Wondering how you describe the rash of measles, molluscum contagiosum, hand foot mouth, or chickenpox? Learn how in today’s episode!

This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Aruna Venkatesan and Gabriel Molina (dermatologists at Santa Clara Valley Medical Center). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.

Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.com

Key Points:

• When describing a rash, include the basic morphology, size, color, location, distribution and configuration, and any secondary morphology
• When taking photos, try to have natural light and make sure the rash is in focus. If taking a close up photo, make sure to have a photo further away so that the location of the rash is clear.

Sources:

• Stanford Medicine: https://stanfordmedicine25.stanford.edu/the25/dermatology.html
• Allmon A, Deane K, Martin KL. Common skin rashes in children. American family physician. 2015 Aug 1;92(3):211-6.
• CDC Measles: https://www.cdc.gov/measles/data-research/index.html

How do you know when a head injury can be observed or if more work-up needs to be done? Find out in this episode!

This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Julia Magana (pediatric emergency medicine). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.

Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.com

Key Points:

• Low risk head injuries do not need head imaging. The criteria for low risk head injuries are those where the patient’s GCS is 15 without altered mental status and do not have signs of skull fracture. If any of these signs are present, head imaging with a head CT is recommended
• If the head injury includes history of loss of consciousness or vomiting, a non-frontal scalp hematoma (ie parietal, temporal, or occipital), a severe mechanism of injury, or a severe headache, then generally observation is still recommended but a head CT can be obtained based on clinical decision making.

Sources:

• Stat Pearls. Pediatric Head Trauma. Micelle J, et al. February 2024: https://www.ncbi.nlm.nih.gov/books/NBK537029/
• Pediatrics. Abusive Head Trauma in Infants and Children: Technical Report. Sandeep Narang, et all. February 2025: https://publications.aap.org/pediatrics/article/155/3/e2024070457/201049/Abusive-Head-Trauma-in-Infants-and-Children

Opioid use disorders affect babies and children in all ways. In newborns, it can present as neonatal opioid withdrawal syndrome (also known as NOWS). Learn how hospital systems are managing infants with NOWS with the Eat, Sleep, Console protocol in our episdoe today!

Key Points:

• Eat Sleep Console (ESC) focuses on non-pharmacological intervention first before initiating medication. This includes limiting excessive stimulation, keeping the room dark and quiet, swaddling, rocking, swaying, and giving babies a pacifier or feeding.
• Compared to using the Finnegan scoring system, ESC results in shorter or equal length of hospital stay for infants with NOWS. However, some critics of ESC raise the concern for undertreating infants with NOWS.
• Morphine, clonidine, and phenobarbital are common agents used to treat infant with NOWS

Sources:

• Neoreviews (2025) 26 (4): e223–e232. https://doi.org/10.1542/neo.26-4-010
• Hosp Pediatr (2025) 15 (3): e121–e125. https://doi.org/10.1542/hpeds.2024-008094
• Hosp Pediatr (2025) 15 (3): e99–e101. https://doi.org/10.1542/hpeds.2025-008332
• Kaltenbach K, O'Grady KE, Heil SH, et al. Prenatal exposure to methadone or buprenorphine: Early childhood developmental outcomes. Drug Alcohol Depend. 2018;185:40-49. https://doi.org/10.1016/j.drugalcdep.2017.11.030
• Rees P, Stilwell PA, Bolton C, et al. Childhood Health and Educational Outcomes After Neonatal Abstinence Syndrome: A Systematic Review and Meta-analysis. J Pediatr. 2020;226:149-156.e16. https://doi.org/10.1016/j.jpeds.2020.07.013

Learn about language and speech development, potential etiologies of speech delay, and early interventions for speech delay.

Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.com

This episode was written by pediatricians Lidia Park and Tammy Yau as well as UCD pediatrics resident Elaine Ho, with content support from Anisha Srinivasan (UCD child development and behavioral pediatrician). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.

Key Points

• CDC and AAP have created updated 2022 developmental guidelines that includes changes in speech and language milestones for childrens and have added guidelines forage ages 15 months and 30 months
• Differential for speech delay is broad and includes hearing loss, global developmental delay, autism, and isolated language disorders
• Interventions include speech therapy services and exercises at home
• Pediatricians play critical role in surveillance, evaluation, and management of speech delays to allow for earlier intervention and improved outcomes

Sources

• Jennifer M. Zubler, Lisa D. Wiggins, Michelle M. Macias, Toni M. Whitaker, Judith S. Shaw, Jane K. Squires, Julie A. Pajek, Rebecca B. Wolf, Karnesha S. Slaughter, Amber S. Broughton, Krysta L. Gerndt, Bethany J. Mlodoch, Paul H. Lipkin; Evidence-Informed Milestones for Developmental Surveillance Tools. Pediatrics March 2022; 149 (3): e2021052138. 10.1542/peds.2021-052138
• Maris Rosenberg, MD, Nancy Tarshis, MA, MS, 2016. "Speech and Language Concerns (Chapter 195)", American Academy of Pediatrics Textbook of Pediatric Care, Thomas K. McInerny, MD, FAAP, Henry M. Adam, MD, FAAP, Deborah E. Campbell, MD, FAAP, Thomas G. DeWitt, MD, FAAP, Jane Meschan Foy, MD, FAAP, Deepak M. Kamat, MD, PhD, FAAP, Rebecca Baum, MD, FAAP, Kelly J. Kelleher, MD, MPH, FAAP
• Heidi M. Feldman; Evaluation and Management of Language and Speech Disorders in Preschool Children. Pediatr Rev April 2005; 26 (4): 131–142. https://doi.org/10.1542/pir.26-4-131
• Henry Adam; Speech and Language Concerns. Quick References 2022; 10.1542/aap.ppcqr.396455
• ASHA Communication Milestones and Age Ranges https://www.asha.org/public/developmental-milestones/communication-milestones/

Audio Clips: From Youtube Channel “Pathways”

The 4 to 6 Month Baby Communication Milestones to Look For: https://www.youtube.com/watch?v=d0FGHFrMRXI

10-12 month Old Communication Milestones https://www.youtube.com/watch?v=zYHpjZC2qCA

19-24 Month Communication Milestones: https://www.youtube.com/watch?v=-2C--4gay2c

Vaccines are life saving medical treatments. Like all medicine, there are benefits and risks to vaccines. Learn how to address common concerns about vaccines and combat misinformation in this episode!

Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.com

This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Dean Blumberg (UC Davis pediatric infectious disease). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.

Key Points:

• Vaccine benefits largely outweigh risks.
• Vaccines do not cause autism. The frequently cited study that reportedly links vaccines to autism was funded by an anti-vaccine group and only looked at 12 children.
• Thimerisol is a preservative that is not used in routine vaccinations other than certain influenza vaccines. Anti vaccine groups raise the concern for ethylmercury toxicity from thimerisol but studies looking at mercury levels after vaccination with thimerisol containing vaccines showed the peak mercury levels to still be within the normal EPA range.
• Oral rotavirus is associated with an increased risk of intussusception. A history of intussusception is a contraindication to the rotavirus vaccine

Sources:

• Pediatrics (2016) 138 (3): e20162146. https://doi.org/10.1542/peds.2016-2146
• Pediatrics (2024) 153 (3): e2023065483. https://doi.org/10.1542/peds.2023-065483
• Desai R, Cortese MM, Meltzer MI, et al. Potential intussusception risk versus benefits of rotavirus vaccination in the United States. Pediatr Infect Dis J. 2013;32(1):1-7. doi:10.1097/INF.0b013e318270362c
• Wakefield AJ, Murch SH, Anthony A, et al. Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children [retracted in: Lancet. 2004 Mar 6;363(9411):750. doi: 10.1016/S0140-6736(04)15715-2. Lancet. 2010 Feb 6;375(9713):445. doi: 10.1016/S0140-6736(10)60175-4.]. Lancet. 1998;351(9103):637-641. doi:10.1016/s0140-6736(97)11096-0
• Deer B. Secrets of the MMR scare. The Lancet's two days to bury bad news. BMJ. 2011;342:c7001. Published 2011 Jan 18. doi:10.1136/bmj.c7001
• Pichichero ME, Gentile A, Giglio N, et al. Mercury levels in newborns and infants after receipt of thimerosal-containing vaccines. Pediatrics. 2008;121(2):e208-e214. doi:10.1542/peds.2006-3363
• Uhlmann V, Martin CM, Sheils O, et al. Potential viral pathogenic mechanism for new variant inflammatory bowel disease. Mol Pathol. 2002;55(2):84-90. doi:10.1136/mp.55.2.84
• Uptodate “Autism spectrum disorder and chronic disease: no evidence for vaccines or thimerisol as a contributing factor”
• https://www.aap.org/en/news-room/fact-checked/fact-checked-vaccines-safe-and-effect-no-link-to-autism/?srsltid=AfmBOopWG_rQ1lTaaOvgJLyTk6VdbCN3ypSErxFzhVRjkQ2A4Fet9d

With increasing awareness and diagnosis of autism, there has also been an increase in misinformation regarding autism. The goal of today's episode is to provide a brief overview on autism and provide evidenced based information to better inform listeners!

Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.com

This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Kathleen Angkustsiri (UC Davis developmental and behavioral pediatric specialist). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.

Key Points:

• Autism diagnostic criteria have changed to increase detection of milder cases. Asperger's is included in autism.
• Per the DSM-5, autism is a condition with impairments in social communication (social and emotional reciprocity, non-verbal communication, and relationships) and restrictive and repetitive behaviors.
• Autism diagnosis also requires 2 out of 4 restrictive or repetitive behaviors: 1. Restrictive or repetitive patterns of behavior, interests, or activities 2. Insistence of sameness, inflexible adherence to routines, ritualized patterns 3. Highly restricted, fixated interest abnormal in intensity or focus. 4. Hyper or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment
• Autism can present as regression of social and/or language skills.
• The Modified Checklist for Autism in Toddlers – Revised with Follow-up (MCHAT-R/F) is the most widely known and validated screening tool for autism for ages 16-30 months. A score of 8 or more is high risk for autism

Sources:

• Pediatrics (2020) 145 (1): e20193447. https://doi.org/10.1542/peds.2019-3447

Ever get caught in a sticky ethical situation regarding genetic testing? You're not alone. Join us as we try to navigate these real life issues.

Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.com

This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Video Jhaveri (UC Davis neonatology fellow). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.

Key points:

• Genetic testing may seem relatively benign and non-invasive but is actually fraught with unforeseen issues such as surprise consanguinity and non-paternity.
• Racial and economic disparities are prevalent with genetic testing and their interpretation. For example most test value interpretations are based on people of European and Asian descent.
• We cannot easily predict outcomes and prognosticate even with genetic testing. Prognosis is often fraught with the issue of promoting "ableism".

Sources:

Katharine P. Callahan, Ellen W. Clayton, Amy A. Lemke, Bimal P. Chaudhari, Tara L. Wenger, Allison N. J. Lyle, Kyle B. Brothers; Ethical and Legal Issues Surrounding Genetic Testing in the NICU. Neoreviews March 2024; 25 (3): e127–e138. https://doi.org/10.1542/neo.25-3-e127

Osteomyelitis is an infection of the bone and is often a delayed diagnosis given the ambiguity of the signs and symptoms. Listen in on how you might be able to better detect and treat osteomyelitis without delay.

Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.com

This episode was written by pediatric resident Victoria Tran Toft and pediatricians Tammy Yau and Lidia Park with content support from Natasha Nakra (UC Davis pediatric infectious disease). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.

Key points:

• Osteomyelitis can present as limp or hesitancy with movement; this can occur with or without fevers and localizing signs.
• Main diagnostics include CRP, which also aids in assessing treatment response.
• Treatment is a long course of antibiotics. Typically, starting empiric IV antibiotics in the hospital and then transitioning to oral agents.

Sources:

• PIDS/IDSA Guideline on Diagnosis and Management of Acute Hematogenous Osteomyelitis in Pediatrics. Published 8/5/2021. Journal of the Pediatric Infectious Diseases Society. https://doi.org/10.1093/jpids/piab027