This episode was written by Dr. Tammy Yau and Dr. Lidia Park, with content support from Dr. Lisa Rasmussen. Drs. Tammy and Lidia take full responsibility for any errors or misinformation.

Key points:

• Vitamin K is important in preventing early and late onset bleeding in newborns (up to 6 months of age), most importantly, intracranial bleeding.
• Intramuscular vitamin K is most effective but oral vitamin K regimens are used outside of the US and are better than not giving any vitamin K

Sources/Supplemental Information:

• AAP Pediatrics 2022, Hand: https://doi.org/10.1542/peds.2021-056036

CDC Vitamin K Handout: https://www.cdc.gov/ncbddd/vitamink/vitamin-k-fact-sheet-general.html

Can someone with HIV breastfeed their child? You might be surprised at the answer!

Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com.

This episode was written by Dr. Tammy Yau and Dr. Lidia Park, with content support from Dr. Laura Kair. Drs. Tammy and Lidia take full responsibility for any errors or misinformation.

Key points:

• New guidelines from the CDC recommend allowing mothers with HIV on antiretroviral therapy (ART) with an undetectable viral load to breastfeed their child if they desire, whether or not they live in a developed or underdeveloped country. The risk for HIV transmission through breastmilk in these cases is 0.6%
• In the US, you can call the national perinatal HIV/AIDS hotline at 1-888-448-8765 for advice
• 

Sources

• CDC 2023 Infant Feeding for Individuals with HIV in the US: https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/maternal-or-infant-illnesses/hiv.html

Stay up to date with new research on shortening antibiotic treatment duration for urinary tract infections (UTIs) with our episode today where we review a recently published randomized control trial (RCT). Learn how to critically analyze study data and what key points we take away.

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This episode was written by Dr. Tammy Yau and Dr. Lidia Park, with content support from Dr. Michelle Hamline. Drs. Tammy and Lidia take full responsibility for any errors or misinformation.



Key points:

• A single RCT found similar risk of UTI recurrence in children who received a 5 day course vs 10 day course of antibiotics within the first 30 days

Sources

• Pediatrics 2024, Montini et al: https://doi.org/10.1542/peds.2023-062598
• BMJ 2007, Montini et al: https://doi.org/10.1136/bmj.39244.692442.55
• Cochrane Rev 2012, Altamimi et al: https://doi.org/10.1002/14651858.CD004872.pub3
• JAMA Ped 2021, Pernica et al: https://doi.org/10.1001/jamapediatrics.2020.6735
• JAMA Ped, 2022, Williams et al: https://doi.org/10.1001/jamapediatrics.2021.5547

Ever seen a tuft of hair over the lower back or a sacral dimple? Learn how to recognize and manage normal vs abnormal back and spinal findings in our episode today.

Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com.

This episode was written by Dr. Tammy Yau and Dr. Lidia Park, with content support from Dr. Laura Kair. Drs. Tammy and Lidia take full responsibility for any errors or misinformation.

Key points:

• Spinal dysraphism is the incomplete fusion of the spine during development.
• Not all spinal dysphraphisms will have abnormal cutaneous manifestations that you can see on exam
• Diagnose spinal dysphraphisms with spinal ultrasound in young children and MRI in older children
• Sacral dimples can be normal but should be worked up if they are larger than 5 mm at the base, above 2.5cm from the anus, not midline, or if there are multiple dimples

Sources

• Pediatrics in Review 2019, Holmes and Li: https://doi.org/10.1542/pir.2018-0155
• Peds in Review 2011, Zywicke and Rozzelle: https://doi.org/10.1542/pir.32-3-109
• Hospital Pediatrics 2020, Aby et al: https://doi.org/10.1542/hpeds.2019-0264

Toxoplasmosis is a parasitic TORCH infection that is often associated with cats but did you know owning a cat is not associated with increased prevalence? Learn more on how the disease is actually acquired and how to prevent infection in this episode!

Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com.

This episode was written by Dr. Tammy Yau and Dr. Lidia Park, with content support from Dr. Ritu Cheema. Drs. Tammy and Lidia take full responsibility for any errors or misinformation.

Key points:

-Cats, undercooked meat, and raw seafood can lead to toxoplasmosis infection

-Findings of toxoplasmosis infection in utero include scattered intracranial calcifications and chorioretinitis

-Treat toxoplasmosis infection in neonates with pyrimethamine, sulfadiazine, and folinic acid

Sources:

AAP 2017 https://publications.aap.org/pediatrics/article/139/2/e20163860/59988/Diagnosis-Treatment-and-Prevention-of-Congenital?autologincheck=redirected

Learn about how the virus that causes cold sores can also cause serious complications in infants.

Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com

This episode was written by Dr. Tammy Yau and Dr. Lidia Park, with content support from Dr. Ritu Cheema. Drs. Tammy and Lidia take full responsibility for any errors or misinformation.

Key points:

-First time HSV infection in pregnancy is higher risk to infants than reactivation of previous infection

-Symptoms of neonatal HSV infection include seizures, vesicles, and irritability

-Diagnose HSV with viral culture or PCR of bodily fluids

-Use acyclovir to treat infants and pregnant people with HSV infection

Sources:

AAFP 2022 https://www.aafp.org/pubs/afp/issues/2002/0315/p1138.html

Redbook 2021 https://publications.aap.org/redbook/book/347/chapter-abstract/5752755/Herpes-Simplex?redirectedFrom=fulltext

Neoreview 2018 https://publications.aap.org/neoreviews/article/19/2/e89/87448/Neonatal-Herpes-Simplex-Virus-Infection

Despite widespread vaccination, there are still breakthroughs of varicella (commonly known as chicken pox). Let's dive into this episode of our TORCH series.

Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com

This episode was written by Dr. Tammy Yau and Lidia Park, with content support from Dr. Ritu Cheema. Drs. Tammy and Lidia take full responsibility for any errors or misinformation.

Key points:

-Transplacental varicella transmission can lead to congenital varicella syndrome which includes dermatomal rash, cicatrix, limb hypoplasia, microcephaly, and cataracts

-Use Acyclovir to treat neonates and pregnant people with active varicella infection. Congenital varicella syndrome does not require treatment.

-Varicella immunoglobulin can be used to prevent infection in certain cases including exposed neonates 5 days before delivery and 2 days after delivery.

Sources:

VZV in Newborns: Neoreviews (2016) 17 (9): e507–e514. https://doi.org/10.1542/neo.17-9-e507

TORCH infections: Pediatr Rev (2011) 32 (12): 537–542. https://doi.org/10.1542/pir.32-12-537

This week on our series on TORCH infections, we are discussing syphilis, an increasingly prevalent disease in the pediatric population.

Follow us on Twitter/X @Pediagogypod and Instagram/Threads @pediagogy and connect with us at pediagogypod@gmail.com

This episode was written by Dr. Tammy Yau and Dr. Lidia Park, with content support from Dr. Elizabeth Partridge. Drs. Tammy and Lidia take full responsibility for any errors or misinformation.

Key points:

-Most congenital syphilis is asymptomatic. Less commonly will present with rash, snuffles, hepatosplenomegaly, anemia, and jaundice.

-Untreated disease can cause neurosyphilis and bone defects

-Compare mother's RPR titers to baby's and look for findings consistent with syphilis.

-Workup is based on whether mother was adequately treated and includes CBC, LP, skeletal survey, and LFTs.

-Treatment is with IV penicillin G for 10 days.

Sources:

AAP Red Book Syphilis chapter

Sankaran D, Partridge E, Lakshminrusimha S. Congenital Syphilis-An Illustrative Review. Children (Basel). 2023 Jul 29;10(8):1310. doi: 10.3390/children10081310. PMID: 37628309; PMCID: PMC10453258.

Fang J, Partridge E, Bautista GM, Sankaran D. Congenital Syphilis Epidemiology, Prevention, and Management in the United States: A 2022 Update. Cureus. 2022 Dec 27;14(12):e33009. doi: 10.7759/cureus.33009. PMID: 36712768; PMCID: PMC9879571.

https://www.cdc.gov/std/treatment-guidelines/STI-Guidelines-2021.pdf