Dr Ranj Singh, leading paediatrician on ITV’s This Morning and CBeebies’ Get Well Soon programme, talks to Kayley Loveridge about key health concerns among children, his thoughts on vaccinations and how we can close the poverty gap in Britain to ensure every child gets the healthcare they deserve.
Q. What are your main concerns today when it comes to children’s health?
RS: As a medical professional, my main areas of concern when it comes to child health are, firstly, infections and their prevention.
Secondly, accidents in children and young people. The third thing is the increasing incidence of acquired diseases. These are 'adult' diseases that children are getting. Here, we’re talking about things like obesity, heart disease and Type 2 diabetes. We would usually associate these conditions with older people, but we’re starting to see them in younger and younger ages, and that’s worrying.
The fourth big area we are increasingly becoming aware of is mental health. We are seeing more and more young people struggling with mental health issues, but we are less and less able to deal with it. That’s a real worry. The final area that we need to keep in mind is personal and sexual health. That includes everything from sex education and awareness about safety and consent, to having healthy relationships. We have to equip our kids better for real life, and that means dealing with difficult subjects like this. While we’re bogged down in everything else, we mustn’t forget that these are the day-to-day things that young people have to manage, and we have a responsibility to help and guide them.
Q. What are the key things that would-be parents should keep in mind when trying to conceive?
RS: I would say, firstly, don’t fret; try not to panic. It’s very understandable and easy to be nervous about issues with conception, but difficulty conceiving is not uncommon.
It’s also important to be realistic. Conception isn’t always easy and it can take time. It’s important to be aware that some of the treatments on offer at the moment—including IVF—don’t actually have very high success rates. That can be hard to hear.
Thirdly, it’s important to look after yourself and your general health. General health is tied into fertility, so ensure you eat healthily, get some exercise, cut out smoking and watch your drinking. That applies to both men and women.
That leads on to my fourth point, which is about taking care of your mental health. Problems conceiving can have a big impact on your mental wellbeing, too.
Finally, be careful and don’t be conned. There are many companies offering a range of treatments, many of which are not evidence-based. It’s a seriously misleading market, and I think it’s a national scandal.
Q. In your view, how important is it that children are administered the recommended vaccinations in their early years?
RS: Speaking from the perspective of someone who looks after children and young people specifically, I can categorically say that one of the most effective things you can do to protect the health of your child, and those around them, is to make sure they are immunised. There is a lot of scientific evidence for vaccinations, provided you look in the right place. There is a lot of evidence that they work and that they are safe for the vast majority of people. They prevent life-limiting and sometimes lethal conditions and we are very lucky to have a free national vaccination programme.
If you look at it from an overall health perspective, there have been three major medical advances in the UK which have led to reduced disease and deaths amongst children. They are: better sanitation, the use of antibiotics and vaccination.
Q. In what ways can parents incorporate healthy foods into the diets of even the fussiest of little eaters? How can malnutrition affect
a child’s cognitive abilities?
RS: Get kids interested in food from an early age. As soon as you start weaning them when the time is right, try different things. Get creative and try to make food colourful—and we know that colourful food tends to be better for our health. If your child doesn’t like the look of something, try presenting it in different ways. For example, if your child doesn’t like vegetables, put them into something or disguise them, or work out other ways of getting them in. Get kids involved in the preparation of food, too, so that they are more likely to want to try it. It’s very normal for children to be wary or refuse food to start with but just persevere. It can take as many as 20 goes before they will accept a new food! And don’t worry, your child will not go hungry. It’s important to make sure that children's diets are good enough as it doesn’t just affect their physical health, but also their cognitive abilities, too.
Q. Some child healthcare cases—such as the Charlie Gard case—receive huge media attention. How far do you think this kind of coverage detracts from the core issue of the child’s health and becomes a more political argument?
RS: The sad Charlie Gard case taught us a lot of things about how medical cases might play out in the media and the impact that can have, both positive and negative. There’s no doubt that when cases like this come to light, people will start talking about them and it raises awareness of rare conditions. Charlie’s case got lots of people interested in mitochondrial disorders and that was important.
However, the downside of things playing out in the media, especially social media, was that facts were often misinterpreted and people made unfair judgements based on that. There were a lot of very unfair and inaccurate things being said and that caused negative opinions of hard-working people in the medical profession. I feel that amongst all that arguing, we sadly lost sight of the child that was in the middle of it all.
Q. According to the RCPCH, ‘Children living in the most deprived areas are much more likely to be in poor health.’ How far do you think the class divide and poverty makes this true and what can we do to ensure that all children get the healthcare they deserve?
RS: There is a lot of research to show that children from deprived backgrounds have poorer health. For example, babies from the most deprived areas of the country are several times more likely to die under the age of one year than those from the most affluent parts, or if their mums are under 18, or if they’re from certain ethnic backgrounds.
This reflects the big class and poverty divide that exists and we need to make sure that we address that. Firstly, we need to educate people about child health so they’re better equipped when it comes to caring for their kids. Secondly, we’ve got to fund resources and services better. This is where politics plays a big part: we have to try to reduce variation in services across the country if we’re going to ensure that every child has the best start in life.
Q. In your experience, what are the most common misconceptions parents make when it comes to their baby’s health?
RS: I think there are lots of misconceptions about babies’ feeding and pooping. No child feeds perfectly and all of them have different bowel habits! We need to remember that every child is different, and as long as your baby is healthy, gaining weight and is generally well, you can probably relax a bit.
Another misconception is that natural immunity is always better than vaccine-acquired immunity. That’s not the case at all, and not vaccinating your kids puts them in danger.
Thirdly, I would say that lots of people panic when babies cry. Crying isn’t always a sign of something wrong. Babies will cry to communicate when they are in pain, hungry, cold or if they just want some comfort. Crying doesn’t mean that you have to worry, although persistent crying for no known reason can sometimes be a worrying sign.
Finally, I think we should address ‘fever phobia’. Lots of people worry about high temperatures, but they don’t usually cause your child any harm. What’s more important is to know what is causing the fever and whether you need to do something about that.
Q. There has been much debate concerning breastfeeding versus bottle-feeding. What is your view on this?
RS: No-one will disagree that breastfeeding is the natural way to feed your child. It’s associated with a range of short and long-term benefits for baby, such as better immunity, reduced risk of allergies and reducing the risk of obesity. Similarly, there is a range of benefits for mum, too, such as reducing the risk of certain cancers.
However, we have to understand and accept that breastfeeding isn’t always easy or possible, and that it is a choice. We have to support people who can’t or struggle to breastfeed or those who simply choose not to. The important thing is that people are trying to do what is best for them and their child, and no-one deserves to be judged or feel unsupported.
Q. Finally, what three key pieces of advice would you give parents who want to give their children the healthiest start in life?
RS: Nourish, nurture and protect. Nourish your child physically and mentally. That means making sure they’ve got a good diet, that they’re active, that they have opportunities to learn, play and acquire all of those important skills.
Nurture them by providing them with an environment where they feel supported, listened to and loved and where they can be who they are without fear.
Protect them, not just physically, but in terms of their health and well-being, too. So that includes preventative measures like vaccinations but also teaching them about safety and injury prevention.
There’s no one best way to raise a child. Every child, parent and their relationship will be different. You do what is best for you and your child.