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Pediatrician by Tio Manolo

Thursday, August 20, 2026 Edition XXXXXXXXXXXXXXXXXII
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This Week in Pediatrics

Executive Order Cuts Recommended Childhood Vaccines Down to 11: Report | PharmExec

President Trump signs an executive order shrinking the recommended childhood vaccine schedule from 18 diseases to 11, and calls for the MMR shot to be split into three separate injections.

[Encore] Why all providers should be watching what’s happening in pediatrics

Children’s hospitals are under intense financial strain in 2026 offering an early warning for all providers. Learn what’s driving the financial pressure and how all leaders should adapt.

Back-to-School Health Tips from PCI Pediatrics

Published: Aug. 18, 2026 at 10:46 AM CDT ... Dr. Jorie Shire with Physicians' Clinic of Iowa Pediatrics joined us to talk about back-to-school health needs, from physicals and vaccines to medications and mental health

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Research of the Day

Bedtime Screen Use and Sleep Quality in School-Age Children: Actigraphy Study

Using wrist actigraphy and sleep diaries, this study objectively measured sleep in 800 children ages 6-12 with varying bedtime screen habits. Screen use within 1 hour of bedtime significantly delayed sleep onset and reduced total sleep time.

Key findings: (1) 30-minute average delay in sleep onset with bedtime screens; (2) 45-minute reduction in total sleep time; (3) Blue light filtering partially but not fully mitigated effects.

🩺 What this means for your practice:

Recommend screen-free wind-down periods of 1+ hours before bed. Counsel families on device-free bedrooms. Address screen habits as part of sleep hygiene discussions.

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Popular Beliefs

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.

Green mucus means bacterial infection requiring antibiotics

What the evidence shows: Mucus color changes naturally during viral infections and does not reliably distinguish viral from bacterial causes. Green/yellow mucus indicates immune cell activity, which occurs in both viral and bacterial infections. Antibiotics should be prescribed based on clinical criteria, not mucus color.

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

Breakfast Consumption and Cognitive Performance in School-Age Children

This crossover study compared cognitive test performance in 200 children ages 8-11 on days with and without breakfast. Skipping breakfast significantly impaired attention, memory, and problem-solving speed, with effects noticeable by mid-morning.

Key findings: (1) 18% slower response time on attention tasks without breakfast; (2) Short-term memory scores 12% lower; (3) Nutrient-dense breakfasts outperformed high-sugar options for sustained attention.

🩺 What this means for your practice:

Screen for breakfast skipping during well visits, especially in lower-income families. Connect families with school breakfast programs when appropriate. Quick, balanced breakfast options can be discussed as anticipatory guidance.

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Genetics

Genetic Predictors of Peanut Allergy Persistence

Genome-wide association study identifies genetic variants associated with peanut allergy persistence versus resolution. Children with certain variants are more likely to outgrow their allergy, informing timing of oral food challenges.

Key findings: (1) 4 genetic variants strongly associated with persistence; (2) Genetic testing could reduce unnecessary avoidance and challenges; (3) Environmental factors remain important in allergy development.

🩺 What this means for your practice:

Genetic testing may soon help predict which children will outgrow allergies. For now, continue regular reassessment with IgE testing and oral challenges as clinically indicated.

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Did You Know? Numbers & Statistics

5.4M
Children under 18 with asthma in the United States
CDC, 2024
50M
Antibiotic prescriptions to children annually in US
CDC, 2024
19.7%
Children and adolescents with obesity (BMI ≥95th percentile)
CDC NHANES, 2024
9.4%
Children ages 3-17 diagnosed with anxiety
CDC NHIS, 2024