Child health in Scotland is amongst the poorest in western Europe, according to a major study.
Experts are calling for more action to tackle smoking, obesity and child mortality, as they say poverty is the main cause of poor health.
The State of Child Health - Scotland report found more than 210,000 children live in poverty, 28% are overweight or obese, and around 400 die each year in Scotland - with a significant number of deaths potentially avoidable.
Compiled by the Royal College of Paediatrics and Child Health (RCPCH), the report also shows almost 30 % of pregnant women in the most deprived areas are smokers.
The report looks at 25 health rates including asthma, diabetes and epilepsy, as well as obesity, breastfeeding and mortality, to provide a snapshot of health and wellbeing.
It said Scotland leads the way with high vaccination rates, few cases of tooth decay and a decline in suicide rates amongst young people.
But the report adds: "Child health in Scotland is amongst the poorest in western Europe.
"Over 210,000 children live in poverty, 28% are overweight or obese and approximately 400 infants, children and young people die each year, with a significant number of these deaths potentially avoidable."
The Scottish Government said it is committed to ensuring the best start in life for children, and it hailed progress in changing relationships with tobacco and alcohol.
Dr Steve Turner, RCPCH officer for Scotland, said: "The Scottish Government has repeatedly said that children are a priority, and its focus on strong early years provision is heartening.
"But there are significant gaps and the problem of health inequalities is continuing to grow.
"It is startling that over 29% of pregnant women in the most deprived areas are smokers, compared to just 4.5% in the least deprived, putting babies at risk of complications during pregnancy and birth and increasing the likelihood of cot death or still birth.
"Before a child is even born they are set on a path to ill health. This simply cannot be allowed to continue."
The report recommends extending the smoking ban to school grounds, sport fields and playgrounds, raising awareness of the benefits of breastfeeding, and measuring child health rates more regularly.
Dr Turner added: "In addition to specific actions, we want to see Scottish Government adopt a 'child health in all policies' approach. That means that whatever policies are made, from whatever Government department, they must consider the impact on child health.
"Healthy children make healthy adults, so it makes not only moral, but economic sense to invest early."
Public Health Minister Aileen Campbell said: "We agree that our children's health should be a priority for all. This is why this Government has committed to ensuring the best start for all our children...
"The State of Child Health report recommendations provide focus to develop this further; including delivering on our Programme for Government a commitment to produce a child health and wellbeing strategy.
"We look forward to working with RCPCH to take this forward to improve all children's health over the next 10 years and beyond."
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