Is it a cold or the flu?

A cold or the flu? Both can get out of control

“Remember: colds = gradual and annoying. Flu = sudden and miserable.”

Please read here for our post of how to tell if your your child has a cold or the flu.

Stay well, may the new year bring you neither one.

Julie Kardos, MD and Naline Lai, MD
©2020 Two Peds in a Pod®


The winter cold virus

Do not use this to a treat winter cold

Believe it or not, pharmacies sold this “cold remedy” until the 1960s!

Honey, tar, and alcohol, oh my! Tucked away in a display at the Mercer Museum of Bucks County, Dr. Lai found this old bottle of cough syrup from the late 1800s. While we do NOT recommend this type of medicine for children of any age for any condition, it does remind us that we wish we had the perfect cold remedy to offer our patients who have a winter cold virus. 

Whether your child caught their cold from the infant room in daycare or the high school hallway during change of class time, kids with colds suffer similar symptoms in a similar time course.

Kids can start out feeling extra tired or out of sorts for a day or so, then they may develop a sore throat, runny nose, maybe a fever, and then the cough sets in. Fever from a cold virus starts within the first two days of a cold. Younger kids sometimes develop loose bowel movements or vomit mucus. Colds can cause watery eyes. Symptoms from a winter cold virus interrupt sleep and disrupt appetites.

What can parents do to help their children feel better from a winter cold virus?

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Tribute to Big Bird and 6 year olds

We were thrilled to hear Caroll Spinney, a.k.a. Bird Bird and Oscar the Grouch, address the American Academy of Pediatrics National Conference back in 2011 (Dr. Lai’s iPhone 3 or 4 captured this “high” quality photo).

Caroll Spinney, the late puppeteer who was both Big Bird and Oscar the Grouch on Sesame Street, had the idea back in 1969 to make Big Bird a forever 6 year old. We were sad to hear of his passing today, but glad that Big Bird’s portrayal of 6 year olds lives on. Please read our post to learn more about 6 year olds.

Julie Kardos, MD and Naline Lai, MD
©2019 Two Peds in a Pod®


Thank-you Magic: Happy Thanksgiving 2019

thank-you: teaching manners

Manners can work magic. Here’s how, when, and why to say “thank-you” to your children.

“Thank-you for bringing your plate to the sink,” to your 2-year-old becomes “Thank-you for clearing the table,” to your 8-year-old becomes “Thank-you for cooking dinner,” to your 14-year-old.

“Thank-you for putting your clothes in the hamper,” to your 3-year-old becomes “Thank-you for folding your clothes,” to your 6-year-old becomes “Thank-you for doing the laundry,” to your 10-year-old.

“Thank-you for sharing your toy with your sister,” to your four-year-old becomes “Thank-you for babysitting your sister,” to your 13-year-old.

“Thank-you for climbing right into your car seat,” to your 3-year-old becomes “Thank-you for buckling your seat belt before I drive,” to your 9-year-old becomes “Thank-you for driving over to the store for more milk,” to your 16-year-old. 

“Thank-you for the hug,” to your 1-year-old becomes “Thank-you for the hug,” to your 5-year-old becomes “Thank-you for the hug,” to your 15-year-old becomes “Thank-you for the hug,” to your 50-year-old.

May your Thanksgiving include many servings of “thank-you.”

Happy Thanksgiving,

Julie Kardos, MD and Naline Lai, MD
©2019 Two Peds in a Pod®


Screen time for kids: How much is too much?

screen time for kids

When Dr. Lai’s niece was in preschool she would complain of headaches- the culprit? Too much screen time and the need for glasses. Check out the post that Dr. Lai contributed to Children’s Hospital of Philadelphia’s Health Tip of the Week on screen time for kids.

Julie Kardos, MD and Naline Lai, MD
2019 Two Peds in a Pod®


Afraid of a tantrum? How to set limits for your child

set limits for your child and don't fear the tantrumHas your toddler ever pulled off your glasses and thrown them? Slapped another toddler at the playground? Bitten their brother? Run off in a store and ignored you when you called? Are you afraid to set limits for your child because you fear the tantrum that may result?

Yes, toddlers are cute, but left to their own devices, they grow into the school bully, the family bully, or worse yet, they don’t listen to an adult and run into the street in front of a car.

Unbeknownst to you, you probably started to set limits for your child as early as 6 months of age.

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Flu vaccine 2019-2020

flu vaccine 2019-2020

Excited for his Germ Fighters, this kiddo wears his “Vaccines save, bro” shirt for all of his pediatric office vaccine visits.

The US flu vaccine 2019-2020 is here!

Who should get it?

Unless medically contraindicated, all kids aged six months and older should get the flu vaccine. Your child’s pediatrician will ask you questions to be sure the flu vaccine is appropriate for your child.

Is the flu vaccine different this year from last year?

Yes, so even if your child received a flu vaccine last year, they should get another one this year.  The predicted flu strains change yearly so manufacturers make up a new batch of flu vaccines every year.

Which flu vaccine should they get- the shot or the-spray-in-the-nose kind?

All kids can get the shot. Kids two years and older without certain other medical conditions can get the nose spray. If your child is eligible for both, then the best type to get is the one that is available- they are both effective.

When should they get the flu vaccine?

The goal is to be completely immunized for this year’s flu season by Halloween- the end of October. When it comes to the flu vaccine, “better late than never” also holds true. It is impossible to predict precisely when the flu will hit and how long it will circulate. So even if it’s mid winter, get the vaccine if it is still available.

How many doses do they need?

If your child is under the age of nine years and never had a flu vaccine or had only one prior dose of flu vaccine before the date of June 30, 2019, then they need two doses separated by a minimum of four weeks. All other kids need one dose only every year.

What are the common side effects of the flu vaccine?

The injectable brands of flu vaccine, like all shots, can cause mild symptoms such as soreness or redness in the body area where a child gets the shot, fever, or fatigue. The nasal spray version can cause some nasal congestion, sore throat, fever, and muscle aches.

Can any flu vaccine cause the flu?


You can read a summary about the nasal spray form of the flu vaccine here and well as the injectable form of the flu vaccine here. Both of these Vaccine Information Statements expand on all of the above points.  

Still on the fence about flu vaccine 2019-2020?

Last year, 116 children in the US died from the flu, and almost half of these children were previously healthy kids. The average age of death was six years. Of those who died and COULD have received flu vaccine- meaning the ones that were older than 6 months of age, 70% did NOT receive the flu vaccine. So flu vaccine might have averted more than half of these flu deaths.

Additionally, of children last year in the hospital with flu, the majority did NOT receive flu vaccine. The flu killed thousands of adults last year.  School-aged children are the group most likely to spread the flu germs. Therefore, flu vaccine not only can protect your children and those too young or too ill to be vaccinated, but also protects your children’s grandparents.

Click here for an exhaustive review of the American Academy of Pediatrics recommendations for this year’s flu season. We hoped to provide you all with the most important highlights. You can read our flu vaccine myth-busters here.

Julie Kardos, MD and Naline Lai, MD
©2019 Two Peds in a Pod®


Treating fever: some like it hot!

fever in childrenWhile most of us enjoy back-to-school night, we do NOT enjoy back-to-school fever. Here is our guide for evaluating and treating fever in your child.

Julie Kardos, MD and Naline Lai, MD

©2019 Two Peds in a Pod®


School avoidance: Why won’t my child go to school?

prevent school avoidance

Happily hopping off to school — image by Sasin Tipchai from Pixabay

Do you recognize these school avoidance scenarios?

  • Your child feels sick every school-day morning, but not on weekends. 
  • Your kid outright refuses to get on the bus or into your car on school mornings. 
  • After witnessing another kid throwing up in school, your kid refuses to go back to school in fear that they might throw up in school. 
  • Beginning with the second or third day of school, your child says it doesn’t “feel right” to be away from mom or dad for the day. 
  • Your middle schooler or high schooler gets ready for school and then feels too tired to actually leave the house. They go back to sleep for several hours and that convinces you and them that they needed to stay home and rest. 

It can happen at any age, in any grade. School avoidance is the older kid version of daycare separation anxiety.

Before getting into the why’s of school avoidance, let’s jump to the most important part of how to treat school avoidance: While it may feel difficult for you and cause tears to flow, you need to get your school-avoiding child BACK TO SCHOOL!

All other treatment modalities and all other issues can be dealt with while your child continues to attend school. The longer you let your child stay home, the more difficult it will be for them to return to school.

Can there be legit reasons that your child avoids going to school? Of course! Think about the following factors that might come into play: Continue Reading