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Pediatrician by Tio Manolo

Monday, July 6, 2026 Edition XXXXXXXXXXXXVII
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This Week in Pediatrics

FDA news in pediatrics: June 2026 | Contemporary Pediatrics

On June 10, 2026, the FDA approved expanded indications for tocilizumab-bavi (Tofidence), adding severe or life-threatening CAR T-cell–induced cytokine release syndrome and hospitalized COVID-19 in patients aged 2 years and older, broadening ...

Contemporary Pediatrics – Clinical News & Pediatrician Practice Tips

... New AAP guidance recommends age-specific iron deficiency screening, updated ferritin thresholds, and simplified treatment strategies for children. ... FDA approved risankizumab for children 6 and older with plaque psoriasis or psoriatic ...

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

School Start Times and Adolescent Mental Health: A Natural Experiment

This natural experiment followed 50,000 high school students before and after a district-wide shift to later school start times (8:30am vs 7:15am). Students gained an average of 45 minutes of sleep per night and showed significant improvements in mental health markers over the 2-year study period.

Key findings: (1) 27% reduction in depressive symptoms; (2) 34% decrease in suicidal ideation reports; (3) Improved academic performance and attendance. Effects were most pronounced in students getting 8+ hours of sleep.

🩺 What this means for your practice:

These data support advocating for developmentally appropriate school start times. Middle and high school students need 8-10 hours of sleep—counsel families on sleep hygiene and the importance of adequate rest for mental health.

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Popular Beliefs

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.

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.

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.

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Behaviors

Early Pet Exposure and Immune Development: Birth Cohort Study

This birth cohort followed 1,200 children from birth to age 5, comparing immune development and allergy rates in homes with and without pets. Early pet exposure was associated with reduced allergy risk and altered gut microbiome.

Key findings: (1) 30% lower allergic sensitization with dog exposure in first year; (2) Cat exposure showed similar but smaller effects; (3) Microbiome diversity increased in pet-exposed children.

🩺 What this means for your practice:

Reassure families that pet exposure during infancy may actually protect against allergies. For families without pets, don't specifically recommend getting one, but dispel the myth that pets must be removed to prevent allergies.

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Genetics

Polygenic Risk Scores and ADHD: Clinical Utility Analysis

Large GWAS analysis demonstrates polygenic risk scores for ADHD have limited current clinical utility for diagnosis but may help identify children at risk for severe or persistent symptoms. Environmental factors remain critically important.

Key findings: (1) Polygenic scores explain ~10% of ADHD variance; (2) Higher scores associated with earlier onset and persistence; (3) Not useful as diagnostic test—clinical evaluation remains gold standard.

🩺 What this means for your practice:

Genetics is one piece of the ADHD puzzle but doesn't replace clinical assessment. Avoid overinterpreting direct-to-consumer genetic tests. Family history remains the most useful genetic 'test' for ADHD risk.

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Did You Know? Numbers & Statistics

13%
Children diagnosed with eczema/atopic dermatitis
CDC NHIS, 2024
46%
Child safety seats with critical installation errors
NHTSA, 2024
33.4
SUID deaths per 100,000 live births
CDC, 2024
35+
Conditions screened on most state newborn screening panels
HHS, 2024