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Pediatrician by Tio Manolo

Tuesday, June 30, 2026 Edition XXXXXXXXXXXXI
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This Week in Pediatrics

FDA updates in pediatric care: Q2 2026 recap | Contemporary Pediatrics

On April 22, 2026, the FDA approved dupilumab (Dupixent; Regeneron/Sanofi) for chronic spontaneous urticaria (CSU) in children aged 2 to 11 years who remain symptomatic despite H1-antihistamine therapy.

Top 5 pediatric health headlines you missed in January 2026 | Contemporary Pediatrics

Under the revised schedule, several vaccines—including those for hepatitis A, hepatitis B, respiratory syncytial virus, influenza, rotavirus, and meningococcal disease—are no longer routinely recommended for all children.

Pediatric clinical trial update: Q2 2026 | Contemporary Pediatrics

The findings further support the long-term efficacy and tolerability of TransCon CNP, which received FDA approval in February 2026 for pediatric patients aged 2 years and older with achondroplasia and open epiphyses.

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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

Warm milk helps children sleep

What the evidence shows: While milk contains tryptophan (a sleep-promoting amino acid), the amount is modest. Any sleep benefit likely comes from the comforting ritual and warmth rather than pharmacologic effect. A consistent bedtime routine matters more than any single component.

Wait 30 minutes after eating before swimming

What the evidence shows: There's no evidence that swimming after eating causes cramps or drowning. While digestion diverts some blood flow to the gut, it doesn't impair swimming ability in normal circumstances. Common-sense supervision is always important regardless of meal timing.

Letting babies walk early causes bowlegs

What the evidence shows: There is no evidence that early walking causes bowlegs. Most infants have some degree of bowing that typically resolves by age 3-4. Pathologic bowing has other causes (Blount disease, rickets). Encourage normal motor development and monitor for asymmetric or progressive bowing.

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Behaviors

Secondhand Smoke Exposure and Cognitive Development: Cohort Study

This cohort study measured cotinine levels and cognitive outcomes in 2,000 children at multiple time points. Even low-level secondhand smoke exposure was associated with measurable effects on attention and working memory.

Key findings: (1) Detectable cotinine associated with 5-point IQ difference; (2) Higher rates of learning difficulties; (3) No safe threshold identified—any exposure had measurable effects.

🩺 What this means for your practice:

Screen for smoke exposure at well visits. Counsel caregivers that even 'smoking outside' may not fully protect children. Connect families with smoking cessation resources.

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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

2.5M
Youth sports-related concussions annually in US
CDC, 2024
24%
Children meeting 60 min/day physical activity guideline
CDC YRBS, 2024
5.4M
Children under 18 with asthma in the United States
CDC, 2024
9.8%
Children ages 3-17 diagnosed with ADHD
CDC NHIS, 2024