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Child health
Beds Still Burning: Suicide Should Not Be in the Vocabulary of Children
Indigenous children are seen as an intrinsic, systematic foundation of hope in Aboriginal conceptualisations of hope, yet are grossly overrepresented in Australian suicide statistics. Despite being a target of the Australian Government's almost 20-year-long Closing the Gap campaign, the numbers are only getting worse. ‘It's not depression, it's despair’ are words that echo a sentiment so ghastly for parents of Indigenous children who only hope to bestow them with the gift of exactly that: hope. It is only sensible to counteract this with holistic, culturally empowered, strengths-based well-being programs to both develop Cultural strength while concurrently instilling a sense of Cultural pride and identity.
Rudi Louis Taylor-Bragge
Progressing Cross-Sector Collaboration for People With Eating Disorders and Higher Weight: Priority Actions From an Expert Roundtable Using a Modified Nominal Group Technique
Introduction Eating disorders are more prevalent in people with higher weight than those with low weight. However, contention between the fields of obesity and eating disorders has prevented meaningful progress in research, prevention, identification and coordinated clinical services for people with co-occurring conditions. In Australia, public health approaches and provision of treatment services for people with eating disorders and clinical obesity are siloed, often resulting in contradictory messaging. To address this, a roundtable meeting was held in November 2024 in Sydney, Australia, with 28 experts in one or both of these fields, including researchers, clinicians and service leaders working across paediatric and adult care, and individuals with lived experience. Guided by the National Eating Disorders Collaboration stepped system of care framework, participants identified key challenges and possible solutions, and established five priority actions.Main RecommendationsThe priority actions across sectors are: Health Campaigns focused on raising awareness of eating disorders at higher weight, using appropriate language and reducing weight stigma; improved Screening and Assessment using standardised protocols across healthcare settings; supporting Primary Healthcare and improving the use of Medicare items; Tailored Treatment Pathways including integrated care models; and building Workforce Capacity to upskill professionals to provide safe, person-centred care.Changes in Management as a Result of the StatementThese actions aim to promote improved cross-sector collaboration and effective, safe, coordinated and integrated approaches to prevention, identification and treatment across the fields of obesity and eating disorders. They address the complex medical and psychological needs of those with co-occurring eating disorders and higher weight or clinical obesity through a skilled workforce and improved access to care. Effective integration, collaboration and coordination across services is essential for long-term recovery support.
Hiba Jebeile, Leah Brennan, Tracy Burrows, Xochitl de la Piedad Garcia, Angelique F. Ralph, Supreet Saluja, Evan Atlantis, Sarah P. Garnett, Carmel J. Harrison, Eve T. House, Natalie B. Lister, Lisa Moran, Milan K. Piya, Elizabeth Rieger, Evelyn Smith, Phillipa Hay, Sarah Trobe
Intergenerational Child Protection Contact and Child Development Outcomes: A Whole Population Linked Data Study
Objectives To investigate maternal child protection histories, and offspring child protection contacts and developmental outcomes, for children at age 5 years.Study DesignObservational cohort study using linked South Australian administrative birth, perinatal, child protection and child development data.Participants, SettingChildren with a South Australian birth registration and a record in the 2009, 2012, 2015 or 2018 Australian Early Development Census (AEDC).Main Outcome MeasuresHighest level of child protection system contact for children before starting school, and developmental vulnerability on one or more AEDC domains.ResultsOf 69,332 children, 7522 (10.8%) had a mother with a history of any child protection contact, and 1019 (1.5%) had a mother with at least one out-of-home care placement. Maternal child protection history was associated with increasing levels of socio-economic and health disadvantage around the time of birth. For example, overall there were 8245/69,332 (11.9%) children born into a home where the parent(s) were unemployed, compared with 549/1019 (53.9%) with a maternal out-of-home care history. For children whose mothers had child protection contact, 3793/7522 (50.4%) had their own child protection contact by age 5 years, compared with 7033/61,810 (11.4%) for children whose mothers had no contact. Of 6771 children whose mothers had child protection contact, 2724 (40.2% [95% confidence interval], 39.1%–41.4%) were developmentally vulnerable on one or more AEDC domains when they started school, compared with 12,002/58,165 (20.6% [95% confidence interval], 20.3%–21.0%) children with no maternal child protection history.ConclusionChild protection contact is common in both mothers and children, and maternal child protection history carries an increased burden of poor development outcomes at school entry. The scale and intersection of child protection system contact, early life disadvantage and poor development outcomes have implications for appropriately resourcing health-led supportive responses as early as possible during the perinatal and early childhood periods.
Meredith Forsyth, Alicia Montgomerie, Kathleen Falster, Deepa Jeyaseelan, Paul Hotton, John Lynch, Rhiannon M. Pilkington
Impact of the 2025 New South Wales Respiratory Syncytial Virus Prevention Program on Infant Notifications and Hospitalisations: A Population-Based Analysis
The 2025 NSW RSV Prevention Program, which achieved an estimated coverage of 63% maternal vaccination and 18% for infant immunisation, led to more than 40% reduction in RSV notifications and hospitalisations among infants aged younger than 6months.
Janaki Amin, Sally L. Ellis, Christopher Lambeth, Jessica Gugusheff, Christine Selvey
Australian Guidelines for Assessment and Diagnosis of Fetal Alcohol Spectrum Disorder: Overview of the Development Process and Revised Diagnostic Criteria
Introduction The Australian Guidelines for the Assessment and Diagnosis of Fetal Alcohol Spectrum Disorder were released in May 2025. These guidelines, updated from the 2016 Australian Guide, were developed through extensive stakeholder consultation, a comprehensive review of empirical evidence and the application of a novel Grading of Recommendations, Development and Evaluation (GRADE)-based approach for developing evidence-based diagnostic criteria. Recommendations The guidelines include 11 GRADE-based recommendations, forming the core of the diagnostic criteria, and 11 lived experience statements, supporting client-centred assessment approaches. The guidelines also feature 40 good practice statements and 18 implementation considerations, tools and tips as practical resources and supports for practitioners. Changes in Management as a Result of the Guidelines Key changes in the new guidelines include: A minimum prenatal alcohol exposure threshold for diagnosis to support more precise identification of fetal alcohol spectrum disorder (FASD); The assessment of neurodevelopmental impairments and functioning has been refined, including detailed advice for practitioners seeking to identify clinically significant impairments; Inclusion/exclusion of neurodevelopmental domains as part of the assessment; and Revisions to some of the content of the included neurodevelopmental domains. Changes have also been made with attention to the needs of First Nations Australians and people from other culturally and linguistically diverse backgrounds. The guidelines advocate for the use of shared decision-making approaches, promoting collaboration between practitioners, individuals attending for assessment and their support network. Importantly, the guidelines will enable an accessible, holistic and flexible assessment process, supporting timely and accurate assessment and diagnosis of FASD in Australia. The rigorous development process also provides practitioners with confidence in the guidelines, promoting increased uptake of assessment and diagnostic practices, and informing international diagnostic criteria and guidelines.
Natasha Reid · Nicole Hewlett, Nicole Hayes, Zachary Munn, Haydn Till, Delyse Hutchinson · James Stewart, Max Naglazas, Andrea Crawford, Raewyn C. Mutch, Carmela F. Pestell, Rowena Friend, Lisa K. Akison · Chelsea Vanderpeet, Prue Walker, Matthew Gullo, Doug Shelton, Elizabeth J. Elliott, Fiona Kay, Katrina Harris, Jayden Logan, Storm Anderson · Natalie R. Kippin, Seema Padencheri, Sophie Harrington, Diana Barnett, Kelly Skorka, Robyn Doney · Philippa Middleton
Strengthening Care for Children (SC4C), an Integrated Paediatrician‒General Practitioner Model for Reducing Hospital Referral Rates: a Stepped-Wedge Cluster Randomised Controlled Trial
ObjectivesTo assess the effectiveness of Strengthening Care for Children (SC4C) for reducing the number of referrals by general practitioners of patients under 18years of age to hospital services.Study DesignStepped-wedge cluster randomised trial; data collected for up to 16months after the intervention.SettingGeneral practices in North Western Melbourne and Central and Eastern Sydney primary health networks, 1 May 2021–30 September 2023.ParticipantsGeneral practitioners who worked at least two clinical sessions each week, saw patients under 18years of age, and for whom at least 1 month of referrals data during the control period were available; families of people under 18years attending these practices.InterventionWeekly (6 months) then fortnightly (6 months) general practitioner–paediatrician co-consultations; monthly paediatrician-led case discussions; weekday phone and email support by paediatricians.Main Outcome MeasuresProportion of general practitioner visits in which patients were referred to publicly funded hospital outpatient clinics or emergency departments (patient level), overall and by baseline referral rate. Secondary outcomes: Referrals after completion of the intervention; general practitioner confidence regarding child health care; low value care for frequent childhood conditions; family preference for general practitioner or paediatrician care.ResultsOne hundred and thirty participating general practitioners from 22 general practices conducted 50,101 consultations during the control period; 125 general practitioners from 21 general practices received the intervention and undertook 96,804 consultations. Patients were referred to hospitals in 2.3% of control period consultations and 1.9% of intervention period consultations (risk difference, −0.34 [95% confidence interval {CI}, −0.69 to 0.004] percentage points). Among general practitioners with high referral rates at baseline (5% or higher), patients were referred to hospital outpatient or emergency department in 7.3% of control period consultations and in 3.0% of intervention period consultations (risk difference, −4.28 [95% CI, −6.59 to −1.97] percentage points); the referral rate was also lower after the intervention period (sustainability vs. control periods: 2.9% vs. 5.8%; risk difference, −2.92 [95% CI, −5.36 to −0.48] percentage points). The proportions of general practitioners confident about their knowledge and skills regarding child health care were larger during the intervention than the control period. Quality of care and family preference for general practitioner-led care for their children remained high across the study. No adverse events were recorded.ConclusionStrengthening primary care for children reduces the frequency of hospital referrals of children by general practitioners with high referral rates, increases rates of general practitioner confidence about caring for children and maintains family preference for general practitioner-led care.Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12620001299998 (prospective)
Harriet Hiscock · Cecilia Moore · Sonia Khano · Lena A. Sanci · Kim M. Dalziel · Gary Freed · Douglas I. R. Boyle · Tammy Meyers Morris · Siaw-Teng Liaw · Jane Le · Yvonne A. Zurynski · Susan Woolfenden · Raghu Lingam
Birth prevalence, clinical sequelae, and management of congenital cytomegalovirus infections in Australia, 1999–2023: a national prospective study
Universal newborn screening could improve timely detection and avert neurological and other adverse consequences of CMV infections
Ece Egilmezer · Suzy M Teutsch · Carlos Nunez · Stuart T Hamilton · Adam W Bartlett · Pamela Palasanthiran · Elizabeth J Elliott · William D Rawlinson
Vaping may be slowing Australia’s tobacco control progress
It is time to phase out the commercial tobacco industry and require that the industry pays for the costs our society incurs as a result of its activities
Michelle I Jongenelis · Mike Daube
The early implementation phase of the Omega‐3 Test‐and‐Treat Program for reducing the risk of preterm birth, South Australia, 2021–22: an implementation evaluation study
The program could be integrated into routine antenatal care to reduce the risk of preterm birth in Australia
Karen P Best · Celine Northcott · Lucy A Simmonds · Philippa Middleton · Lisa N Yelland · Vanessa Moffa · Khoa Lam · Penelope Coates · Cornelia Späth · Carol WK Siu · Karen Glover · Rhiannon Smith · Robert Gibson · Maria Makrides
The First Future Healthy Countdown 2030 progress report: tracking Australian children and young people’s health and wellbeing to drive accountability
Australia has the means to ensure that children and young people can thrive. We are in a critical period, and failure to act risks leaving a generation behind
Georgie Frykberg · Angelica Ojinnaka‐Psillakis · Planning Saw · Kevin Kapeke · Cham Kim · Amie Furlong · Susan Maury · Anna M H Price · Peter D Sly · Taylor Dee Hawkins · Khalid Muse · Pasi Sahlberg · Prue Warrilow · Fiona J Stanley · Jordan Cory · Carolyn Wallace · Adam Valvasori · Ngiare Brown · Craig A Olsson · Yichao Wang · Sharon R Goldfeld · Rosemary Calder · Kate Lycett
Early childhood learning for lifelong health impact
The lessons of early literacy reform show that strong evidence, when acted upon, drives better outcomes. By bringing together rapid ECEC reforms with unique, embedded cohorts (GenV and ORIGINS), Australia offers a globally unprecedented opportunity to unite rigorous early education and health research and practice at scale for lasting child wellbeing and population health
Melissa Wake · Jon Quach · Jacqueline Davis
Early childhood learning for lifelong health impact
The lessons of early literacy reform show that strong evidence, when acted upon, drives better outcomes. By bringing together rapid ECEC reforms with unique, embedded cohorts (GenV and ORIGINS), Australia offers a globally unprecedented opportunity to unite rigorous early education and health research and practice at scale for lasting child wellbeing and population health
Melissa Wake · Jon Quach · Jacqueline Davis
Adult attention deficit hyperactivity disorder in Australia: how its current commercial model for diagnosis and treatment is encouraging misdiagnosis
High costs and inconsistent diagnostic standards for attention deficit hyperactivity disorder in adults contribute to overdiagnosis in high-functioning individuals and exclusion of more impaired patients
Richard CJ Bradlow · Ferghal Armstrong · Edward Ogden
The importance of universal child and family health services for equitable early development
By optimising existing investments and leveraging Australia’s strong universal foundation, we can enhance child and family health services and improve outcomes for all children and their families
Anna MH Price · Elodie O’Connor · Sharon R Goldfeld
Concurrent use of hormonal long‐acting reversible contraception by women of reproductive age dispensed teratogenic medications, Australia, 2013–2021
Michelle KY Chen · Adrian Lim · Deshan F Sebaratnam
Cass Review does not guide care for trans young people
Good medicine is guided by the values of the patient, not those of a clinician, politician or commentator. The Cass Review, lacking expertise and compromised by implicit stigma and misinformation, does not give credible evidence-based guidance
Julia K Moore · Cate Rayner · S Rachel Skinner · Katie Wynne · Blake S Cavve · Brodie Fraser · Uma Ganti · Claire McAllister · Gideon Meyerowitz‐Katz · Tram Nguyen · Anja Ravine · Brian Ross · Darren B Russell · Liz A Saunders · Aris Siafarikas · Ken C Pang
An autoethnographic critique of a past report of inpatient psychiatric treatment for gender diverse children
Contrary to ongoing representations of efficacy, “therapy” that aimed to change or suppress a gender diverse child served to delay self-acceptance for two decades and caused long term harm
Jayne McFadyen · Timothy W Jones · Rowena Koek · Fintan Harte · Brendan Jansen · Megan Galbally · Warren Kealy‐Bateman · Catherine Wall · Quinnehtukqut McLamore · Anja Ravine
The first live term birth following uterus transplantation in Australia
Uterus transplantation could be adopted as an assisted reproductive technology for women with uterine factor infertility
Rebecca Deans · Brigitte Gerstl · Antonia W Shand · Sarah Lyons · Aaron Budden · Helen L Barrett · Grant Luxton · Mangalee Fernando · Kenneth Yong · Karen Keung · Kaushalya Arulpragasam · Henry Pleass · King Man Wan · Eva Kehag · Jana‐Emily Pittman · Mianna Lotz · Maria Fenn · Erin Nesbitt‐Hawes · Lily Byun · Katrina Tang · Mats Brannstrom · Jason Abbott
The public health impacts of mining in Australia
A multisectoral approach and stronger multilevel government coordination are required to address the health impacts associated with proximity to mining and exposure to toxic chemicals
Javier Cortes‐Ramirez · Ruby N Michael · Leisa‐Maree Toms · Melissa Haswell
Current gaps in knowledge and future research directions for Aboriginal and Torres Strait Islander children with cancer
A discussion on what is known about cancer in Aboriginal and Torres Strait Islander children, including a summary of literature on Indigenous childhood cancer around the world. Future areas of research and clinical advances are outlined.
Alexandra Truong · Kayla Williams‐Tucker (Ngarluma, Wongutha, Wudjari Noongar) · Ahmi Narkle (Whadjuk Goreng Noongar) · Eden Slicer (Gundungurra) · Jessica‐Elise Chapman (Kamilaroi, Bundjalung) · Jessica Lawler · Rishi S Kotecha · Hetal Dholaria · Justine R Clark (Adnyamathanha) · Alex Brown (Yuin) · Raelene Endersby · Nicholas G Gottardo · Jessica Buck (Kamilaroi)
Respiratory syncytial virus preventives for children in Australia: current landscape and future directions
A review of advancements in respiratory syncytial virus (RSV) prevention within Australia, focusing on the recent introduction of nirsevimab, a long-acting monoclonal antibody, and Abrysvo, a maternal RSV vaccine.
Sam T Barnett · Jane Tuckerman · Ian G Barr · Nigel W Crawford · Danielle F Wurzel
What is needed to improve young people's access to sexual health care through primary care?
Strengthening the primary care system will assist health care practitioners with the time and resources to provide good sexual health care to young people
Helen Bittleston · Meredith Temple‐Smith
Social determinants of health and intensive care unit admission rates and outcomes for children, Australia, 2013–2020: analysis of national registry data
Targeted interventions based on further research are needed to reduce differences associated with social determinants of health
for the Australian and New Zealand Intensive Care Society Paediatric Study Group and Centre for Outcomes and Resource Evaluation
The potential of maternal and child health service data in Australia: how lessons from the COVID‐19 pandemic can accelerate data‐informed decision making
A discussion on the possibility and urgency of using linked maternal and child health data, with Victoria and South Australia as case studies, while there is a political window of opportunity for collaborative action
Ashleigh Shipton · Meredith O'Connor · Melissa Wake · Sharon Goldfeld · Helen Lees · Catina Adams · Kristina Edvardsson · Leesa Hooker · Jatender Mohal · Rhiannon M Pilkington · Fiona K Mensah
Aboriginal and Torres Strait Islander infants admitted to the Hunter New England neonatal intensive care unit, 2016-2021: a retrospective medical record audit
Effective strategies for culturally safe NICU care, including localised approaches, requires further research
Jessica Bennett · Michelle Kennedy · Jamie Bryant · Amanual Mersha · Larissa Korostenski · Michelle Stubbs · Justine Parsons · Luke Wakely
