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: https://www.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: https://www.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: https://www.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: https://www.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: https://www.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: https://www.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: https://www.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: https://www.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: https://www.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: https://www.childrenscolorado.org/.

Tics are common in childhood, but recognizing when they are part of typical development, and when they may indicate Tourette syndrome or another tic disorder, can be challenging for pediatricians. A child repeatedly blinks during a well visit. A parent mentions a new throat-clearing sound that has been happening for weeks. Soon comes the question pediatricians hear often: "Should I be worried?"

In this episode, we take a closer look at tics and Tourette syndrome, helping pediatricians distinguish common childhood tics from situations that may warrant further evaluation. We'll explore the natural history of tic disorders, common co-occurring conditions, and practical strategies for counseling and supporting families.

Joining us for this conversation is Chelsey Stillman, PA-C, a physician assistant at Children's Colorado and the creator and director of the Integrative Tic Clinic. She is also an Assistant Professor of Pediatrics.

Some highlights from this episode include:

• What tics are and how common they are in children
• The natural history and typical course of tic disorders
• The differences between transient tics, chronic tic disorders, and Tourette syndrome
• Common conditions that can co-occur with tic disorders

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

When adults look back on school, they often remember more than lessons and worksheets. They remember recess — the playground, movement, friendships, laughter and freedom. Yet in many schools today, recess can be one of the most negotiable parts of the school day. It may be shortened, delayed or withheld in favor of academics, structure or behavior management. But research continues to show that recess is far more than a break. Regular opportunities for play and movement support children's physical health, mental well-being, social development, and ability to learn. Pediatricians are uniquely positioned to keep play, movement and recess part of the conversation about child health.

We're joined by two experts from Children's Hospital Colorado: Amanda Lopez, a school health nurse, and Eve Kutchman, a prevention education and outreach manager. Together, they share insights into the role of recess in children's health and development and how pediatricians can advocate for making play a priority.

Some highlights from this episode include:

• The health benefits of recess that go beyond a "break" from learning
• How movement and play support children's physical, emotional and social health
• What children may lose when recess is shortened, delayed or withheld
• How health care professionals can help keep recess visible in conversations about child health

This episode is underwritten by Ovintiv, proud philanthropic supporter of Charting Pediatrics and the Children's Hospital Colorado Foundation. Ovintiv recognizes that their responsibility begins in the communities where they live and work. They are committed to giving back and building safer and more resilient communities. Ovintiv's generous support has made a monumental difference for our patients and families, from enhancing health outcomes to reducing health disparities.

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

Some of the most serious diagnoses in pediatrics begin with common pediatric symptoms. A child comes in looking pale or with a febrile illness. They've been more tired than usual. Maybe they're bruising easily or complaining their legs hurt. Individually, none of these symptoms are unusual. Together, or with persistence, they can tell a different story. Leukemia is the most common childhood cancer, but it's earliest signs often resemble everyday illnesses.

The episode introduces Ashley Rogers, MD, a pediatric oncologist at Children's Hospital Colorado and faculty member at the University of Colorado School of Medicine, as the newest host of Charting Pediatrics. As David Brumbaugh concludes his remarkable nine-year tenure as host, he passes the microphone to Dr. Rogers, ushering in the next chapter of the podcast.

Dr. Rogers joins the conversation to share her expertise on childhood leukemia, including key considerations for diagnosis, treatment and the pediatrician's role in recognizing and managing these patients. This episode offers both valuable clinical insights and a warm welcome to a new voice who will continue bringing evidence-based pediatric education to listeners.

Some highlights from this episode include:

• Earliest signs of leukemia pediatricians can look out for
• How to distinguish between viral illnesses or leukemia
• Red flags that shouldn't be dismissed
• Role of the pediatrician after a leukemia diagnosis

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

Tick bites used to be a seasonal nuisance, something you might mention briefly at a well visit in late spring. But that's no longer the reality. With emergency department visits for tick bites climbing to their highest levels in nearly a decade and tick populations expanding into new regions, pediatricians are now seeing the ripple effects of a changing environment in real time. In this episode, we break down what's driving this surge, how to approach tick bites in clinic, and what's new in our understanding of tick-borne illness — including important updates on alpha-gal syndrome that every clinician should have on their radar.

In this episode, we are joined by tick expert, Justin Searns, MD. He specializes in pediatric infectious diseases and hospital medicine at Children's Hospital Colorado. He is also an associate professor at the University of Colorado School of Medicine.

Some highlights from this episode include:

• Why tick bites are currently at an all-time high
• Best practices for tick removal and immediate post-removal care
• When tick-borne illnesses should be a concern for pediatricians
• Prevention strategies and geographical considerations

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

Puberty doesn't always follow the expected timeline. What happens when it shows up ahead of schedule? For pediatricians, the early appearance of breast development, pubic hair or accelerated growth can trigger a cascade of questions. Is this a normal variant? Should we investigate further? When is it time to refer? In this episode, we unpack the complexities of precocious puberty and explore how timely identification and thoughtful management can make a lasting difference for kids and their families.

To create clarity, we are joined by Stephanie Hsu, MD, PhD, and Clare Parker, MD. Dr. Hsu specializes in endocrinology here at Children's Hospital Colorado and is an associate professor at the University of Colorado School of Medicine. Dr. Parker is a pediatric endocrinology fellow.

Some highlights from this episode include:

• The differences in early puberty between boys and girls
• Environmental impacts that can lead to misleading results
• Signs and symptoms pediatricians can look out for
• Treatment options and their severity

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

A child's future begins long before the first words, first steps or even the first smile. In the span of just 1,000 days, billions of neural connections are formed, and the foundation for lifelong health, learning, and resilience quietly takes shape. Pediatricians understand the critical nature of early development, and they translate that message to parents, helping guide, nurture, recognize risk and shape outcomes that can last decades.

To explore this fascinating time in a child's life, we are joined by two experts. Caroline Dias, MD, PhD, and Annie Helms, MD, both specialize in developmental and behavioral pediatrics here at Children's Hospital Colorado and are assistant professors at the University of Colorado School of Medicine. Dr. Helms also leads the BLOSSOM Clinic at Children's Colorado.

Some highlights from this episode include:

• How small things can have the biggest impact in these 1000 days
• The importance of supportive caregivers
• The balance of nature versus nurture
• Easing parent's minds that they aren't "doing enough"

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

The human spine is designed to support, balance and adapt through a lifetime of growth. But what happens when that growth starts to bend in an unexpected direction? Scoliosis often emerges during periods of rapid development, turning what should be a normal growth spurt into a race against progression. The challenge isn't just finding the curve. It's predicting what that curve will do next.

To explore the latest in scoliosis care, we are joined by Mark Erickson, MD. He specializes in orthopedic surgery and is the Medical Director of the spine center at Children's Hospital Colorado. He is a professor at the University of Colorado School of Medicine as well as the fellowship director of pediatric orthopedic surgery.

Some highlights from this episode include:

• How and when scoliosis most commonly presents in children
• What pediatricians can look for during a routine exam
• Particular red flags in the history or physical exam that should cause concern
• How pediatricians should determine who needs imaging

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

When most people hear the word "discipline", they think consequences, punishments or stopping bad behavior in the moment. But what if we've been thinking about discipline too narrowly? We are reframing discipline in toddlers through a completely different lens. One rooted in connection, development and emotional regulation. Because toddler "misbehavior" isn't usually about manipulation or defiance. More often, it's communication.

To help us create developmentally appropriate expectations, we are joined by two experts. Julia Palozzi, PsyD, specializes in child psychology here at Children's Hospital Colorado and is an instructor at the University of Colorado School of Medicine. Alyson Hatten, MS, is a Licensed Professional Counselor, specializing in child counseling as well as infant and early childhood mental health. She also is an assistant professor.

Some highlights from this episode include:

• Reframing what children can't do into what they can do
• Why allowing emotional dysregulation is critical to a child's development
• Setting developmentally appropriate expectations
• Discipline strategies and how pediatricians can guide families to utilize them

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

It's one of the most unsettling calls a pediatrician can get: a baby who turned blue, stopped breathing or suddenly went limp, only to appear completely normal moments later. Welcome to the clinical gray zone of BRUE (Brief Resolved Unexplained Event). It sits at the intersection of alarm and ambiguity, where the history is often dramatic, but your clinical exam is reassuring. We are going to go beyond the definition and into real-life decisions that you have to make on the phone and in the office. From risk stratification to avoiding unnecessary testing, we break down what actually matters in the moment and what doesn't.

This episode was recorded during a live podcast event in Colorado Springs with Michael DiStefano, MD, and Jamie Hug, DO. Dr. DiStefano is the Chief Medical Officer of Children's Hospital Colorado, Colorado Springs, and a pediatric emergency medicine physician. Dr. Hug is a pediatrician in Southern Colorado at the Children's Clinic of Pueblo.

Some highlights from this episode include:

• What is considered a BRUE
• When to refer to the emergency department
• How pediatricians can reassure families and validate their experiences
• Why history is so critical to the exam

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

For many families, water represents joy, summer afternoons, swimming lessons, beach vacations, backyard pools and time spent together. But in pediatrics, we also know that water can become dangerous in seconds, often quietly and without warning. Drowning remains one of the leading causes of preventable death in children, and recent updates from the American Academy of Pediatrics reinforce that prevention must be layered, proactive and tailored. In this episode, we explore how pediatricians can support drowning prevention, because some of the most important work in pediatrics happens long before an emergency occurs.

We are joined by Jason Woods, MD. He specializes in emergency medicine at Children's Hospital Colorado and is the Associate Program Director of the Pediatric Emergency Medicine Fellowship Program at the University of Colorado School of Medicine. He is also an associate professor.

Some highlights from this episode include:

• The AAP guidelines and toolkit details about drowning prevention
• Why the definition of drowning has changed and why that matters
• How drowning prevention is layered
• The role of the pediatrician in feeling confident to counsel families on this topic

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