The biggest health challenges facing children in Wales - by one of the country's leading doctors

Dr David Tuthill is the Royal College of Paediatrics and Child Health’s (RCPCH) new officer for Wales. Here he highlights the main hurdles he believes need to be tackled to better health for our children.

The NHS turns 70 this summer and since its conception in 1948, it has delivered many great things.
It can create, prolong, enhance and sustain life.
 It has also introduced child health screening and universal vaccination which has dramatically reduced the devastating burden of infectious disease.

We have a health service which supports us in our greatest time of need, any time day or night, and is free at the point of delivery.
It is a service that is the envy of many nations.
 However, new challenges have arisen as children’s lifestyles have become more sedentary, more families live fragmented lives and many individuals are pressurised by digital media.

Thus, despite the advancements in care, it faces several challenges that must be overcome if it is to be "the envy of the world" as its creators hoped.

Obesity is the greatest public health threat facing this country and nationally costs the NHS over £6bn a year to treat.

In Wales, 27% of children are classified as being overweight or obese putting them at increased risk of developing type 2 diabetes, asthma and sleep problems – conditions that are now taking hold much earlier in life. Unless something is done to reverse this trend, these children are likely to become overweight or obese adults, adding further strain on their health and the NHS.

We know that many factors fuel the obesity crisis including a lack of physical exercise, families and healthcare workers not recognising or acting on overweight children and the hidden sugar and fat content in food.

In the wider environment we are surrounded by junk food and drink advertising, while the infrastructure of our towns and cities is often not conducive to children walking or cycling to school.

The UK Government published Chapter Two of its long-awaited childhood obesity plan this month and as Welsh Government plans to publish its own bespoke plan for Wales, it provides an opportunity to build on some of the strong policies that Westminster champions.

Westminster is to consult on the advertising of junk food before 9pm, mandatory calorie labelling in restaurants and cafés, price promotions on unhealthy foods and supermarket product placement such as confectionery at check-outs.

I would be particularly pleased about the potential for better planning support for local authorities, helping them consider the health and wellbeing of the community in all new developments.

Dental health

Poor quality food and sugary drinks don’t just affect the waistline, they have a terrible impact on children’s teeth too. Excess refined sugar leads to obesity, but it is also one of the leading causes of tooth decay.

Having poor dental health can cause toothache and dental infections as well as affect a child’s ability to sleep, speak and eat. In Wales one in three five-year-olds have tooth decay and while this rate has reduced over recent years it is still the biggest reason why children under five go to hospital for a general anaesthetic.

Welsh Government’s Designed to Smile programme has been making a real difference by giving dental advice, providing toothbrushes and toothpaste, and encouraging families to see a dentist before their child’s first birthday.
It also delivers nursery and school-based toothbrushing and fluoride varnish programmes.
Let’s continue to build on this good work and urge councils to prioritise children’s oral health in their Health and Wellbeing Strategies.

Families can help improve children’s oral health by:
swapping fizzy drinks for water
brushing their child’s teeth twice daily for two minutes with fluoride toothpaste
spitting out excess froth, don’t rinse your mouth out after brushing your teeth
ensuring their child visits the dentist by their first birthday
not using baby bottles after your baby’s first birthday