First, tell your children that you love them. Then, read this post where we explain heart murmurs.
We hope you have a Valentine’s Day that can’t be beat!
Julie Kardos, MD and Naline Lai, MD
©2020 Two Peds in a Pod®
veggies, veggies, veggies
“Monitor your child’s diet closely to make sure they are getting enough calories… Some teens need 4,000 calories a day when they’re in a growth spurt!”
Check out the Children’s Hospital of Philadelphia Tip of the Week- a post on vegetarian teen diet basics with input from Dr. Lai!
Julie Kardos, MD and Naline Lai, MD
©2020 Two Peds in a Pod®
Substance abuse, bullying, poverty, violence, chronic illness— all adverse childhood experiences that can lead to toxic stress in children. Sounds overwhelming, but there are ways from the CDC (Centers for Disease Control) to prevent adverse experiences in childhood from causing lifelong trauma. Bloggers like us are teaming together with the American Academy of Pediatrics to spread the word about one method which carries the hashtag #findyour3.
Adverse childhood experiences (ACEs) can cause unremitting stress. Termed “toxic stress,” this type of stress will actually change a child’s brain structure. This stress can lead to health and social problems such as depression, substance abuse, diabetes, heart disease, chronic lung and kidney disease, and even unemployment.
Identifying just three people or organizations that kids can turn to for help, can build resilience in the face of adversity. The three can include a parent, grandparent or other relative. But the three do not have to be biologically related. Pediatricians, therapists, teachers, counselors, neighbors, sports coaches, or youth group leaders are all examples of possible positive adult influences. Encourage your own child or children you know to engage in school or community related activities in order to help them to find their three.
For a more comprehensive review of ACEs and the prevention and treatment of toxic stress please see this review article from the NIH (National Institute of Health).
You can also read some of our earlier posts for more ways to build resilience in your children and ideas on how to explain scary news to your children. Also, read on how to tell your child about an impending divorce and tips on how to communicate effectively with your young children.
Spread the word #findyour3 #preventACEs
Julie Kardos, MD and Naline Lai, MD
©2020 Two Peds in a Pod®
“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®
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.
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.
It can take 2-3 weeks for ALL symptoms of a cold to resolve. However, kids usually feel their worst during the first week. If they are not feeling too miserable, they can still go to school. Keep your child home from school if they require too much TLC for a teacher to provide while caring for everyone else in the class. Older kids should stay home if they feel too tired or miserable to learn. Having trouble getting an older kid to pack a water bottle and go to school? Just remind them, “There is nothing wrong with your brain…just your nose.”
How to keep from getting a winter cold virus? Wash your hands, wash your kids’ hands, and did we remember to say “wash hands?” Remember to get everyone in your family the flu vaccine, because the flu is MUCH WORSE than a cold, and you already know how miserable a cold can make your child feel.
And please do NOT use the cold remedy in the photo that Dr. Lai took at the museum. Better to ride out the winter cold with “tincture of time,” and chicken soup.
Julie Kardos, MD and Naline Lai, MD
©2019 Two Peds in a Pod®
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®
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®
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®
Has 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.
If you breastfed, you may remember this scenario: you were breastfeeding your 6-month-old when they suddenly bit you very hard with their new tooth.
Did you continue to breastfeed calmly and ignore the mind numbing agony? Did you say in a sweet sing-song voice, “Honey, biting hurts Mommy. Mommy does not like being hurt. Please do not do that again?”
If you are like Dr. Kardos and Dr. Lai, you did not have time to say any of the above, because you were suddenly in PAIN. You likely removed your baby from your breast immediately and yelled, “OW!” Your baby (like each of ours) may have cried (howled) from surprise. However, your baby probably never bit you again while breast feeding!
Fast forward to the present and imagine you are holding your 16 month old and they hit, bite, pinch, pull your hair, or pull off your glasses. Maybe they were angry, but equally possible they may have been simply excited. Even though you know they are not purposefully hurting you, it is important to stop this behavior. Say in a firm voice: “No hitting!” and put them down.
Time-out does not have to be spent on a chair in the corner of the room. Time-out is not a terrible punishment. Just like in sports, it is a pause in the play. By giving a time-out, your child learns that they do not get more attention for mean or aggressive behaviors, but less attention. As a variation, you can time-out a toy.
What if your baby starts crying on the floor? Give them a minute to recover. Remember that time-out lasts one minute per year of age. For your 16 month old, time-out will last one minute. At two years, time out will last two minutes. When time-out is complete, offer comfort. If they repeat the behavior, put them back down again.
Your goal, when you set limits for your child, is to stop a behavior that can hurt them or hurt others.
For example, “Good job putting your toys back into the box,” or “I like how you remembered to take my hand when we cross the street,” or “I like how you sit in your chair at dinner instead of standing up.” You will be amazed at how often children repeat desired behaviors that you point out to them.
If your toddler got a hold of a pair of scissors, you would take those scissors away immediately, without thought or fear about their feelings. You would put your child’s immediate safety ahead of their desire to play with scissors, and you would not stop to explain why they should give up this new-found plaything. Likewise, if you tell your child to come to you for any reason, be ready to physically go and lead them if they choose to ignore you. For instance, at a party, wait to tell them to come until you are ready to go. Otherwise they will learn that you “cry wolf” and will ignore you.
If your child throws a toy train at his friend’s house, say “No throwing trains!” and take the train away for a time-out. Telling them that “you are in trouble when we get home” means nothing to a toddler.
Toddlers have a TINY attention span. Just give them a command or an explanation that is 3-4 words or less. For example, “No hitting, it hurts!” is enough. Telling them that hitting hurts others, asking how would they like to be hit and telling them about the need to be kind, is wasted effort. The time for longer explanations is when they are developmentally capable of putting themselves in another’s shoes, around age six years for most children.
Say “No throwing sand!” not “You are bad for throwing sand!”
Toddlers are not mind-readers. You need to tell them not to open the trash can and rummage through it, otherwise they will not know any better.
For instance, as you see your child raise their hand to hit you, firmly hold their wrist and say “Don’t hit. Soft touches,” and simultaneously bring their hand to pat your cheek. This will give you a chance to praise your child.
Toddler tantrums are NORMAL reactions to feeling angry or frustrated. Many toddlers throw tantrums in response to your telling them “no” or “stop.” It is not fair to expect toddlers not to throw tantrums. Just put on your bored face (and some ear plugs) and wait for it to be over.
If a tantrum immediately occurs, remind yourself that at least you stopped your child from hurting themselves or others. Tantrums don’t hurt anyone. You can read more about how to manage tantrums here.
When you set limits for your child, you teach them to behave in ways that will keep them and others safe. Act confidently when you set limits, and your child will learn to interact appropriately with others and gain self-control.
Julie Kardos, MD and Naline Lai, MD
©2019 Two Peds in a Pod®
Now that school has been in session for over a month, it’s not too early for you to learn all about strep throat. It might even save you a trip to the doctor’s office!
Julie Kardos, MD and Naline Lai, MD
©2019 Two Peds in a Pod®