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The United States has the highest rate of maternal deaths among high-income nations and women of color, are disproportionately affected. For Black women in this country, the rate jumps from 22 deaths with every 100,000 births to 50 deaths for every 100,000 births. When it comes to postpartum depression, these same women are several times more likely to suffer, but less likely to receive treatment.
To understand these disparities and discuss ways to combat them, we are joined by three experts. Shaleah Dardar, MD, and Brigitte McClellan, PsyD, specialize in child and adolescent psychiatry at Children’s Hospital Colorado and are both assistant professors at the University of Colorado School of Medicine. Whitney Dunlap is a lactation consultant and health educator.
Some highlights from this episode include:
Barriers and biases that put Black mothers and their babies at a disadvantage How primary care providers can create a safe space for parents to be vulnerable The overlap of adult care and newborn care during post-partumFor more information on Children’s Colorado, visit: childrenscolorado.org.
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Pediatric providers around the world are focused on helping sick children — finding cures, creating new treatment options and developing innovative techniques to improve care. But when it comes to conflict zones and border areas, there are fewer doctors available to protect the health of vulnerable children. Paul Wise, MD, MPH, is a physician who has dedicated his career to taking on that complex and sometimes daunting problem, working to improve and reform systems so that no child suffers needlessly.
Dr. Wise has served as the Juvenile Care Monitor for the U.S. Federal Court, overseeing the treatment of migrant children in the United States detention system. He’s also served as the senior advisor to St. Jude Global’s SAFER Ukraine collaborative since 2022, and he’s supported international work in Gaza, Central America and Venezuela. As a professor and fellow of multiple disciplines at Stanford University, he is dedicated to bridging the fields of child health equity, public policy and international security studies. He is also Co-Director for the Stanford Center for Prematurity Research. He has served in a variety of professional and consultative roles, including special assistant to the U.S. Surgeon General.
Some highlights from this episode include:
A discussion of Dr. Wise’s experiences at the southern border and how they shaped his care recommendations for migrant children. A global understanding of what children face in unstable environments like border areas and war zones. A close look at what changes have already been implemented at local, national and international levels to better protect vulnerable children. Suggestions on the role primary care providers can play in making conflict zones around the world safer for children in need.For more information on Children’s Colorado, visit: childrenscolorado.org.
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2024 marks 100 years since the Geneva Declaration of the Rights of the Child. In the aftermath of World War I, this declaration called for universal attention to the needs of children, including their health. A century later, we’ve made progress, but children still face vast challenges here in the United States and around the world. How can we advance the global cause of children’s health? In this episode we talk to one of the world’s foremost ambassadors for this work about the struggles and opportunities facing children’s healthcare.
Professor Ann Skelton is a renowned children’s rights expert and Chair of the UN Committee on the Rights of the Child. She is a professor of law at the University of Pretoria and Leiden University, as well as a visiting professor at the University of Oxford and the University of Strathclyde.
Some highlights from this episode include:
A look into Ann Skelton’s work The current state of children’s rights in the U.S. and around the world The challenges facing children’s healthcare and how health advocacy can help change that Tangible opportunities to engage in to ensure all children have access to the healthcare they needFor more information on Children’s Colorado, visit: childrenscolorado.org.
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Bringing a baby into this world is the start of many significant changes, yet one change that some families may not anticipate is post-partum depression (PPD). This condition affects more than the parent’s wellbeing, it can impact children and other family members too. About one in five new parents experience mood or anxiety concerns during pregnancy or after delivery, making maternal mental health conditions the most common complication of pregnancy and childbirth. While 80% of them will fully recover, setting them up for success can start in the pediatric primary care setting.
To understand how primary care providers can help support parents with post-partum depression, we are joined by two experts for this episode. Celeste St. John-Larkin, MD, specializes in child and adolescent psychiatry at Children’s Hospital Colorado and is an associate professor of child psychiatry at the University of Colorado School of Medicine. She is also The Anschutz Chair in Perinatal Mental Health. Kelly Glaze, PsyD, is a psychologist at Children’s Colorado and an assistant professor of child psychiatry at the University of Colorado School of Medicine.
Some highlights from this episode include:
How long parents are at risk of PPD after birth The difference between PPD and baby blues How primary care pediatricians can support the adults alongside their kids How to navigate support after giving birthFor more information on Children’s Colorado, visit: childrenscolorado.org.
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From startups to global corporations, CEOs have the power to make immense strides in any respective industry. In pediatric medicine, they drive advancements in child health through high-quality care, coordinated programs, education, research and advocacy. While providers are working directly with patients, these leaders are preparing the infrastructure for success while pushing us to reimagine healthcare. It’s because of them, institutions like Children’s Hospital Colorado and Nationwide Children's remain among the top 10 pediatric hospital systems in the country. In this episode, we go beyond the white coat by sitting down with two of the most influential CEOs in pediatrics.
Jena Hausmann is the President and CEO of Children’s Colorado and Tim Robinson is the CEO of Nationwide Children’s. Under Jena’s leadership, Children’s Colorado has been recognized nationally and internationally for our medical, research and advocacy programs. Jena has been a champion for increasing research and innovation and improving pediatric mental health. Tim’s leadership has helped transform Nationwide Children’s from an important regional children’s medical center into an internationally prominent academic healthcare system. Nationwide has become a model for how a hospital system can improve neighborhoods, increase health care access in rural communities, drive innovation and pioneer economic development.
Some highlights from this episode include:
The career path of working in healthcare to becoming a CEO How pediatric healthcare has evolved and where it’s going The current challenges and threats to the healthcare landscape The importance of children’s hospitals partnering with community providersFor more information on Children’s Colorado, visit: childrenscolorado.org.
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The most common congenital viral infection in children is cytomegalovirus infection (CMV). Oftentimes the mother will experience little to no symptoms, but the virus can significantly affect the newborn, with outcomes ranging from no symptoms to severe systemic and intercranial complications. What if we could prevent this infection all together with a vaccine? A candidate MRNA vaccine against CMV has elicited promising immune responses to date and is on a pathway towards FDA approval.
To learn more about this treatment, we are joined by one of the nation’s leading experts in vaccine development for the prevention of congenital viral disease. Sallie Permar, MD, is the Nancy C. Paduano Professor and Chair of Pediatrics at Weill Cornell Medicine. She serves as pediatrician-in-chief at New York-Presbyterian/Weill Cornell Medical Center. She is also a professor of immunology and microbial pathogenesis at the Weill Graduate School of Medical Sciences.
Some highlights from this episode include:
The scale of impact of congenital CMV in children Understanding how the virus originates with the mother and affects the baby Where the CMV vaccine stands in the vaccine development process Strategies for educating the public and primary care providers on this new treatmentFor more information on Children’s Colorado, visit: childrenscolorado.org.
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As a child, a nosebleed can be painful and embarrassing. Surprisingly, it’s also something primary care providers run into often in their practices. While the great majority of nosebleeds, also called epistaxis, are limited in severity and duration, about 6% of people who experience them will seek medical attention. Interventions range from self-treatment and home remedies to more intensive procedural options and medications. Why are we seeing so many cases of epistaxis in our offices? What is causing the onset of these nosebleeds, and are environmental changes a culprit?
To explore the intricacies of epistaxis, we are joined by Jeremy Prager, MD. Dr. Prager specializes in otolaryngology at Children’s Hospital Colorado and is a Professor of Otolaryngology at the University of Colorado School of Medicine.
Some highlights from this episode include:
How to differentiate between a nosebleed and a more severe epistaxis diagnosis. The importance of partnership between the specialist and the primary care provider to properly care for a nosebleed. The most common causes of a nose bleed in children by age. How to support patients when outpatient management isn’t working.For more information on Children’s Colorado, visit: childrenscolorado.org.
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One of the great medical accomplishments of our time is the evolution of precision medicine. The ability to understand a patient’s unique genetic profile has become more accessible to our patients, and now, there are multiple mechanisms for using that information to overcome disease.
One of the specialties leading the way in precision medicine is pediatric neurology. According to the World Health Organization, more than one in three people are affected by some type of neurological condition. They are a leading cause of ill health and disability worldwide. This subset of precision medicine will not only help us decrease those numbers but also allow us to treat some of these conditions in ways we have never done before.
To detail this exciting work, we’re joined by two experts. Scott Demarest, MD, and Julie Parsons, MD, are both pediatric neurologists at Children’s Hospital Colorado and faculty at the University of Colorado School of Medicine. Dr. Demarest focuses on rare epilepsy conditions, and Dr. Parsons specializes in neuromuscular disease. Dr. Demarest is the Clinical Director of the Precision Medicine Institute at Children’s Colorado.
Some highlights from this episode include:
Understanding precision neurology within the context of precision medicine Why precision neurology positively impacts diagnosis and treatment options How families are more easily accessing important genetic testing The role primary care providers play with caring for these rare diseasesFor more information on Children’s Colorado, visit: childrenscolorado.org.
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Many of us avoid talking about suicide, not only because it’s a difficult conversation, but also because we don’t know how to. And avoiding that conversation can be a barrier to helping those most at risk.
One family from Colorado is at the forefront of changing the stigma and creating opportunities for fearless conversations. They courageously shared their story in a powerful documentary released earlier this year called “My Sister Liv.” In this special episode, we honor Liv Kunik’s life and learn about how her story is spurring hundreds of courageous discussions around suicide.
The guests for this episode are family members at the heart and soul of the documentary, as well as mental health advocates. Honey Beuf is Liv’s mom, and she is the co-founder and Executive Director of The Liv Project. Tess Kunik is Liv’s sister and the co-founder of The Liv Project. Her voice also narrates the film, taking us through Liv’s story. Jessica Hawks, PhD, is the Clinical Director of the Pediatric Mental Health Institute at Children’s Hospital Colorado and a child and adolescent psychologist. She is also an Associate Professor at the University of Colorado School of Medicine.
Some highlights from this episode include:
An overview of how the “My Sister Liv” documentary came together and the impact it’s having in the community Ways for friends, family and providers to have “fearless conversations” A discussion of how providers can best care for suicidal patients and their families, such as asking direct questions A look at advocacy efforts underway and tools created to support courageous conversations A youth suicide prevention resource from the American Academy of Pediatrics and the American Foundation for Suicide Prevention providers can use in their daily practiceVisit The Liv Project website to learn more about their work, how you can access the film and details about the game mentioned in the episode, The Game that Goes There.
For more information on Children’s Colorado, visit: childrenscolorado.org.
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In the state of Colorado, cases of Neonatal Abstinence Syndrome (NAS) and Neonatal Opioid Withdrawal Syndrome (NOWS) increased by 120% from 2011 to 2016. Clinicians provide critical support to improve outcomes for these newborns, and there’s been impressive collaboration among healthcare providers around this issue. Two important examples are the Colorado Hospitals Substance Exposed Newborn Quality Improvement Collaborative, otherwise known as CHoSEN QIC, and Kids in Care Setting Clinic (KICKS). In this episode, we learn about these initiatives and how they benefit hospitals like Children’s Hospital Colorado to provide the best care for our patients.
Joining us for this discussion are two experts. Bird Gilmartin, MD, is the Medical Director for Kids in Care Settings Clinic (KICS) at Children’s Colorado, as well as an associate professor of clinical pediatrics at the University of Colorado School of Medicine. Sunah (Susan) Hwang, MD, specializes in neonatal and perinatal medicine at Children’s Colorado and is an associate professor of pediatric neonatology at the University of Colorado School of Medicine.
This episode looks at:
The epidemic of perinatal opioid use, as well as illicit and legally prescribed substance abuse Suggestions on shifting your perspective as a provider about families with substance use issues The ways these substance abuse programs intertwine with our legal systemSome resources our experts recommend utilizing are the Colorado Perinatal Care Quality Collaborative (CPCQC), Illuminate, and Tough as a Mother.
For more information on Children’s Colorado, visit: childrenscolorado.org.
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Despite the pervasiveness of child trafficking in the United States, many communities aren’t aware of the scope of the issue. Here in Colorado, the University of Colorado’s Kempe Center is recognized as a leader in the fight against child abuse, and they are important voices in the global conversation around identifying and ending child trafficking. By committing to responding, treating and preventing all forms of child abuse and neglect, medical professionals can make a difference in this crucial effort.
To shed light on these realities and provide insight into how we can all play a part, we are joined by Denise Abdoo, PhD, CPNP., who specializes in child abuse neglect at Children’s Hospital Colorado. She is an associate professor of pediatrics at the University of Colorado School of Medicine, as well as a member of the Kempe Center’s facility.
Some highlights from this episode include:
The current state of child trafficking nationally and globally The work the Kempe Center is doing to help combat child abuse The reasons why child trafficking is under reported Ways the medical community can provide both physical and mental health careFor more information on Children’s Colorado, visit: childrenscolorado.org.
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With kids back in school, pediatric viral illnesses are revving their engines. It seems we have returned to normal seasonality for viral disease after the coronavirus pandemic. Top of mind with the arrival of fall is respiratory syncytial virus (RSV). We know how quickly the onset of RSV season can take over our waiting rooms.
Last year, two important developments occurred that could change the course of RSV prevention: the FDA approval of a maternal vaccine and a monoclonal antibody for infants. Far too few mothers and infants benefitted from these treatments during last year’s respiratory season, but now we’ve had a year to prepare to do better.
Joining us to discuss this hot topic are two expert pediatricians. Sean O’Leary, MD, is an Infectious Disease Physician at Children’s Hospital Colorado, a Professor of Pediatrics at the University of Colorado School of Medicine and is the chair of the American Academy of Pediatrics Committee on Infectious Diseases, also known as the Red Book Committee. Matt Dorighi, MD, specializes in pediatrics at Cherry Creek Pediatrics. He is currently chair of the Pediatric Care Network, the largest clinically integrated network for children in the state of Colorado.
Some highlights from this episode include:
Guidelines for Nirsevimab and the maternal vaccine Why availability will not be a barrier this respiratory season How practices can combat vaccine hesitancyFor more information on Children’s Colorado, visit: childrenscolorado.org.
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Children with autism spectrum disorder (ASD) tend to have more medical complications than the average kid. Among the most common challenges are gastrointestinal (GI) disorders like abdominal pain, constipation and diarrhea. Untreated GI distress in kids with ASD has been linked to many other issues, including sleep, behavioral and psychiatric disorders. Many of these same kids also have selective eating, which impacts their intake of necessary nutrients. Due to these many layers of complexity, it can be challenging to know how to help a child with ASD and GI symptoms.
To understand this intricate issue, we are joined by Christine Waasdorp Hurtado, MD, who specializes in gastroenterology at Children’s Hospital Colorado. She is the Southern Colorado Executive Faculty Director of the Department of Pediatrics, as well as a Professor of Pediatrics for the University of Colorado School of Medicine.
Some highlights from this episode include:
The most common GI issues in kids with ASD How primary care providers can best treat these kids How certain treatment outcomes can improve quality of lifeFor more information on Children’s Colorado, visit: childrenscolorado.org.
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Sharing data transparently, whether at a local or a national level, is a foundational contributor to healthcare quality. Atul Gawande wrote about this in his 2004 essay labeled ‘The Bell Curve’. Over the last several decades, we have seen many pediatric specialties organize and collaborate around data collection at a national scale to improve care. We’ve seen firsthand how our hospital’s participation in a national cardiac critical care registry has driven quality improvement, better measurable outcomes and improved cardiac arrest rates for patients. Getting the data collection right is the first challenge. In between that first step and actually seeing improvements is a tremendous amount of work. In this episode, we explore the value of data sharing and transparency to improve outcomes for kids.
Our experts for this episode are Carly Scahill, DO, and Kelly O’Neil. Dr. Scahill specializes in pediatric cardiology as a pediatric cardiac intensivist. She is also the Fellowship Director for pediatric cardiology and the cardiac intensive care unit (CICU), as well as an associate professor of pediatrics at the University of Colorado School of Medicine. Kelly O’Neil is a registered nurse and the Manager of the Heart Institute Data Registries and Outcomes. Before her current role, she was a CICU nurse for over ten years.
Some highlights from this episode include:
The purpose and use of clinical registries How data collection improves measurable outcomes The future of data collection in healthcare How to get more entities involvedFor more information on Children’s Colorado, visit: childrenscolorado.org.
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Over the last few decades, the roles of nurse practitioners (NPs) and physician assistants (PAs), also known as advanced practice providers (APPs), have greatly expanded to touch even more patient-family lives. They are an essential part of the care we provide, and their roles have evolved over time. In this episode, we explore the crucial part they play in our medical system and how that might continue to evolve in the future.
For this episode, we are joined by two University of Colorado leaders who continue to help keep our APP programs among the top ranked in the country. Jonathan Bowser is the Child Health Associate and Physician Assistant Program Director at the University of Colorado School of Medicine. He is also the Associate Dean of Physician Assistant Studies, the Section Head of Pediatrics, and an associate professor. Jill Marks, NP, is the Specialty Director of the Acute Care Pediatric Nurse Practitioner Program at the University of Colorado College of Nursing. She is also an inpatient nurse practitioner for the section of pediatric neurology at the University of Colorado School of Medicine.
Some highlights from this episode include:
Background on the creation of NPs and PAs The ways these roles have changed over time The impact APPs make on patient care The role APPs will play in healthcare in the futureFor more information on Children’s Colorado, visit: childrenscolorado.org.
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Our medical community is committed to providing excellent patient care, and it’s also our duty for that care to extend to our planet. Climate change is an increasingly important global health issue where children are the most vulnerable to adverse health outcomes. One major contributing factor to climate change in medicine is the use of nitrous oxide in spaces like the operating room and outpatient clinics. Efforts are underway in hospitals across the country to decrease our environmental impact, including at Children’s Hospital Colorado.
To explore the exciting new project happening at Children’s Colorado and to discuss the environmental impacts on a global scale, we are joined by two experts. Tom Majcher, DO, is the Chief of Anesthesiology at Children’s Colorado, as well as a professor of pediatrics and clinical practice for anesthesiology at the University of Colorado School of Medicine. Diane Gordon, MD, specializes in anesthesiology at Children’s Colorado and is an associate professor of pediatric anesthesiology at the University of Colorado School of Medicine.
Some highlights from this episode include:
How nitrous oxide is currently used in medical settings The damage it does on the environment What efforts are underway to reduce its impact How to keep the same standard of care with new alternatives The importance of this transition in the operating roomFor more information on Children’s Colorado, visit: childrenscolorado.org.
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Over the last few decades, there have been many incredible medical advances in newborn care. At Children’s Hospital Colorado, we’re launching an exciting new initiative to take another step forward in care for our tiniest patients.
For newborns who need to be hospitalized, getting home as soon as possible is critical for their successful development. A common barrier for discharge that can keep babies in the neonatal intensive care unit (NICU) for additional days or weeks is the need for a nasogastric (NG) tube. Ensuring an infant is receiving proper nutrition is essential to securing a safe discharge. What if we could deliver NG tube feeds at home and provide all the necessary support? That’s the game changing idea we explore in this episode with our neonatology experts.
To dive into this topic, we are joined by three neonatologists practicing at Children’s Colorado. Stephanie Bourque, MD, Kathleen Hannan, MD, and Danielle Smith, MD, tell us about a new at-home NG tube feed program that the team at Children’s Colorado is currently developing. Dr. Smith is the Medical Director of the NICU, Dr. Bourque is the Associate Medical Director of the NICU, and all three of our guests are faculty at the University of Colorado School of Medicine.
Some highlights from this episode include:
What the need has been historically for NG tubes Model for this at-home program What’s required to make this at-home model a reality The role of the primary care provider in this partnership The impact a change like this could have on patient outcomes and family satisfactionFor more information on Children’s Colorado, visit: childrenscolorado.org.
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Join us for another insightful season of Charting Pediatrics! The same hosts you know and love will continue to bring the latest and greatest information about pediatric medicine to your ears. Joined by renowned experts, we will explore prominent topics while being moved by their personal stories. This is a season you won't want to miss!
For more information on Children’s Colorado, visit: childrenscolorado.org.
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We all know what it feels like to have a headache, but each person can experience that intensity for dozens of different reasons. Globally, headache disorders affect approximately 40% of the population, which is about 3.1 billion people. Headaches are also among the three most common neurological conditions for most age groups starting at age 5.
As such a ubiquitous issue, it’s important for providers to understand, diagnose and treat headaches. What are the most common reasons for headaches in children? How should pediatricians know when a headache is more than surface-level discomfort?
To learn about the latest in pediatric headaches, we are joined by two headache experts, Marcy Yonker, MD, and Angelina Koehler, NP. Dr. Yonker is the Director of the Headache Program at Children’s Colorado and the Dale, Cindy and Kristin Francescon Endowed Chair for Headache Treatment with the University of Colorado Department of Pediatrics. Angelina Koehler is a certified pediatric nurse practitioner in the Neuroscience Institute at Children’s Colorado.
Some highlights from this episode include:
What PCPs should take into account about migraines How to approach headache treatment options What to consider with hesitation around certain medications When to look for signs of a more serious illnessFor more information on Children’s Colorado, visit: childrenscolorado.org.
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For almost 50 years, Dr. Fritz Karrer has been wearing a surgeon’s cap, growing as a surgeon alongside the evolution of his specialty. For 40 of those 50 years, he’s been at Children’s Hospital Colorado, making an everlasting impact on kids and their families. On the brink of retirement, we look at his exemplary career and discuss how he’s watched firsthand the progression of pediatric surgery. His half century of perspective makes him the perfect expert to dive into the growth of pediatric surgery.
Dr. Karrer specializes in pediatric surgery and surgical critical care at Children’s Colorado and is a Professor of Pediatric Surgery at the University of Colorado School of Medicine. He’s also a colonel in the U.S. Army Reserve, he was recognized as a top doctor in 2023 by 5280 Magazine and he’s been awarded the James Strain Award and the Military Medical Merit from the U.S. Army.
Some highlights from this episode include:
The incredible journey of Dr. Karrer’s career The ways pediatric surgery has evolved over the last 50 years The influence of technology on pediatric surgery Advice for young doctors wanting to follow a similar pathFor more information on Children’s Colorado, visit: childrenscolorado.org.
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