In Reply Several years ago, we implemented a protocol to manage pain and sedation based on regular clinical pain and sedation assessments in our neonatal intensive care units.1 At that time, given the significant amount of studies published in that field, we found it extremely difficult to choose 1 scale, among others. These difficulties motivated us to write this systematic review to provide clinicians

To the Editor Giordano et al1 have published an outstanding article in which they provide a complete list of pain scales suitable for use among preverbal patients, with the aim of providing readers an opportunity to choose the appropriate scale for the target population. Unfortunately, among useful warnings they give to choose the appropriate scale, they do not include that most scales developed to

The acquisition of literacy, from earliest emergent stages to full fluency with understanding and self-expression in written language, represents a distinct developmental trajectory. Unlike other developmental arenas, achieving literacy combines environmental stimulation and informal interaction in the preschool years with formal school-based instruction in decoding print and reflects the integration

Matthew C. Aalsma Ekram Wassim Abdelwahab Asnawi Abdullah

The Original Investigation titled “Associations Between Screen-Based Media Use and Brain White Matter Integrity in Preschool-Aged Children,”1 published online November 4, 2019, was changed to open access status under a CC-BY license. This article was corrected online.

In the Original Investigation titled “Association Between Initial Use of e-Cigarettes and Subsequent Cigarette Smoking Among Adolescents and Young Adults: A Systematic Review and Meta-analysis,”1 published online June 26, 2017, and in the August 2017 print edition, there was an error in the first sentence of the Results section. The number given as “16 621 adolescents and young adults” should have

In Reply In my Editorial1 of the article by Adelman et al,2 there is no statement that the distinct naming convention failed to reduce wrong patient error rates in multiple-birth newborns. There are statements in the Editorial1 that report the findings of the study support the authors’ hypothesis2 that following the adoption of the Joint Commission standard, wrong patient errors among children of multiple

To the Editor The Editorial by Freed, “When New Standards to Improve Safety Do Not Actually Improve Safety,”1 makes an important point: all organizations must be careful when implementing changes to improve safety and assess whether the changes were made successfully, achieved the desired improvement, and did not have unintended consequences. Unfortunately, the Editorial had several important inaccuracies

The obesity epidemic has not spared adolescents, and as Cardel and colleagues1 note in this issue of JAMA Pediatrics, there are unique aspects to developing effective treatments for adolescents. Adolescence includes a wide age, 11 to 21 years, which spans developmental periods. There are unique psychological challenges during the journey from childhood to adulthood, which include the drive for autonomy

Nearly 20 years ago, health economist Henry Aaron characterized the US health care system as “an administrative monstrosity, a truly bizarre mélange of thousands of payers with payment systems that differ for no socially beneficial reason, as well as staggeringly complex public systems with mind-boggling administered prices and other rules expressing distinctions that can only be regarded as weird

The proliferation of observational literature on the topic of high-flow nasal cannula (HFNC) as a therapy for acute viral bronchiolitis is nothing short of remarkable. A brief PubMed search reveals a ratio of observational studies to randomized trials of at least 10 to 1 in the past 3 years alone. This proliferation suggests that, right or wrong, we have embraced the widespread use of HFNC clinically

To the Editor In the 2019 December issue of JAMA Pediatrics, Dreier et al1 reported on the long-term risk of epilepsy, psychiatric disorders, and mortality following febrile seizures. This large register-based study reports a 22.7% cumulative risk of recurrent febrile seizures after the first seizure and an increased risk of epilepsy and psychiatric disorders, increasing with additional hospital admissions

To the Editor We read with interest the article by Dreier et al,1 which demonstrated that febrile seizure is associated with risk of epilepsy, but more importantly, also psychiatric disorders. The risk of psychiatric disorders was found to be 17.2% at birth, 21.4% after the first, 25% after the second, and 29.1% after the third febrile seizure. The study included any psychiatric disorders in the ranges

Diagnostic errors cause substantial harm to patients but remain largely unappreciated within the patient safety movement in health care.1 The National Academy of Medicine defines a diagnostic error as “failure to (a) establish an accurate and timely explanation of the patient’s health problem(s) or (b) communicate that explanation to the patient,” but this universal definition can be difficult to apply

In Reply We thank Zhang and Niu and Aghai for their interest in our systematic review of use of the early-onset sepsis (EOS) calculator. Zhang and Niu worry about study heterogeneity and publication bias. We carefully assessed all 13 included studies and found it appropriate to meta-analyze the 6 studies reporting data before and after EOS calculator implementation with comparable settings in both

To the Editor We read with great interest the systematic review and meta-analysis by Achten et al,1 who reported a significant association of using the neonatal early-onset sepsis (EOS) calculator with the substantially reduced use of empirical antibiotics for suspected EOS. The findings of this meta-analysis emphasize the importance of using the neonatal EOS calculator to enhance the accuracy of administrating

To the Editor This letter is in response to the systematic review and meta-analysis by Achten et al1 on the use of the neonatal early-onset sepsis (EOS) calculator. The meta-analysis clearly demonstrated that the use of the neonatal EOS calculator is associated with a reduction in the use of empirical antibiotics. However, the authors’ conclusion that “Available evidence regarding safety of the use

In this issue of JAMA Pediatrics, the findings of Boudreaux et al1 suggest that federal rental assistance for families with low incomes may be important for reducing emergency department visits for asthma. This study adds to the increasing body of research on the ways in which housing assistance is associated with health and has implications for housing and health care policies, especially given the

Numerous national surveys, cohort studies, and meta-analyses have documented the etiologic and experiential connections between childhood abuse, physical illness, and mental health disorders1,2 spanning from childhood to adulthood. Yet pediatric training and practice typically focus primarily on the identification and treatment of physical health conditions. The recent advent of enthusiasm for integrated

In Reply We thank Triunfo for her interest and thoughtful comments to our article in JAMA Pediatrics, “National Trends in the Provision of Human Milk at Hospital Discharge Among Very-Low-Birth-Weight [VLBW] Infants.”1 We whole-heartedly agree with the 2 main points brought forward for further discussion. Regarding the first point, we agree that discussions regarding health benefits of human milk should

To the Editor A research article entitled “National Trends in the Provision of Human Milk at Hospital Discharge Among Very Low-Birth-Weight Infants”1 (VLBW) has been published in JAMA Pediatrics. Parker et al describe the US trends in the provision of human milk at hospital discharge among 346 248 infants born between 23 and 29 weeks’ gestation or with a birth weight of 401 g to 1500 g, all cared for

Pediatric firearm injury and mortality are matters of national concern. The pediatric firearm mortality rate has increased by approximately 30% over the past decade,1 largely due to increases in both firearm homicide and suicide. Currently, firearm injury is the second leading cause of death for American youths (age 1-19 years).1

Vision: JAMA Pediatrics will be the most respected source of information for investigators, providers, and policy makers seeking the highest quality evidence to guide decision making. Mission Statement: JAMA Pediatrics seeks to provide state-of-the-art information to individuals and organizations working to advance the health and well-being of infants, children, and adolescents. The journal also provides

In the Original Investigation titled “Electronic Cigarette and JUUL Use Among Adolescents and Young Adults,”1 published online January 21, 2020, a correction was made to fix some incorrectly reported percentages for race/ethnicity in Table 1. This article was corrected online.

In the Original Investigation titled “Neurodevelopmental Abnormalities in Children With In Utero Zika Virus Exposure Without Congenital Zika Syndrome,”1 published online January 6, 2020, a correction was made to remove a key that had been incorrectly placed in Figure 1. This article was corrected online.

In the Viewpoint entitled “The Unaware Physician’s Role in Perpetuating Somatic Symptom Disorder,”1 the third author’s name was inverted. It should have been Giorgio Cozzi instead of Cozzi Giorgio. This article was corrected online.

In the Original Investigation titled “Two-Year Neurodevelopmental Outcomes After Mild Hypoxic Ischemic Encephalopathy in the Era of Therapeutic Hypothermia,” published online November 11, 2019, and also in the January 2020 issue of JAMA Pediatrics,1 a reference was inadvertently omitted. In the second paragraph of the Introduction, the following sentence should have included 2 references instead of

In Reply We found in a double-blind, randomized, placebo-controlled trial that high-dose vitamin D supplementation during pregnancy was associated with reduced risk of recurrent wheeze1 and enamel defects in offspring.2 Deng and Niu suggest that this finding was flawed by residual confounding. However, the design mitigates confounding. This is demonstrated in our study showing equal distribution of

Nørrisgaard et al1 reported important findings from a randomized clinical trial that the odds of enamel defects in offspring were lowered by approximately 50% with high-dose vitamin D supplement during pregnancy than with the low dose during a 6-year follow-up. Enamel defects constitute a global problem reaching epidemic proportions,2 and identification and management of potential risk factors remains

In Reply We thank Wang and Niu as well as Reddy and Ahuja for their thoughtful comments about our work.1 Wang and Niu pointed out that owing to growth in the total US population from approximately 282 million in 2000 to 327 million in 2017, the total numbers reported in our study might not comparable across years. While proportions reported in our study should help mitigate these concerns and population

To the Editor We congratulate Meinhofer and Angleró-Díaz on the publication of their study regarding trends within foster care and parental drug use.1 As Meinhofer and Angleró-Díaz note, the results of the study closely mirror trends of the opioid epidemic that currently plagues the United States.1 The authors note that literature is scarce on associations between parental opioid use and foster care

To the Editor We read with great interest the Research Letter by Meinhofer and Angleró-Díaz,1 who observed substantially increasing trends in the number of foster care entries attributable to parental drug use during 18 fiscal years from 2000 to 2017 in the United States by analyzing data from the Adoption and Foster Care Analysis and Reporting System. Although foster care can offer protection for

In Reply We thank Zhou and Niu for their comments regarding our pragmatic cluster randomized trial. The authors raise 2 specific issues that they believe are legitimate. First, Zhou and Niu question the generalizability of the trial conducted in Chamarajnagar district, South India, to rural children from the rest of India. In support of their concern is cited evidence for genetic diversity among Indian

To the Editor In their pragmatic cluster randomized clinical trial, Shet et al1 reported a perceivable effect of community-based parental education and counseling annexed with usual treatment on children’s anemia cure rate in India. Globally, anemia has escalated to epidemic proportions, with an estimated prevalence of 32.9% in 2010, causing 68.36 million years lived with disability.2 Hence, strategies