News

In my 40-plus years of pediatrics, I have sometimes treated patients based on the best of intentions, but with perhaps the worst of evidence. Here are some “best practices” I have used, and discarded, over time.

image of eye

The mother of a healthy 4-week-old boy brings him to the office for evaluation of a small pit on the medial canthus of the left eye, noted since birth. There is constant drainage of tears onto the left side of his face and exudate on the bottom of the left medial canthus.

stock image of money being cut by scissors

For children living below the federal poverty level, public insurance programs are a lifeline to crucial healthcare services. If eligibility requirements change, however, thousands of children could be left without healthcare-a move that could result in billions of dollars’ worth of uncompensated care for hospitals each year.

stock image of childhood vaccine

The number of kindergartners starting school without protection against vaccine-preventable diseases is increasing in states that allow nonmedical exemptions to recommended immunizations.

Infants born to mothers who receive vitamin D supplementation while pregnant are at reduced risk of being small for gestational age and experience improved growth during infancy, with no increased risk of fetal or neonatal mortality and congenital malformation. These were major findings of a systematic review and meta-analysis of 24 randomized controlled trials involving 5405 participants.

A 33-year-old female, G3P1011, was transferred from an outside facility at 33 weeks and 6 days gestation for anticipated preterm delivery secondary to preeclampsia. On prenatal ultrasound, her fetus was diagnosed with an omphalocele and delivery was preferred at an institution with a neonatal intensive care unit to manage the infant.

Compared with their peers who spend no more than 2 hours each weekday exposed to digital media, school-aged children who are in front of screens for longer are less likely to be doing well overall, according to their parents. Furthermore, how much digital media exposure (DME) a child gets is inversely related, in a dose-dependent manner, to markers of childhood “flourishing.”