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        <title>Frontiers in Pediatrics | New and Recent Articles</title>
        <link>https://www.frontiersin.org/journals/pediatrics</link>
        <description>RSS Feed for Frontiers in Pediatrics | New and Recent Articles</description>
        <language>en-us</language>
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        <pubDate>2026-08-18T16:32:17.963+00:00</pubDate>
        <ttl>60</ttl>
        <item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1885979</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1885979</link>
        <title><![CDATA[Salmonella Typhimurium infection complicating very early-onset inflammatory bowel disease presenting with Pseudo-intussusception: a case report]]></title>
        <pubdate>2026-08-18T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Qian Liu</author><author>Ling Yang</author><author>Xuefeng Sun</author><author>Yishan Liu</author><author>Hui Yang</author>
        <description><![CDATA[The clinical manifestations of acute non-typhoidal Salmonella infection can overlap with underlying very early-onset inflammatory bowel disease (VEO-IBD), complicating early differential diagnosis. We report a 5-year-old boy who presented with fever, paroxysmal abdominal pain, and high-volume watery hematochezia. Initial abdominal ultrasonography revealed a “concentric ring sign” mimicking intussusception, while laboratory tests concurrently demonstrated elevated serum total immunoglobulin E (IgE) levels. Subsequent water-soluble gastrointestinal contrast studies and computed tomography ruled out mechanical intestinal obstruction. Early endoscopy and mucosal biopsy revealed cryptitis and chronic active inflammation from the rectum to the sigmoid colon, and stool cultures isolated Salmonella Typhimurium, with serum total IgE peaking at 2965 IU/mL. Based on these clinical findings, the patient was diagnosed with concurrent acute Salmonella Typhimurium infection and VEO-IBD. The patient received a combined regimen of systemic intravenous cefotaxime sodium and localized therapy comprising dexamethasone retention enemas and mesalazine suppositories, with symptom resolution within 10 days. This case illustrates the value of multimodal imaging and early endoscopy in differentiating overlapping enteric infections from VEO-IBD, and suggests that integrating systemic antimicrobials with localized anti-inflammatory agents may be a feasible therapeutic strategy.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1935719</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1935719</link>
        <title><![CDATA[Serum phoenixin-14 shows no association with metabolic syndrome in children with obesity: a cross-sectional study]]></title>
        <pubdate>2026-08-18T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Zafer Bağcı</author><author>Rukiye Uyanık</author><author>Ümmügülsüm Can</author><author>Deniz Yılmaz</author><author>Sadinaz Akdu</author>
        <description><![CDATA[BackgroundPhoenixin is a novel neuropeptide encoded by the SMIM20 gene, implicated in energy homeostasis and reproduction, but its role in pediatric metabolic syndrome remains unknown.MethodsThis cross-sectional study enrolled 98 children and adolescents aged 7–18 years [45 with Metabolic syndrome (MetS) and 53 with obesity without MetS]. MetS was defined by modified International Diabetes Federation criteria. Biochemical analyses included fasting glucose, lipid profile, and liver enzymes on a Beckman Coulter AU5800 analyzer; insulin, cortisol, adrenocorticotropic hormone (ACTH), thyroid, and reproductive hormones on a Roche Cobas e601 electrochemiluminescence immunoassay system; and HbA1c by high-performance liquid chromatography (Bio-Rad D10). Serum phoenixin-14 was quantified by sandwich ELISA (Bioassay Technology Laboratory Cat. No. E7481Hu; sensitivity 8.19 ng/L; intra-assay CV 6.8%, interassay CV 9.2%). Group comparisons were performed using Mann–Whitney U and chi-square tests; a general linear model (GLM) adjusting for age and Tanner stage assessed the independent effect of the MetS and obese groups on serum phoenixin-14.ResultsSerum phoenixin-14 did not differ between the MetS and obese groups (519.75 ± 196.67 vs. 567.86 ± 368.40 pg/mL; p = 0.955). After adjustment for age and Tanner stage by GLM (n = 95), the difference remained non-significant (adjusted difference: −26.5 pg/mL, 95% CI: −152.1 to 99.1; p = 0.676; adjusted means: MetS 529.1 pg/mL vs. Obese 555.7 pg/mL). Tanner stage was a significant covariate (B = 73.04, p = 0.009). Children with MetS were older (13.62 ± 2.51 vs. 12.19 ± 2.65 years; p = 0.010) and had higher median insulin (30.80 vs. 18.20 µIU/mL; p < 0.001), higher triglycerides (172.04 ± 70.94 vs. 106.68 ± 39.27 mg/dL; p < 0.001), lower high-density lipoprotein-cholesterol (38.56 ± 7.73 vs. 47.02 ± 9.99 mg/dL; p < 0.001), and higher ACTH (28.86 ± 14.12 vs. 22.44 ± 11.86 pg/mL; p = 0.018).ConclusionsIn this cohort, serum phoenixin-14 did not differ between obese children with and without metabolic syndrome after adjusting for age and pubertal stage (p = 0.676). These findings do not support a discriminative role for phoenixin-14 in pediatric MetS. Further studies including healthy normal-weight controls are needed to determine whether phoenixin-14 concentrations are altered in pediatric obesity.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1737317</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1737317</link>
        <title><![CDATA[Assessment of childhood disease patterns in outpatient settings: a retrospective study from 2016 to 2020]]></title>
        <pubdate>2026-08-18T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Lei Ding</author><author>Wencai Ma</author><author>Jie Yu</author><author>Xiaodan Li</author><author>Yulin Sun</author><author>Fei Li</author>
        <description><![CDATA[Background and aimThe Coronavirus Disease 2019 (COVID-19) pandemic has significantly impacted pediatric health. Although numerous studies in China have reviewed childhood diseases, specific patterns in certain regions still require more detailed analysis. This was a single-center retrospective study conducted at the Fifth People's Hospital of Wujiang District, Suzhou, Jiangsu, China. It aims to compare the characteristics of pediatric outpatient visits from 2016 to 2019 (pre-pandemic) and 2020 (pandemic), providing insights into how childhood disease patterns have evolved during and after the pandemic.MethodsWe conducted a retrospective analysis to collect routine administrative data on children from outpatient departmentsResultsA total of 236,977 visits in outpatient children were recorded, with the highest proportion of visits occurring in 2017 (24.5%) and the lowest in 2020 (11.3%). Changes in visit numbers were mainly associated with fluctuations in respiratory diseases (59.1%). The proportions of respiratory and infectious diseases varied across different years, with the highest proportions observed in 2019 (25.5% and 59.4%, respectively). There was a consistent higher prevalence of male children compared to their female counterparts in terms of demographic characteristics, with a ratio ranging from 1.2 to 1.3. The largest proportion of outpatient visits was observed among preschool-aged children (32.5%), followed by toddlers (26.0%) and school-age children (20.2%). Notably, the fourth quarter consistently had the highest number of visits (30.5%), while the third quarter exhibited the lowest visit numbers (20.0%). Fever (68.6%) was the most frequently reported symptom in outpatient visits with abnormal symptoms and signs.ConclusionsThis study highlights the impact of the COVID-19 pandemic on outpatient visits among children in Wujiang District, Suhzou, revealing a downward trend in 2020 compared to previous years. Notably, respiratory diseases remained the most common reason for outpatient visits, with distinct demographic patterns observed. These findings may help inform local healthcare planning and resource allocation in similar settings.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1881684</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1881684</link>
        <title><![CDATA[Development and internal validation of a monocyte-to-albumin ratio-based risk assessment model for coronary artery lesions in Kawasaki disease]]></title>
        <pubdate>2026-08-18T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Min-Min Li</author><author>Gao-Min Liu</author>
        <description><![CDATA[IntroductionCoronary artery lesions (CAL) are the most severe complication of Kawasaki disease (KD), yet accurate and practical risk assessment tools remain limited. This study aimed to develop and validate a parsimonious logistic regression model for CAL risk assessment using routine clinical and laboratory parameters.MethodsA total of 324 consecutive KD patients were retrospectively enrolled. Candidate predictors were screened by univariate analysis and a strict consensus-based strategy integrating five feature-selection methods (LASSO, random forest, Boruta, recursive feature elimination, and univariate threshold). Ten machine learning algorithms were compared, and the final model was selected based on performance and interpretability. A nomogram, calibration curve, and an online calculator were developed.ResultsAmong 324 patients, 64 (19.8%) had baseline CAL. Four variables [fever duration, GGT, monocyte-to-albumin ratio (MAR), and ESR] were consistently selected by all five methods. Logistic regression yielded a Brier score of 0.142, with high specificity (0.846), but limited sensitivity (0.421) on the hold-out test set. No significant effect modification was observed in exploratory interaction analyses assessing the association of MAR on CAL across the evaluated covariates (all adjusted P > 0.05). GBM model offered superior sensitivity (0.684) than other models, suggesting a potential exploratory role in sensitivity-driven screening scenarios. An online calculator was deployed strictly for exploratory research purposes.ConclusionsA simple four-variable logistic model incorporating fever duration, GGT, ESR, and MAR provides preliminary CAL risk assessment. However, the modest event count and single-center nature mandate multi-center external validation before any clinical application.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1908007</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1908007</link>
        <title><![CDATA[Palliative care for children with cancer in Cuba: a narrative review and adaptation of the World Health Organization integration model]]></title>
        <pubdate>2026-08-18T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Mariuska Forteza Sáez</author><author>Maria del Carmen Llantá Abreu</author><author>Yolainy Romero Rodríguez</author><author>Dayne Clarivel Quintero Vázquez</author>
        <description><![CDATA[BackgroundPalliative care for children with cancer represents an urgent health priority in Cuba. The country has a universal and free health system with national coverage, but the systematic provision of specialized pediatric palliative care (PPC) in oncology remains heterogeneous, with significant gaps across the eight pediatric oncology reference centers.ObjectiveTo describe the state of PPC development for children with cancer in Cuba, analyze it through the lens of the simultaneous integration model proposed by the World Health Organization (WHO), and identify gaps and opportunities for strengthening. This review is intentionally limited to pediatric oncology; PPC needs of children with non-oncological life-limiting conditions fall outside its scope.MethodsNarrative review of scientific literature published between 2000 and 2024, normative documents of the Cuban Ministry of Public Health (MINSAP), and reports from international organizations (WHO, PAHO, IAHPC, ALCP). Two authors independently screened identified records; disagreements were resolved by discussion with a third author. The WHO analytical framework for PPC integration was applied to evaluate six key dimensions: policy, education, medicines, services, research, and financing.ResultsCuba has a solid normative basis for PPC, including Ministerial Resolution No. 261/2020 and the National Cancer Control Program. Primary care coverage is universal, and the family doctor system facilitates care continuity, though the current level of formal PC training among family physicians specifically has not been systematically documented. Gaps were identified in: specialized staff training, equitable access to opioids at home, formal constitution of PPC teams in all eight centers, and published clinical research on outcomes in this population.ConclusionsCuba has favorable structural conditions for implementing an integrated, high-quality PPC model for children with cancer. The implementation of the National Pediatric Palliative Care Project 2026–2028 represents an important opportunity. Explicit alignment with the WHO model, strengthening specialized training, and generation of national scientific evidence are recommended.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1888678</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1888678</link>
        <title><![CDATA[Microbial etiology and antimicrobial resistance patterns in neonates admitted to a tertiary neonatal intensive care unit in Mogadishu, Somalia]]></title>
        <pubdate>2026-08-18T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Ali Kutta ÇELİK</author><author>Tigad Abdisad Ali</author><author>Farah Abdullahi Ismail</author><author>Suad Abdikarim ISSE</author><author>Mucahit TÜRKAN</author><author>Abdıkarım Abdı Adam</author><author>Liban Ade Hussein</author><author>Edanur Yeşil</author><author>Mohammed A. M. Ahmed</author>
        <description><![CDATA[ObjectiveNeonatal sepsis continues to be one of the leading causes of morbidity and death, particularly in low- and middle-income countries (LMICs). This study aimed to evaluate the microbiological etiology, temporal trends, and antibiotic resistance patterns in a tertiary neonatal intensive care unit (NICU) over a six-year period.MethodsThis retrospective study included neonates admitted to a tertiary neonatal intensive care unit between 2018 and 2024. Early-onset infections were defined as infections occurring within the first 72 hours of life, while late-onset infections were defined as infections occurring after 72 hours. Logistic regression analysis was used to assess temporal trends and identify factors associated with multidrug-resistant infection.ResultsMicrobial growth was observed in 891 (30.0%) of the total samples. A total of 891 isolates (30.0% of all samples) with complete data were included in the final study after duplicate and contaminated isolates were removed. Among these isolates, 472 (53.0%) were Gram-positive bacteria, 366 (41.1%) were Gram-negative bacteria, and 53 (5.9%) were Candida spp. isolates. isolates. In addition to a greater proportion of Gram-negative organisms (43.6% vs. 35.4%) and Candida species (7.5% vs. 2.6%), late-onset infections showed considerably higher culture-positive rates (37.7% vs. 20.7%, p < 0.001) than early-onset infections. On the other hand, Gram-positive organisms predominated in early-onset infections (62.0% vs. 48.9%, p < 0.001). In Multivariate logistic regression analysis, study year was not independently associated with MDR after adjustment (aOR: 1.06, 95% CI: 0.98–1.14, p = 0.169), whereas late-onset infection was still independently linked with MDR infection (aOR: 2.53, 95% CI: 1.84–3.47, p < 0.001). Despite changes in MDR rates throughout the course of the research years, carbapenem resistance demonstrated a significant growing trend over time (p for trend = 0.004). Notably, none of the commonly used empirical antibiotics met the recommended susceptibility level of ≥80%.ConclusionThis six-year study reveals a significant burden of neonatal infections in the NICU, with Candida spp. and Gram-negative organisms predominating in late-onset infections and Gram-positive organisms in early-onset infections. Carbapenem resistance dramatically increased over time, and late-onset infection was independently linked to multidrug resistance. These results highlight the necessity of stronger IPC, localized antimicrobial stewardship, updated empirical treatment guidelines, and regular AMR surveillance.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1898215</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1898215</link>
        <title><![CDATA[Longitudinal gut microbiota development from infancy to toddlerhood: a systematic review and platform-stratified meta-analysis]]></title>
        <pubdate>2026-08-18T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Hongyun Li</author><author>Qinghong Xia</author>
        <description><![CDATA[BackgroundGut-microbiota development during early life is associated with immune, metabolic, and neurodevelopmental maturation, but longitudinal findings differ across sampling schedules and sequencing platforms.MethodsPubMed/MEDLINE, Web of Science Core Collection, Embase.com, and Scopus were searched from inception through 21 July 2026. Two authors independently screened records and full reports. Reports were linked to their underlying studies/cohorts, and the full evidence set was mapped at cohort level. Hedges-corrected standardized mean changes were synthesized with REML random-effects models and modified Hartung-Knapp intervals only within compatible developmental windows, sequencing platforms, and taxonomic levels.ResultsThe searches identified 10,337 records; 5,640 duplicates were removed and 4,697 unique records were screened. Of 344 reports sought, 11 were not retrieved, 333 were assessed, and 173 reports representing 95 studies/cohorts were included. Seven reports contributed to the primary quantitative panels. In primary 16S syntheses, Shannon diversity was higher at approximately 12 months (Hedges g 1.62, 95% CI 0.85–2.39; I2 = 83.0%; k = 4), as was Chao1 richness (g 2.14, 95% CI 1.69–2.60; I2 = 0%; k = 3). Exact-paired-only sensitivity estimates remained positive but were imprecise for Shannon (g 1.93, 95% CI −1.00–4.85; k = 2) and Chao1 (g 2.07, 95% CI −1.73–5.88; k = 2). Primary taxon syntheses contained two 16S estimates per outcome and were exploratory.ConclusionsThe evidence suggests that alpha diversity generally increases during the first year of life, although the magnitude and between-cohort consistency remain uncertain. Certainty ranged from low to very low, and taxon-specific findings require platform- and age-window-specific interpretation.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1934287</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1934287</link>
        <title><![CDATA[How much sweating is enough? Predicting thermoregulatory capacity in patients with ectodermal dysplasia based on a minimal pilocarpine-induced sweat volume]]></title>
        <pubdate>2026-08-18T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Anja Bachfischer</author><author>Carola Berking</author><author>Smail Hadj-Rabia</author><author>Umberto Simeoni</author><author>Anna L. David</author><author>Holm Schneider</author>
        <description><![CDATA[BackgroundPathogenic EDA gene variants underlying X-linked hypohidrotic ectodermal dysplasia cause either anhidrosis (null mutations) or hypohidrosis (hypomorphic mutations). Due to their inability to sweat, heat-stressed individuals with EDA null mutations are unable to regulate their body temperature without external cooling and are thus vulnerable to heat-induced injury. For the purpose of developing a therapeutic intervention it would be necessary to know what sweat production is sufficient for normal thermoregulation, e.g., by correlating perspiration in a standard test with thermoregulatory ability, so that a certain sweat volume can be used as an endpoint in clinical trials of drug candidates.MethodsIn patients with hypomorphic EDA mutations, perspiration in response to pilocarpine iontophoresis was determined with the Macroduct sweat collector and volumetry after 30 minutes. Parental- or self-reported heat intolerance and clinical signs of overheating were recorded. If sweat production was borderline, exercise-induced and thermal sweating were assessed by infrared thermography of the skin and core temperature monitoring. In addition, a systematic review of the literature reporting sweat volumes obtained after pilocarpine iontophoresis and thermoregulatory ability of patients with hypomorphic EDA mutations was performed.ResultsWe studied a rare cohort of individuals with hypomorphic EDA mutations (n = 14) managed at the German national centre for ectodermal dysplasias. Subjects who produced more than 15 µL of sweat upon stimulation with pilocarpine did not show heat intolerance or signs of overheating. Pilocarpine-induced sweating of 16 µL/30 min in early childhood was found to correlate with normal thermoregulation at the age of 10 years. The literature review suggested that a pilocarpine-induced sweat production of 15 µL/30 min in boys indeed represents the bottom of the normal range.ConclusionA sweat volume ≥15 µL, measured in a standard test on male infants using the Macroduct system, appears to indicate normal thermoregulatory capacity in the European climate.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1893524</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1893524</link>
        <title><![CDATA[School-age somatic, internalizing, attention, and social difficulties in moderate anthropometric undernutrition: a primary-care case-control study]]></title>
        <pubdate>2026-08-18T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Dilek Altun Varmış</author><author>Selda Pamiry</author>
        <description><![CDATA[BackgroundModerate anthropometric undernutrition is associated with developmental risks, but the emotional, behavioral, and functional profiles of children with moderate anthropometric undernutrition managed in outpatient primary care follow-up remain insufficiently characterized.Methods This cross-sectional case-control study examined 60 mother-child dyads in Adana, Türkiye (undernutrition, n = 30; control, n = 30). Children were assessed by age group using the Child Behavior Checklist, and mothers completed parent-proxy measures of quality of life, psychological distress, and parenting-related emotion regulation.ResultsNo statistically significant between-group differences were detected in the measured sociodemographic and general clinical variables, although the sample was not powered to establish equivalence or exclude residual confounding. Children with moderate anthropometric undernutrition were more often described as eating less or showing selective eating, and family relationship quality was less often rated as good. Parent-proxy quality of life, maternal psychological distress, and parenting-related emotion regulation did not differ at the group level. Preschool CBCL scores were comparable. In the CBCL/6-18 subgroup, primary comparisons using age- and sex-normed T-scores identified higher Somatic Complaints, Anxious/Depressed, Social Problems, Attention Problems, Internalizing Problems, and Total Problems scores in the undernutrition group. Somatic Complaints (q = 0.020), Attention Problems (q = 0.036), Anxious/Depressed (q = 0.047), and Internalizing Problems (q = 0.047) remained significant after false-discovery-rate correction; Social Problems and Total Problems did not survive correction and are interpreted as preliminary. Externalizing Problems were not elevated at the group level. Within the undernutrition group, higher internalizing and externalizing T-scores were associated with poorer parent-proxy quality of life in the primary Pearson analyses, although these associations were attenuated and did not survive correction in the all-Spearman sensitivity analysis.ConclusionBecause of the cross-sectional design, the direction of these associations cannot be established; they may reflect nutritional influences on psychosocial functioning, behavioral or feeding difficulties contributing to low weight, or shared antecedents of both. These findings suggest a selective school-age psychosocial screening signal, rather than generalized impairment, in outpatient moderate anthropometric undernutrition. Routine nutrition follow-up may benefit from brief behavioral screening, feeding behavior assessment, and family-sensitive primary care support.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1863943</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1863943</link>
        <title><![CDATA[Breastfeeding difficulties and maternal–infant bonding at three months postpartum in a Turkish cohort]]></title>
        <pubdate>2026-08-18T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Bulent Gunes</author><author>Ferit Dogan</author><author>Ahmet Guzelcicek</author><author>Aydin Bozkaya</author><author>S. Songul Yalcin</author>
        <description><![CDATA[BackgroundBreastfeeding difficulties are common in the early postpartum period and have been hypothesized to negatively affect maternal–infant bonding. We aimed to investigate the relationship between breastfeeding problems and mother–infant bonding at 3 months postpartum in a sample of Turkish mothers.MethodsWe conducted a cross-sectional observational study of 257 mothers of 3-month-old infants in Turkey. Participants completed a questionnaire including demographic and obstetric information, breastfeeding practices and difficulties, and the Postpartum Bonding Questionnaire (PBQ) to assess maternal–infant bonding. Bonding difficulty was defined as a PBQ total score >25. Bivariate analyses (chi-square or Fisher's exact tests) compared mothers with and without bonding difficulties, and a multivariable logistic regression model was used to identify independent predictors of bonding problems at 3 months postpartum.ResultsOverall, 33 mothers (12.8%) met criteria for bonding difficulties at 3 months. A total of 144 mothers (56.0%) reported at least one breastfeeding problem during the first 3 months postpartum. In bivariate analyses, breastfeeding difficulties were more common among mothers with bonding difficulties than among those without (81.8% vs. 52.2%, P = .001). Mothers with bonding difficulties were also more likely to have higher education (81.8% vs. 54.9% with ≥ secondary education; P = .003), to be employed outside the home (21.2% vs. 8.9%; P = .06), and to have a female infant (66.7% vs. 38.8% female; P = .003). No significant differences were found by maternal age, parity, or feeding mode (exclusive breastfeeding vs. formula feeding, P = .64). In multivariable logistic regression, breastfeeding difficulties were independently associated with bonding impairment (adjusted odds ratio [OR] 3.5, 95% confidence interval [CI] 1.5–8.0, P = .003). Maternal higher education (adjusted OR 3.0, 95% CI 1.1–8.0, P = .031) and having a female infant (adjusted OR 3.1, 95% CI 1.2–7.5, P = .016) were also independent predictors; maternal employment showed a positive but non-significant association (adjusted OR 2.2, 95% CI 0.9–5.5, P = .081).ConclusionsIn this Turkish sample, mothers who reported breastfeeding difficulties had higher odds of impaired maternal–infant bonding at 3 months postpartum. These findings support routine assessment of breastfeeding-related distress during postpartum care.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1892954</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1892954</link>
        <title><![CDATA[Retinopathy of prematurity remains the leading cause of childhood blindness in children attending schools for the blind in Guadalajara: a fifteen-year comparison]]></title>
        <pubdate>2026-08-18T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Luz Consuelo Zepeda Romero</author><author>Juan Carlos Barrera de Leon</author><author>⁠José Alfonso Gutiérrez Padilla</author><author>Sofía Jacqueline Baeza Magaña</author><author>Ivana Jimenez Lopez</author><author>Sara Carolina Boyzo Arcadia</author><author>Mariana Padilla Escobar</author><author>Diana Estefanía Gutiérrez Gómez</author><author>Manuel Alejandro Del Callejo Bernal</author><author>Daniel Pérez Rulfo Ibarra</author><author>Guillermo Yanowsky Reyes</author>
        <description><![CDATA[ObjectiveTo identify the main causes of blindness in children attending at 3 schools for blind in the metropolitan area of Guadalajara (MAG), Jalisco, Mexico and to highlight the importance of preventing childhood visual disability.MethodsAn observational, cross-sectional, and descriptive study was conducted in students enrolled in three schools for children with visual disabilities during the period September–December 2025 in Guadalajara, Jalisco, Mexico. Information was obtained from the review of clinical and school records, interviews with parents, and ophthalmologic evaluation, with prior institutional approval from the participating schools. A standardized World Health Organization (WHO) form was used to record sociodemographic variables, perinatal history, ophthalmologic diagnosis, etiology, treatments, and comorbidities. A descriptive analysis with an epidemiological approach was carried out using frequencies and measures of central tendency. Finally, the information was anonymized and handled confidentially, in accordance with ethical research principles.ResultsThis school-based, observational, descriptive cross-sectional study included a total of 106 children, 55 were female (51%) and 51 were male (49%). Retinal disorders constituted the main cause of visual loss with 64 cases (60%), predominantly sequelae of retinopathy of prematurity (ROP) in 50 children (47%). The second cause identified was optic nerve abnormalities with 19 cases (18%). 57 cases (54%) were associated with factors from the neonatal period. 50 children (47%) with diagnosis of ROP, had a mean gestational age of 30.6 weeks and a mean birth weight of 1443 g; 8 children (16%) were outside Mexican screening criteria and 28 (56%) outside United Kingdom criteria. 44 children (88%) with ROP presented blindness and 34 (68%) did not receive treatment and neurodevelopmental comorbidities were identified in 7 children (14%).ConclusionsChildhood blindness in the studied population was predominantly associated with potentially preventable causes, especially sequelae of ROP, positioning itself as the leading cause of childhood blindness in a school-based sample in Guadalajara. It is necessary to strengthen the prevention of retinopathy of prematurity through neonatal care, ensuring timely detection and treatment, as well as adapting neonatal screening programs and criteria to the regional context to reduce the burden of childhood visual impairment. These findings highlight the persistence of preventable ROP-related blindness among children attending specialized schools.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1809544</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1809544</link>
        <title><![CDATA[Development of a nomogram to predict acute liver injury in children with Mycoplasma pneumoniae pneumonia]]></title>
        <pubdate>2026-08-18T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Shisi Xiong</author><author>Yanlin Tan</author><author>Junmei Bian</author><author>Xingxing Bao</author><author>Jiajun Zhou</author><author>Min Liang</author>
        <description><![CDATA[ObjectiveTo construct and validate a nomogram for predicting acute liver injury in children with Mycoplasma pneumoniae pneumonia (MPP).MethodsThis retrospective study included 964 hospitalized children with confirmed MPP from January 2021 to December 2024. Acute liver injury was defined as the study endpoint. Missing data were handled by multiple imputation (m = 5). The cohort was divided into a training set and a validation set at a ratio of 7:3 using stratified random sampling. Least absolute shrinkage and selection operator (LASSO)-logistic regression was used for feature selection, and the selected variables were entered into multivariable logistic regression to construct a nomogram. Model performance was assessed using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA).ResultsAmong the 964 children, 131 developed acute liver injury, corresponding to an incidence of 13.6%. The cohort was divided into a training set of 676 children, including 92 with acute liver injury, and a validation set of 288 children, including 39 with acute liver injury. Baseline characteristics were comparable between the training and validation sets (P > 0.05). LASSO regression identified 11 candidate predictors: gender, age, body temperature ≥37.5 °C, history of allergy, neutrophil percentage, lymphocyte percentage, D-dimer, total protein, γ-glutamyl transpeptidase (GGT), lactate dehydrogenase (LDH), and creatine kinase isoenzyme MB (CK-MB). In multivariable analysis, female gender, GGT, LDH, and CK-MB were independently associated with an increased risk of liver injury, whereas age was negatively associated with liver injury. D-dimer showed marginal statistical significance. The nomogram showed good discrimination, with an area under the curve (AUC) of 0.837 in the training set and 0.874 in the validation set. Calibration curves showed acceptable agreement between predicted and observed risks, and DCA suggested potential clinical net benefit within a certain threshold range.ConclusionThis nomogram, based on routinely available clinical and laboratory indicators, may help identify children with MPP at increased risk of acute liver injury and support early liver function monitoring. Further prospective multicenter validation is needed.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1759723</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1759723</link>
        <title><![CDATA[Internet-Based home care education for children with pulmonary hypertension: a public health perspective]]></title>
        <pubdate>2026-08-18T00:00:00Z</pubdate>
        <category>Mini Review</category>
        <author>Yan Li</author><author>Juan Huang</author><author>Xuan Zhang</author><author>Yanhong Liu</author><author>Qingqing Song</author>
        <description><![CDATA[BackgroundPediatric pulmonary hypertension (PH) requires complex, specialized home care. Digital health interventions offer scalable solutions to address healthcare disparities, improve educational access, and reduce health system burdens while empowering caregivers.ObjectiveThis mini-review evaluates internet-based home care education for pediatric PH, focusing on public health implications, implementation strategies, and population-level outcomes.MethodsWe conducted a comprehensive narrative review of recent literature on internet-based education platforms and telehealth solutions for pediatric pulmonary hypertension, evaluating them through public health frameworks of accessibility, equity, and scalability.Key findingsInternet-based programs significantly improve medication adherence, complex skill acquisition (e.g., central line care), early symptom recognition, and caregiver self-efficacy. Effective platforms leverage multimodal learning, adaptive technologies, and interactive features. From a public health perspective, these interventions reduce preventable emergency department visits, lower long-term healthcare costs, and enhance quality of life. However, major barriers persist, including the digital divide, variable digital health literacy, and a lack of standardized content validation.ConclusionsInternet-based home care education is vital for pediatric PH management. Future efforts must prioritize standardized, evidence-based curricula, health equity across socioeconomic strata, digital health reimbursement policies, and integration into existing public health infrastructure to maximize population-level benefits.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1810586</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1810586</link>
        <title><![CDATA[Exploring the impact of DEP on pediatric Crohn's disease using machine learning and molecular docking methods]]></title>
        <pubdate>2026-08-18T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Lei Zhang</author><author>Xingyu Ji</author><author>Su Ma</author><author>Huimin Chen</author>
        <description><![CDATA[BackgroundDiethyl phthalate (DEP) is a prevalent plasticizer with multiple toxic effects and high bioavailability in humans, especially children. Pediatric Crohn’s disease (PCD) is a severe chronic intestinal inflammatory disorder with a rising incidence worldwide. To date, the potential associative relationship between DEP exposure and PCD pathogenesis remains inadequately clarified, lacking systematic transcriptomic and experimental exploration.MethodsIn this study, bioinformatics analysis was performed based on 682 PCD samples and 127 normal samples retrieved from multiple GEO datasets. A series of analytical strategies including differential expression analysis, weighted gene co-expression network analysis (WGCNA), compound target prediction, functional enrichment analysis, machine learning modeling, and molecular docking simulation were comprehensively utilized, followed by preliminary animal validation. All analyses in this study focused on exploring statistical correlation rather than causal relationships, given the absence of individual DEP exposure data and inherent methodological limitations.ResultsThrough differential analysis and WGCNA, 24 differentially expressed genes and 194 chemical targets from ChEMBL were obtained, among which 14 overlapping genes were identified. GO and KEGG analyses indicated that DEP may contribute to PCD toxicity by regulating nucleotide synthesis and amino acid metabolism. Five core genes were screened via machine learning and SHAP analysis. Animal experiments verified that PLAU protein expression in DEP, TNBS, and DEP + TNBS groups was notably higher than in the control colon tissue.ConclusionThis study systematically explores the potential associative links between DEP-related molecular dysregulation and PCD pathological alterations at the transcriptomic and tissue levels. The findings provide preliminary scientific references for understanding DEP-associated pediatric intestinal health risks and developing targeted preventive strategies for children's environmental health protection.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1902799</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1902799</link>
        <title><![CDATA[Pediatric atopic dermatitis: biomarker advances in severity, persistence, and non-invasive monitoring]]></title>
        <pubdate>2026-08-18T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Zhuoyuan Li</author><author>Yuanjun Li</author>
        <description><![CDATA[Atopic dermatitis (AD) in children differs immunologically and in barrier characteristics from adult AD, yet current severity assessment still relies heavily on clinical scoring systems with inherent subjectivity. This review summarizes advances in biomarkers associated with disease severity and persistence, as well as non-invasive detection techniques and targeted therapies. TARC/CCL17, periostin, total IgE, and eosinophil counts show consistent utility in grading severity, whereas FLG loss-of-function mutations, VEGF, S100A8/A9, and early skin barrier indicators are promising predictors of disease persistence and atopic march progression. Tape stripping and sebum RNA analysis enable safe, repeated monitoring in children. Despite these advances, most biomarkers still lack pediatric-specific cut-offs and large-scale validation. Future efforts should focus on establishing multi-marker panels, pediatric reference intervals, and machine learning models for endotype classification. Incorporating these tools into routine practice would facilitate early risk stratification, precise targeted treatment selection, and ultimately more personalized management of pediatric AD.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1898161</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1898161</link>
        <title><![CDATA[From PICU to home: a longitudinal airway safety framework for children with tracheostomies]]></title>
        <pubdate>2026-08-18T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Zuyu Yang</author><author>Hongxing Dang</author>
        <description><![CDATA[BackgroundAs survival improves among children with chronic lung disease, severe neurologic impairment, neuromuscular disorders, congenital airway anomalies, and long-term ventilator dependence, pediatric tracheostomy care has shifted from a procedure-centered issue to a sustained respiratory care challenge. Post-tracheostomy adverse events are still frequently framed as isolated complications rather than as part of a continuous airway-safety and home-transition pathway.PurposeThis article synthesizes post-tracheostomy risk across four connected domains: acute airway-threatening events, chronic cannulation-related morbidity, hospital-to-home transition, and decannulation-related functional outcomes, and develops a pediatric longitudinal airway safety framework.MethodsWe conducted a structured narrative search and qualitative synthesis drawing primarily on recent pediatric guidelines, systematic and scoping reviews, multicenter studies, national database analyses, and qualitative investigations, with priority given to publications from 2010 onward.ResultsMajor topics addressed include hemorrhage, false passage, accidental decannulation, tube obstruction, air leak syndromes, peristomal skin injury, respiratory infection, granulation tissue, airway stenosis or malacia, persistent tracheocutaneous fistula, dysphagia, impaired phonation, and caregiver burden. The framework differs from existing guidance and reviews by using phase of care and changing dominant risk as its organizing logic, linking each phase to the care setting, surveillance priorities, responsible teams, escalation thresholds, caregiver capability, and child- and family-centered outcomes.ConclusionA risk-stratified pathway connecting PICU care with community-based respiratory management may improve safety, reduce avoidable healthcare utilization, and better align clinical practice with the realities faced by children and families across the full trajectory of tracheostomy dependence.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1963583</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1963583</link>
        <title><![CDATA[Editorial: Exploring child abuse from clinical, legal, and forensic perspectives]]></title>
        <pubdate>2026-08-18T00:00:00Z</pubdate>
        <category>Editorial</category>
        <author>Donato Morena</author><author>Emanuela Turillazzi</author><author>Vittorio Fineschi</author>
        <description></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1885428</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1885428</link>
        <title><![CDATA[Diagnostic pitfalls in systemic juvenile idiopathic arthritis: insights from 6 misdiagnosed cases]]></title>
        <pubdate>2026-08-17T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Xiaona Zhu</author><author>Yinyin Guo</author><author>Jixin Guo</author><author>Jun Yang</author><author>Tingyan He</author>
        <description><![CDATA[ObjectiveSystemic juvenile idiopathic arthritis (sJIA) is a diagnosis of exclusion with nonspecific early manifestations. Misdiagnosis is common due to overlap with infections, autoinflammatory diseases, and malignancies. We aimed to characterize a series of patients initially diagnosed with sJIA who subsequently reclassified following further evaluation were.MethodsWe retrospectively reviewed the clinical records, laboratory findings, genetic analyses, and imaging data of six pediatric patients initially diagnosed with sJIA but later revised to alternative diagnosis after further investigations. These patients were enrolled at Shenzhen Children's Hospital between January 2011 and December 2022.ResultsAll six patients initially fulfilled at least one set of sJIA classification criteria. All patients presented with recurrent fever (100%, 6/6), three had arthritis (50%, 3/6), and five exhibited rash (83.3%, 5/6). Elevated inflammatory markers were observed in all patients (100%, 6/6). The median age at initial sJIA diagnosis was 64 months (IQR, 24–145). The median delay from initial diagnosis to final diagnosis was 9.5 months (IQR, 5–12). Three patients (50%, 3/6) were considered to have refractory sJIA prior to diagnostic revision. Final diagnoses included autoinflammatory diseases (n = 3), Takayasu arteritis (n = 1), inflammatory myofibroblastic tumor (n = 1), and suspected congenital hemophagocytic lymphohistiocytosis (n = 1).ConclusionssJIA is defined by classification criteria and represents a diagnosis of exclusion, requiring long-term dynamic reassessment to distinguish it from other diseases with overlapping clinical features. Early recognition of atypical manifestations and timely comprehensive evaluation are essential to avoid misdiagnosis, particularly in distinguishing monogenic autoinflammatory disorders and malignancies.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1908940</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1908940</link>
        <title><![CDATA[Bibliometric analysis of research on pediatric hypothyroidism treatment: a global perspective on trends and emerging fronts (2018–2026)]]></title>
        <pubdate>2026-08-17T00:00:00Z</pubdate>
        <category>Systematic Review</category>
        <author>Wei Wu</author><author>Zhengyun Sun</author><author>Mengxun Liu</author><author>Yu Huang</author><author>Tingting Liu</author><author>Xiaobing Qiu</author><author>Yuanbiao Wang</author>
        <description><![CDATA[BackgroundPediatric hypothyroidism is among the most prevalent endocrine disorders in childhood, yet no bibliometric analysis has systematically mapped the research landscape of its treatment.ObjectiveThis study aimed to characterize the publication trends, geographic distribution, research hotspots, and emerging fronts in pediatric hypothyroidism treatment research from 2018 to 2026.MethodsA comprehensive search was conducted in the Web of Science Core Collection (WoSCC) as the primary database, with external data validation performed via PubMed. Bibliometric indicators were analyzed using CiteSpace, Python and R. Keyword co-occurrence networks were constructed with Louvain community detection, and burst detection was performed to identify emerging research fronts.ResultsA total of 1,302 publications were included. Annual output grew from 138 (2018) to a peak of 183 (2022). The United States (n = 263, 20.2%), China (n = 203, 15.6%), and Italy (n = 137, 10.5%) were the leading contributors. Five thematic clusters were identified: (1) congenital hypothyroidism and neonatal screening; (2) subclinical hypothyroidism; (3) pregnancy-related thyroid disorders; (4) autoimmune thyroid disease; and (5) comorbidities and genetic syndromes. Burst detection revealed “obesity” (burst strength = 7.2), “COVID-19” (4.0), and “thyroid dyshormonogenesis” (3.2) as emerging fronts.ConclusionsThe field is shifting focus from congenital hypothyroidism screening optimization toward subclinical hypothyroidism management and the recognition of obesity-related TSH elevation as a distinct physiological entity. Future research should prioritize prospective trials on watchful-waiting strategies and obesity-specific TSH reference ranges.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fped.2026.1918217</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fped.2026.1918217</link>
        <title><![CDATA[Prevalence and risk factors of Helicobacter pylori infection among children attending mercy pediatric hospital and royal hospital, Mogadishu, Somalia: a cross-sectional study]]></title>
        <pubdate>2026-08-17T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Omar Sidow Zubair</author><author>Abdifitah Ibrahim Nor</author><author>Abdulwahed Nor Abdi</author><author>Abdikani Yasin Haji Ali</author><author>Farhia Mohamed Mire</author><author>Safia Mohamud</author><author>Nimco Mohamed Ahmed</author><author>Mohamed Hassan Mohamud</author><author>Dunia Haji Ali</author>
        <description><![CDATA[BackgroundHelicobacter pylori (H. pylori) infection is a major cause of peptic ulcer disease and gastric cancer, with the highest global prevalence in Africa. Despite this, pediatric data from Somalia remain critically scarce. This study determined the prevalence and independent risk factors of H. pylori infection among children attending two referral hospitals in Mogadishu, Somalia.MethodsA facility-based cross-sectional study was conducted from 14, February 2026 to 16, April, 2026 (two months) at Mercy Pediatric Hospital and Royal Hospital, Mogadishu. Sociodemographic and risk-factor data were collected through structured caregiver interviews, and H. pylori infection status was determined by stool antigen testing using an immunochromatographic assay. Univariable and multivariable logistic regression analyses were performed using SPSS version 20.0.ResultsUsing consecutive sampling, 175 children were enrolled (Mercy: 117; Royal: 58), 65 (37.1%; 95% CI: 30.0%–44.3%) were positive for H. pylori infection. On multivariable analysis, four factors were independently associated with infection: rural residence (aOR = 3.09; 95% CI: 1.20–7.96; p = 0.020), low parental education (aOR = 2.34; 95% CI: 1.03–5.35; p = 0.043), failure to wash fruits and vegetables before serving (aOR = 2.40; 95% CI: 1.06–5.46; p = 0.036), and street food consumption (aOR = 2.66; 95% CI: 1.29–5.51; p = 0.008). The model demonstrated good fit (Hosmer–Lemeshow χ2 = 5.44; p = 0.709). Soap use, which was strongly associated in univariable analysis, was attenuated to non-significance after multivariable adjustment, a pattern consistent with confounding.ConclusionApproximately one in three children attending these referral hospitals was infected with H. pylori. Infection was independently associated with rural residence, lower parental education, and food-related exposures. Prevention strategies may benefit from system-level responses combining improved water and sanitation infrastructure, targeted caregiver education, and promotion of safe food-handling practices.]]></description>
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