Every parent knows the struggle of battling a cold. The battle is especially hard when the cold germs land right before a birthday party, a holiday gathering, or a family trip. Here are tips on how to treat a cold.

Understanding Colds

Colds typically last about 1-2 weeks, with the first week often being the toughest. Common symptoms include a sore throat, runny nose, cough, and general fatigue. Sometimes, colds can cause a mild fever, and in some cases, a bit of tummy trouble. While there’s no magic cure, there are plenty of ways to make your kids more comfortable.

Tips for Treating Common Cold Symptoms

Sore Throat
Not every sore throat means strep throat! If your child has a sore throat along with a runny nose and cough, it’s likely part of their cold. Post nasal drip hurts. To ease the discomfort, you can give a pain reliever like acetaminophen (e.g. Tylenol) every 4 hours or ibuprofen (e.g. Motrin, Advil) every 6 hours. Read this post to learn how these medicines differ from each other.  Always check the label for dosing or call your doctor if you’re unsure.

For kids over one year old, honey can be a soothing remedy. Offer a teaspoon or two on its own or mix into warm, decaffeinated tea or in warm milk. Alternatively, offer ice pops- the cold helps numb throat pain. And don’t forget hydration! Offer plenty of fluids—breast milk or formula for babies, and juice, milk, or water for older kids.

Call the pediatrician: If your child’s throat pain is severe or they aren’t drinking enough fluids to urinate at least 3-4 times in 24 hours, it’s time to reach out to their doctor.

Runny or Stuffy Nose
To prevent the irritation a runny nose, apply a dab of petroleum jelly (e.g. Vasoline) under their noses.

For stuffiness, try using saline drops or saline spray to help loosen up the mucus. If your baby struggles to breathe through their nose, gently suction out the mucus with a bulb syringe. But don’t overdo it—only suction if their stuffy nose prevents them from drinking or sleeping. Older kids can take long steamy showers and babies can take an extra bath to relieve their stuffiness.

For safety reasons, avoid decongestants and cold medicines for young children. Even for older kids, cold medicine often does not work and can cause unwanted side effects. We recommend avoiding formulations with multiple ingredients-it can be confusing to keep track of what is going into your child. For example, you might give your teen a dose of acetaminophen and then find out that the multisymptom cold medicine you gave already also contains acetaminophen.

Interesting pediatric fact: nose boogers can turn from clear to white to yellow to green, all in the same cold.

Call the pediatrician: If your child’s runny nose lasts more than two weeks or your child complains about facial pain or swelling, call your child’s doctor.

Coughing
Keep your child well-hydrated, and if they’re over a year old, honey can help soothe that cough. Offer 1-2 teaspoons a few times a day or mix it into a warm drink.

Create a steam-filled environment. Try running a hot shower and sitting in the bathroom with your child while they breathe in the steam. If your child has asthma, make sure to follow their asthma action plan.

It is not necessary to confine your coughing child to their bed or to the couch. Walking around encourages deeper breathing which improves lung function. Likewise, have them do deep “yoga” breathes to “pop-out” their lungs.

Call the pediatrician: Call their doctor if their cough doesn’t improve after 10-14 days. If your child is having difficulty breathing, looks pale or blue, or becomes lethargic, take them to the closest Emergency Department.

Fever
Colds can cause fevers, most often in the first few days. To treat a cold with fever-related discomfort, acetaminophen or ibuprofen can help. Check out our detailed post on managing fever for more information.

Call the pediatrician: If the fever lasts more than 2-3 days, or if it goes away for a day or more and then comes back, it’s best to consult your child’s doctor. The cold may have evolved into something else like an ear infection or pneumonia. Additionally, all babies younger than two months of age should be seen by a physician for fever of 100.4 or higher as soon as you realize they have a fever.

More Tips

Watch for pain. Depending on location, pain can be a sign of a new bacterial infection on top of a cold virus. For example, ear pain can signify an ear infection, chest or shoulder pain can signify pneumonia, and pain over the face (cheeks or forehead or behind the nose) can signify a sinus infection.

Hydrate, hydrate, hydrate! Thin that mucous. Signs of dehydration include lack of tears on crying, dry mouth and lips, and as we said above, a decrease in wet diapers/frequency of urination or dark urine. If your child is not eating, they will need sugar for energy and salt to keep up their blood pressure. Vary the beverages, do not give water only. Colds are a perfect time for chicken soup.

Fresh air can work wonders, so let your child play outside or crack a window to air out the house. Going outside in the cold does not actually cause colds.

Extra story time or playtime can distract kids from feeling under the weather.

Kids can return to school once they’ve been fever-free for at least 24 hours and their symptoms are improving.

May the germs fighting with impunity fall to your child’s immunity!

Julie Kardos, MD and Naline Lai, MD
©2024 Two Peds in a Pod®

Photo generated by ChatGPT

As a parent, there are few things more heartbreaking than seeing your child upset because they’ve been bullied. Whether your second grader is crying after being teased on the school bus or your teen is avoiding the school bathroom to escape cruel remarks, the feeling of powerlessness can be overwhelming. You may be tempted to go after the bully yourself. But there are more effective, long-term ways to help your child handle bullying. 

Bullies are always in a position of power over their victims; either they are physically larger, older, or more “popular.” While you or your child may want to “get back” at the bully, retaliation only fuels anger and can land your child in trouble. Remind your child that most bullies act out because they feel insecure themselves. Teach your child empathy for the bully.

What can you do?

Teach your child how to stop a bully, walk away from dangerous situations, and talk to someone when they need help.

Stop the bully. Have your child give strong verbal responses. Teach your child to stand up for themselves with a clear, confident message. A firm “STOP talking to me like that!” or “Don’t do that!” will not only assert their boundaries but also could attract the attention of nearby peers or adults who can step in. Another helpful tactic, especially if no one else is around to help, is de-escalation. Encourage your child to take deep breaths, and to ignore provocations by pretending they do not care what the bully says to them.

Walk away from conflict. If a bully is getting physical or continuing to harass your child, teach them to walk away and seek safety. They can move toward a teacher, a classroom, or any safe space where an adult can intervene.

Advise your child to tell as many trusted adults as possible if they’re feeling unsafe. If one adult isn’t sure how to help, another will. Tell them to keep asking.

Cyberbullying

Stop the cyberbully by responding with silence. Explain to your child that bullies thrive on any and all responses to their bullying. Not only that, but your child’s on-line response can be permanent. Teach them to withhold a response and let adults take charge. 

In general, establish rules about your child’s online behavior and limit access to devices and sites. For example, encourage your child never to post anything hurtful or negative.  Even something as small as a “dislike” can escalate a situation or can be misinterpreted.

If the bully threatens your child online, avoid responding to the bully AND take your child’s device with the evidence to the school and possibly to the police. Here is contact information for social media apps, gaming networks, and related platforms where you can report cyberbullying.

Information gathering

Make it clear to your child that it’s always okay to talk to you if something’s bothering them. Ask open-ended questions like:

“How’s school going?”

“How are things with your friends?”

“Have you seen anyone getting bullied?”

“Are you feeling okay at school?”

If your child says they’re having trouble with a friend or classmate, avoid brushing it off. Ask questions like, “What happened?” or “Did something happen between you?”

Keep an eye out for signs that your child might be struggling emotionally. They may show increased reluctance to go to school or act sad, angry, or anxious.

Be aware that sometimes kids who are bullied turn around and become bullies.

 Partner with your child’s school for support

Once you’re aware that your child is being bullied at school, it’s important to for you to talk to adults at the school. Let the teacher, counselor, or principal know exactly what’s going on. Be clear that you want additional supervision, particularly at recess and lunchtime. Schools often have a zero-tolerance policy for bullying, but they can’t address an issue that they don’t know about.

Building your child’s self-confidence

Bullies often target kids who seem smaller, weaker, or less confident. It’s important to help your child feel good about themselves so they’re less likely to become a target. Make it known by your words and actions that you love your children unconditionally. This builds self esteem. As Dr. Lai says,”Helping a kid’s confidence grow is harder than helping their body grow.” If a child is physically smaller than the bully, remind them that “You don’t have to be a big person to do big things.”

Consider enrolling your child in activities that boost self-esteem, like karate, team sports, or music lessons. Encourage friendships with supportive peers. Be the fun parent and invite kids over for a playdate, or host a family activity like a kickball game or movie night.

We leave you with a classic anti-bullying retort: “I’m rubber, you’re glue; whatever you say bounces off of me and sticks to you.”

Additional Resources:

• The American Academy of Pediatrics – for more information on bullies, victims, consequences of bullying, and how to respond to bullying
• StopBullying.gov – U.S. Department of Health and Human Services
• Cyberbullying Research Center
• Teaching Tolerance – Fostering tolerance for parents and educators

Naline Lai, MD and Julie Kardos, MD

©2024 Two Peds in a Pod®

Now that school is back in full swing, you might notice your child scratching their head… and maybe you’re starting to scratch your head too. Let’s dive into the topic of lice and clear up some of the confusion.

What Are Lice, Really?

Lice are small, harmless insects that cause itching but don’t spread disease. The itching comes from a reaction to their saliva—similar to how poison ivy causes a reaction on the skin. It sounds gross, we know, but the good news is that lice are more of an annoyance than a health risk.

By the time you spot a live louse on your child, they’ve likely had lice for at least a month. So, while it might seem alarming to spot a louse crawling on their head, it’s not an emergency. Schools shouldn’t send kids home early for lice; after all, they’ve likely been in class with lice for weeks. That said, treating lice promptly can relieve the itching and stop them from spreading. Children can return to school the day after their first lice treatment.

How Do Lice Spread?

Lice can’t jump or fly; they only crawl. For lice to spread, kids’ heads need to be close together. Lice can also spread through shared hats or hair brushes, so remind your kids not to share these items, whether they’re playing dress-up or getting ready for a school dance.

Spotting Lice and Nits (Lice Eggs)

It’s easy to mistake other things—like sand or dandruff—for lice eggs. Here’s a tip: lice eggs (otherwise known as nits) are glued tightly to the hair shaft near the scalp and are difficult to remove with your fingers. Dandruff and sand slide easily along the hair shaft between your fingers. 

Lice Treatment Options

• Topical Permethrin 1% (e.g. Nix): This over-the-counter treatment works well for many families. Follow the directions on the label, and repeat the treatment in 7-9 days. Nix has a comprehensive  website that explains lice and how  to treat them. Permethrin targets both lice and their eggs.
• Topical Ivermectin: Previously branded as Sklice, this treatment is now available over-the-counter. The generic version is as effective as the name brand. Follow the directions, and repeat after 7-9 days.

If neither of these treatments work, doctors can prescribe additional medications. Most cases of lice succumb to permethrin or ivermectin, so you likely won’t need a prescription. Safety tip: avoid using more than one product at a time. This prevents too much medication on your child’s head at the same time.

According to the American Academy of Dermatology, simply combing your child’s hair to remove lice and nits can be effective. Though time-consuming, thorough combing works when done properly. Here’s a helpful 3-minute video from a dermatologist on using medication and combing to treat lice.

All lice shampoos and lotions should be applied to dry hair, left on for the recommended time, and then rinsed off. Make sure to read and follow the directions carefully for whichever product you choose.

Treating Your Home

Once your child is treated, it’s important to treat their environment too. Wash any recently-used sheets, towels, blankets, and hats in hot water (at least 130°F), and dry them on high heat for 20 minutes. Seal non-washable items, like stuffed animals, in plastic bags for two weeks to let any lice and nits to die off.

Got More Questions?

This should cover most of what you need to know about lice, but if you’re still itching for more info, we contributed to this post in The Children’s Hospital of Philadelphia’s “Health Tip of the Week.”

Stay tuned for more tips on what might be “heading” your way!

Julie Kardos, MD and Naline Lai, MD

©2024 Two Peds in a Pod®

Hello, parents! As we gear up for another winter season, we want to share some important RSV prevention updates. RSV, or Respiratory Syncytial Virus, can cause nasty colds, but it’s particularly concerning for babies under 8 months old, as it leads to more hospitalizations than any other illness in this age group.

Good News About Beyfortus!
Last winter, we saw some fantastic results from nirsevimab, better known as the brand name Beyfortus. Beyfortus is RSV antibody designed to protect our littlest ones. It was shown to be 90% effective in reducing hospitalizations due to RSV. That’s a big win for babies and their families.

How Can You Protect Your Baby?
There are two key ways to help keep your young infant safe from severe RSV:

• For Expecting Moms: If you’re pregnant, you can receive an RSV immunization between weeks 32 and 36 of your pregnancy. This helps build immunity for your baby, so they won’t need Beyfortus after they are born. However, if your baby arrives early—within two weeks of when you got the shot—they will need their own dose to ensure protection against severe RSV.

• For Newborns: All babies under 8 months old during RSV season should receive a dose of Beyfortus if their mom didn’t get the immunization. This includes all babies, whether they’re healthy, sick, premature, or full term. Many hospital nurseries and NICUs give these antibodies (given as an injection) before your baby goes home. If your hospital doesn’t have it, your pediatrician can help.

Why Beyfortus is a Game Changer
In the past, we gave an RSV antibody shot that was reserved for severely premature babies and those with serious lung issues. It required monthly doses for 5-6 months during the RSV season. Beyfortus, on the other hand, offers protection for a full 5 months with just one shot—making it much easier for busy parents!

Timing Matters
Beyfortus is given only during RSV season, which runs from October to March. If your baby is under 8 months old and hasn’t had their dose yet, please reach out to your pediatrician for this vital protection. Plus, it’s safe to give Beyfortus alongside any other childhood vaccines.

A Quick Reminder
RSV is an incredibly common illness, with nearly all kids catching it by the age of 2 years. While many childrn will have mild cases, we’re grateful to have options like Beyfortus to help keep your baby from becoming severely ill.

We’re here to support you and your family in staying healthy this season!

Julie Kardos, MD and Naline Lai, MD
©2024 Two Peds in a Pod®

Frustrated that your young child is not listening? This in-person talk gives some basics on ways to set limits and self-calming techniques. Your two peds, Dr. Lai will be on hand to moderate!

Naline Lai, MD and Julie Kardos, MD

©2024 Two Peds in a Pod®

We often hear about ways to chase away anxiety such as “deep breathing” and “grounding exercises” but how do you go about teaching your child those techniques? Drs. Kardos and Lai give three short ways to instill calmness into your child’s day. You can read more about childhood anxiety in this helpful post from The Children’s Hospital of Philadelphia.

Naline Lai, MD and Julie Kardos, MD

©2024 Two Peds in a Pod®

Playing in the great outdoors really is great. But when your kids scamper inside, make sure they wash their hands. Now that the winter viral season has receded, the big reason to wash hands is spring allergy season. The pollen they’ve collected on their hands will make its way to their face exacerbating already itchy noses and eyes.

The easiest way to tell if your young child is experiencing seasonal allergies is if your nose starts to twitch. If your child’s nose also starts to twitch, they probably also have allergies. Allergies have a strong inheritance pattern. If both parents have allergies, up to 50-80 percent of their kids may have allergies. Keep in mind, allergies never cause a fever and since children need to be exposed to an irritant before they can be allergic to it, children under two years of age are less likely to have seasonal allergies—not enough seasons have passed.

For other ways to keep spring allergies in check- read up on this post contributed by Dr. Lai in the CHOP Health TIp of the Week.

Another reason to wash hands after zipping indoors? Poison ivy…but that’s a story for another day.

Naline Lai, MD and Julie Kardos, MD

©2024 Two Peds in a Pod®

We know how it’s easy to spend money on the kids- just wait until they are old enough to get Venmo. Here are some money saving tips for parents to save a little dough and put that saving towards the next family vacation and orthodontia!

Julie Kardos, MD and Naline Lai, MD

©2024 Two Peds in a Pod®

Listen here as Dr. Kardos talks about the latest in pediatrics on “Your Radio Doctor” with Dr. Maryanne Ritchie.

Julie Kardos, MD and Naline Lai, MD

©2024 Two Peds in a Pod®

Parents local to Northampton Township, PA: We welcome you to come hear local pedatricians from The Children’s Hospital of Philadelphia and mental health experts talk about basic ways you can help manage anxiety and some information about medications for children and teens on February 8, 2024 at 6:30pm in the Northampton Library.

The talk is free and there will be time for questions. Please register so we set up enough chairs!

Special note: your Two Peds will be in attendance. Hope to see you there!

Naline Lai, MD and Julie Kardos, MD

©2024 Two Peds in a Pod®