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Pediatrician by Tio Manolo

Thursday, March 26, 2026 Edition XXV
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This Week in Pediatrics

American Academy of Pediatrics Endorse Child Immunizations

NYC Health Department announced the endorsement of the 2026 childhood and adolescent immunization schedule.

It’s not just vaccines: Parents are refusing other routine preventive care for newborns | CNN

At a February meeting of the Idaho chapter of the American Academy of Pediatrics, doctors said they knew of eight deaths from vitamin K deficiency bleeding in the state over the preceding 13 months, said Patterson, who is president of the chapter.

Yep, a mom's COVID shot during pregnancy protects her baby, a large study finds | KGOU - Oklahoma's NPR Source

ACOG reaffirmed that guidance last week, and a new study of more than 140,000 infants further confirms the protection that COVID vaccination during pregnancy offers babies in their first few months of life.

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Research of the Day

Early Antibiotic Exposure and Neurodevelopmental Outcomes: A Population-Based Cohort Study

This large population-based cohort study examined over 1.2 million children to investigate the association between antibiotic exposure in the first year of life and subsequent neurodevelopmental outcomes. The researchers found a modest but statistically significant association between early broad-spectrum antibiotic use and increased risk of ADHD and autism spectrum disorder diagnoses, though the absolute risk increase remained small.

Key findings include: (1) Children exposed to antibiotics in the first year had a 12% increased relative risk of ADHD diagnosis; (2) The association was stronger with repeated courses of broad-spectrum antibiotics; (3) The effect persisted after adjusting for maternal infections and other confounders.

🩺 What this means for your practice:

While the study shows an association, causation is not established. The findings support judicious antibiotic use in infants—prescribing when clinically indicated, but avoiding unnecessary courses.

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Popular Beliefs

Sugar makes children hyperactive

What the evidence shows: Multiple double-blind, placebo-controlled studies have found no significant effect of sugar on behavior or cognitive performance in children, even in those reportedly 'sensitive' to sugar. The perceived hyperactivity is often due to the context (parties, holidays) or parental expectations. However, limiting added sugars remains important for dental health and nutrition.

Chocolate causes acne

What the evidence shows: The relationship between diet and acne is complex. Some studies suggest high-glycemic diets and dairy may worsen acne, but chocolate specifically has not been definitively proven to cause breakouts. Individual responses vary—advise patients to observe their own triggers.

The flu shot can give you the flu

What the evidence shows: Flu vaccines contain inactivated virus or viral proteins that cannot cause influenza infection. Some people experience mild side effects (sore arm, low-grade fever) that mimic illness. It takes 2 weeks for protection to develop, so some may get infected before the vaccine works.

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Behaviors

Growth Mindset and Academic Resilience in Middle School

This school-based intervention taught growth mindset principles to 4,000 middle schoolers. Students who internalized growth mindset showed improved grades, greater persistence, and reduced anxiety around academic challenges.

Key findings: (1) 0.3 GPA improvement in intervention group; (2) 25% reduction in test anxiety; (3) Effects largest for initially low-performing students. Teacher reinforcement of messages enhanced effects.

🩺 What this means for your practice:

Praise effort over ability when discussing academics with patients. Encourage families to use growth mindset language. Struggle is part of learning, not a sign of inability.

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Genetics

Exon-Skipping Therapy for Duchenne Muscular Dystrophy: Expanded Approvals

FDA has approved additional exon-skipping therapies targeting previously untreatable Duchenne muscular dystrophy mutations. These antisense oligonucleotide treatments now cover 80% of DMD patients, slowing disease progression.

Key findings: (1) Treated patients maintain ambulation 2-4 years longer; (2) Cardiac and respiratory function also preserved; (3) Earlier treatment initiation correlates with better outcomes.

🩺 What this means for your practice:

Genetic testing to identify specific DMD mutation is essential for treatment planning. Refer to neuromuscular centers for evaluation. Treatment options continue to expand rapidly.

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Did You Know? Numbers & Statistics

283K
People under 20 with type 1 diabetes in the US
CDC, 2024
2.5M
Youth sports-related concussions annually in US
CDC, 2024
35+
Conditions screened on most state newborn screening panels
HHS, 2024
2-3
Per 1,000 infants born with hearing loss
CDC, 2024