Peninsula Pediatrics

Category: General Pediatrics

Why We Don’t Routinely Test for MTHFR Gene Variants or Heavy Metals

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As parents, it’s natural to want the best for your child’s health. You may have heard about MTHFR gene variants or heavy metal testing and wondered whether your child should be tested. There is a lot of information online and in adult medicine, sometimes parents are tested, and it can be confusing.  As pediatricians, we do not routinely recommend these tests, and here’s why.  

Understanding MTHFR Gene Variants  

MTHFR (methylenetetrahydrofolate reductase) is a gene that helps the body process folate (Vitamin B9), which is essential for cell growth and metabolism. Everyone has two copies of this gene, and variations in the gene are common—about 40% of people have one. A variant may slightly decrease the body’s ability to process folate, but in most cases, the body still processes enough for normal function.  

Most people with an MTHFR variant do not experience any symptoms or health issues, which is why routine testing is not useful. There is no specific treatment for having an MTHFR variant, and knowing your status does not change medical care. The more meaningful test, if someone has concerning symptoms, is a homocysteine level, as MTHFR-related issues only become relevant if homocysteine is elevated. However, this is still very rare in children.  

Should my child be tested for MTHFR Gene Variants?

Based on guidance from the American Academy of Pediatrics (AAP), MTHFR testing is not recommended in children because it does not provide useful or actionable medical information for children. Variations in the MTHFR gene are very common in the general population and, by themselves, do not cause disease. Knowing whether a child has an MTHFR variant does not change medical management, does not predict health problems, and does not guide treatment. Research in pediatrics has shown that MTHFR variants are not a cause of developmental delays, behavioral concerns, anxiety, ADHD, autism, or most other medical symptoms. They also do not reliably predict blood clot risk in children. Because of this, testing can create unnecessary worry without providing any information to help a child. We specifically recommend not testing for MTHFR in children, even when parents have been tested or when there is a family history and instead we focus on symptoms that a child does have and things we can test or do that are helpful and guide us to decisions that can benefit children. Additionally, even when an MTHFR variant is present, children with a normal diet do not need special supplements or treatment beyond standard age-appropriate nutrition.

Should I Give My Child More Folate?  

If your child has no symptoms or folate deficiency, there is no need to supplement with extra folate as a precaution. A well-balanced diet that includes vegetables, fruits, whole grains, lentils, beans, and fortified cereals provides enough folate for healthy development. If your child is ever found to be deficient, your pediatrician will guide you on the right approach.  

Heavy Metals and Children’s Health  

Heavy metal exposure can be concerning, but routine testing for metals like mercury, arsenic, and cadmium is not recommended unless there is a clear risk factor or symptoms. These exposures are rare, and our daily environment contains only trace amounts that the body naturally eliminates.  

To reduce unnecessary exposure, parents can take simple precautions:  

  • Wash fruits and vegetables thoroughly.  
  • Avoid excessive fruit juice consumption, as some juices have been found to contain small amounts of heavy metals.  
  • Provide a variety of foods to prevent overexposure to any single source.  
  • Ensure your drinking water is safe by checking with your local health department.  

 

Heavy Metals in Vaccines  

Some parents worry about heavy metals in vaccines, but routine childhood vaccines do not contain harmful levels of heavy metals. Thimerosal, a mercury-based preservative, was removed from most vaccines in the early 2000s, and the trace amounts used in some multi-dose flu vaccines (our office uses single dose prefilled syringes) have not been shown to cause harm. The benefits of vaccines in preventing serious diseases far outweigh any theoretical risks from minimal exposure.  

Lead Exposure and Testing  

Unlike other heavy metals, lead exposure remains a real concern in certain situations. Children are routinely tested for lead exposure at 1 and 2 years old, or later if they are at risk. Risk factors include:  

  • Living in a home built before 1978 with chipping or peeling paint.  
  • Using imported pots, pans, or toys that may contain lead-based coatings.  
  • Having a caregiver who works in jobs with lead exposure, such as construction or battery manufacturing. 

If you are concerned about lead in your home, talk to your pediatrician about testing and prevention strategies.  

Final Thoughts  

We understand that navigating health information can be overwhelming, and we are here to support you. While MTHFR variants and heavy metals are widely discussed online, routine testing is not needed in most cases. If you ever have concerns about your child’s health, we encourage you to reach out. We are always happy to discuss evidence-based guidance to help your child grow up healthy and strong.

Fevers in Children: What Parents Should Know

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When your child’s head feels warm, or they seem unusually tired or fussy, your first instinct may be to check for a fever, and that would be right! Fevers are a common part of childhood and one of the body’s natural ways of fighting infections. While a fever can feel scary, especially in a young child, it’s usually a symptom rather than an illness itself. Understanding what fevers are, when to treat them, and when to contact your pediatrician can help you care for your child with confidence.

A fever is defined as a temporary increase in body temperature, usually in response to an infection. Normal body temperature varies slightly from person to person, but a temperature of 100.4°F (38°C) or higher generally indicates a fever. Common signs include the body and head feeling warm, flushed cheeks, sweating, shivering, and changes in behavior like irritability or unusual sleepiness. Some children may also experience headaches, body aches, or tummy discomfort.

In infants younger than 3 months, even a slight fever can be more concerning because their immune systems are still developing. For older children, mild to moderate fevers often accompany common infections like colds, the flu, or ear infections. While fevers can make kids uncomfortable, they usually go away as the underlying illness improves. Newborns and young infants require special attention when it comes to fevers. Babies younger than 3 months should be evaluated by a pediatrician immediately if their temperature reaches 100.4°F (38°C) or higher, even if they appear otherwise comfortable. Fevers in very young infants can be a sign of a serious infection and should not be ignored. Between ages 3 months and 3 years, fevers can typically be monitored at home if your child behaves relatively normally, is eating and drinking, and is not unusually irritable or lethargic. However, if your child develops additional concerning symptoms, such as trouble breathing, persistent vomiting, a stiff neck, a rash that doesn’t fade when pressed, unusual drowsiness or if the fever persists for 3 days, please call the doctor right away.

While fevers are uncomfortable, they aren’t inherently dangerous. In fact, they’re part of your child’s immune system, working to fight off infection. Very high fevers are less common in children than many parents expect, and most fevers under 104°F do not need aggressive treatment if your child is otherwise acting reasonably well. Keeping your child comfortable and observing them carefully is typically the first step. Fevers can vary throughout the day and may rise in the late afternoon or evening before settling down overnight. It’s important to use a reliable thermometer and follow instructions carefully for the most accurate reading. Don’t rely on feeling their forehead or other parts of their body alone, as temperatures can be misleading.

If your child is uncomfortable, acetaminophen and ibuprofen are common medications that can be used to reduce fever and relieve pain. Acetaminophen can be given to children 2 months and older when properly dosed by weight and age. Always call your Pediatrician prior to giving Acetaminophen to an infant under 3 years old as infants this young are typically evaluated in office first.  Ibuprofen is generally recommended for children 6 months and older. Always follow the dosing instructions on the label or as provided by your pediatrician, and never give aspirin to children, as it’s associated with Reye syndrome, a rare but serious condition.

Remember that medication is meant to make your child more comfortable, but it does not cure the fever itself. If your child is playing, drinking fluids, and otherwise acting normally, a fever alone does not necessarily need to be treated. Keeping them hydrated and ensuring they get enough rest is often enough.

Fevers are a common part of childhood illness, and while they may cause parents to worry, most are not harmful and can be managed with careful observation and comfort measures. If you have questions about how to take your child’s temperature, when to give medication, or when to call for medical help, please contact our office. 

Update on Hepatitis B Birth-Dose Recommendations

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As your child’s medical home, we want to clearly and calmly address a recent recommendation change discussed by the CDC’s Advisory Committee on Immunization Practices (ACIP) regarding the Hepatitis B vaccine at birth.

First and most importantly:

Nothing has changed in our medical guidance, our vaccine policies, or our recommendation that newborns receive the Hepatitis B vaccine within 24 hours of birth.

The American Academy of Pediatrics (AAP) promptly issued a statement reaffirming its long-standing stance: the birth-dose of Hepatitis B remains critical protection for all newborns. The New York State Department of Health and NYC Department of Health have also reiterated that they continue to strongly recommend Hepatitis B vaccination at birth.

We know that vaccine updates can feel confusing—especially when national organizations use new or unfamiliar language. Our goal is always to provide clarity and reassurance, grounded in science and the well-being of your baby.

At Peninsula Pediatrics:

We follow the evidence.

We support the AAP birth-dose recommendation.

We remain committed to protecting newborns with the earliest and most effective prevention available.

Hepatitis B infection in infancy is serious, and early vaccination provides proven long-term protection when it matters most. This is why national pediatric and public health organizations continue to stand firmly behind the birth dose.

If you are currently expecting, preparing a birth plan, or have questions about timing or safety, please reach out. We are always here for thoughtful, compassionate, and judgment-free conversations.

Thank you for trusting us with your family’s care.

We remain as committed as ever to guidance rooted in science, compassion, and the protection of every child entrusted to us.

Peninsula Pediatrics