The short answer is that the data is wrong in that case.
When Crossref member organizations register DOIs for their content, they submit the metadata assocaited with each item as XML. We make that XML, more-or-less unaltered, available through an older XML-based API. And then we convert the XML to JSON when the records are indexed in the REST API.
Sometimes the XML comes from the registrants with errors, and those errors are passed through to the JSON records as well. We do our best to have good documentation available to our member organizations, and to put checks in place when possible to catch certain kinds of errors at the point of metadata submission, but we can’t catch everything.
In this case, when AAP submitted the metadata for 10.1542/peds.2023-062391 they incorrectly escaped the “<” in that title, and submitted it as
<titles>
<title>Sooner Is Better: Early Human Milk Fortification for Hospitalized Preterm Infants &lt;29 Weeks</title>
</titles>
instead of
<titles>
<title>Sooner Is Better: Early Human Milk Fortification for Hospitalized Preterm Infants <29 Weeks</title>
</titles>
It’s possible that whatever process AAP uses for sending metadata to PubMed made the same error, and PubMed has better systems in place for cleaning it up. Or, it’s possible that AAP didn’t make the same escape/encoding error in the data they sent to PubMed. I’m not sure.
But, for the most part, we’re limited to what the content registrants send us, and that accounts for a lot of the errors and inconsistencies that you might notice in the metadata that’s output downstream.