Pediatric Annals最新文献

The use of food as medicine to treat illness and maintain health has ancient roots across various cultures. Despite significant scientific progress during the past 2 centuries linking diet, the microbiome, and overall health, modern challenges persist due to sociocultural factors, aggressive food marketing, and insufficient nutritional education. However, there is increasing support from health systems, insurers, nonprofits, philanthropic organizations, and government bodies to develop health policies that promote access to high-quality meals for disease prevention and management. Culinary medicine is now incorporated into undergraduate and postgraduate medical education through electives, certifications in culinary and lifestyle medicine, and continuing medical education conferences. There is substantial potential for culinary medicine to enhance patient care across diverse populations and settings, including individual consultations, group visits, schools, farms, and community gardens. Collaborative efforts among stakeholders can advance practical solutions to translate scientific knowledge into effective policy and practice. [Pediatr Ann. 2025;54(3):e83-e87.].

Yoga, a 3,000-year-old tradition, is now regarded as a holistic approach to health in the Western world. The aim of a yoga practice is to connect the mind, body, and spirit. Today, unlike generations past, children and adolescents experience stress and mental health challenges due to various demands including daily distractions of technology, reduced downtime, pressures from their peers, overscheduling of activities, overvaluing productive time and greater pressure to succeed academically. There is evolving evidence showing yoga and other mindfulness-based practices are paramount for today's children. Yoga can improve resilience, mood, and self-regulation skills pertaining to emotions and stress. Thus, yoga can serve as an important life skill tool for children and young people to cope with stress and self-regulation in a lifelong perspective. [Pediatr Ann. 2025;54(3):e102-e106.].

Ensuring good sleep is crucial for the overall well-being of children, as it impacts their development, mental health, and physical wellness. Children with sleep disorders, especially those with comorbid health conditions, may experience insufficient or low-quality sleep. Given that sleep disorders typically have multifactorial contributors, the holistic approach of integrative medicine is well suited to address sleep health concerns comprehensively. This article will provide insignia into evidence-based integrative interventions for common pediatric sleep disorders. These interventions encompass foundational sleep hygiene principles, mind-body interventions, behavioral therapies, dietary supplements, and other nonpharmacologic methods. [Pediatr Ann. 2025;54(3):e88-e93.].

Integrative medicine (ie, combining conventional and complementary therapies) offers a holistic approach that significantly enhances pediatric care. The WINSS (well-being, interactions and inflammation, nutrition, sleep, and steps) program, initiated in March 2023, applies this approach by addressing physical, emotional, developmental, and lifestyle aspects of children's health. Evidence highlights the impact of lifestyle modifications on long-term health, particularly for children, who benefit from proactive preventive measures. The program integrates stress reduction, positive social interactions, nutrition, sleep hygiene, and physical activity into routine care. Initial results show improved behavioral and nutritional outcomes, including stabilized body mass index and healthier lifestyle habits among participants. The program is well-received by families; although, challenges in reimbursement and resource development remain. Future efforts will focus on expanding educational tools and securing better reimbursement structures. Overall, the WINSS framework represents a promising model for comprehensive, patient-centered pediatric care. [Pediatr Ann. 2025;54(3):e107-e111.].

Traditional health care models lack capacity to address the complex intersections of social, mental, emotional, and physical health and well-being. Adverse childhood experiences (ACEs) are common and can negatively affect lifelong physiology at molecular, cellular, and organ levels. Therefore, it is critical to address ACEs, support positive childhood experiences, and create services that promote holistic well-being. The Center for Resiliency and Wellbeing's (CRW) novel approach to care includes surveilling and screening for adversity, providing integrated and integrative services (I and I model), and changing the culture of health care through education and research. Since 2020, approximately 1,300 unique patients have been cared for by the CRW. The CRW team focuses on the human stress response, integrative care education, and trauma-specific mental health approaches. Early recognition and intervention for ACEs can impart immense personal and population benefits. The I and I model promotes healthy development, stable and nurturing relationships, and skill-building to improve lifelong health and well-being. [Pediatr Ann. 2025;54(3):e94-e101.].

Infantile hemangiomas (IHs) are the most common vascular tumors in children. While many are uncomplicated, a significant minority can cause cutaneous complications or be associated with multiorgan congenital anomalies. Infants with so-called "segmental" IH (patterned and not round) are at-risk for two related syndromes: PHACE (posterior fossa anomalies, hemangioma of the head or neck, cerebrovascular arterial anomalies, cardiac and eye anomalies) and LUMBAR (IH of the lower body; urogenital anomalies and IH ulceration; spinal cord malformations; bony, anorectal, arterial, and renal anomalies). Prompt recognition of LUMBAR syndrome is crucial, given the potential for IH-associated complications, such as ulceration and permanent disfigurement, and more importantly, associated regional birth anomalies. This article synthesizes current knowledge on LUMBAR syndrome, including recognition, evaluation, diagnosis, risk factors, pathogenesis, and management. [Pediatr Ann. 2025;54(3):e112-e116.].

As more children with congenital heart disease (CHD) survive to adulthood, reproductive health care in this demographic is becoming increasingly important. While all women with CHD can have an increased risk of morbidity associated with contraception and pregnancy, these risks can range from those that are medically manageable to catastrophic sequalae that can affect quality of life. Clinicians should discuss reproductive health before puberty and should counsel for pregnancy, family planning, and contraception. Comprehensive counseling during adulthood should include risks during the peripartum period, fetal risk, and long-term cardiovascular sequalae, and should be done with a cardiologist experienced in CHD. [Pediatr Ann. 2025;54(2):e70-e73.].

Chest pain is a common presenting complaint in children and adolescents that often causes significant anxiety for both the patient and their families. Unlike in adults, the majority of chest pain in pediatrics is noncardiac in nature. The following article outlines the important elements of the history and physical, as well as ancillary tests, that can help differentiate between the noncardiac causes of chest pain. It also highlights high-risk features concerning for cardiac causes of chest pain that require further evaluation by a pediatric cardiologist. The most common cardiac causes of chest pain are discussed, as well as the initial management and treatment for the general pediatric provider. [Pediatr Ann. 2025;54(2):e57-e63.].