Socioeconomic status (SES) is inversely related to mortality and health in children; the higher an individual’s SES, the less likely illness and death. It is unknown whether the association of SES and pediatric mortality exists in the inpatient setting.

Within children’s hospitals, in-hospital mortality is inversely associated with SES, but is lower than expected for even the lowest SES quartile. The association between SES and mortality varies by clinical service line. (Read the full article)

The eating of non–nutrient dense snack foods is considered a major factor contributing to childhood obesity. Parents are often ineffective at encouraging healthier snacking habits.

Children consumed fewer calories when snacking on nutrient-rich cheese and vegetables compared with when they were served potato chips. (Read the full article)

When research involving children is determined to present greater than minimal risk but no potential for direct benefit, permission is required from both parents, unless one is not reasonably available. These requirements are variably understood and applied, and guidance is lacking.

In a study on newborn screening, a sizeable percentage of fathers were not reasonably available, reflecting complexities of parental status and family relations. Guidelines developed in this project may provide tools for researchers and institutions to apply in other contexts. (Read the full article)

Paternal mental disorders during the postnatal period are associated with an increased risk for behavioral and emotional problems in their children; however, less is known about the effect of fathers’ mental health during pregnancy on children’s development.

The study demonstrated a positive association between fathers’ prenatal mental health and their children’s subsequent socioemotional and behavioral development. Psychological distress in fathers was associated with a risk for emotional difficulties in their children at 36 months of age. (Read the full article)

A reduced nephron number is associated with glomerular hyperfiltration, resulting in renal injury such as hypertension, proteinuria, and chronic kidney disease. Patients with a solitary functioning kidney have an increased risk of dialysis in early adulthood.

This study demonstrates that a subset of children with a solitary functioning kidney progress toward renal injury during childhood. Risk factors for renal injury are ipsilateral anomalies of the kidney and urinary tract and small renal length. (Read the full article)

Health care transition services assist youth with special health care needs (YSHCN) in transitioning to adult care without gaps in services or health insurance coverage. Less than half of YSHCN receive anticipatory assistance in this transition; receipt of these services for youth with autism spectrum disorder is unknown.

Youth with autism spectrum disorder receive transition services half as often as youth with special health care needs. Quality of health care is associated with increased receipt of health care transition services. Presence of comorbid conditions decreased receipt of transition services. (Read the full article)

Bisphenol A (BPA) is an environmental endocrine disruptor that can leach from polycarbonate plastics and epoxy resins, leading to widespread exposure. Fetal and early postnatal periods are particularly vulnerable to exposure to BPA.

This study identified medical devices as a potential source of exposure to BPA among premature infants in the NICU, even when efforts to reduce polycarbonate plastics were taken. (Read the full article)

Reasons mothers cite for breastfeeding cessation vary across an infant's first year of life; however, once women stop breastfeeding, little is known about whether they breastfed as long as they desired or reasons why they did not meet their desired duration.

About 60% of mothers do not meet their desired breastfeeding duration. Mothers who do not breastfeed as long as they desire primarily cite concerns about maternal or child health and processes associated with breastfeeding as their reason to stop breastfeeding. (Read the full article)

Many studies have identified an association between television viewing and antisocial behavior, although very few have been able to demonstrate a cause-and-effect sequence. The issue of whether excessive television viewing contributes to antisocial behavior remains controversial.

Excessive television viewing during childhood and adolescence was associated with objective and subjective measures of antisocial behavior in adulthood. These associations were not explained by preexisting antisocial tendencies or other potential confounders. Excessive television appears to have long-term psychosocial consequences. (Read the full article)

UV radiation exposure in tanning beds is associated with an increased risk of skin cancer. Because of the rising rate of melanoma, the World Health Organization recommends that persons <18 years of age not use tanning devices.

Despite scientific evidence to the contrary, tanning facilities in Missouri, a state without indoor-tanning regulations, often misinformed consumers regarding the risk of skin cancer and would allow children as young as 10 years old to use tanning devices. (Read the full article)

Failure to thrive (FTT) is a common and vexing pediatric problem. Evaluation has historically involved large batteries of tests, multiple consultations, radiologic studies, and prolonged hospital admissions, resulting in significant costs and inconsistent results.

Scheduled failure to thrive (FTT) admissions on weekends result in increased lengths of stay and health care costs compared with weekday admissions of similar levels of complexity. Reduction in planned weekend admissions for FTT could significantly reduce health care costs. (Read the full article)

Of more than 2 million children infected with HIV, almost 90% live in resource-limited settings where pediatric HIV care is often suboptimal. Implementing electronic health records with computerized decision support offers a potential tool for improving care.

This randomized, controlled trial demonstrates that computer-generated clinical reminders can significantly improve clinician compliance with HIV care guidelines for children in a resource-limited setting. This intervention is scalable as developing countries implement electronic health record systems. (Read the full article)

The Supplemental Nutrition Assistance Program (SNAP) is the largest federal nutrition assistance program. Studies among adults suggest that SNAP participation may be associated with suboptimal diets. Few studies have extensively examined these associations among children.

SNAP participation was not associated with childhood obesity. SNAP children consumed diets poorer in some aspects than nonparticipants, but intake of some micronutrients was higher. The diets of both groups of low-income children were far from meeting dietary guidelines. (Read the full article)

Skin and soft tissue infections (SSTIs) are a common pediatric condition often requiring inpatient management. Several studies describe recent increases in hospitalizations due to SSTIs.

In addition to rising hospitalizations, analysis of pediatric SSTI resource utilization trends revealed a twofold increase in incisions and drainages over a 13-year period. A growing number of incisions and drainages were performed in younger children. (Read the full article)

In Mexico, substantial declines in childhood diarrhea deaths have been documented since the introduction of the rotavirus vaccine in 2007. However, there is concern of lower vaccine effectiveness in less developed regions of Mexico with higher diarrhea-related mortality.

We documented significant and comparable declines across all 3 regions of Mexico with different levels of development, indicating equitable vaccine distribution to children with varying risk of mortality and reaffirming the beneficial effects of rotavirus vaccination against fatal diarrheal disease. (Read the full article)

Attention-deficit/hyperactivity disorder (ADHD) has been viewed as a neurodevelopmental disorder, adversely affecting behavior and school performance, with studies suggesting increased risk for poor adult outcomes. However, no prospective studies have examined long-term outcomes of childhood ADHD in an epidemiologic sample.

Our epidemiologic study indicates that adults with childhood ADHD are at increased risk for death from suicide. ADHD persists into adulthood in 29.3% of childhood ADHD cases, and 56.9% have ≥1 psychiatric disorder other than ADHD. (Read the full article)

Although amphibians are known Salmonella carriers, aquatic African dwarf frogs are specifically marketed toward children, who are especially vulnerable to Salmonella infections. Both direct animal contact and indirect contact with animal habitats can lead to human Salmonella infections.

This is the first reported outbreak of human Salmonella infections associated with African dwarf frogs, particularly among young children. Parents should be aware of the risk of Salmonella infections from both direct and indirect animal contact. Pediatricians should regularly inquire about animal contact and advise families about risks. (Read the full article)

Children with chronic illnesses are at risk for emotional and behavioral problems. Therefore, interventions that focus on coping with the negative consequences of the disease are needed. Evidence-based interventions are limited and often focus on a single diagnosis group.

This study demonstrates the efficacy of a cognitive-behavioral group intervention for children with various chronic illnesses. The findings indicate that the involvement of parents is important to achieve long-term results. (Read the full article)

The reasons why teens are not immunized are related to parental lack of knowledge and the need for provider recommendations.

The reasons for vaccine refusal for human papillomavirus vaccine differ from other teen vaccines, and concerns about its safety are increasing over time. (Read the full article)

Konzo is an irreversible sudden-onset upper-motor neuron disorder affecting children dependent on bitter cassava for food. The neuroepidemiology of konzo is well characterized. Children subsisting on poorly processed bitter cassava without adequate dietary sulfur-based amino acids are especially at risk.

We found a pervasive subclinical neurocognitive effect in children with konzo. This study provides the first evidence we are aware of that a motor proficiency examination can effectively characterize konzo severity. (Read the full article)

Adherence to infant feeding recommendations in the United States is low. The prevalence of early introduction of solid foods (<4 months of age) in the United States has been estimated to range from 19% to 29%.

Mothers’ most commonly cited reasons for early solid food introduction include perception of readiness, hunger, wanting to feed something in addition to breast milk or formula, perception of interest in solids, advice from a clinician, and to improve infant’s sleep. (Read the full article)

Rates of screen media use have risen in parallel with rates of obesity among young people. Identifying the specific characteristics of media use that are associated with obesity can help elucidate the explanatory processes and inform effective interventions.

This study examines the associations between BMI and characteristics of media use including the type of device, duration of use, and attention to the medium. The more that participants paid primary attention to television, the higher their BMI. (Read the full article)

Some Western studies show early introduction of solid food is associated with subsequent obesity. However, introduction of solid food and obesity share social patterning, making these observations vulnerable to residual confounding.

In a non-Western developed setting, there was no clear association of the early introduction of solid food with childhood obesity. Studies in populations with a different confounding structure may be valuable in clarifying and reconciling potentially confounded epidemiologic associations. (Read the full article)

Previous studies have suggested that health care providers, family members, friends, and others play a role in shaping parents’ vaccination decisions. Other research has suggested that the media can influence whether parents decide to vaccinate their children.

Through the application of social network analysis, this study formally examines and quantifies how parents are influenced by the people and sources around them. Its findings suggest that social networks are important, particularly for parents who do not completely vaccinate. (Read the full article)

Previous studies have found a relationship between exclusive breastfeeding for ≥6 months and iron deficiency. Little is known about the relationship between total breastfeeding duration, including the period after the introduction of complementary foods, and infant iron status.

Our results suggest that infants with longer total breastfeeding duration may be at risk for iron deficiency. Our findings highlight a clinically important association warranting additional investigation that may inform future guideline updates regarding assessment of risk for iron deficiency in young infants. (Read the full article)

Perforation in the setting of retained esophageal foreign body is rare, but can be catastrophic. The role of imaging in screening for injury after removal has not previously been studied.

The rate of esophageal injury among children with retained esophageal foreign body is 1.3%. Intraoperative findings suggestive of injury are predictive of perforation. Routine chest radiography is not warranted in those who do not meet this criterion. (Read the full article)

Prompt, high-quality diagnosis of acute pyelonephritis and later identification of children with scarring are important to prevent future complications. Examination by dimercaptosuccinic acid scan is the current clinical gold standard but is not routinely performed.

Procalcitonin demonstrated a more robust predictive ability, compared with C-reactive protein or white blood cell count, to selectively identify both children who had acute pyelonephritis during the early stage of urinary tract infections, as well as those with late scarring. (Read the full article)

Studies reveal that mothers of infants with colic (defined by Wessel’s criteria of >3 hours per day of distress) are more likely to develop depression. No studies have examined whether the consolability of infant crying predicts maternal depression risk.

Prolonged inconsolable infant crying has a stronger association with maternal depressive symptoms than overall daily duration of fussing and crying, suggesting that a mother’s report of inability to soothe her infant may be a powerful indicator of her depression risk. (Read the full article)

Hospitalizations under observation status are presumed to be shorter and less resource-intensive, but utilization for pediatric observation-status stays has not been studied.

Children’s hospitals use observation status with great variation. Resource utilization for pediatric patients under observation status overlaps substantially with inpatient-status utilization, calling into question the utility of segmenting pediatric patients according to billing status. (Read the full article)

Head injuries and concern for skull fracture are common in pediatrics. Point-of-care ultrasound is an imaging tool that can be used to diagnose fractures. However, there are scant data regarding the accuracy of point-of-care ultrasound in skull fracture diagnosis.

Clinicians with focused point-of-care ultrasound training are able to diagnose skull fractures in children with high specificity. Ultrasound may be valuable to diagnose skull fractures in children at the point of care. (Read the full article)

Routine head ultrasound scans (HUSs) are frequently performed in the preoperative evaluation of the infants with congenital heart disease, and brain MRI is being increasingly used in the research setting. The utility of HUSs in this population has not yet been established.

This is the first study to prospectively evaluate the utility of routine HUSs compared with MRIs in asymptomatic newborns and young infants undergoing cardiac surgery. Our findings suggest that routine HUS is not indicated in asymptomatic term or near-term neonates undergoing surgery for CHD. (Read the full article)

Medication ingestions are increasing among children despite a number of public health interventions. The majority of these poisonings are related to prescription as opposed to over-the-counter medications.

Rising rates of poisonings in children are strongly correlated with rising use of hypoglycemics, antihyperlipidemics, β-blockers, and opioids among adults. These events are associated with considerable health care utilization, both in terms of emergency department visits and hospital admissions. (Read the full article)

Atherosclerotic cardiovascular diseases are rooted in childhood. Vascular intima-media thickness (IMT) and elasticity are early surrogate markers of atherosclerosis. In adults, cardiorespiratory fitness is associated with enhanced arterial elasticity and decreased IMT.

Fitness was favorably associated with aortic IMT and elasticity in adolescents. The association was independent of several cardiometabolic risk factors. In fit adolescents, the increase in IMT during the preceding 6 years was smaller compared with low-fit peers. (Read the full article)

The ideal management of children with vesicoureteral reflux (VUR) remains a source of debate. There is little evidence to support many of the current management practices for children with VUR who have had 1 or 2 urinary tract infections.

Baseline associations, including bladder and bowel dysfunction and imaging studies, from the largest randomized, controlled trial conducted to date aimed at assessing the value of antimicrobial prophylaxis in children with urinary tract infection and VUR are presented. (Read the full article)

Cognitive and behavioral problems after pediatric traumatic brain injury lead to poor functioning across multiple settings and can persist long-term after injury. Executive dysfunction is particularly common; however, there is a paucity of evidence-based interventions to guide treatment.

This study is among the largest randomized controlled trials performed in pediatric traumatic brain injury. It demonstrates the ability to use an online problem-solving-based intervention to improve caregiver ratings of executive dysfunction within 12 months after injury. (Read the full article)

Popular press and research show that sibling aggression is common. Too often, however, it is dismissed as benign, and other forms of child aggression, such as peer aggression, are considered more serious. Peer aggression is linked to poorer mental health.

Using a national probability sample, we show that the nature and severity of sibling aggression have negative links to children’s and adolescents’ mental health. We demonstrate that sibling and peer aggression are comparable their links to symptoms of distress. (Read the full article)

Child maltreatment is a serious and prevalent public health problem in the United States. Responsible for substantial morbidity and mortality, maltreatment affects children's physical and mental health.

Although many health impacts of child maltreatment have been documented, no claims-based study has quantified the impact of maltreatment on health service utilization and costs. This study presents systematic claims-based estimates of maltreatment impacts on utilization and costs for the Medicaid population. (Read the full article)

Functional somatic symptoms (FSS) in children account for 10% to 15% of visits in medical services. Few studies have investigated the full range of pediatric FSS and factors linked to the medical help-seeking for young children with these symptoms.

More parental worries, higher symptom severity and impact, and previous contact to medical services are found among the children with FSS who seek medical consultation. Putative risk mechanisms include the early pattern of health care use and parental worries. (Read the full article)

Retinal hemorrhage (RH) is an important sign of pediatric abusive head trauma. Raised intracranial pressure (ICP) is sometimes proposed as an alternate cause of RH in children being evaluated for possible child abuse.

Nontraumatic, markedly elevated ICP rarely causes RH in children. When it does, RH are superficial intraretinal and located adjacent to a swollen optic nerve head. This pattern does not match the widespread pattern seen in abusive head trauma. (Read the full article)

Respiratory syncytial virus (RSV) infection is a leading cause of hospitalization among infants. Most estimates of RSV hospitalization rates are imprecise, having been calculated by using retrospective discharge diagnosis data and stratified age groups no narrower than 6 to 12 months.

Prospective, population-based surveillance data for infants hospitalized with laboratory-confirmed RSV infection were combined with birth certificate information to yield more precise age-specific hospitalization rates. These data should help determine priorities for the use of existing and future RSV prophylaxis strategies. (Read the full article)

Diabetic ketoacidosis (DKA) is a short-term complication of type 1 diabetes and is a major cause of preventable hospitalization in children. Hospital resource utilization and readmission rates for DKA across the US are not known.

Readmission for DKA within a year of hospitalization is common, accounting for one-fifth of all DKA admissions. Resource use, hospital length of stay, and readmission rates vary widely across major US children’s hospitals, even after adjusting for hospital differences in patients. (Read the full article)

Twin studies suggest that bronchopulmonary dysplasia (BPD) is heritable; however, only a small number of genetic loci have been associated with BPD and these explain only a limited amount of this heritability.

A genome-wide association study of singleton infants (899 BPD cases and 827 controls) of 25 to 30 weeks’ gestational age did not identify single-nucleotide polymorphisms associated with BPD at the genome-wide significance level but did identify polymorphisms warranting further study. (Read the full article)

Children with autism spectrum disorder (ASD) and those with ADHD are at risk for problematic video game use. However, group differences in media use or in the factors associated with problematic video game use have not been studied.

Boys with ASD and ADHD demonstrated greater problematic video game use than did boys with typical development. Inattention was uniquely associated with problematic use for both groups, and role-playing game genre was associated with problematic use among the ASD group only. (Read the full article)

Blood cultures are a common investigation in children admitted to the hospital with skin and soft tissue infections. The yield of blood cultures in this condition is unknown.

Blood cultures are not useful in children admitted to the hospital with uncomplicated skin and soft tissue infections, and they may be associated with increased length of hospital stay. (Read the full article)

Newborns with critical congenital heart disease (CCHD) are at risk for cardiovascular collapse or death if discharged from the birth hospital without a diagnosis. Newborn screening aims to identify CCHD missed in prenatal and postnatal examinations.

Birth hospital nursery level and CCHD type were found to be associated with late CCHD detection. Routine newborn screening could conceivably reduce differences in the frequency of late diagnosis between birth hospital facilities. (Read the full article)

The number of overweight and obese children has dramatically increased in recent decades. To combat this trend, information on possible gender-related differences in risk factors of overweight and obesity is critical.

This study examines associations of gender and physiologic and behavior measurements with potential cardiovascular risk. Lunch consumption and screen time were associated with weight; however, other associations with weight differ by gender. This information can be used to tailor future interventions. (Read the full article)

At the time of their pediatric medical evaluation, patients with functional abdominal pain (FAP) have higher levels of emotional symptoms compared with youth without FAP. No controlled prospective study has evaluated psychiatric outcomes for FAP patients in adulthood.

This prospective study showed that pediatric FAP was associated with high risk of anxiety disorders in adolescence and young adulthood. Risk was highest if abdominal pain persisted, but was significantly higher than in controls even if pain resolved. (Read the full article)

Pulse oximetry screening at 24 hours of age improves detection of critical congenital heart disease in asymptomatic newborns.

This study describes an initial experience with pulse oximetry screening for critical congenital heart disease and provides a strategy for preparing for state implementation of recent federal newborn screening recommendations. (Read the full article)

Latino children are diagnosed with autism spectrum disorders (ASDs) less often and later than white children. Primary care pediatricians (PCPs) may play an important role in early ASD identification for Latinos.

PCPs find it more difficult to assess for ASDs in Latinos with Spanish primary language, view Latino parents as less knowledgeable about ASDs, and experience frequent barriers to ASD diagnosis in Latino patients. Many PCPs do not offer recommended screenings in Spanish. (Read the full article)

Term neonates in resource-poor settings frequently develop hypothermia. Plastic bags or wraps are a low-cost intervention for the prevention of hypothermia in preterm and low birth weight infants that may also be effective in term infants.

For term neonates born in a resource-poor health facility, placement in a plastic bag at birth can reduce the incidence of hypothermia at 1 hour after birth. (Read the full article)