Pediatric randomized controlled trials (RCTs) provide key evidence to inform health interventions and improve outcomes for neonates, infants, children and adolescents. The CONSORT-Children and Adolescents Extension (CONSORT-C 2026) contains core items developed alongside the SPIRIT-C 2026 standards for pediatric RCT protocols. An explanation and elaboration document provides examples, explanations and key elements for each reporting item. It helps study authors and users of evidence to include the necessary details in pediatric RCT protocols. It improves reporting transparency, reveals evidence limitations, and increases the overall impact of pediatric RCTs.[1]