Bubble Wrap PLUS – July 2025

Can’t get enough of Bubble Wrap? The Bubble Wrap Plus is a monthly paediatric Journal Club reading list from Professor Jaan Toelen (University Hospitals Leuven) and Dr Anke Raaijmakers (Sydney Children’s Hospital). 

This comprehensive list is developed from 34 journals, including major and subspecialty paediatric journals. We suggest that this list can help you discover relevant or interesting articles for your local journal club or keep you up to date on the latest paediatric research.

For some of us, the summer holidays are approaching, a time for relaxation and re-charging of the mental batteries. Many will be looking through the bestseller lists for enjoyable books to read at the beach or after a refreshing walk in nature. Could we tempt you with some text that may be less alluring with regards to linguistic beauty, but enormously alluring with regards to its scientific value?

Here are the highlights of the JC list of July 2025:

Role models can help children build their own identity and sense of belonging in our society. Often, these role models can be found in real life, but also in modern media, such as movies or animated films.

A recent study in Pediatrics investigated the prevalence and of facial differences in animated films (a euphemism for disfigurements such as a scar or other). Of the 500 characters analysed, only 1.8% exhibited visible “facial differences” (mainly the baddy in the movie with a scar on the face).

Only one (!) character positively referenced their facial difference. The authors conclude that there are no representative heroes without perfect features. We should wonder if this practice affects empathy or the acceptance of non-perfect appearances in young audiences.

Asthma and ADHD are both common in children and often co-occur, which increases caregiving complexity and health care utilisation. In a study by Chong et al., children with both conditions were included and randomised to an “Acceptance and Commitment Therapy–based Parenting Program”. Although the main outcome was unscheduled healthcare visits, they also examined asthma control, symptoms, and management. About one visit was prevented over the study period compared to standard care.

But there was more: they also had better asthma control, reduced ADHD symptoms, greater parental psychological flexibility, and improved asthma management self-efficacy compared to standard care alone. A promising result which may be applicable to other co-occurring diseases (including ADHD comorbidities).

Lately, montelukast has been one of the more contested medications in paediatrics.  A study in this issue of the Journal of Paediatrics and Child Health on the neuropsychiatric side effects of montelukast shows a significant increase in the frequency of many psychiatric symptoms, including insomnia, nightmares, drowsiness, behavioural problems, irritability, depressive mood, agitation, anxiety, hyperactivity, learning difficulties and headache. This was most pronounced when concomitant antihistamines were used.

Most of you will recall the JC list of February 2025, where a large Swedish study showed no association with neuropsychiatric adverse events of montelukast in children. It is interesting to compare the two studies, with such diametrically opposite findings, to determine whether montelukast can be used liberally or with caution in our patient population.

TikTok is a popular social media platform for our youth and can be both a source of information (even health education) and misinformation. In this issue of Pediatrics, Hales and colleagues investigated skin care regimens of content creators aged 18 years or younger. Each video reached had an average of 1.1 million views (youngest content creator was only 7!). Regimens featured an average of 6 products, costing an average of more than $150 per regimen (approximately 125€).

The authors conclude that these regimens are costly, infrequently include sunscreen, and often involve exposure to ingredients that carry a risk of irritation, allergic contact dermatitis, and sun sensitivity. Most importantly, they offer little to no benefit for the paediatric populations they are targeting.

We hope that you enjoy the list!

Best wishes,

Anke and Jaan

If we have missed out on something useful or you think other articles are absolutely worth sharing, please add them in the comments!