This Week in Pediatrics
CDC Updates Childhood Immunization Schedule for 2026
The Centers for Disease Control and Prevention has released updated recommendations for the 2026 childhood immunization schedule, including new guidance on RSV vaccination timing and COVID-19 booster protocols for children aged 6 months and older.
FDA Approves First Oral Treatment for Pediatric Type 2 Diabetes
A new oral GLP-1 receptor agonist has received FDA approval for use in children as young as 10 years old with type 2 diabetes, offering an alternative to injectable medications for pediatric patients.
WHO Reports Decline in Global Measles Vaccination Coverage
New data from the World Health Organization shows a concerning 3% decline in global measles vaccination coverage compared to pre-pandemic levels, with public health officials urging renewed vaccination efforts to prevent outbreaks.
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.
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. This can be part of anticipatory guidance discussions with parents about antibiotics.
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.
Teething causes high fevers and diarrhea
What the evidence shows: While teething may cause mild symptoms (gum irritation, drooling, slight temperature elevation), it does not cause high fever (>102°F/38.9°C) or diarrhea. These symptoms should prompt evaluation for other causes. Attributing significant illness to teething may delay diagnosis of serious conditions.
Reading to babies is pointless—they don't understand
What the evidence shows: Research consistently demonstrates that reading to infants from birth supports language development, vocabulary acquisition, and later literacy skills. Even before understanding words, babies benefit from hearing language patterns, rhythm, and the bonding experience. The AAP recommends reading aloud beginning in infancy.
Behaviors
Screen Time and Executive Function in Preschoolers: A Longitudinal Analysis
This prospective cohort study followed 850 children from ages 2 to 5 years, examining the relationship between screen time exposure and executive function development. Researchers used validated parent-report measures and direct assessments of working memory, inhibitory control, and cognitive flexibility.
Children with more than 2 hours of daily screen time at age 2 showed lower scores on executive function measures at age 5. Notably, the type of screen content mattered—educational programming showed smaller associations than passive entertainment viewing. Joint parent-child viewing partially mitigated negative effects.
These findings support counseling families on the AAP recommendation of less than 1 hour per day of high-quality programming for children 2-5 years. Emphasize co-viewing and educational content when screens are used. Executive function is crucial for school readiness and later academic success.
Genetics
Gene Therapy Shows Promise for Spinal Muscular Atrophy Type 1
Long-term follow-up data from the Phase 3 clinical trial of onasemnogene abeparvovec gene therapy reveals sustained motor milestone achievements in children with SMA Type 1 treated before 6 months of age. At 5-year follow-up, 94% of early-treated patients maintained the ability to sit independently, and 68% achieved independent walking—outcomes historically unprecedented in untreated SMA Type 1.
The study also reports on safety outcomes, with no new treatment-related serious adverse events emerging after year 2. These results strengthen the case for newborn screening and early intervention in SMA.
This data reinforces the critical importance of early diagnosis and treatment in SMA. Support newborn screening initiatives in your state. For families with SMA history, discuss carrier testing and ensure rapid referral to neuromuscular specialists if symptoms arise.