Δρ Νικόλας Καλογήρου - Παιδίατρος / Dr Nicolas Kalogirou Paediatrician

17/03/2026

SLEEPING LIKE A BABY - NOT

You have probably heard this expression or seen photos of babies gracefully sleeping in their bassinets and been led to believe that babies sleep soundly through the night for 8 hours perhaps awakening occasionally to smile at you . And you might have bought expensive online courses that promise fast sleep training in 3 simple steps so that you can get your baby to sleep through the night . My advise is to keep the receipts .

Here is an important fact. Human babies have not been designed to let their mothers sleep for 8 consecutive hours and thinking that you can trounce nature’s design would probably make Darwin sigh and delete his ‘’origin of species’’ draft .

There are a few simple reasons behind this.

Babies have been moulded by millions of years of evolution to feel uneasy about lack of human proximity . This was a necessary survival trait because babies who were left unattended where more likely to get eaten by tigers ( you have to remember that the world was not a safe haven until a couple of thousand years ago ) . The elders and sages say ‘’it takes a village to raise a baby’’ which basically used to be the norm in the past. Our ape cousins live in kinship networks where the babies are everyone’s responsibility . In contrast today , grandma lives in another city , grandpa is busy fishing , your sister doesn’t know anything about babies and the baby’s father has to go back to work in 2 weeks ( and probably you too in a few months ).

Then there is the fact that human breast milk gets digested easily , as opposed to formula milk. Hence is entirely normal for breast fed infants to need to nurse every couple of hours even through the night.

Modern medicine argues that an infants ability to self soothe and go back to sleep without needing your help starts developing at age 4 months , therefore sleep training can start as early as age 4- 6 months (sic) . My personal experience is that this is not entirely true and sleep behaviour is affected by other factors apart from age. Such as baby’s temperament ( some babies are good sleepers in which case - congratulations you won the lottery ! ) , bed sharing or not and family’s lifestyle .

I used to mention the pros and cons of ‘’crying it out ‘’ method vs ‘’graduated extinction’’ ( aka Ferber method ) and let parents decide but I have now completely stopped mentioning the former. Cry it out method literally forces the baby to give up on you . Although the studies about it’s long term adverse effects on attachment and child’s future emotional wellbeing show that is not damaging , there are evidence showing high cortisol levels which in simple English means that babies probably get super stressed with this.

Mammals have evolved 100 millions of years ago and despite living in modern WEIRD societies ( Western , Educated , Industrialized , Rich , Democratic ) there is an ancestral monkey still hardwired in our brains . Doctors and patients alike should humbly keep this evolutionary perspective in mind.

Welcome to Limassol Paediatric centre. We pride ourselves on having created a caring environment offering comprehensive care in children and young people from age 0 to 18 years. Our paediatric clinic operates under GESY healthcare system, but we also see private patients.

10/03/2026

Attempted bribery !

Listen, Dr. Nicolas 7 year-old M. whispered, leaning across my office like a mob boss negotiating a union contract. "We both know why I'm here. The ouchy pointy stick. "

She reached into her pocket and revealed a slightly damp Kinder chocolate .

She slid it towards me with a serious face . "Make it go away," she murmured. :)

07/03/2026

SOME THOUGHTS ON 24/7 SEEKING

Occasionally I get tagged in posts where people ask for doctor recommendations and sometimes people mention my name. I usually don’t look at these but every once in a while I have a sneaky peek .

One post a while back caught my attention . A family was asking for suggestions for a paediatrician who should more or less be at work 24/7 or something along these lines . It transpired that they were not happy with their doctors opening hours on the weekends (!) . Although it was a relief to see that many of the comments below were reprimanding and acknowledging that doctors can’t work 24/7 , quite a few others were highly recommending doctor X or Y as being always available and therefore super caring .

Convenience notwithstanding , we all fancy going to supermarket on Sundays because we have more free time , I found that deeply problematic. Mainly because most of us are oblivious to human limitations . Although I wouldn’t expect everyone to be familiar with the nuances of clinical risk analysis there is some basic common sense in this . These were lessons taught from aviation industry and adopted across the board in all professions in high stake environments . That is anywhere where human errors may prove fatal or have serious consequences ( ie not supermarket cashiers ) . In the so called ‘’dirty dozen’’ of human factors leading to errors the top 3 are : fatigue , distractions and working under pressure.

Simply put, the way you don’t want your pilot to be sleep deprived and exhausted by the same token , you do not want the doctor examining your child to be on his 7th consecutive day of 12 hour shifts - no matter how much caffeine he consumed or how superhuman he thinks he is .

By the way this also reminds me of a senior colleague in his retirement years who I met one night at a restaurant who was bragging about seeing 50 patients a day and not been for holidays or out of office for many years and how we ‘’snowflake generation’’ are too lazy and entitled .

I am sorry but ‘’He/she is always available therefore is a caring doctor’’ is not a valid argument . If anything I can argue the exact opposite . That he or she may actually be compromising patient safety .

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