Pediatric Patients Are Not Miniature Adults, Handle With Care

Despite what medieval paintings might suggest, children are not homunculi—Latin for "little men". From the first wail of infancy to the hormonal chaos of adolescence, the human body undergoes a remarkable transformation. Each stage of growth brings its own medical complexities, vulnerabilities, and quirks. Poorly managed illnesses during these developmental years don’t just affect the immediate present, they can cast long shadows over a person’s life.

Some good-looking abs. Source

This fragility places added pressure on healthcare professionals tasked with delivering pediatric care, accompanied by a unique set of human factors challenges that extend well beyond clinical expertise. As hinted at by the cheerful murals and cartoon-covered walls of most pediatric clinics, treating children requires not just medical precision, but also psychological finesse and at times a touch of theatrical performance. Healthcare professionals must juggle patient safety concerns that are already complex, made even more so when young patients are involved.

Weight-based dosage. Medication units in healthcare is a safety minefield, but in pediatrics, this challenge is compounded by the need to factor in a child’s weight, age, and developmental stage when calculating doses. A miscalculation isn’t just a minor error; in a child’s smaller body, even slight deviations can mean the difference between an ineffective dose and a dangerous overdose. Clinicians must navigate this intricate web of conversions, dilution requirements, and changing weight metrics while still remaining mindful of adult dosage regimens to avoid exceeding maximum limits.

Newborns all look the same, at least to men according to this research. Oftentimes the only way to correctly identify a baby is through its identification tag, and everyone, including the parents, would be none the wiser without it. When this delicate link in the process chain fails, babies can receive the wrong medication, be unintentionally breast-fed by a different mother, or are unknowingly brought home and raised by people who are not their biological parents.

Are you a robot? Select all images of the same baby. Source

Children are not the best communicators. Not all young patients can verify their two patient identifiers, and if they could, they may still lack the vocabulary, awareness, or understanding to articulate their discomfort. Information gathering is brokered through their parents, which can introduce biases, misinterpretations, or exaggerations driven by a natural inclination to protect. Parents themselves might be the source of communication interference. As an example, teenage daughters might not be as forthcoming about their sexual history prior to an x-ray, particularly if their parents are in the room. Healthcare providers must not only decipher the child's limited verbal cues but also navigate the emotional landscape of concerned parents, making high-stakes decisions with sensitivity and precision

Children tend to be uncooperative patients, and parents tend to be passionate patient advocates. Unlike adults, who can (begrudgingly) endure discomfort for the sake of treatment, children react instinctively to medical care with fear, resistance, and sometimes outright defiance. A routine vaccination can turn into a full-blown standoff, a blood draw into a wrestling match. Achieving compliance usually involves distraction, coaxing, and/or strategic bribery. Driven by an innate desire to shield their children from harm, parents scrutinize every decision, question every procedure, and advocate fiercely for what they believe is in their child’s best interest, even if it means rejecting vaccines.

Children do not hesitate to show their unwillingness to comply. Source 

Working in pediatrics thus demands great situational awareness, cognitive agility, emotional labor, refined communication skills, and more. Human factors research regularly addresses these considerations, shedding light on how system design, workflow efficiency, and cognitive load impact task performance in various industries including healthcare. For example, medication strategies grounded in human factors principles include standardizing unit of measure such as metric units (e.g.: patient weight in kilograms rather than pounds), implementing hard stops for impossible pediatric values (e.g.: 500kg, should one too many zeros were entered), and automating value retrieval and computation so as not to reply on human's unstable math skills.

Recognizing the World Health Organization's World Patient Safety Day 2025 focus on "safe care for every newborn and every child", we must harness human factors to advance patient safety. Design information and devise tools to make dosage calculations effortless for everyone. Put in place protocols and best practices for clear, empathetic communication with parents. Share your reasoning, anticipate concerns, and outline your plan to alleviate their sense of uncertainty and win their allegiance. Be attuned to the child’s emotional state and experience. How we engage with them in every fleeting moment shapes their broader perception of care. Create a care system that not only mitigates these elevated patient safety risks in pediatrics, but also recognizes that a child’s anxiety is not just an inconvenience—it is a significant barrier to effective treatment.

A little human factors can go a long way. Source

Incidentally, Greek and Roman art that came after the Middle Ages valued the depiction of idealized, proportionate human figures. Michelangelo's sculpture David is famous for its highly detailed anatomical features that were based on careful observation and study. Leonardo da Vinci's Vitruvian Man depicts a man with his arms and legs extended in two overlapping positions enclosed within a circle and a square, reflecting da Vinci's own perception of a person's ideal proportions. This integration of art and science, with the emphasis on measuring and analyzing humans, underpins the spirit of human factors. Many human factors associations adopt variations of the Vitruvian Man as their logo.

If you're a pediatric healthcare professional, or simply a parent, what challenges come to mind when caring for a sick child?