“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®

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®

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®

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®

Physical therapist Dr. Deborah Stack brings us quick exercises for kids and teens – Dr. Lai and Kardos

After six months of COVID; yes, it really has been that long already, your family has probably found some favorite outdoor hiking spots or bike routes.  But what can you do when it’s too cold or wet outside?  How can you combat literally HOURS of kids sitting at computers especially if they only have 30-45 minutes until their next class? Here are quick exercises for kids and teens and a table of caloric expenditure for common activities.

Schedule active movement breaks into their day.  Take advantage of that lunch and recess “break” and be an example yourself. 

Here are some short burst ideas:

• Have a 15-minute dance party
• Use your body to make all the letters of the alphabet
• Shadow box to some music
• Dust off the treadmill or stationary bike in the basement
• Play ping-pong
• Do a few chores (carrying laundry baskets up and down is great exercise)
• Jump rope
• Jog in place
• Do jumping jacks
• Pull out some “little kid games” such as hopscotch or hulahoop
• Let each child in your house choose an activity for everyone to try
• Do a family yoga video
• Walk or “run” stairs…kids can try to beat their prior score for a minute of stairs
• Take walking/wheeling/even wheelbarrow laps around the house
• Stretch out calves, quadriceps, arms and back…see ergonomics post for counteracting all the sitting

Don’t forget the teenagers;  they still need activity too especially if their teams are not practicing or competing.  Staff from the Mayo Clinic recommend kids ages 6-17 should have one hour of moderate exercise each day.  Exercise can help improve mood (through the release of endorphins), improve sleep and therefore attention (critical with all the online learning), and improve cardiovascular endurance.  Here are some numbers to get the kids moving:

All activities are based on 20 minutes and a teen who weighs 110 pounds.  The number of calories burned depends on weight.  If your child weighs more, he will burn a few more calories, if he weighs less, he’ll burn a few less.  Below the table are links to some free and quick calorie calculators on the web so your kids can check it out for themselves.  For those attached to their phones, there are web apps too.

Try these activity calculators:

http://www.caloriecontrol.org/healthy-weight-tool-kit/lighten-up-and-get-moving

https://www.webmd.com/fitness-exercise/healthtool-exercise-calculator

Keep ’em moving- you’ll have more fit, better rested, and happier kids!  

Deborah Stack, PT DPT PCS
©2020 Two Peds in a Pod®

Dr. Stack is a board certified specialist in pediatric physical therapy and the owner of the Pediatric Therapy Center of Bucks County, LLC in Doylestown, PA. In addition to treating children ages 0-21 for conditions such as torticollis, coordination,  neurologic and orthopedic disorders, she also instructs physical therapists across the country in pediatric development and postural control and is a Certified Theratogs fitter.

Chances are, because of COVID 19, this school year will look different for your children. Here are your Two Peds’ tips for helping your children if they are learning online this fall.

Start with basics such as setting a sleep schedule. Think about how many hours your child slept during the spring quarantine and over the summer. If they woke up refreshed, that is the optimal amount of sleep they need to be alert during class. Incorporate this into your school year expectations.  Falling asleep too late and sleeping too late? Check here on how to get your child’s late schedule under control. 

Set up an eating routine. Healthy eating habits have not changed from when you were a child. Stick to the school year schedule of breakfast, lunch, dinner and a morning and afternoon snack – just like at school. Don’t allow the  kids to graze. Without structure, children tend to throw off their weight- in fact, kids tend to gain weight more quickly  in the summer than during the school year. 

Rehearse mask wearing. Even though they attend school at home, your kids will go to the grocery store, see a good friend or get a haircut. Teach them to wear a mask properly so you don’t need to spend time readjusting their masks outside of the house.  

Keep up the hand hygiene at home: Washing hands always limits germ spread. WHEN–before and after eating, after using the bathroom, after playing outside, and before and after school, the HOW–soap and water preferred for the duration of time it takes to sing the Happy Birthday song twice, or hand sanitizer if a sink is not available, and the WHY–avoid germ spread. See our post on handwashing.

Prevent neck and back strain from continual computer use: Read these posts on ergonomics and proper computer positioning to prevent your children from feeling like pretzels  at the end of the day. Likewise, prevent eye strain.

If you are worried about the amount of additional time your children will spend in front of the computer for entertainment in addition to schoolwork, use the American Academy of Pediatrics’ Family Media Plan tool to create a customized screen time contract.

Create a home learning space that your child can call their own. This will be where your child will complete schoolwork and homework. This is especially important if you child usually spends time doing homework on their bed. You want your child to associate their bed with relaxation and sleep rather than activities that rev up their mind. 

Get your child the flu vaccine this fall. Even if you never immunized in the past, this is the year you should. Please see our post on the benefits of the flu vaccine. 

Help your child to “roll with the punches.” Change, even happy change, can be stressful for adults. After all, we all know how adults often run around frantically during the winter holidays. If you feel frustrated, angry, or fearful about the pandemic, try to keep the brunt of your own negativity from your children. Kids are often more adaptable than you might give them credit for, but they tend to mimic their parents and look to parents about how to respond to new situations. Seek adult help to prevent your own negative feelings from flowing over and smothering your children.

You can do this. Who taught your children their first words? How to walk? The color of an apple? How to organize their homework? You will still have teachers who will teach the content of a class. Your role, as it always has been, is to provide the best possible  learning environment.

No matter how it looks, we wish your family a great start to the school year!

Naline Lai, MD and Julie Kardos, 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®

Do you wonder if any communication actually occurs when you talk to your teen? We invite you to read this post for some coaching on how to talk to your teen in ways that they will find palatable.

Julie Kardos, MD and Naline Lai, MD

©2019 Two Peds in a Pod®

“Should I give my kid the Gardasil® vaccine?” Friends and relatives, as well as our patients’ parents, continue to ask us this question.

Our answer is always: “Yes.”

Gardasil® vaccine is the current HPV vaccine on the United States market. The vaccine prevents cancer-causing strains of human papillomavirus from infecting a person’s body. HPV cancers include cervical cancer in women, penile cancers in men, and cancers of the mouth and throat in everyone. The vaccine also protects against genital warts.

According to the  Centers for Disease Control report, nearly 90 million HPV vaccines were distributed from June 2006 through March 2016. That’s a lot of vaccinations. In the US, the large majority of HPV vaccine given was the Gardasil® vaccine.

You can read a detailed report of the way the safety of the vaccine was studied here. 

Here are the updates:

1. The vaccine prevents cancer-causing strains of HPV from infecting teens and young adults. You can read the latest study about this here. 
2. The vaccine is still safe. The HPV vaccine has still NOT caused any deaths, has NOT caused cases of premature ovarian failure, and has NOT caused any new chronic pain syndromes or neurologic diseases. If you read on the internet or on Facebook any gory tales about Gardasil, you can check those stories on “Snopes.” This website determines whether a popular internet story is a myth or a fact. 
3. Your child may need only two doses of HPV vaccine instead of three. We now know that younger teens achieve immunity with fewer doses than older teens. So, if your child gets the FIRST dose of this vaccine prior to his 15th birthday, then he needs only one more dose of vaccine 6 months later. Those starting the Gardasil® vaccine on or after their 15th birthday still need 3 doses of vaccine for maximum protection against the disease.
4. If your child has a weak immune system, they also might need three doses. Children with weakened immune systems (check with your child’s pediatrician) should get 3 doses of Gardasil®.
5. Teens and tweens are more likely to feel dizzy or to faint after all vaccinations, not only after the HPV vaccine. There are reports that HPV vaccine causes kids to faint, but fainting may occur with any teen vaccine. It is well known that surges of anxiety can cause fainting.  Although they are older, teens are often very apprehensive about getting vaccines. Babies and toddlers rarely faint. Although a toddler may be mad about a vaccine injection, they are not anxious. To prevent any light headedness, your teen’s doctor may have them sit for a few minutes after a vaccine. 

There’s a reason why we give the vaccine “so young.” Once people are infected, the vaccine does not work as well. Even though it may be difficult to imagine your child needing protection from a sexually transmitted disease, prevention of cancer-causing strains of human papillomavirus is most effective when HPV immunization is given well before your kids have had any exposure to the virus.

Yes, the HPV vaccine is safe, and yes, we gave it to our own kids.

Julie Kardos, MD and Naline Lai, MD
Ⓒ2019 Two Peds in a PodⓇ