As debate rages about vaccination requirements and who to blame for a spate of measles outbreaks throughout the United States, a new study provides more statistical certainty that there is no relationship between the MMR vaccine and autism.
For the study, published in the Annals of Internal Medicine, researchers at Copenhagen’s Statens Serum Institut used a population registry to assess the risk of autism among 657,461 children born in Denmark between 1999 and 2010. Scientists studied the participants through 2013, of whom 6,517 were diagnosed with autism during this timeframe. They concluded that that these diagnoses were not correlated with vaccination against measles, mumps, and rubella.
“The study strongly supports that MMR vaccination does not increase the risk for autism, does not trigger autism in susceptible children, and is not associated with clustering of autism cases after vaccination.”
“No increased risk for autism after MMR vaccination was consistently observed in subgroups of children defined according to sibling history of autism, autism risk factors (based on a disease risk score) or other childhood vaccinations, or during specified time periods after vaccination,” the study authors write.
“The study strongly supports that MMR vaccination does not increase the risk for autism, does not trigger autism in susceptible children, and is not associated with clustering of autism cases after vaccination,” the paper concludes. “It adds to previous studies through significant additional statistical power and by addressing hypotheses of susceptible subgroups and clustering of cases.”
This isn’t the first large-scale study that unequivocally disproves a link between vaccines and autism. A study of 537,000 children, published in 2002 in the New England Journal of Medicine, concluded with similar results, according to NPR.
Anti-vaccine groups frequently cite a study conducted by Andrew Wakefield, published in prominent British medical journal The Lancet in 1998, that claimed a link between the MMR vaccine and autism; that “study” was fraudulent and prompted an apology from The Lancet, which issued a retraction in 2010. “A British medical panel concluded last week that Dr. Wakefield had been dishonest, violated basic research ethics rules and showed a ‘callous disregard’ for the suffering of children involved in his research,” reported The New York Times in 2010. (Wakefield has since lost his medical license in the U.K.)
“The idea that vaccines cause autism is still around despite our original and other well-conducted studies,” epidemiologist Anders Hviid, MD, of the Staten Serum Institute in Copenhagen, who authored the new study, tells NPR. “Parents still encounter these claims on social media, by politicians, [and] by celebrities.”
Night falls, and quiet permeates the house. A cloud moves across the moon, the wind rustles through the trees. All is still—but something approaches. A prowler, a nightmare? No, no. It’s the “sundown scaries,” the anticipatory fear and anxiety that can strike parents in the evening before bed. Conversation has been churning on social media, with a handful of TikToks about “sundown scaries” garnering hundreds of thousands of views. The videos, and many of the comments, bemoan how little people talk about the phenomenon when it is apparently so common. Even if it’s not a clinical diagnosis, it’s certainly something many parents feel.
clinical psychologist with board certification in behavioral sleep medicine, and associate professor of psychology and pediatrics at Indiana University School of Medicine
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“It’s definitely one of those things that no one prepared me for, that sense of dread or doom when the sun goes down,” says infant sleep specialist Rachel Shepard-Ohta on TikTok. “It almost feels like this homesickness in a way. It’s just a very sad, scary feeling every night.”
This feeling of foreboding that creeps in as the sun sets can become all too common during the winter months when the sun sets at an incredibly rude 4:30 pm. That’s known as “sunset anxiety,” and it’s linked to the natural drop in mood and energy that occurs in the evening. But those emotions can be even more dramatic for new parents—or really, anyone who deals with nighttime wakings, whether or not the cause is a howling infant. Darkness is “a very salient cue that night, and whatever it brings, is coming,” clinical psychologist Sarah Honaker, PhD, an associate professor of psychiatry and pediatrics at Indiana University School of Medicine, tells Well+Good.
Why is the evening so scary?
The evening can spark negative emotions for parents in a few ways. In the pre-baby era, the hours before bed probably consisted of taking time for yourself, having some fun, and winding down. With a newborn, that can actually be the time when laundry and dirty bottles pile up, and you don’t even have the energy to tackle them. In those moments, the overwhelm is real. At the same time, you might also feel anticipation about the physical agony awaiting you once you do manage to get horizontal. The contrast between what you were used to feeling in the night (relaxation) and what you face now (fatigue, care for another human being) can prompt those doldrums.
“Previously, you maybe had an idea that as the sun goes down, your responsibilities are also winding down,” Honaker says. “When you have a newborn, that is definitely no longer the case.”
Or maybe your little one makes the change in your lifestyle even more apparent. Some parents experience “witching hours,” when babies can be naturally more fussy during the evening (and when parents are naturally more tired). Want to end your day by stopping in at your favorite neighborhood pizza place? Or maybe even just relaxing with a glass of wine at home? Sorry, that’s not gonna happen with a tired baby. While exhausted from a long day, missing out on those past rituals can be its own sunset scary bitterness.
Pre-bedtime stress could even make it harder to get some shut-eye. This ZZZ-robbing sleep anxiety can make you even more nervous about the night.
“Nothing is worse than finally falling asleep and then having that cry wake you 30 minutes later,” Honaker says. “And so sometimes [anticipating] that can make it harder to fall asleep as well.”
How to face your (evening) fears
What can be done about the “sunset scaries” to make you feel better? If a baby is keeping you up, Honaker says to remember that this experience is temporary—you will sleep again.
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But Honaker also advises you to “protect your sleep.” Meaning, you should still try to prioritize sleep hygiene and, as much as possible, stick to a bedtime routine. At the same time, let’s take the pressure off the evenings. You don’t need to let the hour(s) between putting the baby down and your own bedtime be when you make judgements about your life.
“It’s not just about sleep, it’s about your feelings of productivity, your ability to relax, your image of what is a good parent, what is a good woman, what am I supposed to be, and how does that match up with what I am,” Honaker says. “This phenomenon really could get at a lot of those [questions].”
Finally, understand that you are not alone. The fact that there’s a catchy moniker for this emotional experience proves it. “It can be validating to know that the feelings that you’re having are a normal developmental experience and not something that is wrong with you,” Honaker says.
Just like the night, the “sunset scaries” will come to a natural end—whether with the development of your baby, or the passing of the seasons into more hours of daylight. In the meantime, be kind to yourself and know you’re doing your best.
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double board-certified family medicine physician specializing in regenerative and hormone health
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The study, published last week in Environmental Health Perspectives1, collected urine samples from 630 kids ages 4 to 8 after parents were asked to fill out questionnaires about the exact types and brands of skin and hair care products used on the children in the past 24 hours. Concentrations of 16 different types of phthalates—a class of endocrine-disrupting chemicals—were found in the urine samples. Products associated with the highest levels of phthalates were body lotions, body oils, “2-in-1” shampoo and conditioners, and ointments. Black, Asian, and Hispanic children were also found to have higher phthalate urine levels than other sociodemographic groups.
While past studies have only looked at phthalates’ effects on fetuses, this study shows that young children are being consistently exposed to endocrine disruptors—chemicals that have been linked to long-term developmental and reproductive health effects, per the study.
What does this mean for parents; should we all be worried? And are there ways to protect children from phthalates? We spoke with Gowri Reddy Rocco, MD, a double board-certified family medicine physician who specializes in regenerative health and hormones, to learn more.
We’re all exposed to endocrine disruptors, but children are more vulnerable
Many of the personal care products, fragrances, plastic packaging, pre-packaged foods, detergents, perfumes, and plastic water bottles sold in the U.S. have endocrine-disrupting chemicals, particularly phthalates.
“Phthalates are a group of chemicals that help make plastic more pliable and flexible,” says Dr. Rocco. But they can also be found in things like shampoos, lotions, ointments, and other personal care products.
What do these chemicals do in the body? They mimic, block, or interfere with hormones in the body’s endocrine system, per the Endocrine Society. While phthalates typically flush out of our system within two days, per the Centers for Disease Control and Prevention (CDC), the buildup of exposure can have long-term effects, per the study. According to Dr. Rocco, this can include fertility and reproductive issues, including low sperm count and inability to conceive, as well as an increased risk for breast cancer, obesity, and thyroid issues.
More new research has even found these chemicals may cause girls to enter puberty earlier, increasing their future risk of things like heart disease and breast cancer, per a September 2024 paper in Endocrinology2. In young children, endocrine disruptors have also been associated with developmental delays and reproductive health issues in the future, per Dr. Rocco and a December 2015 review in Endocrine Reviews3.
Children are especially vulnerable to the effects of products that touch the skin because they absorb substances more easily than adults, per the Environmental Health Perspectives study. Additionally, children’s organs are more vulnerable to disruptions as they are still developing, says Dr. Rocco.
Should we be worried about these study findings?
Dr. Rocco says we shouldn’t let these findings send us into a panic, but they should definitely raise a healthy level of concern about the chemicals we’re exposed to every day. This study didn’t confirm that skin care products caused negative health outcomes; it simply demonstrated that children’s exposure to harmful chemicals in skin and hair care is frequent and high.
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Unfortunately, it’s really difficult to limit endocrine-disruptors from our daily lives. These chemicals are in so many things, and the study authors acknowledge this as a gap in their research. (While they did ask parents about their children’s diet and environments, there was no way to tell for sure whether these contributed to elevated phthalate levels or if it was from skin and hair care products alone.)
The study also highlighted that for families with a lower socioeconomic status, less expensive products—which may contain these harmful chemicals—might be their only options. Products labeled “phthalate- or paraben-free” are often more expensive. And even so, certain products labeled “phthalate- and paraben-free” may not actually be completely free from these ingredients, the Environmental Health Perspectives study pointed out.
The study also found that children of color simply used more hair oils and lotions than other groups in general, upping their exposure to harmful chemicals. In fact, it’s possible that some beauty products targeted toward communities of color have higher levels of these chemicals, per an August 2018 paper in Environmental Research4.
Bottom line? These findings underline a major need for change, which starts with stricter FDA regulations on endocrine-disrupting chemicals. “There needs to be a responsibility on the FDA’s part, without a double standard, to protect our children and every body,” says Dr. Rocco. She adds that while the European Union has banned more than 1,300 harmful chemicals from products, the FDA has only banned 11.
So what can we do to keep kids safe?
According to Dr. Rocco, taking small steps to reduce exposure on a regular basis is the key here. Meaning, you don’t have to toss every product in sight right away. “This isn’t doom and gloom; this is just education to improve family’s lives,” she says.
For starters, Dr. Rocco recommends using fewer products on your children in general. They don’t necessarily need all the products advertised for kids, she adds. You can even make DIY lotions, soaps, and other personal care products, she says. And if you are going to buy products, go back to the basics: organic, non-GMO, and free from fragrances, parabens, sulfate, and phthalates.
If you’re having a hard time figuring out which products are best, Dr. Rocco suggests searching products on one of the following websites:
EWG Healthy Living (a free app that can help you identify harmful substances in products)
SkinSAFE (the database used in the study to categorize skin care products, which also has a BabySafe section)
Skin Deep (a database created by the Environmental Working Group)
YUKA (a free app that allows you to scan barcodes of products in store)
You can also reach out to your child’s pediatrician if you need skin and hair care product recommendations.
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Other ways you can reduce endocrine-disruptor exposure in general include avoiding plastic as much as possible, using stainless steel or glass bottles, using wax paper instead of plastic wrap or sandwich bags, eating more organic fruits and vegetables, getting exercise (which helps you sweat out toxins), and even having houseplants (which can provide more oxygen), Dr. Rocco says.
Bloom, Michael S., et al. “Impact of skin care products on phthalates and phthalate replacements in children: The echo-fgs.” Environmental Health Perspectives, vol. 132, no. 9, Sept. 2024, https://doi.org/10.1289/ehp13937.
Shu Yang, Li Zhang, Kamal Khan, Jameson Travers, Ruili Huang, Vukasin M Jovanovic, Rithvik Veeramachaneni, Srilatha Sakamuru, Carlos A Tristan, Erica E Davis, Carleen Klumpp-Thomas, Kristine L Witt, Anton Simeonov, Natalie D Shaw, Menghang Xia, Identification of Environmental Compounds That May Trigger Early Female Puberty by Activating Human GnRHR and KISS1R, Endocrinology, Volume 165, Issue 10, October 2024, bqae103, https://doi.org/10.1210/endocr/bqae103
Gore, A C et al. “EDC-2: The Endocrine Society’s Second Scientific Statement on Endocrine-Disrupting Chemicals.” Endocrine reviews vol. 36,6 (2015): E1-E150. doi:10.1210/er.2015-1010
Helm, Jessica S., et al. “Measurement of endocrine disrupting and asthma-associated chemicals in hair products used by black women.” Environmental Research, vol. 165, Aug. 2018, pp. 448–458, https://doi.org/10.1016/j.envres.2018.03.030.
