We’ve heard some interesting things about cow’s milk over the years. I am going to share with you four myths about milk that I continue to hear from my patients’ parents. Spoiler: reading myth #4 can save you lots of money.

Myth #1: Don’t give milk to a child with a fever, the milk will curdle (or some other variant).

Truth: As long as your child is not vomiting, milk is a perfectly acceptable fluid to give your febrile child. In fact it is superior to plain water if your child is refusing to eat, which is very typical of a child with a fever. Fevers take away appetites. So if your child stops eating while she is sick, at least she can drink some nutrition. Milk has energy and nutrition, which help fight infection (germs). Take milk, add a banana and a little honey (if your child is older than one year), and maybe some peanut butter for added protein, pour it into a blender, and make a nourishing milk shake for your febrile child. Children with fevers need extra hydration anyway. Even febrile infants need formula or breast milk, NOT plain water. The milk will not curdle or upset them in any way. If, on the other hand, your child is vomiting, then stick to clear fluids until her stomach settles.

Myth #2: Don’t give children milk when they have a cold because the milk will give them more mucus.

Truth: There is NOTHING mucus-inducing about milk. Milk will not make your child’s nose run thicker or make his chest more congested. Let your runny-nosed child have his milk! Yet my own mother cringes when I give my children milk when they have colds. Never mind my medical degree; my mom is simply passing on the wisdom of HER mother which is that you should not give your child milk with a cold. Then again, my grandmother also believed that your body only digests vitamin C in the morning which is why you have to drink your orange juice at breakfast time. But that’s a myth I’ll tackle in the future.

Myth #3: You can’t over- dose a child on milk.

Truth: Actually, while milk is healthy and provides necessary calcium and vitamin D, too much milk CAN be a bad thing. To get enough calcium from milk, your child’s body needs somewhere between 16 to 24 ounces of milk per day. Of course, if your child eats cheese, yogurt, and other calcium-containing foods, she does not need this much milk. New recommendations for healthy Vitamin D requirements have been increased recently to 400 IU (international units) daily which translates into 32 ounces of milk daily. BUT we pediatricians know from experience that over 24 ounces of milk daily leads to iron-deficiency anemia: calcium competes with iron absorption. You’re better off giving an over-the-counter vitamin such as Tri-Vi-Sol or letting older children chew a multivitamin that contains 400 IU of vitamin D. In addition to iron-deficiency anemia, drinking all that extra milk is bad for teeth (all milk contains sugar) and can also lead to obesity from excessive calories or can in fact lead to poor weight gain in children who are picky eaters to begin with: the milk fills them up too much for them to have any appetite left for food.

Myth #4: Organic milk is healthier than non-organic milk.

Truth: If you compare organic milk to non-organic milk, the nutrients on the label of the milk carton are the SAME. “But what about the growth hormones in milk,” you may wonder. First of all, cows may be supplemented with growth hormone, but their milk is not. In addition, let me explain about growth hormone. Some children are actually born without growth hormone, and other kids develop growth hormone deficiency because of kidney failure, or cancer treatment, or other medical problems. These children need supplemental growth hormone. Unfortunately for these kids, the only way that we have to give growth hormone to these kids is by injection (a shot) every day. Do you know why? Growth hormone gets DIGESTED in the stomach and is not active if a child eats/drinks it. SO, even if non-organic milk contained growth hormone (which it doesn’t) then your child would have no effects of it anyway because their guts would break it down before it could act on their bodies. WHEW! So unless you just like the taste better, you do NOT have to spend twice as much money on organic milk. Just buy regular milk. Put that extra money away in your college funds.

In summary, you can safely continue serving your children milk in sickness and in health, in moderation, at a lower cost than organic, every day. Now, all this talk about milk really puts me in the mood to bake cookies…

Julie Kardos, MD with Naline Lai, MD
©2013 Two Peds in a Pod®

Update: Please read this article , by the American Academy of Pediatrics in 2012, for a comprehensive, unbiased review of the data comparing health benefits of conventional vs organic milk and other foods–Drs. Kardos and Lai, October 6, 2013.

Revised from the original post from 10/5/2009

Pediatricians associate Back to School with “Time to get your flu vaccine.” At least this pediatrician mom does. As I try to figure out when I can get my own three children over to my office to get their flu vaccines, we want to give you a flu vaccine update.

Good News.

Last year we responded to your concerns about arsenic in food, particularly rice, and shared with you the FDA’s recommendation at that time.

We are relieved that after considerable research which included analyzing over 1300 samples of rice products, the FDA scientists determined that “… the levels of inorganic arsenic found in the samples are too low to cause immediate health damage.” Please see this link for the details of the investigation and recommendations.

Bottom line: continue to offer a well-balanced diet to your children and vary the types of grains that you serve to your families.

Julie Kardos, MD and Naline Lai, MD
©2013 Two Peds in a Pod®

As you stand watching your budding baseball star at his five o’clock practice, the rest of your kids start to whine. “Please, please, please,” they say. “Can we go to the snack stand? We can’t wait for dinner.” Feeling faint from hunger yourself, you begrudgingly acquiesce and later cringe as you see them trouping back from the snack stand with fluorescent nacho cheese covered chips and candy. Sound familiar? Today we bring you thoughts from a mom who did the unthinkable… she revamped her kids’ sports snack stand menu. Now she brings you ideas to overhaul yours. We are impressed. –Drs. Kardos and Lai

Skittles, hot dogs, nachos, soda, and ice cream.  If you have been to your child’s sporting event recently, then this should sound like a typical snack stand menu.  Somehow, sports and junk food are synonymous.  But doesn’t that contradict itself?  Aren’t we having our children participate in sports to keep them healthy?  Well, then, why are we feeding our children junk food at the very moment that they need fuel to help them perform better?  These foods are laden with sugar, trans fat, and sodium, foods which will adversely affect the health of your family.

As parents, we need to take back control of what we are feeding our children. Statistics show that type 1 and type 2 diabetes are on the increase among children.  According to the SEARCH for Diabetes in Youth study, the prevalence of type 2 diabetes increased 21 percent among American youth from 2001-2009, while type 1 diabetes rose 23 percent.  The effects of diabetes are staggering:  heart disease, blindness, kidney disease, nervous system disease, and poor circulation leading to amputation.  And diabetes is only one of the many negative results of eating processed junk food.  

You may be thinking, what’s the harm in eating a little junk food at snack stands?  Well, it wouldn’t be overly harmful if snack stands were the only place that our children occasionally purchase junk food.  Think about all of the other locations that our children consume unhealthy food:  school lunches, fast food restaurants, vending machines, and convenience stores.  All of these poor food choices add up and will eventually lead to serious health consequences.

Over the past few weeks, I revamped the menu of the snack stand for my daughters’ summer swim team.  I was apprehensive about making these changes because I was concerned about how the parents and children would react.  Would my own children be subjected to teasing because I took away the M&M’s?  I was able to transform the menu from items riddled with sugar and trans fat to whole foods fresh from our grocery store.  Here’s a sample of items that we offered:

Old Menu                                                       New Menu

Skittles                                                             Fresh Fruit Salad

Cupcakes                                                         Smoothies made from fruit

Brownies                                                         Chocolate Covered Frozen Bananas

Cow Tails                                                         Trail Mix

Soft Pretzels                                                    Air Popped Popcorn

Hoagies on White Bread                                 Subway Hoagies on Whole Wheat Bread

Snapple (with more sugar than soda!)           Water

Gatorade                                                         100% Fruit Juice

Of the hundreds of families that we served, I only had one person who complained.  One!  Instead, I had an outpouring of support and many families who appreciated having fresh, healthy food choices for their family.  One dad went as far as emailing the president of our board to compliment us on our healthy snack stand. 

So, what can you do if your snack stand does not yet offer healthy choices?   Here’s a bit of food for thought:

• Pack your own snacks!  You can control what your family is eating by giving them healthy choices.*  Here are my favorite items to pack in our cooler:
  • Water
  • Peanut Butter and Banana Sandwiches on whole wheat (cut them into quarters for little snacks to share)
  • Make your own trail mix with a variety of nuts, plain cheerios, and toss in a few mini chocolate chips to make this feel like a sweet treat!
  • Nature Valley Honey Oat Snack Bars
  • Fruit Kabobs
  • Applesauce cups (natural, no sugar)
  • Fruit cups (packed in fruit juice)
  • Cheese sticks
  • Air popped popcorn – pop enough in an air popper to store in a new trash bag.  Add a little melted butter and salt and shake.  Bring solo cups and scoop out for your child to share with their friends. 
• If you must purchase an unhealthy choice from a snack stand, then try splitting it into two portions.  Ask your child to eat half of it now, and save the other half.  Cutting the portion size down is an important step towards getting healthy. 
• Try feeding your family before you leave for an event.  You will have more control and choices about what your child eats. 
• Talk to the board of your child’s team and ask them to revisit the food that is served in your snack stand.
• If you are visiting another team, then find the name and email address of the board members and email about making a change.

Together, let’s make steps towards changing the way that we think about the food that we feed our children.  The next generation’s life depends upon it.  If that is not enough incentive, then think about how much money you will be saving.  Maybe you can save enough to treat yourself to a little something nice.  Now, we’re talking!

*NOTE:  If you child is resistant towards making these changes, focus on one area (i.e. drinks, sandwiches, or snacks) and make that your focus.  Do not try to make too many changes all at one.  You may find that your chances of success increase when you only focus on one food area at a time.

Mary McDonald, MA

© 2013 Two Peds in a Pod®

Mary McDonald holds a Masters of Education from Arcadia University and a health coach certification from Institute of Integrative Nutrition.  She is a high school teacher, a mom of four daughters, and an advocate for healthy food choices.  For more information on her health coaching services, please contact her at nutrition101withmary@gmail.com or visit her website at nutrition101withmary.com.

We had such a great response to our Two Peds in a Pod® visual diagnosis post that we are posting another summertime picture puzzle:

What is it? Pictured below are the toes of one of my best friend’s toddler. She is happy, has no fever, and plays nearly everyday in the neighborhood pool. The round shiny pink bumps and dots on her toes appeared yesterday morning and haven’t changed much in a day. They don’t seem to bother her very much… answer below.

It’s Swimming pool pulpitis- a fancy word for a reaction of the pulp (the meaty tip) of fingers or toes. Mostly seen on the finger tips, the pulpitis is usually caused by irritation of the fingers by the rough side of the swimming pool as kids pull themselves in and out. Kids are sometimes annoyed by the dots, but they go away on their own as soon as the kids decide to use the ladder. In this case, this little swimmer irritated her toes, not her fingers, while “monkey walking” along the side of the swimming pool in the water.

Naline Lai, MD with Julie Kardos, MD

We interrupt your summertime to present another Two Peds in a Pod® visual diagnosis learning session. Do you recognize this rash? Hint: it is mildly itchy and painful and can result from scratching bug bites or a skinned knee. Read on for the answer.

The rash on this child’s arm is impetigo. Impetigo is just a fancy name for a crusty skin infection on the surface of the skin. The infection is caused by the common germs that often lurk on our skin, Staphylococcus and Streptococcus. (You may recognize the germ Streptococcus from our sore throat post because it can also cause Strep throat). The germs wait for a break in our skin, from a tiny cut, pimple or a scrape, then invade the skin and spread. Impetigo is often seen next to the nose because the germs love to lurk in the nasal passages and kids often pick at the skin under the nose when it gets irritated from a cold virus.

Doctors tend to describe infections with appetizing food analogies (yes, we know- eew). In this case, impetigo is often described as having honey-colored-crusted lesions. The areas are tender and red, and often itchy. Kids often spread this infection on themselves when they scratch at the infection and then touch other areas of their skin.

Pediatricians treat impetigo with either a topical antibiotic or oral antibiotic for anywhere from 7 to 10 days. The choice of how to treat depends in part how much of the skin is affected and which body surfaces are involved. The infection is contagious until 24 hours after starting treatment.

Prevent this infection: Hand washing is a great way to prevent spread of impetigo. Washing all skin wounds well with soap and water is another way to prevent the emergence of this infection. See our prior post on wound care.

Ok, now back to the pool and barbeques for all our summertime readers. Just remember your bug spray and remind your children not to scratch and pick at their skin.

Naline Lai, MD and Julie Kardos, MD

©2013 Two Peds in a Pod®

The green crosses in the photo signify that the building is a medical marijuana dispensing site. As the TMZ tour bus director pointed out the crosses when my family was recently on vacation in Hollywood, I saw all the kids on the bus crane their heads to look at the building. As I watched the kids, I was reminded that it is summer time and summer brings late night parties for teens. For parents, it brings late nights of worry.   “I’d know if my kid was high or drunk,” you say to yourself. Or would you? Here are some signs you can use to tell:

Your tween or teen wanders in late on a Saturday night and acts like he is in slow motion. “I’m just tired,” he claims. Have him look you straight in the eye as you talk to him. Even if he is lying, the truth will be in his eyes. More specifically, it’s in the size of his pupils (the black part of his eyes). Too big (nearly covers the colored part of his eyes) or too little (like pinpoints) is a sign he is currently high.

Remember when we used to call sun screen lotion “suntan lotion,” and tolerating red blistering shoulders was considered a small price to pay for a tan?  Live and learn.

Dr. Kardos’s dad is a pediatrician and during our long grueling hours of residency training he’d always serve as a source of encouragement. One of my favorite memories will always be the proud look in his eyes years later as he watched his daughter present at a physician conference.

Today we honor all Dr. Dads- dads or father figures- who help their children in times of crisis, illness, or injury.  Following is a tribute sent by one of our readers, Jennifer Taylor.

Happy Father’s Day!

Dr. Lai with Dr. Kardos
_________________________

We are parents to three boys so needless to say, our house is always full of cuts, bruises or injuries of some sort. Band-Aids and “feel better” kisses are a regular part of our daily activity. And while my husband is a great “Doctor Dad” to all three boys, it is his every day involvement in my youngest son’s medical care that makes him a truly amazing father.

My son Luke is 4 years old. At the age of 6 months, he was diagnosed with an in-utero stroke. We were told at the time of his diagnosis that he may never talk or walk based on where the stroke hit. We’ve had several years of therapy, doctor’s appointments and testing. Throughout it all, Kris has been an amazing supporter- both for Luke and me.

While I tend to see the glass half-empty, Kris is perpetually positive. He always says “When Luke can” instead of “If”. He does research on therapies that might shake things up in Luke’s progress and is certainly a very active participator in all the therapies we receive. Kris stops in to chat with all the therapists so that they know he is Luke’s Dad. He is at every medical appointment: driving us to CHOP at 7:00 in the morning because he knows I hate driving on Route 76 by myself; heading up to Lehigh Valley Hospital for a speech consult; sitting by me while Luke has some sort of test done, holding my hand and telling me it will be okay. He is compassionate throughout it all and yet he still pushes Luke to succeed, knowing that our little boy can accomplish anything. When Luke gets frustrated, it is my husband who can calmly get him to try, try again. And they say laughter is the best medicine so my husband pulls out all the jokes and silly behavior he knows to get Luke to go “one more time.”

I really could go on and on about what a wonderful Dad my husband is but the true testament to him is sitting on the floor next to me singing and playing. Luke wouldn’t be where he is now without Kris.

And for that, I am eternally grateful.

Jennifer Taylor
©2013 Two Peds in a Pod®