Children under three are less likely to undergo surgery today than they were two decades ago, with the largest drop seen in infants, according to US research.

The findings support the hypothesis that parental and practitioner concerns about anaesthetic exposure may have affected surgical decision-making in infants, the authors write in JAMA Pediatrics.

In 2016, the US Food and Drug Administration issued a warning against “repeated or lengthy” exposure to anaesthetics in children younger than three, based on concerns about effects on brain development.

Using data from the National Health Interview Survey, the authors investigated trends in surgery in young children from 1998 to 2017.