Two Peds in a Pod®

Food Allergies- Epinephrine hints and a free coloring book

Allergy Coloring Book — For a free electronic copy of a food allergy coloring book, write us at twopedsinapod@gmail.com

As kids head back to school, it’s a good time to review how to administer your food-allergic kid’s emergency epinephrine. Dr. Lai, who has two young adults who grew up with food allergies, and Dr. Kardos offer these hints:

-Double check to make sure the medication has not expired. Also, make sure you are giving the school medication that does not expire in the middle of the school year.Double check to make sure the medication has not expired. Also, make sure you are giving the school medication that does not expire in the middle of the school year.

-What about antihistamine or asthma medications? Yes, go ahead and send them in with your child, but remember, only epinephrine can reverse the life-threatening symptoms of an anaphylaxis. Other medicines like antihistamines cannot stop the reaction.

Why do tummy time?

Tummy time can prevent flat head syndrome, or plagiocephaly

Your insta feed is probably flooded with ideas on how to encourage tummy time with your baby.

We see one pediatrician has garnered nearly a million views. So why bother with tummy time in the first place?

In the late 1990s, pediatricians noted that while the safe sleep recommendation of “back to sleep” prevented sudden infant death syndrome, back sleeping caused the back of heads to flatten. Tummy time gives babies time off of the back of their heads.

Rest assured, it is not important for your baby to have a perfect basketball-shaped head. Instead, you are helping to prevent obvious flattening. Once your baby learns to sit, around 6 to 7 months, they will spend much less time lying down and have more time for their heads to round out as they continue to grow.

Flattening from pressure on the skull is called “positional plagiocephaly,” which is different from the more serious condition of craniosynostosis. Routine pediatrician visits help your baby’s doctor to determine if your baby’s head is growing correctly.

Prevent your children from ingesting THC edibles

gummy bears on a dish that look just like edibles

“4 Bucks County Middle School Students Sickened After Ingesting THC Gummies”

This incident occurred close to our pediatric offices and involved four students, just 12 and 13 years old. As pediatricians—and as members of this community—we feel it’s important to talk about what happened and why it matters.

THC is the active compound in marijuana. In edible forms like gummies, the concentration can be quite high. For a child, consuming even a small amount of these products can lead to serious, and sometimes life-threatening, effects.

At this time, it is unclear whether the students in our nearby middle school knew the gummies contained THC, or where they obtained them—whether from a store, a friend, a sibling, or an adult. What we do know is that these products are easy for middle schoolers to access and very easy to mistake for regular candy.

Is it ADHD or something else?

children ADHD — Mr. Rover suddenly came to the realization that every student he had ever taught had ADHD.

Does this sound familiar?

On Monday, your son Robby leaves late for the school bus because he couldn’t find his shoes, then he stopped to fiddle with a Lego model on the way out the door.

On Tuesday, his homework that took you hours to get him to complete the night before never makes it off the kitchen table.

On Wednesday, he jumps off a five-foot wall at recess “just because” and lands in the nurse’s office.

On Thursday, he comes home tantruming because other kids didn’t want to play with him during recess.

By Friday, you’re sitting at a parent-teacher conference hearing words like impulsive, distracted, underperforming, can’t sit still, and needs constant redirection. A teacher suggests testing for Attention Deficit Hyperactivity Disorder which is better known as ADHD.

If this feels familiar, please know you are not alone. As pediatricians, we’ve sat with many families at this exact moment. It’s natural to feel relief that someone else sees the struggle, and at the same time, worry: What if it’s something else?

That’s such an important question.

What else could it be?

ADHD is common and very real. But several other conditions can look like ADHD—or make attention problems worse. Kids with ADHD are not even necessarily hyperactive. When pediatricians evaluate a child for possible ADHD, we think broadly before landing on a diagnosis.

You’ve Got This: A Gentle Guide to Early Breastfeeding

If you can stick with breastfeeding for the first two weeks, you’ll get past most of the common hurdles. Those early days can feel intense, but a little knowledge (and a lot of grace) goes a long way. Here are some practical, encouraging tips to help you get off to a strong start to early breastfeeding.

Keep at It

Your baby is your best milk-maker. Every time your baby nurses, their sucking tells your body to make more milk. The more often the breasts are stimulated, the more milk your body produces.

Why do babies cry?

Why do babies cry? In short, infants cry to communicate. Remember, babies cannot talk. They can’t even smile back at you until around six weeks of age.

Dr. Kardos recently welcomed her first grandbaby into the world, so we revisit our baby posts with a fresh eye. Here is the first of many!

The long and short of it is that babies cry when they…

Are tired.
Are hungry.
Feel too cold.
Feel too hot.
Need to be changed –Dr. Kardos never really believed this reason before she had her twins. Her firstborn couldn’t have cared less if he was wet and could nap right through a really poopy diaper. Then she had her twins. She was amazed that their crying stopped if she changed the tiniest bit of poop or a wet diaper. Go figure. As Dr. Lai says, “different kids are different.”
Are bored. Try swapping out the white noise and cue up some hip-hop or K-pop instead. Maybe they want a car ride. Another option: try moving them to another room in the house for a simple change of scenery.
Feel pain. Look for a piece of hair wrapped around a finger or toe. Make sure they are not out-growing the elastic wrist or ankle band on their clothing. Dr. Lai’s second born is a young adult but there is still a faint mark on her ankle from tight elastic that only a mom would notice.
If the crying is worse in a well-lit room, their eye appears red and irritated, or there are scratch marks next to their eye, your baby may have scratched their eye (corneal abrasion). Call your pediatrician if you suspect this.
Need to be swaddled. Remember a fetus spends the last trimester squished inside of their mom. Discovering their own randomly flailing arms and legs can be disconcerting to a newborn.
Need to be UN-swaddled. Hey, some like the freedom to flail.
Need to be rocked/moved. Dr. Lai’s firstborn spent hours tightly wrapped. Her dad held her in a nearly upside down position nicknamed “upside-down-hotdog.” Every evening he paced with her all around the living room.
Need to burp. Lay your crying baby down for a minute. Bring them up again to see if you can elicit a burp.
Are gassy. Bicycle their legs while on their back. Position them over your shoulder so that their belly presses against you. You’d be gassy too if you couldn’t move very well. The gassy baby is a topic for this entire post– talk to your doctor for other ideas.
Are sick. Watch for fever, inability to feed normally, labored breathing, diarrhea or vomiting. Check and see if anything is swollen or not moving. Listen to the cry. Is it weak and whimper-like (sick) or is it loud and strong (not so sick)? Do not hesitate to check with your pediatrician. Fever in a baby younger than eight weeks old is considered 100.4 degrees F or higher measured rectally. A feverish newborn needs immediate medical attention.

Gift Ideas for Newborns: Recommendations from Pediatricians

Baby in a bath under a water shower to highlight gift ideas for newborns

Looking for gift ideas for baby showers or baby namings beyond cute baby outfits and big items? Dr. Kardos welcomes a little one into her family soon so we thought we’d give you some pediatrician-inspired ideas. These gifts support the essentials of what little (and big) people need to do: eat, sleep, pee, poop, love, and learn.

EAT

Pick up breast pump accessories, bottles and nipples, post-partum doula help, and lactation consultant sessions for the new mom.

Vitamin D supplementation is recommended for all babies, whether breast or formula fed. The dose is 400 IU = 10mcg per day. Ask the pharmacist for help finding these over-the-counter baby vitamins.

If your child is afraid of vaccines: take the sting out

As Drs. Kardos and Lai can attest, even a pediatrician’s child does not always approach the prospect of an immunization with a grin on their face. When Dr. Lai’s daughter was two years old, she thanked her nurse for her flu vaccine by giving her a surprise punch. Here are ways you can take away the sting of a needle if your child is afraid of vaccines.

Set the stage

Your child looks to you for clues on how to act. If mommy and daddy are trembling in the corner of the room, it will be difficult to convince your child that the immunization is “no big deal.” Do avoid a weeks-long build up. Simply announce to your child right before you leave to get the immunization, ”We are going to get an immunization to protect you from getting sick.”

Back to School Health Tips

girl raising hand inside the classroom — Photo by Anastasia Shuraeva on Pexels.com

Whether your child is starting preschool or their last year of high school, use our back to school health tips to start strong:

Sleep

Even if school started for your child, you have time to change their summer sleep schedule. You can adjust it to fit their school year sleep needs.

Take a week or so to gradually dial back their bedtime. Otherwise, they will spend the first week of school jet lagged. The right amount of sleep for your child is whatever amount it takes them to wake naturally or to awaken with minimal prompting . Some kids need 8- 9 hours of sleep, others require 11-12 hours.

Beds are for sleeping only: no playing, studying, phone scrolling, or completing homework in bed. Teach them to “let go” of the day and associate their bed with drifting off to sleep.

Make sure kids of all ages get some exercise, preferably outside, to ward off insomnia at bedtime. On the other hand, exercise too close to bedtime will wind a child up.

Bottle Feeding Your Baby: from birth and beyond

There are many reasons that your baby may need formula or breast milk fed through a bottle. Some parents initially feel guilty using a bottle. If this is the case with you, know that babies bond with their parents and other caregivers with every bottle they take. One benefit of bottle feeding is that moms can get more sleep. After all, they are recovering from the herculean feat of giving birth and others can share in nourishing the baby. Below are tips for bottle feeding your baby:

Different babies are different

Some newborns will want the equivalent of Thanksgiving dinner. That is, they may take 2-3 ounces at one feeding. Others have had enough to eat after a small snack of half an ounce. Your baby will tell you they’ve had enough by pushing the bottle out of their mouth or using the bottle as a pacifier (non nutritive suck) rather than sucking hard enough to draw out the liquid (nutritive suck). Do not panic if your baby is a little gaggy when they first learn to drink. Remember, they spend 9 months getting nutrition through an umbilical cord and are inexperienced with sucking and swallowing.