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.”

Avoid the apology 

Avoid saying “I’m sorry.” Say instead, ”Even if this is tough, I am happy that this will protect you.”

Never lie

 If your kid asks “Will it hurt?” say “Less than if I pinch you.”

Watch your word choice. 

Calling an immunization “a shot” or “a needle” conjures up negative images. Avoid negative statements about injected vaccines. We cringe when parents in the office threaten their children with, “If you don’t behave, then the doctor will give you a shot.” Remember, shots protect against deadly diseases and are not punishments for children.

Kids talk

Be aware that kids, especially those in kindergarten, love to scare each other with tall tales. Ask your child what they have heard about vaccines. Let children know that Johnny’s experience will not be their experience. Clamp down on the older sibling who is teasing their younger one. Instead, enlist the older sibling to help quell any nerves. 

The moment is almost here

Pack some of the tools you use at home to calm your child. A favorite book or stuffy is comforting. Have your child practice breathing slowly in through her nose and blowing out worries through her mouth. For the younger children, bring bubbles or a pin wheel for your child to blow during the immunization. In a pinch, rip off a piece of the exam paper from the table in the room and have your child blow the paper.

The moment is here

Holding something very cold, placing a cold pack on your child’s arm around the area to be vaccinated, or placing a cold pack on the NON-vaccine arm can distract your child’s brain from feeling the pain of an injection. Some children prefer to look at the vaccination process, while others prefer to look away. Either way is fine. 

Tell your child to count backwards from 10 

It will be over before your child says the number seven.

Have as much direct contact with your child as possible. 

The more surfaces of their body you touch, the less your child’s brain will focus on the injection. By touching your child, you are also sending reassuring signals to him. For the younger child, if he is on the exam table, stay close to his head and hug his arms, or have him on your lap. Holding him firmly will make him feel safe and will prevent him from moving during the injection. Movement causes more pain or even injury.

For the older child and teens, hold their hands. We sometimes see parents of older teens and college students leave the room. However, even big kids may need company during vaccines.

After the drama is over

Have your older child sit quietly for a moment. As the anxiety and tension suddenly fall away, the body sometimes relaxes too suddenly and a child will start to faint. This phenomenon seems to happen most often with the six foot tall stoic teenage boys, but we’ve also seen teen girls and some younger kids get a bit light-headed. If your child becomes pale (or green), have them lie down for a few minutes until they feel better.

Compliment your child

Remind them that their vaccine will keep them from getting severely sick and allow them to see their friends, play their sports, and attend school.

For more tips click here.  

Someday all immunizations will be beamed painlessly into children via telepathy. Until then, we have no advice on how to take the sting away from the punch of a two year old.

Naline Lai, MD and Julie Kardos, MD
©2025 Two Peds in a Pod® revised from 2014

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.

For kids who drink coffee, tea, soda or any caffeine containing drinks- avoid these beverages any later than noon. Caffeine can last in the body for up to 24 hours and interferes with sleep.

Visit the bathroom

We know many kids who “hold it” all day in school, despite what we otherwise advise. Remind your children to stop by the potty at least once during the school day. If they claim they don’t need to urinate, they may be dehydrated. Send them in with a water bottle to school. Dr. Lai is fond of saying “You wouldn’t walk around with a baggie full of pee on the outside. So don’t walk around with one on the inside.”

Eat

Pack healthy snacks. Remind your kids that candy has no nutritional value.

Instead of only packing carbohydrates, try giving sliced carrots/celery/peppers and supply hummus, peanut butter, or cream cheese for dipping. Consider packing apple or pear slices along with nut butters or a slice of cheese.

Milk can be a good drink to send along with snacks-even if your child does not eat, they will get some protein as well as carbs from the milk.

Give your child enough time to eat breakfast in the morning. Pack a well balanced lunch, and offer the above snacks after school in addition to packing them for the school day.

Immunize

Flu shots are available by late August/early September each year and some pharmacies already carry them. New this year, some health insurance companies will allow parents to administer the nasal FluMist vaccine at home to their children-ask your pediatrician if your child medically qualifies for this. Otherwise, take them to their pediatrician, school health clinic, or local pharmacy for their annual flu vaccine.

Covid vaccines are safe and effective for children. They reduce the chance of severe Covid complications that would require hospitalization, reduce death from Covid, and also prevent long-Covid symptoms such as months of cough and/or fatigue. The American Academy of Pediatrics (AAP) recommends Covid vaccines for all children this year if they have never had one.

Be sure all of their vaccines are up to date. These include vaccines that prevent meningitis, pneumonia, whooping cough (the “100 day cough,”) measles, mumps (can cause sterility and deafness), and polio.

Stock of up these items to help your child if they get a back-to-school cold:
Honey, nasal saline, tylenol or ibuprofen

And just in case, remind yourself of what to do if the boogers begin to flow by reading our “back-to-school cold” post.

Have a wonderful school year!

Julie Kardos, MD and Naline Lai, MD
©2025 Two Peds in a Pod®

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.

By two months of age, some babies take 4 ounces at every meal, others guzzle 8 ounces and are content with longer intervals between feedings. Your pediatrician will weigh your baby and measure your baby’s length and head size to be sure that they are getting enough to eat. If your baby is peeing and pooping several times daily, they are likely drinking enough to gain weight.

Put more formula or breast milk in the bottle than you expect your baby to take. Allow them to stop when they are no longer hungry. Cajoling your baby to finish up the last drop takes away their ability to follow their own hunger drive. It also can lead to more spit up. Be okay with “wasting” some formula or breast milk. Likewise, if your baby starts to fall asleep while feeding, it is time to end the feeding. Put them into their crib or bassinet. Teach them that “Cribs are for sleeping” and “Bottles are for feeding.” Think of this action as the gentlest form of sleep training. Babies who are not hungry but continue to “dream” feed may face cavities when their teeth come in. This is because of having formula or breast milk (both are sweet) constantly bathing their gums.

How often should your baby eat?

Some bottle fed babies start out eating every two hours, others feed every 3-4 hours. By two months, some babies sleep between 8-10 hours overnight and make up for the “missed feedings” by eating more frequently during the day. Offer a bottle when they act hungry.

Should bottles be sterilized?

According to the Centers for Disease Control, baby bottles should be sterilized for infants under two months of age. After that, wash bottles well with warm soapy water or in the dishwasher.

If using powder formula, you may mix it with tap water. If you drink your own tap water, your baby can too. But if you routinely boil or filter your own drinking water, do the same for your baby. You don’t need to buy bottled water, “nursery water,” or any other gimmicky water. If you drink well-water, have it tested for contaminants before you use it to mix formula powder, or buy read-to-feed formula.

If you have old lead pipes, test your water for lead. Additionally, use cold water for preparing baby formula, as hot water leaches the lead more easily into the water from the pipes.

If your baby is under 2 months of age, was born prematurely, or has an immune deficiency, talk to your pediatrician about how to prepare powder formula or if you should give liquid formula instead.

Avoid the microwave

Microwaves produce hot-spots that can burn a baby. The American Academy of Pediatrics advises warming a bottle in a bowl of warm water. This is all moot if your baby takes formula at room temperature. Try room temperature… you never know!

Best formula choice

Standard FDA-approved cow-milk based formulas with iron meet most babies’ needs. Some parents have coupons for one brand over another. It is perfectly okay to save money and buy the store brands. It is safe to toggle between brands, breast milk or types of formulations (eg ready-to-feed vs. powder). Some formulas are made from goat’s milk and some are organic. As long as you buy an FDA regulated formula, all of these are safe and nutritious for your baby. The ingredient list does not differ much among formulas that promote “for fussy babies, for gassy babies, for colic babies, etc.”

There are several concerns over formulas obtained from other countries. They are not regulated by the FDA. Also, formulas may not be shipped or stored correctly, potentially leading to temperature fluctuations that can affect nutrients. Of further concern, if there is a formula recall, you might not hear about it until much later. Other concerns about formulas produced outside of the United States are delineated in this post by the American Academy of Pediatrics.

You may have read in the news recently that formula contains lead and other heavy metals- is this a real concern?

This consumer report, released in March 2025, analyzed infant formulas sold in the United States. The bottom line is that most formulas are safe and the FDA needs to continue their active involvement in infant formula regulation.

Transitioning to a “big kid” milk

For health reasons, do not give your baby any cow’s milk, goat’s milk, or nut/oat/soy milk before their first birthday. Before a year, anything besides formula or breast milk may not provide enough nutrition for growth and may irritate the gut enough to cause microscopic bleeding. Bleeding can lead to severe iron deficiency which can affect brain growth and hinder normal development.

Infant formula has the same calorie count and similar nutritional content as breast milk. Love and food can come through a bottle. Ultimately, what works within your family is what is right for your baby.

Julie Kardos, MD and Naline Lai, MD
©2025 Two Peds in a Pod®

We know parents who started reading to their children before they were born, but don’t fret if you didn’t start when baby was in the womb. It’s never too late to start. Today we give you a developmental guide to reading with your young child.

Three months of age

By three months of age, most babies are sleeping more hours overnight and fewer hours during the day (and, hence, so are their parents). Now you have time to incorporate reading into your baby’s daily schedule. At this age babies can visually scan pictures on both pages of a book. Babies see better close-up, so you can either prop your baby on your lap with a book in front of both of you, or you can lie down next to your baby on the rug and hold the book up in front of both of you. The classic Goodnight, Moon by Margaret Wise Brown or any basic picture book is a great choice at this age.

Six months of age

By six months of age many babies sit alone or propped and it is easier to have a baby and book in your lap more comfortably. Board books work well at this age because 6-month-olds explore their environment by touching, looking, and MOUTHING. Sandra Boynton’s Moo, Baa, La La La was a favorite of Dr. Kardos’s twins at this age, both to read and to chew on.

Nine months of age

By nine months many babies get excited as you come to the same page of a known book that you always clap or laugh or make a funny noise or facial expression. They also enjoy books that involve touch, such as Pat the Bunny, by Dorothy Kunhardt.

One year

At one year, kids are often on the move. They learn even when they seem like they are not paying attention. At this age, your child may still want to sit in your lap for a book, or they may walk or cruise around the room while you read. One-year-olds may hand you a book for you to read to them. Don’t read just straight through a book, but point repeatedly at a picture and name it.

18 months old

By 18 months, kids can sit and turn pages of a book on their own. Flap books become entertaining for them because they have the fine motor skills that enable them to lift the flap. The age of “hunter/gatherer,” your 18-month-old may enjoy taking the books off of the shelf or out of a box or basket and then putting them back as much as they enjoy your reading the books.

Two-year-olds

Two-year-olds speak in two word sentences, so they can ask for “More book!” Kids this age enjoy rhyming and repetition books. Jamberry, by Bruce Degen, is one example. You can also point out pictures in a book and ask “What is that?” or “What is happening?” or “What is he doing?” Not only are you enjoying books together, but you are preparing your child for the culture of school, when teachers ask children questions that the teacher already knows the answers to.

Here is some magic you can work: you may be able to use books to halt an endless tantrum: take a book, sit across the room, and read in a soft, calm voice. Your child will need to quiet down in order to hear you and he may very well come crawling into your lap and saving face by listening to you read the book to him.

Three-year-olds

Three-year-olds ask “WHY?” and become interested in nonfiction books. They may enjoy a simple book about outer space, trucks, dinosaurs, sports, puppies, or weather. They can be stubborn at this age. Just as they may demand the same dinner night after night (oh no, not another plate of grilled cheese and strawberries!), they may demand the same exact book every single night at bedtime for weeks on end! Try introducing new books at other times of day when they may feel more adventurous, and indulge them in their favorite bedtime books for as long as they want. They may even memorize the book as they “read” the book themselves, even turning the pages at the correct time.

Four and five-year-olds

Four and five-year-olds have longer attention spans and may be ready for simple chapter books. For example, try the Henry and Mudge books by Cynthia Rylant. Kids this age still enjoy rhyming books (cue in Dr. Seuss) and simple story books. At four, kids remember parts of stories, so talk about a book outside of bedtime.

Some children this age know their letters and even have some sight words, but refrain from forcing your child to learn to read at this age. Studies show that by second grade, kids who have been exposed to books and reading in their homes are better readers than kids who have not, but the age children start to read does not correlate with later reading skills. So just enjoy books together.

E-readers and iPads

What about e-readers and books on ipads? The shared attention between a parent and a child is important for developing social and language skills, so share that ebook together.

Now that you have read our post, go read to your child, no matter how old he is. Even a ten-year-old enjoys sharing a book with their parents. Eventually, you will find your whole family reading the same book (although maybe at different times) and before you know it, you’ll have a book club…how nice, to have a book club and not worry about cleaning the house ahead of time…

Julie Kardos, MD and Naline Lai, MD
©2025 Two Peds in a Pod® originally posted in 2017

With measles, Benjamin Franklin’s old saying, “An ounce of prevention is worth a pound of cure,” holds. Unfortunately, pediatricians don’t have any medication that kills the measles virus. Children who are hospitalized are given support, but nothing to kill the germ. For instance, pediatricians may give oxygen to children with measles pneumonia. Pediatricians may also give Vitamin A to help prevent blindness from measles, but again, vitamins do not stop the germ.

Giving your child the MMR (Measles, Mumps, and Rubella) vaccine is the best and most natural method to prevent measles. Immunizations prompt a body’s own immune system to make antibodies. These “germ fighters” are ready to defend your child when a nasty virus like measles appears. Pediatricians give this vaccine according to a tried and true vaccine schedule at 12-15 months of age and again at 4-6 years of age. The recent death of an unvaccinated child from measles in Texas serves as a tragic reminder of the risks of not vaccinating.

How nasty is this virus?

Pretty nasty. About 1 in 5 people infected with measles end up in the hospital, and pneumonia strikes about 1 out of about every 20 children with measles. If you think about a classroom of children, that’s a lot of kids.

Also, with measles, Friedrich Nietzsche’s old saying, “What does not kill you makes you stronger,” does not necessarily hold. Measles can cause “immune amnesia.” This means that measles causes your body to “forget” about prior viral infections. Remember your child’s first year of daycare when they seemed to catch “everything?” Surviving measles could mean that your child can “catch everything” again. You can read more about this problem here.

For information on what symptoms to watch for, read the Children’s Hospital of Philadelphia’s recent post about measles.

For more vaccine information, please refer back to our prior post about how vaccines work.

We kicked this ugly disease out of the United States once; we can do it again!

Naline Lai, MD and Julie Kardos, MD

©2025 Two Peds in a Pod®

Dr. Kardos recalls what a game-changer it was when her twin babies could feed themselves. Although messy, it was much easier than spoon feeding simultaneously two hungry babies. Now that you started your baby on solids using ideas from our last post, let’s move on to tips on cups, finger foods and more. Mealtime will be less chaotic.

Cups and finger foods

Starting at six months your child moves towards three solid food meals a day. Babies continue to drink breast milk or formula in between, but you can start teaching them how to use a cup. Offer a few sips of water, formula or breast milk when they sit down to eat. Use any type of cup, including an open cup. Avoid juice since it contains a lot of sugar and very little nutrition.

By nine months your baby will eat three meals a day. Unlike a six-month-old who grabs at objects using their entire fist, a nine-month-old begins to pick up small pieces of food between their finger and thumb. Check out this post on finger foods if you need some examples of nutritious foods to offer.

Health and safety alerts

Have your child sit at a table with a grownup during meals. This is for safety, education, and socialization. You will be there to provide assistance if your child chokes (click here to find a CPR class near you or virtually). Children learn to eat by watching you eat. And finally, you will create a lifelong habit of gathering together for meals.

Avoid choking hazards. Cut table food into bite-sized pieces smaller than a grape, or approximately Cheerio® sized. Avoid raw vegetables, chewy meats, nuts, and hot dogs since these foods never “mush down.”

Offer structured meal times. Grazing on food and drink all day leads to cavities and suppresses appetite.

Other food tips

About fish: Fish is packed with nutrition. But which fish to dish? Salmon and cod are good choices. Avoid the few that may contain mercury such as swordfish and orange roughy. Check this FDA site for a comprehensive list.

Avoid fried foods and highly processed foods. Do not buy “toddler meals” which are high in salt and “fillers.” If the first three ingredients are “flour, water, sugar/corn syrup,” don’t buy it. We are dismayed by the baby-junk food industry that insinuates that “fruit chews,” “yogurt bites” and “cookies” have a place everyone’s diet. Instead, feed your child REAL fruit and ACTUAL yogurt.

The bottom line about feeding your baby

Keep in mind the overall goal: Children should eat because they are hungry, not because they are bored, tired, or because parents want them to eat. Enjoy mealtime with your baby. As Dr. Kardos can attest, these same babies will run through the door after school asking, “What’s for dinner tonight?”

Julie Kardos, MD and Naline Lai, MD

© 2025 Two Peds in a Pod®

Your baby stares at you as you eat, and their eyes follow everything you put into your mouth. Are they ready to join your family at the dinner table?  Has your pediatrician given you the go-ahead to start feeding your baby solid foods? Here are tips on how to start your baby on food.

Before you get started

Eating a meal with family is social as well as nutritious. Keep eating a pleasant and relaxed experience. Avoid force-feeding or tricking your child into eating. Feed your baby at the family table. Your baby learns to eat by watching others eat. Family meals foster family connections.  

The first taste: Babies expect a breast or a bottle when hungry. So make sure your baby is happy and awake but NOT starving the first time you feed her solid food because at this point she is learning a skill, not eating for nutrition. Keep a camera nearby because babies make great faces when eating food for the first time. Many parents like to start new foods in the morning so that they have the entire day to make sure it agrees with their baby. 

Babies often start out eating solid foods between 4-6 months, although it is fine to keep them on breast milk or formula exclusively until six months of age. Food is for fun and less for nutrition at this point. Teeth are not required;  however,  good head control is. It’s hard to eat when you can’t hold your head up! You can offer foods directly from your plate. Mash up what you are eating, or offer a piece of food too large to choke on – cue in a chicken drumstick – for your baby to explore with their mouth.

Avoid putting cereal or any solid foods into bottles. It is a choking hazard, gets stuck in the nipple and does not count as “learning to eat.”

How to feed

Sit your baby in a high-chair at the table with your family. Your baby learns by imitation, so now is a great time to establish healthy eating habits for the baby as well as yourself. 

Some babies will learn in just one feeding to open their mouths when they see the spoon coming, and to swallow without gagging. They already likely bring toys to their mouths to explore, so an alternative to offering pureed food on a spoon is allowing them to pick up their own food to explore and taste. Some refer to allowing babies to self-feed from the start as “baby-led weaning.”

Other babies take several weeks to catch on to the idea of eating solids. They may gag as they try new food. This gag reflex protects their airway and allows them to spit out food that they did not properly mash in their mouth. Choking is different and is rare. Take a CPR class to learn what to do if your child chokes.

It’s best to try one new food at a time. Then, if your baby has a reaction to the food such as a rash, diarrhea, or a frowny face, you’ll know what to blame.

What to feed

Flexibility: There’s no single “best” first food. Depending on your culture, you might introduce lentils, hard boiled eggs, or oatmeal first. If giving baby cereal, mix it with breast milk or formula rather than water or juice.

Nutritional focus: Choose iron-rich foods like pureed meats, tofu, lentils, or iron-fortified baby cereals. Babies need extra iron as their stores from birth diminish.

Allergy prevention: Introduce peanut-based products and other allergenic foods early to help reduce allergy risks. Once your baby tries an allergenic food, it is important to keep it in their diet consistently. Read the guidelines here. 

Avoid honey: Honey before one year of age can cause botulism, a muscle- paralyzing illness.

Tempted by food pouches? They are convenient, but also expensive. They are not as “educational” for your child, as all food in pouches have identical consistency. Plus, as Dr. Kardos likes to point out, “We are raising children, not astronauts.” Directly feeding from a pouch teaches kids to suck their food. Place the contents onto a spoon instead. Babies advance their oral motor skills when they manipulate different textures, and their taste buds expand as they eat foods that vary in flavor.  

Variety is the spice of life: once you know a food agrees with your baby, you do not need to feed the same food day after day. In particular, because of concerns of arsenic, avoid overindulgence in rice cereal. 

Not all kids like all foods. Don’t worry if your baby hates carrots or bananas. Many other choices are available. At the same time, you can offer a previously rejected food multiple times because taste buds change.

How do I know when to stop feeding?

Follow your baby’s hunger cues.  Feed until they turn their head away or otherwise show disinterest.

And what do I do about nursing and bottles?

Unlike adults who eat and drink at the same meal, babies eat and drink at separate times. They can continue to breast feed or bottle feed at their usual times. You will notice that the more solids your baby eats, the less liquid they drink. For a preview of coming attractions: by 8-9  months of age, most babies naturally decrease liquid intake and breast feed/bottle feed  3-4 times per day. This translates to drinking about 12-24 ounces per day. 

Stay tuned for more feeding tips

Now that you’ve read our tips on how to start feeding your baby on food, stay tuned for more helpful feeding tips for continued success and lifelong healthy eating.  

Julie Kardos, MD and Naline Lai, MD

© 2025 Two Peds in a Pod®

A google search of baby food pouches yields overwhelming options. When I see babies sucking on these pouches I think: are we in a spaceship? We are raising children, not astronauts. Most of us do not suck our meals; we bite and chew them. Please consider the following problematic aspects of baby food pouches before you buy more of them.

The texture in every food pouch is the same. 

Babies develop their tongue muscles and jaw muscles by experiencing different textures. They learn to move food from the center of their mouth to the sides, where their gums are. As they grow teeth they learn how to use them for biting and chewing foods. Homemade purees such as oatmeal and mashed potatoes differ from each other. Pouch purees are identical to each other and offer little in the way of challenging and strengthening mouth muscles. 

The flavor of every specific pouch is the same. 

Every strawberry pouch tastes the same as the next, every spinach and broccoli pouch tastes the same as every other spinach and broccoli pouch, every pear and oatmeal pouch tastes the same. However, each of these whole foods can vary in flavor, color, and texture. Taste buds develop with exposure to differing flavors. Variety is the spice of life and a diet heavy in pouch food may not encourage your children to try new foods. 

Dental health and general health alert

Grazing on food pouches causes the same potential outcome as grazing on sippy cups full of milk or juice: the sugar bathes teeth and gums in sugar, leading to cavities in those very teeth that your baby worked so hard during sleepless nights to grow. Even pouches with “no added sugar” contain plenty of sugar to injure young teeth. If even one fruit is listed in the ingredient list, then likely the pouch contains well above the recommended sugar level for babies. You can read more about how manufacturers of baby foods fail to meet World Health Organization standards of baby nutrition and mislead consumers here.

Heavy metals were found in some baby food pouches. According to Consumer Reports, fresh or frozen foods generally are safer for babies than food pouches. 

Pouches are expensive!

For instance, a 3.5 oz banana food pouch by a well-known brand costs $1.69. Extrapolating, a pound of this same pure banana food pouch costs $7.72. Compare this to the average price for one pound of bananas in the US: around 63 cents. Put another way: Banana food pouches can cost 12 times more than fresh bananas.

The cap of a baby food pouch poses a choking hazard.

If the cap fits through a toilet paper tube or a paper towel tube, it is small enough to get lodged in a child’s airway. Be sure that your baby cannot grab the cap.

The plastic of baby food pouches adds to environmental pollution. 

The pouches are not always recyclable and end up in landfills. Pouches fail to support a greener lifestyle.

Our conclusion 

Baby kangaroos live in pouches. Astronauts live on pouches. We propose that the rest of us should live pouch-free. 

Julie Kardos, MD with Naline Lai, MD

© 2024 Two Peds in a Pod® Banana image created wtih ChatGPT

This is not the first time we have published this post. Again, a school shooting happened, and you may be wondering how to explain this tragedy to your children.

Understand that your kids sense your emotions. Not telling them about an event may make them concerned that they are the cause for your worried hushed conversations. Break away from your discussion with adults to say, “Do you know what we are talking about? We are not talking about you.”

While difficult, it is possible to talk about a school shooting with your child in an age-appropriate manner.

Even though an event may be far away, media makes it seem as if it happened next door, and sooner or later your children will see or hear about it. Tell the facts in a straight forward, age appropriate manner. Answer questions and don’t be afraid to answer with an “I don’t know.”

Preschoolers are concrete in their thinking—dragons are real and live under their bed, so don’t put any there that do not exist. For a preschooler a simple “Mom is sad because a lot of people got hurt,” will suffice. Young school-aged kids will want to know more details. And be prepared to grapple with more high level questions from teens.

Look for the helpers.

Mr. Fred Rogers, who hosted Mister Roger’s Neighborhood for 30 years, tells this story about seeing scary things on the news: “My mother would say to me, ‘Look for the helpers. You will always find people who are helping.’ To this day, especially in times of ‘disaster,’ I remember my mother’s words, and I am always comforted by realizing that there are still so many helpers-so many caring people in this world.”

What if the kids ask, “Will that happen here?” or “Why did that happen?” Again, reassure in a simple, straight-forward manner. For instance, you can say, “Many people are working hard to prevent something like that here.” Consider answering the question with a question. Asking “What do you think?” will give you an idea of exactly what your child fears. You can also reach out to other family supports for help with answers. Say to your child, ”I wonder what our minister or school counselor has to say about this, let’s ask.”

More ways to help your children

Routine is reassuring to children, so turn off the background 24 hour television and internet coverage and make dinner, take them to sports activities, and get the homework done.

Give your kids something tangible to do to be helpful. Help them set up a coin donation jar at school or put aside part of their allowance for a donation.

Some children become overly anxious and fearful. If your child’s worries interfere with her ability to conduct her daily activities, such as performing at school, sleeping, eating, and maintaining strong relationships with family and friends, then seek professional help.

Parent your children so they feel secure in themselves and secure in the world around them. You may not hold the answers to why a tragedy strikes, but you do hold the ability to comfort and reassure your children.

For more advice on this difficult topic, please see this American Academy of Pediatrics recommendation for parents.

Naline Lai, MD and Julie Kardos, MD
©2024 Two Peds in a Pod®, adapted from our 2018 post

Do you plan to travel with young children this holiday season? You won’t appreciate how much your baby has grown until you attempt a diaper change on a plane. For families, any holiday can become stressful when traveling with young children is involved. Often families travel great distances to be together and attend parties that run later than their children’s usual bedtimes. 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.

Before you travel

Identify the nearest children’s hospital, urgent care center, or pediatrician who is willing to see out-of-town new patients. This way, if your child becomes ill enough to need medical care while you are away from home, you will already know where to go. Also be sure that your children are up to date on all recommended vaccines. You wouldn’t want your child to receive a “gift” of flu or whooping cough on your travels.

Traveling with young children: flying

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.

Refrain from offering 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 slumber.

Traveling with young children: poor sleepers and picky eaters

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 climbs 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. One exception about problem solving to consider 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 years ago when one of her children ate too much of the beautiful and 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.

Avoid germ spread, but also keep perspective

If you have a young baby, take care to avoid losing control of your ability to protect your 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. Dr. Lai likes to think it made her father-in-law’s recovery go more smoothly.

Traveling with shy children

If you have a shy child, try to arrive early to the family gathering. This avoids the situation of walking into a 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 greet guests, 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.

It’s ok to change course

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.

Holiday travel is special for children

Enjoy your CHILD’s perspective of holidays! Enjoy their pride in learning new customs, their enthusiasm for opening gifts, their joy in playing with cousins they seldom see, their excitement in reading holiday books, and their happiness as they spends extra time with you. This experience makes traveling with young children worth the extra planning.

We wish you all the best this holiday season!

Julie Kardos, MD and Naline Lai, MD
©2024 Two Peds in a Pod®
Updated from 2017