My husband and I finally saw the Star Trek movie the other night, and as I write our first blog entry for Two Peds in a Pod® I feel like I am aboard the USS Enterprise taking off from the space station for the first time, to “explore all aspects of child care, to boldly go where this pediatrician has never gone before,” namely, cyberspace.

After all, I spend my work days in my pediatric office seeing patients and interacting with parents directly. The internet was born while I was in medical school and because I was so busy studying, then working and raising a family, cyberspace remains mostly foreign territory to me. However, I realize that the huge majority of my patients’ families turn to the internet for all sorts of information, including medical advice.  Unfortunately, medical advice in cyberspace is often shady, inaccurate, or incomplete.

Dr. Lai and I hope to give you easily accessible, accurate pediatric information in the form of podcasts for those who are auditory learners and written blogs posts for those who prefer written material.

We will address the everyday questions that we hear from parents in our practices and we welcome your suggestions. Please email us at twopedsinapod@gmail.com to suggest future blog post and podcast content. We promise to keep our podcasts and blog entries brief so we can give you maximum information with your time constraints in mind.

Thank you for being a part of our maiden voyage.

Julie Kardos, MD

This little ten-month-old wishes Two Peds in a Pod® a happy ten-YEAR-old birthday!

Let’s take a stroll back ten years to 2009. Ten years ago Facebook was just five years old. Back then there was no Instagram (2010), no Pinterest (2010), no Snapchat (2011).  People were mesmerized by virtual vegetable picking (FarmVille) and taking care of Zhu Zhu pets. Bulky video gaming consoles ruled. The “New” Super Mario Bros. Wii really was “new.” Apple’s “pile of poo” emoji had just arrived the year before. And ten years ago, Two Peds in a Pod® was born. The idea that doctors would write advice on the internet was so novel that even NPR thought the concept worthy of a story. Today we take a Happy Birthday look back at our first five posts:

Then and now

Our blog’s first five posts, from the summer of 2009, include the very same topics parents ask us about now in the summer of 2019. 

Back then parents wondered about infant sleep, or lack thereof. Please note that we began our infant sleep podcast with the reminder that newborns are not meant to sleep through the night. Fisher Price should have listened to our podcast, because now in 2019 we are writing about rock‘ n play recalls. 

Two posts tackled  Potty training and picky eating. Spoiler to both posts: you can lead a horse to water but you can’t make him drink!These days, we’re still talking about both topics in the office. But now, people also ask about the need for probiotics to regulate bowels and digestive health in their child. Unfortunately, in 2019 probiotics have not panned out to be the hoped-for panacea for all gastrointestinal ailments. But they are helpful in some types of diarrhea. 

In 2019 we talked about the tick borne illness Lyme disease and we’re still talking about ticks now. As for the  mystery object Dr. Lai found in a drawer, ten years later the models are kinder and sport a raised lip instead of a contraption that can break off. 

Blog writing a decade later

Internet traffic has grown exponentially. Possibly because of so many sources of misinformation, we see more and anxious parents who receive conflicting information about how to raise their kids. We depend on you to let your friends know about this site. We would rather spend more time on writing than on search engine optimization. Despite the congested writing climate, our mission (read our maiden voyage) remains the same, to bring you practical pediatric advice. What fuels us? Our intense and comprehensive pediatric training from Children’s Hospital of Philadelphia, our combined over forty years of practicing pediatrics, and our passion for helping children and their families, give us the experience and the motivation to continue to help all of you whether online or in our offices.

A last blast from the past

How many of you remember our initial logo penned by the combined efforts of Dr. Kardos’s brother and her sister-in-law? That’s an iPod dangling from Dr. Lai’s neck-remember those?

It’s good to be ten.

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

hurray! launching a new look (photo credit: pixabay)

It’s no longer a secret. Many of you have noticed our new Two Peds in a Pod® logo. And indeed, we’re launching a whole new look. It’s a new vibe with the same dependable and relevant pediatric advice in a mobile friendly format!

The average blog’s lifespan is counted in months, not years, and as we complete our ninth year, we’re proud to have exceeded that expectation many times over. But it’s now harder to hang in.

Please don’t let us disappear off the internet!

As more and more advertisers jockey for spots at the top of search engines and more content crowds the web, it has grown tougher to reach parents. In fact, if you are reading this on Facebook, it’s because we’ve just paid Facebook to have this post reach all of our followers. We’re proud to avoid distracting pop-out ads on our blog, and we’re depending on your grassroot efforts to inform other parents and caregivers about our site. Invite your friends to follow us!

It’s been nine years, and like a cat with nine lives, we are determined to land on our feet. We believe, more than ever, that the internet is the best medium to reach you at all hours of the day. Help grow our worldwide presence.

Wishing you all Peds on earth!

Naline Lai, MD and Julie Kardos, MD
©2018 Two Peds in a Pod

Read our very first blog post from 2009 here.

Photo by Lexi Logan

Happy 8th Birthday Two Peds in a Pod!

If our blog had a “face” we would put a party hat on a smiling head with disproportionately large emerging adult teeth and a body with gangly legs and arms.  In honor of our blog’s eighth birthday  (read our very first post here) today’s post celebrates your eight-year-olds.

Typical eight-year-olds are no longer squishy-faced babies and no longer adoring young elementary school students who still think of their parents as heroes. Now you have an emerging friend-seeking, active child.

Eight-year-olds understand logic and are less apt to believe in “real” magic but are interested in spotting the “trick.” Parents may find that eight is the year that their child stops believing in Santa or the tooth fairy. If they do believe in Santa, expect them to question how Santa reaches all the children in one night, or how he can fit down a chimney.

This is an academic leap year. There is less hand holding in school. The switch-over from “learning how to read” to “reading in order to learn”  begins. Instead of rote memorization of individual words, reading comprehension increases and children now gain knowledge from books. Some eight-year-olds may prefer to read to themselves before bedtime because they can read to themselves faster than you can read to them. Even if they are reading on their own, continue to share books together at bedtime.  For many kids, this is the age when they begin to struggle academically if they have a previously unrecognized learning disability.

Eight-year-olds begin to notice kids who stand out, especially kids who act or look different from the other kids, and can be cruel with their observations and exclusions. Teach your child about differences and the importance of tolerance. As Dr. Lai tells her kids, “You don’t have to be friends with everyone, you just have to be nice.”

The long march through adolescence starts now. Some girls start to show the initial  sign of puberty called breast-budding (chest development). Teach your daughters about periods at this age because some girls begin to menstruate in the next couple of years, and girls who are caught unawares can become quite frightened by unexpected blood coming out of them. You can refresh your memories and check your facts about periods from our prior post on this subject.

Many eight-year-olds, even those who seem years away from puberty, become stinky. Trust us, you will notice, and so will others, so encourage them to wash their entire body, INCLUDING ARMPITS, every day WITH SOAP and to use deodorant daily. We do not have a favorite brand but you could look initially for a deodorant alone rather a deodorant/antiperspirant combination product as they may irritate young skin. Note that even though they may smell like adults, their brains are only eight years old, so you will have to remind your eight-year-olds to use the deodorant. One trick is to keep the deodorant next to the toothbrush so when they brush their teeth every morning, they will remember to incorporate deodorant into their morning routine.

Other self-care tasks also will need reminders. After years of tracking your child’s pee and poop pattern, you now probably don’t know when the last time your child moved her bowels. No need to follow your child into the bathroom, but every once in a while ask about their bowel and bladder habits. During the school year, be aware that eight-year-olds may avoid school bathrooms and don’t urinate all day, which can lead to problems with leaking urine (accidents) and urinary tract infections.

Eight-year-olds continue to  improve their concentration spans and have a greater interest in learning new skills. For many, this is the age of active sport participation (playing “real” sports games), the start of learning a musical instrument or foreign language, and club participation such as 4H or scouts. Some eight-year-olds begin to spend many hours a week in a chosen activity such as gymnastics (however, please note that the American Academy of Pediatrics recommends against home trampolines for all kids). Eight years is when they can handle the toys and art equipment that are labeled “for eight and above.” You will be impressed at the attention to detail that an eight-year-old can display in art projects.

Children this age often prefer to spend time with a friend rather than a younger sibling or parents. It is fun and also good for self-esteem for your child to host a friend at your home and to spend time with friends at their homes. While eight-year-olds are fully capable of entertaining themselves, they still require adult supervision, even if that supervision is from another room or floor of the house. Eight-year-olds do not yet need their own phones: an adult should always be present in case trouble arises. However, it is appropriate to teach your eight-year-old to use a phone and to arrange a get-together or a car pool after first checking with parents. Screen-addiction (to television, computers, and hand-held devices) starts early; set screen time rules now so that you won’t be frustrated later.

Speaking of self-reliance, by all means teach your eight-year-old to cook a simple meal, use the microwave and toaster oven, set and clear the table, do dishes, load and unload a dishwasher and washing machine, and take out the trash. Again, parents should supervise, but the goal is to create an independent adult. Eight-year-old egos enjoy a good boost when you acknowledge their increased sense of responsibility and contributions to running the household.

Last tip: if you are driving your child and an eight-year-old friend, be sure to have enough booster seats in the car for everyone (US law requires booster seats through age 8 years-see our post on car safety).

Yes, eight is great, and Two Peds is thrilled to celebrate this birthday.  Your eight-year-old celebrates this birthday smack dab in the middle of the “golden years” of parenting. During these years, they are too young to drive and too old to take a nap. The typical blog lasts less than 6 months, so keep us going by reading, sharing, sending us your post ideas, and inviting us to speak (twopedsinapod@gmail.com). Our information is only good if others read it and share it! Please “follow” us on Facebook, tweet about us, email subscribe, and continue to get the word out. Pediatric colleagues: we welcome guest bloggers, so if you have something to share that we haven’t already said, please contribute.

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

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

Today, as Two Peds in a Pod turns six years old, we think about our favorite six-year-old, Big Bird.

A friend sent me this link to an interview with Caroll Spinney on NPR. Now 81 years old, Caroll Spinney has played Big Bird on Sesame Street since the show first aired in 1969. According to the puppeteer, Big Bird has always been six years old.

Spinney wanted Big Bird to forever bubble over with the curiosity and enthusiasm for  learning which characterize a six year old’s development. In kindergarten or first grade, a six-year-old rapidly gains new skills. They learn how to read at this age if not earlier.

They like to belong to a group and feel included.

Sit in the back of a first grade classroom and listen to the class have a conversation. The teacher may ask the kids, “Who has ever been to the ocean?” and watch all the hands go up. As she calls on each child to tell his story about going to the beach, some kids tell about their beach vacations, some talk about which relative or friend they visited at the beach, and at least one six-year-old will say “I never saw the ocean, but I have a dog!” because they want so desperately to belong to the conversation.

As part of their interest in others, they will join sports teams, scouts, begin religious school or specialized language schools.

Although they may seem interested in everything, be careful not to over schedule. This might be the first year of “all day” school, and even a child who attended an all day childcare or kindergarten can tire out after a full day of learning. Also, as part of their interest in group participation, children may start to form “clubs” as they play. To ward off future bullying, teach your child,” You can’t be friends with everyone. You just have to be nice.”

Six-year-olds still have a great sense of wonder and imagination.

They believe in Santa Claus and the Tooth Fairy. They also are interested in science and nature, planets and dinosaurs, and how things work. They can simultaneously believe in the very real and concrete and believe in magic.

Six-year-olds ask “Why?”

And they are not shy about it: Why do I have to go to bed? Why does that man have only one leg? Why do helium balloons float? Why do people die? Sometimes the “Why’s” can lead into  whining, but luckily, six-year-olds can be easily distracted out of their perceived injustices.

Kids at this age tend to concern themselves with body integrity

They may cry over a relatively minor injury such as a paper cut or skinned knee. If you want attention from a room full of six-year-olds, put a Band-Aid on your arm and they will all ask, ” Why do you have a Band-Aid?”

We are excited that Two Peds in a Pod® turns six today. Like Big Bird, we hope to forever ask “Why,” as well as “How?” and “When?”  May your children continue to inspire a sense of wonder and curiosity in your lives, whether they are six months, six years, sixteen, or sixty!

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

Click here to read our very first post from six years ago.

Two Peds in a Pod is proudly brought to you by Dr. Julie Kardos and Dr. Naline Lai.

We are practicing pediatricians.
We met and became friends during our pediatric residency training at The Children’s Hospital of Philadelphia. In practice now for over 20 years, we are board-certified primary care pediatricians in The Children’s Hospital of Philadelphia Care Network. Currently, Dr. Kardos is also on-staff at St. Mary Medical Center and Dr. Lai is also on-staff at Doylestown Hospital in Bucks County, PA. We also serve on the advisory board of Happy Healthy Kids.

We are moms.
We are both married with three children apiece. A lot goes on between yearly check-ups with your child’s doctor. We understand that parents have questions about their children outside of office visits and turn to the Internet for answers. Two Peds in a Pod was launched in 2009 in order to provide a warm place for you to find common-sense, accurate, concise information.  

We are bloggers and guest speakers.
We’ve published over 500 posts and received great feedback from readers and the community. At times our medical advice crosses over into social commentary — for example, when fads like silly bands are cutting off circulation, or fashion trends like Uggs are creating stinky feet. Other professionals such as teachers, grief experts, and psychotherapists guest blog to give parents the full picture of what goes on with kids today. We also give talks around the country and record podcasts for fellow physicians — learn more about our public outreach.

We are glad you found us!
We are driven to write because of families like yours. We write to share the joy of raising children. Join us on our online journey around the world. Please help our outreach continue to grow by letting other parents know about our site, commenting, and sending ideas for future topics. Or invite us over for a “house call” at your next event.

For more on our story click here.

Pictured above, left to right: Dr. Naline Lai and Dr. Julie Kardos.

One year ago today we posted our first blog post Maiden Voyage and what an adventure it has been! In honor of Two Peds in a Pod’s first birthday we reprint Dr. Kardos’s post “Let ‘Em Eat Cake”:

After completing my pediatric training, I worked for a couple of years in a large pediatric office before I had any children of my own. I was always struck by the Life Event of a child’s first birthday. This milestone carries so much meaning and emotion for families. My patients’ parents described huge birthday parties with characters such as Elmo walking around or Moon Bounces, large catered affairs with numerous friends, family members, and entire neighborhoods. Often I would see a child sick in my office a few days before such an event with parents who were panicked that their child might be sick on his Big Day, or I would see a child for his one year well check and hear many details about the enormous party. Of course I also saw plenty of children a few days after their first birthday party who became ill, most likely, from a well-intentioned friend or relative who was already sick and passed the illness on to the birthday child at the party. I heard about the kids who clapped for the Happy Birthday song and kids who cried and one who vomited from excitement… all over the birthday cake. Many of my patients had their first full blown temper tantrum during their own over-stimulating first birthday party.

I remember not quite understanding why parents go through such effort and expense to throw a party that their child will never remember at a developmental stage where 99 percent of children are having stranger anxiety and separation anxiety. Well meaning famillies would often forgo daily routine to skip naps, eat at erratic times, and then expect their birthday child to perform in front of a large crowd singing loudly at them. “My husband and I will do it differently,” I would tell myself.

Now, three of my own children later, I must apologize for not quite understanding about that first birthday. I remember waking up on the day my oldest turned one year. My pediatrician brain first exclaimed “Hurray! No more SIDS risk!” Then my mommy brain took over, “Ohmygosh, I survived the first year of parenthood!” This day is about Celebration of the Parent. I finally understood completely why my patients’ parents needed all the hoopla.

Because I am actually a little uncomfortable in large crowds, my son’s first birthday party included all close relatives who lived nearby, people he was well familiarized with. Some pediatric tips I had picked up which I will pass on:

1)      Sing the Happy Birthday song, complete with clapping at the finale, for about one month straight leading up to the birthday. Children love music and hearing a very familiar song sung by a large group is not as overwhelming as hearing an unfamiliar song.

2)      Plan mealtime around your child, not the guests. If you are inviting people close to your heart, they will accommodate. Dinner can be at 5:00pm if that’s when your child usually eats, or have a lunch party that starts midmorning and then end the party in time to allow your child to have his regularly scheduled afternoon nap. Most one-year-olds are usually at their best in the morning anyway.

3)      If your child becomes sick, cancel the party. Your child will not be disappointed because he won’t understand what he is missing. You as parent would have a lousy time anyway because all of your attention will be on your ill child and you will be anxious. Your guests who are parents will appreciate your refraining from making them and their own children sick.

Recently while performing a one-year-old well check I asked about my patient’s birthday party and her parents told me “Oh, we didn’t have a party. It was like any other day, although we did give her a cupcake for dessert.”

Now THIS is a pragmatic approach to parenting because, again, no child will ever have memories of her own first birthday. However, I hope the parents did take time, at least with each other, to congratulate themselves and to feel really good about making it to that huge milestone in their parenting career. I hope they savored their accomplishment as much as their child savored the cupcake.

_____________________________

How far we’ve come, and it is all thanks to you. We’ve watched with excitement as our readership climbed from two hits (from our husbands) to almost 20,000 hits. Two Peds in a Pod now has email and Facebook subscribers. You can find us through directories such as Technorati and iTunes and recently, Two Peds expanded to the West Coast of the United States with a bimonthly column in Family Magazine Group. Some of our Face book friends hail from Canada and we consistently receive hits from the United Kingdom. Looks like our goal to impact one million kids around the world may not be a far-fetched dream.

Our greatest reward is when people say to us, “That blog post was so helpful.” We are thrilled to reach out to many families.

While our main podcast recording studio continues to be our kitchen table, we also recorded with one mom’s group in their living room and another parenting group in a child care center.  From focus group back out to cyperspace!

We still depend on you to tell other families about our site. Our sources of inspiration continue to be our patients, your children and our own clans. Please keep those topic suggestions coming! As working pediatricians and parents like you, we want to continue to be your reliable (and sometimes amusing) source of sound pediatric information.

Thank you for reading, listening, commenting and letting your friends know about Two Peds in a Pod. Let the adventure continue!

Sincerely,
Julie Kardos, MD and Naline Lai, MD
©2010 Two Peds in a Pod℠