Frontiers in Pediatrics

IntroductionThe circadian clock is an internal, [~]24-hour biological timer that synchronizes physiology with the day-night cycle. Social jetlag (SJL) describes the misalignment between this internal clock and social schedules, a condition affecting approximately 70% of the population and linked to a spectrum of metabolic, mental, and cognitive health issues. This study examined how the 2022 FIFA World Cup disrupted normal childrens sleep routines and other associated factors from parents prospe...

IntroductionCentral line-associated bloodstream-infection (CLA-BSI) and catheter-related bloodstream infections (CR-BSI) remain a significant concern in pediatric inpatient units. ObjectiveTo analyze a case series of CLA-BSI and CR-BSI in hospitalized pediatric patients in hospitals with rigorous infection prevention measures. Materials and MethodsThis was an analytical, descriptive, and retrospective study conducted in patients aged 0 to 18 years, admitted between August 2023 and March 2025, ...

BackgroundPediatric long COVID is associated with substantial symptom burden, yet evidence-based pharmacologic treatments remain limited. Low-dose naltrexone (LDN) has been proposed as a potential symptomatic therapy, but data in pediatric populations is lacking. MethodsWe conducted a retrospective analysis of pediatric and young adult patients ([≤]25 years) with a clinical diagnosis of long COVID who were prescribed LDN between July 2020 and July 2025 at three multidisciplinary pediatric lo...

BackgroundCongenital anomalies are among the leading causes of neonatal morbidity and mortality, particularly in low- and middle-income countries. Early detection through newborn screening improves outcomes, yet little is known about the screening practices of healthcare professionals (HCPs) in Ethiopia. In our setting, many children with congenital malformations are not identified at birth and present later, after being discharged from the birth facility. MethodsA cross-sectional study was con...

Background and ObjectivesDecision-making about resuscitating a critically ill child is complex yet common. We aimed to study the survival thresholds at which physicians, compared to parents, decide to treat or withhold resuscitating a child. Moreover, we aimed to compare physicians survival estimates with those from a nationwide registry. MethodsWe conducted a cross-sectional survey-based study in the United States. Clinical vignettes based on hypothetical survival probabilities were used to st...

Malnutrition is a deficiency of both macro- and micro-nutrients. Malnutrition is common in children with congenital heart defects due to reduced intake, poor gastrointestinal absorption resulting from gut hypo-perfusion and increased metabolism. The present study aimed to determine the prevalence and predictors of hypovitaminosis D in children with congenital heart defects aged 1 to 12 years compared with apparently healthy controls. MethodsA comparative cross-sectional study conducted from Jul...

BackgroundChildren with tracheostomies experience frequent and recurrent acute respiratory infections (ARIs). While cultured respiratory pathogens can inform ARI diagnosis, it is unknown if their presence in the airway affects future ARI risk. ObjectiveTo identify predictors of frequent (3+) ARIs within 36 months of tracheostomy. MethodsWe conducted a single-center, retrospective cohort study of children with tracheostomies placed between 2010-2016. Medical records were reviewed for each encou...

BackgroundPediatric poisonings are a significant cause of emergency admissions, often linked to accessible household toxins. This study investigates the epidemiological patterns, clinical presentations, and management strategies at a tertiary care hospital in Algiers, Algeria. MethodsA retrospective descriptive analysis was conducted on anonymized pediatric poisonings cases. Variables included age, sex, type of ingestion, intent (accidental vs. voluntary), substances involved, endoscopic findin...

BackgroundPre-referral stabilization is a critical yet neglected component of pediatric emergency care in low-resource settings. It involves delivering life-saving interventions-- such as airway management, oxygen therapy, fluids, glucose, and anticonvulsants at the initial point of care before referral. The WHOs ETAT Guidelines emphasize the prompt recognition and management of life-threatening conditions in children to reduce mortality. Despite Tanzanias adoption of ETAT, the extent to which p...

BackgroundEarly relational health (ERH) is thought to buffer the association between early life stress (ELS) and child psychopathology, but limited work has directly tested this hypothesis. ObjectiveWe evaluate mother-infant emotional connection, a facet of ERH, as a buffer of combined and individual impacts of specific ELS exposures (maternal mental health and interpartner conflict) on child psychopathology. MethodsParticipants included mother-infant dyads (n=100) followed longitudinally in t...

BackgroundAsthma is a frequent comorbidity in children with sickle cell disease and has been associated with an increased risk of acute complications, particularly vaso-occlusive crises and acute chest syndrome. However, determinants of clinical severity among children with sickle cell disease and confirmed asthma remain poorly characterized, especially in tropical settings. This study aimed to identify factors associated with clinical severity in this population. MethodsWe conducted an observa...

Background and ObjectivesCurrent potassium reference intervals for neonates fail to account for sampling method differences and prematurity-related factors, leading to unnecessary resampling and interventions. We aimed to establish sampling-specific potassium reference intervals for term and preterm neonates using comprehensive electronic health record data. MethodsWe analyzed 195 606 blood gas measurements from 10 290 neonates (2007-2024) at a tertiary neonatal intensive care unit. After ex-cl...

Patient portals are designed to enhance patient and caregiver engagement by providing access to health information, communication with care teams, and telehealth services, yet their impact on health care utilization among hospitalized children is not well understood. In this cross-sectional study, we examined associations between patient portal enrollment and use and hospitalization outcomes among 40,377 children admitted to an urban quaternary or suburban tertiary pediatric hospital between 202...

Background and ObjectivesPatient portals allow adolescents and caregivers of pediatric patients to better engage with health care, improving their medication adherence, health knowledge, self-efficacy, and receipt of preventive care. However, disparities in access to and comfort with using these portals persist. Hospitalization represents a promising opportunity to address these disparities among a high-risk population. Design/MethodsWe conducted a cross-sectional analysis to identify dispariti...

IntroductionBronchopulmonary dysplasia (BPD) remains a major complication among extremely low gestational age (ELGA) infants, with long-term respiratory and neurodevelopmental consequences. Despite advances in neonatal care, effective therapies to prevent BPD are lacking. Mesenchymal stromal cells (MSC), particularly those derived from umbilical cord (UC-MSC), offer promise due to their pleiotropic effects. Preclinical and early-phase clinical studies have demonstrated safety and potential effic...

Dysglycemia is a critical metabolic disturbance associated with mortality in acutely ill children, yet its burden may be underrecognized in low-income settings due to reliance on single point-of-care measurements. Using continuous glucose monitoring (CGM), we aimed to characterize glucose patterns in acutely ill children of different anthropometric status. MethodsChildren aged 2-23 months admitted with acute illness were prospectively recruited from two hospitals in Bangladesh and Malawi. Clini...

ObjectiveTo examine whether screen time predicts interindividual variability regarding pubertal development across adolescence. Study designThis longitudinal cohort study included 10786 participants (47.9% female) from the Adolescent Brain Cognitive Development (ABCD) study. First, associations were examined between average daily screen time (hours/day, parent-reported Screen Time Survey) at baseline (mean age = 9.91 {+/-} 0.63 years) and pubertal timing, derived from Pubertal Development Scale...

Fortification of human milk (HM) is essential to meet the nutritional needs of very low birthweight infants (VLBWI). Most available fortifiers are derived from cows milk, raising concerns about tolerability, immunogenicity and access in low-resource settings. LioNeo is a novel multinutrient fortifier produced exclusively from freeze-dried donor HM by a certified Human Milk Bank in Brazil. Preclinical and Phase 1 testing demonstrated safety and tolerability. This Phase 2 trial evaluated the effic...

BackgroundPediatric eczema is a highly prevalent condition that often causes substantial suffering among affected children and their families. Numerous modifiable lifestyle and environmental risk factors for the condition have been identified, although these risk factors and related interventions have generally been studied in isolation. The goal of this study was to evaluate the effects of an integrative program for parents of children with eczema that simultaneously addressed multiple lifestyl...

ObjectivesVentilator-associated pneumonia (VAP) is a significant complication in pediatric patients with severe bronchiolitis undergoing mechanical ventilation (MV) in pediatric intensive care units (PICUs). The role of respiratory microbiota in VAP development remains underexplored in this vulnerable population. This study aimed to characterize respiratory microbiota in critically ill children with severe bronchiolitis receiving critical care and identify microbial patterns associated with VAP....