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[Series] Navigating the challenges in and identifying the priorities for childhood cancer survivorship in Asia

Survival after childhood cancer has markedly improved over the past decades in Asia, leading to a growing number of survivors in the region. However, long-term care for these individuals remains a substantial challenge in Asia due to the insufficient availability of comprehensive childhood cancer survivorship programmes in the region. Many countries and regions of Asia are only beginning to acknowledge the significance of post-treatment care. In this third paper in a Series on childhood cancer control in Asia, we provide an overview of the challenges, disparities, and enablers in the provision of long-term follow-up care in Asia.

[Review] The sleep–circadian connection: pathways to understanding and supporting autistic children and adolescents and those with attention-deficit hyperactivity disorder

Autism and attention-deficit hyperactivity disorder (ADHD) are among the most common neurodivergent neurotypes worldwide. Epidemiological evidence shows that sleep and circadian disturbances, such as difficulty initiating and maintaining sleep, and delayed sleep–wake phase, are highly prevalent in autistic children, children with ADHD, and those with both neurotypes. Despite scientific advancements, a comprehensive framework integrating sleep and circadian mechanisms with targeted interventions for autism and ADHD remains underdeveloped.

[Articles] Inequalities in neonatal unit mortality in England and Wales between 2012 and 2022: a retrospective cohort study

There are stark socioeconomic and ethnic inequalities in babies admitted to and who die in neonatal units in England and Wales. Mortality inequalities are partly explained by case-mix on entry to the neonatal unit, suggesting in-unit factors such as care practices explaining residual inequalities. Further work to investigate the role of care practices is required, as well as policies and practices to address upstream drivers of these inequalities.

[Articles] Vascular and inflammatory diseases after COVID-19 infection and vaccination in children and young people in England: a retrospective, population-based cohort study using linked electronic health records

Children and young people have higher risks of rare vascular and inflammatory diseases up to 12 months after a first COVID-19 diagnosis and higher risk of rare myocarditis or pericarditis up to 4 weeks after a first BNT162b2 vaccine, although the risk following vaccination is substantially lower than the risk following infection. These findings are of great importance for national policy makers and caregivers considering vaccination consent for children, and support the public health strategy of COVID-19 vaccination in children and young people to mitigate the more frequent and persistent risks associated with SARS-CoV-2 infection.

[Corrections] Correction to Lancet Child Adolesc Health 2025; 9: 754–55

De Ioris MA, Locatelli F. Long-term sequelae in survivors of high-risk neuroblastoma: the price of success. Lancet Child Adol Health 2025; 9: 754–55—In this Comment, both Maria Antonietta De Ioris and Franco Locatelli should have been affiliated with Haematology and Oncology, Cell and Gene Therapy at Bambino Gesù Children's Hospital, Rome, and only Franco Locatelli should have been affiliated with the Department of Life Sciences and Public Health, Catholic University of the Sacred Heart, Rome. These corrections have been made as of Nov 4, 2025.

[Correspondence] Attention to menarche, puberty education, and menstrual health monitoring are essential

In August, 2025, Maria Lohan and colleagues reported on the 30 sexual and reproductive health and rights (SRHR) research priorities identified for young adolescents (age 10–14 years), the output of a collaborative global exercise intended to bolster investment and research for this overlooked group.1 We commend their emphasis on young adolescents’ developmental needs, the perspectives of their caregivers, and the underlying determinants of positive SRHR. Among the highlighted areas, strengthening menstrual health programming (priority 11) is especially urgent to promote health and address ongoing gender inequality in this age group.

[Correspondence] Toward climate-smart, mental health-safe schools

Matea Cañizares’ call to reduce heat stress in schools is timely and welcome.1 The Philippines had repeated heat-related school disruptions in April and May, 2024, including a nationwide shift to distance learning and widespread local suspensions.2 Many schools are crowded and poorly ventilated, and many homes lack air conditioning. Therefore, heat follows learners from classroom to bedroom, undermining study and sleep. Meanwhile, 2024 was the warmest year on record (around 1·55–1·60°C above pre-industrial levels), establishing a new operational baseline for school systems.

[Comment] Addressing the crisis in paediatric dialysis: a call for urgent action

Dialysis is a life-sustaining therapy for children with kidney failure, who are largely dependent on medical devices (including dialysis machines, catheters, filters, lines, and solutions). Children on dialysis are a rare disease cohort,1,2 but despite the small numbers of children on dialysis, they require a large portfolio of medical devices for peritoneal dialysis, haemodialysis, and apheresis that are age-specific and size-specific. Paediatric dialysis centres offer both acute and long-term dialysis to newborns, including premature babies, through to young people aged up to 18 years, and require adaptions of medical devices to the child's age-specific anatomy and physiology.

[Comment] Linking routine data with school-based trials: unlocking long-term insights

The UK is uniquely positioned to advance the evaluation of child and adolescent public health interventions through routinely collected administrative data. Increasingly robust infrastructures—such as the National Pupil Database and the Education and Child Health Insights from Linked Data—provide longitudinal, population-level information for assessing intervention effectiveness over time.1,2 These developments create new opportunities to revisit and augment existing school-based cluster randomised trials (CRTs), moving beyond short-term outcomes to examine long-term, real-world impacts.

[Comment] Building momentum to improve childhood cancer outcomes in Asia

Asia has a diverse set of countries1 with unique childhood cancer burden patterns, health-care systems, resource availability, and cultures. Although this variability in aspects important to childhood cancer care can make considering Asian countries as a group challenging, efforts to improve childhood cancer outcomes benefit from collaboration between geographically and historically connected communities and countries. A holistic picture of the current state of childhood cancer care in Asia and identification of the potential priorities to improve care and outcomes, leveraging previous regional experience, is crucial to collective regional endeavours to implement sustainable childhood cancer improvements.

[Comment] Clinical and statistical insights from the FEED1 trial

In The Lancet Child & Adolescent Health, Shalini Ojha and colleagues report the results of the FEED1 trial.1 The trial evaluated the provision of full milk fluids within 3 h of birth, compared with gradual milk feeding supplemented with intravenous fluids or parenteral nutrition, to preterm infants born at 30 weeks and 0 days (30+0 weeks) to 32+6 weeks of gestation. The FEED1 trial recruited 2088 infants in 46 UK neonatal units over 4·75 years, placing it as one of the largest preterm infant feeding trials.

[Editorial] The example we set: Gen AI, honesty, and authenticity

Artificial intelligence (AI)—algorithm-based technologies solving complex tasks that previously required human thinking—has permeated life for decades in our daily use of search engines, navigation apps, and recommendation algorithms. Yet, generative AI (Gen AI)—a form of AI that generates new and original outputs using technologies like large language models (LLMs)—has us struggling to keep pace with its rapid, often inscrutable evolution, and is pushing us to consider our values towards progress in paediatric research and clinical care.

[Health Policy] European and North American guidelines for treating irritable bowel syndrome and functional abdominal pain in childhood: a guide for health-care professionals

Abdominal pain-related disorders of gut–brain interaction (AP-DGBI; including irritable bowel syndrome, functional abdominal pain—not otherwise specified, abdominal migraine, and functional dyspepsia) are very common among children and adolescents worldwide. Two of these disorders, irritable bowel syndrome and functional abdominal pain–not otherwise specified, have high rates of school absenteeism, psychological comorbidities, and chronicity into adulthood. A wide range of psychosocial, dietary, and pharmacological treatments have been explored for treatment of irritable bowel syndrome and functional abdominal pain—not otherwise specified in children.

[Review] The effects of plastic exposures on children's health and urgent opportunities for prevention

Children face an urgent threat in the form of hazards posed by plastics in the environment. Despite robust and rapidly accumulating evidence on the effects of plastic on children's health, plastic presents a paradox for child health providers: while plastic is a vehicle for so many interventions, robust evidence from laboratory and human studies show that chemicals used to produce plastics contribute to chronic conditions in multiple organ systems and disrupt hormone function, and exposure to plastic-derived toxins is associated with adverse birth outcomes, metabolic conditions, neurodevelopmental disease and disability, and reproductive conditions.

[Articles] Longitudinal association between dysmenorrhoea in adolescence and chronic pain in adulthood: a UK population-based study

Dysmenorrhoea in adolescence adversely affects immediate wellbeing and contributes to an increased risk of chronic pain in adulthood, thus lending supporting evidence to calls to consider adolescent dysmenorrhoea a crucial public health issue. Future work should focus on early identification and effective management, including non-pharmacological strategies and self-management, which relies on continuing work to improve young people's menstrual literacy.