Charting Pediatrics

Recent episodes

1. Evaluating Precocious Puberty from Charting Pediatrics

   Jul 28, 202627 min

   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: childrenscolorado.org .

2. First 1,000 Days of Brain Building from Charting Pediatrics

   Jul 21, 202630 min

   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. P ediatricians understand the critical nature of early development , and they translate that message to parents , helpi ng 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: childrenscolorado.org .

3. When is a Curve a Sign of Scoliosis? from Charting Pediatrics

   Jul 14, 202628 min

   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 . I t'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 M edical D irector 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: childrenscolorado.org .

4. Helping Parents With Discipline from Charting Pediatrics

   Jul 7, 202638 min

   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 . O ne 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: childrenscolorado.org .

5. Making Sense of BRUE from Charting Pediatrics

   Jun 30, 202618 min

   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 p ediatric e mergency m edicine 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: childrenscolorado.org .

6. New Drowning Prevention Guidance from Charting Pediatrics

   Jun 23, 202629 min

   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 P rogram 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 Childr en's Colorado, visit: childrenscolorado.org .

7. Atypical Anorexia: Looking Beyond the Scale from Charting Pediatrics

   Jun 16, 202623 min

   What if the patient you're least worried about is the one most at risk? In pediatrics, we're trained to look for red flags such as low weight, failing growth curves and visible signs of malnutrition. But atypical anorexia challenges that instinct. These patients may sit comfortably on the growth chart, or even above it, while experiencing the same dangerous behaviors and medical instability as those with classic anorexia. In this episode, we rethink what we've been taught to look for. We explore how atypical anorexia presents, why it's so often missed and what it takes to recognize the warning signs hiding beneath the surface . To discuss this important topic, we are joined by Kimberly Sheffield , PhD . She is an eating disorders psychologist at Children's Hospital Colorado, as well as the clinical director of PMHI day programs, and the associate training director for psychology training. Some highlights from this episode include: The differences between atypical anorexia and low weight anorexia How pediatricians can make sure these kids are properly identified The impact of behavior on their actions How parent s or family member s involvement can make a difference For more information on Children's Colorado, visit: childrenscolorado.org .

8. Heart Murmurs: Red Flags and Reassurance from Charting Pediatrics

   Jun 9, 202625 min

   Heart murmurs are one of the most common findings in pediatric practice, but determining which ones warrant further evaluation can be challenging. While many murmurs are innocent, others may signal underlying structural heart disease and require timely referral and management. In this episode, we discuss how pediatricians can approach the evaluation of heart murmurs, including key features of the child's history and physical exam that help distinguish benign murmurs from those that may be pathologic. We also explore how factors can influence what you hear through your stethoscope. Joining us is Christopher Rausch, MD , pediatric cardiologist and D irector of the Cardiac Developmental Outcomes Program at Children's Hospital Colorado. He is also a professor at the University of Colorado School of Medicine. Dr. Rausch shares practical insights to help pediatricians feel more confident in evaluating murmurs, identifying red flags , and knowing when referral is appropriate . Some highlights from this episode include: How to differentiate the sound of a murmur The biggest differences between a murmur during the first few days of life and as a teenager How common it is for children to experience a murmur during their developmental years Counseling families and deciphering fact versus fear For more information on Children's Colorado, visit: childrenscolorado.org .

9. Ebola in 2026 from Charting Pediatrics

   Jun 4, 202627 min

   Ebola has a way of cutting through the noise of the news cycle . I ts name alone can shift conversations in exam rooms and on living room couches. But what's circulating in headlines is not always what's circulating in reality . For pediatricians, that gap matters. In this episode, we break down what's actually happening right now with Ebola, what is known about current risk and how clinicians can respond when families arrive with urgent questions shaped more by media than by medicine. To guide us through the science, we are joined by Sam Dominguez , MD, PhD . He is the Medical Director of the Clinical Microbiolog y Laboratory, as well as the Associate Medical Director of Infection Control and Prevention at Children's Hospital Colorado. He is a professor at the University of Colorado School of Medicine. Some highlights from this episode include: The current status of Ebola in Africa How difficult it is to contract Ebola The role of the pediatrician in screening patients who are traveling from other countries How pediatricians can ease minds while also promoting the facts For more information on Children's Colorado, visit: childrenscolorado.org .

10. The Latest on Child Abuse in Pediatrics from Charting Pediatrics

    Jun 2, 202625 min

    There's a moment in a pediatrician's day that doesn't show up on the schedule. It's the bruise that doesn't quite match the story , or the awkward pause after a parent answers a question just a little too quickly or the child who won't make eye contact or let go of your sleeve. In these moments, pediatricians become more than clinicians . T hey be come interpreters, advocates and sometimes the only line of protection. To help us understand the latest on child abuse, we are joined by Denise Abdoo , PhD, CPNP . Dr. Abdoo is a pediatric nurse practitioner who specializes in child abuse and neglect. She is also an associate professor at the University of Colorado School of Medicine. Some highlights from this episode include: What's changed in treating child abuse over the last decade The impact of social media on child abuse The most easily missed signs in a pediatric visit Recent changes in laws, reporting and expectations For more information on Children's Colorado, visit: childrenscolorado.org .

11. Hantavirus Beyond the Headlines from Charting Pediatrics

    May 28, 202630 min

    When a rare disease suddenly dominates headlines, questions spread quickly and so does anxiety. Over the past few weeks, hantavirus has re-entered the national conversation, leaving many families wondering how concerned they should be . For pediatricians, moments like this can be challenging as they balance public concern with clinical reality , and help families navigate information that is often incomplete, alarming or misleading. In this episode, we take a closer look at hantavirus through an evidence-based pediatric lens including w hat it is, how transmission occurs, who is truly at ris k and what clinicians should know when these questions inevitably enter the exam room. To create clarity, we are joined by Samuel Dominguez , MD, PhD and Justin Searns , MD . Dr. Dominguez is the Medical Director of the Clinical Microbiolog y Laboratory, as well as the Associate Medical Director of Infection Control and Prevention at Children's Hospital Colorado. Dr. Searns specializes in pediatric infectious diseases and hospital medicine. Both of these experts teach at the University of Colorado School of Medicine. Some highlights from this episode include: Differentiating the types of hantaviruses based on rodent and region Outlining the current status of the cruise ship outbreak Tips and tricks for talking with worrie d families The potential impact on patients Below are some helpful resources related to hantavirus: Hantavirus Pulmonary Syndrome: CDC "Super-Spreaders" and Person-to-Person Transmission on Andes Virus in Argentina: The New England Journal of Medicine For more information on Children's Colorado, visit: childrenscolorado.org .

12. The Pediatric UTI Playbook from Charting Pediatrics

    May 26, 202637 min

    Pediatric urinary tract infections, or UTIs, don't always follow a scrip t. While they're one of th e most co mmon diagnoses, they're also one of the most nuan ced. T hey can be subtle, inconsistent and easy to over — or under — diagnose. Aside from clear urinary symptoms, they can show up as a feve r without a source, vague abdominal pain, new incontinence or a child who simply isn't acting like the mselv es. And in those moments, the decisions pediatricians make such as who to test, how to collect a sample or how to interpret results, carry real clinical weight. To dive into this topic, we are joined by Kevin Olson , PA , and Meghan Rommel , NP, w ho practice in the Department of Pediatric Urology at Children's Hospital Colorado. Some highlights from this episode include: The challenges of diagnosis and the importance of getting it right How UTIs present differently across age s When to use antibiotics versus when more discovery is needed Approaching recurrent UTIs in children For more information on Children's Colorado, visit: childrenscolorado.org .

13. Genetic Testing in Pediatrics from Charting Pediatrics

    May 19, 202633 min

    Genetic testing is no longer a distant, specialized tool reserved for rare disease clinics or academic centers. It's showing up in pediatric practice. For example, pediatricians are increasingly considering genetic diagnoses in children with developmental delays outside the normal range. A NICU graduate may already carry a genetic diagnosis when they see their pediatrician after discharge . What does the practicing pediatric provider need to understand about ordering and interpreting genetic tests? In this episode, we unpack how community pediatricians can make sense of the world of genomics. Joining us for this robust conversation are Austin Larson , MD , and Margarita Saenz , MD . Dr. Larson is a pediatric medical and biochemical geneticist. He is the M edical D irector of P recision M edicine C linical I nformatics, as well as the D irector of the M itochondrial C are N etwork C linic at Children's Hospital Colorado. Dr. Saenz specializes in clinical genetics and dysmorphology. She is the M edical D irector of P recision Me dicine E ducation and F amily E ngagement. They both are faculty members at the University of Colorado School of Medicine. Some highlights from this episode include: Recent advances making genetic testing more accessible to patients How the rise of exome and genome sequencing has changed the diagnostic approach in pediatrics Secondary findings and how they should be discussed in advanced Practical advice for a pediatrician who feels overwhelmed to order and interpret these tests For more information on Children's Colorado, visit: childrenscolorado.org .

14. Conjunctivitis Confusion in Kids from Charting Pediatrics

    May 12, 202626 min

    It's one of the most common calls you'll get as a pediatrician , and one of the fastest infections to spread through a classroom. A pink eye shows up and suddenly the questions follow: Is it contagious? Do they need drops? Can they go back to school? Pink eye seems like a simple fix until it's not . From bacterial to viral to allergic , knowing what you're looking at can change how it impacts a family. Rebecca Edwards Mayhew , MD, PhD , specializes in pediatric ophthalmology and adult strabismus, at Children's Hospital Colorado. She is also an a ssistant p rofessor at the University of Colorado School of Medicine. Some highlights from this episode include: Distinguishing between viral, bacterial and allergic conjunctivitis How to consult families about contagion and school policies Red flags that should immediately raise concerns for more serious pathology When treating with antibiotics makes sense and when to wait and watch For more information on Children's Colorado, visit: childrenscolorado.org .

15. Picky Eating or ARFID? from Charting Pediatrics

    May 5, 202632 min

    "Picky eater" is one of the most common labels in pediatrics and one of the easiest to overlook. But when a child's diet is shrinking instead of expanding, when meals are a source of stress instead of routine , or when growth and nutrition start to feel like a question mark , it's worth taking a second look. In this episode, we're discussing ARFID: what it looks like in clinic , how t o spot the difference from typical picky e ating , and how to approach these patients with a sharper clinical lens. In this episode, we are joined by Kimberly Sheffield , PhD . She is an eating disorders psychologist at Children's Hospital Colorado, as well as the C linical D irector of Pediatric Mental Health Institute ( PMHI ) day programs , and the A ssociate T raining D irector for P sychology T raining. Some highlights from this episode include: Specific growth or nutrition patterns that should raise suspicion of ARFID Treatment options pediatricians can manage in clinic Overlap between ARFID and neurodiversity Patterns to look for in certain age groups This episode is underwritten by Ent Credit Union, proud supporter of Charting Pediatrics and Children's Hospital Colorado. Ent is Colorado's largest credit union serving more than 550,000 members at 60 service centers across the Front Range. Ent generously responded to Children's Colorado's State of Emergency for pediatric mental health in 2021 and is pleased to support this episode. Visit ent.com, insured by NCUA. For more information on Children's Colorado, visit: childrenscolorado.org .

16. The Future of Food Allergy from Charting Pediatrics

    Apr 28, 202631 min

    A toddler takes their first bite of peanut butter and breaks out in hives. A parent sits across from you, equal parts frightened and overwhelmed, asking the question you hear every day , "What happens now?" Food allergies have long lived at the intersection of fear and uncertainty , for families and clinicians alike. But that story is changing. A landscape once defined by strict avoidance is rapidly evolving into proactive management, personalized risk assessment , and emerging therapies that are reshaping outcomes . In this episode, we step into that evolving world. From early introduction and updated diagnostic strategies to the expanding role of oral immunotherapy and biologics, we'll unpack what's here, what's coming , and what it means for how you care for patients in real time. T wo allergy experts, David Fleischer , MD , and Allison Hicks , MD , join us for this episode . Dr. Fleischer is the S ection H ead of A llergy and I mmunology, as well as the D irector of the A llergy and I mmunology C enter at Children's Hospital Colorado. Dr. Hicks is the D irector of F ood I mmunotherapies. They both teach at the University of Colorado School of Medicine. Some highlights from this episode include: How food allergy management has evolved The biggest misconceptions about food allergies The latest guidelines on early, consistent introduction to different foods What the current treatment options look like and the role of the pediatrician For more information on Children's Colorado, visit: childrenscolorado.org .

17. Gut Instincts: The Pediatric Microbiome from Charting Pediatrics

    Apr 21, 202633 min

    Inside every one of us is a complex, evolving ecosystem influencing everything from immunity to inflammation to long-term health. This is known as our gut microbiome. The choices made early on, such as how babies are born, fed and treated, can have lasting effects. In this episode, we explore the pediatric gut microbiome: what builds it, what disrupts it and why it matters more than some may think . We're joined by g astroenterology experts Jaime Belkind-Gerson, MD , and Edwin DeZoeten, MD . Dr. Belkind -Gerson is th e Director of the N eu rogastroenterology program at Childre n's Colo rado. Dr. DeZoeten is the D irector of the P ediatric I nflammatory B owel D isease C enter. They are also professors at the University of Colorado School of Medicine. Some highlights from this episode include: What influences the gut microbiome at an early age How diet influences the overall health of the microbiome The connection between the brain and the gut Separating f act versus fiction in probiotics For more information on Children's Colorado, visit: childrenscolorado.org .

18. The Parent Behind the Patient from Charting Pediatrics

    Apr 14, 202636 min

    Every pediatric visit tells two stories. One is about the child in front of us: their growth, symptoms and milestones. The other belongs to the parent beside them, often unspoken but deeply felt. In this episode, we're talking about parental wellbeing and why it belongs at the center of pediatric care. From chronic stress and mental health challenges to resilience and support systems, a caregiver's experience doesn't stay in the background but rather shapes a child's biology, behavior and long-term health. To discuss this important topic, we are joined by Mona Amin, DO . She is a board-certified pediatrician, a mom of two and the founder of the incredible podcast PedsDocTalk , a globally recognized platform reaching over 1.5 million people . Some highlights from this episode include: Why a parent's mental health impacts child health and development The role the pediatrician can play in identifying parental struggles Common misconceptions about parental mental health Healthy boundaries between sharing details and privacy For more information on Children's Colorado, visit: childrenscolorado.org .

19. Thyroid Disorders in Kids from Charting Pediatrics

    Apr 7, 202625 min

    A tired teen who struggles to get out of bed or a child whose growth is falling behind expectations , are familiar clinical problems, each with a differential diagnosis. Thyroid disorders are often on the differential for many common symptoms we see , yet thyroid disease rarely walks into the office announcing itself. Instead, thyroid disorders can hide in plain sight, disguised as other diagnoses such as anxiety, depression, ADHD, delayed puberty, constipation or "just teenage hormones . " In this episode, we've diving into the physiology, the pitfall s and the practical decisions behind pediatric thyroid care. Because when we understand the thyroid , we can protect long-term health. Maggie Chan, MD , is an endocrinologist at Children's Hospital Colorado, as well as an associate professor at the University of Colorado School of Medicine. Some highlights from this episode include: Most common thyroid disorders in children How to differentiate between mental health symptoms versus thyroid symptoms When to screen and what labs to test for T hree practical takeaways to utilize in clinic For more information on Children's Colorado, visit: childrenscolorado.org .

20. Coordinating Pediatric Aerodigestive Care from Charting Pediatrics

    Mar 31, 202625 min

    A natomy doesn't work in silos. For example, t he airway affects feeding. Feeding affects growth. Reflux affects the lungs. Suddenly, one child has three subspecialists and one very full calendar. Aerodigestive medicine lives in that overlap, and while multidisciplinary teams bring powerful expertise , primary care providers are co-managing these patients. They are fielding the "is this normal" calls . T hey are tracking growth, advocating for these patients and helping families make sense of recommendations. In this episode, we talked to two experts about what meaningful co-management looks like, Emily DeBoer, MD , and Todd Wine, MD . Dr. DeBoer specializes in p ulmonology at Children's Colorado and is a p rofessor at the University of Colorado School of Medicine. Dr. Wine specializes in otolaryngology and is an a ssociate p rofessor. Some highlights from this episode include: Which patients benefit from multidisciplinary aerodigestive care versus traditional single- specialty referrals How respiratory diagnoses impact patients How primary care clinicians can support patients Overview of aerodigestive programs across the country For more information on Children's Colorado, visit: childrenscolorado.org .