Four Recent Studies on Kids You Probably Missed
Why they are useful, and why they didn't generate headlines
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A popular topic in this newsletter is “bad studies that animate the media.” Sometimes I feel like if this was your main consumption of research, you’d conclude that all studies are bad, and also that the media likes alarmist headlines. The second is true; the first is not. Many research papers are not bad. Perhaps more important to note, much of what is produced by academic journals — even on topics the general public might be interested in — never gets surfaced in the media at all.
One of my favorite things to do is peruse relevant journals and see what they are up to that I’m not hearing about in the New York Times or in the scary headlines you send me on Instagram DMs. Today I’m going to surface the results of one of those perusals. I spent a few hours in JAMA Pediatrics, a top pediatrics journal (impact factor: 26.8). Here’s some of the interesting stuff I found, plus a bit of speculation at the end about why they didn’t pop up in your news feed.
Early bedtime is good
The first paper that caught my eye was titled “Nonpharmacological Interventions to Lengthen Sleep Duration in Healthy Children.”
This paper is a review and meta-analysis of randomized interventions with the goal of increasing sleep in kids. As I’ve talked about before, sleep is incredibly important for kids’ development, and many kids do not get enough of it. But increasing sleep for kids can be challenging; kids fight sleep, and it’s sometimes hard to know how to go about doing this.
The review paper covers 45 studies that tried different interventions (mostly in-home with families) to increase children’s sleep. It is a formal meta-analysis, which means the authors searched for papers on this question and then used a standard procedure to combine the numbers to draw overall conclusion, even though the individual trials themselves didn’t all do exactly the same thing.
Trials were included in the study if they used any intervention that might affect sleep, even if it was part of a slightly different goal. For example: some of the interventions in these studies were focused on combating obesity, and better sleep habits are often part of that. Most interventions used some form of talking to families about how to improve sleep, and possibly making specific suggestions.
Here are the headline results. Overall, on average, these interventions increased sleep by 10 minutes. This is significant, but it’s also fairly small. However, the interventions that focused on an earlier bedtime increased sleep by 47 minutes — this effect is significant and much larger than the interventions that did other things.
The individual study with the largest effect here is relevant to those of us with slightly older kids. This 2017 paper intervened with high school students who got an average of five to seven hours of sleep a night. The intervention group was told to go to bed 1.5 hours earlier than they typically would. They ended up getting 72 minutes more sleep and “had reduced symptoms of sleepiness, anger, [low] vigor, fatigue, and confusion.”
Overall: we know sleep matters. This paper reaffirms that, and points to earlier bedtime as a key (for older kids, too).
Kids and marathons
Of course I’d gravitate here: “Kids on the Run — Is Marathon Running Safe for Children?” This one is a “Viewpoint” piece, so it’s not a formal data analysis, but it brings in a variety of evidence from an expert viewpoint. The motivation is a story from May, when a 6-year-old finished the Flying Pig Marathon, to the chorus of much criticism of his parents. (Pause: For those of you who have gone hiking with your kids and found them asking for snacks and whining while you can still see the parking lot — can you imagine this? Anyway.)
The question in this piece is whether there is any reason to think that small children running marathons is dangerous. In most current marathons, children are not allowed. However: the authors note that historically there was child participation in marathons. For example: between 1982 and 2007, 310 children between 7 and 17 years old completed the Twin Cities Marathon. Their risk of medical encounters afterward was lower than adults’. There are a number of other examples — kids as young as 12 successfully completing ultra-marathon events (that’s events longer than 26 miles) and so on.
The broad conclusion of the piece is that we have limited evidence to suggest this is dangerous, but also little evidence to point to any value in terms of (say) long-term engagement with running. There are also concerns about overuse injuries, which occur in adults as well, as a result of these events. The authors end with a discussion of what pediatricians should address with parents and kids if the kids are participating in endurance sports events.
This was interesting. It didn’t make me want to bring my 7-year-old on my next half marathon, though.
Masks and face touching
It wouldn’t be 2022 unless there were a few COVID papers. One that caught my eye: “Effect of Wearing a Face Mask on Hand-to-Face Contact by Children in a Simulated School Environment.”
This paper reports on a randomized trial in which some kids (ages 5 to 18) were asked to wear face masks and some to not. The authors used camera footage to judge whether wearing a mask caused kids to touch their face more. This is something that has been speculated.
The authors find that kids with the masks do not touch their face more than those without.
This paper actually isn’t wildly interesting. But it illustrates to me the slow progress of science. When we argue about masks, there are a lot of pieces of data that are missing from these arguments. This is one of them. In and of itself, it doesn’t suggest we should do anything in particular, but it’s one small puzzle piece in a bigger picture.
Kids and cannabis gummies
Finally, we’ve got a report that I was surprised didn’t get some coverage: “The Continued Rise of Unintentional Ingestion of Edible Cannabis in Toddlers — A Growing Public Health Concern.” As the title suggests, this is a paper about the phenomenon of children eating cannabis gummies because they look like actual gummy candy.
This report is fairly light on actual evidence; it’s, again, more of a viewpoint. The authors cite a 13-fold increase in cannabis encounters for children under 6 over the period from 2004 to 2018. However: the number of encounters is still extremely small — in one cited study, it’s 29 cases over a 10-year period. The complications of cannabis consumption among children include confusion, neurological issues, extreme drowsiness, etc. They may well require hospitalization, at least for observation.
What I liked about this paper is the authors make a compelling point that there is a possible danger due to the discomfort with discussing these issues. Pediatricians aren’t yet comfortable with the conversation that starts with: “Do you have cannabis candies in your house, and, if so, can we talk about how you are storing them?” There is a chance this will change with more legalization. And, frankly, it would be good for children if it did.
The practical note here is that if you have cannabis gummies or cookies or any delicious treats in your house, please store them in a location where they will not be found and confused for actual candy by your children.
Why aren’t these covered?
I found all four of these (and more! I limited myself) both interesting and, in at least one case (early bedtime), relevant and actionable for parents. But none of them — except maybe the last — are scary, sexy, or exciting. They are helpful, to both parents and pediatricians, and add to our knowledge. But they do not necessarily lend themselves to clickable headlines.
The lesson here, other than to have an early bedtime and not to store your cannabis gummies with the other gummies, is probably one of awareness. Studies we see in the media are selected for something, and it isn’t always for being the most thoughtful or useful.
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