found that people often apply insufficient amounts of sunscreen. Some assume that sunscreen is itself a complete protection.\u003C\u002Fp\u003E\n\u003Cp\u003E\"Sunscreen is not a suit of armour: it should be used in combination with some other protection measures,\" says Henderson. \"It should generally be thought of as the last resort when you haven't got any other way to protect your skin.\"\u003C\u002Fp\u003E\n\u003Cp\u003EIn Australia, the Cancer Council recommends another four sun protection measures: clothing, shade, a broadbrimmed hat and sunglasses. Their use was popularised through an unusually successful health campaign, launched decades ago in Australia in response to the country's particular melanoma risk.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220704-why-childhood-sunburns-are-so-dangerous-4"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0cgthsc"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220704-why-childhood-sunburns-are-so-dangerous-5"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003E\u003Cstrong\u003ESlip, Slop, Slap\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EAnnual rates of melanoma in women in Australia are \u003Ca href=\"https:\u002F\u002Fwww.uow.edu.au\u002Fglobal-challenges\u002Fmaking-future-industries\u002Fnext-generation-sunscreen\u002F\"\u003E10 times higher than those of women\u003C\u002Fa\u003E in Europe. For men, they are \u003Ca href=\"https:\u002F\u002Fwww.uow.edu.au\u002Fglobal-challenges\u002Fmaking-future-industries\u002Fnext-generation-sunscreen\u002F\"\u003E20 times higher\u003C\u002Fa\u003E. This is partly due to climatic conditions and the fact that the Earth's orbit is not perfectly circular: the southern hemisphere is closer to the Sun during its summer months than the northern hemisphere is in its own summer. As a result, the Sun feels more intense in places like Australia, where UV rates are higher by comparison. (Incidentally, the highest level of ultraviolet radiation ever recorded on Earth's surface was measured \u003Ca href=\"https:\u002F\u002Fwww.frontiersin.org\u002Farticles\u002F10.3389\u002Ffenvs.2014.00019\u002Ffull\"\u003Ein 2003 in the Bolivian Andes\u003C\u002Fa\u003E, with a UV index of 43).\u003C\u002Fp\u003E\n\u003Cp\u003EIn 1981, when the dangers of UV rays were becoming apparent, the then Anti-Cancer Council of Victoria launched an education campaign that is ongoing 40 years later.\u003C\u002Fp\u003E\n\u003Cp\u003EThe SunSmart campaign – also known as the Slip, Slop, Slap campaign – used a cheerful seagull called Syd to encourage people to \"slip on a shirt, slop on sunscreen and slap on a hat.\" Crucially, one of its central messages is that sunscreen alone is not enough. Covering up with clothing, and seeking shade, is also important. It is considered one of Australia's most successful community health campaigns, which is attributed to its longevity, consistency and being well-funded.\u003C\u002Fp\u003E\n\u003Cp\u003E\"We've seen a decline in melanoma rates in people under 60 in Victoria and under 50 in Australia since the 1980s, when the SunSmart campaign began,\" says Osborne. \"This is a cohort of people who used to embrace the sun and loved getting a tan. It was a huge ask to tell them to take protective measures, and it was a big cultural shift.\"\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220704-why-childhood-sunburns-are-so-dangerous-6"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"The message needs to be constantly reinforced – Phil Barker","id":"future\u002Farticle\u002F20220704-why-childhood-sunburns-are-so-dangerous-7"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003E\"There's absolutely no doubt that the Slip, Slop, Slap campaign increased public awareness of sun exposure, and it has been hugely effective in influencing our behaviour,\" says Phil Barker, honorary principal fellow in chemistry at the University of Wollongong. \"But the message needs to be constantly reinforced to educate the new generations of parents and their children.\"\u003C\u002Fp\u003E\n\u003Cp\u003EIndeed, recently there have been alarming incidents of sunburn reported in Australia. A \u003Ca href=\"https:\u002F\u002Fwww.sunsmart.com.au\u002Fabout-sunsmart\u002Fmedia-and-communications\u002Fmedia-releases\u002F2020\u002Falarming-number-of-minors-presenting-at-victorian-hospital-emergency-department-with-sunburn.html\"\u003Ereport on cases of sunburn at Victorian emergency departments\u003C\u002Fa\u003E showed that the summer of 2018-19 had the second highest number of cases since 2004. One in two hospital presentations for sunburn were children and adolescents, and one in five were children under nine years of age.\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003ESun warnings by phone\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EAn app developed in Australia, and co-designed by Cancer Council Victoria, ARPANSA and other organisations, aims to help prevent skin cancer skin cancer by showing users the UV index in their local area. A global version, the free \u003Ca href=\"https:\u002F\u002Fpublic.wmo.int\u002Fen\u002Fmedia\u002Fpress-release\u002Fsunsmart-global-uv-app-launched\"\u003ESunSmart Global UV phone app\u003C\u002Fa\u003E, was launched by the World Health Organization and its partners this year. The app will be especially helpful for those holidaying in new destinations, according to Barker.\u003C\u002Fp\u003E\n\u003Cp\u003E\"If you're going to an unfamiliar place, make sure you know what the expected UV index is, and amend your sun protection strategies accordingly,\" says Barker.  \u003C\u002Fp\u003E\n\u003Cp\u003EBarker is currently working on developing \"next generation\" sunscreens that are specifically designed to provide protection in Australia's extreme exposure conditions. He estimates they may be on the market by 2026.\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220704-why-childhood-sunburns-are-so-dangerous-8"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0cgtls4"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220704-why-childhood-sunburns-are-so-dangerous-9"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003E\u003Cstrong\u003EThe future of suncare?\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EDeveloping new ways to remind people to reapply their sunscreen can be a difficult area for scientists to research, says Elke Hacker, a senior research fellow in public health at Griffith University. \"We need to know whether the technology developed in the lab is useful in the real world, but it is morally inappropriate for scientists to put people potentially in risky environments where they will be wearing their sunscreen out.\"\u003C\u002Fp\u003E\n\u003Cp\u003EHowever, Hacker and her team at Queensland University of Technology found an environment where people voluntarily sit in the sun for over four hours: a cricket match.\u003C\u002Fp\u003E\n\u003Cp\u003EThe team \u003Ca href=\"https:\u002F\u002Fwww.sciencedirect.com\u002Fscience\u002Farticle\u002Fpii\u002FS0091743519301732\"\u003Estudied the effect of UV detection stickers reminding people to reapply their sunscreen\u003C\u002Fa\u003E during the four-day Ashes Test of 2017 in Brisbane, Australia. The stickers change colour in response to UV. A total of 428 people completed the study, which made it the largest of its kind. The sticker was clear when the sunscreen was freshly applied, and when the sunscreen wore off it and it was time to re-apply, the sticker's colour changed to purple. There was also a control group of people who were provided with free sunscreen, but no stickers; while the sticker group were provided with free sunscreen, and stickers.\u003C\u002Fp\u003E\n\u003Cp\u003EThe stickers were found to improve the frequency of sunscreen reapplication, prompting 80% of cricket goers to reapply their sunscreen as compared with 68% in the control group. However, the results also highlighted the challenges of sunscreen use: 39 people wearing stickers still experienced sunburn, perhaps because they were simply exposed to the sun for too long, or because the sunscreen was not properly reapplied.\u003C\u002Fp\u003E\n\u003Cp\u003E\"\u003Ca href=\"https:\u002F\u002Fwww.improvinghealth.com.au\u002F2019\u002F07\u002F16\u002Fuv-sticker-raises-cricket-fans-sunscreen-use\u002F\"\u003EPrevious studies\u003C\u002Fa\u003E have shown that people sometimes apply only half the recommended thickness to cover the skin,\" says Hacker.\u003C\u002Fp\u003E\n\u003Cp\u003EThe correct amount is two milligrams per square centimetre, which is equal to seven teaspoons of sunscreen for an adult body. That equates to one teaspoon for each arm and leg, two for the torso, plus one teaspoon for the face, neck and ears. It needs to be reapplied every two hours.\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220704-why-childhood-sunburns-are-so-dangerous-10"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0cjrs68"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220704-why-childhood-sunburns-are-so-dangerous-11"},{"bodyHtml":{"assets":[]},"calloutBodyHtml":"\u003Cp\u003EThis article is part of \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Ffamily-tree\" target=\"_blank\"\u003E\u003Cstrong\u003EFamily Tree\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E, a series of features that explore the issues and opportunities that families face all over the world. You might also be interested in other stories about children's health and development:\u003C\u002Fp\u003E\n\u003Cul\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20220609-do-pets-help-childrens-development\"\u003EHow pets give your kids a brain boost\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20220622-whats-really-inside-babies-first-foods\"\u003EWhat's really inside babies' first foods\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20220525-is-a-vegan-diet-healthy-for-kids\"\u003EIs a vegan diet safe for children?\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003C\u002Ful\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E","calloutTitle":"Family Tree","cardType":"CalloutBox","iFrameType":"","id":"future\u002Farticle\u002F20220704-why-childhood-sunburns-are-so-dangerous-12"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003E\u003Cstrong\u003ESunscreen basics\u003Cbr \u002F\u003E\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EExperts recommend using a broad-spectrum sunscreen lotion that has a sun protection factor (SPF) 30 or above and putting it on 20 minutes before you go out in the sun. This will give it a chance to sink into the skin's pores and prevent it from immediately being brushed or sweated off. If you're going out doing things like swimming and then toweling off, or exercising and sweating, you'd need to reapply. \"With kids, the same rules apply,\" says Henderson.\u003C\u002Fp\u003E\n\u003Cp\u003ELotions may be more effective than aerosols, with research suggesting the latter can be insufficiently protective in windy conditions. Hacker's latest \u003Ca href=\"https:\u002F\u002Fnews.griffith.edu.au\u002F2022\u002F02\u002F16\u002Fresearchers-put-aerosol-sunscreens-to-the-test\u002F\"\u003Estudy at Griffith University tested five aerosol sunscreens\u003C\u002Fa\u003E and found 28% to 93% of aerosol sunscreen was lost in 20 kilometre per hour winds, and 32% to 79% of aerosol sunscreen was lost when the wind dropped to 10 kilometres an hour. These winds are considered everyday conditions at Australian beaches.\u003C\u002Fp\u003E\n\u003Cp\u003E\"In some cases, a person would need to spray an aerosol sunscreen for up to 250 seconds per limb, or more than a bottle's worth, to provide adequate protection to the whole body,\" says Hacker.\u003C\u002Fp\u003E\n\u003Cp\u003ESome may consider just staying out of the sun altogether, but Barker says that would be neither practical nor healthy. Others agree.\u003C\u002Fp\u003E\n\u003Cp\u003E\"Our bodies need some sunlight for vitamin D production and there are other benefits to running around outdoors, especially in childhood. There's been links with children not spending enough time outdoors and developing short-sightedness,\" says Henderson.\u003C\u002Fp\u003E\n\u003Cp\u003EInstead, a good option is to enjoy the summer sunshine \u003Ca href=\"https:\u002F\u002Fwww.nhs.uk\u002Flive-well\u002Fseasonal-health\u002Fsunscreen-and-sun-safety\u002F\"\u003Eat the start and the end of the day\u003C\u002Fa\u003E, when the UV rays are lower. In Australia, there's yet another mnemonic for that: Between 11 and 3, slip under a tree.\u003C\u002Fp\u003E\n\u003Cp\u003E--\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003E* This article has been updated on 11 July 2022 to correct the year that the highest-ever UV index was measured in the Andes, which was in 2003, not 2014 as was previously stated.\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E--\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EJoin one million Future fans by liking us on \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.facebook.com\u002FBBCFuture\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EFacebook\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, or follow us on \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Ftwitter.com\u002FBBC_Future\"\u003E\u003Cstrong\u003E\u003Cem\u003ETwitter\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E or \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.instagram.com\u002Fbbcfuture_official\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EInstagram\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E.\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EIf you liked this story, \u003C\u002Fem\u003E\u003Ca href=\"http:\u002F\u002Fpages.emails.bbc.com\u002Fsubscribe\u002F?ocid=fut.bbc.email.we.email-signup\"\u003E\u003Cstrong\u003E\u003Cem\u003Esign up for the weekly bbc.com features newsletter\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, called \"The Essential List\" – a handpicked selection of stories from BBC \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EFuture\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fculture\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003ECulture\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fworklife\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EWorklife\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ftravel\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003ETravel\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E \u003Cem\u003Eand \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Freel\"\u003E\u003Cstrong\u003E\u003Cem\u003EReel\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E delivered to your inbox every Friday.\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220704-why-childhood-sunburns-are-so-dangerous-13"}],"collection":["future\u002Fpremium-collection\u002Ffamily-tree"],"disableAdverts":false,"displayDate":"2022-07-06T01:00:00Z","embeddedCustomHtml":"","embeddedInfographicUrl":"","embeddedType":"infographic","headlineLong":"Why sunscreen is not enough to prevent sunburns","headlineShort":"Why childhood sunburns are so dangerous","image":["p0cgtgl2"],"imageAlignment":"centre","imageAltText":"","isSyndicated":true,"latitude":"","longitude":"","mpsVideo":"","option":[{"Content":{"Description":"Apple News Publish: Select to publish, remove to unpublish. (Do not just delete or unpublish the story)","Name":"publish-applenews-system-1"},"Metadata":{"CreationDateTime":"2016-02-05T14:32:31.186819Z","Entity":"option","Guid":"13f4bc85-ae27-4a34-9397-0e6ad3619619","Id":"option\u002Fpublish-applenews-system-1","ModifiedDateTime":"2022-02-27T22:52:24.455144Z","Project":"wwverticals","Slug":"option\u002Fpublish-applenews-system-1"},"Urn":"urn:pubpipe:wwverticals:option:option\u002Fpublish-applenews-system-1","_id":"62b420921f4b7b5d34253c8b"}],"partner":null,"primaryVertical":"future","promoAlignment":"centre","promoAltText":"","promoImage":null,"relatedStories":null,"relatedTag":null,"summaryLong":"Five simple steps helped Australia bring down high skin cancer rates – and could help others stay safe in the sun.","summaryShort":"Our first 20 years are key for sun protection","tag":["tag\u002Fhealth","tag\u002Fchildren"],"textToSpeech":false,"creationDateTime":"2022-07-06T00:00:51.956085Z","entity":"article","guid":"fdf8b834-8f41-4fab-8f92-6128fc4309f1","id":"future\u002Farticle\u002F20220704-why-childhood-sunburns-are-so-dangerous","modifiedDateTime":"2022-07-11T11:08:47.400598Z","project":"wwverticals","slug":"future\u002Farticle\u002F20220704-why-childhood-sunburns-are-so-dangerous","cacheLastUpdated":1657756319027},"future\u002Farticle\u002F20220622-whats-really-inside-babies-first-foods":{"urn":"urn:pubpipe:wwverticals:article:future\u002Farticle\u002F20220622-whats-really-inside-babies-first-foods","_id":"62b41ff81f4b7b03f84badae","ambientVideo":"","articleType":"story","assetVideo":null,"author":["future\u002Fauthor\u002Fanna-turns"],"bodyIntro":"Scientists are discovering the extraordinary power of human milk and the benefits it brings to infants, but there are also some hidden contaminants that can lurk in breast and formula milks.","businessUnit":"worldwide","cards":[{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EThroughout the first year of their lives, I breastfed my two children without the use of infant formula. Breast milk has been shown to be an \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC4882692\u002F\"\u003Eideal source of nutrition\u003C\u002Fa\u003E for babies, with many benefits for their developing brains, immune systems and digestive tracts, and I was glad to be able to offer them that boost. But when I had my \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20220512-the-chemicals-that-linger-for-decades-in-your-blood\"\u003Eblood tested for persistent toxic chemicals\u003C\u002Fa\u003E while researching a book on pollution, I discovered that some pesticides banned more than 40 years ago could still be detected in my body. There is also evidence that low levels of some chemical contaminants can be \u003Ca href=\"https:\u002F\u002Fpubs.acs.org\u002Fdoi\u002F10.1021\u002Facs.est.0c06978\"\u003Epassed from a mother into her breast milk\u003C\u002Fa\u003E. Yet formula milk is also prone to\u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC2799451\u002F\"\u003E contamination with toxic chemicals\u003C\u002Fa\u003E or \u003Ca href=\"https:\u002F\u002Fwww.cdc.gov\u002Fcronobacter\u002Foutbreaks\u002Finfant-formula.html\"\u003Epotentially harmful bacteria\u003C\u002Fa\u003E, which have led to high-profile food scares and recalls in recent years.\u003C\u002Fp\u003E\n\u003Cp\u003EIt made me wonder what's really in the first foods our children consume – from the most beneficial ingredients, to hidden, undesirable or even toxic ones. And given what we know about some of the dangers, what can be done to improve all the available options for babies, be they breast- or formula-fed, and offer them the best possible start in life?\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003EThe milk that changes every day\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EBreast milk is considered the top choice for a baby's first food (the World Health Organization recommends that infants should be \u003Ca href=\"https:\u002F\u002Fwww.who.int\u002Fnews-room\u002Ffact-sheets\u002Fdetail\u002Finfant-and-young-child-feeding\"\u003Eexclusively breastfed for the first six month of life\u003C\u002Fa\u003E). It mainly consists of \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC4882692\u002F#B11-nutrients-08-00279\"\u003Ewater, fat, protein, as well as vitamins, minerals, digestive enzymes and hormones\u003C\u002Fa\u003E. It is rich in \u003Ca href=\"https:\u002F\u002Fwww.frontiersin.org\u002Farticles\u002F10.3389\u002Ffped.2020.00428\u002Ffull\"\u003Ematernal antibodies\u003C\u002Fa\u003E, and has \u003Ca href=\"https:\u002F\u002Facademic.oup.com\u002Fjn\u002Farticle\u002F138\u002F9\u002F1801S\u002F4750860\"\u003Eanti-infective properties\u003C\u002Fa\u003E. Breast milk is also a dynamic, adaptable food – it is fattier in the \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC3586783\u002F\"\u003Eafternoon and evening\u003C\u002Fa\u003E than in the morning, for example. It also varies during a feed. When the baby latches onto the breast, the first gush of milk, or foremilk, is thin and high in lactose, making it thirst-quenching and easy to drink. The so-called \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC3586783\u002F\"\u003Ehindmilk that follows is creamier and fattier\u003C\u002Fa\u003E, making it more filling. This dynamic aspect is one reason why breast milk is hard to replicate, despite \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20220525-infant-formula-the-superfood-you-never-think-about\"\u003Econsiderable advances in the quality of infant formula\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003E\"Human milk varies over the course of lactation, over the course of a day, from the start to the end of the feed, and to some extent on maternal factors such as her diet,\" says Mary Fewtrell, a professor of paediatric nutrition at University College London, who published \u003Ca href=\"https:\u002F\u002Fbmcmedicine.biomedcentral.com\u002Farticles\u002F10.1186\u002Fs12916-019-1473-8\"\u003Ea peer-reviewed study of lactation\u003C\u002Fa\u003E. \"That all makes it difficult to decide on a precise amount that should be included in a formula whose composition doesn't change with the baby's age.\"\u003C\u002Fp\u003E\n\u003Cp\u003EFewtrell highlights non-nutrient ingredients in breast milk such as hormones, cells (including stem cells), microRNAs (small strands of genetic material), which give it unique properties. \"We still don't fully understand the role of all these components but… quite probably they allow the mother to transmit information to the infant about her own experiences and the environment, which is why breastfeeding is sometimes described as 'personalised nutrition'.\"\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"infographic","imageAlignment":"centre","imageOrientation":"landscape","pullQuoteImageAlignment":"centre","videoImageAlign":"centre","id":"future\u002Farticle\u002F20220622-whats-really-inside-babies-first-foods-0"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0cfb02g"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220622-whats-really-inside-babies-first-foods-1"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EHowever, while \u003Ca href=\"https:\u002F\u002Fwww.cdc.gov\u002Fbreastfeeding\u002Fdata\u002Freportcard.htm\"\u003Emore than 80% of babies in the US are breastfed at the start of their life\u003C\u002Fa\u003E, according to the Centers for Disease Control and Prevention, that rate falls to 58% at six months. Health authorities have tried to \u003Ca href=\"https:\u002F\u002Fwww.hhs.gov\u002Fsurgeongeneral\u002Freports-and-publications\u002Fbreastfeeding\u002Ffactsheet\u002Findex.html\"\u003Eincrease that\u003C\u002Fa\u003E rate, for example by offering more breastfeeding support to mothers. Diagnosing and treating conditions \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20220322-how-dangerous-is-tongue-tie\"\u003Esuch as tongue-tie in babies\u003C\u002Fa\u003E can also help. But in the meantime, parents who do use formula may also wish to understand more about it, including what might be done to improve it.\u003C\u002Fp\u003E\n\u003Cp\u003E\"Whilst human milk is the biological norm for human infants and provides benefits for both mother and infant, some women may be unable to breast-feed or choose not to do so, and some choose to partly breast-feed,\" says Fewtrell. \"For young infants, the only safe alternative if an infant is not breast-fed (or not fully breast-fed) is an infant formula which is designed to meet the nutritional needs of infants and support normal growth and development.\" Flexibility is expected – there's no \"one size fits all\" approach to infant nutrition, she says.\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003ETowards better formula\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EThe manufacture of infant formula has come a long way over recent decades. Throughout the 19th and early 20th centuries, bottle-feeding was not a safe option. In orphanages during the early 1900s, as many \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F14510003\u002F\"\u003Eas 80% of bottle-fed babies died\u003C\u002Fa\u003E during the first year of life due to infections from unsterilised bottles, or malnourishment. Since infant formula was first commercially produced in 1865 using just four key ingredients (cows' milk, wheat and malt flour, and potassium bicarbonate), its nutritional contents have been refined in remarkable ways.\u003C\u002Fp\u003E\n\u003Cp\u003ESo what's in formula today?\u003C\u002Fp\u003E\n\u003Cp\u003EMultiple fat sources are often used in formula, including cows' or goats' milk (often skimmed, which isn't as fatty as breast milk) and vegetable oils such as palm, sunflower or rapeseed, plus fatty acids. One fatty acid called DHA (docosahexaenoic acid, a type of omega-3 fat), which \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F29413359\u002F\"\u003Eplays an important role in infant development\u003C\u002Fa\u003E, is now \u003Ca href=\"https:\u002F\u002Feur-lex.europa.eu\u002Flegal-content\u002FEN\u002FTXT\u002F?uri=CELEX%3A32016R0127\"\u003Ea mandatory ingredient in the European Union\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003EIn breast milk, the main carbohydrate is lactose. In formula, this is usually added into the skimmed dairy milk powder base. Maltodextrin (a carbohydtrate derived from maize or potatoes) is also added. In the UK, glucose (a sugar) isn't routinely added but in the US, glucose sugars such as corn syrup are more commonly used. One problem is that this can \u003Ca href=\"https:\u002F\u002Fwww.nature.com\u002Farticles\u002Fs41415-020-1252-0\"\u003Eincrease the risk of dental decay in infants\u003C\u002Fa\u003E when their teeth come through.\u003C\u002Fp\u003E\n\u003Cp\u003EThe \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC3586783\u002F\"\u003Emajor breast milk proteins\u003C\u002Fa\u003E are whey and casein, which \u003Ca href=\"https:\u002F\u002Fwww.sciencedirect.com\u002Fscience\u002Farticle\u002Fpii\u002FS0955286316301711\"\u003Echange in proportion as the baby grows\u003C\u002Fa\u003E, plus lactoferrin which is found at higher concentrations in colostrum, the first milk a mother produces after birth. The protein quantity and composition differs in formulas based on cows' and goats' milk, which have a \u003Ca href=\"https:\u002F\u002Fift.onlinelibrary.wiley.com\u002Fdoi\u002Ffull\u002F10.1111\u002F1750-3841.15574\"\u003Ehigher casein to whey ratio than human milk\u003C\u002Fa\u003E. Plant-based ones are often made with soya protein. Formula also contains a mix of vitamins (including A, D, B and K), minerals such as calcium, magnesium, iron, zinc and many other trace elements.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220622-whats-really-inside-babies-first-foods-2"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0cfb181"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220622-whats-really-inside-babies-first-foods-3"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EUnfortunately, formula can also contain lurking, unwelcome ingredients: just like I discovered pollutants in my own body, toxic substances can make their way into infant formula, too. \u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003EHeavy metal mix\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EIn 2017, the Clean Label Project, a US-based not-for-profit that tests products for toxic substances such as pesticides and heavy metals, found that almost \u003Ca href=\"https:\u002F\u002Fcleanlabelproject.org\u002Fbaby-food-infographic\u002F\"\u003E80% of 86 infant formula samples tested\u003C\u002Fa\u003E positive for arsenic. It also discovered that soy-based formulas \u003Ca href=\"https:\u002F\u002Fcleanlabelproject.org\u002Fbaby-food-infographic\u002F\"\u003Ehad seven times more cadmium, a carcinogenic metal found in batteries\u003C\u002Fa\u003E, than other formulas.\u003C\u002Fp\u003E\n\u003Cp\u003ETwo years later, researchers from the Clean Label Project and the department of neurology at the University of Miami \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F30253364\u002F\"\u003Epublished a study into the heavy metal content of 91 infant formulas\u003C\u002Fa\u003E. They found that 22% of infant formula samples tested exceeded the lead exposure limit set by \u003Ca href=\"https:\u002F\u002Foehha.ca.gov\u002Fproposition-65\"\u003ECalifornian state law\u003C\u002Fa\u003E, while 23% exceeded the state's limit for cadmium. The study concluded that \"low-level heavy metal contamination is widespread\" in baby foods and formulas and that \"further research is needed to understand the long-term health effects of this chronic daily low-level heavy metal exposure in babies\". Another study of baby foods in Sweden found that the dietary cadmium exposure of children fed infant formula was up to \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F10789373\u002F\"\u003E12 times higher than those who are breast fed\u003C\u002Fa\u003E, although the levels were still within weekly tolerable limits set by the WHO and FAO.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220622-whats-really-inside-babies-first-foods-4"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"Food safety regulators insist they are actively trying to tackle the issue of heavy metals in baby foods","id":"future\u002Farticle\u002F20220622-whats-really-inside-babies-first-foods-5"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EJackie Bowen, an environmental biologist and executive director of Clean Label Project, co-authored the study. She campaigns for greater transparency about the hidden contaminants that end up in our food, including infant formula. According to Bowen, food safety regulation can miss those contaminants since it focuses primarily on microbial pathogens such as \u003Cem\u003EE. coli\u003C\u002Fem\u003E that cause acute, short-term food poisoning.\u003C\u002Fp\u003E\n\u003Cp\u003EFood safety regulators, however, insist they are actively trying to tackle the issue of heavy metals in baby foods. The US Food and Drug Administration (FDA), for example, insists it \u003Ca href=\"https:\u002F\u002Fwww.fda.gov\u002Ffood\u002Fcfsan-constituent-updates\u002Ffda-response-questions-about-levels-toxic-elements-baby-food-following-congressional-report\"\u003Eroutinely monitors baby foods for toxic elements\u003C\u002Fa\u003E and takes action if they present a health concern. It says it is working with food companies and other stakeholders in an attempt to reduce the levels of heavy metals and other toxic substances in baby foods \u003Ca href=\"https:\u002F\u002Fwww.fda.gov\u002Ffood\u002Fmetals-and-your-food\u002Fcloser-zero-action-plan-baby-foods\"\u003Eto as low as possible.\u003C\u002Fa\u003E But a recent report by the Committee on Oversight and Reform at the US House of Representatives \u003Ca href=\"https:\u002F\u002Foversight.house.gov\u002Fsites\u002Fdemocrats.oversight.house.gov\u002Ffiles\u002F2021-02-04%20ECP%20Baby%20Food%20Staff%20Report.pdf\"\u003Ecriticised the FDA and food companies for not doing enough\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003EThe FDA, however, says it is continuing to issue guidance to industry that will help lead to \"meaningful and lasting reductions in exposure to toxic elements from foods\", alongside its sampling and enforcement work.\u003C\u002Fp\u003E\n\u003Cp\u003E\"As parents and caregivers ourselves, we recognise and understand concerns about toxic elements and how they could impact the health of children,\" a spokesperson told the BBC.\u003C\u002Fp\u003E\n\u003Cp\u003E\"Consumers are increasingly concerned about how the foods they eat are linked to long-term chronic diseases like cancer or infertility that can take decades to manifest,\" explains Bowen who adds that, in the US, this food safety regulation is 'silent' when it comes to heavy metal contamination. \"There's a growing divide between the court of law and the court of public opinion of what it means for food to be safe.\".\u003C\u002Fp\u003E\n\u003Cp\u003EHeavy metals like cadmium and lead naturally occur in the Earth's crust, so it's impossible to totally eliminate them. But human activities such as mining, fracking, industrial agriculture and the use of waste water for irrigation, exacerbate the presence of heavy metals in air, water and soil in the form of pollution, Bowen argues. Unlike microbial pathogens which can be destroyed by high heat and other methods, there's no way to get rid of such contaminants once they are in a product, she says. Instead, the problem has to be addressed at the start of the process, by beginning with clean, uncontaminated soil. After all, formula starts with farming, since key ingredients come from dairy livestock or crops.\u003C\u002Fp\u003E\n\u003Cp\u003E\"If you want a high-quality finished product, that comes from high-quality ingredients. That comes from healthy nutritious soils and that comes from good environmental policy that isn't going to allow for that level of pollution that contributed to the problem,\" says Bowen who explains that certain formula ingredients are at higher risk of heavy metal contamination. Soy, a mainstream plant-based substitute for cows' milk, tends to bioaccumulate heavy metals, as does hemp, whereas pea protein doesn't have that same tendency.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220622-whats-really-inside-babies-first-foods-6"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0cf9z67"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220622-whats-really-inside-babies-first-foods-7"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EHidden formula contaminants are only one part of the problem. Powdered formula gets mixed with tap water to create infant milk. That poses a health risk in areas where that water is contaminated by old, flaking lead pipes, which happened in \u003Ca href=\"https:\u002F\u002Fwww.bbc.co.uk\u002Fnews\u002Fworld-us-canada-59243426\"\u003EFlint, Michigan, for example\u003C\u002Fa\u003E (lead exposure \u003Ca href=\"https:\u002F\u002Fwww.cdc.gov\u002Fbreastfeeding\u002Fbreastfeeding-special-circumstances\u002Fenvironmental-exposures\u002Flead.html\"\u003Ecan also affect breastfeeding mothers\u003C\u002Fa\u003E). While lead piping is gradually being replaced, water testing typically focuses on microbes, rather than high levels of heavy metals, Bowen says.\u003C\u002Fp\u003E\n\u003Cp\u003E\"It's one thing to solve the problem for infant formula, but unless you solve heavy metal contamination of the drinking water that gets mixed with powdered milk to give to baby, you're only fixing half the problem,\" she says. \"What are we doing to prevent these problems in the first place?\"\u003C\u002Fp\u003E\n\u003Cp\u003EThe \u003Ca href=\"https:\u002F\u002Fwww.fda.gov\u002Ffood\u002Fmetals-and-your-food\u002Fcloser-zero-action-plan-baby-foods\"\u003EUS Food and Drug Administration's Closer to Zero action plan\u003C\u002Fa\u003E, which aims to reduce exposure to arsenic, lead, cadmium and mercury from foods eaten by babies and young children, could be one step towards cleaner food.\u003C\u002Fp\u003E\n\u003Cp\u003ECommon formula ingredients such as palm and soy have also raised wider environmental concerns, because \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20211025-palm-oil-the-everyday-ingredient-that-harms-the-climate\"\u003Etheir production often involves destruction of native forest habitat\u003C\u002Fa\u003E. For some, the solution is to use organic formula ingredients and source them as locally as possible. In Australia, for example, formula maker Bubs sources milk from local goat farms and cattle, which they say helps them ensure the traceability of the ingredients they use.\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003EFeeding the microbiome\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EIn recent years, there has been growing awareness of the important role of the human microbiome, the ecosystem of \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20211115-how-your-microbiome-can-improve-your-health\"\u003Emicroorganisms that thrive inside and on our bodies\u003C\u002Fa\u003E, including in our digestive system. Emily Bloxam, a paediatric dietitian at City Dietitians in London who specialises in neonatal nutrition and allergies, explains that while the nutritional composition of formula is now closer to breast milk than ever before, breast milk is \"a key driver\" for the development of the baby's gut microbiome. Breast milk components that facilitate this development, such as maternal antibodies and healthy gut bacteria, cannot be artificially manufactured yet. \u003C\u002Fp\u003E\n\u003Cp class=\"xmsonormal\"\u003E\"Bifidobacteria is a key probiotic (friendly bacteria) found in breastmilk which colonises an infant's gut during the first 1,000 days of life and aids immune function, while reducing the risk of asthma, eczema and gastrointestinal symptoms,\" says Bloxam. \"Breast milk also contains prebiotics called human milk oligosaccharides (HMOs) which feed the Bifidobacteria allowing their growth.\"\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220622-whats-really-inside-babies-first-foods-8"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0cfb0mm"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220622-whats-really-inside-babies-first-foods-9"},{"bodyHtml":{"assets":[]},"calloutBodyHtml":"\u003Cp\u003EThis article is part of \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Ffamily-tree\" target=\"_blank\"\u003E\u003Cstrong\u003EFamily Tree\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E, a series of features that explore the issues and opportunities that families face all over the world. You might also be interested in other stories about a baby's first months:\u003C\u002Fp\u003E\n\u003Cul\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20220322-how-sleep-training-affects-babies\"\u003EWhat really happens when babies are left to cry it out?\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20220131-the-science-of-safe-and-healthy-baby-sleep\"\u003EThe science of healthy baby sleep\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20220322-how-dangerous-is-tongue-tie\"\u003EHow dangerous is tongue-tie?\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003C\u002Ful\u003E\n\u003Cp\u003EYou can also climb new branches of the Family Tree on \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fworklife\u002Ffamily-tree\"\u003EBBC Worklife\u003C\u002Fa\u003E.\u003C\u002Fp\u003E","calloutTitle":"Family Tree","cardType":"CalloutBox","iFrameType":"","id":"future\u002Farticle\u002F20220622-whats-really-inside-babies-first-foods-10"},{"bodyHtml":{"assets":[],"html":"\u003Cp class=\"xmsonormal\"\u003EOver \u003Ca href=\"https:\u002F\u002Fwww.sciencedirect.com\u002Fscience\u002Farticle\u002Fabs\u002Fpii\u002FS0278691522000746\"\u003E150 types of HMOs\u003C\u002Fa\u003E have been found in breast milk. In fact, the gut microbiomes of breastfed infants have been found to be \u003Ca href=\"https:\u002F\u002Fwww.nature.com\u002Farticles\u002Fs41598-020-72635-x\"\u003Edistinctly different to those of formula-fed babies\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003ESome hypoallergenic formulas now include prebiotic and probiotic additions which are designed to bring the gut microbiome of milk-allergic infants closer to that of breastfed infants. Newly developed probiotic Bifidobacteria supplements can be mixed with formula or breast milk for babies who have been delivered by C-section and therefore not exposed to some of their mother's gut bacteria during a vaginal delivery. Some HMOs have been chemically engineered for addition to infant formula as well.\u003C\u002Fp\u003E\n\u003Cp class=\"xmsonormal\"\u003EHowever, any added ingredients in formula still lack one distinctive feature of breast milk: the ability to constantly change and adapt. As Bloxam explains, \u003Ca href=\"https:\u002F\u002Fwww.nature.com\u002Farticles\u002Fs41390-019-0368-x\"\u003Ebreast milk is in a complex constant state of flux\u003C\u002Fa\u003E: \"The amounts and composition of these beneficial substances vary among women according to a number of factors such as genetics, geographical regions, stages of lactation and diet. Even within one individual, breast milk composition changes daily to meet the infant's needs.\"\u003C\u002Fp\u003E\n\u003Cp class=\"xmsonormal\"\u003E\u003Cstrong\u003ELab-grown milk?\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp class=\"xmsonormal\"\u003EOne way to potentially mimic some of those properties may be to grow breast-milk-producing cells in a laboratory, something scientists are beginning to explore.\u003C\u002Fp\u003E\n\u003Cp class=\"xmsonormal\"\u003EBioMilq, a North Carolina-based start-up, was set up by cell biologist Leila Strickland after she struggled to produce enough breast milk for her first child. Her team take cells from human breast tissue and breast milk before growing them in flasks in the lab. They are fed a mix of nutrients and vitamins, then incubated inside a bioreactor, where the cells start secreting the milk components that are found in natural human milk. However, BioMilq is still a few years at least away from market. Also, lab-grown milk would still not be as individually tailored to a baby's fluctuating needs as their own mother's milk.\u003C\u002Fp\u003E\n\u003Cp class=\"xmsonormal\"\u003EOther biotech companies are also working on lab-grown milk projects that could change how we think of manufactured infant formula in the future. \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Fbespoke\u002Ffollow-the-food\u002Fthe-green-milk-made-from-cells.html\"\u003EIn Singapore, Turtle Tree Labs is culturing cells from various different mammals\u003C\u002Fa\u003E, including cows, sheep, goats, camels and now humans, to create milk components. In New York, researchers at Helaina, a start-up, are using fermentation processes that programme yeast cells to manufacture functional human milk proteins, which could eventually be added to infant formula and other food products.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220622-whats-really-inside-babies-first-foods-11"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"We can quite successfully produce formulas to provide adequate and safe nutrition so the baby grows and develops as expected. However I think it would be impossible to ever mimic the 'non-nutrient' components – Mary Fewtrell","id":"future\u002Farticle\u002F20220622-whats-really-inside-babies-first-foods-12"},{"bodyHtml":{"assets":[],"html":"\u003Cp class=\"xmsonormal\"\u003EHowever, breast milk is a constantly changing fluid so in a way it's a moving target, with some components still not fully understood, says Fewtrell, the professor of paediatric nutrition at University College London.   \u003C\u002Fp\u003E\n\u003Cp class=\"xmsonormal\"\u003E\"We can quite successfully produce formulas to provide adequate and safe nutrition so the baby grows and develops as expected,\" she says. \"Indeed, there have been improvements to the composition of formulas in recent years so that they can more closely reproduce the growth patterns and some outcomes seen in breast-fed infants. However I think it would be impossible to ever mimic the 'non-nutrient' components in this complex fluid.\"\u003C\u002Fp\u003E\n\u003Cp class=\"xmsonormal\"\u003EAs for my investigation into my own body's toxic load, and the harmful chemicals that were perhaps present in my breastmilk, Bloxam, the dietician, reassures me:  \"I'd encourage breastfeeding wherever possible as the benefits for mother and baby would far outweigh any risks [from contamination].\" \u003C\u002Fp\u003E\n\u003Cp\u003EStill it appears I'm not the only one wondering about the ingredients in my own milk. Stephanie Canale, previously a family medical doctor, is the founder of Lactation Lab in California, a private company that analyses breast milk for nutritional content as well as environmental toxics. Mothers send in frozen samples of their breast milk to check the levels of various ingredients including minerals and vitamins. The idea is that they can then adapt their diet accordingly.\u003C\u002Fp\u003E\n\u003Cp\u003ECanale says that when we look at a baby's nutrition, we need to include everything from prenatal vitamins to the food a breastfeeding mother consumes and the meals a weaning baby eats. Formula may be one part of that mosaic, in families where it is used. \u003C\u002Fp\u003E\n\u003Cp\u003E\"It's this holistic approach,\" says Canale who would like to see stricter regulations in the US about the contents of formula. \"I'm from Canada and it still surprises how much high-fructose corn syrup is present in US products, including formula. Moms are going to drive this change by saying we need to be better aware of what is going into these products, especially formula because that child is eating the same thing every single day – there's no variation [like there is naturally with breast milk].\"\u003C\u002Fp\u003E\n\u003Cp class=\"xmsonormal\"\u003EIn the case of the toxic chemicals – whether they find their way into breast milk or into formula – the question is clearly not just about how we can provide our children with safe nutrition. It is also about how we can provide them and future generations with a safe, liveable environment, and reduce pollution along the entire food chain. One answer, surely, is to start by using fewer harmful chemicals in the first place.\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003E* Listen to\u003C\u002Fem\u003E\u003Cem\u003E \u003C\u002Fem\u003E\u003Cem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fprogrammes\u002Fm0011lf7\"\u003E\u003Cstrong\u003EMy Toxic Cocktail\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E, Anna Turns's investigation for BBC Radio 4's Costing the Earth series on \u003Ca href=\"http:\u002F\u002Fwww.bbc.com\u002Fsounds\"\u003EBBC Sounds\u003C\u002Fa\u003E.\u003C\u002Fem\u003E\u003Cem\u003E \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.mombooks.com\u002Fbook\u002Fgo-toxic-free\u002F\"\u003E\u003Cem\u003E\u003Cstrong\u003EGo Toxic Free: Easy and Sustainable Ways to Reduce Chemical Pollution\u003C\u002Fstrong\u003E\u003C\u002Fem\u003E\u003C\u002Fa\u003E\u003Cem\u003E \u003C\u002Fem\u003E\u003Cem\u003Eby Anna Turns is out now\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003E--\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EThis article was updated on 27 June to include a quote from the FDA.\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E--\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EJoin one million Future fans by liking us on \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.facebook.com\u002FBBCFuture\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EFacebook\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, or follow us on \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Ftwitter.com\u002FBBC_Future\"\u003E\u003Cstrong\u003E\u003Cem\u003ETwitter\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E or \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.instagram.com\u002Fbbcfuture_official\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EInstagram\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E.\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EIf you liked this story, \u003C\u002Fem\u003E\u003Ca href=\"http:\u002F\u002Fpages.emails.bbc.com\u002Fsubscribe\u002F?ocid=fut.bbc.email.we.email-signup\"\u003E\u003Cstrong\u003E\u003Cem\u003Esign up for the weekly bbc.com features newsletter\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, called \"The Essential List\" – a handpicked selection of stories from BBC \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EFuture\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fculture\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003ECulture\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fworklife\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EWorklife\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ftravel\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003ETravel\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E \u003Cem\u003Eand \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Freel\"\u003E\u003Cstrong\u003E\u003Cem\u003EReel\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E delivered to your inbox every Friday.\u003C\u002Fem\u003E\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220622-whats-really-inside-babies-first-foods-13"}],"collection":["future\u002Fpremium-collection\u002Ffamily-tree"],"disableAdverts":false,"displayDate":"2022-06-23T01:00:00Z","embeddedCustomHtml":"","embeddedInfographicUrl":"","embeddedType":"infographic","headlineLong":"The surprising science of breast milk","headlineShort":"The milk that changes every day","image":["p0cf9y3f"],"imageAlignment":"centre","imageAltText":"","isSyndicated":true,"latitude":"","longitude":"","mpsVideo":"","option":[{"Content":{"Description":"Apple News Publish: Select to publish, remove to unpublish. (Do not just delete or unpublish the story)","Name":"publish-applenews-system-1"},"Metadata":{"CreationDateTime":"2016-02-05T14:32:31.186819Z","Entity":"option","Guid":"13f4bc85-ae27-4a34-9397-0e6ad3619619","Id":"option\u002Fpublish-applenews-system-1","ModifiedDateTime":"2022-02-27T22:52:24.455144Z","Project":"wwverticals","Slug":"option\u002Fpublish-applenews-system-1"},"Urn":"urn:pubpipe:wwverticals:option:option\u002Fpublish-applenews-system-1","_id":"62b420921f4b7b5d34253c8b"}],"partner":null,"primaryVertical":"future","promoAlignment":"centre","promoAltText":"","promoImage":["p0cfb0mm"],"relatedStories":null,"relatedTag":null,"summaryLong":"Scientists are discovering the extraordinary power of human breast milk and the benefits it brings to infants, which make it so difficult to replicate.","summaryShort":"Human milk contains so many elements it is difficult to replicate","tag":["tag\u002Ffood","tag\u002Fbabies","tag\u002Fparenting"],"textToSpeech":false,"creationDateTime":"2022-06-23T00:00:02.975146Z","entity":"article","guid":"7d00a8ce-59b0-406a-8493-995f3267945b","id":"future\u002Farticle\u002F20220622-whats-really-inside-babies-first-foods","modifiedDateTime":"2022-06-27T16:56:16.485008Z","project":"wwverticals","slug":"future\u002Farticle\u002F20220622-whats-really-inside-babies-first-foods","cacheLastUpdated":1657756319028},"future\u002Farticle\u002F20220609-do-pets-help-childrens-development":{"urn":"urn:pubpipe:wwverticals:article:future\u002Farticle\u002F20220609-do-pets-help-childrens-development","_id":"62b4200d1f4b7b0e3a0d317e","ambientVideo":"","articleType":"story","assetVideo":null,"author":["future\u002Fauthor\u002Fkelly-oakes"],"bodyIntro":"Choosing a pet starts with understanding how they fit into the home. Kelly Oakes explores what happens when animals join a family – and their profound impact on children's development.","businessUnit":"worldwide","cards":[{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EPick up a book from a young child's bookshelf and you're more likely to find an animal protagonist than a human one. From very hungry caterpillars to great big humpback whales, children seem universally fascinated by animals. But while characters in a picture book are often far removed from reality, the pets many of us share a home with offer children a more realistic glimpse of the animal world – and a meaningful relationship that influences them in a whole host of other ways, too.\u003C\u002Fp\u003E\n\u003Cp\u003EUnderstanding that relationship may not only help parents choose the right pet for their child, but also give them deeper insights into the factors that make for a truly successful bond.\u003C\u002Fp\u003E\n\u003Cp\u003EFor many people, pets are much-loved family members who provide support across many stages of life. They can \u003Ca href=\"https:\u002F\u002Flink.springer.com\u002Fchapter\u002F10.1007\u002F978-3-030-64085-9_2\"\u003Ehelp couples to cement their relationship, act as playmates for young children, and provide companionship for parents when children leave home\u003C\u002Fa\u003E. One study in the US found that \u003Ca href=\"https:\u002F\u002Fwww.frontiersin.org\u002Farticles\u002F10.3389\u002Ffvets.2018.00152\u002Ffull\"\u003E63% of households with a baby under 12 months old had a pet\u003C\u002Fa\u003E, and an Australian study found a \u003Ca href=\"https:\u002F\u002Fwww.sciencedirect.com\u002Fscience\u002Farticle\u002Fabs\u002Fpii\u002FS0022347620300251\"\u003E10% increase in pet ownership around the time the children start school\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003EMany parents intuitively feel that looking after an animal can offer children valuable lessons about caregiving, responsibility and empathy. \"It's really important, especially for young kids, to learn that someone's perspective might be different from their own,\" says Megan Mueller, associate professor of human-animal interaction at Tufts University, US. \"That's an easier lesson to learn, perhaps, with an animal than it is with, say, a sibling or a peer.\"\u003C\u002Fp\u003E\n\u003Cp\u003EBut claims about the beneficial impacts of pets on children go further, suggesting that pets can influence children's \u003Ca href=\"https:\u002F\u002Flink.springer.com\u002Fchapter\u002F10.1007\u002F978-3-030-64085-9_5\"\u003Esocial skills, physical health, and even cognitive development\u003C\u002Fa\u003E, and that keeping them is \u003Ca href=\"https:\u002F\u002Fwww.tandfonline.com\u002Fdoi\u002Fabs\u002F10.2752\u002F089279306785593801\"\u003Eassociated with higher levels of empathy\u003C\u002Fa\u003E. For children with autism and their families, pet care may help \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F32130592\u002F\"\u003Ereduce stress\u003C\u002Fa\u003E and create opportunities to \u003Ca href=\"https:\u002F\u002Fwww.pediatricnursing.org\u002Farticle\u002FS0882-5963(13)00293-5\u002Ffulltext\"\u003Eform supportive bonds\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003EOther research shows that children gain from animals in-the-moment, too. In one pair of studies, \u003Ca href=\"https:\u002F\u002Fwww.tandfonline.com\u002Fdoi\u002Fabs\u002F10.2752\u002F175303710X12750451258896\"\u003Echildren made fewer errors on an object categorisation task\u003C\u002Fa\u003E and \u003Ca href=\"https:\u002F\u002Fwww.tandfonline.com\u002Fdoi\u002Fabs\u002F10.2752\u002F175303710X12682332910051%20\"\u003Eneeded fewer prompts in a memory task\u003C\u002Fa\u003E when there was a dog in the room. Research has even found that, for adults at least, the \u003Ca href=\"https:\u002F\u002Fwww.tandfonline.com\u002Fdoi\u002Fabs\u002F10.1080\u002F08927936.2019.1621516\"\u003Esimple act of viewing our pets as family members improves our wellbeing\u003C\u002Fa\u003E – though headlines touting the wide-ranging benefits of pet ownership are not without criticism, since people often \u003Ca href=\"https:\u002F\u002Fwww.psychologytoday.com\u002Fus\u002Fblog\u002Fanimals-and-us\u002F202109\u002Fare-pets-good-us-we-think-they-are\"\u003Ebelieve that their pets improve their health and happiness\u003C\u002Fa\u003E, even when objective measures don't show any difference.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220609-do-pets-help-childrens-development-0"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0cdl64k"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220609-do-pets-help-childrens-development-1"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003E\u003Cstrong\u003EInteracting with pets – and with other people\u003Cbr \u002F\u003E\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003ESo, are pets truly at the root of all these benefits, or do we just think they are? Hayley Christian, associate professor at the School of Population and Global Health at the University of Western Australia in Perth, is one of the researchers attempting to unravel cause from effect.\u003C\u002Fp\u003E\n\u003Cp\u003EUsing data from a longitudinal study of 4,000 children at ages five and seven, Christian and colleagues discovered that pet ownership was \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F32093933\u002F\"\u003Eassociated with fewer peer problems and more prosocial behaviour\u003C\u002Fa\u003E. In separate research they found that \u003Ca href=\"https:\u002F\u002Fwww.sciencedirect.com\u002Fscience\u002Farticle\u002Fpii\u002FS2211335522000602\"\u003Echildren aged 2 to 5 with a family dog were more active, spent less time on screens, and slept more\u003C\u002Fa\u003E on average, than those without a pet.\u003C\u002Fp\u003E\n\u003Cp\u003ECrucially, it was the dog-facilitated physical activity – such as going on family dog walks – that made the difference.\u003C\u002Fp\u003E\n\u003Cp\u003EThen, in a study published last year, they put these two pieces of the puzzle together. After controlling for factors such as socio-economic status, the researchers saw that \u003Ca href=\"https:\u002F\u002Fwww.nature.com\u002Farticles\u002Fs41390-020-1007-2\"\u003Echildren who regularly engaged in dog-related physical activity had better developmental outcomes\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003E\"We can actually say that children having pets and interacting with them over time in early childhood does seem to cause these added benefits in terms of their social-emotional development,\" says Christian, who is also a senior research fellow at the Telethon Kids Institute.\u003C\u002Fp\u003E\n\u003Cp\u003EThat's not to say that every family should get a pet – or every child with a dog is better off than those without. Behavioural issues, complex medical needs and the financial burden of caring for an animal can all make life with a pet less than rosy. Families living in housing that is not pet-friendly face further barriers. \"I don't think we're ever going to get to the point where we recommend that everyone with a kid gets a dog,\" says Mueller.\u003C\u002Fp\u003E\n\u003Cp\u003EIn fact, Mueller looked into \u003Ca href=\"https:\u002F\u002Fwww.tandfonline.com\u002Fdoi\u002Fabs\u002F10.1080\u002F08927936.2022.2027093?journalCode=rfan20\"\u003Ewhether the mental health of US teenagers with pets was better than their non pet-owning counterparts during the Covid-19 pandemic\u003C\u002Fa\u003E – and found that the animals appeared to make no difference. \"My hypothesis is that Covid was a huge stressor and there probably isn't one thing that's enough to overcome it,\" she says.\u003C\u002Fp\u003E\n\u003Cp\u003EIt's also possible that the pandemic put a stop to one of the ways in which living with a dog can give us a boost. \"We get the social benefits from interacting with the dog, but there's also this way in which animals can facilitate social interaction with other people,\" says Mueller. During lockdowns, teenagers might have stuck to their daily dog walks but avoided conversations with other dog walkers, losing out on small moments of social interaction.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"infographic","imageAlignment":"centre","imageOrientation":"landscape","pullQuoteImageAlignment":"centre","videoImageAlign":"centre","id":"future\u002Farticle\u002F20220609-do-pets-help-childrens-development-2"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0cdl4n9"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220609-do-pets-help-childrens-development-3"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003E\u003Cstrong\u003EBuilding a strong relationship\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EWhen it comes to the positive influence of pets on children, the state of their relationship is key – not just living under the same roof. \"Relationship quality seems to be a better predictor of some of these health outcomes than just whether or not you have a pet in the home,\" says Mueller.\u003C\u002Fp\u003E\n\u003Cp\u003ETime spent with a pet is one factor. If your sibling has a hamster that lives in their room, you're unlikely to feel very attached to it, for example, compared to a family dog that you walk every day after school.\u003C\u002Fp\u003E\n\u003Cp\u003EA child's age can also help determine how solid their relationship with a particular pet becomes. Children aged between six and 10 \u003Ca href=\"https:\u002F\u002Fwww.tandfonline.com\u002Fdoi\u002Fabs\u002F10.1080\u002F08927936.2017.1357882\"\u003Edevelop stronger bonds with animals that are more similar to humans\u003C\u002Fa\u003E, like cats and dogs, than with biologically far-removed species like birds and fish. But older children, aged between 11 and 14, report being just as attached to less closely-related species – including mice – as they are to their dogs or cats. \u003C\u002Fp\u003E\n\u003Cp\u003EFamily dynamics also play a part. The Australian longitudinal study saw that \u003Ca href=\"https:\u002F\u002Fwww.sciencedirect.com\u002Fscience\u002Farticle\u002Fabs\u002Fpii\u002FS0022347620300251\"\u003Echildren without siblings can especially benefit from pets\u003C\u002Fa\u003E – perhaps because they sometimes act as a surrogate sibling. \"Parents are more likely to allow their child to be independently mobile [for example, run an errand alone] if they went with a sibling or a friend,\" says Christian. \"And guess what else? A dog.\"\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220609-do-pets-help-childrens-development-4"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"Babies in households with a pet are better at recognising animal faces by the time they are 10 months old, research shows","id":"future\u002Farticle\u002F20220609-do-pets-help-childrens-development-5"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EPets can even aid social interactions within households. In foster families, research suggests \u003Ca href=\"https:\u002F\u002Fwww.tandfonline.com\u002Fdoi\u002Ffull\u002F10.1080\u002F14616734.2017.1280517\"\u003Ea pet can help facilitate close relationships between foster carers and children\u003C\u002Fa\u003E, as well as providing companionship in its own right.\u003C\u002Fp\u003E\n\u003Cp\u003EWhen children get to know their pets, it opens them up to a deeper understanding of animals in the wider world. \"They tend to learn from their pet, somehow, how to be more understanding, empathetic and responsive to animals in general,\" says John Bradshaw, former reader in companion animal behaviour at the University of Bristol, UK, and author of several books on cats and dogs.\u003C\u002Fp\u003E\n\u003Cp\u003EOne study in the UK found that children \u003Ca href=\"https:\u002F\u002Fwww.tandfonline.com\u002Fdoi\u002Fabs\u002F10.1080\u002F08927936.2016.1189749\"\u003Ewho had pets at home were more likely to have higher levels of belief about animals' minds\u003C\u002Fa\u003E, that is, thinking that animals have thoughts and feelings of their own.\u003C\u002Fp\u003E\n\u003Cp\u003E\"You can have all sorts of imaginary stories in your head about a lion, but until somebody takes you to Africa, you'll never meet one in the wild,\" he says. \"But a dog or a cat is there and can teach you about what it's actually like to be an animal, that animals are not human, they have very special lives that belong to them and not to us.\"\u003C\u002Fp\u003E\n\u003Cp\u003EEven young babies are watching and learning about the animals they live with. Research by Karinna Hurley and Lisa Oakes at the University of California, Davis, US, found that infants in households with a pet were \u003Ca href=\"https:\u002F\u002Fwww.frontiersin.org\u002Farticles\u002F10.3389\u002Ffvets.2018.00152\u002Ffull%20\"\u003Ebetter at recognising animal faces by the time they were 10 months old\u003C\u002Fa\u003E than those without. \u003C\u002Fp\u003E\n\u003Cp\u003EWhat's more, a child's relationship with their pet could provide a much-needed link with nature. \"To have a real living, breathing, slightly messy animal running around the house is a good way of making those connections,\" says Bradshaw.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220609-do-pets-help-childrens-development-6"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0cdl6zy"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220609-do-pets-help-childrens-development-7"},{"bodyHtml":{"assets":[]},"calloutBodyHtml":"\u003Cp\u003EThis article is part of \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Ffamily-tree\" target=\"_blank\"\u003E\u003Cstrong\u003EFamily Tree\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E, a series of features that explore the issues and opportunities that families face all over the world. You might also be interested in other stories about children's behaviour and development:\u003C\u002Fp\u003E\n\u003Cul\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20220105-the-arctic-parenting-style-that-fosters-resilience\"\u003EHow Arctic kids learn resilience\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20211201-the-german-tradition-that-calms-school-anxiety\"\u003EWhy Germany loves \"school cones\"\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20220105-how-asia-fell-in-love-with-forest-schools\"\u003EAsia's new love of forest schools\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003C\u002Ful\u003E\n\u003Cp\u003EClimb new branches of the Family Tree on \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fworklife\u002Ffamily-tree\"\u003EBBC Worklife\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E","calloutTitle":"Family Tree","cardType":"CalloutBox","iFrameType":"","id":"future\u002Farticle\u002F20220609-do-pets-help-childrens-development-8"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003E\u003Cstrong\u003EWhat do animals think of kids?\u003C\u002Fstrong\u003E \u003C\u002Fp\u003E\n\u003Cp\u003ERemembering our pets' wild origins can give us an insight into how they see our families.\u003C\u002Fp\u003E\n\u003Cp\u003EDogs \u003Ca href=\"https:\u002F\u002Fwww.cell.com\u002Fcurrent-biology\u002Ffulltext\u002FS0960-9822(21)00880-0\"\u003Eevolved to live alongside humans\u003C\u002Fa\u003E and have the potential to form very strong bonds with us. Cats, on the other hand, are solitary creatures at heart. Even so, they do seem to regard their human housemates as family. \"Our cats greet us by raising their tails and rubbing around our legs – precisely what they do when meeting another cat they know well or consider a family member,\" writes Bradshaw in his book, \u003Ca href=\"https:\u002F\u002Fwww.penguin.co.uk\u002Fbooks\u002F277\u002F277326\u002Fthe-animals-among-us\u002F9780141980164.html\"\u003EThe Animals Among Us\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003EBut whether this kinship translates to children depends on a pet's own early life experiences.\u003C\u002Fp\u003E\n\u003Cp\u003EBoth cats and dogs have a brief window – for puppies this is between around eight and 16 weeks of age – where they learn about the sorts of people they might encounter in their lives. \"We know that if puppies or kittens have not met children at all by the time they get to six months or so – depending on their underlying temperament – they can display really quite adverse reactions,\" says Bradshaw. \"That suggests that they don't really recognise children as human, unless they've been introduced to them as part of the humanity package.\"\u003C\u002Fp\u003E\n\u003Cp\u003EThis makes perfect sense when you look at it from the animal's point of view, he says: \"A baby is nothing like an adult human. It's much smaller, it can't stand up, it makes very different noises to an adult human, and it smells very different to an adult human.\"\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220609-do-pets-help-childrens-development-9"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"Children rank pets as some of the most important beings in their lives – but pets can take time to get used to kids","id":"future\u002Farticle\u002F20220609-do-pets-help-childrens-development-10"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EUnderstanding how a pet sees the world is vital to making sure everyone gets along. If a cat urinates on a new cot or pram brought into the house, it's easy to jump to conclusions. \"If you were not sympathetic to the way the cat thinks you might think, 'Oh, the cat's just getting cross because I'm going to have a baby, it must know',\" says Bradshaw. \"Of course, they don't know. It's very often the olfactory environment [the smell of the home] that's been churned up and the cat's lost its familiar points of reference.\"\u003C\u002Fp\u003E\n\u003Cp\u003EBoth cats and dogs rely heavily on their noses, so having lots of new smells in the house is like \"coming home and finding that someone has painted your walls completely opposite colours,\" says Bradshaw. On the flip side, familiar scents can keep them happy. In one trial, Bradshaw and his colleagues put a t-shirt that had been worn by a dog's owner into their bed. \"That familiar smell seemed to work wonders for the dog, they were much more relaxed,\" he says.\u003C\u002Fp\u003E\n\u003Cp\u003ENot anthropomorphising our pets – meaning, expecting them to think and behave like humans – is especially important when it comes to a child's safety. \"You can never be 100% sure how a dog is going to react in any one given situation,\" says Bradshaw. \"There's all sorts of possible things which can trigger the dog into a different mode of behaviour, maybe one that the owner has never seen before.\"\u003C\u002Fp\u003E\n\u003Cp\u003EUltimately, each child-pet relationship is unique, with its own quirks, benefits, and pitfalls – and in some ways researchers are only just starting to understand what makes a child's relationship with their pet mutually beneficial. \"The field is really moving towards looking at these more individual differences,\" says Mueller.\u003C\u002Fp\u003E\n\u003Cp\u003EMeanwhile, children themselves rank pets as \u003Ca href=\"https:\u002F\u002Fonlinelibrary.wiley.com\u002Fdoi\u002Fabs\u002F10.1046\u002Fj.1365-2214.2001.00202.x\"\u003Esome of the most important beings in their lives\u003C\u002Fa\u003E, seeing their animal companions as a comfort and emotional support, as well as being infallible confidantes for a secret. Some of those benefits \"are very difficult to quantify because they're very individual, and science deals in populations and big numbers,\" says Bradshaw. \"Just because it's not very tangible and easily measured, it doesn't mean it's not real.\"\u003C\u002Fp\u003E\n\u003Cp\u003E--\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EJoin one million Future fans by liking us on \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.facebook.com\u002FBBCFuture\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EFacebook\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, or follow us on \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Ftwitter.com\u002FBBC_Future\"\u003E\u003Cstrong\u003E\u003Cem\u003ETwitter\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E or \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.instagram.com\u002Fbbcfuture_official\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EInstagram\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E.\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EIf you liked this story, \u003C\u002Fem\u003E\u003Ca href=\"http:\u002F\u002Fpages.emails.bbc.com\u002Fsubscribe\u002F?ocid=fut.bbc.email.we.email-signup\"\u003E\u003Cstrong\u003E\u003Cem\u003Esign up for the weekly bbc.com features newsletter\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, called \"The Essential List\" – a handpicked selection of stories from BBC \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EFuture\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fculture\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003ECulture\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fworklife\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EWorklife\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ftravel\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003ETravel\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E \u003Cem\u003Eand \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Freel\"\u003E\u003Cstrong\u003E\u003Cem\u003EReel\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E delivered to your inbox every Friday.\u003C\u002Fem\u003E\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220609-do-pets-help-childrens-development-11"}],"collection":["future\u002Fpremium-collection\u002Ffamily-tree"],"disableAdverts":false,"displayDate":"2022-06-14T00:00:00Z","embeddedCustomHtml":"","embeddedInfographicUrl":"","embeddedType":"infographic","headlineLong":"How pets give your kids a brain boost","headlineShort":"How pets give your kids a brain boost","image":["p0cdky76"],"imageAlignment":"centre","imageAltText":"","isSyndicated":true,"latitude":"","longitude":"","mpsVideo":"","option":[{"Content":{"Description":"Apple News Publish: Select to publish, remove to unpublish. (Do not just delete or unpublish the story)","Name":"publish-applenews-system-1"},"Metadata":{"CreationDateTime":"2016-02-05T14:32:31.186819Z","Entity":"option","Guid":"13f4bc85-ae27-4a34-9397-0e6ad3619619","Id":"option\u002Fpublish-applenews-system-1","ModifiedDateTime":"2022-02-27T22:52:24.455144Z","Project":"wwverticals","Slug":"option\u002Fpublish-applenews-system-1"},"Urn":"urn:pubpipe:wwverticals:option:option\u002Fpublish-applenews-system-1","_id":"62b420921f4b7b5d34253c8b"}],"partner":null,"primaryVertical":"future","promoAlignment":"centre","promoAltText":"","promoImage":null,"relatedStories":null,"relatedTag":null,"summaryLong":"Choosing a pet starts with understanding how they fit into the home. Kelly Oakes explores what happens when animals join a family – and their profound impact on children's development.","summaryShort":"Scientists unlock the secrets of a special bond","tag":["tag\u002Fpsychology"],"textToSpeech":false,"creationDateTime":"2022-06-14T00:00:53.028791Z","entity":"article","guid":"fad08750-d5f1-41f3-b421-fc57bde7a453","id":"future\u002Farticle\u002F20220609-do-pets-help-childrens-development","modifiedDateTime":"2022-06-14T00:02:02.856465Z","project":"wwverticals","slug":"future\u002Farticle\u002F20220609-do-pets-help-childrens-development","cacheLastUpdated":1657756319028},"future\u002Farticle\u002F20220607-what-should-you-do-when-a-child-misbehaves":{"urn":"urn:pubpipe:wwverticals:article:future\u002Farticle\u002F20220607-what-should-you-do-when-a-child-misbehaves","_id":"62b41ff81f4b7b7f6763e561","ambientVideo":"","articleType":"story","assetVideo":null,"author":["future\u002Fauthor\u002Famanda-ruggeri"],"bodyIntro":"From the impact of giving a child a time out, to the latest research on punishment-free parenting, Amanda Ruggeri investigates the fascinating science of discipline.","businessUnit":"worldwide","cards":[{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EYour toddler smacks another child at play group, upset that she won't share her toy. Your pre-schooler needles you at the store, whining that he \u003Cem\u003Ereally\u003C\u002Fem\u003E wants that sweet. Your 12-year-old refuses to set the table, storming off to her room and slamming the door.\u003C\u002Fp\u003E\n\u003Cp\u003EAsk any parent, and they’ll tell you that dealing with situations like these can be among the most challenging – and common – parts of parenting. If the frustration of the moment itself weren’t enough, there’s the difficulty of how to respond. Do you give a time out? Threaten to take away privileges? Negotiate? Or do you follow the approach being promulgated by an increasing number of advocates, which holds that connecting with a child in their moment of distress, not punishing them, leads to calmer, better-behaved, and emotionally more in-tune kids?\u003C\u002Fp\u003E\n\u003Cp\u003E\"The word 'discipline' has been misconstrued as 'punishment', meaning inflicting pain as a consequence of doing something,\" says Dan Siegel, clinical professor of psychiatry at the UCLA School of Medicine and the author of six books on parenting, including No-Drama Discipline. He points out that the word \"discipline\" comes from the Latin word \u003Cem\u003Edisciplina \u003C\u002Fem\u003E– \u003Ca href=\"https:\u002F\u002Fwww.etymonline.com\u002Fword\u002Fdiscipline\"\u003Ewhich means instruction or teaching\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003E\"Parents say, 'Parents should be good disciplinarians.' We go, 'Yes – and a disciplinarian is a teacher.'\"\u003C\u002Fp\u003E\n\u003Cp\u003ELike any parenting decision – from \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20220322-how-sleep-training-affects-babies\"\u003Ewhether to sleep train\u003C\u002Fa\u003E to the dilemma of \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20200925-how-screen-time-affects-childrens-brains\"\u003Escreen time\u003C\u002Fa\u003E – how we discipline (or \"teach\") our children is deeply personal. Our beliefs around discipline have been shaped by \u003Ca href=\"https:\u002F\u002Fwww.snaicc.org.au\u002Fgrowing-up-our-way-aboriginal-and-torres-strait-islander-child-rearing-practices-matrix-2011-snaicc\u002F\"\u003Eour culture\u003C\u002Fa\u003E, \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC3079037\u002F\"\u003Ethe attitudes of those around us\u003C\u002Fa\u003E, \u003Ca href=\"https:\u002F\u002Fminds.wisconsin.edu\u002Fhandle\u002F1793\u002F52963\"\u003Ehow we were raised\u003C\u002Fa\u003E, even \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC2759998\u002F\"\u003Eour current stress levels\u003C\u002Fa\u003E. Whether we think discipline is needed at all is also situational, depending even on which rules we set: a three-year-old told not to leave the playroom is more likely to \"disobey\", for example, than a three-year-old who is allowed to come in and out as she pleases.\u003C\u002Fp\u003E\n\u003Cp\u003EEven beliefs that are a no-brainer in some societies are unusual in others. \"The Anbarra child hears of no rules and receives no punishment,\" \u003Ca href=\"https:\u002F\u002Fwellcomecollection.org\u002Fworks\u002Fp823ppzn\"\u003Eone anthropologist noted\u003C\u002Fa\u003E of the Aboriginal tribe. \u003Ca href=\"https:\u002F\u002Fwww.snaicc.org.au\u002Fgrowing-up-our-way-aboriginal-and-torres-strait-islander-child-rearing-practices-matrix-2011-snaicc\u002F\"\u003EOther Aboriginal approaches to discipline\u003C\u002Fa\u003E include the idea that \"the child has the ultimate choice to obey or not and adults are not overly upset if the command is not complied with\". Rather than with rewards or punishments, children learn how to behave \"through trial and error over a period of years\". The Sámi, an indigenous group spread across the Arctic, espouse a similar parenting philosophy, \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20220105-the-arctic-parenting-style-that-fosters-resilience\"\u003Eletting children make their own decisions\u003C\u002Fa\u003E about even when to eat and sleep. Instead of punishments, there are intricate, unspoken rules and communal activities that nudge children towards desired behaviour, such as going hunting or fishing together.\u003C\u002Fp\u003E\n\u003Cp\u003EIn other societies, parents take a harsher approach. One Unicef report found that more than 90% of children in countries including Ghana and Egypt \u003Ca href=\"https:\u002F\u002Fwww.unicef.org\u002Fdocuments\u002Fhidden-plain-sight-statistical-analysis-violence-against-children\"\u003Ehave experienced either physical or psychological aggression as forms of discipline\u003C\u002Fa\u003E in the last month.\u003C\u002Fp\u003E\n\u003Cp\u003EOne thing we know is that every caregiver will, at some stage, find themselves dealing with a child not doing as they're told. \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F12612249\u002F\"\u003EAnywhere from 25% to 65% of parents say that their children are at least sometimes noncompliant\u003C\u002Fa\u003E, with 1% to 9% saying this is a frequent or severe problem. \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F6346154\u002F\"\u003EThis peaks in toddlerhood\u003C\u002Fa\u003E, \u003Ca href=\"https:\u002F\u002Fpsycnet.apa.org\u002Frecord\u002F1988-10459-001\"\u003Eafter which children start to use tactics like negotiation\u003C\u002Fa\u003E to get what they want – underscoring the idea that in younger children, at least, disobedience and pushing limits is a part of normal development.\u003C\u002Fp\u003E\n\u003Cp\u003EBut what does the science say about how to respond? And is there really a way to guide children towards kind, thoughtful, cooperative behaviour that doesn't involve punishment at all, as some experts argue?\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"infographic","imageAlignment":"centre","imageOrientation":"landscape","pullQuoteImageAlignment":"centre","videoImageAlign":"centre","id":"future\u002Farticle\u002F20220607-what-should-you-do-when-a-child-misbehaves-0"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0cchbw2"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220607-what-should-you-do-when-a-child-misbehaves-1"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003E\u003Cstrong\u003EAngry parent, angry child?\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EWhat the vast majority of scientists, paediatricians and psychologists now agree on is that harsh parenting tactics and corporal punishment, including spanking or \"smacking\", are unhelpful – and can cause harm to the child \u003Ca href=\"https:\u002F\u002Fjournals.sagepub.com\u002Fdoi\u002F10.1177\u002F0165025417697852\"\u003Eeven when parents think the spanking is mild and justified\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003EThe American Academy of Pediatrics changed their policy statement in 2018 \u003Ca href=\"https:\u002F\u002Fpublications.aap.org\u002Fpediatrics\u002Farticle\u002F142\u002F6\u002Fe20183112\u002F37452\u002FEffective-Discipline-to-Raise-Healthy-Children\"\u003Eto warn parents against spanking\u003C\u002Fa\u003E, and its use at home is now \u003Ca href=\"https:\u002F\u002Fendcorporalpunishment.org\u002Fcountdown\u002F\"\u003Ebanned by 63 countries\u003C\u002Fa\u003E and territories ranging from \u003Ca href=\"https:\u002F\u002Fwww.bbc.co.uk\u002Fnews\u002Fuk-wales-60781395\"\u003EWales\u003C\u002Fa\u003E to Colombia. (Spanking at home remains legal in the US, Canada and Australia while in the US, 19 states also allow its use in schools, something banned in nearly every other nation.)\u003C\u002Fp\u003E\n\u003Cp\u003EBut despite signs that \u003Ca href=\"https:\u002F\u002Fgruppocrc.net\u002Fwp-content\u002Fuploads\u002F2013\u002F02\u002FBussman_-_Europe_5_nation_report_2009.pdf\"\u003Esuch bans, along with broader social changes, have helped\u003C\u002Fa\u003E reduce spanking, many parents do it. In the UK, \u003Ca href=\"https:\u002F\u002Flearning.nspcc.org.uk\u002Fresearch-resources\u002Fpre-2013\u002Fchild-abuse-neglect-uk-today\"\u003E42% of parents said they've smacked their child\u003C\u002Fa\u003E over the course of the previous year. In the US, \u003Ca href=\"https:\u002F\u002Fsrcd.onlinelibrary.wiley.com\u002Fdoi\u002F10.1111\u002Fj.1467-8624.2012.01820.x\"\u003Ealmost one-third of parents reported spanking their one-year-olds over a given month\u003C\u002Fa\u003E, while one study in North Carolina found that \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC3125508\u002F\"\u003E70% of the mothers of two-year-olds – and 5% of the mothers of three-month-olds\u003C\u002Fa\u003E – admitted to doing so in the previous year. One 2013 poll found that \u003Ca href=\"https:\u002F\u002Ftheharrispoll.com\u002Fnew-york-n-y-september-26-2013-to-spank-or-not-to-spank-its-an-age-old-question-that-every-parent-must-face-some-parents-may-start-off-with-the-notion-that-i-will-never-spank-my-child-bu\u002F\"\u003E78% of US parents thought spanking could be appropriate\u003C\u002Fa\u003E – though \u003Ca href=\"https:\u002F\u002Fjournals.lww.com\u002Fjrnldbp\u002FAbstract\u002F2018\u002F09000\u002FUS_Pediatricians__Attitudes,_Beliefs,_and.5.aspx\"\u003Eonly 22% of US paediatricians\u003C\u002Fa\u003E do.\u003C\u002Fp\u003E\n\u003Cp\u003EYet research suggests that physical punishment only makes the problem worse.\u003C\u002Fp\u003E\n\u003Cp\u003E\"It turns out the kids who are spanked get more aggressive over time. If it was working, that would go down. But it doesn't,\" says Elizabeth Gershoff, a professor of human development and family sciences at the University of Texas at Austin, who studies the effects of corporal punishment on children. \"It actually is doing the opposite of what parents want.\u003C\u002Fp\u003E\n\u003Cp\u003E\"We've shown that over and over by now.\"\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Ca href=\"https:\u002F\u002Fdoi.org\u002F10.1037\u002Ffam0000191\"\u003EOne robust review of high-quality research\u003C\u002Fa\u003E co-authored by Gershoff found spanking in childhood was associated with the child being more aggressive, antisocial, and having poorer mental health, with a worse parent-child relationship and a higher likelihood of mental health problems or antisocial behaviour as adults. It also found children were more likely to have lower cognitive abilities and lower self-esteem – and that spanking was not associated with any improvement in child behaviour.\u003C\u002Fp\u003E\n\u003Cp\u003E\"No study has found physical punishment to have a long-term positive effect, and the vast majority have found negative effects,\" \u003Ca href=\"https:\u002F\u002Fwww.jkacap.org\u002Fjournal\u002Fview.html?doi=10.5765\u002Fjkacap.2017.28.1.20\"\u003Econcluded another review of 25 years of physical punishment research\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003EIt's not just physical punishment that can backfire, but also \u003Ca href=\"https:\u002F\u002Fncvc.dspacedirect.org\u002Fhandle\u002F20.500.11990\u002F2156\"\u003E\"psychological aggression\"\u003C\u002Fa\u003E like  shouting and name-calling. Such verbal harshness towards a child at age 13 \u003Ca href=\"https:\u002F\u002Fsrcd.onlinelibrary.wiley.com\u002Fdoi\u002Fabs\u002F10.1111\u002Fcdev.12143\"\u003Epredicted more child behaviour problems and depressive symptoms\u003C\u002Fa\u003E over the next year, for example, even if parents were warm the rest of the time. Harsh parenting tactics including spanking, raising one's voice, or getting angry \u003Ca href=\"https:\u002F\u002Fwww.sciencedirect.com\u002Fscience\u002Farticle\u002Fabs\u002Fpii\u002FS0301051118301248\"\u003Emay even change children's brains\u003C\u002Fa\u003E, activating a pattern of heightened fear and vigilance even when there is no actual threat.\u003C\u002Fp\u003E\n\u003Cp\u003EStill, as with spanking, such tactics are common. In the US, one survey found \u003Ca href=\"https:\u002F\u002Fonlinelibrary.wiley.com\u002Fdoi\u002F10.1111\u002Fj.1741-3737.2003.00795.x\"\u003E98% of parents of five-year-olds report having engaged\u003C\u002Fa\u003E in some form of psychological aggression in the last year. Unicef has found that \u003Ca href=\"https:\u002F\u002Fwww.unicef.org\u002Fdocuments\u002Fhidden-plain-sight-statistical-analysis-violence-against-children\"\u003Enearly seven in 10 children aged two to 14 worldwide were \"shouted, yelled or screamed at\"\u003C\u002Fa\u003E in the last month. Four in 10 were called \"dumb or lazy\".\u003C\u002Fp\u003E\n\u003Cp\u003EIf attacking the child physically or verbally doesn't improve their behaviour and can have such negative consequences, why do parents do it?\u003C\u002Fp\u003E\n\u003Cp\u003ESome may \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC3079037\u002F\"\u003Ebe re-enacting the way they themselves were brought up\u003C\u002Fa\u003E. Others may be reacting out of anger or helplessness, unable to control their own emotions. And some may simply think it's the only or best way to deal with a misbehaving child.\u003C\u002Fp\u003E\n\u003Cp\u003EAs science has shown these tactics to be less than ideal, other forms of punishment have come to the fore – such as \"time out\" (withdrawing attention from a child for a certain amount of time) or \"taking away a privilege\" (such as not letting the child watch their favourite TV programme).\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220607-what-should-you-do-when-a-child-misbehaves-2"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0cch8vw"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220607-what-should-you-do-when-a-child-misbehaves-3"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003E\u003Cstrong\u003EThe time out controversy\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EAccording to some experts, there are other, more effective ways to encourage good behaviour than any punishment at all (more on that later). But even if parents are told this – and believe it – it doesn't always change their response. Punishment isn't always about changing a child's behaviour, but stems from a parent's desire to express disapproval, satisfy their sense of justice, or even just vent their feelings.\u003C\u002Fp\u003E\n\u003Cp\u003EAs a result, it's unlikely we'll ever get to the point where most families practise \"punishment-free parenting\", no matter the potential benefits to the child, says Alan Kazdin, professor of psychology and child psychiatry at Yale University and director of the Yale Parenting Center in New Haven, Connecticut.\u003C\u002Fp\u003E\n\u003Cp\u003E\"You could build the behaviours you want without punishment. But at the same time, one has to be realistic. Parents are not going to abandon punishment,\" he says.\u003C\u002Fp\u003E\n\u003Cp\u003E\"So as professionals we say to ourselves, what, within the research, is the most mild punishment that is as effective, gives parents a tool, and avoids all the negative effects of hitting, shouting, screaming? A brief time out is one. And taking away a privilege is another.\"\u003C\u002Fp\u003E\n\u003Cp\u003EBut researchers define time out fairly narrowly, and not in the way that many parents practise it.\u003C\u002Fp\u003E\n\u003Cp\u003EFor time out, \"the child is simply told that their behaviour is inappropriate, and that the consequence is time out\", \u003Ca href=\"https:\u002F\u002Fmuse.jhu.edu\u002Farticle\u002F378886\u002Fsummary\"\u003Esays one review\u003C\u002Fa\u003E. While most parents think of it as happening on a \"naughty step\" or in a child's room, researchers define time out not as where it takes place, but as a stint of time where the child is not given attention. Time out doesn't even have to be away from the caregiver, experts say; it can be quiet time in the same room.\u003C\u002Fp\u003E\n\u003Cp\u003EImportantly, the parent doesn't add other, more aggressive punishments – so no yelling, calling the child \"naughty\", or even telling them to use the time to think about what they've done.\u003C\u002Fp\u003E\n\u003Cp\u003E\"We want time out not to be shaming, but just boring. We want it to be so much more boring than whatever else is going on in the environment,\" says Corey Lieneman, a postdoctoral fellow in child and adolescent psychology at the University of Nebraska Medical Center and co-author, with West Virginia University child psychology professor Cheryl McNeil, of the forthcoming book Time Out for Child Behavior Management.\u003C\u002Fp\u003E\n\u003Cp\u003E\"If you add things on top, like yelling, or allowing your child to escape the time out chair repeatedly, then it becomes exciting for the kid… And I think it's a common misconception to think that children have to sit in time out and think about what they've done, or they have to feel badly about what they've done. It's more about just seeing a difference: it's fun when I listen, it's boring when I don't.\"\u003C\u002Fp\u003E\n\u003Cp\u003EIn terms of length, \u003Ca href=\"https:\u002F\u002Fpsycnet.apa.org\u002Frecord\u002F2011-01321-001\"\u003Ea time out should last for one to five minutes\u003C\u002Fa\u003E – there's no evidence that a longer stint has more of an effect.\u003C\u002Fp\u003E\n\u003Cp\u003ETime out also should be used sparingly, researchers say. It should be used for clear disciplinary situations, \u003Ca href=\"https:\u002F\u002Fmuse.jhu.edu\u002Farticle\u002F378886\u002Fsummary\"\u003Enot ones that are \"emotionally upsetting\"\u003C\u002Fa\u003E for the child, or where their attachment system, and need to be close to a caregiver, are activated. And it should be in the context of an otherwise positive parenting relationship.\u003C\u002Fp\u003E\n\u003Cp\u003EIf parents are trained to use time out in this expert-approved way, does it actually work?\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220607-what-should-you-do-when-a-child-misbehaves-4"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"What punishment does, at best, is immediately suppress the behaviour. The trouble is, the research is unequivocal: what happens is the behaviour returns at the same rate – Alan Kazdin","id":"future\u002Farticle\u002F20220607-what-should-you-do-when-a-child-misbehaves-5"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EThere is relatively little research on time outs and similar punishments, says Gershoff. This makes it a more complex question than, say, spanking. In particular, there are few robust RCTs – randomised controlled trials, the gold standard of scientific research. In \u003Ca href=\"https:\u002F\u002Fwww.tandfonline.com\u002Fdoi\u002Fabs\u002F10.1080\u002F01494929.2020.1712304\"\u003Ethe first known review of time out's effectiveness\u003C\u002Fa\u003E, published in 2020, for example, the authors found just six relevant randomised controlled trials done between 1978 and 2018. All had small sample sizes – a maximum of 43 participants.\u003C\u002Fp\u003E\n\u003Cp\u003EFrom the available data, they concluded that time out improves children's behaviour in the short term. One meta-analysis of programmes that help teach parenting skills, for example, found that if parents participated in a programme that included time out, there was \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F18205039\u002F\"\u003Ea greater average improvement in children's behaviour\u003C\u002Fa\u003E than programmes that did not include time out. \u003C\u002Fp\u003E\n\u003Cp\u003EThe evidence for any long-term benefit, however, is thinner.\u003C\u002Fp\u003E\n\u003Cp\u003E\"What punishment does, at best, is immediately suppress the behaviour. It stops it – much of it by a startle reaction, but it stops it,\" says Kazdin. \"The trouble is, the research is unequivocal: what happens is the behaviour returns at the same rate.\"\u003C\u002Fp\u003E\n\u003Cp\u003EOne of the few long-term studies done on time out followed children from ages three to 10. Once everything was taken into account – such as whether a parent used other forms of physical punishment – \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F31513092\u002F\"\u003Ethere were no differences in behaviour\u003C\u002Fa\u003E between the children who received time out and those who did not. The researchers interpreted this to mean there was no evidence that time out harmed children. But it did not seem to help them long-term, either.\u003C\u002Fp\u003E\n\u003Cp\u003EOther studies suggest that time outs \u003Ca href=\"https:\u002F\u002Fwww.sciencedirect.com\u002Fscience\u002Farticle\u002Fabs\u002Fpii\u002FS0005789481801360?via%3Dihub\"\u003Emay help when used as part of broader programmes\u003C\u002Fa\u003E that support parents and teach them non-violent, gentle ways to encourage good behaviour. But it's not always clear if the time outs themselves were beneficial, or the gentler approach as a whole, which also included techniques like praising the child more, and listening to them.\u003C\u002Fp\u003E\n\u003Cp\u003E\"It is really hard to isolate any one strategy,\" says Lieneman. \"It'd be like isolating one vitamin: is one vitamin helpful or not helpful? We have a lot of evidence that [time out] is helpful, but it's mixed in with all of the other health behaviours, so all of the other positive relationship aspects.\"\u003C\u002Fp\u003E\n\u003Cp\u003EThe child's personality may also play a role. Robert Larzelere, professor of human development and family science at Oklahoma State University and one of the co-authors of the \u003Ca href=\"https:\u002F\u002Fwww.tandfonline.com\u002Fdoi\u002Fabs\u002F10.1080\u002F01494929.2020.1712304\"\u003E2020 review of time out's effectiveness\u003C\u002Fa\u003E, looked at \u003Ca href=\"https:\u002F\u002Fwww.tandfonline.com\u002Fdoi\u002Ffull\u002F10.1080\u002F15295192.2018.1465304\"\u003Eboth the short and longer-term effects of various disciplinary responses\u003C\u002Fa\u003E including time out, privilege removal, and reasoning.\u003C\u002Fp\u003E\n\u003Cp\u003EHe found that, for the 12% most defiant toddlers he studied, punishments and warnings improved behaviour over a two-month period, but only if mothers used this tactic relatively rarely – in up to 16% of their total disciplinary responses. \"The most effective parents prefer to use other tactics, such as mutually acceptable compromises and age-appropriate reasoning, but will back those methods up with a single warning followed by a timeout if toddlers persist in being defiant,\" he says. \"Then these defiant toddlers learn to pay more attention to the reasoning that they usually ignore and to the single warnings.\"\u003C\u002Fp\u003E\n\u003Cp\u003EFor less challenging toddlers, who made up 35% of the children he saw, punishments and warnings backfired: they worked immediately, but at the two-month check-in, they had \u003Cem\u003Eincreased \u003C\u002Fem\u003Ethe child's behaviour problems. And on average, for the remaining majority of children in the middle – 53% of the total – infrequent timeouts had no effect on later behaviour, positive or negative.\u003C\u002Fp\u003E\n\u003Cp\u003EAdding to the complexity, it can, of course, be difficult for a parent to know which of these camps their child falls into.\u003C\u002Fp\u003E\n\u003Cp\u003ESome experts don't recommend using time out at all, unless it is as a punishment-free way, such as separating two fighting children so they can take a break, calm down, and then regroup.\u003C\u002Fp\u003E\n\u003Cp\u003EOne criticism is that in practice, parents don't use time out in the way it is recommended. One study of the parents of 400 US children found that while more than 75% of parents reported using time out, \u003Ca href=\"https:\u002F\u002Fwww.academicpedsjnl.net\u002Farticle\u002FS1876-2859(16)30407-7\u002Ffulltext\"\u003E85% of them were using it in a way that ran counter to the evidence\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003E\"Yes, the research way of using time outs can teach a child skills of self-regulation – but the common use of time out is, in our experience anyway, not done the way the researchers say it should be done. And instead the word is used – \u003Cem\u003E'Take a time out!'\u003C\u002Fem\u003E – in fury and exasperation,\" says Siegel. \"It's used as a way of punishing a child, meaning to inflict emotional pain on them.\"\u003C\u002Fp\u003E\n\u003Cp\u003ESome also have \u003Ca href=\"https:\u002F\u002Fwww.positiveparentingsolutions.com\u002Fdiscipline\u002Ftime-out-problems-and-alternatives\"\u003Econcerns over the potential risks of using a punishment like time out\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003E\"Although we have, to a large extent, moved on from hitting – thank goodness – we've in many cases replaced it with other things that hurt the child psychologically, affect that parent-child relationship, erode trust and contribute to the child feeling completely powerless and helpless,\" says Joan Durrant, child-clinical psychologist and professor of community health sciences at Canada's University of Manitoba, as well as the creator of the programme \u003Ca href=\"https:\u002F\u002Fpositivedisciplineeveryday.com\u002Fpositivedisciplineineverydayparenting\u002F\"\u003EPositive Discipline in Everyday Parenting\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003E\"If I slept in or something, and my husband's reaction was to say, 'You can't drive your car for a week', or 'Go sit in the bathroom for an hour' – it's ridiculous, when you think of applying that to ourselves. But that's what we do to children all the time.\"\u003C\u002Fp\u003E\n\u003Cp\u003EOne concern, she says, is the lesson we do teach children by punishing them: that they must do what an authority figure tells them, \"or else\". \"It sets children up to learn to be submissive, which is extremely dangerous. To do what adults tell them to do right now – the first time ('I don't want any back talk!'),\" she says. \"So when my coach, or my priest, or my teacher wants to coerce me into something, it's a whole lot easier. I've learned that I have to submit.\"\u003C\u002Fp\u003E\n\u003Cp\u003EIndeed, a child's overcompliance – if inspired by fear of an authority figure, such as a fear of punishment – is itself \u003Ca href=\"https:\u002F\u002Fwww.taylorfrancis.com\u002Fbooks\u002Fmono\u002F10.4324\u002F9780203069776\u002Fraising-parents-patricia-crittenden\"\u003Econsidered a mental health problem\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003EBut for non-physical punishments, if given rarely and in the context of otherwise warm, responsive (not authoritarian or overcontrolling) parenting, those risks remain theoretical.\u003C\u002Fp\u003E\n\u003Cp\u003EThe \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F31513092\u002F\"\u003E2020 study that followed toddlers until they were 10\u003C\u002Fa\u003E didn't just find that being given time out made no difference to their behaviour in the long term; on its own, time out also had no impact on their risk of having a poor relationship with their parents, behaving poorly or being anxious or depressed. That did not hold true for physical punishment like spanking, which was associated with increased rule-breaking and aggression as the children got older.\u003C\u002Fp\u003E\n\u003Cp\u003EWhile this study \u003Ca href=\"https:\u002F\u002Fwww.bbc.co.uk\u002Fnews\u002Fhealth-49692573\"\u003Ewas widely reported\u003C\u002Fa\u003E to prove that time out doesn't cause any harm, however, it had flaws. In particular, almost half of the families dropped out of the trial over time, which could skew results: if the families whose children really struggled with their behaviour long-term were those who found it hardest to make it to the study's follow-up assessments, for example.\u003C\u002Fp\u003E\n\u003Cp\u003EUltimately, it's not so much that a punishment like time out is risky as that it's a missed opportunity, says Siegel, who – with his co-author Tina Payne Bryson – earned so much notoriety in 2014 for a \u003Ca href=\"https:\u002F\u002Ftime.com\u002F3404701\u002Fdiscipline-time-out-is-not-good\u002F\"\u003Estory on time out\u003C\u002Fa\u003E, he \u003Ca href=\"https:\u002F\u002Fwww.huffpost.com\u002Fentry\u002Ftime-outs-overused_b_6006332\"\u003Ewrote a follow-up\u003C\u002Fa\u003E to clarify his position.\u003C\u002Fp\u003E\n\u003Cp\u003E\"Rather than focusing on a worry about what time outs do, I would say, 'What do I want to teach? What's the benefit?'\" says Siegel. \"Children learn from what we do. They learn from how we are.\"\u003C\u002Fp\u003E\n\u003Cp\u003E\"So the question then is, what do you want your kid to learn? You want your kid to learn that you don't have skills that allow you to stay calm and clear, and instead, that you're exploding out of frustration, and feeling incompetent? Or do you want them to see that you have skills that, whatever happens, allow you to stay present?” says Siegel.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220607-what-should-you-do-when-a-child-misbehaves-6"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0cchb9v"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220607-what-should-you-do-when-a-child-misbehaves-7"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003E\u003Cstrong\u003EEmotion coaching\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EEven if we don't want children to obey every single command, and while there's a plethora of research indicating that \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC6823599\u002F\"\u003Eovercontrolling parenting can be harmful for children\u003C\u002Fa\u003E, consistent misbehaviour comes with its own long-term risks, at least in older age groups (not, for example, toddlers). One study found that \u003Ca href=\"https:\u002F\u002Fwww.cambridge.org\u002Fcore\u002Fjournals\u002Fdevelopment-and-psychopathology\u002Farticle\u002Fabs\u002Fproblem-behavior-as-a-precursor-of-male-criminality\u002FAD77B062A98F7FE8D0E65A60AC84C550\"\u003E13-year-old children whose teachers and peers said they misbehaved were more likely to commit criminal offences by age 27\u003C\u002Fa\u003E, for example.\u003C\u002Fp\u003E\n\u003Cp\u003EBut there are punishment-free ways to encourage good behaviour, some experts say.\u003C\u002Fp\u003E\n\u003Cp\u003EOne pillar is to have a little more empathy. Children are told what to do an awful lot – one small study found \u003Ca href=\"https:\u002F\u002Fwww.tandfonline.com\u002Fdoi\u002Fabs\u002F10.1300\u002FJ019v11n03_02\"\u003Emothers gave their children an average of 41 instructions per hour\u003C\u002Fa\u003E (the researchers were looking at children who were referred to a family therapy programme for not complying with their parents' instructions, so this might not represent every family). But they aren't as developed as adults in terms of processing that information (it takes \u003Ca href=\"https:\u002F\u002Fwww.researchgate.net\u002Fpublication\u002F254359648_Empirical_Derivation_of_Child_Compliance_Time\"\u003Earound 5.5 seconds\u003C\u002Fa\u003E from hearing a parent's instruction to a child's complying). Nor do they always know \u003Cem\u003Ehow \u003C\u002Fem\u003Eto do what they're told – which may be why \u003Ca href=\"https:\u002F\u002Fdoi.org\u002F10.1177\u002F016502549501800201\"\u003Etalking a child through a task leads to their complying more\u003C\u002Fa\u003E than simply telling them what to do.\u003C\u002Fp\u003E\n\u003Cp\u003EThink of how we would feel in some similar situations to those in which we often punish children, suggests Durrant.\u003C\u002Fp\u003E\n\u003Cp\u003E\"Let's say that I really want to build a cupboard, so I go to somebody who knows how to do this,” says Durrant. “He hands me a power saw and says, 'The first thing you do is saw this wood. Here's the line – cut along that line.' I've never held this thing before. I flick the switch and it goes all over the place. And I damage the wood,\" she says. \"And then they come back and say, 'I told you what to do. How could you create all this damage? Look what you've done. Go to your room for an hour.' I go to my room. I come out. They hand me the saw and say, 'Cut along that line.’ But I've learned nothing. All I've learned is that I should be ashamed. I should have known better. It's all my fault.\"\u003C\u002Fp\u003E\n\u003Cp\u003EOne alternative that has arisen is \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20220516-the-healing-power-of-emotion-coaching\"\u003Eemotion coaching\u003C\u002Fa\u003E, or helping children understand and express their emotions. This approach hinges on the idea that whining, a tantrum or even hitting isn't merely misbehaviour to be \"corrected\", but a sign that a child is emotionally dysregulated. Since children (like adults) cannot learn when they're distressed, its advocates say, \u003Ca href=\"https:\u002F\u002Fbooks.google.co.uk\u002Fbooks?id=JGk5AAAAIAAJ&lpg=PA236&ots=vwLZw8eWBj&dq=Affective%20and%20cognitive%20processes%20in%20moral%20internalization.&lr&pg=PA236#v=onepage&q=Affective%20and%20cognitive%20processes%20in%20moral%20internalization.&f=false\"\u003Ethey need to be brought back to a state of calm\u003C\u002Fa\u003E before being taught a lesson will have any effect. (\u003Cem\u003ERead more from BBC Future about \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20220516-the-healing-power-of-emotion-coaching\"\u003Ethe healing power of emotion coaching\u003C\u002Fa\u003E\u003C\u002Fem\u003E.)\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220607-what-should-you-do-when-a-child-misbehaves-8"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"Children behave in socially appropriate ways, when they feel connected. When they feel loved, respected, supported - Sophie Havighurst","id":"future\u002Farticle\u002F20220607-what-should-you-do-when-a-child-misbehaves-9"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003E\"Children can't work through solving problems and even hear you giving them guidance about what else might help if they're still really emotional. And yet that's when we often try and give instruction and guidance about behaviour. So our whole approach is that you've got to wait till your child settles and calms, and you're connected,\" says Sophie Havighurst, professor of child clinical psychology at the University of Melbourne.\u003C\u002Fp\u003E\n\u003Cp\u003E\"Children behave in desirable ways, or socially appropriate ways, when they feel connected. When they feel loved, respected, supported and validated in their emotional world.\"\u003C\u002Fp\u003E\n\u003Cp\u003EResearch also shows that the more emotionally in-tune with their children parents are, and the less disapproving and critical of their child's feelings, \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F10218267\u002F\"\u003Ethe better children are able to regulate their emotions and behaviour\u003C\u002Fa\u003E. \u003Ca href=\"https:\u002F\u002Fdoi.apa.org\u002FdoiLanding?doi=10.1037%2F0893-3200.10.3.243\"\u003EChildren who receive \"emotion coaching\" are less physiologically aroused\u003C\u002Fa\u003E (an indication that they are better able to regulate their nervous systems), and even are less likely to get sick, than those who do not.\u003C\u002Fp\u003E\n\u003Cp\u003EOne study of 94 children showed that there may also be a self-reinforcing cycle between the way parents perceive their children, and how they respond to them: if parents said that they were likely to minimise their child's emotional reactions, \u003Ca href=\"https:\u002F\u002Fsrcd.onlinelibrary.wiley.com\u002Fdoi\u002F10.1111\u002F1467-8624.00037\"\u003Ethe children were more likely to exhibit problem behaviour later\u003C\u002Fa\u003E – and if young children were perceived by their parents to have poorer emotional regulation, they were more likely to be punished by their parents as they got older.\u003C\u002Fp\u003E\n\u003Cp\u003EWhile there have been a number of RCTs on the impact of emotion coaching, or of similar techniques that replace punishments with more of a problem-solving approach, they have been based on relatively few datasets. But the available evidence shows that the \"positive parenting\" approaches worked better than nothing when used with children who had behavioural problems.\u003C\u002Fp\u003E\n\u003Cp\u003EThere also were signs that how effective they were depended on the individual child. For children who had depression or anxiety in addition to misbehaviour, for example, one study found that \u003Ca href=\"https:\u002F\u002Fdoi.apa.org\u002FdoiLanding?doi=10.1037%2F0022-006X.72.6.1157\"\u003Ecollaborative problem solving was more effective\u003C\u002Fa\u003E than conventional methods that included time out. Another study, co-authored by Havighurst, found that \u003Ca href=\"https:\u002F\u002Fwww.tandfonline.com\u002Fdoi\u002Ffull\u002F10.1080\u002F15374416.2014.963855\"\u003Eemotion coaching worked better than behavioural parent training for eight- to nine-year-olds and for children whose parents reported having poorer psychological wellbeing\u003C\u002Fa\u003E. Meanwhile, behavioural parent training worked better than emotion coaching for younger children and for parents who had better psychological wellbeing.\u003C\u002Fp\u003E\n\u003Cp\u003EIn general, however, the \"alternative\" approaches – which eschewed not only spanking but disciplinary actions like time out – were just as effective as those who used time out.\u003C\u002Fp\u003E\n\u003Cp\u003EOne such example is the \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F25249470\u002F\"\u003Eemotion coaching programme called Tuning into Kids\u003C\u002Fa\u003E, designed by Havighurst and her co-author Ann Harley. It encourages parents to respond to the emotion underlying a behaviour – including by connecting with the child, communicating empathy, helping the child understand their emotions, problem solving, and setting limits (\"I know you're frustrated, it's really hard when you don't want to put your things away. Let's see if you can stomp your feet really hard to let out that steam.\" Later, after the child has calmed: \"It's not easy when you don't want to stop playing. I know it is hard for you. I wonder what you can do next time instead of hitting Daddy?\".)\u003C\u002Fp\u003E\n\u003Cp\u003EIf the child's anger or misbehaviour escalates, parents are discouraged from using a punishment like time out. Instead, they are told to use a \"time in\": staying with a child who is angry or distressed and providing a quiet, calm presence with minimal talk, and a rub of the back, if desired.\u003C\u002Fp\u003E\n\u003Cp\u003E\"We need to teach kids to learn that their emotional needs lead to connection – not disconnection, or punishment,\" says Havighurst. \"One of the things that we support is this idea that when kids are very angry, they often fear rejection. They fear abandonment. And the activation of attachment is that they still need to be attached, even though they're very dysregulated,\" says Havighurst. (This only works, she adds, if the parent isn't very angry or distressed themselves – if so, they may need to step out of the room to avoid verbally or physically harming their child.)\u003C\u002Fp\u003E\n\u003Cp\u003EAt a follow-up 10 months later, the parents who learned about emotion coaching were less likely to dismiss their child's emotions and had greater empathy for their children. They also reported fewer \"\u003Ca href=\"https:\u002F\u002Fpsycnet.apa.org\u002Frecord\u002F1995-27576-001\"\u003Enegative expressiveness\u003C\u002Fa\u003E\" (like fighting) in their families. Meanwhile, parents and teachers reported \"significant\" changes in how the children behaved, as well as in their understanding of emotions. Of the children who had clinical behaviour problems such as hyperactivity or oppositional defiant disorder at the start, 27% no longer had these problems at follow-up with a clinician, compared to 18% of those in the control group.\u003C\u002Fp\u003E\n\u003Cp\u003EThere are caveats. As is common with studies like this, there was a high drop-out rate – follow-up data wasn't available for 31% of parents, 22% of teachers and 20% of direct child assessments – which could, again, make results seem either better, or worse, than they were. (Havighurst points out that in other studies she's done of Tuning into Kids, which had similar results, the retention rate was much higher.)\u003C\u002Fp\u003E\n\u003Cp\u003EAnd, like behavioural parent training, emotion coaching is a suite of interventions, not simply \"time out versus no time out\". Any positive results might not have had anything to do with dropping time out. They could have been, for example, from simply teaching the \u003Cem\u003Eparents \u003C\u002Fem\u003Eabout their own emotions, helping them to become more regulated and calmer.\u003C\u002Fp\u003E\n\u003Cp\u003EThis may be why the research shakes out the way it does, says Larzelere. \"Those programmes emphasise different aspects of positive parenting. So the better, more skilled way that parents can use those kind of skills the better for the child,\" he says. \"But the evidence isn't against time out.\"\u003C\u002Fp\u003E\n\u003Cp\u003EResearchers who advocate for punishments like time out as part of a positive parenting relationship also add that it's not an either\u002For proposition. There isn't any reason that parents can't problem solve, express empathy or talk through emotions with their children as well as issuing a punishment, they say – which \u003Ca href=\"https:\u002F\u002Fwww.sciencedirect.com\u002Fscience\u002Farticle\u002Fabs\u002Fpii\u002FS1077722914001266\"\u003Esome approaches explicitly advocate\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003EThe idea, ultimately, is to provide the parents with a way to respond that is safe for the child. Telling them not to punish the child at all, Kazdin says, risks leaving them at the mercy of their impulses.\u003C\u002Fp\u003E\n\u003Cp\u003E\"We want parents to have tools in their pockets. Because once they're impulsive, it's a smack. It's a shouting, it's a shake, it's a scream, it's something,\" says Kazdin. \"You don't want that kind of stuff.\"\u003C\u002Fp\u003E\n\u003Cp\u003EDurrant, who believes punishment is never productive, also has concerns about escalation, but from the other side. Take time out. \"It often gets very, very ugly, where parents are holding the doorknob, the child's pulling on the other side, there's all kinds of screaming,\" she says.\u003C\u002Fp\u003E\n\u003Cp\u003E\"What we're doing is giving parents a recipe for violence. There's going to be yelling, there's going to be hitting, there's going to be grabbing that child and forcing them down on that chair. Why are we given a prescription for coercion, when we know that every human being resists coercion? And then the more they push back, the more it escalates.\"\u003C\u002Fp\u003E\n\u003Cp\u003EPunishment-free parenting advocates also point out that when we talk about a behaviour intervention's \"effectiveness\", we normally mean, \"Did it make children behave better?\" That's what research studies usually look at, too. That may make sense – but it isn't the whole story.\u003C\u002Fp\u003E\n\u003Cp\u003E\"You get rough measures, like, Is the child behaving better?\" says Havighurst. \"But what happens inside if a child has a parent being much more emotionally responsive to them? What does that build internally in a child? And that's the part I think it's really hard to measure.\"\u003C\u002Fp\u003E\n\u003Cp\u003ESiegel agrees. You can change a child's behaviour by focusing just on the behaviour, he says. But if you look at what's underlying it, helping your child to hone skills of insight and empathy, you can go beyond that.  \u003C\u002Fp\u003E\n\u003Cp\u003E\"That, yes, allows a kid to guide their behaviour, but it's much, much more than that. It allows them to know themselves and others in a way that allows them to thrive, not just survive by regulating their behaviour,\" he says.\u003C\u002Fp\u003E\n\u003Cp\u003E\"I'm interested in something much deeper than the behavioural outcomes. I'm interested in the mind of the child.\"\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220607-what-should-you-do-when-a-child-misbehaves-10"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0cchb05"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220607-what-should-you-do-when-a-child-misbehaves-11"},{"bodyHtml":{"assets":[]},"calloutBodyHtml":"\u003Cp\u003EThis article is part of \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Ffamily-tree\" target=\"_blank\"\u003E\u003Cstrong\u003EFamily Tree\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E, a series of features that explore the issues and opportunities that families face all over the world. You might also be interested in other stories about children's behaviour and development:\u003C\u002Fp\u003E\n\u003Cul\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20220307-the-best-way-to-stop-bullying\"\u003EThe Nordic way to fight bullying\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20220315-how-eco-anxiety-affects-childrens-minds\"\u003EThe children fighting 'eco-anxiety'\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20211110-your-teens-being-sarcastic-its-a-sign-of-intelligence\"\u003EWhy sarcastic teens are the smartest\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003C\u002Ful\u003E\n\u003Cp\u003EYou can also climb new branches of the Family Tree on \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fworklife\u002Ffamily-tree\" target=\"_blank\"\u003EBBC Worklife\u003C\u002Fa\u003E – and check out this playlist on changing families by \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Freel\u002Fplaylist\u002Fthe-next-generation\"\u003EBBC Reel\u003C\u002Fa\u003E. \u003C\u002Fp\u003E","calloutTitle":"Family Tree","cardType":"CalloutBox","iFrameType":"","id":"future\u002Farticle\u002F20220607-what-should-you-do-when-a-child-misbehaves-12"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003E\u003Cstrong\u003ECommon ground\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EThey may come at discipline in different ways. But experts on both sides of the equation overlap in many of their findings about what works best for children.\u003C\u002Fp\u003E\n\u003Cp\u003EFor one, they agree that not only is harsh or authoritarian parenting not optimal – permissive or \"indulgent\" parenting isn't, either. Permissive parenting, which is normally defined as being supportive but with low levels of control or expectations, tends to be a mixed bag. Studies have found that it's associated with \u003Ca href=\"https:\u002F\u002Fsrcd.onlinelibrary.wiley.com\u002Fdoi\u002Fabs\u002F10.1111\u002Fj.1467-8624.1991.tb01588.x\"\u003Ehigh levels of self-confidence in children, but also with more substance abuse and behaviour problems\u003C\u002Fa\u003E, for example.\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F28459276\u002F\"\u003EThe style of parenting that consistently comes out on top is \"authoritative\"\u003C\u002Fa\u003E, where parents have high levels of responsiveness, but also high levels of demandingness.\u003C\u002Fp\u003E\n\u003Cp\u003EIndeed, despite the stereotypes around \"gentle parenting\", a punishment-free approach doesn't mean doing away with boundaries, Havighurst says. It should be authoritative, not permissive.\u003C\u002Fp\u003E\n\u003Cp\u003E\"But there's a way you can do that without using dominance, or withholding or punishing,\" she says. \"It's not about the child doing everything the child's way. It's about coming to some balance. Children learn best when you respond to them with empathy before guiding them in their behaviour.\"\u003C\u002Fp\u003E\n\u003Cp\u003EOn the other hand, researchers who are in favour of consequences like time out, like Larzelere, say these consequences need to be used rarely and in the context of otherwise warm, positive parenting.\u003C\u002Fp\u003E\n\u003Cp\u003E\"It'd be the goal to be as positive as possible,\" he says. \"Parents shouldn't do those things as much as possible and should emphasise the positive relationship with their children.\" Negative consequences, he says, should be a \"backup\" to teach a child to cooperate after other attempts have failed, rather than a go-to response to misbehaviour.\u003C\u002Fp\u003E\n\u003Cp\u003EMost researchers also agree that not only should punishments not be the crux of any parenting strategy – but they're not the best way to teach a child a lesson, either.\u003C\u002Fp\u003E\n\u003Cp\u003E\"Spanking and things like are very attractive for many parents because they often get a quick reaction. You feel like you've dealt with it, and then you can move on. Versus taking time to really talk with children and explain things to them,\" says Gershoff. \"Time out and spanking are these kind of quick fixes that don't really deal with the underlying issue, and they don't help children learn.\"\u003C\u002Fp\u003E\n\u003Cp\u003EReasoning, rather than simply commanding, is something you can do with children from a young age, Gershoff says – it's something they really start to understand when they're two or three.\u003C\u002Fp\u003E\n\u003Cp\u003EIn fact, \u003Ca href=\"https:\u002F\u002Fwww.tandfonline.com\u002Fdoi\u002Ffull\u002F10.1080\u002F15295192.2018.1465304\"\u003ELarzelere's comparison of disciplinary tactics\u003C\u002Fa\u003E found that for the majority of toddlers, the best way to get a toddler to comply in the short term is to offer alternatives – reasoning works best for children who are whining or negotiating.\u003C\u002Fp\u003E\n\u003Cp\u003EAgain, however, it depends on the child. In the longer term, offering alternatives decreases misbehaviour for the 7% least challenging toddlers. For the 20% most defiant toddlers, offering alternatives too often increases misbehaviour – although frequent reasoning, two months later, had helped them behave better. And for the remaining majority of children, offering alternatives had no clear effect either way on behaviour two months later, on average.\u003C\u002Fp\u003E\n\u003Cp\u003E\"We use mild punishment, because parents are going to punish. And mild punishment is only better than regular \u003Cem\u003Eother\u003C\u002Fem\u003E punishment, because the side effects are so few. But it's still not going to teach the child what to do,\" says Kazdin.\u003C\u002Fp\u003E\n\u003Cp\u003EAmong other elements, \u003Ca href=\"https:\u002F\u002Falankazdin.com\u002Fabout-the-kazdin-method\u002F\"\u003Ehis approach\u003C\u002Fa\u003E includes a specific sequence of practise and praise. Say a child is throwing tantrums while hitting you. You should tell your child to \"practise\" having a tantrum, without the hitting. Then give effusive, specific praise (\"That was such a great tantrum! I bet you can't do that again!\"), along with some physical affection. Practise over and over.\u003C\u002Fp\u003E\n\u003Cp\u003EAnother relatively practical strategy is to look at when and how parents issue commands. Just as adults don't like being pulled out of something they're working on, neither do children. When mothers were told to direct their toddlers to play with certain toys, for example, it worked best \u003Ca href=\"https:\u002F\u002Fdoi.org\u002F10.1177\u002F016502549501800201\"\u003Eif the child was already turning towards that toy or if the mother was able to attract them\u003C\u002Fa\u003E to that toy herself, rather than simply making a command. \"A request for action coming out of the blue has little chance of succeeding,\" the researchers write. If you do have to give an instruction, \u003Ca href=\"https:\u002F\u002Fwww.semanticscholar.org\u002Fpaper\u002FChild-compliance-and-maternal-control-techniques.-Schaffer-Crook\u002F8f8618f1239f6c158ec5b50b76a6bb54147dd9f0\"\u003Emake it direct and clear\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003EBoth sides also emphasise the importance of emotional regulation – in the parent. And they underscore the importance of something often completely overlooked: how caregivers act themselves.\u003C\u002Fp\u003E\n\u003Cp\u003E\"Parents leave the most important tool off the table, which is systematic modelling,\" says Kazdin. That means showing the behaviour that you want to see in your child, and pointing it out in others. \"The old thing of my generation was, 'Do what I say, not what I do.'\" If that’s a parent’s approach, he says, \"The research shows – good luck.\"\u003C\u002Fp\u003E\n\u003Cp\u003E--\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EJoin one million Future fans by liking us on \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.facebook.com\u002FBBCFuture\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EFacebook\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, or follow us on \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Ftwitter.com\u002FBBC_Future\"\u003E\u003Cstrong\u003E\u003Cem\u003ETwitter\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E or \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.instagram.com\u002Fbbcfuture_official\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EInstagram\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E.\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EIf you liked this story, \u003C\u002Fem\u003E\u003Ca href=\"http:\u002F\u002Fpages.emails.bbc.com\u002Fsubscribe\u002F?ocid=fut.bbc.email.we.email-signup\"\u003E\u003Cstrong\u003E\u003Cem\u003Esign up for the weekly bbc.com features newsletter\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, called \"The Essential List\" – a handpicked selection of stories from BBC \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EFuture\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fculture\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003ECulture\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fworklife\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EWorklife\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ftravel\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003ETravel\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E \u003Cem\u003Eand \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Freel\"\u003E\u003Cstrong\u003E\u003Cem\u003EReel\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E delivered to your inbox every Friday.\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220607-what-should-you-do-when-a-child-misbehaves-13"}],"collection":["future\u002Fpremium-collection\u002Ffamily-tree"],"disableAdverts":false,"displayDate":"2022-06-10T01:00:00Z","embeddedCustomHtml":"","embeddedInfographicUrl":"","embeddedType":"infographic","headlineLong":"The truth about 'time out'","headlineShort":"The truth about 'time out'","image":["p0ccw37m"],"imageAlignment":"centre","imageAltText":"","isSyndicated":true,"latitude":"","longitude":"","mpsVideo":"","option":[{"Content":{"Description":"Apple News Publish: Select to publish, remove to unpublish. (Do not just delete or unpublish the story)","Name":"publish-applenews-system-1"},"Metadata":{"CreationDateTime":"2016-02-05T14:32:31.186819Z","Entity":"option","Guid":"13f4bc85-ae27-4a34-9397-0e6ad3619619","Id":"option\u002Fpublish-applenews-system-1","ModifiedDateTime":"2022-02-27T22:52:24.455144Z","Project":"wwverticals","Slug":"option\u002Fpublish-applenews-system-1"},"Urn":"urn:pubpipe:wwverticals:option:option\u002Fpublish-applenews-system-1","_id":"62b420921f4b7b5d34253c8b"}],"partner":null,"primaryVertical":"future","promoAlignment":"centre","promoAltText":"","promoImage":null,"relatedStories":null,"relatedTag":null,"summaryLong":"From the impact of giving a child a time out, to the latest research on punishment-free parenting, Amanda Ruggeri investigates the fascinating science of discipline.","summaryShort":"The word 'discipline' has been misconstrued as ‘punishment’","tag":["tag\u002Fparenting"],"textToSpeech":false,"creationDateTime":"2022-06-09T23:59:25.324028Z","entity":"article","guid":"5808642a-60a7-44f7-8860-2b488004a274","id":"future\u002Farticle\u002F20220607-what-should-you-do-when-a-child-misbehaves","modifiedDateTime":"2022-06-23T14:34:50.94583Z","project":"wwverticals","slug":"future\u002Farticle\u002F20220607-what-should-you-do-when-a-child-misbehaves","cacheLastUpdated":1657756319028},"future\u002Farticle\u002F20220525-is-a-vegan-diet-healthy-for-kids":{"urn":"urn:pubpipe:wwverticals:article:future\u002Farticle\u002F20220525-is-a-vegan-diet-healthy-for-kids","_id":"62b41ff81f4b7b7f6237ba5f","ambientVideo":"","articleType":"story","assetVideo":null,"author":["future\u002Fauthor\u002Fkamala-thiagarajan"],"bodyIntro":"Kamala Thiagarajan investigates what vegan families can learn from India's ancient tradition of plant-based cooking, coupled with new scientific insights.","businessUnit":"worldwide","cards":[{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EIn 2010, Ashish Kumar Jain, then 28 and working in the UK as an IT professional, chanced upon an online video that left a deep impact on him. It described the cruelties meted out by the dairy industry, especially to calves. As an expectant parent, and at a time when he was longing to return to India for the birth of his first baby, he says it convinced him and his wife to switch to a vegan diet. Living in Indore, a city in the central Indian state of Madhya Pradesh, the couple decided to raise their child as a vegan, too.\u003C\u002Fp\u003E\n\u003Cp\u003EToday his daughter Arul is a healthy, fit 11-year-old and an ardent vegan advocate herself. Raising her as a vegan child wasn't as stressful as addressing concerns from extended family about these choices, says Jain. One factor made the transition particularly easy, he says: India's long history of meat-free cooking. While that tradition tends to be vegetarian rather than vegan, it holds useful lessons on maximising the nutritional power of plant-based meals – which could benefit the \u003Ca href=\"https:\u002F\u002Fwww.ernaehrungs-umschau.de\u002Fenglish-articles\u002F15-06-2015-vegan-diet-motives-approach-and-duration\u002F\"\u003Egrowing number\u003C\u002Fa\u003E of \u003Ca href=\"https:\u002F\u002Fwww.vrg.org\u002Fnutshell\u002FPolls\u002F2016_adults_veg.htm\"\u003Evegan adults\u003C\u002Fa\u003E and \u003Ca href=\"https:\u002F\u002Fwww.bbc.co.uk\u002Fnewsround\u002F58653757\"\u003Echildren\u003C\u002Fa\u003E not just in India, but around the world.\u003C\u002Fp\u003E\n\u003Cp\u003EAn estimated 400 million people in India (amounting to \u003Ca href=\"https:\u002F\u002Fwww.pewresearch.org\u002Ffact-tank\u002F2021\u002F07\u002F08\u002Feight-in-ten-indians-limit-meat-in-their-diets-and-four-in-ten-consider-themselves-vegetarian\u002F#:~:text=However%2C%20most%20Indians%20do%20not,definition%20up%20to%20the%20respondent.)\"\u003E39% of  the country's population), identify\u003C\u002Fa\u003E as vegetarian for religious and other reasons, compared to \u003Ca href=\"https:\u002F\u002Fnews.gallup.com\u002Fpoll\u002F238328\u002Fsnapshot-few-americans-vegetarian-vegan.aspx\"\u003Eonly about 5% in the US\u003C\u002Fa\u003E. A vegetarian diet is not the same as a vegan diet: it usually includes dairy, for example, whereas a vegan diet avoids all animal products. However, India's vegetarian legacy has resulted in a particularly diverse cuisine of plant-centred dishes easily adapted to vegan requirements. \u003C\u002Fp\u003E\n\u003Cp\u003ECoupled with new scientific insights on plant-based diets from researchers around the world, that experience could also help parents answer a crucial question: is a vegan diet safe for children?\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"infographic","imageAlignment":"centre","imageOrientation":"landscape","pullQuoteImageAlignment":"centre","videoImageAlign":"centre","id":"future\u002Farticle\u002F20220525-is-a-vegan-diet-healthy-for-kids-0"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0c90kx7"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220525-is-a-vegan-diet-healthy-for-kids-1"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003E\u003Cstrong\u003EVeganism on the rise\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EVeganism has been gaining traction around the world, supported by campaigns such as \"\u003Ca href=\"https:\u002F\u002Fwww.bbc.co.uk\u002Fnews\u002Fav\u002Fuk-england-york-north-yorkshire-50987943\"\u003EVeganuary\u003C\u002Fa\u003E\" (which encourages people to go vegan for one month) as well as rising awareness of the \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20220429-the-climate-benefits-of-veganism-and-vegetarianism\"\u003Eclimate benefits of a meat- and dairy-free diet\u003C\u002Fa\u003E. A growing body of research suggests \u003Ca href=\"https:\u002F\u002Fwww.ox.ac.uk\u002Fnews\u002F2019-10-29-plant-based-foods-are-good-both-health-and-environment\"\u003Eplant-based diets have a range of health benefits\u003C\u002Fa\u003E for adults.\u003C\u002Fp\u003E\n\u003Cp\u003EIn India, the growing vegan movement taps into an ancient tradition, with vegan social media groups and influencers highlighting the nutritional power of local cereals, pulses and grains. Indian vegans swap traditional recipes in groups like \"\u003Ca href=\"https:\u002F\u002Fwww.facebook.com\u002Fgroups\u002Fcookingwithmillets\u002F\"\u003ECooking with Millets\u003C\u002Fa\u003E\u003Cspan\u003E\" (\"Let's share our millet journey\"), which promotes\u003C\u002Fspan\u003E a cereal crop endemic to India. Vegan influencers tout the benefits of age-old ingredients such as lentils, chickpeas and mung beans. In 2016, the German International Academy, a residential school in Southern Indian city of Chennai, \u003Ca href=\"https:\u002F\u002Ftimesofindia.indiatimes.com\u002Fcity\u002Fchennai\u002Fkids-dig-into-mock-meat-as-german-school-goes-vegan\u002Farticleshow\u002F60051945.cms\"\u003Emade headlines\u003C\u002Fa\u003E when it became a fully vegan school.\u003C\u002Fp\u003E\n\u003Cp\u003EAnd while many Indian vegetarians rely heavily on dairy products such as ghee (clarified butter), yoghurt, and paneer (cottage cheese), Jain points out that in the past, this wasn't necessarily the case, as many traditional dishes are dairy-free.\u003C\u002Fp\u003E\n\u003Cp\u003EHowever, for children, the risks and benefits of a vegan diet are somewhat more complex than for adults.\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003EPlanning a safe vegan diet\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EPerhaps the most important aspect to consider is that a growing child needs specific nutrients for each developmental stage. If those are missed, the consequences can be dangerous, especially for younger children. Their food also needs to be particularly nutrient- and energy-dense, because their portions are smaller.\u003C\u002Fp\u003E\n\u003Cp\u003E\"Infants and children are growing and developing rapidly (especially during infancy) and have very high requirements for certain nutrients while having relatively small stomachs. This means that the foods they are given should have maximum nutrients and enough energy in a relatively small volume,\" says Mary Fewtrell, professor of paediatric nutrition at University College London's Great Ormond Street Institute of Child Health.\u003C\u002Fp\u003E\n\u003Cp\u003EFor infants, breast milk is seen as the best way of delivering the nutrition and energy they need to grow, while for toddlers and young children, a vegan diet needs to be carefully planned to ensure it meets their needs.\u003C\u002Fp\u003E\n\u003Cp\u003EMisguided veganism has in fact resulted in some rare, avoidable tragedies in that age group. In 2016, \u003Ca href=\"https:\u002F\u002Fwww.thelocal.it\u002F20160708\u002Fone-year-old-vegan-weighing-kg-hospitalized-in-milan\u002F\"\u003Ea one-year-old child in Milan, Italy\u003C\u002Fa\u003E was taken away from his parents after blood tests revealed that he had dangerously low levels of calcium after following a vegan diet. Italian media reported that the one-year-old weighed as much as a three-month-old, and his calcium levels were only enough to barely survive. In 2017, a court in Belgium \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fnews\u002Fworld-europe-40274493\"\u003Econvicted the parents\u003C\u002Fa\u003E of a seven-month old baby boy who had died from dehydration and malnourishment after being fed a diet of vegetable milk made from oats, buckwheat, rice and quinoa.\u003C\u002Fp\u003E\n\u003Cp\u003EFor older children, research suggests that a vegan diet can have benefits – but also, some disadvantages.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220525-is-a-vegan-diet-healthy-for-kids-2"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0cb03r1"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220525-is-a-vegan-diet-healthy-for-kids-3"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003E\u003Cstrong\u003EGroundbreaking research on vegan kids\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EIn 2021, \u003Ca href=\"https:\u002F\u002Facademic.oup.com\u002Fajcn\u002Farticle\u002F113\u002F6\u002F1565\u002F6178918?login=false\"\u003Ea study published in the American Journal of Clinical Nutrition\u003C\u002Fa\u003E compared the health outcomes of a vegan, vegetarian and omnivorous diets in Polish children aged 5-10 years. The study recruited 63 vegetarians, 52 vegan and 72 omniovores – the latter eating a diverse diet which included meat and dairy. Malgorzata Desmond, the lead author of the study, is now an honorary research fellow at UCL Great Ormond Street Institute of Child Health.\u003C\u002Fp\u003E\n\u003Cp\u003E\"Although the number of children in our study was relatively small, this is the largest study of its kind ever performed specifically in vegan children of this age; the first that recruited (over) 50 participants in each plant-based diet group and compared them to carefully matched omnivores,\" says Desmond.\u003C\u002Fp\u003E\n\u003Cp\u003EThe study identified both good and bad points for vegan kids, says Fewtrell, who co-authored the study. \"The good news was that in comparison to their omnivore peers, the vegan children were leaner and had better markers of cardiovascular risk, such as lower blood cholesterol,\" she says. This could contribute to their lowering of heart disease later in life. \"The downsides were that they were shorter and had lower bone mass than expected for their age.\"\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220525-is-a-vegan-diet-healthy-for-kids-4"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"The only finding that the researchers thought was concerning was the vegan children's lower bone mineral density","id":"future\u002Farticle\u002F20220525-is-a-vegan-diet-healthy-for-kids-5"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EWhile vegan kids were 3cm (1.2in) shorter on average, it didn't mean that they were stunted in growth or would always stay short, says Jonathan Wells, professor of anthropology and paediatric nutrition at UCL and another co-author of the study.\u003C\u002Fp\u003E\n\u003Cp\u003E\"Vegan kids had less fat mass, and tended to weigh less. It's possible that they would reach puberty a little later. We've seen that children who reach puberty later actually extended their growing period because they grow for more years,\" says Wells. So there was a potential for these kids to grow taller as adults.\u003C\u002Fp\u003E\n\u003Cp\u003EThe only finding that the researchers thought was concerning was their comparatively lower bone mineral density.\u003C\u002Fp\u003E\n\u003Cp\u003E\"The bone reaches its optimal density by the early 20s. And so, if you don't build bone density at the time, you're not going to be able to do that later,\" Wells says. Those who have lower bone mineral density in adulthood will feel its impacts in older age, making them more vulnerable to diseases like osteoporosis as bones slowly grow more brittle. \"So vegan diets may have changed the profile of disease that people are more at risk to as they age,\" says Wells. \"Instead of cardiovascular disease [heart disease], they may be prone to bone disease (weaker bones). But it's not like they're unhealthy now.\"\u003C\u002Fp\u003E\n\u003Cp\u003ESome of the study's findings were surprising. For example, the vegetarian children tended to eat more junk food like pizza and soft drinks – a reminder that a vegetarian diet doesn't in itself guarantee a healthy, balanced menu. As might be expected, omnivores had the highest estimated intake of protein, and vegans the lowest – but vegetarians had the highest estimated intake of calcium. (Vegans, it turns out, had the lowest).\u003C\u002Fp\u003E\n\u003Cp\u003EAnd nearly a third of children on either vegetarian or vegan diets in the study were not given any B12 supplements or B12–fortified foods – even though such supplements are commonly recommended for people on a plant-based diet. The Academy of Nutrition and Dietetics in the US for example states that \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F27886704\u002F\"\u003Ewell-planned vegetarian and vegan diets are appropriate for all life stages\u003C\u002Fa\u003E, including pregnancy, infancy and childhood. But it also adds that vegans need to ensure they take vitamin B12, be it in the form of supplements or fortified foods.    \u003C\u002Fp\u003E\n\u003Cp\u003EOne possible conclusion is that some of these real-life plant-based diets could have had better results, had they included more nutritious ingredients. Or, as the authors state in the paper: \"Vegan and vegetarian children need guidelines on how to eat healthfully, beyond advice on supplementation.\"\u003C\u002Fp\u003E\n\u003Cp\u003EMore generally, studies of plant-centred diets – so, vegetarian, not just vegan – tend to conclude that they are safe for children. A \u003Ca href=\"https:\u002F\u002Fpublications.aap.org\u002Fpediatrics\u002Farticle\u002Fdoi\u002F10.1542\u002Fpeds.2021-052598\u002F186964\u002FVegetarian-Diet-Growth-and-Nutrition-in-Early\"\u003Elongitudinal study of children aged from six months to eight years in the US\u003C\u002Fa\u003E found there was no evidence of clinically meaningful differences in growth or nutritional status for children with a vegetarian diet, compared to their peers. However, the vegetarian kids (the sample also included vegans) faced higher odds of being underweight. The German Society for Paediatric and Adolescent Medicine also took an overall positive stance in a 2019 \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F31722049\u002F\"\u003Epaper on vegetarian (including vegan) diets for children and teens\u003C\u002Fa\u003E, stating that \"the nutritional needs of growing children and adolescents can generally be met through a balanced, vegetable-based diet\", though it adds that a vegetarian diet in childhood and adolescence requires supervision by a paediatrician, and that vegans should supplement B12.\u003C\u002Fp\u003E\n\u003Cp\u003EA meat-based diet may also harbour risks of its own, due to the hormones found in meat and milk – though the evidence on this is mixed. \"In intensive farming, \u003Ca href=\"https:\u002F\u002Feje.bioscientifica.com\u002Fview\u002Fjournals\u002Feje\u002F179\u002F6\u002FEJE-18-0591.xml\"\u003Econcentrations of estrogens in milk are higher\u003C\u002Fa\u003E due to long milking periods,\" state the authors of one review of studies on estrogens in cow's milk and their potential health effects. They point out that exposure to these hormones can impact children, and disrupt their development in ways that may only become evident in adult life, for example, through a lower sperm count. However, they also argue milk has a number of health benefits. The review concludes that while the amounts of estrogens in cow's milk are too low to affect the health of adult humans, more research should be done on the impact on children, especially during the earliest stages of development.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220525-is-a-vegan-diet-healthy-for-kids-6"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0c90m25"],"imageAlignment":"centre","imageOrientation":"portrait","id":"future\u002Farticle\u002F20220525-is-a-vegan-diet-healthy-for-kids-7"},{"bodyHtml":{"assets":[]},"calloutBodyHtml":"\u003Cp\u003EThis article is part of \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Ffamily-tree\" target=\"_blank\"\u003E\u003Cstrong\u003EFamily Tree\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E, a series of features that explore the issues and opportunities that parents, children and families face all over the world. You might also be interested in other stories in the series:\u003C\u002Fp\u003E\n\u003Cul\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20210923-the-surprising-benefits-of-baby-massage\"\u003EThe surprising benefits of baby massage\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20220322-how-sleep-training-affects-babies\"\u003EWhat really happens when babies are left to cry it out?\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20210913-the-little-known-virus-that-surged-in-children-this-summer\"\u003EHow Covid changed a kids' virus\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003C\u002Ful\u003E\n\u003Cp\u003EYou can also climb new branches of the Family Tree on \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fworklife\u002Ffamily-tree\"\u003EBBC Worklife\u003C\u002Fa\u003E and BBC Culture – and check out this playlist on changing families by \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Freel\u002Fplaylist\u002Fthe-next-generation\"\u003EBBC Reel\u003C\u002Fa\u003E. \u003C\u002Fp\u003E","calloutTitle":"Family Tree","cardType":"CalloutBox","iFrameType":"","id":"future\u002Farticle\u002F20220525-is-a-vegan-diet-healthy-for-kids-8"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003E\u003Cstrong\u003EBack to the roots\u003C\u002Fstrong\u003E    \u003C\u002Fp\u003E\n\u003Cp\u003EIn recent years, the global spotlight has often been on plant-based novelties such as \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20220317-what-is-vegan-cheese-actually-made-from\"\u003Evegan cheese or meat-free burgers\u003C\u002Fa\u003E, which have made it easier for many to switch to a more plant-centred diet. But the focus on these eye-catching innovations can risk missing other ingredients that have been around for centuries – and which could fill some of the potential nutritional gaps of vegan family meals.\u003C\u002Fp\u003E\n\u003Cp\u003EBhavya Chandra Prem, a 33-year-old technical engineer who grew up in the Kunnur district of the Southern Indian state of Kerala, grew up on a predominantly non-vegetarian diet of beef, chicken stew and parathas (an Indian flat bread). She turned vegan almost overnight in 2014 after moving to Sydney for university, when a vegan friend and housemate asked her \"Why would you want to kill and eat something you love?\" A little research showed her the horrific realities of the meat and dairy industry. \"I watched a few documentaries like Cowspiracy, Earthlings and I couldn't live a lie and consume meat or diary or fish products. I have been vegan ever since and I haven't looked back,\" says Prem, who now lives in the Czech Republic.     \u003C\u002Fp\u003E\n\u003Cp\u003EIn 2020, when she learnt that she was pregnant, she had to contend with terrible morning sickness until 22 weeks, and could barely keep anything down except crackers, rice and soup. When that phase passed, she started seeking out healthier and nutrient-dense vegan food with the support of her husband, who is Italian. Her gynecologist said that following a vegan diet wouldn't harm their growing child, as long as she ate high-protein foods.\u003C\u002Fp\u003E\n\u003Cp\u003E\"I ate different types of dals (split pulses), lentils and legumes and tons of vegetable soups, tofu and soy products,\" she says. Her favourites were \u003Cem\u003Echerupayaru \u003C\u002Fem\u003E(a curry made with mung beans), and Kerala-style stews, which typically include coconut milk. \u003C\u002Fp\u003E\n\u003Cp\u003EIn November 2021, her baby boy was born at a healthy 3.6kg (7.9lb), and he is doing well, Prem says. While she adds she doesn't want to impose her own ethical values on her son, she will expose him to more diverse foods beyond meat as he grows older.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220525-is-a-vegan-diet-healthy-for-kids-9"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0c90hfs"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220525-is-a-vegan-diet-healthy-for-kids-10"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003E\u003Cstrong\u003EProtein-rich foods\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EEdwina Raj, a clinical dietician at the Bengaluru-based Aster CMI hospitals, points out that India's traditional foods offer plenty of options for vegans. \"We've seen that some vegans tend to rely too heavily on refined flours and carbohydrates,\" she says. \"Instead, they'll need to focus on complex carbs. We suggest the many varieties of unpolished rice – red, brown, black. As a vegan parent, you'll need to keep in mind the dietary requirements for protein are 1g per kg of body weight and plan your meals accordingly.\" She recommends millets, lentils, dried green peas and beans as sources of high-quality protein.\u003C\u002Fp\u003E\n\u003Cp\u003EKarla Moreno-Bryce (MDA, RD, LD), a vegan Pediatric Nutrition Coach based in Minneapolis, in the US argues that regardless of the family's chosen cuisine, planning healthy vegan meals can be relatively easy.\u003C\u002Fp\u003E\n\u003Cp\u003E\"Meal prepping for vegan kids just requires a little attention to ensure that key nutrients (iron, zinc, iodine, omega-3s, calcium, Vitamin D, and Vitamin B12) are offered during the day through a variety of plant foods and dietary supplements,\" she says. \"It's particularly important that all vegan kids receive a reliable Vitamin B12 supplement, preferably at the time they begin solid foods. This is a nutrient that naturally lacks in plant foods and a supplement, in addition to fortified foods, is the most reliable source of meeting this important nutrient.\"\u003C\u002Fp\u003E\n\u003Cp\u003EWith the right mix of ingredients, she says, parents can offer healthy vegan versions of many different cuisines: \"Many vegan parents focus on ensuring that their children's meals consist of vegetables, and while they are important and provide an array of nutrients, they lack the calories to support a child's growth and development. I encourage vegan parents to focus on providing foods rich in iron (such as beans, lentils, and tofu) and fat (such as avocado and nut butters) since these are two important nutrients during periods of rapid growth,\" says Moreno-Bryce.\u003C\u002Fp\u003E\n\u003Cp\u003ETo meet his growing vegan child's nutritional needs in India, Ashish Kumar Jain has turned to locally grown leafy vegetables, like local spinaches, methi (fenugreek leaves), cumin seeds, coriander, and curry leaves, as well as nutrient-dense sesame seeds, tofu and finger millet. He substitutes milk with extracts from almonds and coconuts, makes \"cheese\" from cashews and potatoes, and yoghurt from peanut milk.\u003C\u002Fp\u003E\n\u003Cp\u003E\"We've never felt deprived of dairy,\" he says. \"And there are many reasons to prioritise veganism that go beyond diet and health – compassion for animals, climate and sustainability. Veganism is a social justice movement, as much as it is a healthy choice.\"   \u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003E* \u003C\u002Fem\u003E\u003Cem\u003EDisclaimer: All content within this article is provided for general information only, and should not be treated as a substitute for the medical and dietary advice of healthcare professionals. The BBC is not responsible or liable for any diagnosis or actions taken by a user based on the content of this site. The BBC is not liable for the contents of any external internet sites listed, nor does it endorse any commercial product or service mentioned or advised on any of the sites. The BBC encourages anyone interested in making dietary changes to consult their healthcare provider beforehand. Always consult your own GP if you're in any way concerned about your health or the health of your child. \u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EThis article has been corrected to state that Bhavya Chandra Prem studied in Sydney, not Spain.\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E--\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EJoin one million Future fans by liking us on \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.facebook.com\u002FBBCFuture\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EFacebook\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, or follow us on \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Ftwitter.com\u002FBBC_Future\"\u003E\u003Cstrong\u003E\u003Cem\u003ETwitter\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E or \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.instagram.com\u002Fbbcfuture_official\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EInstagram\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E.\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EIf you liked this story, \u003C\u002Fem\u003E\u003Ca href=\"http:\u002F\u002Fpages.emails.bbc.com\u002Fsubscribe\u002F?ocid=fut.bbc.email.we.email-signup\"\u003E\u003Cstrong\u003E\u003Cem\u003Esign up for the weekly bbc.com features newsletter\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, called \"The Essential List\" – a handpicked selection of stories from BBC \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EFuture\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fculture\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003ECulture\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fworklife\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EWorklife\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ftravel\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003ETravel\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E \u003Cem\u003Eand \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Freel\"\u003E\u003Cstrong\u003E\u003Cem\u003EReel\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E delivered to your inbox every Friday.\u003C\u002Fem\u003E\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220525-is-a-vegan-diet-healthy-for-kids-11"}],"collection":["future\u002Fpremium-collection\u002Ffamily-tree"],"disableAdverts":false,"displayDate":"2022-06-01T01:00:00Z","embeddedCustomHtml":"","embeddedInfographicUrl":"","embeddedType":"infographic","headlineLong":"Is a vegan diet healthy for children?","headlineShort":"Is a vegan diet safe for children?","image":["p0c90hk0"],"imageAlignment":"centre","imageAltText":"","isSyndicated":true,"latitude":"","longitude":"","mpsVideo":"","option":[{"Content":{"Description":"Apple News Publish: Select to publish, remove to unpublish. (Do not just delete or unpublish the story)","Name":"publish-applenews-system-1"},"Metadata":{"CreationDateTime":"2016-02-05T14:32:31.186819Z","Entity":"option","Guid":"13f4bc85-ae27-4a34-9397-0e6ad3619619","Id":"option\u002Fpublish-applenews-system-1","ModifiedDateTime":"2022-02-27T22:52:24.455144Z","Project":"wwverticals","Slug":"option\u002Fpublish-applenews-system-1"},"Urn":"urn:pubpipe:wwverticals:option:option\u002Fpublish-applenews-system-1","_id":"62b420921f4b7b5d34253c8b"}],"partner":null,"primaryVertical":"future","promoAlignment":"centre","promoAltText":"","promoImage":null,"relatedStories":null,"relatedTag":null,"summaryLong":"Kamala Thiagarajan investigates what vegan families can learn from India's ancient tradition of plant-based cooking, coupled with new scientific insights.","summaryShort":"India offers surprising lessons on veganism","tag":["tag\u002Ffood"],"textToSpeech":false,"creationDateTime":"2022-06-01T00:00:28.415512Z","entity":"article","guid":"cab8ab85-f19d-43f2-9ab5-000ea9f084ac","id":"future\u002Farticle\u002F20220525-is-a-vegan-diet-healthy-for-kids","modifiedDateTime":"2022-06-09T13:03:18.789893Z","project":"wwverticals","slug":"future\u002Farticle\u002F20220525-is-a-vegan-diet-healthy-for-kids","cacheLastUpdated":1657756319029},"future\u002Farticle\u002F20220516-the-healing-power-of-emotion-coaching":{"urn":"urn:pubpipe:wwverticals:article:future\u002Farticle\u002F20220516-the-healing-power-of-emotion-coaching","_id":"62b41ff81f4b7b393d758896","ambientVideo":"","articleType":"story","assetVideo":null,"author":["future\u002Fauthor\u002Fdavid-robson"],"bodyIntro":"Talking about traumatic events can be hard – but makes a huge difference to children's wellbeing, research shows. Here's how to find the right words.","businessUnit":"worldwide","cards":[{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EIf a parent's primary responsibility is to keep their \u003Ca href=\"https:\u002F\u002Fwww.unicef.org\u002Fchild-rights-convention\"\u003Echild safe and free from pain\u003C\u002Fa\u003E – what can they do when circumstances conspire against them?\u003C\u002Fp\u003E\n\u003Cp\u003EWhether it's a death in the family, an injury or illness, or the threat of war, a child's guardians must not only manage their own feelings, but  also negotiate potentially heart-breaking conversations with young minds still struggling to make sense of the world around them. Even seemingly remote news stories can lead to great anxiety and upset which needs to be processed as a family. But the stakes will be so much the higher if the child themself has been directly affected by the events.\u003C\u002Fp\u003E\n\u003Cp\u003EUnfortunately, professional help may not be forthcoming. \"For many kids, parents are the \u003Cem\u003Eonly \u003C\u002Fem\u003Epeople who will offer support following a trauma,\" says Sarah Halligan, a professor of psychology at the University of Bath, in the UK.\u003C\u002Fp\u003E\n\u003Cp\u003EIt should go without saying that love and understanding must be the foundation of these dialogues. But recent research suggests that the specific contents of these interactions, and the language that is used to frame the events, can also have profound effects on children's emotional processing.\u003C\u002Fp\u003E\n\u003Cp\u003EBesides offering immediate comfort, family chat can shape a child's memories of what occurred when their minds return to it in the future, and the ways that they will respond to later upsets. Indeed, if you think about your own reactions to trauma today, it is very likely that you are repeating internalised conversations from your own childhood.\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EYou might also like:\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cul\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20220315-how-eco-anxiety-affects-childrens-minds\"\u003EThe rise of 'eco-anxiety' in kids\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20220322-how-sleep-training-affects-babies\"\u003EWhat happens when babies cry it out\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20220104-how-parenting-changes-you\"\u003EHow children mould their parents\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003C\u002Ful\u003E\n\u003Cp\u003E\"Some people think that if they talk about negative events, they are going to traumatise their child or make it worse,\" says Melanie Noel, a professor of clinical psychology at the University of Calgary, in Alberta, Canada. \"But having these difficult conversations can teach children empathy, understanding, and the ability to regulate their emotions.\"\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003ESocial sponges\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EIt is now well established that parent-child interactions play a crucial role in all kinds of cognitive development.\u003C\u002Fp\u003E\n\u003Cp\u003E\"Children's brains are still developing, and parents provide important scaffolding and support to help children navigate their emotional worlds,\" says Dylan Gee, a professor of psychology at Yale University in Connecticut, US.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"infographic","imageAlignment":"centre","imageOrientation":"landscape","pullQuoteImageAlignment":"centre","videoImageAlign":"centre","id":"future\u002Farticle\u002F20220516-the-healing-power-of-emotion-coaching-0"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0c71bxc"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220516-the-healing-power-of-emotion-coaching-1"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003ERight from birth, a child's attention will be constantly \u003Ca href=\"https:\u002F\u002Fwww.jstor.org\u002Fstable\u002F4139242\"\u003Eguided by cues from the adults around them\u003C\u002Fa\u003E. Sensing their parents' fear could help them to avoid a potentially dangerous animal or \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC6234014\u002F\"\u003Ean untrustworthy person\u003C\u002Fa\u003E, for example.\u003C\u002Fp\u003E\n\u003Cp\u003EAs the child learns to talk, the caregivers' words will also guide their thinking and reasoning – with repercussions that go far beyond their knowledge of vocabulary and grammar.\u003C\u002Fp\u003E\n\u003Cp\u003EEven the most casual chats can \u003Ca href=\"https:\u002F\u002Fjournals.sagepub.com\u002Fdoi\u002Fabs\u002F10.1177\u002F0963721416655100\"\u003Eshape a child's memories\u003C\u002Fa\u003E, for example, so that they weave the details together into a narrative and start making sense of their feelings. After a trip to the hairdresser, a parent might ask how the child felt when the clippers buzzed over their scalp, and if they enjoyed the tickling sensation. Or they might ask if the child had been scared of the water spray. They may then say how proud they were that the child had been able to overcome their shyness, which reinforces the child's feeling of bravery.\u003C\u002Fp\u003E\n\u003Cp\u003EThis greater understanding of their emotions can, in turn, shape a child's behaviour, so that they put more thought into their actions without giving in to their impulses.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220516-the-healing-power-of-emotion-coaching-2"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"Children who are encouraged to explore their feelings have better attention skills and impulse control, research shows","id":"future\u002Farticle\u002F20220516-the-healing-power-of-emotion-coaching-3"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EIn the mid-2010s, Diana Leyva, a professor of psychology at the University of Pittsburgh, in Pennsylvania, US, filmed 210 parent-child pairs as they talked about positive and negative experiences in the child's life. During these conversations, some parents asked many more questions than others – and Leyva found that this could predict the children's behaviour at school a few years later.\u003C\u002Fp\u003E\n\u003Cp\u003EChildren who had been encouraged to delve into their feelings were better able \u003Ca href=\"https:\u002F\u002Fwww.tandfonline.com\u002Fdoi\u002Fabs\u002F10.1080\u002F10409289.2015.1037625\"\u003Emaintain their attention and control their impulses\u003C\u002Fa\u003E in the classroom. Interestingly, it was the conversations about the negative experiences that seemed to make a real difference – perhaps because it is these uncomfortable feelings that are the hardest to understand and regulate, without the guidance from a parent.\u003C\u002Fp\u003E\n\u003Cp\u003EGee calls these kind of productive conversation \"emotion coaching\".\u003C\u002Fp\u003E\n\u003Cp\u003E\"Examples of effective emotion coaching include helping children to identify their feelings, respecting and validating children's feelings, helping children to identify ways to cope with challenging emotions, and providing opportunities to openly discuss children's emotions,\" she says.\u003C\u002Fp\u003E\n\u003Cp\u003EGee's own research has examined how families coped during the pandemic. She found that parents' emotion coaching \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F33591457\u002F\"\u003Ebuffered the effects of the stress during this difficult time\u003C\u002Fa\u003E, so that it had less of an effect on the children's mental health.\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003ETalking about trauma\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EGiven these findings, it is only natural that a parents' behaviour could have a powerful influence on children's responses to other kinds of pain and trauma. \u003C\u002Fp\u003E\n\u003Cp\u003EA few years ago, Halligan's team recruited 132 families who had a child that had experienced a traumatic event – such as a car accident or a house fire – which had resulted in a hospital visit. In addition to answering various questionnaires, the parents and children were asked to engage in a recorded conversation about the event, which the team then analysed.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220516-the-healing-power-of-emotion-coaching-4"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0c71c88"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220516-the-healing-power-of-emotion-coaching-5"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EHalligan found that parents' appraisals of the event could predict \u003Ca href=\"https:\u002F\u002Facamh.onlinelibrary.wiley.com\u002Fdoi\u002Ffull\u002F10.1111\u002Fjcpp.12846\"\u003Ethe child's symptoms of post-traumatic stress six months after the event\u003C\u002Fa\u003E. (Importantly, this was true even after they had controlled for the child’s initial reaction to the event.) The worst characteristic seemed to be \"catastrophic thinking\", in which the parent focused exclusively on the threat and its potentially permanent influence on the child's life. In such cases, the child was more likely to have lingering symptoms further down the line. To a certain extent, the parent's doom-laden beliefs had become self-fulfilling prophecies.\u003C\u002Fp\u003E\n\u003Cp\u003EThis doesn't mean that caregivers should make light of the event or downplay the suffering. \"It's important that parents do acknowledge what children have been through – they shouldn't pretend that this isn't distressing,\" says Halligan. \"But we sometimes see parents enhancing how serious the event was.\" It was this exaggeration of the trauma and its effects that seemed to lead to worse outcomes, compared to families where the parent emphasised the child's ability to recover from the trauma.\u003C\u002Fp\u003E\n\u003Cp\u003EFurther evidence comes from Melanie Noel's research at the University of Calgary. In \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F31335654\u002F\"\u003Eone experiment\u003C\u002Fa\u003E, her team recruited 112 children undergoing a tonsillectomy, or removal of the tonsils. Soon after the operation, each child rated the pain they were feeling (based on a picture-based questionnaire depicting different levels of discomfort). Two weeks later, the team then recorded a conversation between the parent and child describing the experience and their recovery – which were rated according to the level of elaboration and the emotional content. Finally, a month after the operation, the researchers again interviewed the child, probing their memory of the surgery and how much discomfort they had felt.\u003C\u002Fp\u003E\n\u003Cp\u003EIn general, more detailed discussions of the child's overall emotions seemed to help the child to make sense of the event. This was not true, however, if the parents focused too much on the physical pain that the child had endured. In these cases, the children remembered the operation, and their recovery, as being much more upsetting than they had reported straight after the surgery.\u003C\u002Fp\u003E\n\u003Cp\u003E\"Every time you talk about something painful that happened, especially with kids, you open that memory up to be changed and distorted,\" Noel says. \"And some kids develop these scary, exaggerated memories.\"\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220516-the-healing-power-of-emotion-coaching-6"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"Our memories of pain may shape our future experiences","id":"future\u002Farticle\u002F20220516-the-healing-power-of-emotion-coaching-7"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EThat's important, she says, since abundant research has shown our memories of pain seem to shape our future experiences. If we remember an operation as being especially agonising, we will be much more anxious – and experience greater discomfort – when we next undergo surgery\u003Cstrong\u003E.\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003ENoel and her doctoral student Maria Pavlova have now designed a short training programme on the best ways to have more constructive conversations. Parents are advised to avoid talking too much about the physical pain. Instead, they were encouraged to focus on the more positive elements of the experience and to praise the child for the ways they had managed to cope with their discomfort.\u003C\u002Fp\u003E\n\u003Cp\u003EConsider, for example, an interaction in which the child remembers all the tears they spilled during the event. \"I cried for so long\", they say. While it's important not to gloss over that fact, the parent might try to remind the child how quickly they recovered. \"Yes you cried, but only for a few minutes remember? Because then we got ice cream.\" The parent could then emphasise the kindness of the staff – and praise the child for having managed their pain with deep breathing. (You can watch a video outlining this advice in more detail, \u003Ca href=\"https:\u002F\u002Fwww.youtube.com\u002Fwatch?v=lvCabG6_ekI&ab_channel=MegFoundationforPain\"\u003Ehere\u003C\u002Fa\u003E.)\u003C\u002Fp\u003E\n\u003Cp\u003ETo test the benefits of this intervention, Noel and Pavlova once again recruited families with a child undergoing a tonsillectomy. After the operation, the parents were given a short training session. The \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F34425247\u002F\"\u003Eintervention worked exactly as planned\u003C\u002Fa\u003E – reducing the child's tendencies to exaggerate their discomfort in later reminiscences – so that they formed more nuanced and realistic memories of the event.\u003C\u002Fp\u003E\n\u003Cp\u003EAlthough the intervention was specifically designed to change conversations around physical pain, Noel suspects that reframing conversations in this way – so that they emphasise resilience as well as suffering – could help children to process many other kinds of trauma.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220516-the-healing-power-of-emotion-coaching-8"},{"bodyHtml":{"assets":[]},"calloutBodyHtml":"\u003Cp\u003EThis article is part of \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Ffamily-tree\" target=\"_blank\"\u003E\u003Cstrong\u003EFamily Tree\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E, a new series of features from the BBC that explore the issues and opportunities that parents, children and families face all over the world. You might also be interested in some other stories about family dynamics and relationships:\u003C\u002Fp\u003E\n\u003Cul\u003E\n\u003Cli\u003E\u003Cstrong\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20211201-why-family-estrangement-is-surprisingly-common\"\u003EThe family rifts triggered by Christmas\u003C\u002Fa\u003E\u003C\u002Fstrong\u003E\u003C\u002Fli\u003E\n\u003Cli\u003E\u003Cstrong\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20211102-stressed-by-parenting-evolution-explains-why\"\u003EStressed by parenting? Evolution can explain why\u003C\u002Fa\u003E\u003C\u002Fstrong\u003E\u003C\u002Fli\u003E\n\u003Cli\u003E\u003Cstrong\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20211117-how-do-children-choose-a-best-friend\"\u003EThe surprising power of children's friendships\u003C\u002Fa\u003E\u003C\u002Fstrong\u003E\u003C\u002Fli\u003E\n\u003C\u002Ful\u003E\n\u003Cp\u003EYou can also climb new branches of the Family Tree on \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fworklife\u002Ffamily-tree\" target=\"_blank\"\u003E\u003Cstrong\u003EBBC Worklife\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E.\u003C\u002Fp\u003E","calloutTitle":"Family Tree","cardType":"CalloutBox","iFrameType":"","id":"future\u002Farticle\u002F20220516-the-healing-power-of-emotion-coaching-9"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003E\u003Cstrong\u003EPicking your moment\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EFor any family processing trauma, one of the biggest challenges may be finding the right moment to initiate these conversations. Halligan says that some parents may try to avoid talking about the subject – even between themselves – in case the reminders add to the child's suffering. This could create the sense that the subject is somehow taboo. \"Children can often worry that they'll upset their parents, so they become silent on the topic,\" Halligan says. In her opinion, it may be better to allow the topic to come up naturally.\u003C\u002Fp\u003E\n\u003Cp\u003ERegularly asking child how they feel, in general, should give the child the space to talk about their distress when it is pressing on them. \"You need to make sure your child knows that they can have the conversation with you and to provide those opportunities for that conversation in an active way,\" she adds. Even if the child does not talk about the trauma itself, they might chat about other stresses that could provide a good opportunity for emotion coaching.\u003C\u002Fp\u003E\n\u003Cp\u003EChildren may more be likely to open up while you are going about other day-to-day activities – such as a drive in the car or a walk in the park. \"Parents often find good opportunities to talk to children when other things are going on,\" Halligan says.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220516-the-healing-power-of-emotion-coaching-10"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0c71dh0"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220516-the-healing-power-of-emotion-coaching-11"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EIf you then follow the suggestions inspired by the research – to validate the child's feelings, to emphasise the good alongside the bad, and to affirm the child's ability to cope – you may be equipping them with broader emotional skills that will last for decades to come.\u003C\u002Fp\u003E\n\u003Cp\u003E\"If we want to foster resilience in children, we need to teach parents how to have validating conversations with children about stressful, scary and traumatic things,\" says Noel. \"It could prevent a lot of problems later on.\"\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003E* David Robson is an award-winning science writer and author of \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fdavidrobson.me\u002Fthe-expectation-effect\u002F\"\u003E\u003Cem\u003EThe Expectation Effect: How Your Mindset Can Transform Your Life\u003C\u002Fem\u003E\u003C\u002Fa\u003E\u003Cem\u003E, published by Canongate (UK) and Henry Holt (USA) in early 2022. He is \u003C\u002Fem\u003E\u003Ca href=\"http:\u002F\u002Fwww.twitter.com\u002Fd_a_robson\"\u003E\u003Cem\u003E@d_a_robson\u003C\u002Fem\u003E\u003C\u002Fa\u003E\u003Cem\u003E on Twitter.\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E--\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EJoin one million Future fans by liking us on \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.facebook.com\u002FBBCFuture\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EFacebook\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, or follow us on \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Ftwitter.com\u002FBBC_Future\"\u003E\u003Cstrong\u003E\u003Cem\u003ETwitter\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E or \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.instagram.com\u002Fbbcfuture_official\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EInstagram\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E.\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EIf you liked this story, \u003C\u002Fem\u003E\u003Ca href=\"http:\u002F\u002Fpages.emails.bbc.com\u002Fsubscribe\u002F?ocid=fut.bbc.email.we.email-signup\"\u003E\u003Cstrong\u003E\u003Cem\u003Esign up for the weekly bbc.com features newsletter\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, called \"The Essential List\" – a handpicked selection of stories from BBC \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EFuture\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fculture\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003ECulture\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fworklife\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EWorklife\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ftravel\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003ETravel\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E \u003Cem\u003Eand \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Freel\"\u003E\u003Cstrong\u003E\u003Cem\u003EReel\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E delivered to your inbox every Friday.\u003C\u002Fem\u003E\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220516-the-healing-power-of-emotion-coaching-12"}],"collection":["future\u002Fpremium-collection\u002Ffamily-tree"],"disableAdverts":false,"displayDate":"2022-05-17T01:00:00Z","embeddedCustomHtml":"","embeddedInfographicUrl":"","embeddedType":"infographic","headlineLong":"The healing power of 'emotion coaching'","headlineShort":"The healing power of 'emotion coaching'","image":["p0c71ffp"],"imageAlignment":"centre","imageAltText":"","isSyndicated":true,"latitude":"","longitude":"","mpsVideo":"","option":[{"Content":{"Description":"Apple News Publish: Select to publish, remove to unpublish. (Do not just delete or unpublish the story)","Name":"publish-applenews-system-1"},"Metadata":{"CreationDateTime":"2016-02-05T14:32:31.186819Z","Entity":"option","Guid":"13f4bc85-ae27-4a34-9397-0e6ad3619619","Id":"option\u002Fpublish-applenews-system-1","ModifiedDateTime":"2022-02-27T22:52:24.455144Z","Project":"wwverticals","Slug":"option\u002Fpublish-applenews-system-1"},"Urn":"urn:pubpipe:wwverticals:option:option\u002Fpublish-applenews-system-1","_id":"62b420921f4b7b5d34253c8b"}],"partner":null,"primaryVertical":"future","promoAlignment":"centre","promoAltText":"","promoImage":null,"relatedStories":null,"relatedTag":null,"summaryLong":"Talking about traumatic events can be hard – but makes a huge difference to children's wellbeing, research shows. Here's how to find the right words.","summaryShort":"How to turn pain into moments of emotional growth","tag":["tag\u002F20150401-psychology","tag\u002Fchildren"],"textToSpeech":false,"creationDateTime":"2022-05-17T00:00:57.69083Z","entity":"article","guid":"ad0dd44d-5042-49e0-840e-618a563dd915","id":"future\u002Farticle\u002F20220516-the-healing-power-of-emotion-coaching","modifiedDateTime":"2022-05-17T00:01:25.294803Z","project":"wwverticals","slug":"future\u002Farticle\u002F20220516-the-healing-power-of-emotion-coaching","cacheLastUpdated":1657756319029},"future\u002Farticle\u002F20220427-the-test-that-could-find-lost-twins":{"urn":"urn:pubpipe:wwverticals:article:future\u002Farticle\u002F20220427-the-test-that-could-find-lost-twins","_id":"62b41ff81f4b7b106623e7d6","ambientVideo":"","articleType":"story","assetVideo":null,"author":["future\u002Fauthor\u002Fjessica-mudditt"],"bodyIntro":"A surprisingly high number of people began life as a twin – without ever realising. Could a new test reveal if you had a co-twin before you were born?","businessUnit":"worldwide","cards":[{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EAs a child, Jeffrey Craig had recurring dreams that he had an identical twin.\u003C\u002Fp\u003E\n\u003Cp\u003E\"The dreams were frequent, and always the same. There was another version of me lying in bed beside me. It wasn't a stranger: I knew that it was another me. It was a bit surprising, but I wasn't scared – it was actually soothing.\"\u003C\u002Fp\u003E\n\u003Cp\u003EDuring his research as an associate professor at the Murdoch Children's Research Institute in Australia, Craig learnt about \"vanishing twin syndrome\", whereby one twin dies early on in the pregnancy. Remnants of that twin may remain in the womb, or the tissue may disintegrate and the cells be absorbed by the other twin or the placenta. Reading about this, Craig began to question whether the dream had more significance.\u003C\u002Fp\u003E\n\u003Cp\u003E\"I began to wonder if I had a distant memory of sharing a womb with a twin,\" says Craig, who is now a lecturer in epigenetics and cell biology at Deakin University School of Medicine and deputy director of Twins Research Australia.\u003C\u002Fp\u003E\n\u003Cp\u003ERecent research on vanishing twins, in which Craig was not involved but which he peer-reviewed, may help solve his mystery. A global team of twin researchers have discovered a way of \u003Ca href=\"https:\u002F\u002Fwww.nature.com\u002Farticles\u002Fs41467-021-25583-7\"\u003Efinding out if someone was once an identical twin\u003C\u002Fa\u003E – regardless of whether their other twin is still alive, or was lost before they were born. The method's accuracy is about 60-80%. Craig considers it a major advance in the field, and he is also deeply curious on a personal level. If the researchers succeed in developing a reliable test to identify people who lost a co-twin in the womb, \"I could test my hypothesis that the dream I had in which there was another me sleeping beside me originated because I started life as a twin,\" he writes in an email.\u003C\u002Fp\u003E\n\u003Cp\u003EThe odds of having once been a twin are higher than many realise. The rate of twins among live births is \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC3182188\u002F\" target=\"_blank\" data-auth=\"NotApplicable\" data-linkindex=\"0\"\u003Eonly about 1.3%.\u003C\u002Fa\u003E But as many as \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F1970983\u002F#:~:text=After%20simple%20adjustments%20for%20varying,90%25%20will%20survive%20to%20term.\" target=\"_blank\" data-auth=\"NotApplicable\" data-linkindex=\"1\"\u003E12% of all naturally conceived pregnancies\u003C\u002Fa\u003E may begin as twin pregnancies, according to one study. In about one in eight of such pregnancies, one of the twins vanishes, resulting in a single birth, the study suggests.\u003C\u002Fp\u003E\n\u003Cp\u003EThose who are left-handed may have an even higher probability, because twins are \u003Ca href=\"https:\u002F\u002Fwww.psychologytoday.com\u002Fau\u002Fblog\u002Fthe-asymmetric-brain\u002F201909\u002Fare-twins-more-likely-be-left-handed\"\u003Emore likely\u003C\u002Fa\u003E to be left-handed. While 9% of the general population is left-handed, 15% of identical twins and 12% of non-identical twins are left-handers.\u003C\u002Fp\u003E\n\u003Cp\u003EHelping people uncover if they started life as a twin could have important implications for their health, some experts say. It may also contribute to a better understanding of identical twins and their early development – many aspects of which are still shrouded in mystery.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"infographic","imageAlignment":"centre","imageOrientation":"landscape","pullQuoteImageAlignment":"centre","videoImageAlign":"centre","id":"future\u002Farticle\u002F20220427-the-test-that-could-find-lost-twins-0"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0c4mjw5"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220427-the-test-that-could-find-lost-twins-1"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003E\u003Cstrong\u003EMysterious twins\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EThe scientists did not originally set out to develop a test to find out if people had vanished twins. Instead, their initial goal was much more fundamental: to look for differences in the epigenome – meaning, chemical tags that mark the human genome and tell it what to do – that could lead to a better understanding of exactly how and why identical twins form in the first place.\u003C\u002Fp\u003E\n\u003Cp\u003EIdentical twins, also known as monozygotic twins, form when one egg, fertilised by one sperm, splits early on. Finding an explanation for why the egg splits has proven elusive. The leading hypothesis is that it occurs at random. Identical twins occur in few species: humans, dogs, cattle, horses and pigs. From an evolutionary perspective, their existence doesn't make much sense, since producing offspring with genetic diversity provides a better chance of survival.\u003C\u002Fp\u003E\n\u003Cp\u003E\"We know so much about the human body, but despite many years of research, we still have no idea where identical twins come from. It's one of the remaining mysteries in human biology,\" says Jenny van Dongen, an expert in twin research and epigenetics at Vrije Universiteit Amsterdam, who led the study.\u003C\u002Fp\u003E\n\u003Cp\u003EThe researchers originally wanted to investigate the role of so-called epigenetic processes – that is, chemical markers that sit on top of genes, and can switch them on or off – in the formation of twins. Such epigenetic markers can be added to or removed from genes by the human body in response to changes in a person's environment or lifestyle. The role of epigenetic processes has been studied in fields as diverse as \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20190326-what-is-epigenetics\"\u003Etrauma research\u003C\u002Fa\u003E and cancer prevention. Epigenetic changes have also been found to be essential for \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F22457114\u002F\"\u003Eearly human development\u003C\u002Fa\u003E, when the embryo is first formed. \u003C\u002Fp\u003E\n\u003Cp\u003EIn particular, DNA methylation – a process by which a small chemical tag known as a \"methyl group\" is added to the DNA – helps regulate how embryonic genes function, thereby enabling healthy development.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220427-the-test-that-could-find-lost-twins-2"},{"bodyHtml":{"assets":[]},"calloutBodyHtml":"\u003Cp\u003E \u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E","calloutTitle":"Family Tree","cardType":"PullQuote","iFrameType":"","pullQuote":"Identical twins keep a distinctive, lifelong \"epigenetic signature\", research shows","id":"future\u002Farticle\u002F20220427-the-test-that-could-find-lost-twins-3"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003ETo find out if different levels of DNA methylation also played a part in the formation of twins, the team analysed levels of DNA methylation in 3,046 existing DNA samples from identical twins in the UK, Australia, the Netherlands and Finland. They compared this pattern to a control group of 3,396 non-identical twins. This ensured that the two groups were as similar as possible, having both shared a womb with a twin, the difference only being that the identical ones resulted from the split egg. \u003C\u002Fp\u003E\n\u003Cp\u003EThe researchers found a characteristic pattern of methylation in the identical twins' samples, also known as a molecular signature, or epigenetic signature. When they analysed samples from the same people taken at different points over time, they discovered that this pattern remained stable. \u003C\u002Fp\u003E\n\u003Cp\u003EThe precise role of this chemical signature in the formation of identical twins is not entirely clear. It could be a kind of chemical scar left by the process of the egg splitting; or it could be what led to the split in the first place.\u003C\u002Fp\u003E\n\u003Cp\u003EBut as the paper notes, the discovery of this distinctive, stable signature resulted in a never-expected side outcome: because identical twins keep the epigenetic signature all their lives, it can be used to find out if someone was originally an identical twin, even if their other twin was never born.\u003C\u002Fp\u003E\n\u003Cp\u003EUsing this discovery, the researchers developed an algorithm to predict whether someone is an identical twin, and applied it to fresh data sets. When tested on these data sets, the algorithm's predictions had an accuracy rate of 60-80%.\u003C\u002Fp\u003E\n\u003Cp\u003EThis means that even decades after their birth, a surviving identical twin could learn of their lost twin's existence through a simple cheek swab.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220427-the-test-that-could-find-lost-twins-4"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0c4mmhq"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220427-the-test-that-could-find-lost-twins-5"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003E\"We don't know if the test will ever be 100% accurate, but there are things we can try, such as a more complicated mathematical algorithm,\" says van Dongen.\u003C\u002Fp\u003E\n\u003Cp\u003EThe test only applies to identical twins. Non-identical, or fraternal, twins form in an entirely different way, namely, when a woman produces two eggs and each is fertilised by a different sperm. Genetically, this makes them as similar as siblings. The factors that influence the chance of having non-identical twins are much better understood than for identical twins. \u003Ca href=\"https:\u002F\u002Fwww.uwa.edu.au\u002Fnews\u002FArticle\u002F2020\u002FMay\u002FOlder-women-more-likely-to-conceive-twins#:~:text=Women%20are%20more%20likely%20to,collaboration%20involving%20researchers%20at%20UWA.\"\u003EOlder mothers\u003C\u002Fa\u003E, and mothers from families where non-identical twins are common, are more likely to have them, for example. Ethnicity can also be a factor. The \u003Ca href=\"https:\u002F\u002Fwww.nhs.uk\u002Fpregnancy\u002Ffinding-out\u002Fpregnant-with-twins\u002F\"\u003Echances\u003C\u002Fa\u003E of being a non-identical twin are highest among \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC2840794\u002F\"\u003ENigerians\u003C\u002Fa\u003E, with a rate of 40.2 per 1,000 births and lowest among the Japanese, at \u003Ca href=\"https:\u002F\u002Fwww.researchgate.net\u002Fpublication\u002F51817748_Trends_in_Occurrence_of_Twin_Births_in_Japan\"\u003E10.45 per 1,000 births\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003ELost twins?\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EThe test could shed new light on a range of twin-related scientific questions, firstly by simply establishing much more clearly who is a twin. On an individual level, it could help people struggling with painful uncertainty over their identity, and the possibility of having a lost twin.\u003C\u002Fp\u003E\n\u003Cp\u003E\"It is a major breakthrough for several reasons,\" says Nancy L Segal, a psychology professor specialising in twin studies at California State University, Fullerton and the author of a new book on separated twins called \u003Ca href=\"https:\u002F\u002Fwww.cambridge.org\u002Fcore\u002Fjournals\u002Ftwin-research-and-human-genetics\u002Farticle\u002Fabs\u002Fdeliberately-divided-inside-the-controversial-study-of-twins-and-triplets-adopted-apart-nancy-segal-rowman-littlefield-publishing-group-2021-491-pp-isbn-9781538132852-hardback-9781538132869-electronic\u002F1042E12E1B086E73CAC622D0129453A9\"\u003EDeliberately Divided\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003E\"It offers new insights into the biological processes underlying identical twinning. It helps identify cases of identical twin survivors whose co-twins died at birth. It also allows confirmation of suspected switched-at-birth identical twin cases when DNA testing may not be immediately feasible.\"\u003C\u002Fp\u003E\n\u003Cp\u003ESegal regularly receives emails from people who are searching for their lost twin.\u003C\u002Fp\u003E\n\u003Cp\u003E\"Some tell me they've been in therapy and realise that the root of their problems is that their identical twin died at birth,\" says Segal. \"They say they feel lost. They are really hung up on it.\"\u003C\u002Fp\u003E\n\u003Cp\u003EJenny van Dongen, the researcher who co-developed the test, has received around 30 emails from people wanting to take it. In some cases, their mothers said there were signs of a miscarriage during pregnancy. Others simply have a hunch.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220427-the-test-that-could-find-lost-twins-6"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"She knows that she had a twin. She has dreams about it – Judith Hall","id":"future\u002Farticle\u002F20220427-the-test-that-could-find-lost-twins-7"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EJudith Hall, professor emerita at the University of British Columbia, has been studying twins for 50 years and is considered a world authority in genetics and pediatrics. Her daughter believes she was an identical twin, although Hall herself had no indications at the time.\u003C\u002Fp\u003E\n\u003Cp\u003E\"She knows that she had a twin. She has dreams about it,\" says Hall simply.\u003C\u002Fp\u003E\n\u003Cp\u003EHowever, Segal is sceptical about prenatal memories of a lost twin.\u003C\u002Fp\u003E\n\u003Cp\u003E\"It's a romantic notion,\" she says. \"As a scientist, I remain open to the evidence that it could be possible, but so far I've not seen it. In all the twins I've studied who were raised apart [after being separated at birth] not one of them thought they were a twin. They were as surprised as we were.\"\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003EWhen two becomes one\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EThere are various hypotheses as to why a twin vanishes.\u003C\u002Fp\u003E\n\u003Cp\u003E\"It could be that something is wrong with one fetus, or perhaps the mother doesn't have enough room,\" says Segal. \"The womb was designed for one baby, not two. It could simply be a correction to ensure the health of the twin who survives.\"\u003C\u002Fp\u003E\n\u003Cp\u003EIf a twin disappears before 12 weeks, it is unlikely the mother would know because ultrasounds are rarely conducted that early.\u003C\u002Fp\u003E\n\u003Cp\u003E\"In medical terms, it is called 'vanishing twin syndrome' because at an early ultrasound there are two heartbeats, but later one of them seems to disappear,\" says van Dongen. \"However, those who have lost a twin pregnancy prefer to call it a stillborn pregnancy.\"\u003C\u002Fp\u003E\n\u003Cp\u003ESometimes there are visible remnants of the other twin. A rare phenomenon known as fetus papyraceus or 'paper doll fetus' describes a mummified fetus that died before the age of 10 weeks. It is flattened between the membranes of the living twin and uterine wall. It occurs in \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC3976727\u002F#r1\"\u003Eone in 12,000\u003C\u002Fa\u003E pregnancies.\u003C\u002Fp\u003E\n\u003Cp\u003E\"It is like a small piece of parchment that looks like a tiny baby,\" says Craig, the twin researcher.\u003C\u002Fp\u003E\n\u003Cp\u003EAn even rarer occurrence is called fetus-in-fetu or a 'parasitic twin', when one twin is absorbed inside the other, and parts of that twin remain in the other.\u003C\u002Fp\u003E\n\u003Cp\u003E\"Quite often, there's a structure that resembles a spine. And there can be hair and parts of a limb,\" says van Dongen.\u003C\u002Fp\u003E\n\u003Cp\u003EFetus-in-fetu is extremely rare. It occurs in about \u003Ca href=\"https:\u002F\u002Fcasereports.bmj.com\u002Fcontent\u002F12\u002F8\u002Fe230835\"\u003Eone in 500,000 live births\u003C\u002Fa\u003E and there have been only 200 cases reported globally.\u003C\u002Fp\u003E\n\u003Cp\u003E\"A person may have a lump somewhere that they only get checked out as an adult. You can imagine how surprising it would be if an x-ray reveals that their twin is tucked away in their abdominal cavity,\" says Craig.\u003C\u002Fp\u003E\n\u003Cp\u003EIn the case of non-identical twins, some of the deceased twin's genetic material may find its way into the surviving twin. In a remarkable \u003Ca href=\"https:\u002F\u002Ftime.com\u002F4091210\u002Fchimera-twins\u002F\"\u003Ecase\u003C\u002Fa\u003E in 2015, a man underwent fertility treatments and the DNA in his sperm turned out to be 90% his and 10% that of his unborn fraternal twin. While he and his twin shared a womb, he absorbed some of his twin's cells, effectively becoming a blend of himself and his brother.\u003C\u002Fp\u003E\n\u003Cp\u003EThe passing of cells between twins or triplets during early development was once considered rare, but is in fact \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20150917-is-another-human-living-inside-you\"\u003Enot that uncommon\u003C\u002Fa\u003E. Around \u003Ca href=\"http:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpubmed\u002F8741872\"\u003E\u003Cstrong\u003E8% of non-identical twins and 21% of triplets\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E have two blood groups: this makes them a chimera – a fusion of two bodies.\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003EIdentical twins – or not?\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EEven the distinction between identical and non-identical twins may not be as clear as was once thought. For example, it was once believed that identical twins always shared a single placenta, while non-identical twins each had their own placenta.\u003C\u002Fp\u003E\n\u003Cp\u003EWhen Sydney-based digital marketer Claire Chow had an ultrasound at 10 weeks, she was told that there were two amniotic sacs and two placentas, and that she was therefore having fraternal, or non-identical, twins.\u003C\u002Fp\u003E\n\u003Cp\u003EBut when her daughters, Madeline (Maddie) and Mia, were born, she noticed that they seemed completely alike. Maddie had a rounder face and Mia had a tiny mark on her nose – those were the only differences. As the girls grew older, strangers kept commenting on how \"identical\" they were. At the age of four, the twins were DNA tested. They are 99.99% identical.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220427-the-test-that-could-find-lost-twins-8"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0c4mn06"],"imageAlignment":"centre","imageOrientation":"portrait","id":"future\u002Farticle\u002F20220427-the-test-that-could-find-lost-twins-9"},{"bodyHtml":{"assets":[]},"calloutBodyHtml":"\u003Cp\u003EThis article is part of \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Ffamily-tree\" target=\"_blank\"\u003E\u003Cstrong\u003EFamily Tree\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E, a series of features that explore the issues and opportunities that parents, children and families face all over the world. You might also be interested in other stories about scientific puzzles and discoveries:\u003C\u002Fp\u003E\n\u003Cul\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20210923-the-surprising-benefits-of-baby-massage\"\u003EThe surprising benefits of baby massage\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20220322-how-sleep-training-affects-babies\"\u003EWhat really happens when babies are left to cry it out?\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20220322-how-dangerous-is-tongue-tie\"\u003EWhy are tongue-tie cases on the rise?\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003C\u002Ful\u003E\n\u003Cp\u003EYou can also climb new branches of the Family Tree on \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fworklife\u002Ffamily-tree\" target=\"_blank\"\u003E\u003Cstrong\u003EBBC Worklife\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E.\u003C\u002Fp\u003E","calloutTitle":"Family Tree","cardType":"CalloutBox","iFrameType":"","id":"future\u002Farticle\u002F20220427-the-test-that-could-find-lost-twins-10"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003E\"The girls have a freckle in the exact same spot on the opposite side of their faces. They have opposite squinty eyes. They're both right-handed, but Maddie used her left hand when she was younger,\" says Chow.\u003C\u002Fp\u003E\n\u003Cp\u003ESuch mirroring characteristics occur in \u003Ca href=\"https:\u002F\u002Fblogs.scientificamerican.com\u002Fguest-blog\u002Fmirror-mirror-examining-natures-copy-and-paste\u002F\"\u003E25% of identical twins\u003C\u002Fa\u003E, known as mirror twins. Mirror twins have birthmarks, organs and dominant hands on opposite sides of their body, and one may be left-handed while the other is right-handed.\u003C\u002Fp\u003E\n\u003Cp\u003EIdentical twins also have one potentially life-saving characteristic: they can have transplants from one another without any need to artificially suppress their immune system. Their bodies generally easily accept each other's parts.\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003ETesting at birth?\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EGiven such important aspects of identical twin-hood, Craig and Segal advocate DNA testing all twins at birth to check if they are identical, or fraternal.\u003C\u002Fp\u003E\n\u003Cp\u003E\"Some people think that DNA testing twins isn't important, but I think they're misguided. It's a very profound piece of information about your identity,\" says Segal.\u003C\u002Fp\u003E\n\u003Cp\u003EFor those who were born as apparent singletons, the prospect of being able to test for hidden twins later in life may transform entire areas of research and healthcare.\u003C\u002Fp\u003E\n\u003Cp\u003EJudith Hall is currently trying to secure funding to use the new test on singletons with congenital anomalies such as \u003Ca href=\"https:\u002F\u002Facademic.oup.com\u002Fhumrep\u002Farticle\u002F26\u002F12\u002F3466\u002F2914287\"\u003Eneural tube defects\u003C\u002Fa\u003E and arthrogryposis, a group of conditions that affect the joints. Identical twins are more likely to suffer from these conditions, as well as cerebral palsy. It may turn out that singletons with these conditions began their life as an identical twin.\u003C\u002Fp\u003E\n\u003Cp\u003E\"We do not entirely understand the cause of cerebral palsy,\" says van Dongen. \"If we can determine that a significant number of patients with cerebral palsy used to have a monozygotic twin, then we may find better treatment targets.\"\u003C\u002Fp\u003E\n\u003Cp\u003EHer team published the algorithm so that others can use it.\u003C\u002Fp\u003E\n\u003Cp\u003ECraig, who used to dream of a lost twin, plans to take the test when the accuracy rate improves.\u003C\u002Fp\u003E\n\u003Cp\u003E\"I think I would have liked to have had a twin,\" he says. \"I was the eldest child in my family and I wasn't a naturally social person. I remember hiding behind the cubby house when I was in kindergarten. Maybe I would have been more social if I'd had a twin, because having a twin teaches sociability.\"\u003C\u002Fp\u003E\n\u003Cp\u003EHowever, he still feels ambivalent about the idea of finally having an answer: \"The question is, what would it mean for me? And for my parents? Would it cause us grief? I've got to really think about whether I want this information. But perhaps it would provide some kind of closure.\"\u003C\u002Fp\u003E\n\u003Cp\u003E--\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EThis article has been corrected. The previous version gave wrong sample sizes for the DNA samples used in the research. The team analysed 3,046 DNA samples from identical twins in the UK, Australia, the Netherlands and Finland, and compared this to a control group of 3,396 non-identical twins. The previously version wrongly stated that they analysed 924 samples from identical twins, and 1,033 from identical twins.\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E--\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EJoin one million Future fans by liking us on \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.facebook.com\u002FBBCFuture\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EFacebook\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, or follow us on \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Ftwitter.com\u002FBBC_Future\"\u003E\u003Cstrong\u003E\u003Cem\u003ETwitter\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E or \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.instagram.com\u002Fbbcfuture_official\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EInstagram\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E.\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EIf you liked this story, \u003C\u002Fem\u003E\u003Ca href=\"http:\u002F\u002Fpages.emails.bbc.com\u002Fsubscribe\u002F?ocid=fut.bbc.email.we.email-signup\"\u003E\u003Cstrong\u003E\u003Cem\u003Esign up for the weekly bbc.com features newsletter\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, called \"The Essential List\" – a handpicked selection of stories from BBC \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EFuture\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fculture\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003ECulture\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fworklife\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EWorklife\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ftravel\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003ETravel\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E \u003Cem\u003Eand \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Freel\"\u003E\u003Cstrong\u003E\u003Cem\u003EReel\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E delivered to your inbox every Friday.\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220427-the-test-that-could-find-lost-twins-11"}],"collection":["future\u002Fpremium-collection\u002Ffamily-tree"],"disableAdverts":false,"displayDate":"2022-05-06T12:56:58Z","embeddedCustomHtml":"","embeddedInfographicUrl":"","embeddedType":"infographic","headlineLong":"Do you have a lost twin?","headlineShort":"Do you have a lost twin?","image":["p0c4mhp2"],"imageAlignment":"centre","imageAltText":"","isSyndicated":true,"latitude":"","longitude":"","mpsVideo":"","option":[{"Content":{"Description":"Apple News Publish: Select to publish, remove to unpublish. (Do not just delete or unpublish the story)","Name":"publish-applenews-system-1"},"Metadata":{"CreationDateTime":"2016-02-05T14:32:31.186819Z","Entity":"option","Guid":"13f4bc85-ae27-4a34-9397-0e6ad3619619","Id":"option\u002Fpublish-applenews-system-1","ModifiedDateTime":"2022-02-27T22:52:24.455144Z","Project":"wwverticals","Slug":"option\u002Fpublish-applenews-system-1"},"Urn":"urn:pubpipe:wwverticals:option:option\u002Fpublish-applenews-system-1","_id":"62b420921f4b7b5d34253c8b"}],"partner":null,"primaryVertical":"future","promoAlignment":"centre","promoAltText":"","promoImage":null,"relatedStories":null,"relatedTag":null,"summaryLong":"A surprisingly high number of people began life as a twin – without ever realising. Could a new test reveal if you had a co-twin before you were born?","summaryShort":"The odds are higher than many realise","tag":["tag\u002Fgenetics"],"textToSpeech":false,"creationDateTime":"2022-05-06T00:00:32.075097Z","entity":"article","guid":"e599cfc0-8790-4839-892d-e6a24e2d0a80","id":"future\u002Farticle\u002F20220427-the-test-that-could-find-lost-twins","modifiedDateTime":"2022-05-09T11:00:22.086785Z","project":"wwverticals","slug":"future\u002Farticle\u002F20220427-the-test-that-could-find-lost-twins","cacheLastUpdated":1657756319030},"future\u002Farticle\u002F20220322-how-dangerous-is-tongue-tie":{"urn":"urn:pubpipe:wwverticals:article:future\u002Farticle\u002F20220322-how-dangerous-is-tongue-tie","_id":"62b41ff71f4b7b71516cd8ab","ambientVideo":"","articleType":"story","assetVideo":null,"author":["future\u002Fauthor\u002Fkamala-thiagarajan"],"bodyIntro":"Awareness of tongue-tie, and its hidden impact on children's health, is rising around the world. Here's how it can be spotted and fixed.","businessUnit":"worldwide","cards":[{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EPurna Parmar had been looking forward to breastfeeding her son, Janav, after his birth in 2011. But whenever he latched on to her breast, she felt a searing pain. Soon, her nipples were sore, raw and bleeding. \"I found it excruciatingly painful,\" says Parmar, a customer care executive in Mumbai, India. \"And yet, I was wracked by guilt that I couldn't even do this basic thing for my child.\"\u003C\u002Fp\u003E\n\u003Cp\u003EEveryone around her was dismissive of the problem, suggesting it was natural for new mothers to face some breastfeeding issues. Her pediatrician suggested she switch to formula. Instead, she put up with the pain and kept up with the feeding routine as best as she could. But as time passed, Parmar realised something was wrong. At parties, her son could never play with the other kids, because he was always the last to finish his meal. At home, mealtimes were draining. Janav lingered over his food, taking up to two hours to finish.\u003C\u002Fp\u003E\n\u003Cp\u003E\"At first, I thought he was a sluggish eater,\" says Parmar. \"Even his walking was slow and unsteady. And he just couldn't balance on a bike.\" Rushing him only created more stress. Eventually, she pureed his meals, as he couldn't chew and swallow most foods. He was constantly exhausted.\u003C\u002Fp\u003E\n\u003Cp\u003EIn 2019, when Janav was eight years old, the mystery was finally solved: he was diagnosed with a severe case of ankyloglossia, also known as tongue-tie, a genetic condition now gaining attention from medical experts and families around the world.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"infographic","imageAlignment":"centre","imageOrientation":"landscape","pullQuoteImageAlignment":"centre","videoImageAlign":"centre","id":"future\u002Farticle\u002F20220322-how-dangerous-is-tongue-tie-0"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0bwv526"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220322-how-dangerous-is-tongue-tie-1"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EIn babies born with tongue-tie, the thin strip of tissue that connects the underside of the tongue to the mouth is unusually tight. This means that instead of resting on the roof of the mouth, the tongue is tied to the floor of the mouth, which can prevent the babies from feeding properly.\u003C\u002Fp\u003E\n\u003Cp\u003EThe condition is thought to be genetic, and has been \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F19707023\u002F\"\u003Eknown for millennia\u003C\u002Fa\u003E, but can be hard to diagnose. In the United States, \u003Ca href=\"https:\u002F\u002Fwww.nature.com\u002Farticles\u002Fs41390-020-01239-y\"\u003Eabout 8% of children under one-year-old\u003C\u002Fa\u003E suffer from it, according to a review published in 2020.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220322-how-dangerous-is-tongue-tie-2"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"In some countries, tongue-tie cases have increased 10-fold","id":"future\u002Farticle\u002F20220322-how-dangerous-is-tongue-tie-3"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EExperts say that awareness of it has been rising around the world in recent years, and some countries have seen a \u003Ca href=\"https:\u002F\u002Fonlinelibrary.wiley.com\u002Fdoi\u002F10.1111\u002Fapa.14242\"\u003Emore than 10-fold increase in diagnosed cases\u003C\u002Fa\u003E. In the US, both \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F28168891\u002F\"\u003Ethe number of tongue-tie diagnoses, and tongue-tie surgeries, have soared\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003EHowever, there are still families like Parmar's suffering through years of pain and stress caused by undiagnosed tongue-tie. In developing countries like India, healthcare providers may focus on fighting more immediate threats to babies' health, such as infections, and as a consequence, leave tongue-tie unnoticed and untreated for years. Even in countries where the condition is more frequently diagnosed, it can be overlooked.\u003C\u002Fp\u003E\n\u003Cp\u003ESome years ago, Kate Canavan, a mother-of-two living in Raleigh, North Carolina, noticed her younger daughter Anna's speech was not very clear. Anna was only two years old at the time, Canavan had not had any breastfeeding issues, and her pediatrician told her not to worry about it. It wasn't until Anna was four that another pediatrician said something could be amiss and referred them to a speech therapist.\u003C\u002Fp\u003E\n\u003Cp\u003E\"The speech therapist told us that she had a lip-and-tongue-tie and if those weren't addressed, the speech therapy really wouldn't be very effective because her mouth anatomy was limiting her articulation,\" says Canavan, meaning, her daughter couldn't move her lips and tongue freely enough to speak clearly.\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003ETrapped\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EThe first signs of tongue-tie can be problems and pain during breastfeeding, as in the case of Parmar and her baby son.\u003C\u002Fp\u003E\n\u003Cp\u003E\"Children with tongue-tie can't extend their tongues beyond the tip of their lips. This results in ineffective latching, sucking and swallowing, all actions that are so essential for breastfeeding,\" says Ju-Lee Oei, a senior neonatologist at the Royal Hospital for Women in Randwick, Australia.\u003C\u002Fp\u003E\n\u003Cp\u003EAs the baby tries to move the trapped tongue and clamps down on the breast to try and feed, the result can be extremely painful for the mother.\u003C\u002Fp\u003E\n\u003Cp\u003EFor others, like Canavan's daughter, the problems emerge later.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220322-how-dangerous-is-tongue-tie-4"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0bwv3sv"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220322-how-dangerous-is-tongue-tie-5"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003E\"Many children with tongue-tie will not have symptoms,\" says Amulya K Saxena, a consultant pediatric surgeon at Chelsea Children's Hospital, Chelsea and Westminster Foundation Trust and president of the European Association of Pediatric Surgeons, in an interview over email.\u003C\u002Fp\u003E\n\u003Cp\u003EThe tethering of the tongue itself can be hard to spot. The lingual frenulum is a strip of tissue extending from the back of the mouth to the midline of the tongue. If this tissue is restrictive, the tip of the tongue can't extend beyond the lips, the tongue-tie can be quite evident. However, there is a more hidden kind of tongue tie, located deeper in the mouth, which requires a health professional to detect and diagnose, Saxena says.\u003C\u002Fp\u003E\n\u003Cp\u003EChildren living with tongue-tie may find it hard to use their tongue freely, be it to play a wind instrument, lick their lips or an ice cream, or use their tongue to help clean their teeth during the day. \"In some children, it may cause cuts under the tongue if the lingual frenulum gets trapped between the lower incisor teeth,\" Saxena says.\u003C\u002Fp\u003E\n\u003Cp\u003EThe tongue's awkward position, and weaker tongue muscle as a result of the lack of movement, can cause problems beyond the mouth.\u003C\u002Fp\u003E\n\u003Cp\u003E\"One of the biggest issues with tongue-tie is that the air-pressure balance in the mouth is affected, and this can cause nasal breathing that disrupts sleep,\" says Ankita Shah, a pediatric dentist and director of the Tongue Tie and Sleep Institute in Mumbai, who diagnosed Parmar's son's case.\u003C\u002Fp\u003E\n\u003Cp\u003EChildren with tongue-tie often contend with open-mouth breathing and snoring, she says, which affects the quality of their sleep. They wake up frequently with a congested nose, and tend to clench or grind their teeth while asleep, leading to neck and shoulder stiffness, and headaches. The constant discomfort, even if quite subtle, can affect their posture and overall wellbeing.\u003C\u002Fp\u003E\n\u003Cp\u003E\"We don't realise how much the alignment of the teeth, tongue and the jaw can influence an entire range of body functions,\" says Shah.\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003EA quick fix?\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EIn milder cases, the problem may resolve itself, says Saxena, the London-based surgeon. The connecting strip stretches as the baby feeds and moves her tongue, and over time, the tongue is less restricted. Advice on the right breastfeeding technique, massaging the frenulum, and exercising the tongue can all help resolve such mild cases, in his view. But if that doesn't work, or if the tongue-tie makes breastfeeding very difficult, he recommends the release procedure. This involves a small cut into the frenulum to help release the tongue.\u003C\u002Fp\u003E\n\u003Cp\u003EHowever, all of these problems – struggling with feeding, eating, breathing, sleeping and speaking – can have other causes. And while in countries like India tongue-tie may be under-diagnosed, some doctors in other countries see a risk of over-diagnosing it.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220322-how-dangerous-is-tongue-tie-6"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"We went from 10 cases of tongue-tie a month, to 10 per week - Ju-Lee Oei","id":"future\u002Farticle\u002F20220322-how-dangerous-is-tongue-tie-7"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003E\"In 2017, when we had a huge surge in cases, we decided to look into it,\" says Oei. The Royal Hospital for Women in Randwick, Australia, where she works, records 4,500 births on average each year. Until that year, they usually had only 10 requests for tongue-tie surgery every month. \"We went from 10 a month, to 10 cases per week,\" says Oei.\u003C\u002Fp\u003E\n\u003Cp\u003ECases at other hospitals in the area had risen too, and some practitioners were charging steep rates for the procedure. \"We realised that the surgery was in high demand because it was seen as a quick-fix to correct breastfeeding troubles. However, cutting the frenulum to release the tongue doesn't magically solve all problems,\" she says.  \u003C\u002Fp\u003E\n\u003Cp\u003EThe results of their global study, published in 2018, noted that the diagnosis of tongue-tie had risen more than 10-fold in some countries, \u003Ca href=\"https:\u002F\u002Fonlinelibrary.wiley.com\u002Fdoi\u002F10.1111\u002Fapa.14242\"\u003Evaried considerably around the world\u003C\u002Fa\u003E and that greater efforts to standardise care were needed.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220322-how-dangerous-is-tongue-tie-8"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0bwv5vl"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220322-how-dangerous-is-tongue-tie-9"},{"bodyHtml":{"assets":[]},"calloutBodyHtml":"\u003Cp\u003EThis article is part of \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Ffamily-tree\"\u003E\u003Cstrong\u003EFamily Tree\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E, a series of features from the BBC that explore the issues and opportunities that parents, children and families face all over the world. You might also be interested in some other stories about babies' health and development:\u003C\u002Fp\u003E\n\u003Cul\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20220131-the-science-of-safe-and-healthy-baby-sleep\"\u003E\u003Cspan\u003EThe science of healthy baby sleep\u003C\u002Fspan\u003E\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20210913-the-little-known-virus-that-surged-in-children-this-summer\"\u003E\u003Cspan\u003EHow Covid boosted a kids' virus\u003C\u002Fspan\u003E\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20210923-the-surprising-benefits-of-baby-massage\"\u003E\u003Cspan\u003EThe surprising benefits of baby massage\u003C\u002Fspan\u003E\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003C\u002Ful\u003E\n\u003Cp\u003EYou can also climb new branches of the Family Tree on \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fworklife\u002Ffamily-tree\"\u003E\u003Cstrong\u003E\u003Cspan\u003EBBC Worklife\u003C\u002Fspan\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E and BBC Culture – and check out this playlist on changing families by \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Freel\u002Fplaylist\u002Fthe-next-generation\"\u003E\u003Cspan\u003EBBC Reel\u003C\u002Fspan\u003E\u003C\u002Fa\u003E.\u003C\u002Fp\u003E","calloutTitle":"Family Tree","cardType":"CalloutBox","iFrameType":"","id":"future\u002Farticle\u002F20220322-how-dangerous-is-tongue-tie-10"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003ESince then, the guidelines at their hospital have changed, says Oei. Every child struggling to breastfeed because of suspected tongue-tie must now be assessed by a breastfeeding consultant. Surgery is recommended only after two-to-four weeks of trying to solve the breastfeeding issues with the consultant's support.\u003C\u002Fp\u003E\n\u003Cp\u003EAs Oei and her colleagues note in their research paper, even the relatively simple surgery used for tongue-tie should not be carried out lightly, as \"subjecting infants to a surgical procedure, no matter how minor, causes pain, stress, possibly longer-term neurological harm\".\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003ESurgery and 'tongue yoga'\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003ESaxena, the pediatric surgeon in London, has noticed that families are growing more aware of tongue-tie. \"Patient support groups and professional bodies are now offering information on social media,\" she says.\u003C\u002Fp\u003E\n\u003Cp\u003EIn India, Shah has also observed a rise in the number of families seeking help, including those with older children. But she, too, advises against resorting to surgery too quickly.\u003C\u002Fp\u003E\n\u003Cp\u003EOut of 10 patients who walk into her clinic, roughly only half will need surgery, says Shah. It depends on the severity of the tongue-tie, and its impact on the body, including the airways. \"We evaluate the varying symptoms each patient has with this condition, and we ask ourselves if the problem is only because of the tongue-tie? We try to correct other associated problems first before opting for surgery.\"\u003C\u002Fp\u003E\n\u003Cp\u003EWhile older children may need general anaesthesia, cases in younger children tend to be treated with local anaesthesia, Shah says. In the case of newborns, anaesthesia isn't used at all, as the risks would outweigh the benefits.\u003C\u002Fp\u003E\n\u003Cp\u003EHowever, surgery is not the end of the treatment, says Carmelle Gentle, an independent midwife and breastfeeding consultant based in London. Gentle, who has set up a donation-based tongue-tie centre in South London, recommends that parents help the baby use and strengthen their tongue after the snip, through various exercises.\u003C\u002Fp\u003E\n\u003Cp\u003E\"We support babies to use their tongue in a new way,\" she says. \"It's a bit like yoga. You may not be able to touch your toes at the beginning of the session, but regular, gentle practice helps you get there.\" \u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220322-how-dangerous-is-tongue-tie-11"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"I was just so relieved that there was a name for what we were going through – Purna Parmar","id":"future\u002Farticle\u002F20220322-how-dangerous-is-tongue-tie-12"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EFor some, the growing awareness – and right diagnosis – can be life-changing.\u003C\u002Fp\u003E\n\u003Cp\u003EKate Canavan's daughter, Anna, was helped by surgery. \"Because her frenulum was so thick and muscular, and she was so young, the speech therapist and an [ear, nose and throat specialist] recommended that the procedure be done with a surgical scissors and under general anaesthesia. That way, they would be careful to not damage surrounding tissue while releasing the tongue,\" says Canavan over email.\u003C\u002Fp\u003E\n\u003Cp\u003EAfter the 15-minute procedure, Anna didn't need any pain medication and was able to eat and drink without any problems. She even went to pre-school the next day. Within a month of surgery, her speech improved dramatically.\u003C\u002Fp\u003E\n\u003Cp\u003EPurna Parmar in Mumbai, whose son had suffered from tongue-tie for so many years, burst into tears when her doctor told her about the condition: \"I was just so relieved that there was a name for what we were going through.\"\u003C\u002Fp\u003E\n\u003Cp\u003EIt then took her two years to convince her family that an operation was necessary, but it was worth it, she says. He had the surgery, and it helped. Today, Janav enjoys experimenting with different foods, can finish his meal in 20 minutes – and is then off to ride his bike. \u003C\u002Fp\u003E\n\u003Cp\u003E--\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EJoin one million Future fans by liking us on \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.facebook.com\u002FBBCFuture\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EFacebook\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, or follow us on \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Ftwitter.com\u002FBBC_Future\"\u003E\u003Cstrong\u003E\u003Cem\u003ETwitter\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E or \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.instagram.com\u002Fbbcfuture_official\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EInstagram\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E.\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EIf you liked this story, \u003C\u002Fem\u003E\u003Ca href=\"http:\u002F\u002Fpages.emails.bbc.com\u002Fsubscribe\u002F?ocid=fut.bbc.email.we.email-signup\"\u003E\u003Cstrong\u003E\u003Cem\u003Esign up for the weekly bbc.com features newsletter\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, called \"The Essential List\" – a handpicked selection of stories from BBC \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EFuture\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fculture\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003ECulture\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fworklife\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EWorklife\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ftravel\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003ETravel\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E \u003Cem\u003Eand \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Freel\"\u003E\u003Cstrong\u003E\u003Cem\u003EReel\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E delivered to your inbox every Friday.\u003C\u002Fem\u003E\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220322-how-dangerous-is-tongue-tie-13"}],"collection":["future\u002Fpremium-collection\u002Ffamily-tree"],"disableAdverts":false,"displayDate":"2022-04-13T11:52:17Z","embeddedCustomHtml":"","embeddedInfographicUrl":"","embeddedType":"infographic","headlineLong":"How dangerous is tongue-tie?","headlineShort":"How dangerous is tongue-tie?","image":["p0bwv48p"],"imageAlignment":"centre","imageAltText":"","isSyndicated":true,"latitude":"","longitude":"","mpsVideo":"","option":[{"Content":{"Description":"Apple News Publish: Select to publish, remove to unpublish. (Do not just delete or unpublish the story)","Name":"publish-applenews-system-1"},"Metadata":{"CreationDateTime":"2016-02-05T14:32:31.186819Z","Entity":"option","Guid":"13f4bc85-ae27-4a34-9397-0e6ad3619619","Id":"option\u002Fpublish-applenews-system-1","ModifiedDateTime":"2022-02-27T22:52:24.455144Z","Project":"wwverticals","Slug":"option\u002Fpublish-applenews-system-1"},"Urn":"urn:pubpipe:wwverticals:option:option\u002Fpublish-applenews-system-1","_id":"62b420921f4b7b5d34253c8b"}],"partner":null,"primaryVertical":"future","promoAlignment":"centre","promoAltText":"","promoImage":null,"relatedStories":null,"relatedTag":null,"summaryLong":"Awareness of tongue-tie, and its hidden impact on children's health, is rising around the world. Here's how it can be spotted and fixed.","summaryShort":"Cases are soaring in some places, presenting doctors with a puzzle.","tag":["tag\u002Fhealth"],"textToSpeech":false,"creationDateTime":"2022-04-13T00:00:11.710733Z","entity":"article","guid":"3489ec23-2108-437e-8552-e6e80e2e96a9","id":"future\u002Farticle\u002F20220322-how-dangerous-is-tongue-tie","modifiedDateTime":"2022-04-13T10:18:01.273072Z","project":"wwverticals","slug":"future\u002Farticle\u002F20220322-how-dangerous-is-tongue-tie","cacheLastUpdated":1657756319030},"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies":{"urn":"urn:pubpipe:wwverticals:article:future\u002Farticle\u002F20220322-how-sleep-training-affects-babies","_id":"62b41ff81f4b7b052460db1b","ambientVideo":"","articleType":"story","assetVideo":null,"author":["future\u002Fauthor\u002Famanda-ruggeri"],"bodyIntro":"Some parents see \"sleep training\" as the key to a good night's rest. Others argue that it's distressing for babies. What do scientists say about its risks and benefits?","businessUnit":"worldwide","cards":[{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EIn 2015, Wendy Hall, a paediatric sleep researcher based in Canada, studied 235 families of six- to eight-month-old babies. The purpose: to see if sleep training worked.\u003C\u002Fp\u003E\n\u003Cp\u003EBy its broadest definition, sleep training can refer to any strategy used by parents to encourage their babies to sleep at night – which can be as simple as implementing a nighttime routine or knowing how to read an infant's tiredness cues. Tips like these were an important part of Hall's intervention.\u003C\u002Fp\u003E\n\u003Cp\u003ESo was a strategy that has become commonly associated with \"sleep training\" and tends to be far more divisive: encouraging babies to put themselves to sleep without their parents' help, including when they wake up at night, by limiting or changing a parent's response to their child. This may mean a parent is present, but refrains from picking up or nursing the baby to physically soothe them. It can involve set time intervals where a baby is left alone, punctuated by parent check-ins. Or, in the cold-turkey approach, it may mean leaving the baby and shutting the door. Any of these approaches often mean letting the baby cry – hence the common, if increasingly unpopular, moniker \"cry-it-out\".\u003C\u002Fp\u003E\n\u003Cp\u003EIn global terms, the idea of \"training\" babies to \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20220131-the-science-of-safe-and-healthy-baby-sleep\"\u003Esleep alone and unaided is uncommon\u003C\u002Fa\u003E. Modern Mayan mothers, for example, \u003Ca href=\"http:\u002F\u002Flocal.psy.miami.edu\u002Ffaculty\u002Fdmessinger\u002Fc_c\u002Frsrcs\u002Frdgs\u002Femot\u002Fmorelli%20cosleep.dp92.pdf\"\u003Eexpressed shock\u003C\u002Fa\u003E when they heard that in the US, babies were put to sleep in a separate room. But in North America, Australia and parts of Europe, many families swear by some form of the technique. Parents can be especially willing to give it a shot \u003Ca href=\"https:\u002F\u002Fwww.newyorker.com\u002Fmagazine\u002F2021\u002F06\u002F28\u002Fthe-promise-and-the-peril-of-a-high-priced-sleep-trainer\"\u003Ewhen broken nights begin to affect the entire family's wellbeing\u003C\u002Fa\u003E – poor baby sleep is associated with \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC2083609\u002F\"\u003Ematernal depression and poor maternal health\u003C\u002Fa\u003E, for example. In the US, \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F17252893\u002F\"\u003Emore than six in 10 parenting advice books\u003C\u002Fa\u003E endorse some form of \"cry-it-out\". \u003Ca href=\"https:\u002F\u002Fwww.tandfonline.com\u002Fdoi\u002Ffull\u002F10.1080\u002F02646838.2014.910864\"\u003EHalf of parents who responded to questionnaires in Canada\u003C\u002Fa\u003E and Australia and \u003Ca href=\"https:\u002F\u002Fkops.uni-konstanz.de\u002Fbitstream\u002Fhandle\u002F123456789\u002F41944\u002FMaute_2-17r51ejpj7y349.pdf;jsessionid=2CFFBB6D0B291BB6BF7E2D8AAB4E4480?sequence=1\"\u003Eone-third of parents surveyed in Switzerland and Germany\u003C\u002Fa\u003E said they've tried it (although the surveys are not necessarily representative of parents as a whole in these countries, due to the way they were conducted). Around the world, an \u003Ca href=\"https:\u002F\u002Fwww.marketplace.org\u002F2017\u002F01\u002F16\u002Fsleeping-baby-325-million-industry\u002F\"\u003Eentire industry\u003C\u002Fa\u003E is devoted to helping parents sleep train.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-0"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0by4bv5"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-1"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EIn their study, Hall and her team predicted that the babies whose parents were given instructions for sleep training along with advice would sleep better after six weeks than those who were not, with \"significantly longer longest sleep periods and significantly fewer night wakes\".\u003C\u002Fp\u003E\n\u003Cp\u003EThis would be in line with existing findings. Dozens of studies say they have found sleep interventions effective; paediatricians routinely recommend sleep training in countries like the \u003Ca href=\"https:\u002F\u002Fwww.healthychildren.org\u002FEnglish\u002Fages-stages\u002Fbaby\u002Fsleep\u002FPages\u002Fgetting-your-baby-to-sleep.aspx\"\u003EUnited States\u003C\u002Fa\u003E and \u003Ca href=\"https:\u002F\u002Fwww.sciencedirect.com\u002Fscience\u002Farticle\u002Fabs\u002Fpii\u002FS1389945721001349\"\u003EAustralia\u003C\u002Fa\u003E (although infant mental health professionals often \u003Ca href=\"https:\u002F\u002Fwww.aaimhi.org\u002Fkey-issues\u002Fposition-statements-and-guidelines\u002FAAIMHI-Position-paper-1-Controlled-crying.pdf\"\u003Edo not\u003C\u002Fa\u003E). However, research is never perfect, and many of those prior studies \u003Ca href=\"https:\u002F\u002Fwww.basisonline.org.uk\u002Fhcp-limitations-of-sleep-training-research\u002F\"\u003Ehad attracted some criticism\u003C\u002Fa\u003E – which Hall was hoping to address.\u003C\u002Fp\u003E\n\u003Cp\u003EFor one, \u003Ca href=\"https:\u002F\u002Faasm.org\u002Fresources\u002Fpracticeparameters\u002Freview_nightwakingschildren.pdf\"\u003Erelatively few studies\u003C\u002Fa\u003E on sleep training \u003Ca href=\"https:\u002F\u002Fonlinelibrary.wiley.com\u002Fdoi\u002Ffull\u002F10.1111\u002Fapa.15182\"\u003Ehave met the gold standard\u003C\u002Fa\u003E of scientific research: trials where participants are randomly allocated to receiving the intervention, that have a control group that did not receive the intervention (especially important with sleep research, since \u003Ca href=\"https:\u002F\u002Fsci-hub.wf\u002F10.1111\u002Fj.1469-7610.1995.tb01821.x\"\u003Emost babies naturally sleep in longer stretches\u003C\u002Fa\u003E \u003Ca href=\"https:\u002F\u002Fwww.sciencedirect.com\u002Fscience\u002Farticle\u002Fabs\u002Fpii\u002FS1389945720300381?via%3Dihub\"\u003Eover time\u003C\u002Fa\u003E), and that have enough participants to detect effects.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-2"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"Relatively few studies on sleep training have met the gold standard of scientific research","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-3"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EA number of studies, for example, have been non-randomised, with parents deciding on the method of treatment themselves. This makes it hard to prove cause and effect. For example, parents who have reason to think their babies will only cry for a short while (or not at all), then fall asleep, may be more open to trying out controlled crying to begin with – which could skew results to make it seem more effective than it is. Alternately, it could be parents whose babies really struggle to fall asleep by themselves that are more drawn to the method, making it look \u003Cem\u003Eless \u003C\u002Fem\u003Eeffective than it is. And, of course, the difficulty of studying something like sleep training is that even in a randomised trial, parents assigned a controlled crying method may decide against it – so a \"perfect\" study is impossible to set up. Many trials often have high drop-out rates, meaning parents who found sleep training especially difficult may not have their experiences reflected in the results.\u003C\u002Fp\u003E\n\u003Cp\u003EMeanwhile, the majority of studies rely on \"parent report\", such as questionnaire responses or sleep diaries kept by the parents, rather than using an objective measure to determine when a baby is awake or asleep. But if a child has learned not to cry when he wakes, then his parents might not wake, either – which could lead them to report that their child slept through the night \u003Ca href=\"https:\u002F\u002Facademic.oup.com\u002Fsleep\u002Farticle\u002F42\u002F1\u002Fzsy191\u002F5115272\"\u003Eregardless of what happened\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003EThere is also the problem of \u003Ca href=\"https:\u002F\u002Fwww.verywellmind.com\u002Fcognitive-biases-distort-thinking-2794763\"\u003Econfirmation bias\u003C\u002Fa\u003E: if parents expect an intervention to help their child's sleep, then they may be more likely to see that child's sleep as having improved after an intervention.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-4"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0by4c4d"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-5"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003E\u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC4643535\u002F\"\u003EHall's study – involving 235 babies and their parents – was designed to respond to some of these criticisms\u003C\u002Fa\u003E. As a randomised controlled trial, half of the parents were instructed in what's called either \"graduated extinction\", \"controlled comforting\" or \"controlled crying\": soothing a crying baby for short increments, then leaving them for the same amount of time, with intervals gradually getting longer regardless of the child's response. For parents who were \"really uncomfortable\" leaving their child crying alone in the room, Hall says, the researchers advised staying in the room – but not picking the child up – in an approach called \"camping out\".\u003C\u002Fp\u003E\n\u003Cp\u003EThe intervention group also received tips and information about infant sleep, such as myth-busting the idea that fewer naps would lead to more nighttime sleep. (It's worth noting that this mix of a controlled crying method with other advice \u003Ca href=\"https:\u002F\u002Fwww.basisonline.org.uk\u002Fhcp-limitations-of-sleep-training-research\u002F\"\u003Eis common in studies examining sleep training\u003C\u002Fa\u003E, but makes it more difficult to parse which, if any, results are from the controlled crying alone.) To ensure both groups received some kind of instruction, the control group parents received information about infant safety.\u003C\u002Fp\u003E\n\u003Cp\u003EAs well as asking parents to record sleep diaries, Hall's study included \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC3109647\u002F\"\u003Eactigraphy\u003C\u002Fa\u003E, which uses wearable devices to monitor movements to assess sleep-wake patterns.\u003C\u002Fp\u003E\n\u003Cp\u003EWhen the researchers compared sleep diaries, they found that parents who had sleep-trained thought their babies woke less at night and slept for longer periods. But when they analysed the sleep-wake patterns as shown through actigraphy, they found something else: the sleep-trained infants were waking up just as often as the ones in the control group. \"At six weeks, there was no difference between the intervention and control groups for mean change in actigraphic wakes or long wake episodes,\" they wrote.\u003C\u002Fp\u003E\n\u003Cp\u003EIn other words, parents who sleep-trained their babies \u003Cem\u003Ethought\u003C\u002Fem\u003E their babies were waking less. But, according to the objective sleep measure, the infants were waking just as often – they just weren't waking up their parents.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-6"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"We weren't saying that the kids wouldn't wake. We were saying that they would wake, but they wouldn't have to signal their parents – Wendy Hall","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-7"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003ETo Hall, this shows the intervention was a success. \"What we were trying to do was help the parents to teach the kids to self-soothe,\" she says. \"So in effect, we weren't saying that they wouldn't wake. We were saying that they would wake, but they wouldn't have to signal their parents. They could go back down into the next sleep cycle.\"\u003C\u002Fp\u003E\n\u003Cp\u003EThe actigraphy did find that sleep training improved one measure of the babies' sleep: their longest sleep period. That was an improvement of 8.5%, with sleep-trained infants sleeping a 204-minute stretch compared to 188 minutes for the other babies.\u003C\u002Fp\u003E\n\u003Cp\u003EAnother part of her hypothesis also proved correct. Her team expected that parents who did the intervention would report having better moods, higher-quality sleep and less fatigue. In a finding that won't surprise anyone who has rocked or nursed an infant to sleep several times a night, this proved to be true – and, for many experts and parents, is a key upside of sleep training.\u003C\u002Fp\u003E\n\u003Cp\u003EBut for anyone who has ever read, Googled, or been served social media ads about infant sleep, the fact that sleep training researchers believe training isn't meant to reduce the number of times a baby wakes – and that it might extend their longest sleep stretch by an average of just 16 minutes – might come as a surprise. \u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003EThe origins of \"cry it out\"\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003ESleep training is a relatively new phenomenon, even in countries where it is now quite common. As BBC Future \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20220131-the-science-of-safe-and-healthy-baby-sleep\"\u003Ehas covered before\u003C\u002Fa\u003E, before the 19th Century, new parents didn't seem to be particularly concerned about their infants' sleep. \u003Ca href=\"https:\u002F\u002Fjournals.sagepub.com\u002Fdoi\u002Fabs\u002F10.1177\u002F0192513X20949891\"\u003EThis changed as the Industrial Revolution brought longer work days\u003C\u002Fa\u003E and as the Victorian era emphasised independence, even among babies.\u003C\u002Fp\u003E\n\u003Cp\u003EIn 1892, the \"father of paediatrics\", Emmett Holt, went so far as to argue that crying alone was good for children: \"in the newly born infant, the cry expands the lungs\", he wrote in his popular parenting manual \u003Ca href=\"https:\u002F\u002Fwww.gutenberg.org\u002Ffiles\u002F15484\u002F15484-h\u002F15484-h.htm\"\u003EThe Care and Feeding of Children\u003C\u002Fa\u003E. A baby \"should simply be allowed to 'cry it out'. This often requires an hour, and in extreme cases, two or three hours. A second struggle will seldom last more than 10 or 15 minutes and a third will rarely be necessary.\"\u003C\u002Fp\u003E\n\u003Cp\u003EIt wasn't until the 1980s, however, that the first official cry-it-out \"programmes\" were introduced. In 1985, Richard Ferber advocated what he called the \"controlled crying\" or \"graduated extinction\" method, letting a child cry for longer and longer periods. (He later said he'd been misunderstood and, contrary to popular belief, that he \u003Ca href=\"https:\u002F\u002Fwww.npr.org\u002Ftemplates\u002Fstory\u002Fstory.php?storyId=5439359&t=1646393189891\"\u003Ewouldn't suggest this approach\u003C\u002Fa\u003E for every child that doesn't sleep well.) In 1987, Marc Weissbluth advised simply putting the infant in his crib and closing the door – dubbed \"unmodified extinction\".\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-8"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0by4cjv"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-9"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EWith some variations, these are largely the versions of sleep training that have persisted, with \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F17252893\u002F\"\u003Eone 2006 study of 40 popular parenting books finding that twice as many promoted cry-it-out as opposed it\u003C\u002Fa\u003E. Some books suggest following some form of controlled crying even for newborns.\u003C\u002Fp\u003E\n\u003Cp\u003EIt's worth noting that even researchers who advocate for sleep interventions, including Hall, think starting so young – any time before six months old, in fact – is a mistake. They also say they would not recommend sleep training for children who could be more prone to psychological damage, including babies who have experienced trauma or been in foster care, or babies with an anxious or sensitive temperament. (Breastfeeding mothers have an additional reason to wait until six months to sleep train, say lactation experts, since early night-weaning may reduce supply.)\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F24042081\u002F\"\u003ESleep training strategies for babies under six months old are unlikely to work\u003C\u002Fa\u003E in any case, researchers have found. \"The belief that behavioural intervention for sleep in the first six months of life improves outcomes for mothers and babies is historically constructed, overlooks feeding problems, and biases interpretation of data,\" one review of 20 years' worth of relevant studies put it. \"These strategies have not been shown to decrease infant crying, prevent sleep and behavioural problems in later childhood, or protect against postnatal depression.\"\u003C\u002Fp\u003E\n\u003Cp\u003EIn addition, the researchers wrote, these strategies risk \"unintended outcomes\" – including increased crying, an early stop to breastfeeding, worsened maternal anxiety, and, if the infant is required to sleep either day or night in a separate room, an increased risk of Sudden Infant Death Syndrome (SIDS).\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-10"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"No one should ever do that to a three-month-old. They don't have object permanence, they don't know that if you're not in the room you haven't disappeared from the planet. It's psychologically damaging – Hall","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-11"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EHall once received a telephone call from a concerned grandmother, she says, saying that her son and his wife had taken their three-month-old to a sleep trainer. \"The sleep trainer had been basically really hard line, and this kid was now seven months old and was having huge attachment issues,\" Hall says. \"I just wrote her back and said, no one should ever do that to a three-month-old. They don't have object permanence, they don't know that if you're not in the room you haven't disappeared from the planet. It's psychologically damaging.\u003C\u002Fp\u003E\n\u003Cp\u003E\"And this is the problem with having a lot of people out there who just put up a shingle and start working with parents and telling them what they should or shouldn't do, without an understanding of what they're potentially doing to these babies.\"\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-12"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"infographic","image":["p0by4f0v"],"imageAlignment":"centre","imageOrientation":"landscape","pullQuoteImageAlignment":"centre","videoImageAlign":"centre","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-13"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EOlder babies' reactions can vary. For some, tears are brief or \u003Ca href=\"https:\u002F\u002Fdrcraigcanapari.com\u002Fnice-sleep-training-success-story\u002F\"\u003Enon-existent\u003C\u002Fa\u003E. For others, it can be \u003Ca href=\"https:\u002F\u002Fcommunity.whattoexpect.com\u002Fforums\u002Fsleep-training-1\u002Ftopic\u002Fferberstill-crying-for-2-hours-74997541.html\"\u003Ehours of crying\u003C\u002Fa\u003E, even to the point of vomiting (common enough to be a frequent \u003Ca href=\"https:\u002F\u002Fwww.reddit.com\u002Fr\u002Fsleeptrain\u002Fcomments\u002Ftiagi4\u002Fhelp_baby_shaking_and_vomited_during_ferber\u002F\"\u003Etopic of conversation\u003C\u002Fa\u003E on sleep-training forums and addressed by baby sleep books including Ferber's). And while methods like camping out – where parents stay in the room but don't pick up, nurse or cuddle the baby – often are considered gentler, they \u003Ca href=\"https:\u002F\u002Fwww.reddit.com\u002Fr\u002Fsleeptrain\u002Fcomments\u002F9r1no3\u002Fcamping_out_vs_cio_for_8_month_old\u002F\"\u003Ecan upset and confuse some babies more than harder-line strategies\u003C\u002Fa\u003E and tend to take longer.\u003C\u002Fp\u003E\n\u003Cp\u003EEither way, many parents feel sleep training is a necessary rite of passage – not only to get a good night's sleep themselves, but because they're told that their babies will sleep better, longer and more deeply, and that they need this to thrive. This refrain is especially common in the world of sleep coaching, an unregulated industry where \u003Ca href=\"https:\u002F\u002Fwww.wsj.com\u002Farticles\u002Fthe-coaches-parents-call-when-the-baby-wont-sleep-1535463081#:~:text=Some%20are%20turning%20to%20a,to%20sleep%20on%20their%20own.\"\u003Econsultation fees can be hundreds of dollars\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003EBut that's \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20220131-the-science-of-safe-and-healthy-baby-sleep\"\u003Enot quite what the research shows\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003E \u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-14"},{"bodyHtml":{"assets":[]},"calloutBodyHtml":"\u003Cp\u003E\u003Cem\u003EThis article is the second part of a two-part special Family Tree report by Amanda Ruggeri on safe and healthy baby sleep. Read the \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20220131-the-science-of-safe-and-healthy-baby-sleep\"\u003Efirst part here, on the biggest myths of baby sleep\u003C\u002Fa\u003E.\u003C\u002Fem\u003E\u003C\u002Fp\u003E","cardType":"CalloutBox","iFrameType":"","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-15"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003E\u003Cstrong\u003ECrying it out – but still waking up\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EOne of the few long-term studies done on sleep training, for example, \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC2083609\u002F\" target=\"_blank\"\u003Ecompared eight-month-old babies who were trained using controlled crying (waiting longer and longer before responding to cries), or camping out\u003C\u002Fa\u003E (sitting with the baby until they fall asleep without picking them up, and gradually moving further and further away), versus continuing to respond to their babies as normal. All of the babies in the trial, conducted in Australia, were described by their mothers as having sleep problems.\u003C\u002Fp\u003E\n\u003Cp\u003EIn questionnaires they filled out, some of the mothers did report that sleep training helped their babies in the short term. But not all. Eighty-four percent of those who used controlled crying, and 49% of those who used camping out, said those approaches were helpful. (It's also worth noting that the intervention that the most mothers rated highest was very different: \"having someone to talk to\", seen as helpful by 95%.)\u003C\u002Fp\u003E\n\u003Cp\u003EAnd for those who did find a form of sleep training helpful, effects didn't necessarily last. Two months after the intervention, when the babies were 10 months old, 56% of sleep-training and 68% of the other mothers reported that their babies still had sleep problems. When the infants were 12 months, 39% of sleep-training versus 55% of the other mothers did.\u003C\u002Fp\u003E\n\u003Cp\u003EThis doesn't just mean that sleep training may not work for every baby. It also means that, for the families which did find sleep training effective, it often needs to be repeated for the effects to last. This is backed up by other research: one Canadian questionnaire found that, on average, \u003Ca href=\"https:\u002F\u002Fwww.tandfonline.com\u002Fdoi\u002Fabs\u002F10.1080\u002F02646838.2014.910864?journalCode=cjri20\"\u003Eparents tried controlled crying between two and five times\u003C\u002Fa\u003E in their baby's first year.\u003C\u002Fp\u003E\n\u003Cp\u003ELonger-term, the Australian study found that any parent-reported improvements in sleep from sleep training \u003Ca href=\"https:\u002F\u002Fpediatrics.aappublications.org\u002Fcontent\u002F122\u002F3\u002Fe621?sso_redirect_count=2\"\u003Edisappeared by age two\u003C\u002Fa\u003E.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-16"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"What we found when the children were six was no difference to their sleep and no difference to their behaviour – Harriet Hiscock","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-17"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EWhen the children were six years old, the \u003Ca href=\"https:\u002F\u002Fwww.researchgate.net\u002Fpublication\u002F230830539_Five-Year_Follow-up_of_Harms_and_Benefits_of_Behavioral_Infant_Sleep_Intervention_Randomized_Trial\"\u003Eresearchers found no difference on any measure\u003C\u002Fa\u003E – negative or positive – between those who were sleep trained and those who weren't, including in their sleep patterns, behaviour, attachment, or cortisol levels.\u003C\u002Fp\u003E\n\u003Cp\u003E\"What we found was no difference to children's sleep, no difference to children's behaviour, and parents were no more harsh, abusive or disengaged from their children,\" says Harriet Hiscock, one of the study's authors and a fellow at Australia's National Health and Medical Research Council.\u003C\u002Fp\u003E\n\u003Cp\u003EThe study's finding that sleep training can reduce sleep problems for some families in the short term, meanwhile, is consistent with a large body of research. One authoritative 2006 \u003Ca href=\"https:\u002F\u002Faasm.org\u002Fresources\u002Fpracticeparameters\u002Freview_nightwakingschildren.pdf\"\u003Ereview of 52 studies\u003C\u002Fa\u003E found that more than 80% of children who received an intervention (including strategies other than cry-it-out methods, like implementing a bedtime routine) demonstrated \"clinically significant improvement that was maintained for three to six months\". \u003C\u002Fp\u003E\n\u003Cp\u003EBut there was no objective sleep measure used in more than 77% of the studies included in the 2006 review – part of the reason why, of the 52 studies reviewed, the researchers considered only 11 of them to have high-quality data. There also was no objective measure used in Hiscock's study. As \u003Ca href=\"https:\u002F\u002Fonlinelibrary.wiley.com\u002Fdoi\u002Ffull\u002F10.1111\u002Fapa.15182\"\u003Eone review of sleep training research\u003C\u002Fa\u003E put it, \"there are weaknesses\" even in many of the randomised controlled trials, \"as many intervention studies have used parental reports, questionnaires and diaries, and not objective measurements such as actigraphy data, as outcomes\".\u003C\u002Fp\u003E\n\u003Cp\u003EResearch conducted with an objective measure such as actigraphy, on the other hand, has found no real difference in sleep between infants that were sleep-trained and those who were not. Hall's study is not the only one. \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F23516146\u002F\"\u003EOne Canadian study of 246 mothers and their newborns found \"no significant differences\"\u003C\u002Fa\u003E in number of wakes or amount of sleep between the infants whose mothers received information on strategies to optimise their babies' sleep, and those who did not. Interestingly, the mothers received this advice slept just six minutes longer than those who did not. A study of 802 families in New Zealand found that, \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F28576897\u002F\"\u003Ethere was \"no significant intervention effect on sleep outcomes\"\u003C\u002Fa\u003E at six months, with night wakes reducing by 8% and sleep duration increasing by six minutes in babies who were left to fall asleep independently, compared to babies who were rocked or fed to sleep.\u003C\u002Fp\u003E\n\u003Cp\u003EAnd one \u003Ca href=\"https:\u002F\u002Fpediatrics.aappublications.org\u002Fcontent\u002F137\u002F6\u002Fe20151486\"\u003Every small study of 43 infants which compared three groups\u003C\u002Fa\u003E – controlled crying, \u003Ca href=\"https:\u002F\u002Fparentingscience.com\u002Fbedtime-fading\u002F\"\u003Ebedtime fading\u003C\u002Fa\u003E (where babies are put to bed so late that they drop off easily, with bedtime then being brought forward gradually), and a control group – was widely reported when it was published as showing sleep training to be successful, with parents in the non-control groups reporting that their babies woke less and slept longer. But, again, that wasn't found with an objective measure. As the study's authors noted, \"no significant sleep changes were found by using objective actigraphy, suggesting sleep diaries and actigraphy measure different phenomena (eg, infants' absence of crying by parents vs infants' movements, respectively), further suggesting infants may still experience wakefulness but do not signal to parents\".\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-18"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"I don't expect sleep-trained babies to wake less frequently. I don't always expect that they're going to sleep more on an objective measure – Jodi Mindell","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-19"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003ESleep researcher Jodi Mindell, associate director of the Sleep Center at the Children's Hospital of Philadelphia and a proponent of sleep training herself, says the reason for this is simple: sleep training's main goal is not to keep babies from waking, or to help them get more sleep. It's to teach them to go back to sleep by themselves, rather than waking their parents.\u003C\u002Fp\u003E\n\u003Cp\u003E\"All babies wake frequently during the night. It's just whether or not they have the skill to fall back to sleep independently,\" she says.\u003C\u002Fp\u003E\n\u003Cp\u003E\"I don't expect babies to wake less frequently. I don't always expect that they're going to sleep more on an objective measure.\" \u003C\u002Fp\u003E\n\u003Cp\u003EThese frequent wakes may be tough on parents, but they play an important role in keeping babies safe and healthy. As we've covered previously, \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20220131-the-science-of-safe-and-healthy-baby-sleep\"\u003Ebabies have evolved to wake frequently for nutrition, caregiving and their own protection\u003C\u002Fa\u003E, including against SIDS.\u003C\u002Fp\u003E\n\u003Cp\u003EEven when done as a randomised controlled trial with an objective measure, meanwhile, sleep training research has other challenges. There is some evidence, for example, that trial participants may feel more pressure to follow through a sleep intervention than they would otherwise, \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F18257788\u002F\"\u003Eraising questions about how applicable these findings are to everyday parents\u003C\u002Fa\u003E – a \u003Ca href=\"https:\u002F\u002Fcatalogofbias.org\u002Fbiases\u002Fhawthorne-effect\u002F\"\u003Ephenomenon that is hardly unique\u003C\u002Fa\u003E to paediatric sleep research.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-20"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0by4lhv"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-21"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003ETake the questionnaire in Canada: \u003Ca href=\"https:\u002F\u002Fwww.researchgate.net\u002Fpublication\u002F263320518_Parental_perceptions_of_the_effectiveness_of_graduated_extinction_in_reducing_infant_night-wakings\"\u003Eonly 14% of parents reported that controlled crying eliminated all night wakings\u003C\u002Fa\u003E, and almost half said it didn't reduce wakings at all – results, the researchers wrote, which indicate \"that parents in the community are experiencing considerably less success with graduated extinction than parents in clinical\u002Fresearch setting\".\u003C\u002Fp\u003E\n\u003Cp\u003EThe discrepancy makes sense, especially if you consider that many of these trials have been run by sleep clinics or their researchers, says Helen Ball, the director of the Durham Infancy and Sleep Centre, professor of anthropology at Durham University and a long-time critic of cry-it-out methods of sleep training. \"The people who run those trials have a particular mindset,\" she says – for example, that sleep training works – which may translate to study participants being more committed to the intervention.\u003C\u002Fp\u003E\n\u003Cp\u003E\"I'm always somewhat sceptical that the data that these studies produce are actually applicable to real life.\"\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003ESoothed or stressed?\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EIf sleep-trained babies are still waking frequently, just not crying or signalling, this points to a different debate at the heart of sleep training. When they wake, are these babies actually learning to calm themselves down from a stressed state (emotionally \"self-regulating\")? Or are they just as stressed and in need of caregiving when they wake, but have simply learned that if they cry, no one will respond?\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-22"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"Don't underestimate the abilities of children to self-regulate. Parents can help them learn to self-regulate by giving them opportunities to self-regulate – Hall","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-23"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EMany sleep training researchers firmly believe the former. \"Don't underestimate the abilities of children to self-regulate,\" says Hall, the paediatric sleep researcher who used actigraphy in \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC4643535\u002F\"\u003Eher study of 235 Canadian families\u003C\u002Fa\u003E. \"Parents can help them learn to self-regulate by giving them opportunities to self-regulate. That's how you can look at self-soothing – it's an opportunity to calm themselves down.\"\u003C\u002Fp\u003E\n\u003Cp\u003EIt's difficult to measure objectively whether babies are truly soothing themselves, or have just given up calling for help.\u003C\u002Fp\u003E\n\u003Cp\u003EOne way could be to measure cortisol, which is often known as the stress hormone. But cortisol rises and falls in response to factors besides stress, and the studies that have measured it have had mixed results. One \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F21945361\u002F\"\u003Efound that the babies' cortisol levels were elevated\u003C\u002Fa\u003E right after a sleep intervention, but there was no control group of un-trained babies to compare it to. \u003Ca href=\"https:\u002F\u002Fpediatrics.aappublications.org\u002Fcontent\u002F137\u002F6\u002Fe20151486\"\u003EThe small study of 43 infants found that cortisol declined\u003C\u002Fa\u003E, but it didn't measure cortisol until a week after the intervention. And in an attempt to find out whether sleep training led to elevated stress levels long-term, a third study, Hiscock's longitudinal study in Australia, \u003Ca href=\"https:\u002F\u002Fpediatrics.aappublications.org\u002Fcontent\u002F130\u002F4\u002F643\u002Ftab-e-letters\"\u003Etook cortisol samples five years later\u003C\u002Fa\u003E and found no difference between the cohorts.\u003C\u002Fp\u003E\n\u003Cp\u003E\"I personally have an issue with the cortisol studies,\" says Mindell. \"Cortisol changes throughout the day. Even sampling cortisol is very difficult. It's based on many things, including how many hours a person has been awake, how it's sampled – it's a complicated thing. People often think 'oh, if we measure cortisol, we'll know if the baby's stressed or not stressed'.\"\u003C\u002Fp\u003E\n\u003Cp\u003EEven the term \"self-soothing\" has a confusing history. Coined by sleep researcher Thomas Anders in the 1970s, it's often used synonymously with the idea that babies can self-regulate. For Anders, however, \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC1201414\u002F\"\u003Ea self-soothing baby was simply one who put themselves back to sleep without parental intervention\u003C\u002Fa\u003E – he wasn't trying to quantify their stress levels.\u003C\u002Fp\u003E\n\u003Cp\u003EOf the few studies that have looked at the short- to longer-term outcomes of sleep training, none have found an effect on a baby's attachment or mental health. Hiscock's study, for example, the largest and longest longitudinal study done on sleep training, found \u003Ca href=\"https:\u002F\u002Fwww.researchgate.net\u002Fpublication\u002F230830539_Five-Year_Follow-up_of_Harms_and_Benefits_of_Behavioral_Infant_Sleep_Intervention_Randomized_Trial\"\u003Esleep-trained children were no more likely to be insecurely attached\u003C\u002Fa\u003E to their caregiver at six years of age than their peers. (Experts like Hiscock say they aren't aware of any studies that look at potential long-term effects of cold-turkey cry-it-out, just at modified extinction. They also examined healthy babies at least six months old. So these findings aren't necessarily applicable to infants trained at younger ages, or in other ways.)\u003C\u002Fp\u003E\n\u003Cp\u003ELike other longitudinal studies, Hiscock's lost touch with a number of families when it was time for the final follow-up: 101 of the original 326. That means it is theoretically possible that the sleep training did affect some children in either a negative or positive way long-term, but that their experiences weren't captured. It's more likely, though, that any effects of a single intervention simply \"washed out\" after six years, says Hiscock.\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003EThe upsides of responding\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EAnother way to examine the self-regulation question is to consider babies' developing brains – and their limitations. Human babies are born very neurologically immature compared with other mammals, with brains around one-third of the size of an adult's. The prefrontal cortex, \u003Ca href=\"https:\u002F\u002Fwww.frontiersin.org\u002Farticles\u002F10.3389\u002Ffnbeh.2018.00337\u002Ffull#:~:text=Neuroscientific%20research%20has%20revealed%20that,emotion%20(e.g.%2C%20amygdala).\"\u003Ethe \"home\" of emotional regulation in the brain\u003C\u002Fa\u003E, is \u003Ca href=\"https:\u002F\u002Fwww.intechopen.com\u002Fchapters\u002F63179\"\u003Eone of the last parts of the brain to mature\u003C\u002Fa\u003E, not developing fully \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC3621648\u002F#:~:text=The%20development%20and%20maturation%20of%20the%20prefrontal%20cortex%20occurs%20primarily,the%20age%20of%2025%20years.\"\u003Euntil one's mid-20s\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003EAs a result, throughout infancy and toddlerhood, the brain relies on \"co-regulation\" – the aid of a soothing caregiver – to calm down. In a position \u003Ca href=\"https:\u002F\u002Fpublications.aap.org\u002Fpediatrics\u002Farticle\u002F129\u002F1\u002Fe232\u002F31628\u002FThe-Lifelong-Effects-of-Early-Childhood-Adversity\"\u003Eadopted by the American Academy of Pediatrics\u003C\u002Fa\u003E, for example, the National Scientific Council on the Developing Child defines a \"positive\" stress response as one that \u003Ca href=\"https:\u002F\u002Fpublications.aap.org\u002Fpediatrics\u002Farticle\u002F129\u002F1\u002Fe232\u002F31628\u002FThe-Lifelong-Effects-of-Early-Childhood-Adversity\"\u003Eresults from stress that is brief, \"mild to moderate\"\u003C\u002Fa\u003E and which hinges on \"the availability of a caring and responsive adult who helps the child cope with the stressor, thereby providing a protective effect that facilitates the return of the stress response systems back to baseline status\".\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-24"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0by4gn9"],"imageAlignment":"left","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-25"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EIn particular, one of the most crucial periods for developing emotional regulation is from six to 12 months, says Dan Siegel, clinical professor of psychiatry at the University of California, Los Angeles' School of Medicine and author of numerous books on child development including The Whole-Brain Child. \"The second half of the first year of life is a big moment of learning to regulate yourself,\" he says. For that reason, he says, there may be an argument for waiting at least until after the first year to sleep train.\u003C\u002Fp\u003E\n\u003Cp\u003EWhile cortisol measurements need to be taken with a grain of salt, scientists point out that studies consistently show that babies of less responsive parents have higher cortisol levels, particularly after a stressful event. Researchers have found, for example, that \u003Ca href=\"https:\u002F\u002Facamh.onlinelibrary.wiley.com\u002Fdoi\u002F10.1111\u002Fj.1469-7610.2007.01818.x\"\u003Enewborns whose mothers were more \"sensitive\" to them during a bath\u003C\u002Fa\u003E – defined as being aware of, and responding appropriately and promptly to, an infant's communications – better regulated their cortisol levels when they were taken out. The cortisol levels of seven-month-olds with less sensitive mothers also \u003Ca href=\"https:\u002F\u002Fonlinelibrary.wiley.com\u002Fdoi\u002F10.1002\u002Fdev.20397\"\u003Etook longer to regulate after a stressful situation\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003EThis is no less true overnight. One study found that \u003Ca href=\"https:\u002F\u002Fpennstate.pure.elsevier.com\u002Fen\u002Fpublications\u002Fassociations-between-bedtime-and-nighttime-parenting-and-infant-c\"\u003Eresponding to three-, six- and nine-month-old infants overnight was associated with lower infant cortisol levels\u003C\u002Fa\u003E. Another found that the young infants of mothers who were emotionally available at bedtime – including responding to their babies within one minute of crying – \u003Ca href=\"https:\u002F\u002Fpsycnet.apa.org\u002Frecord\u002F2014-39506-009\"\u003Ehad lower cortisol levels\u003C\u002Fa\u003E than babies of less responsive mothers (though, again, we need to be cautious about over-interpreting the significance of cortisol findings). \"Because infants may be especially tired at bedtime, they may have reduced tolerance for stress and therefore require additional help in regulating their emotions,\" the researchers wrote. \"Thus, parents' ability to soothe their children and create a quiet, safe environment which allows them to fall asleep may be particularly relevant to infant regulatory processes such as cortisol secretion.\"\u003C\u002Fp\u003E\n\u003Cp\u003EMeanwhile, a large body of research has shown that a caregiver's consistent responsiveness is \u003Ca href=\"https:\u002F\u002Fwww.scielosp.org\u002Farticle\u002Fssm\u002Fcontent\u002Fraw\u002F?resource_ssm_path=\u002Fmedia\u002Fassets\u002Fbwho\u002Fv84n12\u002Fv84n12a16.pdf\"\u003E\"most often associated with language, cognitive and psychosocial development\"\u003C\u002Fa\u003E, including better \u003Ca href=\"https:\u002F\u002Fwww.sciencedirect.com\u002Fscience\u002Farticle\u002Fabs\u002Fpii\u002FS0065240702800520\"\u003Elanguage acquisition\u003C\u002Fa\u003E, \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F7398451\u002F\"\u003Efewer behavioural issues\u003C\u002Fa\u003E and \u003Ca href=\"https:\u002F\u002Fpsycnet.apa.org\u002FdoiLanding?doi=10.1037%2F0012-1649.30.3.355\"\u003Eless aggression\u003C\u002Fa\u003E, \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F1446549\u002F\"\u003Ehigher intelligence\u003C\u002Fa\u003E and \u003Ca href=\"https:\u002F\u002Fpsycnet.apa.org\u002Ffulltext\u002F2014-52728-006.html\"\u003Emore secure attachment\u003C\u002Fa\u003E.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-26"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0by4h2v"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-27"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EFor researchers like those who found babies had lower cortisol when responded to overnight, the risk of stress is longer term. \"Because early experiences of stress may program the HPA (hypothalamic-pituitary-adrenal) axis to be more stress reactive, \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F11016553\u002F\"\u003Eincreasing risk of physical and mental health problems in later life\u003C\u002Fa\u003E, our results suggest that parenting in infant sleep contexts may play an important role in shaping how the child responds to stress across childhood,\" they wrote.\u003C\u002Fp\u003E\n\u003Cp\u003EPlus, for pre-verbal infants, crying is one of their only forms of communication, particularly if they are trying to wake sleeping parents – leading to \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F21295501\u002F\"\u003Econcerns about the impact of an intervention specifically aimed to \"extinguish\" their cries\u003C\u002Fa\u003E. (Critics of cry-it-out note that this \u003Ca href=\"https:\u002F\u002Fsarahockwell-smith.com\u002F2015\u002F10\u002F22\u002Fhelp-my-baby-always-cries-in-the-car\u002F\"\u003Eintention\u003C\u002Fa\u003E and end goal is one of the differences between a baby crying in sleep training versus in a situation where a baby is crying but a parent may be unable to provide their usual level of comforting, such as while driving.)\u003C\u002Fp\u003E\n\u003Cp\u003EAnd if an infant is regularly waking frequently or having difficulty settling, it could be the sign of an underlying health issue like \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F9588641\u002F\"\u003Ereflux\u003C\u002Fa\u003E or a \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC5034598\u002F\"\u003Etongue tie\u003C\u002Fa\u003E, so it's important to rule out any medical reasons for sleep problems first.\u003C\u002Fp\u003E\n\u003Cp\u003ESleep training critics also argue that we may simply not be asking the right questions, or using the right scientific tools, to fully understand the potential risks.\u003C\u002Fp\u003E\n\u003Cp\u003E\"I think [attachment and cortisol levels] are just two things that we've got tools to measure. So that's why they're picked,\" says Ball. \u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003EDifferent personalities\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EThere is a further complicating factor: the degree to which a baby's individual personality plays a part in whether they put themselves to sleep independently on their own, or whether sleep training is a success.\u003C\u002Fp\u003E\n\u003Cp\u003EFor example, \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC4459553\u002F\"\u003Eresearch has found\u003C\u002Fa\u003E that \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC1201415\u002F\"\u003Ethe more parents actively help their infants in going to sleep\u003C\u002Fa\u003E, the longer it can take those babies to learn to sleep independently. This is often interpreted to mean that you must leave your baby to it or sleep train for them to become an independent sleeper. But these were observational studies – so it could be, instead, that babies who need soothing to go to sleep have parents who respond by soothing them. \u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-28"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"Early sleep problems are more predictive of future sleep disturbances than are intervening parental behaviours – Valérie Simard et al","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-29"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EIndeed, other research has found that \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F8509492\u002F\"\u003Ebabies with more difficult temperaments\u003C\u002Fa\u003E are also poorer sleepers – and \u003Ca href=\"https:\u002F\u002Fwww.sciencedirect.com\u002Fscience\u002Farticle\u002Fabs\u002Fpii\u002F0163638394900043\"\u003Eparents respond to them more\u003C\u002Fa\u003E at night. One longitudinal study found that \u003Ca href=\"https:\u002F\u002Fjamanetwork.com\u002Fjournals\u002Fjamapediatrics\u002Ffullarticle\u002F379353\"\u003Eif babies slept poorly, their parents were more likely to engage in behaviours to help them settle\u003C\u002Fa\u003E even when they were toddlers. The results \"suggest that early sleep problems are more predictive of future sleep disturbances than are intervening parental behaviours\", the researchers write.\u003C\u002Fp\u003E\n\u003Cp\u003ERecent research also has found that \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F16761546\u002F\"\u003Echildren with more sensitive temperaments (sometimes nicknamed \"orchid children\")\u003C\u002Fa\u003E can react more strongly to their environments – \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F19883141\u002F\"\u003Esuch as being more negatively affected by stress\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003EIndeed, some children remain calm and collected even when a caregiver walks away momentarily, sleep researchers say. Others become upset and frustrated. This is a sign, they say, that some children learn to self-regulate earlier than others.\u003C\u002Fp\u003E\n\u003Cp\u003E\"It means that you have to be really careful when you're giving parents suggestions about how to manage sleep problems, that you're taking those differences in separation anxiety into account,\" says Hall.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-30"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0by4hhw"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-31"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EThese differences in temperament may help explain why sleep training (or, for that matter, suggestions such as \"put your baby down drowsy but awake\") seems to work brilliantly for some families, who find their baby barely grizzles before drifting off, and don't work at all for others, whose infants might sob for hours and days on end. The \u003Ca href=\"https:\u002F\u002Fwww.researchgate.net\u002Fpublication\u002F263320518_Parental_perceptions_of_the_effectiveness_of_graduated_extinction_in_reducing_infant_night-wakings\"\u003Equestionnaire of Canadian parents\u003C\u002Fa\u003E, for example, found that 25% reported using controlled crying for bouts of more than two weeks at a time – 13% even tried for more than a month. (Mindell's advice: \"Stick with it for seven to 10 days, and after seven to 10 days, if it's not working, take a break. Don't just keep going down that path.\")\u003C\u002Fp\u003E\n\u003Cp\u003EIt's also worth noting that in their top-line results, studies normally report on the average outcome, which doesn't show the variation of every family's experience, especially those at the extremes – such as those who found sleep training a smashing success, or a total failure.\u003C\u002Fp\u003E\n\u003Cp\u003EGiven those individual differences, when talking about helping a child with any new skill, Siegel says, he encourages parents to consider the \"zone of proximal development\". The lower part of the zone is what the child can do on their own, while the top part is a more complex skill that you must do with a child. \"The best imparting of skills is within the zone. 'Let me teach you how to do it. Here's how you brush your teeth.' 'Now, let's see if you can do it on your own. Oh, you really can't, okay.' 'Okay, now you're a month older, and now you can',\" he says.\u003C\u002Fp\u003E\n\u003Cp\u003ENot \u003Ca href=\"https:\u002F\u002Fevolutionaryparenting.com\u002Fis-infant-sleep-a-skill\u002F\"\u003Eeveryone believes\u003C\u002Fa\u003E that falling asleep independently is a skill, pointing out that it normally happens developmentally with or without teaching and that, unlike, say, crawling, it can be something that comes and goes (a child might self-settle at nursery but not at home, or for a few months and then stop). But if it is a skill, then it's most effective to work within that zone, not pushing a child past their edge, Siegel says.\u003C\u002Fp\u003E\n\u003Cp\u003ESo how do you know what the edge is? Does 15 minutes of crying mean the step you're trying to teach is too advanced for the child at that time? An hour?\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-32"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"If within five minutes, your child is not finding a way to bring them into a calmer state, then their zone of proximal development has been pushed, I think, beyond its limits – Dan Siegel","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-33"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003E\"I can't answer as a scientist,\" says Siegel. \"But intuitively, as a parent, as a therapist, as an educator, if within five minutes, your child is not finding a way to bring them into a calmer state, then their zone of proximal development has been pushed, I think, beyond its limits. And then you would want to give them support.\"\u003C\u002Fp\u003E\n\u003Cp\u003EThe difficulty is that sleep training is based on the understanding that you are \"rewarding\" a child's crying if you respond to them, teaching them that you will respond if they signal you – so this is exactly what extinction-based programmes say not to do.\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cstrong\u003EFamily fatigue  \u003Cbr \u002F\u003E\u003C\u002Fstrong\u003E\u003C\u002Fp\u003E\n\u003Cp\u003EResearchers tend to focus on sleep training's potential impact on babies – which makes sense, since they're the most vulnerable, helpless members of the family unit. But sleep training obviously affects the rest of the family, too.\u003C\u002Fp\u003E\n\u003Cp\u003EIt's worth noting that it can go either way: some parents \u003Ca href=\"https:\u002F\u002Fthebeyondsleeptrainingproject.com\u002Fblog\u002Fmy-sleep-school-experience-my-biggest-regret-guest-post-by-elise-lacy\"\u003Edeeply regret using an extinction method\u003C\u002Fa\u003E with their little ones, for example, especially \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F27655457\u002F\"\u003Eif it goes against their instincts\u003C\u002Fa\u003E. On average, the Canadian questionnaire found, \u003Ca href=\"https:\u002F\u002Fwww.tandfonline.com\u002Fdoi\u002Ffull\u002F10.1080\u002F02646838.2014.910864\"\u003Eparents tend to find controlled crying \"quite stressful\"\u003C\u002Fa\u003E for both themselves and their child. \"You risk parents' mental health by overriding their instincts, because I think that makes parents feel anxious about what they want to be doing (comforting their baby) versus what they end up doing (leaving them to cry). And then I think it's really difficult to know what you're risking on behalf of the baby,\" says Ball.\u003C\u002Fp\u003E\n\u003Cp\u003EWhat you hear more frequently, however, is that sleep training can help families, and some research backs this up. Hiscock's study found that \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F18762495\u002F\"\u003Ethe mothers of sleep-trained babies were less likely to be depressed\u003C\u002Fa\u003E when the baby was two years old. Other research has found that \u003Ca href=\"https:\u002F\u002Fonlinelibrary.wiley.com\u002Fdoi\u002F10.1111\u002Fjpc.13311\"\u003Ethe fathers of four-month-olds with sleep problems had greater anger towards their babies\u003C\u002Fa\u003E and more depressive symptoms, and that \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F17473096\u002F\"\u003Einfant sleep problems were associated with poorer health in both mothers and fathers\u003C\u002Fa\u003E.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-34"},{"bodyHtml":{"assets":[]},"calloutBodyHtml":"\u003Cp\u003EThis article is part of \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Ffamily-tree\" target=\"_blank\"\u003E\u003Cstrong\u003EFamily Tree\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E, a series of features from the BBC that explore the issues and opportunities that parents, children and families face all over the world. You might also be interested in some other stories about babies' and children's wellbeing:\u003C\u002Fp\u003E\n\u003Cul\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20220131-the-science-of-safe-and-healthy-baby-sleep\"\u003EThe biggest myths of baby sleep\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20211117-how-do-children-choose-a-best-friend\"\u003EHow children choose a best friend\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003Cli\u003E\u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Ffuture\u002Farticle\u002F20210923-the-surprising-benefits-of-baby-massage\"\u003EThe surprising benefits of baby massage\u003C\u002Fa\u003E\u003C\u002Fli\u003E\n\u003C\u002Ful\u003E\n\u003Cp\u003EYou can also climb new branches of the Family Tree on \u003Ca href=\"https:\u002F\u002Fwww.bbc.com\u002Fworklife\u002Ffamily-tree\" target=\"_blank\"\u003E\u003Cstrong\u003EBBC Worklife\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E.\u003C\u002Fp\u003E","calloutTitle":"Family Tree","cardType":"CalloutBox","iFrameType":"","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-35"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EA parent's mental health may in turn affect the infant's actual sleep patterns: one small study using actigraphy found that \u003Ca href=\"https:\u002F\u002Fwatermark.silverchair.com\u002Fsleep-32-5-693.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAswwggLIBgkqhkiG9w0BBwagggK5MIICtQIBADCCAq4GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMk4JiJ-sAwN0skK5jAgEQgIICf2rjBz2v8rBe0jpmKFl0B-SmqCwj3dPf21PSKXPgkvXmJI9xCf7zNIL7K52EXGZTvp0ryfOBisNBuyzhNn4vtpb4Di18E84Hx-XyDk4EllVt-sXsEmp6rulBsWVIjiHkHXa1JCAwyrcFIoM4W5wxBWQrJ4cec-LpqC6zawGExjs-ymlRHVfojAbcmzg1hZSlGVZr0ZInOy7j1j_qL9U38mP2CAAUs6b5_3px1J9RF-nwd0H6GiKGXEVMcAW4jAy-R7gn2sLPFTdgqZkBN6aj4dAIrBIZ6FZK0vNhhZ6OXhC3t-2-lkPMFeR06NmU2MifCe_z0iuK2y-uRngOq4jkPOxbLrtY0CbTOcO2F5notaIfFvyUqIsinTYWyzkspJhWM2dVyKBt7zuJC0e7xmRKCcn7-aYeHrcCxnaNx-K0NH5uGaOAh6vAfxBVKfWQdyqt4aNsbW50N1VN2F0GPCuKmKVJR3cm8Ayy-1OpcAKZc6PGJ5lYPVFT8fOZvC0yiTCGa0lF-CVebqumw3JI-yAE2tcjVovbwA__gS3zfICB4h8dN3u4W9moMNrIEK6uXXi3SIlpdBJUI2LwEurpCYXEDFSw9cYTC8GSltmyEnw4qvOvZjX9aWavDXkNSED8QyHPXTIlYnLL5EEuGszX7OYp_yO2APYlMGomEDzwdbQPUev3_1NX1UGZfUUMho13T_RnOBXIJqqL4X6T6oF-vEZvFtqcyhk9v8eVOWJFqeWCdMGiaWmHda4mlbRXgeTIA05tHDfjTd1RwmYo4WqsMrz9lViYKjlBgTYVCM_kQnKChygYDeyHYltyfTtmnU6NP-HBappbl2mK1fMCX9wiXMxs1g\"\u003Edepressed mothers were more likely to have babies who have more disturbed sleep\u003C\u002Fa\u003E. A parent's poor mental health can also put babies \u003Ca href=\"https:\u002F\u002Facamh.onlinelibrary.wiley.com\u002Fdoi\u002Fabs\u002F10.1111\u002F1469-7610.00661\"\u003Eat a higher risk of insecure attachment\u003C\u002Fa\u003E.\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC4643535\u002F\"\u003EHall's study\u003C\u002Fa\u003E also looked at this element. While actigraphy showed that babies slept and woke similarly whether they were sleep trained or not, their parents' perceptions of the situation were very different. At six weeks, parents of just 4% of the sleep-trained infants versus 14% of the control-group infants reported that their child had a severe sleep problem. And the parents' levels of fatigue, sleep quality, and depressed mood all improved significantly.\u003C\u002Fp\u003E\n\u003Cp\u003EWhile there are some caveats to the findings – such as that \u003Ca href=\"https:\u002F\u002Fwww.basisonline.org.uk\u002Fhcp-sleep-training-research-evidence\u002F\"\u003Ethey may apply mostly to mothers who already have symptoms of depression\u003C\u002Fa\u003E – many experts see this as a strong argument for using sleep training to ultimately boost the whole family's wellbeing.\u003C\u002Fp\u003E\n\u003Cp\u003E\"If we're not healthy and functioning as parents, it's very hard to look after our children and give them the love and parenting that they need,\" says Hiscock. \"There are some people who say we have to put the baby first and don't worry about the parent, and I just think that's wrong, because if you don't have a mum who's healthy and thriving, it's hard to have a baby who's healthy and thriving. It's a relationship dynamic – it's not one or the other.\"\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-36"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"If we're not healthy and functioning as parents, it's very hard to look after our children and give them the love and parenting that they need – Hiscock","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-37"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EAcademics who oppose sleep training agree that these factors are important. Their issue, they say, is with the fact that many parents often are simply advised to sleep train, without being told about nuances – such as that it doesn't work for every baby or that it often needs to be repeated – and that they aren't presented with other options.\u003C\u002Fp\u003E\n\u003Cp\u003E\"I think it's often sold to parents who feel like they're in a tight spot, and they've got to sleep train their child in order to be able to survive. But actually, I think we need to help them come up with other strategies way before they get to that crisis point,\" says Ball.\u003C\u002Fp\u003E\n\u003Cp\u003EOne strategy that both Ball and James McKenna, the founder and director of the Mother-Baby Behavioral Sleep Laboratory at the University of Notre Dame, have found works for some low-risk families is bedsharing, or cosleeping. Small studies have found that \u003Ca href=\"https:\u002F\u002Fwatermark.silverchair.com\u002Fsleep-20-2-142.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAswwggLIBgkqhkiG9w0BBwagggK5MIICtQIBADCCAq4GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMspRcLUCfvuGcEsOfAgEQgIICfx4l-4Gkq1a9ZP8kB4fQgv5xnHTmB4AaiqOBtuFjZwbmtAdrBFDfCKiCmWUI5APDNg8S5JCfHYhzCnjYLE0ko6FTgLyiSpWvkZ_ooLOvnjxGX8z79olJpKf7wlhmsme3oq-21vTitXjXULXEeyncfHDUemXdubEJTorcMCEnYuEJj0UZyLonx0tzyqad5qkpjT-spePRYHIhWrbEe8s4JdRhqTU-WwcVmR3q9AAddQgn3fS7YRtakfmjAt-yblXwYB3085WE3kG-jaETaWnXPBNtl-SSrt9SiKfVkwJuV-W-QKa5dhEOz5y4HXac18FN5a14oscYomgU07mGSxbO_tjOpregEaihp3sjqArgj2Lyr6Aojxm-PaKThRvrV3DtJP5R3Q49NaDXOGzWSBsPCQSN8aqZyhYZ8GIECq4psTxNiAoyeJHuv1zzMAIg0IDt2xIrde98pV1A-UHFIlzeJN2jAbybZWkQ1HM6pA302dca0nLyQn-jGuSy4-g3dSr6J-6DFOy_OEKiWl3lviEwTomaXDZYISZ8OZ1Sl8nLHTzkX4d7xjaDW7LZj576iHEUpuUQD5dXGIiOElH3Sw5jLchWiwanb8KOZyroU0aMBsPWfbGhIl16_hTUFkvmekwZdFE5eaVAuk35kJUVpg7CWvOiklZC7zJBb6S7RMPIGciSrHitUYThzwSUjR5VQj8qS6UCtvC5ptCWnNFbgEw6BaFpBETtZcq-7WM4E20a_XAr10eusjKVpayhu2KhT88XCyZIGw4Wjtb4LNk2ykRBt6HMFYzxydQCRM_s2QPQfKN2tQgc7RLv94Vvq_rc_6ZWgEaGfNe-GzkHXdWh9lE4_g\"\u003Emothers report having better sleep when bedsharing\u003C\u002Fa\u003E than when sleeping separately from their infants, even though objective measures find only modest changes to their sleep, and while research has shown that while \u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F15577276\u002F\"\u003Ebedsharing infants wake more frequently\u003C\u002Fa\u003E, their \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC1201416\u002F\"\u003Etotal awake time doesn't differ from solitary sleepers\u003C\u002Fa\u003E. (The Lullaby Trust lists guidelines for safe bedsharing \u003Ca href=\"https:\u002F\u002Fwww.lullabytrust.org.uk\u002Fsafer-sleep-advice\u002Fco-sleeping\u002F\"\u003Ehere\u003C\u002Fa\u003E).\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-38"},{"bodyHtml":{"assets":[]},"cardType":"Image","iFrameType":"","image":["p0by4j9q"],"imageAlignment":"centre","imageOrientation":"landscape","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-39"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EThere are other strategies which researchers on both sides of the debate agree on. Implementing a bedtime routine is one. One review co-authored by Mindell found that following a bedtime routine is linked to \u003Ca href=\"https:\u002F\u002Fwww.sciencedirect.com\u002Fscience\u002Farticle\u002Fabs\u002Fpii\u002FS1087079217300485\"\u003Echildren falling asleep faster, waking less and sleeping for longer\u003C\u002Fa\u003E. Putting a routine in place even worked when it was the only sleep strategy families followed: one randomised controlled trial of 405 children aged seven to 36 months found that \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC2675894\u002F\"\u003Ethose who were randomly assigned a three-step routine\u003C\u002Fa\u003E of a bath, massage or lotion, and a quiet activity like reading slept better and longer than babies who were not assigned a routine.\u003C\u002Fp\u003E\n\u003Cp\u003EBall, who recently has worked with other researchers to adapt the Australian sleep programme \u003Ca href=\"https:\u002F\u002Feducation.possumsonline.com\u002Fprograms\u002Fsleep-program\"\u003EPossums\u003C\u002Fa\u003E \u003Ca title=\"https:\u002F\u002Fjournals.plos.org\u002Fplosone\u002Farticle?id=10.1371\u002Fjournal.pone.0237240\" href=\"https:\u002F\u002Fjournals.plos.org\u002Fplosone\u002Farticle?id=10.1371\u002Fjournal.pone.0237240\"\u003Einto a version for UK NHS practitioners,\u003C\u002Fa\u003E also points out that there are many ways in which we often make things even harder for ourselves. \u003C\u002Fp\u003E\n\u003Cp\u003E\"We have this cultural obsession with getting children in bed at seven o'clock at night,\" she says. \"But most babies are going to need another feed before their parents go to bed. And usually when a baby falls asleep, the first block of sleep is the longest one of the night.\" That first four hours of sleep also is when we have most of our deep sleep. \"So if you align your period of deepest sleep with the time your baby gets its longest stretch of sleep by going to bed when they do, you're maximising the benefit. Why are we sitting downstairs watching television? And when you say stuff like that to parents, some of them are like, 'We want some us time, we want some child-free time.' Well, then that's your choice. You're trading that off against sleep.\"\u003C\u002Fp\u003E\n\u003Cp\u003EGiving parents more support and information may help, too. Remember the intervention that was seen as helpful to the most mothers in \u003Ca href=\"https:\u002F\u002Fwww.ncbi.nlm.nih.gov\u002Fpmc\u002Farticles\u002FPMC2083609\u002F\"\u003EHiscock's longitudinal study\u003C\u002Fa\u003E: \"having someone to talk to\". A higher percentage of parents also scored learning about what made their child's sleep worse and about normal sleep patterns as helpful than said the same of controlled crying – and receiving advice on how to look after their own well-being and getting information about managing dummies was rated by more mothers than was camping out.\u003C\u002Fp\u003E\n\u003Cp\u003EMore broadly, critics also point out that baby sleep is a societal issue. Many modern families rely on two incomes and have little or no parental leave – aspects that pressure parents to get solid night's sleep quickly, often long before an infant would be developmentally ready to do it on their own, without prodding. It's common to see calls for better (or any) maternity or paternity leave among anti-cry-it-out circles.\u003C\u002Fp\u003E"},"cardType":"Body","iFrameType":"","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-40"},{"bodyHtml":{"assets":[]},"cardType":"PullQuote","iFrameType":"","pullQuote":"Eventually, with or without training, most children stop requiring a caregiver's help at night","id":"future\u002Farticle\u002F20220322-how-sleep-training-affects-babies-41"},{"bodyHtml":{"assets":[],"html":"\u003Cp\u003EWhether families choose to sleep train or not, there is good news: eventually, with or without training, most children stop requiring a caregiver's help at night.\u003C\u002Fp\u003E\n\u003Cp\u003EOne study of more than 4,000 children, for example, found that \u003Ca href=\"https:\u002F\u002Facamh.onlinelibrary.wiley.com\u002Fdoi\u002Fabs\u002F10.1111\u002Fj.1469-7610.1995.tb01821.x\"\u003E71% of five-month-olds who regularly woke at night stopped night wakes by 20 months\u003C\u002Fa\u003E, and 89% ceased by 4.5 years old. (Those who woke frequently as infants were also more likely to wake as pre-schoolers, but again, it's unclear how much of this is down to temperament: a baby who wakes could also be more likely to be a child who wakes).\u003C\u002Fp\u003E\n\u003Cp\u003EThe bottom line on sleep training?\u003C\u002Fp\u003E\n\u003Cp\u003E\"It's only worth doing when parents want to do it and see it as an issue they need help with,\" says Hiscock. \"I meet parents who might be up three, four, five times a night, but they're happy to be, or they're coping and managing with that.\"\u003C\u002Fp\u003E\n\u003Cp\u003EMindell agrees. \"If you're rocking a baby to sleep at four months of age, they're waking once a night, it's working for the family, why would you mess with success? Why would you do sleep training?\u003C\u002Fp\u003E\n\u003Cp\u003E\"We only really recommend it when there's a problem,\" she says.\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003E--\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EJoin one million Future fans by liking us on \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.facebook.com\u002FBBCFuture\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EFacebook\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, or follow us on \u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Ftwitter.com\u002FBBC_Future\"\u003E\u003Cstrong\u003E\u003Cem\u003ETwitter\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E or\u003Cstrong\u003E \u003C\u002Fstrong\u003E\u003C\u002Fem\u003E\u003Ca href=\"https:\u002F\u002Fwww.instagram.com\u002Fbbcfuture_official\u002F\"\u003E\u003Cstrong\u003E\u003Cem\u003EInstagram\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E.\u003C\u002Fem\u003E\u003C\u002Fp\u003E\n\u003Cp\u003E\u003Cem\u003EIf you liked this story, \u003C\u002Fem\u003E\u003Ca href=\"http:\u002F\u002Fpages.emails.bbc.com\u002Fsubscribe\u002F?ocid=fut.bbc.email.we.email-signup\" target=\"_blank\"\u003E\u003Cstrong\u003E\u003Cem\u003Esign up for the weekly \u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Ca href=\"http:\u002F\u002Fbbc.com\u002F\" target=\"_blank\"\u003E\u003Cstrong\u003E\u003Cem\u003Ebbc.com\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Ca href=\"http:\u002F\u002Fpages.emails.bbc.com\u002Fsubscribe\u002F?ocid=fut.bbc.email.we.email-signup\" target=\"_blank\"\u003E\u003Cstrong\u003E\u003Cem\u003E features newsletter\u003C\u002Fem\u003E\u003C\u002Fstrong\u003E\u003C\u002Fa\u003E\u003Cem\u003E, called \"The Essential List\". 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d="M182,358h-68c-0.55,0-1.05-0.225-1.412-0.587C112.225,357.05,112,356.55,112,356V156 c0-0.552,0.224-1.052,0.586-1.414S113.448,154,114,154h68c0.55,0,1.05,0.225,1.413,0.587C183.775,154.95,184,155.45,184,156v200 c0,0.552-0.224,1.052-0.586,1.414S182.552,358,182,358z"></path><path fill="#FF4C98" d="M372.106,248.243l34-58.89c0.275-0.476,0.33-1.022,0.197-1.517c-0.133-0.495-0.453-0.94-0.93-1.215 l-173.205-100c-0.478-0.276-1.023-0.332-1.518-0.2c-0.494,0.132-0.938,0.454-1.214,0.932l-34,58.89 c-0.275,0.476-0.33,1.022-0.197,1.517c0.133,0.495,0.453,0.94,0.93,1.215l173.205,100c0.478,0.276,1.023,0.332,1.518,0.2 C371.386,249.042,371.83,248.721,372.106,248.243z"></path><path fill="#AF0D5B" d="M372.106,263.757l34,58.89c0.275,0.476,0.33,1.022,0.197,1.517c-0.133,0.495-0.453,0.94-0.93,1.215 l-173.205,100c-0.478,0.276-1.023,0.332-1.518,0.2c-0.494-0.132-0.938-0.454-1.214-0.932l-34-58.89 c-0.275-0.476-0.33-1.022-0.197-1.517c0.133-0.495,0.453-0.94,0.93-1.215l173.205-100c0.478-0.276,1.023-0.332,1.518-0.2 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