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®

What you forgot to tell the babysitter

The first time my husband and I went out to dinner after our daughter was born, we walked out the door, got into the car, and sat in the driveway as my husband fretted over how our daughter was doing with the babysitter. “Did you see?” he said. “She looked sad when we left.” After a few minutes elapsed, he still had not started the car engine. Finally, to allay his fears, I told him to sneak back to the house and peek into the window. He came back amazed. “She’s fine,” he said with relief.

Finding someone to appropriately look after your child can be a difficult task. Even if you resist the urge to run back and check on your child when you leave the house, you may wonder as you pull away if there is anything you forgot to tell the babysitter. Chances are, you didn’t think of much beyond leaving your cell phone number and the name of your destination. Linda Miller, a nurse who taught a babysitting course for years for Child, Home, and Community (a United Way agency serving Bucks and Montgomery Country, Pennsylvania), shares with us the information she leaves her own babysitters:

Parents’ cell numbers

Kids’ names, ages and birthdays

House address (chances are, if your sitter lives down the street, she or he doesn’t know your house number)

The full name of the town you live in (is it Borough or Township?) In Nurse Miller’s case, there is a street of the same name in the neighboring township. Ever since the pizza delivery guy went to the wrong house one hungry night, her family is careful to be very clear as to where they live.

The nearest cross street. This important piece of information helps emergency responders confirm they are heading to the correct address. (It could also be helpful if your sitter is old enough to order pizza!)

Where you are going – name and address and phone number.

Phone number to call in an emergency: For most it is 911

Poison control center phone number : 1-800-222-1222

Height and weight of each child – for emergency medication administration

Allergies – to Foods and Medications

Since seconds count in an emergency, even if your sitter is a regular fixture in your home, it doesn’t hurt to point out the safety information each time, should he or she need it.

Remember to bring your sitter’s cell phone number with you so you can reach her, in case you cannot get through on your own house phone.

When is my child old enough to babysit?

Somehow the years passed quickly, and the tables have turned. My daughter herself is a babysitter. How will you know when your own child is old enough to babysit? First ask yourself whether he will be too scared to stay home without an adult. Then ask yourself if he can solve problems on his own. The age that kids start to babysit themselves or younger siblings varies. Ultimately parents need to judge their child’s maturity for themselves. Tweens can be mature enough to babysit themselves and a younger sibling for short period of time. In fact, the American Red Cross babysitting training course (which can be taken online) is offered to kids 11 years and older. Even if your child is not babysitting anyone else, but staying by himself at home, a course will give your child valuable self-care tips.

Outline specific Do’s and Don’ts for your child. Walk them through what to do if the doorbell rings or if the phone rings. What activities are they allowed to do? Are they allowed to eat? Cook? Can friends come over? What will they do in a power outage? What if someone gets injured or sick while you are out? Familiarize him with basic first aid.

Keep anything which is potentially harmful such as medications, guns, and alcohol inaccessible. Make sure you are comfortable with parental controls for computers and the television.

And of course…give them Nurse Miller’s list from above.

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

 In honor of  Father’s Day, we would love to hear your anecdotes of any “Doctor Dad” moments your children have experienced.  Tell us about how your child’s dad or any father figure in your child’s life helped your child through a tough time, an illness, or an injury. Send us your anecdotes to twopedsinapod@gmail.com by June 4 and we will include the top stories in our Father’s Day post. 

Thank you in advance,

Drs. Kardos and Lai   

This Mother’s Day we bring you definitions inspired by our children and our patients. Don’t think we’ll out-hip Urban Dictionary, but we’re moms…. by definition we are not hip. Enjoy your day.

Sleep walker: the daytime state of a new mom.

Sweater: a garment worn by a child when his mother feels cold.

Displacement:  a vacation with toddlers.

Sick: something moms are not allowed to become.

WOW: MOM upside-down.

Mommometer: a mom’s hand on a feverish forehead.

One zillion: number of times a mom says “wash your hands” to her children over the course of their childhoods.

Yesterday: when the sports/camp/school field trip form was due.
Today: when the child hands the mom the sports/camp/school field trip form.

Working mother: Every Mom

Water torture: a grade-school son’s interpretation of a mom’s announcement of “shower night.”

Boomerang: a mom’s realization that her child is acting like she did at the same age.

Happy Mother’s Day from your two Pediatrician Moms,

Julie Kardos, MD and Naline Lai, MD

©2013 Two Peds in a Pod®