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What Parents Need to Know About Moles in Children

Author/s: 
E Meryl Shychuk, Elyse M C Harris, Lindsay A Thompson

Moles can be seen at birth, but most appear during childhood, increase in adolescence, and can continue to increase in number until about age 40 years. Most moles are harmless, and these benign moles can grow as the child grows. However, when moles change in certain ways, as described below, a skin specialist (dermatologist) should evaluate and possibly monitor them, as they might develop into a type of skin cancer called melanoma. In general, melanomas are rare in children and are treatable if found early.

Keywords 
Moles skin cancer children Dermatologists melanoma Sun Protection Factor Sunscreening Agents

Risk Factors for the Development of Food Allergy in Infants and Children: A Systematic Review and Meta-Analysis

Author/s: 
Nazmul Islam, Alexandro W L Chu, Falana Sheriff, Farid Foroutan, Gordon H Guyatt, Romina Brignardello-Petersen, Paul Oykhman, Alfonso Iorio, Ariel Izcovich, Katherine M Morrison, Yetiani Roldan Benitez

Importance: The incidence and risk (predictive) factors for early life food allergy development remain uncertain.

Objective: To estimate the incidence and quantify risk factors for food allergy development.

Data sources: MEDLINE and Embase were systematically searched to January 1, 2025. Data were analyzed from June 1, 2025, to November 25, 2025.

Study selection: Incidence estimates included studies confirming food allergy via food challenge. Risk factor analyses included cohort, case-control, and cross-sectional studies in any language assessing children younger than 6 years using multivariable analyses.

Data extraction and synthesis: Paired reviewers independently extracted data. Random-effects meta-analyses pooled incidence and adjusted odds ratios (ORs). Risk of bias was assessed using the QUIPS tool, and certainty of evidence assessed using GRADE.

Main outcome and measure: The primary outcome was food allergy to age 6 years.

Results: A total of 190 studies involving 2.8 million participants across 40 countries were analyzed. Among studies using food challenge, overall food allergy incidence was likely 4.7% (moderate certainty). Among 176 studies identifying 342 risk factors with varying certainty, the strongest and most certain factors included prior allergic conditions (eg, atopic dermatitis [eczema] within the first year of life [OR, 3.88; risk difference [RD], 12.0%; 95% CI, 8.8%-15.7%], allergic rhinitis [OR, 3.39; RD, 10.1%; 95% CI, 6.7%-14.4%], and wheeze [OR, 2.11; RD, 5.0%; 95% CI, 2.1%-8.8%]), severity of atopic dermatitis (OR, 1.22; RD, 1.0%; 95% CI, 0.6%-1.6%), increased skin transepidermal water loss (OR, 3.36; RD, 10.0%; 95% CI, 6.3%-14.8%), filaggrin gene sequence variations (OR, 1.93; RD, 4.2%; 95% CI, 2.4%-6.4%), delayed solid food introduction (eg, peanut after age 12 months [OR, 2.55; RD, 6.8%; 95% CI, 1.9%-14.6%]), infant antibiotic use (first month [OR, 4.11; RD, 12.8%; 95% CI, 0.4%-40%], first year [OR, 1.39; RD, 1.8%; 95% CI, 0.8%-3.1%], during pregnancy [OR, 1.32; RD, 1.5%; 95% CI, 0.6%-2.5%]), male sex (OR, 1.24; RD, 1.1%; 95% CI, 0.7%-1.6%), firstborn child (OR, 1.13; RD, 0.6%; 95% CI, 0.3%-1.0%), family history of food allergy (eg, mother [OR, 1.98; RD, 4.4%; 95% CI, 2.5%-6.8%], father [OR, 1.69; RD, 3.2%; 95% CI, 1.3%-5.5%], both parents [OR, 2.07; RD, 4.8%; 95% CI, 1.3%-5.5%], siblings [OR, 2.36; RD, 6.0%; 95% CI, 4.4%-8.0%]), parental migration (OR, 3.28; RD, 9.7%; 95% CI, 4.9%-16.3%), self-identification as Black (vs White [OR, 3.93; RD, 12.1%; 95% CI, 5.2%-22.5%], vs non-Hispanic White [OR, 2.23; RD, 5.5%; 95% CI, 3.0%-8.7%]), and cesarean delivery (OR, 1.16; RD, 1.0%; 95% CI, 0.3%-1.2%). Factors like low birth weight, postterm birth, maternal diet, and stress during pregnancy showed no significant risk difference.

Conclusions and relevance: In this meta-analysis, the most credible risk factors associated with development of childhood food allergy are a combination of major and minor risk factors, including early allergic conditions (atopic march/diathesis), delayed allergen introduction, genetics, antibiotic exposure, demographic factors, and birth-related variables.

Keywords 
Food Allergies Development antibiotics children infant Allergies Allergens Food Hypersensitivity

What Parents Should Know About Fire Safety

Author/s: 
Mickey A Emmanuel, Mikhail Goldenberg, Lindsay A Thompson

Many of these injuries are preventable by taking simple steps to make your home safer and knowing what to do when a fire occurs. Most accidental home fires start from cooking, heating equipment, electrical items, or smoking materials. Never leave food unattended on the stove while cooking. Use the back burners, when possible, to keep the hot stove surface and the hot pots and pans out of young children’s reach. Keep a fire extinguisher readily available in the kitchen, and make sure all caregivers know how to use it. Place space heaters away from anything that can catch fire, and always turn them off before going to bed or leaving the room. Ensure fireplaces and wood stoves are screened so that young children are not accidentally burned. This ensures embers stay inside, too. To prevent electrical fires, cover all unused electrical outlets, avoid overloading outlets, and replace any old cords. If you smoke, avoid doing so in the home, especially in bed. Carefully dispose of smoking waste, such as cigarette butts, used matches, and ashes.

If there is a fire, a smoke alarm can warn you to leave the home early and safely. Ensure that a smoke alarm is present on each floor and near every bedroom, avoiding areas like the kitchen to prevent false alarms. Check your smoke alarms monthly and change the batteries once a year unless your alarm has long-life batteries. If you need help, the local fire department can check your fire alarms and can often provide free new ones or replacements. Families with caregivers or children with hearing impairments should use alarms that include flashing lights.

Carbon monoxide is a poisonous gas created from fuel-burning heaters, cars, generators, and appliances. Many smoke alarms are combined with carbon monoxide detectors. If your smoke alarms are not, install a separate carbon monoxide detector on each floor of your home.

A fire escape plan prepares families to understand how to safely exit each room in the home during a fire. To create a fire escape plan, draw a simple map of your home showing 2 escape routes from each room. If you live in an apartment, talk to your children about the importance of using the stairs and avoiding elevators during fires. Establish a common meeting place outside the house. Review the plan with your whole family and with caregivers, such as babysitters, so everyone knows what to do. Practice your escape plan every 6 months so everyone becomes familiar. Children younger than 5 years will need a caregiver to help them during a fire.

Keywords 
Fire safety children parents smoke Cooking smoking Carbon Monoxide

Managing obesity in children: a clinical practice guideline

Author/s: 
Geoff D C Ball, Roah Merdad, Catherine S Birken, Tamara R Cohen, Brenndon Goodman, Stasia Hadjiyannakis

Background: Obesity is a complex, chronic, stigmatized disease whereby abnormal or excess body fat may impair health or increase the risk of medical complications, and can reduce quality of life and shorten lifespan in children and families. We developed this guideline to provide evidence-based recommendations on options for managing pediatric obesity that support shared decision-making among children living with obesity, their families, and their health care providers.

Methods: We followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. We used the Guidelines International Network principles to manage competing interests. Caregivers, health care providers, and people living with obesity participated throughout the guideline development process, which optimized relevance. We surveyed end users (caregivers, health care providers) to prioritize health outcomes, completed 3 scoping reviews (2 on minimal important difference estimates; 1 on clinical assessment), performed 1 systematic review to characterize families' values and preferences, and conducted 3 systematic reviews and meta-analyses to examine the benefits and harms of behavioural and psychological, pharmacologic, and surgical interventions for managing obesity in children. Guideline panelists developed recommendations focused on an individualized approach to care by using the GRADE evidence-to-decision framework, incorporating values and preferences of children living with obesity and their caregivers.

Recommendations: Our guideline includes 10 recommendations and 9 good practice statements for managing obesity in children. Managing pediatric obesity should be guided by a comprehensive child and family assessment based on our good practice statements. Behavioural and psychological interventions, particularly multicomponent interventions (strong recommendation, very low to moderate certainty), should form the foundation of care, with tailored therapy and support using shared decision-making based on the potential benefits, harms, certainty of evidence, and values and preferences of children and families. Pharmacologic and surgical interventions should be considered (conditional recommendation, low to moderate certainty) as therapeutic options based on availability, feasibility, and acceptability, and guided by shared decision-making between health care providers and families.

Interpretation: This guideline will support children, families, and health care providers to have informed discussions about the balance of benefits and harms for available obesity management interventions to support value- and preference-sensitive decision-making

Keywords 
obesity children pediatric obesity
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