Parents should worry less about how much time their children spend using screens, paediatricians have said.
The first UK guidance on screen use for children says there is little evidence that it is harmful in itself.
But experts say it is important that the use of devices does not replace healthy activities, such as sleep, exercising and time with family.
The guidance avoids setting screen time limits, but does recommend not using them in the hour before bedtime.
It was informed by a review of evidence published at the same time, and follows a debate around whether youngsters should have time on devices restricted.
'Great way to explore'
The Royal College of Paediatrics and Child Health (RCPCH), which has produced the guidance for under-18s, said there was no good evidence that time in front of a screen is "toxic" to health, as is sometimes claimed.
While there are associations between higher screen use and obesity and depression, the college said it was not clear if this link was causal.
The college said it was not setting time limits for children because there was not enough evidence that screen time was harmful to child health at any age.
Instead, it has published a series of questions to help families make decisions about their screen time use:
- Is your family's screen time under control?
- Does screen use interfere with what your family want to do?
- Does screen use interfere with sleep?
- Are you able to control snacking during screen time?
Dr Max Davie, officer for health promotion for the RCPCH, said phones, computers and tablets were a "great way to explore the world", but parents were often made to feel that there was something "indefinably wrong" about them.
He said: "We want to cut through that and say 'actually if you're doing OK and you've answered these questions of yourselves and you're happy, get on and live your life and stop worrying'.
"But if there are problems and you're having difficulties, screen time can be a contributing factor."
The recommendation that children should not use the devices in the hour before bedtime comes because of evidence that they can harm sleep.
The devices stimulate the brain, and the blue light produced by them can disrupt the body's secretion of the sleep hormone melatonin.
While there are night modes on many phones, computers and tablets, there is no evidence these are effective, the college said.
Overall, it found the effect of screen time on children's health was small when considered next to other factors like sleep, physical activity, eating, bullying and poverty.
It said there was a lack of evidence that screen time is beneficial for health or wellbeing.
Its guidance recommends that families negotiate screen time limits with their children based on individual needs and how much it impacts on sleep, as well as physical and social activities.
For infants and younger children, this will involve parents deciding what content they watch and for how long they use the devices.
As children get older, there should be a move towards them having autonomy over screen use, but this should be gradual and under the guidance of an adult, the college said.
Dr Davie added: "When it comes to screen time I think it is important to encourage parents to do what is right by their family.
"However, we know this is a grey area and parents want support, and that's why we have produced this guide.
"We suggest that age-appropriate boundaries are established, negotiated by parent and child, that everyone in the family understands."
Tips for parents:
- Mealtimes can be good opportunities for screen-free zones
- If children's screen time use seems out of control, parents should consider intervening
- Parents should think about their own screen use, including whether they use devices unconsciously too often
- Younger children need face to face social interaction and screens are no substitute for this
Meanwhile, a separate study has found that girls are twice as likely to show signs of depressive symptoms linked to social media use at age 14 compared with boys.
The research, by experts at University College London and published in EClinicalMedicine, involved nearly 11,000 young people answering questionnaires on their social media use, online harassment, sleep patterns, self-esteem and body image.
Experts not involved in the study said it added to existing evidence that heavy social media use may be harmful for mental health.
But they called for more research to better understand if it causes depression, or if depressive people are more likely to use social media excessively.
The review of evidence on screen time is published in the BMJ Open journal.
NHS ‘should not prescribe acne drug’
The parents of young people who have killed themselves and patients unable to have sex are calling f..
The parents of young people who have killed themselves and patients unable to have sex are calling for the NHS to stop prescribing acne drug Roaccutane.
Ed Henthorn said it had caused him erectile dysfunction, psychosis and suicidal thoughts.
And one man who believes his son killed himself after taking the drug said the risks "are just too high".
Manufacturer Roche said "millions of patients worldwide have benefited from taking the drug".
The majority of those who take the drug have a positive experience.
"I used to think about girls… but my feelings, thoughts, just faded away," Ed Henthorn told the BBC's Victoria Derbyshire programme.
He was 19 when he took Roaccutane. He describes his acne as mild but bad enough to want to treat.
After three weeks he started to experience side-effects, including reduced energy and sex drive.
Then he experienced erectile dysfunction.
"That was why I decided to stop taking it," he said. (more…)
Spina bifida: Keyhole surgery repairs baby spine in womb
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In a UK first, doctors have used keyhole surgery to su..
In a UK first, doctors have used keyhole surgery to successfully repair the spine of a baby with spina bifida while it was still inside the womb.
Surgeons at King's College Hospital say the procedure is not a cure, but could be the difference between some children learning to walk or not.
Sherrie Sharp and her son Jaxson had the operation 27 weeks into the pregnancy.
Spina bifida was diagnosed after the routine 20-week pregnancy scans.
They showed Jaxson's spine and spinal cord were not forming correctly.
Gaps in the developing spine meant the cord was bulging out of his back and was left exposed to the amniotic fluid in the womb.
This damages the crucial nerves in the spinal cord and could lead to paralysis, a loss of sensation in the legs and problems controlling the bladder and bowels.
The longer the spinal cord is left exposed, the greater the damage.
Sherrie, 29, and from West Sussex, said the news was a shock, but an abortion was a "definite no". (more…)
Less chemotherapy better for older or frail patients with advanced stomach and oesophageal cancers
Less chemotherapy is as effective at controlling disease for elderly or frail patients with advanced..
Less chemotherapy is as effective at controlling disease for elderly or frail patients with advanced cancer of the stomach or oesophagus (food pipe), and leads to fewer side effects such as diarrhoea and lethargy. These are the results of a Cancer Research UK funded study, presented prior to the ASCO conference today (Wednesday).
“Increasingly were realising its not just age that affects how well someone can tolerate their treatment and we need to do more work to understand how other conditions or aspects of frailty might play a role.” – Dr Peter Hall, Cancer Research UK Edinburgh Centre[contfnewc]
Results from the GO2 trial could change the standard of care for patients who cant have full dose chemotherapy due to their age, frailty or medical fitness.
The study, which ran at hospitals all over the UK, coordinated from the University of Leeds, involved 514 people with stomach or oesophageal cancer. Their average age was 76 and the oldest was 96 years old. All were either frail, elderly or medically unfit, and for those reasons would be unlikely to tolerate full-strength treatment, which involves three chemotherapy drugs.
Patients went through a careful medical assessment, then went onto chemotherapy with just two drugs* and were allocated at random to receive them at either full-strength, medium-dose or low-dose. They were then carefully monitored to see how well the cancer was controlled, whether they had symptoms and side-effects, whether they felt their treatment was worthwhile, and what overall effect it had on their quality of life.
The researchers reported that the medium and lower doses of chemotherapy were as effective as the full-strength dose for controlling the cancer. But when the researchers looked at the overall effect of treatment, including quality of life, they reported that it was the lowest dose treatment that came out best.**
Around 15,800 people in the UK are diagnosed with stomach and oesophageal cancers every year***. Almost half (45%) of these people are 75 and over****. By 2035, this proportion is projected to rise to 55%*****, because of the UKs ageing population. This study, is one of few phase III trials in the country that seek to address how to best care for and treat this increasing population of elderly or frail cancer patients.
These findings also open up the possibility of more older and frail patients being able to take part in clinical trials.
Professor Charles Swanton, Cancer Research UKs chief clinician, said: “These valuable results reduce fears that giving a lower dose chemotherapy regimen is inferior and could make a huge difference for patients with stomach or oesophageal cancer who cant tolerate intensive courses of treatment.
“Older or frail patients are often not considered for new drug trials or standard of care therapy as theyre less able to tolerate combination chemotherapy. These trials are critical to provide much needed evidence on the effectiveness of new therapies and combination approaches, helping us develop new treatments for this growing group of patients.”
The researchers also assessed whether there were differences for the patients in the study who were under 75, or less frail, who might be expected to benefit from stronger treatment; but will be reporting that the lowest dose treatment gave the best results for them as well. (more…)
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