Contemporary Pediatrics week in review: November 2-6, 2026

Review some of the top stories from the Contemporary Pediatrics website over the last week, and catch up on anything you may have missed.

Thank you for visiting the Contemporary Pediatrics® website. Take a look at some of our top stories from last week (Monday, November 2 to Friday, November 6, 2026) and click each link to read and watch anything you may have missed.

1.) First pediatric flu death of the 2026-27 season

The CDC reported the 2026-27 season's first influenza-associated pediatric death, in a child who died during the week ending October 10 from illness linked to influenza A(H1N1); FluView did not disclose the child's age, location, or vaccination status. A second pediatric death reported for the week ending October 24 was a late-reported influenza B case from September that raised the 2025-26 season's pediatric total to 199. San Bernardino County, California, separately announced on October 30 the flu-related death of a child with underlying conditions who was too young to be vaccinated, and Colorado confirmed its first pediatric flu death of the season in mid-October.

For the week ending October 24, 7.6% of more than 53,000 clinical specimens tested positive for influenza, with 98.9% of subtyped influenza A viruses identified as A(H1N1)pdm09; children aged 0-4 had the second-highest hospitalization rate (1.8 per 100,000) of any age group, and FluSurv-NET's weekly hospitalization rate is the highest for this point in a season since 2010-11. CDC estimates at least 1 million illnesses, 16,000 hospitalizations, and 900 deaths so far this season, though the agency cautions that seasonal activity remains low nationally overall and that death counts often rise as reporting catches up.

2.) Skipping newborn vitamin K tied to 47% higher infant bleeding risk

A retrospective JAMA cohort of roughly 5.24 million US infants born at 35 to 43 weeks' gestation from 2017 to 2025, drawn from Epic Cosmos EHR data, found that infants who did not receive the standard intramuscular vitamin K injection faced significantly higher bleeding risk. Nonreceipt of the shot more than doubled over the study period, from 3.1% in 2017 to 6.8% in 2025, and 4.5% of infants overall (234,825) did not receive it.

Bleeding by 6 months occurred in 288.0 per 10,000 nonrecipients versus 185.9 per 10,000 recipients, an adjusted risk ratio of 1.47; intracranial bleeding risk was more than double (adjusted risk ratio 2.43), and the risk of death with concurrent bleeding during the birth hospitalization was nearly triple (adjusted risk ratio 2.69). Because the design is retrospective and observational, the authors note it shows association rather than causation, and they could not determine whether some "nonrecipients" had instead received oral vitamin K or a later injection; accompanying commentary called for reinforced vitamin K recommendations and dedicated surveillance.

3.) Study identifies gaps in infant RSV immunization timing

A retrospective cohort poster presented at IDWeek 2026 examined 80,862 infants born between April 2025 and March 2026 across a national network of primary care clinics, of whom 17,771 received the RSV monoclonal antibody nirsevimab (Beyfortus). Among infants born during RSV season, only 35.4% were immunized within the recommended 7-day window after birth, and the median time to administration was 14 days.

Timing varied by insurance type: for in-season births, the median time to administration was 27 days for self-pay infants compared with 14 days for commercially insured infants and 13 days for those covered by Medicaid or the Vaccines for Children program, a gap the researchers linked to insurance-rostering delays rather than to access itself. The analysis covered only outpatient administration and could not capture doses given in birth hospitals, so the authors caution it cannot establish overall nirsevimab coverage; they suggest proactive scheduling, caregiver education, and reminder systems to close the timing gaps.

4.) Cenobamate sNDAs seek PGTC and pediatric focal seizure indications

Two supplemental new drug applications for cenobamate (Xcopri) are now before the FDA: one seeking a primary generalized tonic-clonic (PGTC) seizure indication for patients 12 and older, and a second, submitted in October, seeking a pediatric focal-onset seizure indication. Cenobamate is currently approved in the US only for partial-onset seizures in adults. The PGTC application rests on a phase 3 trial of 169 patients, including 34 adolescents aged 12 to 17, in which median PGTC seizure frequency fell 71.9% with cenobamate versus 39.6% with placebo.

During the 12-week maintenance phase, 43.4% of cenobamate-treated patients were seizure-free compared with 20.5% on placebo, though treatment-emergent adverse events, mainly somnolence and fatigue, occurred in 60.0% of cenobamate patients versus 53.0% on placebo. The efficacy data so far come from sponsor-authored conference abstracts rather than a peer-reviewed publication; outcomes for the adolescent subgroup were not reported separately, and the company has not disclosed FDA target action dates for either application.

5.) What new dietary guidelines mean for pediatric practice

Speaking at the AAP 2026 National Conference & Exhibition, Natalie D. Muth, MD, MPH, RDN, MBA, told pediatricians that the 2025-2030 Dietary Guidelines for Americans do not require major changes to routine nutrition counseling, despite several shifts in emphasis. The guidelines place more weight on animal protein, and Muth cautioned against discouraging plant-based proteins, which she said remain healthy; they also favor whole milk over reduced-fat options for children, a recommendation she noted the AAP and other organizations have not necessarily adopted.

For the first time, the guidelines explicitly address ultra-processed and highly processed foods, giving pediatricians an opening to discuss reducing them when feasible. Muth recommended open-ended questions and small, achievable changes rather than strict rules, and acknowledged that the evidence on dairy fat specifically is mixed; she also noted that food access and family circumstances limit how well any dietary recommendation can be followed in practice.