“4 Bucks County Middle School Students Sickened After Ingesting THC Gummies”

This incident occurred close to our pediatric offices and involved four students, just 12 and 13 years old. As pediatricians—and as members of this community—we feel it’s important to talk about what happened and why it matters.

THC is the active compound in marijuana. In edible forms like gummies, the concentration can be quite high. For a child, consuming even a small amount of these products can lead to serious, and sometimes life-threatening, effects.

At this time, it is unclear whether the students in our nearby middle school knew the gummies contained THC, or where they obtained them—whether from a store, a friend, a sibling, or an adult. What we do know is that these products are easy for middle schoolers to access and very easy to mistake for regular candy.

Why are more children at risk for marijuana poisoning now?

A little over a  decade ago, when marijuana was legalized in states like Colorado, the market for THC-infused foods expanded rapidly. Since then, pediatric poisonings related to THC have increased and continue to rise. In states where THC is legal, more widespread adult use has unintentionally increased children’s exposure, as these products are often stored at home.

While many parents are careful to lock away medications, THC edibles are often overlooked. Their packaging is designed to be appealing and can closely resemble popular candy brands. It’s important to recognize that, just like an overdose of prescription medication, ingesting too much THC can be dangerous—and in some cases, fatal.

Even in states where recreational THC use is illegal, THC-related products are still widely available. These products may be unregulated, inconsistently labeled, and easy for children to obtain.

Symptoms of THC intoxication in children can include:

• Altered mental state or confusion
• Extreme sleepiness or lethargy
• Difficulty walking or poor coordination
• Slurred or slowed speech
• Excessive vomiting
• Trouble breathing
• Loss of consciousness or coma

These symptoms can mimic serious medical conditions such as a stroke or brain injury. Some children require intensive care and life support.

If you suspect your child may have ingested THC, you can call Poison Control at 800-222-1222 for immediate guidance. If your child has trouble breathing, becomes unresponsive, or shows significant changes in mental state, call 911 right away.

How can parents help protect their children from accidental ingestion of THC edibles?

Click to learn more about THC-related compounds, how these products are marketed, and current regulations in Pennsylvania. It’s also important to understand how cannabis can affect the developing brain.

In the photo above, the gummies shown do not contain THC. However, even the most cautious adult would have difficulty telling the difference between candies and THC containing edibles. That’s exactly the concern—and why awareness, prevention, and safe storage are so critical.

Julie Kardos, MD and Naline Lai, MD

©2026 Two Peds in a Pod®

Does this sound familiar?

On Monday, your son Robby leaves late for the school bus because he couldn’t find his shoes, then he stopped to fiddle with a Lego model on the way out the door.

On Tuesday, his homework that took you hours to get him to complete the night before never makes it off the kitchen table. 

On Wednesday, he jumps off a five-foot wall at recess “just because” and lands in the nurse’s office.

On Thursday, he comes home tantruming because other kids didn’t want to play with him during recess.

By Friday, you’re sitting at a parent-teacher conference hearing words like impulsive, distracted, underperforming, can’t sit still, and needs constant redirection. A teacher suggests testing for Attention Deficit Hyperactivity Disorder which is better known as ADHD.

If this feels familiar, please know you are not alone. As pediatricians, we’ve sat with many families at this exact moment. It’s natural to feel relief that someone else sees the struggle, and at the same time, worry: What if it’s something else?

That’s such an important question.

What else could it be?

ADHD is common and very real. But several other conditions can look like ADHD—or make attention problems worse. Kids with ADHD are not even necessarily hyperactive. When pediatricians evaluate a child for possible ADHD, we think broadly before landing on a diagnosis.

Sleep is the first place we look. A tired brain can’t focus. Kids who go to bed too late, wake too early, snore loudly, cough at night, or itch from eczema may not be getting enough restorative sleep. Many parents do not realize their kids are up in bed on their tablets or phones, thus cutting into their sleep time. Even mild sleep deprivation can lead to impulsivity and inattention during the day. A rule of thumb is that children who are difficult to wake for school are not getting enough sleep.

Then there are other basics: Can your child see clearly? Can they hear instructions well? Vision and hearing problems are surprisingly common and easily missed.

Learning differences are another piece of the puzzle. Children with dyslexia or other learning disabilities may appear distracted when they’re actually frustrated or overwhelmed. If school feels too hard, it’s easy to “check out.”

Sometimes conditions that impair communication, such as autism, also play a role since difficulty with focus and social interactions can arise in both conditions.

Emotional stress matters, too. Changes at home, family conflict, or bullying can show up as trouble concentrating. Children don’t always tell us they’re worried—but their behavior often does.

Sometimes the “something else” is another medical problem

What looks like “spacing out” could be absence seizures—brief staring spells that interrupt attention. A simple test called an EEG can help rule this out.

We also consider medication side effects. Common antihistamines for allergies, for example, can cause fogginess in some children. And the caffeine in some kids drink at lunch, like soda and iced tea, causes bed time insomnia, which then interferes with falling sleep, which leads to sleep deprivation.

Occasionally, based on other symptoms, we obtain a simple blood test that uncovers something contributing to attention problems, such as anemia (low iron) or thyroid imbalance. In some communities, we also screen for lead exposure, which can affect focus.

And finally, we think about maturity. Younger children in a grade are more likely to be labeled with ADHD than their older classmates. Sometimes what we’re seeing is developmental readiness, not a disorder.

Of course, many children truly do have ADHD. And sometimes they have ADHD plus something else—like needing glasses. We’ve seen children blossom once we address all the pieces of their puzzle.

So if you’re sitting in that conference chair, take a deep breath. An evaluation isn’t a label—it’s information. Our goal isn’t just to name the problem; it’s to understand your child fully so they can more easily learn. 

With careful assessment, the right support, and partnership between parents, teachers, and pediatricians, children like Robby will thrive.

Julie Kardos, MD and Naline Lai, MD

©2026 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

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

As a parent, there are few things more heartbreaking than seeing your child upset because they’ve been bullied. Whether your second grader is crying after being teased on the school bus or your teen is avoiding the school bathroom to escape cruel remarks, the feeling of powerlessness can be overwhelming. You may be tempted to go after the bully yourself. But there are more effective, long-term ways to help your child handle bullying. 

Bullies are always in a position of power over their victims; either they are physically larger, older, or more “popular.” While you or your child may want to “get back” at the bully, retaliation only fuels anger and can land your child in trouble. Remind your child that most bullies act out because they feel insecure themselves. Teach your child empathy for the bully.

What can you do?

Teach your child how to stop a bully, walk away from dangerous situations, and talk to someone when they need help.

Stop the bully. Have your child give strong verbal responses. Teach your child to stand up for themselves with a clear, confident message. A firm “STOP talking to me like that!” or “Don’t do that!” will not only assert their boundaries but also could attract the attention of nearby peers or adults who can step in. Another helpful tactic, especially if no one else is around to help, is de-escalation. Encourage your child to take deep breaths, and to ignore provocations by pretending they do not care what the bully says to them.

Walk away from conflict. If a bully is getting physical or continuing to harass your child, teach them to walk away and seek safety. They can move toward a teacher, a classroom, or any safe space where an adult can intervene.

Advise your child to tell as many trusted adults as possible if they’re feeling unsafe. If one adult isn’t sure how to help, another will. Tell them to keep asking.

Cyberbullying

Stop the cyberbully by responding with silence. Explain to your child that bullies thrive on any and all responses to their bullying. Not only that, but your child’s on-line response can be permanent. Teach them to withhold a response and let adults take charge. 

In general, establish rules about your child’s online behavior and limit access to devices and sites. For example, encourage your child never to post anything hurtful or negative.  Even something as small as a “dislike” can escalate a situation or can be misinterpreted.

If the bully threatens your child online, avoid responding to the bully AND take your child’s device with the evidence to the school and possibly to the police. Here is contact information for social media apps, gaming networks, and related platforms where you can report cyberbullying.

Information gathering

Make it clear to your child that it’s always okay to talk to you if something’s bothering them. Ask open-ended questions like:

“How’s school going?”

“How are things with your friends?”

“Have you seen anyone getting bullied?”

“Are you feeling okay at school?”

If your child says they’re having trouble with a friend or classmate, avoid brushing it off. Ask questions like, “What happened?” or “Did something happen between you?”

Keep an eye out for signs that your child might be struggling emotionally. They may show increased reluctance to go to school or act sad, angry, or anxious.

Be aware that sometimes kids who are bullied turn around and become bullies.

 Partner with your child’s school for support

Once you’re aware that your child is being bullied at school, it’s important to for you to talk to adults at the school. Let the teacher, counselor, or principal know exactly what’s going on. Be clear that you want additional supervision, particularly at recess and lunchtime. Schools often have a zero-tolerance policy for bullying, but they can’t address an issue that they don’t know about.

Building your child’s self-confidence

Bullies often target kids who seem smaller, weaker, or less confident. It’s important to help your child feel good about themselves so they’re less likely to become a target. Make it known by your words and actions that you love your children unconditionally. This builds self esteem. As Dr. Lai says,”Helping a kid’s confidence grow is harder than helping their body grow.” If a child is physically smaller than the bully, remind them that “You don’t have to be a big person to do big things.”

Consider enrolling your child in activities that boost self-esteem, like karate, team sports, or music lessons. Encourage friendships with supportive peers. Be the fun parent and invite kids over for a playdate, or host a family activity like a kickball game or movie night.

We leave you with a classic anti-bullying retort: “I’m rubber, you’re glue; whatever you say bounces off of me and sticks to you.”

Additional Resources:

• The American Academy of Pediatrics – for more information on bullies, victims, consequences of bullying, and how to respond to bullying
• StopBullying.gov – U.S. Department of Health and Human Services
• Cyberbullying Research Center
• Teaching Tolerance – Fostering tolerance for parents and educators

Naline Lai, MD and Julie Kardos, MD

©2024 Two Peds in a Pod®

Now that school is back in full swing, you might notice your child scratching their head… and maybe you’re starting to scratch your head too. Let’s dive into the topic of lice and clear up some of the confusion.

What Are Lice, Really?

Lice are small, harmless insects that cause itching but don’t spread disease. The itching comes from a reaction to their saliva—similar to how poison ivy causes a reaction on the skin. It sounds gross, we know, but the good news is that lice are more of an annoyance than a health risk.

By the time you spot a live louse on your child, they’ve likely had lice for at least a month. So, while it might seem alarming to spot a louse crawling on their head, it’s not an emergency. Schools shouldn’t send kids home early for lice; after all, they’ve likely been in class with lice for weeks. That said, treating lice promptly can relieve the itching and stop them from spreading. Children can return to school the day after their first lice treatment.

How Do Lice Spread?

Lice can’t jump or fly; they only crawl. For lice to spread, kids’ heads need to be close together. Lice can also spread through shared hats or hair brushes, so remind your kids not to share these items, whether they’re playing dress-up or getting ready for a school dance.

Spotting Lice and Nits (Lice Eggs)

It’s easy to mistake other things—like sand or dandruff—for lice eggs. Here’s a tip: lice eggs (otherwise known as nits) are glued tightly to the hair shaft near the scalp and are difficult to remove with your fingers. Dandruff and sand slide easily along the hair shaft between your fingers. 

Lice Treatment Options

• Topical Permethrin 1% (e.g. Nix): This over-the-counter treatment works well for many families. Follow the directions on the label, and repeat the treatment in 7-9 days. Nix has a comprehensive  website that explains lice and how  to treat them. Permethrin targets both lice and their eggs.
• Topical Ivermectin: Previously branded as Sklice, this treatment is now available over-the-counter. The generic version is as effective as the name brand. Follow the directions, and repeat after 7-9 days.

If neither of these treatments work, doctors can prescribe additional medications. Most cases of lice succumb to permethrin or ivermectin, so you likely won’t need a prescription. Safety tip: avoid using more than one product at a time. This prevents too much medication on your child’s head at the same time.

According to the American Academy of Dermatology, simply combing your child’s hair to remove lice and nits can be effective. Though time-consuming, thorough combing works when done properly. Here’s a helpful 3-minute video from a dermatologist on using medication and combing to treat lice.

All lice shampoos and lotions should be applied to dry hair, left on for the recommended time, and then rinsed off. Make sure to read and follow the directions carefully for whichever product you choose.

Treating Your Home

Once your child is treated, it’s important to treat their environment too. Wash any recently-used sheets, towels, blankets, and hats in hot water (at least 130°F), and dry them on high heat for 20 minutes. Seal non-washable items, like stuffed animals, in plastic bags for two weeks to let any lice and nits to die off.

Got More Questions?

This should cover most of what you need to know about lice, but if you’re still itching for more info, we contributed to this post in The Children’s Hospital of Philadelphia’s “Health Tip of the Week.”

Stay tuned for more tips on what might be “heading” your way!

Julie Kardos, MD and Naline Lai, MD

©2024 Two Peds in a Pod®

We know how it’s easy to spend money on the kids- just wait until they are old enough to get Venmo. Here are some money saving tips for parents to save a little dough and put that saving towards the next family vacation and orthodontia!

Julie Kardos, MD and Naline Lai, MD

©2024 Two Peds in a Pod®

Parents local to Northampton Township, PA: We welcome you to come hear local pedatricians from The Children’s Hospital of Philadelphia and mental health experts talk about basic ways you can help manage anxiety and some information about medications for children and teens on February 8, 2024 at 6:30pm in the Northampton Library.

The talk is free and there will be time for questions. Please register so we set up enough chairs!

Special note: your Two Peds will be in attendance. Hope to see you there!

Naline Lai, MD and Julie Kardos, MD

©2024 Two Peds in a Pod®

Everything has a season, incluing seasonal allergies.

In our area near Philadelphia, we associate spring with the Phillies opener and also with the onset of spring allergies.

Here is a nice summary of how to treat allergies, from The Children’s Hospital of Philadelphia (note that one of your Two Peds was a contributor). And following are some of our prior posts that can help you treat your child’s seasonal allergies this spring:

The Best Allergy Medicine for Kids

The Best Allergy Medicine for Kids aged 2-5 years old

Allergy Eyes: when spring rubs you the wrong way

How to tell the difference between Covid (or any viral cold) and allergies

We hope this post answers all that you are itching to know about seasonal allergies.

Julie Kardos, MD and Naline Lai, MD

©2023 Two Peds in a Pod®

Death, politics, mental illness, and sex- all difficult topics for parents to talk about with their kids. Your Two Peds joined a social worker, school guidance counselor, and former teacher in a lively panel discussion at the Haverford Township Library in Haverford PA on how to normalize conversations on difficult topics between parents and their children. Watch as we talk about on ways parents can give kids give information while limiting their anxiety .

Past posts about ways to share difficult information with your children include the topics of suicide, stillbirth/miscarriage, death of a person, and death of a pet.

Warmly,

Julie Kardos, MD and Naline Lai, MD

©2023 Two Peds in a Pod®