Paediatrics — Updates Since 2020
Guideline & practice changes since 2020
-
ADHD prescribing is moving into general practice (AJGP ADHD issue, Sep 2026). State rules on GP stimulant prescribing changed through 2025-26: NSW continuation prescribers since Sep 2025, Queensland GPs need no approval within dose caps since Dec 2025, SA and Tasmania allow trained GPs to diagnose and initiate, Victoria began GP training in June 2026. The page now also covers adult non-stimulant dosing, switching stimulants, PBS retrospective-diagnosis rules for adults, telehealth and parental-consent issues. Doses are from the AJGP/AADPA articles and not yet checked against eTG. See ADHD.
-
Bronchiolitis rewritten against the Australasian Bronchiolitis Guideline 2025 Update — age-stratified oxygen saturation thresholds, and HFNC is no longer first-line for moderate disease. See Bronchiolitis.
-
Croup: budesonide adds nothing over oral dexamethasone alone; low-dose 0.15mg/kg dexamethasone is as effective as higher doses. See Croup.
-
Tic disorders: treatment does exist — HRT/ERP/CBIT behavioural therapies and clonidine/guanfacine/antipsychotic medication are all established options. See Tic Disorders.
-
SIDS advice updated per Red Nose’s current room-sharing/bed-sharing/vaping guidance. See Sudden Infant Death Syndrome.
-
Plagiocephaly: AJGP comparison table for distinguishing plagiocephaly from craniosynostosis. See Plagiocephaly.
-
Pre-auricular sinus: full BORS diagnostic criteria. See Pre-Auricular Sinus.
-
Autism spectrum disorder prevalence updated per 2022 AIHW data; ADHD medication guidance updated per the AADPA 2022 guideline, and rewritten broader to cover targeted screening (out-of-home care, ODD/conduct disorder, anxiety, epilepsy, substance use, other neurodevelopmental disorders, family history) rather than universal population screening, plus the under-recognition of ADHD in girls, who are less likely to be referred and more likely to be misdiagnosed with anxiety or depression. See Autism Spectrum Disorder and ADHD.
-
Febrile seizures now formally categorised as simple, complex, “afebrile febrile” (occurring during an acute infectious illness without a measured fever), and prolonged (>30 min, i.e. febrile status epilepticus — uncommon, worse outcomes, may signal a genetic epilepsy syndrome). See Febrile Seizures.
-
Febrile child assessment rewritten age-banded: febrile neonates ≤28 days need LP and IV antibiotics regardless of how well they look; infants 28 days–3 months need risk-stratified investigation; and infants <3 months with serious bacterial infection can present with hypothermia and temperature instability instead of fever, or no fever at all. See Febrile Child.
-
Paediatric coeliac disease: only around 20% of Australians with coeliac disease are ever diagnosed, and up to half have no symptoms — a low threshold to test is now recommended rather than waiting for classical malabsorption. The no-biopsy paediatric diagnostic criteria were also updated (recency-wins conflict resolution against an older source). See Coeliac Disease (Paediatric).
-
Failure to thrive now also uses z-score-based severity grading (mild/moderate/severe malnutrition = −1 to −1.9 / −2 to −2.9 / below −3 SD from mean weight-for-length) alongside the older percentile-based definition, better for trending children whose weight sits well off the growth curve. See Failure to Thrive (Poor Growth).
-
Head lice diagnosis requires observing a moving louse or a viable egg — nits (empty casings) alone don’t confirm active infestation, since they can stay glued to the hair for months after successful treatment. See Head Lice, Pubic Lice & Body Lice.
-
Strabismus: no national Australian screening programme exists, so detection relies on opportunistic pick-up. Two look-alikes are now explicitly distinguished before referral — ocular instability of infancy (normal, unsteady alignment up to 3 months) and pseudostrabismus (facial architecture mimicking an eye turn on light-reflex testing with a normal cover test). See Strabismus.
-
A well-looking baby with bilious vomiting can still have malrotation — babies with malrotation can look surprisingly well, so bilious vomiting still needs urgent work-up regardless of clinical appearance. See Paediatric Surgical Conditions.