Charting Pediatrics

Caring for a child with life threatening illness, poor prognosis or who is at the end of life is one of the most difficult experiences a pediatrician can face. Beyond the medical decision making, these moments require complex communication of painful information while supporting children and families through fear, uncertainty, grief, and loss. In this episode, we're exploring the challenges of caring for children with life-threatening illness and the skills that can help clinicians deliver difficult news with clarity, compassion and empathy.

To help us understand how to make these difficult conversations more meaningful and comprehensible, we are joined by two experts: Kristen Eisenman, MD, and Allison Feldman, MD. Both specialize in hospice and palliative medicine, and Dr. Eisenman also specializes in hematology/oncology. They are both associate professors at the University of Colorado School of Medicine.

Some highlights from this episode include:

• The unique role of the pediatrician in end-of-life care, as well as care for a serious illness
• Balancing honesty about prognosis while still allowing families to maintain hope
• Language and communication strategies particularly helpful for families
• How meaningful support and listening can be to struggling families

For more information on Children's Colorado, visit: childrenscolorado.org.

A child can be doing well on paper and still be struggling to grow into who they are. They're meeting milestones. They're doing fine in school. There's no diagnosis and no crisis. There's nothing that sends up a red flag. But are they learning how to manage frustration, build healthy relationships, navigate conflict, recover from setbacks and ask for help when they need it? Mental health in childhood isn't just about identifying what's wrong. It's also about understanding what healthy development looks like and recognizing opportunities to strengthen it before there's a problem to diagnose.

This episode was recorded live on the exhibit floor at the 2026 American Academy of Pediatrics Conference in San Diego, California. Joining us for this episode is Joan Jeung, MD. She is a clinical professor within the Department of Pediatricians and Division of Developmental Medicine at the University of California San Francisco School of Medicine.

Some highlights from this episode include:

• Understanding healthy mental development beyond diagnosis
• How this changes across age groups and what pediatricians should expect
• When and how a pediatrician can provide support to a family who is struggling
• The role of sleep, physical, activity, play, school, friendships and family connection

This episode is underwritten by Wings Credit Union, a proud supporter of Charting Pediatrics and Children's Hospital Colorado. Wings generously responded to Children's Colorado's State of Emergency for pediatric mental health in 2021 and is pleased to support this episode. For more information on Children's Colorado, visit: childrenscolorado.org.

Toilet training may seem like a simple developmental milestone until you're the pediatrician helping a family navigate accidents, resistance, constipation, regression, and the growing pressure to get it right. For many families, toilet training quickly stops being about developmental readiness and starts becoming a collision of pressure, comparison, preschool deadlines, power struggles, and late-night Googling. What seems like a simple milestone on the surface often turns into one of early childhood's most emotionally charged transitions. And for pediatricians, it remains one of the most common yet surprisingly nuanced conversations in clinical practice.

To unpack the developmental science, behavioral realities, and clinical challenges we are joined by two experts: Yodit Denu, PhD, and Melissa Buchholz, PsyD. As child psychologists, they specialize in infant and early childhood mental health. They both teach at the University of Colorado School of Medicine.

Some highlights from this episode include:

• The concept of the "right age" to start toilet training versus when a child is ready
• How pediatricians can counsel families when starting this process
• The connection between toilet training and constipation
• How to promote a healthy, successful experience for families

For more information on Children's Colorado, visit: childrenscolorado.org. Follow us on Instagram @ChartingPediatrics

The NICU discharge is a milestone, but it's not the finish line. For children born prematurely, primary care plays a critical role in what comes next: tracking growth and development, recognizing ongoing health needs and helping families navigate the transition from intensive neonatal care to everyday childhood. But how should pediatricians adjust their approach? And what are the things we're at risk of missing? We're focusing on the practical side of caring for children born prematurely in the primary care setting, with the goal of helping pediatricians turn a complex NICU history into a clear, proactive care plan. Prematurity may shape the beginning of the story, but primary care helps shape what comes next.

To move beyond the NICU discharge summary, we are joined by Laura Brown, MD. She specializes in neonatal and perinatal medicine at Children's Hospital Colorado. She is also a professor at the University of Colorado School of Medicine.

Some highlights from this episode include:

• When to use corrected age versus chronological age for preterm infants
• How a pediatrician should be watching these children differently in the days and months after transition of care
• When preterm babies need specialized follow up care
• Biggest red flags for pediatricians to watch during infancy

For more information on Children's Colorado, visit: childrenscolorado.org.

An earache. A fussy toddler. A worried parent. And often, a familiar prescription: antibiotics. Acute otitis media is one of the most common reasons children receive antibiotics. But as we continue to better understand when antibiotics truly make a difference — and when children may do just as well without them — there's an opportunity to rethink what appropriate treatment looks like. So how can pediatricians confidently reduce unnecessary prescribing while still treating pain, addressing parents' concerns, and making sure the children who do need antibiotics get them? We'll answer that in this episode.

To dive into this ever-evolving topic, we are joined by two experts. Nicole Poole, MD, specializes in infectious diseases at Children's Colorado, serves as the Associate Medical Director of the Antimicrobial Stewardship Program and leads the Outpatient Antibiotic Stewardship Program. She is also an associate professor at the University of Colorado School of Medicine. Holly Frost, MD is a pediatrician at Intermountain Health and also serves as Enterprise Associate Chief Medical Officer, Professor of Research at Intermountain and faculty in pediatric infectious diseases at the University of Utah

Some highlights from this episode include:

• Consequences of prescribing antibiotics when not necessary
• How it impacts pediatrics on a larger scale beyond an individual patient
• Common pitfalls pediatricians encounter when diagnosing AOM
• The importance of addressing pain and ways to do that aside from prescribing antibiotics

For more information on Children's Colorado, visit: childrenscolorado.org.

There was a time when the vaccine conversation in pediatrics felt straightforward: here's the schedule, here's what your child needs, and here's when they need it. Today, it's anything but simple. The recommendations are evolving. The vaccine schedule is under a microscope. New guidance is emerging around COVID-19 and RSV. And at the same time, pediatricians are sitting across from families who may be confused, skeptical or overwhelmed by what they're hearing online. So how do we make sense of all of it — and, perhaps more importantly, how do we talk about it?

To break down the latest recommendations from the American Academy of Pediatrics we are joined by Sean O'Leary, MD, the immunization schedule editor for the AAP. He specializes in infectious diseases and is the director of the Colorado Pediatrics Practice-Based Research Network, also known as the Colorado Children's Outcomes Network. He is also a professor at the University of Colorado School of Medicine.

Some highlights from this episode include:

• Biggest takeaways from the September 2026 vaccine update
• Current schedule: what's changed and what's stayed the same
• Expectations for upcoming respiratory season
• Approaching vaccine hesitancy with families

For more information on Children's Colorado, visit: childrenscolorado.org.

Atopic dermatitis may be common, but it can be anything but simple. For children and their families, sleepless nights from persistent itch and discomfort from recurrent flares can take a real toll, and the treatment landscape is changing quickly. So, what do pediatricians need to know? In this episode, we'll unpack the latest American Academy of Dermatology guidelines for children, from daily skin care and topical treatments to when we need to intensify therapy.

To break down these new guidelines, we are joined by two dermatologists here at Children's Colorado: Emily Gurnee, MD, and Carla Torres-Zegarra, MD. Both teach at the University of Colorado School of Medicine.

Some highlights from this episode include:

• Biggest takeaways from the new guidelines
• How these guidelines impact primary care management of atopic dermatitis
• New treatment options
• Support between primary care provider and specialist when appropriate

For more information on Children's Colorado, visit: childrenscolorado.org.

Wheezing, cough and increased work of breathing are common pediatric presentations that can quickly lead clinicians to consider asthma. But not every child with lower -airway symptoms has asthma. Viral illness, tracheomalacia, aspiration and other conditions can mimic asthma, making the underlying cause difficult to recognize based on symptoms alone. In this episode, we take a closer look at the clinical clues that can help pediatricians distinguish non-asthmatic causes of lower-airway symptoms from asthma.

Monica Federico, MD, is a pulmonologist at Children's Hospital Colorado, the medical director of the hospital's asthma program and a professor at the University of Colorado School of Medicine.

Some highlights from this episode include:

• Common pediatric presentations that can mimic asthma
• Clinical clues that may point to a non-asthmatic cause of wheezing or cough
• Viral illness, tracheomalacia and aspiration as alternative diagnoses
• When persistent or atypical symptoms should prompt a broader evaluation
• How recognizing the underlying cause can change management

For more information on Children's Colorado, visit: childrenscolorado.org.

Fifteen minutes. That's about all the time most pediatricians have to care for an entire child and family. In that brief visit, they are expected to address preventive care, developmental concerns, chronic conditions, behavioral health, documentation, and countless questions from parents, all while building meaningful relationships. It's a lot to ask of both clinicians and the healthcare system. What if the answer isn't working faster, but working differently? Today, we're talking about how pediatric practices can build systems that support better coordinated, family-centered care while creating more sustainable and fulfilling careers for clinicians.

Joining us for this important discussion is Tricia Ramos, MD. She is a general pediatrician visiting all the way from Quezon City in the Philippines.

Some highlights from this episode include:

• How to balance family's needs and pediatricians' priorities in a short visit
• Biggest pain points in today's pediatric practices
• Systems and workflows that have made a meaningful difference in improving care
• High-impact changes smaller or independent clinics can implement

For more information on Children's Colorado, visit: childrenscolorado.org.

Iron deficiency anemia is one of the most common nutritional deficiencies in children and adolescents, but it can sometimes be easy to miss. From the toddler who drinks almost exclusively milk to the adolescent athlete struggling to keep up with their peers or the teen with heavy menstrual bleeding and persistent fatigue, these patients may present differently while sharing the same underlying diagnosis.

In this episode, we explore iron deficiency anemia in pediatric patients, including why it remains so common, which children and adolescents may be at increased risk, and the clinical clues that can help pediatricians recognize iron deficiency before it becomes a missed opportunity. Joining us for this important conversation is Akhila Vadivelan, MD, a pediatric hematologist/oncologist at Children's Hospital Colorado and an assistant professor at the University of Colorado School of Medicine.

Some highlights from this episode include:

• Evaluation, diagnosis and management of iron deficiency anemia
• What this diagnosis means for different populations
• Clinical clues pediatricians should look out for
• When treatment makes sense

For more information on Children's Colorado, visit: childrenscolorado.org.