The Link - September 2025

Hemophilia is a common inherited bleeding disorder caused by the deficiency or absence of clotting factors. Hemophilia can be further broken down into hemophilia A, B and C. Factor VIII deficiency is known as hemophilia A, factor IX deficiency is known as hemophilia B, and factor XI deficiency is known as hemophilia C. Annual incidence of hemophilia A and B in the United States is 1 in 5,000 and 1 in 30,000 male births, respectively.¹ Severe bleeding can be life-threatening, making early recognition and intervention extremely important. Primary care pediatricians are often the first point of contact for these patients and will follow them closely through childhood, serving an essential role in reducing their complications and improving their quality of life.

Parks and gardens do more than beautify neighborhoods—they boost children’s brains, emotions and social skills. Research increasingly shows that green spaces like parks, gardens and tree-lined streets play a crucial role in children’s mental health. These natural settings help reduce stress, improve mood, boost attention, and strengthen social connections. The positive effects often begin early, with children aged 2 to 5 who have access to nearby greenery showing fewer signs of anxiety and depression, making early childhood a key time for these benefits. However, today’s kids spend more time indoors and on screens, limiting outdoor play and increasing risks of both physical and mental health problems. For pediatricians, this growing evidence opens a valuable opportunity to explore children’s exposure to nature during clinical visits, helping to gently support mental and emotional health through preventive care.

After attending this year’s American Academy of Hospice and Palliative Medicine (AAHPM) Annual Assembly, one of my colleagues brought our team back stickers featuring the phrase “It’s Palliative Care, not Palliative Scare.” Many explanations of my job as a palliative care clinician, both to patients and people I encounter outside of work, boil down to this distinction. While most people associate palliative care with advance care planning and end-of-life care, which we do, that is not the entirety of our field. The World Health Organization defines pediatric palliative care as the “active total care of the child’s body, mind and spirit, and also involves giving support to the family. It begins when illness is diagnosed and continues regardless of whether or not a child receives treatment directed at the disease.”¹ I introduce us as a team of doctors and nurses who accompany patients and families on complicated and unexpected medical journeys.

War and conflict impact a staggering number of children. A total of 473 million children, or 1 in 6 globally, reside in a region impacted by conflict. These areas include Afghanistan, Democratic Republic of the Congo, Iraq, Nigeria, Palestinian territories, Sudan, Syria, Ukraine and Yemen, to name a few. Of children around the world who are unvaccinated or undervaccinated, 40% live in countries affected by conflict. In 2024, an estimated 14.3 million children missed all doses of routine vaccines and almost 20 million infants missed at least one dose of diphtheria-tetanus-pertussis containing vaccine globally; 50% of these children live in conflict-impacted regions.