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Women who use marijuana while breastfeeding produce breast milk with a measurable amount of the primary psychoactive ingredient in marijuana, delta-9-tetrahydrocannabinol (delta 9-THC), for up to 6 days since they last smoked. This was the primary finding in a study in 50 breastfeeding women who reported using marijuana and provided breast milk samples to a research repository for analysis.

A previously healthy 4-year-old male, born late preterm by urgent cesarean delivery with an uncomplicated postnatal course, presents to the outpatient clinic for a chief complaint of worsening cough over the past 5 months. He denies current fever, rhinorrhea, shortness of breath, diarrhea, or vomiting. His cough has been worsening in severity and frequency, and mostly occurs during the daytime.

An 8-year-old boy is brought to the office for evaluation of a persistent itchy rash on his extremities, trunk, and face. Although the rash has been present for longer than 3 months, individual skin lesions change from hour to hour and occasionally the rash clears completely only to recur several hours later. He is otherwise healthy with no known allergies, changes in diet, medication use, or recent illness.

Many times, testing seems to be the easiest way to answer a clinical question, but judicious use of tests is the best approach. Here are some guidelines I have followed over the years.

For Contemporary Pediatrics, Erin Bastick, PharmD, sat down with Roberta Michnick Golinkoff, PhD, to discuss the importance of play in a child's development and how pediatricians can help ensure that kids get what they need.