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Cute baby movements or is it infantile spasms in disguise? Learn what to look out for in today's episode! This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Joanna Galindo (pediatric neurology). 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 [email protected] Key points: Infantile spasms are characterized by flexion of the trunk or neck and adduction or abduction of the arms, usually bilateral and symmetric in clusters and occuring in babies less than 1 years oldHypsarrhythmia on EEG is classic for infantile spasms and can help differentiate it from benign spasms of infancy or myoclonic epilepsy of infancyTreatment is with ACTH or high dose steroids and/or vigabatrin.Sources: Pavone P, Polizzi A, Marino SD, et al. West syndrome: a comprehensive review. Neurol Sci. 2020;41(12):3547-3562. doi:10.1007/s10072-020-04600-5Go CY, Mackay MT, Weiss SK, et al. Evidence-based guideline update: medical treatment of infantile spasms [RETIRED]. Report of the Guideline Development Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology. 2012;78(24):1974-1980. doi:10.1212/WNL.0b013e318259e2cfRiikonen R. Biochemical mechanisms in pathogenesis of infantile epileptic spasm syndrome. Seizure. 2023;105:1-9. doi:10.1016/j.seizure.2023.01.004

What happens when kids bite off more than they can chew? Today we discuss pediatric foreign body ingestion, specifically focusing on button batteries. This episode was written by pediatric resident Mariama Lei Poquiz and pediatricians Lidia Park and Tammy Yau, with content support from pediatric gastroenterologist Dean Libet. 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 [email protected]  Key Points:  Children of all ages are at risk for foreign body ingestion, with children ages 6-36 months at the most risk due to their developmental stage. Other vulnerable populations include children and adolescents with behavioral, developmental, and psychiatric conditions. About 98% of all foreign body ingestions in children are found to be both accidental and composed of common items found in the home, including magnets, batteries, coins, toys, jewelry. Button batteries in the esophagus are an emergency and should be endoscopically removed within 2 hours of ingestion. It is important to assess for esophageal injury and aortic involvement because esophageal associated injuries are common and aortoenteric fistulas have a high mortality rate.  Button batteries distal to the esophagus can be managed depending on the child’s age and battery size in conjunction with the clinician’s clinical decision-making skills. If a button battery has not passed the stomach within 14 days of ingestion or if a child develops GI symptoms, the battery must be removed endoscopically. For more information regarding button battery safety, please visit the National Safety Council’s page on button batteries and the US Consumer Product Safety Commission’s page on button, cell, and coin batteries. For button battery ingestion, please call 911 and for immediate triage questions please call the National Battery Ingestion Hotline at 1-800-498-8666.   References  Anfang RR, Jatana KR, Linn RL, Rhoades K, Fry J, Jacobs IN. pH-neutralizing esophageal irrigations as a novel mitigation strategy for button battery injury. Laryngoscope. 2019;129(1):49-57. doi:10.1002/lary.27312 Clinker C, Alvey B, Reynolds E, Wieck M. Post-extraction management of esophageal button battery injuries in children: A scoping review of imaging, ICU admission, and NPO practices. Journal of Pediatric Surgery. 2026;61(7):163066. doi:10.1016/j.jpedsurg.2026.163066 Dana E. Stone, Bryan C. Lembo; Foreign Body Ingestion and Aspiration. Pediatr Rev June 2026; 47 (6): 352–355. https://doi.org/10.1542/pir.2025-006817   Foreign Body Ingestion Algorithms: Button Battery, Coin/Blunt Objects, Magnet, Sharp Objects, Esophageal Food Impaction. Kramer RE, Lerner DG, Lin T, et al. Management of ingested foreign bodies in children: a clinical report of the NASPGHAN Endoscopy Committee. J Pediatr Gastroenterol Nutr. 2015;60(4):562-574. doi:10.1097/MPG.0000000000000729   Leinwand K, Brumbaugh DE, Kramer RE. Button Battery Ingestion in Children: A Paradigm for Management of Severe Pediatric Foreign Body Ingestions. Gastrointest Endosc Clin N Am. 2016;26(1):99-118. doi:10.1016/j.giec.2015.08.003   Litovitz T, Whitaker N, Clark L, White NC, Marsolek M. Emerging battery-ingestion hazard: clinical implications. Pediatrics. 2010;125(6):1168-1177. doi:10.1542/peds.2009-3037   McMahon K, Conners GP, Mohseni M. Pediatric Foreign Body Ingestion. [Updated 2025 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430915/   National Capital Poison Center’s Button Battery Ingestion triage and treatment guideline | poison control. National Capital Poison Center. 2018. Accessed July 22, 2026. https://www.poison.org/battery/guideline. Sutherland J, Bowen L. Ingestion of foreign bodies and caustic substances in children. BJA Educ. 2023;23(1):2-7. doi:10.1016/j.bjae.2022.09.003

Today we discuss pediatric fractures in the emergency department.  We focus on how to identify fractures that may be indicative of child abuse versus those caused by accidental trauma or other medical conditions. This episode was written by UCD pediatric resident Mariama Lei Poquiz, with content support from pediatric emergency medicine and child abuse specialist Julia Magaña and additional help and guidance from pediatric hospitalist Lidia Park. 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 [email protected] Key points: ·       Pediatric fractures may be the cause of accidental, medical, or non-accidental causes. Evaluation of pediatric fractures caused by non-accidental trauma can be done by taking a thorough history, a meticulous physical exam, and clinical judgement supplemented by imaging and laboratory data.   ·       While there are no pathognomonic fractures indicative of child abuse, there are high risk features that increase the suspicion for child abuse. Additionally, there are fractures with higher specificity for child abuse than others. These high specificity fractures include those in the ribs, pelvis, scapula, sternum, classic metaphyseal lesions, and long bones in non-ambulatory children.   ·       Toddler’s fractures are accidental fractures that may mimic child abuse.   ·       The radiographic skeletal survey is the standard screening tool for evaluating children under 2 years old who are suspected of being abused. It is important to also do a follow up skeletal survey approximately 2 weeks after the initial one if the first skeletal survey was positive, equivocal, or negative, but with persistent clinical suspicion. These specific findings can be found in the American College of Radiology guidelines. Other work-up can include head imaging and laboratory studies.      Sources:     Auerbach, M., Coombs, C., Lindberg, D., Magaña, J., Ornstein, A., Sharma, S., & Tiyyagura, G. (2023, October). Bottom Line Recommendations: Child Abuse. Emergency Medical Services for Children Innovation and Improvement Center and Translating Emergency Medicine for Kids.     Cindy W. Christian, COMMITTEE ON CHILD ABUSE AND NEGLECT, James E. Crawford-Jakubiak, Emalee G. Flaherty, John M. Leventhal, James L. Lukefahr, Robert D. Sege, Harriet MacMillan, Catherine M. Nolan, Linda Anne Valley, Tammy Piazza Hurley; The Evaluation of Suspected Child Physical Abuse. Pediatrics May 2015; 135 (5): e1337–e1354. 10.1542/peds.2015-0356    Cohen H, Miller S, Levin T, et al. ACR–SPR Practice Parameter for the Performance and Interpretation of Skeletal Surveys in Children. Amended 2023 (Resolution 2c, 2d)    Sait S, Havariyoun G, Newman H, Das S, Haque S. Effective radiation dose of skeletal surveys performed for suspected physical abuse. Pediatr Radiol. 2023 Jan;53(1):69-77. doi: 10.1007/s00247-022-05477-6. Epub 2022 Aug 17. PMID: 35974201.     Suzanne Haney, Susan Scherl, Linda DiMeglio, Jeannette Perez-Rossello, Sabah Servaes, Nadia Merchant, and the COUNCIL ON CHILD ABUSE AND NEGLECT, SECTION ON ORTHOPAEDICS, SECTION ON RADIOLOGY, and SECTION ON ENDOCRINOLOGY, and the SOCIETY FOR PEDIATRIC RADIOLOGY; Evaluating Young Children With Fractures for Child Abuse: Clinical Report. Pediatrics February 2025; 155 (2): e2024070074. 10.1542/peds.2024-070074    Tibial shaft fractures - pediatric. Orthobullets. Accessed June 12, 2026. https://www.orthobullets.com/pediatrics/4026/tibial-shaft-fractures--pediatric.    Toddler fracture | Radiology Reference Article. Radiopaedia. Accessed June 12, 2026. https://radiopaedia.org/articles/toddler-fracture?lang=us.    Translating Emergency Knowledge for Kids. (2021, March). Bottom Line Recommendations Pediatric Fractures.

When do we use inflammatory markers? What do they tell us? Learn how these lab values make a difference in your clinical decision making! This episode was written by pediatricians Lidia Park and Tammy Yau as well as pediatrics resident Anjali Doshi, with content support from Natasha Nakra, pediatric infectious disease physician. 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 [email protected] Key Points:  ESR is a marker of inflammation anywhere in the body. It is non-specific and doesn’t always indicate infection. CRP is an acute phase reactant that can be useful in inflammation or infection, but is also non-specific. This can be useful in trending if an infectious process or inflammation is improving.Recent studies now show that procalcitonin is a non-specific marker for bacterial infections and more clinicians are leaning away from using this marker.It is important before ordering these markers to assess which is needed and if a normal or elevated level will change your clinical plan before ordering unnecessary tests. References: Pihl AF, Balamuth F, Michelson KA. Inflammatory markers in pediatrics. Pediatr Rev. 2025;46(4):231-245. doi:10.1542/pir.2023-006920 Bell SG, Goldman RD. Pediatric Sepsis. In: StatPearls. StatPearls Publishing; updated January 2025. Accessed June 27, 2026. https://www.ncbi.nlm.nih.gov/books/NBK557485/ Shah S, Bachur R. Pediatric Dehydration. In: StatPearls. StatPearls Publishing; updated 2025. Accessed June 27, 2026. https://www.ncbi.nlm.nih.gov/books/NBK441843/ Shane AL, Sánchez PJ, Stoll BJ. Neonatal Sepsis. In: StatPearls. StatPearls Publishing; updated 2025. Accessed June 27, 2026. https://www.ncbi.nlm.nih.gov/books/NBK539794/ Yo CH, Hsieh PS, Lee SH, et al. Comparison of the test characteristics of procalcitonin to C-reactive protein and leukocytosis for the detection of serious bacterial infections in children presenting with fever without source: a systematic review and meta-analysis. Ann Emerg Med. 2012;60(5):591-600. https://pmc.ncbi.nlm.nih.gov/articles/PMC7640940/ Woods CR, et al. Clinical practice guideline for the evaluation and management of well-appearing febrile infants 8 to 60 days of age. Clin Infect Dis. 2020;70(3):538-543. doi:10.1093/cid/ciz635 Stockmann C, Ampofo K, Killpack J, et al. Procalcitonin accurately identifies hospitalized children with low risk of bacterial community-acquired pneumonia. J Pediatric Infect Dis Soc. 2018;7(1):46-53. doi:10.1093/jpids/pix018

You've heard of ACEs and ABCs, but what about DEF? Here we learn about trauma-informed care. This episode was written by pediatric resident Mallika Iyer-Horiuchi with content support from pediatricians Tammy Yau, Lidia Park, and Jihey Park (general pediatrics). 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 [email protected] Key Points Trauma informed care improves patient interactions and outcomes. Remember the mnemonic DEF which stands for treat Distress, support Emotions, include the Family.”Pain, fear, and uncertainty can amplify trauma responses—treating distress quickly improves both cooperation and recovery.Clear explanations, caregiver presence, and simple coping strategies can significantly reduce pediatric medical traumatic stress.Caregivers’ stress affects the child’s recovery—supporting the family supports the patient. Sources: James Duffee, Moira Szilagyi, Heather Forkey, Erin T. Kelly; COUNCIL ON COMMUNITY PEDIATRICS, COUNCIL ON FOSTER CARE, ADOPTION, AND KINSHIP CARE, COUNCIL ON CHILD ABUSE AND NEGLECT, COMMITTEE ON PSYCHOSOCIAL ASPECTS OF CHILD AND FAMILY HEALTH, Trauma-Informed Care in Child Health Systems. Pediatrics August 2021; 148 (2): e2021052579. 10.1542/peds.2021-052579https://www.healthcaretoolbox.org/d-e-f-framework-trauma-informed-carehttps://www.healthcaretoolbox.org/sites/default/files/images/pdf/DEFpocketcards.pdf  https://www.nctsn.org/

Learn all about non-barrier contraceptives including intrauterine devices, implants, injectables, pills, vaginal rings, and transdermal patches. This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Adrienne Hong (family 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 [email protected] Key points: Intrauterine devices and implants are the most effective contraceptives at preventing pregnancyNon-barrier contraceptives do not protect against sexually transmitted infectionsCombined progestin-estrogen contraceptives are contraindicated in those with migraines, severe hypertension, severe liver disease, sickle cell disease, lupus, history of thromboembolism or stroke, and other diseases that increase the risk for thrombosisEmergency contraception includes oral ulipristal, oral levonorgestrel, and IUDs and should be taken with 72-120 hours after unprotected sexual intercourse. Only oral levonorgestrel is available without a prescription.  Source: Pediatrics July 2025: https://publications.aap.org/pediatrics/article/156/1/e2025072218/202151/Contraceptive-Counseling-and-Methods-forPediatrics August 2020: https://publications.aap.org/pediatrics/article/146/2/e2020007252/36888/Long-Acting-Reversible-Contraception-Specific?autologincheck=redirected Pediatrics August 2020: http://doi.org/10.1542/peds.2020-007237 ACOG 2025: https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2015/09/emergency-contraception

Having “the talk” with your teenage patients? Learn how to navigate discussing sexual intercourse and contraception in this 2 part episode.  This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Adrienne Hong (family 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 [email protected] Key points: Maintain an open dialogue with patients when discussing sexual history. Include the 5 P’s - partners, practices, protection from STIs, past history of STIs, and pregnancy intention. Barrier contraceptives include external condoms, internal condoms, latex sheets or dental dams, diaphragms, cervical caps, sponges, spermicides, and vaginal pH modulators. Condoms can protect against sexually transmitted infections (STIs) and pregnancy while diaphragms, cervical caps, sponges, spermicides, and vaginal pH modulators protect against pregnancy only and not STIs Source: Pediatrics July 2025: https://publications.aap.org/pediatrics/article/156/1/e2025072218/202151/Contraceptive-Counseling-and-Methods-forPediatrics August 2020: https://publications.aap.org/pediatrics/article/146/2/e2020007252/36888/Long-Acting-Reversible-Contraception-Specific?autologincheck=redirected Pediatrics August 2020: http://doi.org/10.1542/peds.2020-007237 ACOG: Barrier Methods of Birth Control: Spermicide, Condom, Diaphragm, and Cervical Cap | ACOG

In this episode we learn how to recognize concerning bruising using the TEN-4-FACESp rule. TEN-4-FACESp is an important rule that teaches us to recognize abnormal bruising and is a clinical tool that helps us decide whether further investigation for child abuse is warranted.  This episode was written by pediatric resident Megan Branson, and pediatricians Tammy Yau and Lidia Park with content support from Julia Magana, a pediatric emergency medicine physician and child abuse specialist. 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 [email protected] Key Points: The TEN-4-FACESp rule highlights high-risk bruising: torso, ears, neck, any bruise in infants ≤4 months, and facial areas (frenulum, angle of jaw, cheeks, eyelids, subconjunctivae), plus patterned bruising Evaluation should include a thorough, neutral history, full skin exam, and consideration of medical causes (e.g., ITP, bleeding disorders), while remembering this is a screening tool—not diagnostic of abuse.This tool can help learners understand more about child abuse and develop their skills for recognizing it in their patients:https://emscimprovement.center/news/introducing-peak-child-abuse-a-free-educational-toolkit/

Is acute appendicitis better than an ugly appendicitis? (Yes that’s supposed to be a joke!) Join us on today’s episode to learn about appendicitis in pediatric patients! This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Julie Fuchs (pediatric surgery). 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 [email protected] Key Points: Symptoms of appendicitis include abdominal pain (classically right lower quadrant with rebound and guarding), anorexia, vomiting, diarrhea, fatigue, and feverDiagnosis can be clinical but imaging with ultrasound or CT is often used to confirm the diagnosisTreatment is typically laparoscopic appendectomy but select patients with uncomplicated appendicitis can be treated with IV antibiotics to avoid surgery. However, these patients need close follow up for recurrence or failure of non-operative management  Sources -AAP April 2022: https://publications.aap.org/pediatrics/article/149/5/e2021054693/186782/Nonoperative-Management-of-Uncomplicated  -StatPearls June 2025: https://www.ncbi.nlm.nih.gov/books/NBK441864/

Did you know that platelet transfusion is NOT the treatment for low platelets in immune thrombocytopenic purpura (ITP)? Learn why in this week's episode! This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Anjali Pawar (pediatric hematology). 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 [email protected] Key Points: Immune thrombocytopenic purpura (ITP) causes low platelets, by definition less than 100,000 microL, in the setting of a normal bone marrow and no other cause of thrombocytopenia.ITP can be acute or chronic meaning lasting longer than 6 months.Acute ITP can be self limiting and not require treatment but treatment can include steroids, IVIG, thrombopoietin receptor agonists (TPO-RA like eltrombopag), or Rhogam.Chronic ITP can include rituximab, eltrombopag, and/or splenectomySources Pediatric in Review, Chu Y, et al (March 2000): https://doi.org/10.1542/pir.21-3-95American Society of Hematology Clinical Practice Guidelines on Immune Thrombocytopenia (2019): https://www.hematology.org/education/clinicians/guidelines-and-quality-care/clinical-practice-guidelines/immune-thrombocytopenia-guidelinesJournal of Pediatrics, Buchanan GR, Adix L (Nov 2002): doi: 10.1067/mpd.2002.128547Platelet Disorder Support Association: https://pdsa.org/images/stories/pdf/ITP-in-Children_FAQ.pdf

Purpura, stomach aches, joint pains, maybe blood in the urine? You better be thinking about IgA nephropathy. Learn more  This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Gia Oh (pediatric nephrologist). 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 [email protected] Key Points: IgA vasculitis (formerly known as Henoch-Schonlein purpura/HSP) is a small vessel vasculitis that causes palpable purpura, abdominal pain, arthritis or arthralgias, IgA deposition on biopsy, and/or renal involvement.Management is mainly supportive with hydration and pain management. Steroids can be given for severe GI or renal involvement as well as immunosuppressants, plasmapheresis, or transplant if severe renal symptoms.IgA vasculitis symptoms typically resolve within 4-6 weeks but 1/3 of patients will have relapse or recurrence within 1 year. Monitoring for renal involvement is important.Sources Reid-Adam, Jessica. Pediatr Rev (2014) 35 (10): 447–449. https://doi.org/10.1542/pir.35-10-447AAP Grand Rounds (2005) 14 (6): 65. https://doi.org/10.1542/gr.14-6-65AAP Grand Rounds (2022) 47 (4): 42. https://doi.org/10.1542/gr.47-4-42

You’ve probably seen an infantile hemangiomas before but did you they can be associated with PHACE or LUMBAR syndrome? Learn about this and everything else about infantile hemangiomas in this week’s episode. This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Caitlin Peterman (pediatric dermatology). 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 [email protected] Key Points: Infantile hemangioma which are the most common benign tumor of infancy. Most will involute on their own after 4 months of age and self-resolveHemangiomas can affect nearby organs causing vision impairment, feeding difficulties, or airway compromise. Other complications include ulceration and disfigurementFirst line treatment includes oral propranolol for thicker lesions and topical timolol for superficial/thin lesions. Surgery or laser is reserved for select hemangiomas  Sources AAP Jan 2019: https://publications.aap.org/pediatrics/article/143/1/e20183475/37268/Clinical-Practice-Guideline-for-the-Management-of?searchresult=1

Ebstein's anomaly is a congenital heart defect that involves an abnormally developed tricuspid valve. Learn more about its effects on the heart physiology in today's episode. This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Daniel Cortez (pediatric cardiology). 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 [email protected] Key Points: Ebstein's anomaly is characterized by an abnormally placed tricuspid valve causing atrialization of the right ventricle. This can lead to single ventricle physiology.Wolff-Parkinson-White (WPW), right bundle branch blocks (RBBB), mitral valve prolapse, mitral valve dysplasia, bicuspid aortic valve, ventricular septal defect, and coarctation of the aorta can all be associated with Ebstein's anomalyTreatment of Ebstein's anomaly requires a patient to be stable enough to tolerate surgical correction like aortopulmonary shunting, PDA stenting, tricuspid valvuloplasty, and/or single ventricle palliation. Some patients will require inhaled nitrous oxide, Prostaglandin E, antiarrhythmics, and/or ECMO as well Sources: Truong et al. “Ebstein Anomaly in the Fetus: Preparing for the Perfect Storm”.Neoreviews (2011) 12 (5): e260–e269. https://doi.org/10.1542/neo.12-5-e260

If you've been getting a lot more questions about hepatitis B and vaccination from your patients and families and wondering where to find the answers, look no further than our episode today filled with useful information from evidence based sources. This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Dean Blumberg (pediatric infectious disease). 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 [email protected] Key Points: As of the time of this podcast publishing, the American Academy of Pediatrics still recommends Hepatitis B vaccination at birth, 1-2 months, and 6-18 months.Hepatitis B vaccination introduction decreased the lifetime prevalence of hepatitis B from 33% to 5% between 1988-2004.4 in every 1000 people with hepatitis B will go on to develop chronic hepatitis B which can lead to liver failure or hepatocellular carcinoma. Hepatitis B has an average incubation of 90 days meaning you might not have symptoms for the first few months of infection. 20-30% of people with hepatitis B do not have a clear source of infection which is why prevention is crucial Sources: “Hepatitis B in Children”. Pediatr Rev (2008) 29 (4): 111–120.https://doi.org/10.1542/pir.29-4-111“Hepatitis B” Red Book chapterhttps://www.aap.org/en/patient-care/immunizations/vaccination-recommendations-by-the-aap/

Have patients asking you about aluminum in vaccines? Listen to this episode to learn about important facts so that you can answer their questions appropriately.  This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Anh Nguyen (allergy and immunology). 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 [email protected] Key Points:  Alumium is an immune adjuvant, it helps the body's innate immune cells recognize vaccine antigen and enhances the ability of the vaccine antigen to activate innate immune cells. Your body has a better response to vaccines with aluminum than without. This is especially important for infantsAluminum toxicity is mostly only seen in adult dialysis patients or chronic kidney disease patients due to aluminum in dialysis and total parenteral nutrition. There are no credible reports of aluminum toxicity linked to vaccinesThere are higher levels of serum aluminum after taking over the counter antacids used to treat GERD than after giving an intramuscular vaccine.Sources: “The Role and Safety of Aluminum Adjuvants in Childhood Vaccines”. Pediatrics (2025)https://doi.org/10.1542/peds.2025-074874