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new years resolutions

A lot of life’s issues boil down to the essentials…eat, sleep, drink, pee, poop, love and learn… for your child and yourself.  We are here to help you to carry out your parenting New Year’s resolutions in all of these areas.

1- Eat  Resolve to help your picky eater become less picky. Become more patient and creative in helping your children eat new foods.

2- Sleep Resolve to fix your child’s sleep problems. Help create a reasonable bedtime routine for your baby and end night time wakenings, and help your tired teen get better sleep.

3- Drink This year resolve to wean your toddler from the bottle/breast to a cup.

3- Pee Resolve to help your child avoid urine accidents and gain a better understanding of bed-wetting.

4- Poop For parents of newborns: resolve to help your gassy baby. For parents of toddlers: resolve to end the battle of the potty and encourage your child to potty train in a peaceful, non punitive and non-controlling way.  Help solve your child’s tendency to hold onto poop, which leads to constipation.

5- Love and Learn to understand your child’s developmental abilities in order to discipline appropriately and have reasonable expectations. Learn how and when to use “time out.”For your teen, learn how to talk with them. Help your child learn to “go it alone,” and calm test/school work anxiety.

As for us, we resolve to continue to be your source of dependable pediatric advice. We resolve to keep current with pediatric advances, remain honest, and treat your family with respect and care as we help you grow your children into confident, independent adults.

Wishing you health and peace in the New Year,
Drs. Kardos and Lai

©2018 Two Peds in a Pod®

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transition to toddler bed

A family asked, “My toddler figured out how to climb out of the crib! How do I transition him into a bed?”

Some kids never climb out of their cribs, but sometimes families need the crib for a new sibling. If this is the case, consider if you really need the crib right away. Using a bassinet for the new baby allows the big brother/sister to get used to having a baby around. Many older siblings regress after the birth of a sibling and it can be useful to keep the older one in a crib for just a little bit longer, then use the new bed as a reward for “helping” or as a token of increased status.

The scariest part of putting your child into a bed is that your child now has access to his bedroom. So if your child is NOT yet climbing out of the crib, do not rush to transition him out. You first need to childproof the bedroom. Crawl on your hands and knees to see what you can reach. See our post on childproofing. For his safety, gate him into his room or keep the door closed. You may also need to gate the steps or gate a hallway to prevent him from wandering into more dangerous rooms, such as the kitchen, in the middle of the night. We know one family who found their child crawling around on the kitchen counters one morning.  Know that open or closed bedroom doors likely do not impact potential fire safety. It is far more important make sure your smoke detectors work.

If you have no reason to break down the crib and your child goes to sleep easily in it, there is no harm in keeping him in his crib. However, once a child is able to climb out, a child is able to fall out. So….time to get out. For many toddlers, the ability to throw a leg over the side of the crib occurs around two years of age or when the toddler reaches three feet tall. If your child is potty trained at this point, he will have easier access to the bathroom at night if he is in a bed rather than a crib, so that is another reason to move to a bed. On the other hand, many kids who are fully potty trained during the day continue to wet the bed for years, so don’t wait for dry overnight diapers to put your child into a bed. Just protect the bed mattress with a water-proof liner until your child masters night time dryness.

How to start the transition? You can talk up sleeping in a big boy/big girl bed “just like Mommy and Daddy.” Let your toddler pick out sheets or buy him ones you know he will love. For example, choose sheets in a  favorite color, or with favorite characters. Supply a pillow and blanket, but if he is used to a crib without bedding, expect the blanket or pillow to end up off the bed. You might want to continue warm pajamas until a blanket stays on. Sometimes kids want a small “kid’s sized” blanket, but sometimes a larger blanket is more apt to stay on the bed.

While kids are often excited by their new bed, remember that toddlers are creatures of habit. Their excitement might lead them to nap enthusiastically in the bed but then they may want their crib at night. Or they might fight their naps now- remember that many children give up napping between the ages of 2-5 years. If space allows, consider leaving the crib set up for the first week of sleeping in the new bed, then break down the crib once you have several successful naps and overnights in the bed.

Some kids may invite a “friend” or two into his bed: stuffed animals, pacifier, or in the case of one of Dr. Kardos’s kids, a soft Philadelphia Eagles football. Many kids fall asleep with toy cars clutched in their hands. If these friends help your child sleep better, then allow the slumber party.

Falling out of bed is common. For his first week in a bed, Dr Kardos’s first son was always found sleeping peacefully in the middle of his room on the carpet after they tucked him into his bed for the night. You can place a carpet or pillow next to the bed so when the inevitable falling overboard occurs, your child has a softer landing.

You could shorten the distance to the ground by placing a mattress, or a mattress plus the box spring, directly on the floor. Then when your child has gone for a few weeks without falling off the mattress,  “build up the bed” onto the standard bedframe.

Alternatively, your child can sleep in a bed with side rails. Note that portable side rails are made for use only on adult beds,  NOT for toddler beds or bunk beds. Guidelines for preventing injury from side rails are found here. Rails are are designed for children aged two to five years who are capable of getting in and out of an adult bed by themselves. According to safety guidelines published by Consumer Reports in 2010, “Be sure they (the rails) fit tightly with no gaps between the mattress and the rail, so that your child can’t get stuck. Leave at least 9 inches between the bed rail and the footboard and headboard of the bed.” The wall is not a bed rail substitute because a child can get trapped between the wall and the mattress.

Decide if you will teach your child to call out to you or to teach him to come into your bedroom if he needs you in the middle of the night. For everyone’s safety, be sure no clothes or clutter between his bed and yours can cause tripping in the dark. A night light in the bathroom helps as well.

As for the beginning of the night, if your child pops out of bed immediately after tucking him in, it’s not too late to teach him how to self-calm  and fall asleep in his own bed. This teaching might involve repeated walking him back to bed in a caring manner with minimal conversation besides: “I love you, good night.”

Now your child’s bedtime story will really include a bed! (For instance click here)

Julie Kardos, MD and Naline Lai, MD
Ⓒ2017 Two Peds in a PodⓇ

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13-1When I was in first and second grade, I took “special gym.”

I attended a public school in a small New Jersey town. The school building was about 100 years old, and the “special services” that my school offered were speech, reading help, and special gym.

I remember being THRILLED that I was selected to take special gym, because instead of just one day a week of bouncing balls and running races and turning somersaults during the school day, I got to go twice a week. I remember how upbeat and energetic the gym teacher was, and how much fun she made these exercises. I do not recall such words as “physical therapy” or “occupational therapy.” In fact, I did not realize the true point of the extra gym days until many years later, when I was in college and reminiscing about elementary school and caught myself mid-sentence:

“Well, when I was in first grade, I took special gym… hey… WAIT a MINUTE….!”

That’s when I realized that I had been flagged with a coordination challenge. Unbeknownst to me, in school I went to physical therapy weekly.

Now that first-quarter parent teacher conferences are over, you may be surprised that your child has been offered special services by the school. Teachers spend hours a day with our kids and are experts in the age group that they teach. Not all kids are good at learning all subjects and not all are equally sociable or equally physically adept. When teachers ask a parent’s permission to supply extra help, parents should not take this request as an affront or attack on their parenting. Rather, it is an opportunity to help kids  succeed.

I was never suspicious about my inclusion in special gym. No one made fun of me for being in the class, and in fact many were jealous. Kids in early grades may be aware that some of their classmates come and go during the day, but they do not distinguish between kids pulled out for a gifted program from kids pulled out for remedial education. As an adult, I appreciate that my teachers made me feel good about being included in the special gym club.

I have a magnet on my car now that says, simply, “13.1,” which is the number of miles that I ran to complete the Trenton Half-Marathon this past October. Special gym did not hold me back—it propelled me forward. I had no idea that my participation in special gym was emotionally charged for my mom until after I called my dad to tell him my race time (2 hours, 11.5 minutes). Only then did he tell me how crushed my mom had been about my inclusion in special gym. I am grateful that she hid that from me.

My message: Let your kids get extra help in school, allow them to be pulled out of a class they are failing and placed into an environment where they can learn and overcome challenges. Allow yourself to mourn the loss of the child you may have pictured. But know this: young children do not have enough life experience to independently think of themselves as failures in the early school years. They look to adults who are important to them for how to respond to challenges and frustration. Encourage them with the positive message that they will receive extra attention and extra time to work at reading or math or physical skills or speech skills. Who knows? They may become the kid who applies to medical school or runs a marathon (or a half-marathon) someday.

Julie Kardos, MD

©2016 Two Peds in a Pod®

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teddy-bear-potty-trainingA shout out to Trinity Day School in Solebury, PA where we spoke with a group of parents yesterday about the pearls and pitfalls of potty training. Today we share some of what we discussed.

At Trinity day School

At Trinity day School

“Will it ever end?” many parents ask. Time moves in slow motion for parents teaching their kids to use the potty. For those trapped in a potty training time warp, take heart. It’s been seven years since we first released out podcast on potty training and we’re proud to report that the  parents who first listened to that podcast have moved onto new parenting challenges like helping with homework. For those in the midst of training, and those who are contemplating training, this post is for you.

Children master potty training typically between the ages of two and four years. Be patient, not everyone is “typical.”  More important than your child’s age is whether she shows she is developmentally ready to train. These signs include:

– is generally agreeable/ can follow directions.

– gets a funny expression before passing urine or poop, or runs and hides, then produces a wet or soiled diaper.

-asks to be changed/ pulls on her diaper when it becomes wet or soiled- remains dry during the day time for at least two hours (look for a dry diaper after nap time.)

-NOT because grandparents are pressuring you to start training their grandchild.

– NOT if the child is  constipated—the last thing you want to do is to teach withholding to a kid who already withholds.

-NOT if a newborn sibling has just joined the family. A new baby in the house is often a time of REGRESSION, not progression. However, if your toddler  begs to use the potty at this time, then by all means, allow him to try. 

Make the potty a friendly place. Have a supply of books to occupy your child while she sits. Make sure her feet are secure on the floor if using a potty chair or on a stool if using the actual toilet. If using the real toilet for training, consider placing a potty training rim on the toilet seat to prevent your child from jack-knifing into the toilet. If your child is afraid of the bathroom, put the potty chair in the hall just OUTSIDE of the bathroom.

Have reasonable expectations based on age. A two year old’s attention span is two minutes. Never force your child to sit on the potty. If he doesn’t want to sit, then he isn’t ready to train.

Your can lead a horse to water… Reward your child for sitting on the potty, even if she does not “produce.” Reward by giving a high-five, verbal praise, or a small, cheap trinket such as a sticker. Do NOT promise your child a trip to Disney for potty training—otherwise, what will you do when she learns to ride a bike or tie her shoes? Plus, unless you are prepared to leave right away, the toddler/preschooler does not developmentally understand the concept of long term reward. Accept that she may simply enjoy sitting fully clothing on the potty while singing at the top of her lungs for a few weeks.

Let your child learn by imitation  At home, have an open door bathroom policy so she can imitate you and her older siblings. At school, she will imitate her potty-trained classmates.

Initially, kids rarely tell their parents  they “have to use the potty.” For these kids, schedule potty visits every 2-3 hours throughout the day. Do potty checks at key times such as first waking up, right before nap, and before bedtime. Be sure to spend extra time a half an hour after meals or after a warm bath. Both meals and warmth stimulate poop!

A child is potty trained when she can do the whole deal: use the potty, help wipe, help un-dress and re-dress, and wash hands.

If the child refuses to wash hands after using the potty, she is not trained. Ultimately, the goal is for her to gain independent  toileting skills.  However, she will need your supervision for a while.

Important note for parents of BOYS: First potty train your son to sit for ALL business. Teach him to gently press his penis downward so pee lands in the toilet and not all over the room. Once your son stands up to urinate, he may become so excited that he may never sit down again. Better to wait until he uses the potty consistently with few accidents before teaching him to stand up. Even after he begins to stands to pee, have him sit on the potty daily to allow him time to poop.

Don‘t be surprised if your child trains for pee before poop. In fact, many kids go through a phase when they ask for a diaper to poop in. After all, it’s frightening to see/feel a chunk of your body fall into an abyss.  Dump the poop from the diaper into the potty and practice waving bye-bye.

A note about night time and naps: Potty train for when your child is awake. Your child will spontaneously, without any training, stay dry at night and during naps. Some kids sleep more soundly than others and some kids are not genetically programmed to stay dry overnight until they are elementary school aged. For more information about bed-wetting please see our post on this topic.  No amount of daytime training will affect what happens during sleep. Moderate fluids right before bed and  continue putting on the diapers at night until you notice that the diapers are dry when your child wakes up. After a week of dry mornings, try your child in underwear overnight. Occasional accidents are normal for years after potty training, so you might want to put a water proof liner under your child’s sheets when first graduating to sleep underwear.

Disposable training pants: We like sticking to underwear while potty trainers are awake and diapers while asleep.  A reluctant trainer tends to find training pants just absorbent enough that he does not care if he is wet. However, the pants are not absorbent enough to prevent rashes from stool or urine. Plus they are more expensive than underwear AND diapers. Explain to your child  “sleep diapers” are perfectly acceptable until their “pee pee learns to wake them up.” Use the training pants when your child is older and is  mortified by the idea of a diaper or if your family is going on a long car ride and you don’t want to risk urine on a car seat.

Above all: avoid power struggles. If potty training causes tears, tantrums, or confusion then STOP TRAINING, put those diapers back on, and try again a few weeks later. 

After the training, keep an eye on how often he pees and poops. Older kids get “too busy” to go to the potty. Make sure he is in the habit of  emptying his bladder four to six times a day and having a soft bowel movement every day or every other day.

Ultimately… you just have to go with the flow. And remember, everything eventually comes out right in the end.

Julie Kardos, MD and Naline Lai, MD
©2016, 2013 Two Peds in a Pod®

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recognizing obesity

In these posters put out by the Pennsylvania medical society, the children on the right are considered obese.

 

Nearly all parents of overweight preschoolers and most parents of obese kids are unaware their children are classified as such , say researchers at New York University and two other medical centers. Click here for  Happy Healthy Kids‘ interview with Dr. Kardos on the subject.

Julie Kardos, MD with Naline Lai, MD
©2015 Two Peds in a Pod®

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how to read nutrition labels

Today, we welcome Health Coach Mary McDonald’s insight on how to read food labels for nutritional content…

Have you ever stood in the cereal aisle staring at the rows and rows of choices and feeling like a deer in headlights? You know that you want to select a cereal that is healthy for your family, but you are not sure which one to choose. So, you start reading the nutrition claims on the front of the box. “Multi-grain. Low fat. Good source of vitamins and minerals. No high fructose corn syrup.” You select a cereal that you think is a good option, only to find out later that the first two ingredients are sugar and grains that are void of nutrition. Navigating the nutrition information highway can be extremely complex, even for an educated person.

One of the reasons for the confusion is the mass influx of marketing from major food manufacturers. According to the Federal Trade Commission, the 44 major food and beverage marketers spent $2.1 billion marketing food to youth in 2006. A second report in 2012 compared data from 2006 to 2009 and found that total spending on food marketing to youth dropped 19.5% to $1.79 billion. But, spending on new media, such as online and viral marketing, increased 50%. The report found that the overall picture of how marketers reach children did not change significantly.

With the major food manufacturers sending constant messaging about the health benefits of their products, a consumer can get very confused about what is healthy to eat. Couple this with the fact that most formal nutrition education ends when a person graduates from high school. Therefore, the major food manufacturer, whose purpose is to sell food, has become the nutrition education for our society. This creates a perfect storm and makes it really difficult to know what is healthy to purchase and consume. So, how we fix this problem? Here are a few quick tips that can help you navigate the nutrition hype:

  1. Don’t look at the front of the packaging to determine if a product is nutritionally sound. Remember, the claims on the packaging are designed to sell more products. In our fast-paced society, it’s easy to fall into this trap, but ignore the marketing because there is more reliable information in the ingredient list. Which brings me to my next point.
  2. Read the ingredient list. You may be surprised if you open your pantry and start to read the labels on the food sitting on your shelves. Many products contain ingredients that are difficult to pronounce, let alone know what they are. What is more concerning is the fact that some ingredients are deceptive in the way that they are represented. For example, enriched wheat flour sounds like a nutritious ingredient, but in reality it is a refined grain that is very similar to white flour. Enriched wheat flour is milled to strip the bran and germ and then some vitamins and minerals are added back in. When reading your labels, don’t be fooled into thinking that you are eating something packed with nutrition when you see enriched wheat flour. If you are looking for a nutritious grain, then look for labels that say whole-wheat flour, and make sure that it is one of the first ingredients on the label.
  3. Five is the magic number. Michael Pollan, the author of Omnivore’s Dilemma, suggests that you should not eat anything with more than five ingredients, or with ingredients you don’t recognize or can’t pronounce. In my opinion, this is singularly one of the best pieces of advice. When you use this rule of thumb, it will naturally lead you towards healthier foods with less additives and preservatives. For example, compare labels on snack bars. According to Eat This Not That, the “coating” on Special K Double Chocolate Protein Meal Bar is made with trans fats, soy, and sugar with a little cocoa processed with alkali, artificial flavor, polysorbate 60 and other artificial ingredients. And that’s just the outside! Then there are the “Chocolatey Chips,” which is market slang for “not real chocolate.” Instead they are just more sugar, soy, trans fats, and artificial flavors mixed with a little cocoa that’s been “alkalized,” a type of processing that destroys up to 75 percent of the healthy nutrients in the chocolate. Compare that snack bar to Clif Kit’s Organic Peanut Butter bar that has only four (yes, 4) ingredients: Organic Dates, Organic Peanuts, Organic Almonds, Sea Salt. I recognize all of those ingredients!
  4. Positive nutrition messaging. One of the best ways to achieve success in any goal is to surround yourself with positive messaging. I have connected with a variety of websites that provide great nutrition education. Eatright.org, a division of the Academy of Nutrition and Dietetics, and Nutritionaction.com, a division of Center for Science in the Public Interest, are two credible sources. Search for a site that fits your needs and sign up for free newsletters. The information will come to you and you can choose when and what to read. It’s that simple.
  5. Cook more at home. Yes, cooking at home can be one of the most effective ways to navigate the nutrition information highway. I realize that this is not always easy considering work, school, and sports schedules. But, it is important to make time for the things that matter most. What can be more important than the health of you and your family?Just like a major roadway, navigating the nutrition highway is complex. Fortunately, we live in a time when there are a variety of ways to receive information.

Mary McDonald, MA

©2015 Two Peds in a Pod®

Mary McDonald has a Masters of Education from Arcadia University and completed her health coach certification from Institute of Integrative Nutrition. She is a high school teacher, a mom of four daughters, and an advocate for healthy food choices. For more information on her health coaching services, please contact her at nutrition101withmary@gmail.com or visit her website at nutrition101withmary.com.

If you live in Bucks County, PA, the Doylestown Food Co-op will be hosting a screening of the documentary, Fed Up, hosted by Katie Couric. This is an eye-opening account of how we view the food that we consume. The screening takes place Thursday 3/26/15 at 7 pm at the County Theatre in Doylestown, PA.

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picky eater vegetables

Crunching on kale

Resolved to eat more vegetables this year? Our pediatrician gardener Dr. Marion Mass shares with us the benefits of kale and how to prepare it so your kids will eat it.

Open one of those ubiquitous “Ten Superfoods” articles and kale is sure to be somewhere on the list. Are there really nutritional benefits to stuffing this leafy green into our pie holes? And can I easily grow kale myself? The answers are ‘yes’ and ‘yes,’ both emphatic!

Just one cup of cooked kale provides 100% of the US RDA of vitamin K, 70% of vitamin C, 10% of Vitamin B6, fiber, and calcium, and 7% of iron. Not much iron, you say? Au contraire, dear parent. The absorption of iron is enhanced by vitamin C, so that 7% is much more available to your child’s body. This information is especially pertinent for female teens, whose iron and calcium intake are likely to be deficient.

In addition, kale houses 45 different flavonoids, which are molecules with antioxidant and anti-inflammatory properties. One of these, a carotenoid, is selectively absorbed into the retina of the eye and protects against age-related macular problems. If that’s not enough, kale (especially when steamed) has been proven to reduce the risk of five cancers: breast, colon, ovarian, prostate and bladder.

While beloved broccoli boasts many of the same nutritional benefits, kale wins the flavonoid content by a mile. Do not misunderstand… there is virtue in all veggies. I do not advocate eating kale nightly, just making it a regular part of you and your child’s diet.

Now what if I told you that even in my home state, frosty Pennsylvania, we are still picking kale from our garden and will be for another month? Kale, especially The Red Russian variety, and the Tuscan, (also called lacinto or dinosaur kale) is one of the most winter-hardy vegetables in existence. We plant a fall crop in mid August located where we have just dug up our potatoes. (Come to think of it, I should plant a spring crop in early April as well.) We start picking the outer leaves in October. The plant keeps producing new leaves from the center. Frost comes and sweetens the flavor. Snow comes, and Kale still grows! Throw a row cover over the top, and you get an additional 4-6 weeks of harvest after the really cold weather sets in.

While easy to plant, Kale has its enemies. Aphids love it, and cabbage worms take a bite. Both can be combated by the release of beneficial insects: ladybugs, lacewings and praying mantises. Thanks to my friends at Gardeners Supply Company for carrying all three insects.

How to get your kid to eat Kale? Ah, there’s the rub. Start with that dinosaur variety. Age 3-6 is what I call ‘the modern age of dinosaurs.’ Use your child’s love of the extinct beasts to your advantage! Dinosaur kale not only looks like a plant that would live in ancient times, but the deep ribbing looks like the skin of an ankylosaurous. Tell the little darlings they will be as tough as T-Rex if they eat it. Does little Emily like salad? Why not make it with kale added in, or even as the main ingredient? Remember the anti-inflammatory proprieties of the flavonoids mentioned above? Sick that fact on your aching adolescent athlete. After suffering two different inflammation-related problems this past cross-country season, my son practically inhales the stuff.

Look at the recipes below. You might want to work up to the kale salad with beets, pepitas and golden raisins. Or just take it to a grown up potluck. Judging from the reactions from the two places I’ve taken it, it may be the best thing I’ve created in my kitchen.

For all recipes, de-stem the kale by holding the stem at its base, use your thumb and index finger to peel the dark green part away from the stem. Always thoroughly wash and salad spin dry kale before use in the following recipes.

Kale Caesar or Kale Vinagrette

1 bunch kale stemmed and torn into salad sized pieces
1 bottle Caesar dressing
juice of ½ orange or 1 lemon
croutons
parmesan

Prep as you would a regular salad. The citrus juice cuts the bitter taste of the kale. Don’t like Caesar? Dress your kale with a sweetly flavored balsamic (fig, orange or cherry is nice), lemon juice salt and olive oil.

Kale Chips, the easy kind

1 bunch of kale de-stemmed and ripped into pieces
2 tbsp olive oil
salt

Preheat oven to 300F. Massage the olive oil into the kale on a large rimmed baking sheet, sprinkle with salt. Option: add cumin, cayenne, curry, or any favorite spice! Bake for 10 minutes, stir, bake for an additional 10 until edges are turning golden.

Kale chips that have more protein, but take more effort

1 bunch of kale stemmed and torn into pieces
¾ cup garbanzo bean flour*
pinch of salt
juice of ½ lemon
¾ cup water
2 tbsp olive oil
optional add ins: pinch of cayenne, pinch of turmeric, pinch of cumin

Preheat oven to 300F. Brush a parchment lined cookie sheet with olive oil. Mix flour with salt, add spices, stir in lemon juice and water. Should be like thin pancake batter. Dip kale pieces in batter and place on cookie sheet. Bake 15 minutes, turn over with tongs, bake an additional 10-15 minutes. Kale will crisp as it cools.

Kale, bean, and sausage soup

1 cup dried beans, soaked overnight cooked until tender (cranberry or roman are my fave)
2 tbsp olive oil
2 medium onions, diced
1 tbsp minced garlic
1 lb sausage(we like Bolton’s local turkey sausage) cut into small pieces
2 bunches kale de-stemmed and chopped
1 ½ tsp dried thyme
8 cups your favorite stock

Sauté onions in olive oil until pale gold, add garlic and sauté for 1 minute, add sausage and cook until it’s edges are brown. Add kale and thyme, pour in broth and cook for 30 minutes, add beans during last 10 minutes. Salt to taste.

Kale and Quinoa Salad with Beets and Pepitas

2 bunches kale, de-stemmed and cut into ribbon thin pieces
¾ cup quinoa, cooked as per package directions (red looks best and has best taste)
5 medium beets, cooked until fork tender and cut into ½ inch cubes
juice of 1 lemon
2 cloves minced garlic
½ cup crumbled cheese (your choice, blue, goat or queso fresco)
¾ cup pumpkin seeds (pepitas), toast them in pan, they taste better
salt
¼ cup olive oil

Mix first 5 ingredients, toss in rest just before serving. I make this from leftover quinoa and beets that I have cooked the night before. Less work!

 

Marion Mass MD, FAAP

©2015 Two Peds in a Pod®

In practice for 17 years, Marion Mass MD, FAAP graduated from Penn State and Duke University Medical School. She completed her pediatric residency at Northwestern University’s Children’s Memorial Hospital in Chicago. Currently Dr. Mass works at Jellinek Pediatrics in Doylestown, PA and serves on the Wellness Council of the Central Bucks School District, PA. Produce from her kids’ garden garnishes the plates of many local families as well as the plates of the restaurant Puck. All garden profits benefit Relay for Life.  When she is not in her home garden, you can find her also tending to her son’s middle school garden.

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In spite of long TSA lines, rental car challenges and all the howling, the wolf family went to grandmother’s house every year for the holidays.

You don’t appreciate how much your baby has grown until you attempt a diaper change on a plane. For families with young children, Thanksgiving or any holiday can become stressful when travel is involved. Often families travel great distances to be together and attend parties that run later than children’s usual bedtime. Fancy food and fancy dress are common. Well-meaning relatives who see your children once a year can be too quick to hug and kiss, sending even not-so-shy kids running. Here are some tips for safer and smoother holiday travel:
If you are flying:

  • Do not offer Benadryl (diphenhydramine) as a way of “insuring” sleep during a flight. Kids can have paradoxical reactions and become hyper instead of sleepy, and even if they do become sleepy, the added stimulation of flying can combine to produce an ornery, sleepy, tantrum-prone kid. Usually the drone of the plane is enough to sooth kids into a slumber.
  • Not all kids develop ear pain on planes as they descend- some sleep right through landing. However, if needed you can offer pacifiers, bottles, drinks, or healthy snacks during take-off and landing because swallowing may help prevent pressure buildup and thus discomfort in the ears. And yes, it is okay to fly with an ear infection.

General tips for visiting:

  • Traveling 400 miles away from home to spend a few days with close family and/or friends is not the time to solve your child’s chronic problems. Let’s say you have a child who is a poor sleeper and tries to climb into your bed every night at home. Knowing that even the best of sleepers often have difficulty sleeping in a new environment, just take your “bad sleeper” into your bed at bedtime and avoid your usual home routine of waking up every hour to walk her back into her room. Similarly, if you have a picky eater, pack her favorite portable meal as a backup for fancy dinners. But when you return home, please refer to our podcast and blog posts on helping your child to establish good sleep habits and on feeding picky eaters! One exception is when you are trying to say bye-bye to the binkie or pacifier.
  • Supervise your child’s eating and do not allow your child to overeat while you catch up with a distant relative or friend. Ginger-bread house vomit is DISGUSTING, as Dr. Kardos found out first-hand when one of her children ate too much of the beautiful and very generously-sized ginger bread house for dessert.
  • Speaking of food, a good idea is to give your children a wholesome, healthy meal at home, or at your “home base,” before going to a holiday party that will be filled with food that will be foreign to your children. Hunger fuels tantrums so make sure his appetite needs are met. Then, you also won’t feel guilty letting him eat sweets at a party because he already ate healthy foods earlier in the day.
  • If you have a young baby, be careful not to put yourself in a situation where you lose control of your ability to protect the baby from germs. Well-meaning family members love passing infants from person to person, smothering them with kisses along the way. Unfortunately, nose-to-nose kisses may spread cold and flu viruses along with holiday cheer.
  • On the flip side, there are some family events, such as having your 95-year-old great-grandfather meet your baby for the first time, that are once-in-a-lifetime. So while you should be cautious on behalf of your child, ultimately, heed your heart. At six weeks old, Dr. Lai’s baby traveled several hours to see her grandfather in a hospital after he had a heart attack. She likes to think it made her father in law’s recovery go more smoothly.
  • If you have a shy child, try to arrive early to the family gathering. This avoids the situation of walking into house full of unfamiliar relatives or friends who can overwhelm him with their enthusiasm. Together, you and your shy child can explore the house, locate the toys, find the bathrooms, and become familiar with the party hosts. Then your child can become a greeter, or can simply play alone first before you introduce him to guests as they arrive. If possible, spend time in the days before the gathering sharing family photos and stories to familiarize your child with relatives or friends he may not see often.
  • Sometimes you have to remember that once you have children, their needs come before yours. Although you eagerly anticipated a holiday reunion, your child may be too young to appreciate it for more than a couple of hours . An ill, overtired child makes everyone miserable. If your child has an illness, is tired, won’t use the unfamiliar bathroom, has eaten too many cookies and has a belly ache, or is in general crying, clingy, and miserable, despite your best efforts, just leave the party. You can console yourself that when your child is older his actions at that gathering will be the impetus for family legends, or at least will make for a funny story.
  • Enjoy your CHILD’s perspective of Thanksgiving and other winter holidays: enjoy his pride in learning new customs, his enthusiasm for opening gifts, his joy in playing with cousins he seldom sees, his excitement in reading holiday books, and his happiness as he spends extra time with you, his parents.

We wish you all the best this Thanksgiving!

Julie Kardos, MD and Naline Lai, MD

©2014 Two Peds in a Pod®
Updated from our 2009 articles on these topics

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vegetable recipes for kids

The many hues of cauliflower-photo by Dr. Mass

Pediatrician and mom Dr. Marion Mass writes this post in honor of Random Acts of Kindness Day, today November 19 in Bucks County, PA. This day is in memory of Abby Schumer, a friend of Dr. Mass’s family, who lost her life to a brain tumor at age 10. Gardening, cooking with her children, and donating meals to families in need is how Dr. Mass’s family celebrates this day.

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Despite the fact that it’s November and several frosts have hit the Northeast, we still have a surplus of fresh vegetables from our organic garden. If you would like to be in this enviable position next year, please see my former guest-blog post explaining why you should get started now!

We garden because we value healthy high quality organic food. There is a no more satisfying way for your family to get it than from your own yard. Right now, garden centers across the Northern Hemisphere are selling off their seeds for cheap. And these seeds can be saved until next year. How should you choose what to grow? Grow some produce you know your family is will eat. First, consider looking for seeds with different hues. For example, many kids will eat lettuce. How about a red or maroon-leafed variety? Ditto that with the gardener’s favorite, tomatoes. There are yellow, orange, pink, black and blue varieties. One of my pet hypotheses is that the more colors we ingest, the healthier we are…and kids love a rainbow plate. Grow some vegetables that are easy to grow: radishes, beans, beets, and the butternut squash and New Zealand spinach described below, all fall into this category.

Spinach is high in vitamins A, B2, B6, E and K, as well as numerous antioxidants and iron. Shockingly, one cup of spinach contains 25% of the US RDA of calcium, welcome information for those who do not consume dairy products. We grow New Zealand spinach because it does not get stringy and bitter like other varieties and doesn’t get mushy when cooked. In addition, two seeds of this variety grow a plant that is so prolific that it feeds my family and several others from late July (seed planted in May) until the hard frost takes it out.

Butternut squash is high in fiber and extraordinarily high in vitamin A. It is great to grow up a gate or fence, the flowers are edible, and if your kids don’t mind crushing stink bugs, easy to grow. This year only 6 seeds grew 65 pounds of our favorite hard squash!

Cauliflower is also high in fiber as well as vitamin C. Recent studies suggest that there are certain phytochemicals in cauliflower with cancer-fighting properties. It’s a little harder to grow, given its attractiveness to the cabbage loper caterpillar, one of my garden nemeses. Vigilance and a few tricks can help you! We purchase praying mantis egg cases and lacewing insect eggs from online stores such as Gardens Alive. These beneficial insects will eat the cabbage loper caterpillar. In addition, finding the green worms on the back of the leaves and hand crushing them depletes their population.

kid vegetable recipes

New Zealand Spinach

Mouth watering recipes:

Farfalle, Sausage and NEW ZEALAND Spinach

This recipe is good with any leafy greens, and would be OK with traditional spinach, but it is exceptional with New Zealand spinach which has a great bite and holds up after cooking. This  recipe is the creation of my wonderful foodie-friend Jeannine

Ingredients – (flexible on all quantities)

1 lb Italian sweet sausage, casing removed
2 cloves garlic, minced
1/3 cup red wine
salt/pepper to taste
New Zealand Spinach, washed/dried -enough leaves to cover (2) dish towels
Farfalle pasta, ¾ lb
Parmesan, freshly grated, to taste

Preparation – takes 15 minutes

1. Cook pasta in pot boiling salt water. Farfalle usually takes 10 minutes.
2. At the same time, in a deep skillet, cook sausage, crumbling with cooking utensil as it cooks; you can add a little water while it cooks, to prevent sticking, but don’t add too much; the meat sticking will help you when you deglaze pan later
3. Once sausage is cooked, add the minced garlic (1) minute
4. Add wine, simmering a few minutes, deglaze the pan with your spatula, all the stuck pieces of browned meats will come off bottom skillet.
5. Then add the dry spinach leaves; even if pan is overflowing with spinach, it will wilt to a much smaller amount. If using “new Zealand” spinach, it needs extra liquid to cook – scoop out a measuring cup of the boiling pasta water and add to the sauasage/spinach mixture to help cook. Cover with lid for approx 2 minutes. You want the spinach to be wilted, but not overcooked.
6. Season with salt and pepper to taste
7. Drain cooked pasta and mix in serving bowl with sausage mixture.
8. Pass grated parmesan cheese
9. Great leftover too.

kid butternut squash recipe

Butternut squash -photo by Dr. Mass

Roasted Butternut Squash with Pepitas and Pomegranates

Preheat oven to 375. Cube a medium butternut squash into ¾ inch pieces. I leave the skin on for extra fiber. Place on a rimmed cookie sheet and drizzle with 1-2 tbsp olive oil, sprinkle with ½ tsp salt. Roast in oven till fork tender, about 45 minutes. Remove from oven, sprinkle with roasted pepitas (pumpkin seeds) and sprinkle with pomegranate seeds. Serve warm or at room temp. Makes a great Thanksgiving vegetarian entrée, just add cubed fresh Mexican cheese (queso fresco)

Roasted Cauliflower

Preheat oven to 350. Cut 1 medium head of cauliflower into 1 inch florets and place on rimmed cookie sheet. Drizzle with 2 tbsp melted butter (it really tastes better than olive oil here) and sprinkle with 2 tsp organic cane sugar, ½ tsp salt, ½ tsp cumin, and a tiny pinch of cinnamon. Roast in oven for 30 minutes until fork tender. We serve this as an appetizer or a side dish. You can vary the spices used… We added chili powder last night, have done it with oregano and thyme or coriander.

Some of my favorite garden websites:

Kitchen Gardeners International (features forums, recipes, blogs and the ability for people to gather on a local level)

Chiot’s Run (garden journal of a small organic garden in the Midwest)

The Royal Horticultural Society (the UK’s leading gardening charity, promotes horticulture and gardening.)

You Grow Girl (unusual plants, recipes, beautiful pictures, and gardening tips)

Skippy’s Vegetable Garden (a Boston city vegetable garden)

Marion Mass, MD
©2014 Two Peds in a Pod®

 

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