pediatrician cartoonThe bad news: Influenza has hit the United States. According to the Centers for Disease Control, eight states (Alabama, Alaska, Mississippi, New York, North Carolina, Ohio, Rhode Island, and South Carolina) have reported widespread influenza activity. Unfortunately, experts predict a bad season; flu has already killed five children so far this season.

The good news is that 90 % of the identified flu strains are covered by this year’s flu vaccine.

The great news is that you can help prevent your child and yourself from getting influenza by getting the flu vaccine. Anyone who takes care of your child should receive this year’s flu vaccine as well. Vaccines are more effective when everyone gets them.

If your child is younger than nine years old and received one or no doses of flu vaccine since July 2010 (when the H1N1 outbreak occurred), he will need two doses of this year’s flu vaccine separated by at least one month to be optimally immunized against the flu. Keep in mind as well that it takes about two weeks for the vaccine to be maximally effective after it is given. So vaccinate now!

For more information about the flu and the flu vaccine, please see our prior posts about how vaccines work, how to distinguish flu symptoms from common cold symptoms, and facts vs myths about the flu and the flu vaccine.

Remember also to wash your hands. And cover your cough.

Julie Kardos, MD and Naline Lai, MD
©2012 Two Peds in a Pod®



Two Peds in a Pod® turns three years old! In honor of our third birthday, we bring you our top ten parental experiences through the years list:

  1. “Helping” your child manage his ice-cream cone (especially when he orders the soft chocolate kind with the chocolate sprinkles)
  2. Coaching a sport you have not played in twenty years.
  3. Playing hours of Mario Cart or Just Dance on the Wii (and losing every time)
  4. Building snowmen
  5. Coloring with brand new crayons (and the aroma of opening that new box of Crayolas!)
  6. If you are a mom, discovering your teen daughter is the same shoe size and you can borrow her hip shoes
  7. Experiencing your child’s first bike ride without training wheels
  8. Getting to be the Tooth Fairy (shhh… don’t tell!)
  9. Re-reading your favorite kid books (Dr. Seuss really was a genius)
  10. Realizing your child honestly believes that you have a really good singing voice

We hope to celebrate many more birthdays with you. Please continue to send us your ideas at, comment on our posts and tell your friends about us. 


Julie Kardos, MD and Naline Lai, MD
©2012 Two Peds in a Pod®








As a call to service in honor of Martin Luther King Day, we bring you an eye opening child advocacy post from guest blogger Dr. Heidi Román, who works with underserved children and their families in California .


Early in my pediatric residency training I entered the exam room to see a one-year old patient. Her mom blurted out excitedly, “We finally have a place to live.”  It turned out that they had been living in motels or with relatives for most of the child’s life.  I paused for a moment as I realized that it had never really registered.  She had been seen in our clinic for multiple visits, but no one had noticed the changing addresses.  No one had asked the questions in a way that allowed her to tell us.  They were homeless.  This was my wake up call.  Since then, I have met many families affected by homelessness.  Many hard working families are pushed into poverty and homelessness by loss of a paycheck, foreclosure, or divorce.  They are reluctant to talk about it.  Children and families are the “hidden” homeless.



While the mainstream media consistently covers the recession, quoting jobs numbers and the like, there is a disturbing new set of data out that doesn’t seem to be getting much press.  Last month the The National Center on Family Homelessness released their report on child homelessness entitled America’s Youngest Outcasts 2010“, and the news is not good.  During the time period of the recession (2007-2010) there was a 38% spike in the number of homeless children.  Currently, there are 1.6 million homeless children in the United States.  Children now make up almost 40% of the homeless population and families with children are the most rapidly growing segment of the homeless population.



That’s a lot of kids and families.  And, as children are often not included in homeless statistics, the number is probably higher.  Why don’t we hear about it more?  Well, homeless families tend to be the invisible segment of the homeless population.  They fly under the radar.  They move from place to place.  They “double up” with friends or relatives for a few months, and then stay in a shelter or motel for a while.  They sleep in their car.  Parents may not even report that they are homeless to teachers or health care providers for fear of losing their children.  There are various reasons that families become homeless.  Certainly worsening poverty, due to job loss or changes in welfare programs, is a major cause of housing loss for families.  But, domestic violence or parental separation is also very often to blame.  




Once families become homeless, it is very difficult to escape.  Even if the parents are lucky enough to find a job, it will likely pay only minimum wage.  Adequate housing is still out of reach for these families.  This is true regardless of the state, city, or town the family lives in; and the gap between income and housing costs is even greater in areas with a high cost of living.  With long waits for Section 8 housing and shelter beds, families are left with few options.



Experiencing homelessness profoundly affects a child’s physical, psychological, and educational health.  Homeless children have higher incidence of trauma-related injuries, poorly controlled asthma, developmental delays, growth problems, and anemia, among other health problems.  Homeless children are far less likely to have a medical home or adequate health insurance.  They are far more likely to utilize the ER for care at a later stage of illness.  Homeless adolescents have much higher risk of being victims of violence or sexual abuse and have higher rates of substance use, HIV, and teen pregnancy.



Homeless children, regardless of cognitive ability, do far worse in school.  They are more likely to change schools during the year or miss more school days, greatly affecting their ability to do well academically and flourish socially.  Even simple things, like being asked by a teacher to draw their room or describe their house, become awkward and painful.



What’s being done about this?  Sadly, not much.  Per the State Report Card on Child Homelessness, only seven states have extensive plans relating to services for homeless families.  In the current economic and political climate, the number of homeless children and families continues to increase and the services provided to them are shrinking. 



What can we do?




  • If you or someone you know is at risk of homelessness:
    • Talk to someone you trust- a physician, teacher, church staff, or social worker.  Learn about emergency assistance programs in your area. 
    • If you will be homeless in a few days or weeks, The National Coalition for the Homeless has a list of things to do.  It includes making sure you have a current and available ID, packing a bag of essentials for each family member, and applying for public and transitional housing.  Search the Coalition’s directory of homeless advocacy organizations and shelters.




  • If you are a person who cares about these kids and families:
    • Learn about the “hidden homeless” and start talking to friends and colleagues.  Work to change misperceptions about homelessness.   Find out how your state is doing in terms of providing services to homeless families.
    • Consider volunteering with or donating to an organization that fights to end homelessness.  National organizations include The National Coalition for the Homeless, The National Law Center on Homelessness and Poverty, and The National Center on Family Homelessness.  Find a local organization to work with here or via internet search.
    • The National Coalition for the Homeless has a great list of other creative ways to get involved.
    • Finally, contact your congressperson and tell them you support H.R. 32 The Homeless Children and Youth Act of 2011.  This bi-partisan bill changes the definition of “homeless person” to include certain adolescents and youth that are currently excluded for technical reasons.  Their inclusion would allow them to access much needed services.  If I can’t convince you, perhaps these kids can.  They testified about their experience being homeless at the H.R. 32 hearing on child and youth homelessness, held by the U.S. House of Representatives’ Financial Services Subcommittee on Insurance, Housing, and Community Opportunity last December.


Heidi Román, MD


Heidi Román MD, FAAP is a mother and pediatrician who practices in San Jose, California.  She has special interest and experience working with under-served families from diverse racial and socio-economic backgrounds.   Dr. Román is a passionate child health advocate who works towards improved health for all kids, both in and out of the clinic.  She writes about everything from parenting to policy at

©2012 Two Peds in a Pod®




We give thanks for the opportunity to parent our children always. With the many challenges of raising children, this Thanksgiving we give thanks for things that save our sanity. We heave a huge sigh of relief for:

the neighbor who will meet your child at the bus stop when you are running late
double strollers
ability to Skype with your teen the first time he is way from home

those folding sports chairs you lug along to all of your children’s sports games

training wheels



Band aids—a sure cure-all

a same day laundry machine repair person


Happy Thanksgiving from your two Peds,

Naline Lai, MD and Julie Kardos, MD


©2011 Two Peds in a Pod®


Special thanks to Lu Lu of YQY Jewelry for surprising us with a two peds in a pod necklace. Lu Lu, who custom handcrafts jewelry and is known for her distinctive woven silver basket designs modified her three peas in a pod necklace into two peds! 

Naline Lai, MD and Julie Kardos, MD 
©2011 Two Peds in a Pod®

All about Two

Happy Birthday to us: Two Peds in a Pod is two years old today. In honor of this momentous day, we share some of the ups and downs of two-year-olds. 

Upside: They can communicate in two word sentences (“more milk!”).
Downside: They can communicate in two word sentences (“no nap!”).

: They start to play “dress up.”
Downside: They nearly strangle themselves with princess necklaces and super hero capes.

Upside: They have long afternoon naps.
Downside: They start to outgrow long afternoon naps.

Upside: Endearing altered sense of reality
Downside: They have no common sense—they would walk off a cliff.

Upside: They love water play.
Downside: They demand “let go!” in a swimming pool.

Upside: They start to show interest in potty training.
Downside: They still occasionally poop in the bathtub.

Upside: They love to give gooey sticky kisses.
Downside: They love to give gooey sticky kisses to runny nosed-friends, the dog, the pet turtle, and the stuffed animal that accidentally spent the night in the backyard.

Upside: They love to explore and use their hands to finger paint and squish play-dough.
Downside: They will find and poke at every piece of already-chewed gum that they find on the sidewalk.

Upside: They are the perfect size to fit in your lap.
Downside: They are the perfect height for cutting their eyebrow on the corner of the kitchen counter as they run by.

Upside: Their determination.
Downside: How long their tantrums can last.

Upside: All the educating we’ve been able to do over the past two years through Two Peds in a Pod. All of our readers’ comments and suggestions. And there’s so much more to write about.
Downside: None!

We are thrilled to have more-than-doubled our daily hits, our email subscribers, and our Facebook friends this past year. We’re now the second entry when you Google the words “Pediatrician Blog.” Please keep the momentum going, continue the dialogue, tell other parents about us and send ideas for blog posts at

Enjoy a birthday cupcake on us.

Julie Kardos, MD and Naline Lai, MD

©2011 Two Peds in a Pod®


In honor of Father’s Day, Two Peds in a Pod sends out a salute to dads.

We salute the dads sent to the grocery store at midnight after the little kids are in bed.

We salute the dads who show up in our offices first thing Saturday morning with a feverish child while birthday party/holiday dinner/ grandparent anniversary celebration preparations go on at home.

We salute the dads who run the weekend errands while their partners go for a long run.

We salute the dads who, when called, immediately drive the teens home from a party- no questions asked.

We salute the dads who make the elaborate chocolate chip pancake and waffle extravaganzas after a sleep over party.

We salute the dads who don’t pay to “opt out” of volunteer duties on a sports team and grab their wheel barrows to prepare muddy fields for play.

We salute the dads who help build the larger-than-life school project and then drive it to school in the pouring rain.

We salute the dads who carry their kids (no matter how old) when they are too tired to walk.

Happy Father’s Day!

Naline Lai, MD and Julie Kardos, MD
©2011 Two Peds in a Pod®


We’re thrilled to announce the showing of our fabulous photographer Lexi Logan’s work at the Art Barn in Buckingham Pennsylvania. The  Art Barn where she collaborates with several other artists, including her renowned sculptor husband Andrew Logan, will be opening to the public for the first time this weekend. Here is the clipping from the May 26 Bucks County Herald: