The aim of this study was to assess the impact of omega-3 fatty acid supplementation among other nonpharmacological treatments on mental health and quality of life (QOL) of children with behavioral disorders. An observational multicenter study of 6- to 12-year-old children with behavior-related problems was performed in Spain with a three-month follow-up assessment. The Kidscreen-10 and Strengths and Difficulties Questionnaires (SDQ) were used to assess effectiveness of each intervention. Characteristics of study population were compared with those of the general population. Subanalyses of two homogenous subgroups, who received versus did not receive dietary supplementation with omega-3 fatty acids, were performed. The study included 942 children (69.1% male) with a mean (SD) age of 8.5 (1.8) years. Overall, patients’ health status and QOL significantly improved at three months (p < .001). Scores on the SDQ also improved, with significant reductions on all subscales (p < .05). Comparison of SDQ results with the same-age general population showed higher overall scores in the study population (8.5 [5.5] vs. 18.6 [8.1], respectively) and on all the subscales (p < .001 in all cases). The omega-3 fatty acid supplementation subgroup presented greater improvements in each category of SDQ (p < .05), except for the emotion subscale. Omega-3 fatty acid supplementation alone or in combination with other nonpharmacological treatments is effective in improving children’s mental health. Overall, nonpharmacological recommendations currently made by pediatricians seem to be effective in improving the perceived health status and patients’ QOL and in the reduction of health problems, especially hyperactivity/inattention and conduct problems.

Management of cow’s milk protein allergy (CMPA) can vary depending on the experience and area of expertise of the clinician responsible for the patient’s follow-up, which may or may not align with the recently published literature. To analyze the perspectives of Spanish pediatricians on this topic, a survey was conducted. The survey aimed to determine the current opinions and attitudes of 222 primary care and hospital pediatricians toward CMPA prevention and nutritional management. Participating pediatricians completed the questionnaire, providing insights into their daily clinical practices, including access to testing, attitudes with respect to various aspects of CMPA diagnosis, prevention, oral food challenges, and treatment. The findings revealed that pediatricians generally agree on the use of extensively hydrolyzed formulas (eHFs) to prevent CMPA in high-risk atopic children, despite limited evidence supporting the widespread use of this practice. However, consensus was lacking regarding the utility of formulas with prebiotics and probiotics for expediting tolerance development. In most cases, pediatricians preferred eHFs for the nutritional management of CMPA, followed by hydrolyzed rice formulas (HRFs), with amino-acid-based formulas (AAFs) being the third option. Certain issues remained controversial among pediatricians, such as prevention methods, symptom assessment, and the role of probiotics. These variations in management approaches reflect the influence of clinician experience and area of expertise, underscoring the need for standardized guidelines in this field.

A cross-sectional survey study was designed to gather information on the use of dietary supplements by Spanish pediatricians. The study questionnaire was completed by 433 pediatricians (62% men, mean age 52.5 years) throughout the country. They also provided data on 10 of their patients (n = 4304) in which synbiotics, immune stimulants, and omega-3 polyunsaturated fatty acids (PUFAs) had been prescribed. Synbiotics were used by 92% of pediatricians, immune stimulants by 80.4%, and omega-3 PUFAs by 75.1%. Synbiotics were mainly used combined with antibiotics (92.6%) and for gastrointestinal disorders (91.2%), immune stimulants to enhance defenses and cold prevention (87.1%), and omega-3 PUFAs to improve symptoms of attention-deficit hyperactivity disorder (ADHD) (84.8%) and concentration (80.1%). Confidence and previous experience with the product (51.6%), composition and indications of the product (43.1%), and tolerability (39.9%) were main factors involved in decision-making. Children treated with omega-3 supplements were significantly older (mean age 7.6 (3.0) years) than those treated with synbiotics (3.9 (3.9) years) or immune stimulants (3.4 (2.8) years) (P<0.001). Short duration of treatment (3 months) was more frequent in the omega-3 group (79.1%). In the immune stimulants group, 60.4% of patients were treated for a period between 1 and 3 months. Clinical improvement was rated by participants as “a lot” in 39% of cases and as “quite” improvement in 50.6%. The overall level of satisfaction was rated as “very satisfied” by 52.1% of participants and as “quite satisfied” by 40.9%. The results show that the use of dietary supplements to improve different conditions, particularly minor disorders, is a widespread clinical practice among Spanish pediatricians. Administration regimens for the three types of supplements, synbiotics, immune stimulants, and omega-3 PUFAs, were consistent with guideline recommendations.

A multicenter cross-sectional study was conducted among 245 experienced Spanish paediatricians, who completed an online survey based on clinically relevant topics in nutrition during the first two years of life and their recommendations to parents in daily clinical practice. Most participants advise about the choking risk associated with baby-led weaning (BLW) and more than 60% consider that infants can receive an insufficient variety and quantity of nutrients with this practice. The general opinion is that there is a lack of evidence for delaying the introduction of gluten and other allergenic foods in the complementary feeding of healthy infants. Most participants agree/strongly agree that two servings of dairy products are the adequate daily amount in a diversified diet and 93.4% disagree/strongly disagree with the use of vegetal beverages under 1 year of life. There is a general agreement to avoid added salt and sugar before 12 months of life, the consideration that organic foods do not have a better nutritional profile than non-organic ones, and the limitations of vegetarian diets especially for adequate provision of micronutrients. Overall, there is an adequate knowledge of the new trends by paediatricians and younger ones seemed more in favor of them and interested in receiving more information on most topics.

During the last decade, feeding patterns, more specifically those of children, have worsened—affecting dietary habits and Mediterranean diet adherence. Here, we examine the post-pandemic feeding habits of Spanish toddlers. A total of 2465 parents of children aged between 12 and 36 months completed an online 25-item multiple-choice survey asking about dietary habits and Mediterranean diet adherence. Only 34 children (1.38%) had an adequate intake of all of the food groups included in the questionnaire. Adherence worsened as toddlers grew (p < 0.0001). Further, lower compliance was found in children with a higher intake of fast food (p < 0.001), those with siblings (p = 0.0045), and children who were the second or third child (p = 0.0005). The food group with the most commonly reported adequate intake was fish (88% of children), followed by pulses (80%), water (79%), and meat (78%). Cow’s milk was the most commonly consumed dairy product among all age groups analyzed. Half of the children exhibited a low consumption of milk and dairy products. These results showed that a lack of adherence to a balanced diet is common among Spanish toddlers in the post-pandemic period and that greater parent education could improve the nutrition of toddlers.

Background: Health care digitalization and pediatric information and communication technology have facilitated the use of telemedicine and digital communication tools in pediatric practice, improving accessibility and efficiency. Meanwhile, artificial intelligence (AI) is emerging as a promising tool in medicine. However, the rapid adoption of these technologies has raised concerns regarding reliability and ethics. Objective: This study examines the level of digitalization in pediatric consultations and explores the perspectives of health care professionals (HCPs) on digital technologies in patient care, analyzing differences by age group, health care management, and institution type. Methods: An observational, cross-sectional survey was conducted among Spanish HCPs dedicated to pediatric care. Participants completed an 18-question web-based questionnaire evaluating their use of digital communication tools, perceptions of online health information, and opinions on AI in clinical practice. Statistical analyses compared responses across age groups, health care management type, and institution type. Results: A total of 495 pediatric specialists participated (female: 273/495, 58.2%; aged >45 y: 324/495, 69.8%). Most participants worked in urban settings (409/469, 87.2%), in primary care (243/313, 77.6%), and in the public sector (253/464, 54.5%). The telephone remained the most used communication channel (462/481, 96.1%), followed by email (290/481, 60.3%) and WhatsApp (139/481, 28.9%). Private-sector HCPs used digital platforms more frequently than public-sector HCPs, including email (136/206, 66% vs 135/247, 54.7%; P=.02), Instagram (23/206, 11.2% vs 5/247, 2%; P<.001), WhatsApp (105/206, 51% vs 26/247, 10.5%; P<.001), and Facebook (18/206, 8.7% vs 3/247, 1.2%; P<.001). Nearly all respondents (417/437, 95.4%) believed that parents were increasingly seeking health information online, yet a considerable proportion (158/458, 34.5%) reported that parents rarely consulted them about reliable sources. Overall, 85.4% (410/480) agreed that the internet and social media raise many questions among parents, while only 7.5% (35/465) believed that the information found is generally reliable. Nearly half of the participants (232/443, 48.5%) proactively suggested trustworthy digital resources, while 44.1% (211/443) did so only when asked. Younger respondents (P=.002), public-sector HCPs (P=.005), and primary care specialists (P=.004) were significantly more likely to offer this guidance, with scientific society resources being the most frequently recommended (402/430, 93.5%). We found that 78.6% (369/470) of participants were familiar with AI, with private-sector HCPs demonstrating greater knowledge than public-sector HCPs (P=.003). Overall, 59.6% (279/468) agreed that AI could significantly improve medicine, a view more commonly held by private-sector HCPs (P=.005). However, 94.8% (306/323) expressed ethical concerns, and 89.8% (422/470) wished to receive AI-related training. Conclusions: The survey highlights the increasing use of digital communication tools in pediatric practice, with private-sector HCPs leading adoption. While AI is viewed as promising, ethical dilemmas remain, underscoring the need for training. Limited confidence in online health information highlights the importance of strengthening digital literacy among both HCPs and parents to optimize patient care.