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Pediatrician by Tio Manolo

Tuesday, April 21, 2026 Edition XXXXXI
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This Week in Pediatrics

Pediatrics - Medscape

Reuters Health Information April 16, 2026 · Managing Care When Gender-Affirming Therapy Is Limited · Medscape Medical News April 16, 2026 · Can DBS Curb Severe Self-Injury in Autism? Medscape Medical News April 16, 2026 · Helicopter Parenting: Risk for Tooth Decay in Children?

Dr. Yvonne Fanous honored with Dr. Leonard L. Bailey Outstanding Clinician at 2026 Children’s Hospital Gala | News

Yvonne Fanous, MD, a pediatric allergist and immunologist at Loma Linda University Children’s Hospital, has been named the recipient of the 2026 Dr. Leonard L. Bailey Outstanding Clinician Award, an honor recognizing her more than four decades ...

2026 Pediatric Sepsis Guidelines Update: New Evidence, Stronger Recommendations

“Most children with sepsis and septic shock now survive, which is fabulous, but there’s an increasing recognition that up to 30% to 40% of children who survive after requiring ICU-level treatment will have some long-term health issues,” ...

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Research of the Day

Iron Deficiency in Infancy and Long-Term Cognitive Outcomes: 10-Year Follow-Up

This prospective cohort followed children with iron deficiency anemia in infancy through age 10, comparing cognitive outcomes to iron-sufficient peers. Despite iron repletion in infancy, children with early anemia showed persistent differences in executive function and spatial memory.

Key findings: (1) Early iron deficiency associated with lower scores on math and reading assessments; (2) Differences in brain structure observed on MRI at age 10; (3) Duration of deficiency correlated with magnitude of effect.

🩺 What this means for your practice:

Emphasize prevention through dietary counseling and appropriate screening. Iron-rich complementary foods should be introduced at 6 months. Consider iron supplementation in high-risk populations.

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Popular Beliefs

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.

Children outgrow ADHD

What the evidence shows: While symptoms often change with age, approximately 60% of children with ADHD continue to have symptoms into adulthood. Hyperactivity typically decreases, but inattention and impulsivity often persist. Ongoing monitoring and treatment adjustment is important across the lifespan.

Starve a fever, feed a cold

What the evidence shows: Neither fevers nor colds benefit from restricting food. Both conditions increase metabolic demands, and adequate nutrition supports immune function. Encourage normal eating as tolerated and emphasize hydration with any illness.

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Behaviors

Sleep Schedule Consistency and ADHD Symptoms: Intervention Study

This intervention study examined whether consistent sleep schedules improved ADHD symptoms in 150 children ages 6-12. Families implemented strict bed/wake times for 8 weeks while tracking symptoms and sleep.

Key findings: (1) Consistent sleep reduced inattention symptoms by 25%; (2) Bedtime resistance decreased significantly; (3) Effects comparable to some medication responses. Weekend sleep consistency was particularly important.

🩺 What this means for your practice:

Before escalating ADHD treatment, optimize sleep hygiene. Consistent bed/wake times (including weekends) can meaningfully improve symptoms. This is a low-risk intervention all families can implement.

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Genetics

Genetic Testing in Hypertrophic Cardiomyopathy: Sports Participation Guidance

Updated guidelines incorporate genetic testing results into sports participation decisions for young athletes with HCM. Some genetically positive but phenotypically negative individuals may safely participate in athletics with appropriate monitoring.

Key findings: (1) Risk stratification improved with genetic markers; (2) Shared decision-making framework more nuanced than previous blanket restrictions; (3) Regular cardiac monitoring essential regardless of sport participation.

🩺 What this means for your practice:

Genetic testing can refine, but not eliminate, cardiac risk assessment. Refer to cardiology for any athlete with suspected or confirmed HCM. Shared decision-making with families is appropriate.

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Did You Know? Numbers & Statistics

1 in 36
Children identified with Autism Spectrum Disorder in the US
CDC ADDM Network, 2024
13.2
Births per 1,000 females ages 15-19 (historic low)
CDC NCHS, 2024
9.4%
Children ages 3-17 diagnosed with anxiety
CDC NHIS, 2024
33.4
SUID deaths per 100,000 live births
CDC, 2024