Authors´ conclusions: higher Poly-and perfluoroalkyl levels in early life are associated with accelerated gains in fat mass percentage during the first six months of life and with lower fat free mass at the age of two years. Both situations have been associated with an unfavorable body composition and metabolic profile later in life.
Reviewers´ commentary: the results of this study show that breastfeeding is a perfluoroalkyl and polyfluoroalkyl substance exposure pathway in infants. There is a relationship between the highest levels of this substances and the rapid gain of fat mass at six months of life. It will be necessary to assess whether these findings affect the protective effect of breastfeeding on the development of obesity and cardiovascular disease in adulthood.
Rivero Martín MJ, Aparicio Rodrigo M. Evid Pediatr. 2025;21:1
Authors´ conclusions: evidence suggests that short-term exposure to CO, SO2, NO2, particulate matter ≤10 μm (PM10) and ≤2.5 μm (PM2.5) is associated with the incidence of acute respiratory disease, even at levels in the permitted air quality range.
Reviewers´ commentary: although the heterogeneity of the studies did not allow meta-analysis, the results support the evidence of the effect of air pollution on respiratory disease. Primary care professionals can contribute to raising public awareness of the need for clean air.
Aparicio Rodrigo M, Fernández Rodríguez MM. Evid Pediatr. 2025;21:2
Authors´ conclusions: this maternal vaccine against respiratory syncytial virus reduces the risk of medically assessed lower respiratory tract disease among infants but increases the risk of preterm birth.
Reviewers´ commentary: an important safety alert regarding a higher incidence of prematurity after administration of this vaccine triggers the termination rule for this study and conditions the magnitude of its efficacy in reducing the risk of respiratory syncytial virus infection.
Oltra Benavent M, Ochoa Sangrador C. Evid Pediatr. 2025;21:3
Authors´ conclusions: intranasal fentanyl (INF) is more effective in reducing pain than other analgesics at the 15- to 20-minute point. However, no significant differences were observed at the 30- and 60-minute time points. In addition, INF exhibited a better adverse outcome profile with a lower risk of nausea and vomiting than other analgesics, although there were no significant differences regarding dizziness and hallucinations.
Reviewers´ commentary: the use of INF is an additional tool on the therapeutic arsenal for cases with moderate or severe pain and difficult venous access. In this meta-analysis, due to methodological limitations, it cannot be concluded that INF is the treatment of choice, as the comparators used are different. Furthermore, regarding side effects, the conclusions cannot be considered valid for the same reason. Observational studies with longer follow-up would be necessary to reach the conclusions specified in this meta-analysis.
Flores Villar S, Fraile Astorga G. Evid Pediatr. 2025;21:4
Authors´ conclusions: although RSV preventive measures are vital for all infants, and specific recommendations exist for patients with high-risk comorbidities, in situations where prioritization becomes necessary, infants born just before or within the early weeks of the epidemic should be considered as a risk group.
Reviewers´ commentary: this study merely confirms the already known increased risk of hospitalization of newborns under 2 months of age during epidemics and the increased likelihood of neonatal illness during epidemic seasons. The study also fails to provide useful data on the most effective measures to prevent severe RSV infection.
Cuestas Montañés EJ, Llerena Santa Cruz E. Evid Pediatr. 2025;21:5
Authors´ conclusions: the Injury Prevention Program (TIPP) of the American Academy of Pediatrics reduced significatively the number of unintended injuries in children less than two years, which adds evidence for its implementation in the well-child visits.
Reviewers´ commentary: this study, with a clinical trial design, adds evidence on the efficacy of non-intentional child injury prevention counseling in primary care, and although it has methodological limitations, it suggests that this counseling should continue to be provided in the pediatric office.
Pérez González E, Esparza Olcina MJ. Evid Pediatr. 2025;21:6
Authors´ conclusions: breakthrough and vaccine failure rates were not different between children who received the two-dose pneumococcal conjugate vaccine (PCV13) and the two-dose primary vaccination plus one booster schedule. Overall invasive pneumococcal disease (IPD) incidence was lower in 2022-23, with the two-dose schedule already implanted, than in 2019-20. The post-pandemic increase in childhood IND, after the withdrawal of restrictions, both globally and by PCV13 serotypes (specially 3 serotype), will require close monitoring.
Reviewers´ commentary: although the two-dose schedule of 13-valent pneumococcal vaccine does not appear to increase the risk of infection after vaccination in children under one year of age or vaccination failures in children over one year of age, there are still some doubts about the influence of this schedule change on the incidence of invasive pneumococcal disease that will be appropriate to confirm or rule out in new studies.
Authors´ conclusions: dual may be superior to single therapy for treating fever in children and getting children afebrile at 4 and 6 hours. High dose ibuprofen was somewhat superior to acetaminophen at 4 hours, but not at 6 hours.
Reviewers´ commentary: alternating, and especially combined treatment, can produce the impression that fever suppression is of critical relevance, when the objective should be treating discomfort. It could also be a source of incorrect dosing. For these reasons, combined or alternating antipyretic treatment, though probably more effective, it proves unnecessary for failing to demonstrate their clinical utility.
Esparza Olcina MJ, Pérez Solís D. Evid Pediatr. 2025;21:8
Critically appraised articles
