Δρ Νικόλας Καλογήρου - Παιδίατρος / Dr Nicolas Kalogirou Paediatrician, Sikouana 22, Káto Polemídia (2026)

11/01/2026

IS CO-SLEEPING WITH YOUR BABY SAFE ?

Disclaimer: The information provided in this post is for informational purposes only and does not constitute medical advice. I do not endorse co-sleeping under my professional capacity.

As a health professional tasked with discussing Sudden Infant Death Syndrome (SIDS) prevention with new parents during their first visit , I am obliged to reiterate the safe sleep guidelines which is that co-sleeping increases the risk for SIDS and should be avoided. I am fully aware that this message may be at odds with the harsh reality of a new mother’s life. However co-sleeping could result in the loss of a life . Therefore most doctors feel is safest to simply tell all parents to never cosleep .

We know that newborns have not been designed to let their mothers sleep for 8 consecutive hours and there are good reasons for that . For starts breastfed infants get hungry every couple of hours ( but this is not an argument in favor of using formulas of course ). Also babies do not like it when not being held or cuddled and feel uneasy with lack of proximity , hence why the get upset when put down on the cot. This is an evolutionary remnant from back in the day when living in the savannas the world was not a safe place to leave a baby out of arm’s reach. Babies who cried when left unattended were most likely to survive and not be eaten by tigers.

So how do parents cope? Studies show that a high percentage of nursing mothers bring their infant into their bed even if they do not admit this. Many parents end up co-sleeping as it settles their baby and enables everyone to sleep.

So why is co-sleeping being labelled hazardous ? Data from the UK and the US show that approximately half of SIDS babies die during co-sleeping . So the maths say that co-sleeping increases the risk of SIDS by 10 fold which is pretty shocking . The caveat here though is that most of this co-sleeping related deaths happen when other hazardous factors are also at play , mainly co-sleeping on sofas , while taking sedative medications or alcohol , or when a parent is a regular smoker . Therefore when we take these factors out of the equation and look at co-sleeping alone the risk is lower , although it is still non-zero . An interesting fact is that SIDS cases in Japan where co-sleeping is the norm for cultural reasons are half of those in the US.

I think shocking messages that imply that all co-sleeping leads to death are not very helpful. They do not reflect the complexity of the evidence, they ignore the harsh reality of looking after a newborn baby, they induce guilt to parents and close down honest conversations .

For those interested in reading more about co-sleeping the lullaby trust website has some great resources on the topic.

07/01/2026

INFANT FORMULA RECALLS !!

Dear all the following infant formulas are being urgently recalled from the market due to concerns regarding potential contamination with a toxin leading to food poisoning

NAN EXPERT pro Lactose Free Batch 51520346AD
NAN EXPERT pro sensitive plus Batches 51250742C1, 52610742C2
S26 GOLD - 1 batch 51550346AE

be mindful that the recall only affects the above specific products and not all products of the NAN or S26 series .

07/12/2025

IS THERE A LINK BETWEEN MICROBIOME AND AUTISM ?

The idea that the gut microbiome may have a causal link with autism has become quite mainstream in recent years. A rule of thumb is that outrageous claims require an outrageous level of evidence before we should believe them. In this case, there is no scientifically coherent story and yet parents of autistic children
are being sold expensive treatments and diets on the basis of it.

WHAT WE KNOW WITH CERTAINTY :

Gastrointestinal issues are very common in Autism Spectrum Disorder , affecting around 50% of individuals,. Problems like constipation, diarrhea, abdominal pain, bloating, and reflux, are more common and more severe than in the general population.

Many studies have reported for the most part that children with autism differ from those without on aspects of the gut microbiome

WHAT IS NOT CERTAIN:

Although there is a ton of data showing associations between dysbiosis ( which means abnormal microbiome ) and a wide range of conditions from schizophrenia to rheumatoid arthritis, there is very little evidence of causation and even less evidence that reversing the dysbiosis has any therapeutic benefit

The key here is that association does not mean causation. For example there is a statistical association between children’s ice cream consumption and death by drowning . Not because the first causes the latter but because both are more frequent during summer months. There is also a statistical association between margarine consumption and divorce rates and tons of other spurious correlations .

WHAT ARE OTHER POSSIBLE EXPLANATIONS

Quite simply that the dysbiosis results from autistic behaviours and not vice versa. Autistic individuals have very restricted diets which take a toll on their microbiome . I see lots of children with autism in my practise and I am yet to meet the one who is eating his 5 a day of fruits and veggies. This is not rocket science.

Correcting long standing abdominal discomfort and pain will improve an autistic child’s behaviour especially the difficult ones. Being happier and less distressed will make you more agreeable and easy going. That does not mean that the core symptoms of autism have gone away.

The new hype - amplified by US health secretary RFK and President Trump – that the rise in autism must be explained by an environmental cause such as Paracetamol or vaccines.

Too many vested interests in the commercial world . There is the food industry, biotech startups and “wellness” companies who profit out of this hype . This notion has formed the basis for tons of supplements , special diets and ‘‘natural’’ remedies promoted by a global wellness industry.

WILL IT HARM ?

I personally do not think probiotics supplements cause any harm and I would not discourage a parent from giving them a try especially in the face of gut problems. But I would be realistic in my expectations and be clear that it would not cure autism . I would discourage you however from embarking on special diets like keto or gluten free against medical advise.

01/10/2025

THE FOLATE HYPE

I see a trend in the community of families with autistic children and other developmental challenges to test for folate deficiency or use folate as a means of therapy . This is an extremely complicated and nuanced topic and I thought I ‘d do a quick review of the evidence. Please note that this not in any way a medical advise and you should discuss this matter further with your healthcare provider before you take any actions.

1. There are 4 different forms of vitamin B9. Folate is the form as it occurs in foods and folic acid is the synthetic form found in vitamin supplements . Folinic acid ( aka leucovorin ) and methyl-folate are activated forms of folate which by pass the body’s pathway of activating folate into a chemically active substance ( in case these pathways are defective which is sometimes the case).

2. Vitamin B9 is extremely important in brain growing during fetal life and early childhood as well as brain function thereafter . The mechanisms behind these are complex but if we were to think of our brains as a car engine then folate would be as important as engine oil.

3. MTHFR gene is involved in one of these folate activation pathways. It has been proposed that in some people with autism defective forms of this gene may be responsible for causing deficiency of active folate forms and thereby the autism . Hence autism would be reversed if one gave this child folate supplements . To date this theory has not been validated by evidence. In simple terms there is no definitive link between MTHFR gene mutations and autism and testing for this is not recommended.

4. Folate receptor autoantibodies (FRAT ). In our brains there is a folate receptor which helps move folate from blood into the brain. There is evidence that in SOME autistic people FRAT block this process hence causing deficiency of folate in our brains thereby causing autism. It is clear that folinic acid ( which does not need to use folate receptor to enter brain) can correct this problem in this specific population . It is NOT a cure for autism in general .

5. It is not very clear what subset of children with Autism have folate defects or have FRAT -related autism and would benefit from supplements nor there is any consensus in the medical community as to whom we should be giving folate or should be testing for FRAT antibodies. FRAT antibody testing is not currently available in Cyprus ( at least that I am aware of )

Parents sometimes fall pray to dubious advise by practitioners of alternative and integrative medicine and I can totally see the appeal . Especially if on the other end what classic medicine has to offer is sometimes an authoritative ‘’respect my authority – I know what is best for your child’’ attitude and giving you a list of 10 generic one-size-fits-all recommendations and wishing you good luck. This can lead to a breakdown in rapport and trust.

If I was a parent of a child with autism I would probably be willing to try pretty much everything provided is safe. So knowing that there is a vitamin that stands a chance of inducing positive changes in some autistic children wouldn’t I too be knocking on my paediatrician’s door asking for it just in case my child would benefit ? Absolutely .

This begs the question : given the complexity of testing would it be reasonable to do a trial of folinic acid in all children with autism ? I do not have the answer to this and there are much more clever and important figures in the science community out there who I trust will help with this very valid question .

14/09/2025

DON’T BOTHER CHILDREN WHEN THEY ARE SKATEBOARDING

The title is borrowed from Jordan Peterson and suggests that overprotective parenting can hinder a child's ability to face the challenges of the real world, and that children naturally seek competence in risky activities so they can learn to navigate risk and build necessary skills for life.

But it is also pertinent and captures the essence of another problem we see in developmental clinics . A significant number of young children who are physically deconditioned from lack of free play and are being labelled as having ‘’motor disorders’’ and referred to neurologists or developmental specialists . This is a cohort of children to whom if you apply the performance criteria of motor coordination and physical condition tests they fall under the norms . I am talking about their endurance, balance and agility like the ability to skip , hop, balance on one leg for a period of time , climb on playground climbers and even run well or throw a ball.

WHO recommends that children under 5 should get a minimum of 3 hours per day of physical activity ( such as outdoors play ) with 1h of that being moderate to vigorous activity. International and European studies show that only around 1 in 5 children meets this target ( no data from Cyprus that I could find but I suspect our ratio is probably the same ) . Only yesterday I was examining a 6 year old who when asked to lift her legs off the examination couch towards the ceiling she couldn’t hold them up for more than a couple of seconds . She did not have a neurological problem or needed MRIs or fancy tests. She was simply deconditioned .

Play - based childhood is being slowly converted into screen-based childhood . The rate at which technology is transforming our daily lives into becoming automated and mechanised , points to a rise in the number of sedentary children and as a result a trend towards the loss of their motor abilities . This is probably going to reach epidemic proportions soon enough , to the point that we may actually have to lower the testing standards as to what we consider normal motor skills in children.

For example , am I allowed to label a 5 year old who can’t climb the slide in a playground as having '' motor delay '' , if that child had not had the opportunity to practice that skill time and again in his life ? Going back to my initial thought, these children do not need to be seeing doctors or physiotherapists or occupational therapists . They simply need more free play .

03/09/2025

Introducing our new administrative assistant Mrs Konstantia Christofi. Delighted to have you onboard and wishing you a great start !

24/08/2025

THE COMFORT CRISIS

One question I am frequently asked is ‘’what shoes should I buy for my baby ‘’ or ‘’does my baby need to wear shoes when taking her first steps ‘’ ? Most people think that fancy expensive orthopedic shoes matter greatly and are willing to spend loads of money on these.

Taking a look at this from an evolutionary perspective , I suppose it’s clear that shoes were not part of nature’s original plan. Billions of babies since the dawn of time managed to roam around the earth on their bare feet perfectly fine. Anatomically our feet contain as much muscles as our hands . So if one thinks the amount of dexterity a strength we have with our hands you would be surprised how weak our foot are because shoes basically shield us from what are feet should be doing .

Shoes restrict the natural movement of babies feet, may interfere with the development of balance, coordination, and muscle strength, and can even hinder the ability to learn to walk . In fact, shoes that are too structured can limit natural foot development and interfere with muscle growth and balance. Hence the high percentage of preschoolers with flat feet ( amongst other orthopedic issues like for example hunchbacks from sedentary lifestyles )

Naturally people living in WEIRD societies ( Western , Educated , Industrialized , Rich , Democratic ) like to engineer discomfort out of their lives . We strive to prescribe comfort for all aspects of our daily living , even more so when it comes to our offsprings , but there are certain comfort items that can sometimes do more harm than good.

It goes without saying I am not advocating for letting your toddler walk bare foot in the streets or in supermarkets . But trust me when I say this , there is absolutely no harm walking bare foot at home or in your back yard and absolutely do not use shoes during the sensitive period of your baby learning to take her first steps.

07/08/2025

Part time secretary( 9 am -1pm ) wanted for my office. Must have adept language skills in Greek and English. Please email your cv to : n.kalogirou@doctors.org.uk

07/08/2025

📣📣📣ΑΝΑΚΟΙΝΩΣΗ ΘΕΣΗΣ ΕΡΓΑΣΙΑΣ: Προσφέρεται θέση εργασίας για γραμματειακή υποστήριξη σε ιατρείο για μερική απασχόληση (πρωινό) .

Απαραίτητα προσόντα είναι άριστη γνώση ελληνικής γλώσσας, καλή γνώση Αγγλικών, χρήση ηλεκτρονικού υπολογιστή και ευγενικός, επικοινωνιακός και ευχάριστος χαρακτήρας. Θα θεωρηθεί ως πλεονέκτημα σχετική εργασιακή εμπειρία, γραμματειακές σπουδές ή επιπλέον γλώσσα.

Οι ενδιαφερόμενοι παρακαλώ να αποστείλουν το βιογραφικό στην διεύθυνση n.kalogirou@doctors.org.uk

06/08/2025

And not only that but this maxim has now been incorporated into clinical decision making tools like the UK sepsis tool for example.

01/08/2025

In light of the recent disastrous events with the wildfires that blazed through Limassol rural area with people loosing their homes and the thousands of square meters of burned vegetation, the post today will not be about paediatrics.

I happen to live in Souni . The once lush and green landscapes around us has now turned into a bleak and baren landscape . Although I was fortunate that my house wasn’t damaged many families sadly lost their homes . Our small community is devasted by the magnitude of the disaster . Amidst the chaos I tried to brace my self and started contemplating how people can handle the tragedies and the hard knots of life . Sometimes you have to look for those little sparkling bits in the darkness and watch the space for tiny opportunities that can make you feel better

I reminded my self of a book by Prof. Jordan Peterson called 12 rules for life. In Rule 12 he says - "Pet a cat when you encounter one on the street". This is a metaphor of course and it's not about the cat itself . It sounds silly but It encourages mindful engagement with the present moment and noticing opportunities for positive experiences, like stopping to pet a cat ( or a dog for that matter ) , even when life around you lies in ruins.

18/05/2025

WHATEVER HAPPENED TO EVIDENCE BASED MEDICINE ? THE VULNURABLE CHILD SYNDROME

These posts are about debunking advice coming from Healthcare professionals which contradicts evidence based practice . I am not trying to discredit the body of medical professionals or finger point , merely raising awareness with regards to Evidence based medicine and critical thinking which are the cornerstone of modern medicine. If it's not backed by evidence it's not a scientific fact . That's called a belief, a hoax or a superstition . We are men and women of science , not tribal Shamans or new age gurus . Bad science , despite the good intentions , can do a great deal of harm .

I hear through the grapevine all sorts of irrational prompts from health care professionals that would normally make me chuckle had they not been potentially harmful. Utterances like :

1. Don’t give your infant eggs over the summer. He may get salmonella or
2. Don’t feed your baby strawberries until age 1 because they are allergenic

Well, actually no ! Properly stored and hard boiled eggs are safe for babies. Plus you end up depriving an infant from a good source of protein and nutrients for many months . In terms of the latter there is no evidence whatsoever that early introduction of strawberries is risky. Actually exactly the opposite is true. The later you introduce a food the more likely your child may develop an allergy to it.

The advise I find most upsetting is what I call the vulnerable child syndrome where people make up unvalidated threats about a looming disaster. Let me give you a common example. A previously healthy 2 year old is admitted to the hospital with a chest infection. Upon discharge their doctor says the child should stay away from kindergarten for 1 month and avoid all social contacts because he is super vulnerable and may get very sick again. That’s despite the child being completely recovered and up and running. Basically keep your child in a glass cage more or less.

Feel free to look at the literature all you want. You will not find ‘’recent infection’’ in the list of causes of weak immune system. If anything our immune systems can handle multiple pathogens simultaneously ( let alone in succession ) hence why human species survived the millennia of evolution . Once a child is up and running he or she can go back to school . Period.

How does this causes harm ?

For start it deprives the child from the wonderful world of peer interaction with all the developmental and socio-emotional benefits this has for their development. In addition , not all families have the social support network to get someone to child mind for a month. This causes a huge practical inconvenience to working parents who may take this advise at face value and do exactly as told.

It doesn’t really matter whether this piece of advise stems from ignorance , lazy medicine or playing it safe ( aka defensive medicine ) . It is harmful.

Δρ Νικόλας Καλογήρου - Παιδίατρος / Dr Nicolas Kalogirou Paediatrician

11/01/2026

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07/12/2025

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24/08/2025

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