Help your Child Handle Bullying

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:

Naline Lai, MD and Julie Kardos, MD

©2024 Two Peds in a Pod®




Lice: Don’t Scratch Your Head Over It!

lice dreams

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®




RSV Prevention Updates for 2024-2025

RSV

Hello, parents! As we gear up for another winter season, we want to share some important RSV prevention updates. RSV, or Respiratory Syncytial Virus, can cause nasty colds, but it’s particularly concerning for babies under 8 months old, as it leads to more hospitalizations than any other illness in this age group.

Good News About Beyfortus!
Last winter, we saw some fantastic results from nirsevimab, better known as the brand name Beyfortus. Beyfortus is RSV antibody designed to protect our littlest ones. It was shown to be 90% effective in reducing hospitalizations due to RSV. That’s a big win for babies and their families.

How Can You Protect Your Baby?
There are two key ways to help keep your young infant safe from severe RSV:



  • For Expecting Moms: If you’re pregnant, you can receive an RSV immunization between weeks 32 and 36 of your pregnancy. This helps build immunity for your baby, so they won’t need Beyfortus after they are born. However, if your baby arrives early—within two weeks of when you got the shot—they will need their own dose to ensure protection against severe RSV.

  • For Newborns: All babies under 8 months old during RSV season should receive a dose of Beyfortus if their mom didn’t get the immunization. This includes all babies, whether they’re healthy, sick, premature, or full term. Many hospital nurseries and NICUs give these antibodies (given as an injection) before your baby goes home. If your hospital doesn’t have it, your pediatrician can help.

Why Beyfortus is a Game Changer
In the past, we gave an RSV antibody shot that was reserved for severely premature babies and those with serious lung issues. It required monthly doses for 5-6 months during the RSV season. Beyfortus, on the other hand, offers protection for a full 5 months with just one shot—making it much easier for busy parents!

Timing Matters
Beyfortus is given only during RSV season, which runs from October to March. If your baby is under 8 months old and hasn’t had their dose yet, please reach out to your pediatrician for this vital protection. Plus, it’s safe to give Beyfortus alongside any other childhood vaccines.

A Quick Reminder
RSV is an incredibly common illness, with nearly all kids catching it by the age of 2 years. While many childrn will have mild cases, we’re grateful to have options like Beyfortus to help keep your baby from becoming severely ill.

We’re here to support you and your family in staying healthy this season!

Julie Kardos, MD and Naline Lai, MD
©2024 Two Peds in a Pod®




Managing anxiety in children

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®




Quick exercises for kids and teens

couch potato

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.

ACTIVITY CALORIES USED
Shooting Basketballs 75
Pickup Basketball game/practice 100
Biking on stationary bike 116
Dancing 75
Hopscotch 67
Ice Skating 116
Jogging in place 133
Juggling 67
Jumping Rope 166
Ping Pong 67
Rock Climbing 183
Running at 5 mph 133
Sledding 116
Treadmill at 4 mph 67
Vacuuming 58
caloriesperhour

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.




Going back to school online? Here’s what pediatricians want you to know

Online school tips

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®




Kids on computers: are special blue light-blocking filters worth the expense?

 

are glasses with special blue light-blocking filters worth the expense?

Kids are spending much more time on computers and other screens learning, staying in touch with friends and family virtually, and playing games. Are glasses with special blue light-blocking filters worth the expense? Our guest blogger, pediatric ophthalmologist Dr. Sheryl Menacker, addresses this question.
-Drs. Kardos and Lai 

There is much buzz about glasses that filter out blue light from computer, phone, and other screen devices.  But are the problems real and are these glasses worth the expense?    

The American Academy of Ophthalmology says no, and here is the explanation from their website.

Are eyeglasses with special blue light-blocking filters worth the expense? 

By absorbing the excess blue light from our devices, the eyeglasses claim to:

  • improve sleep
  • reduce digital eye strain
  • prevent eye disease

We all want to do these things, but it’s not necessary to spend money on special eye wear for computer use. Here’s why:

  • Blue light from computers will not lead to eye disease. It is true that overexposure to blue light and UV light rays from the sun can raise the risk of eye disease, but the small amount of blue light coming from computer screens has never been shown to cause any harm to our eyes.
  • Sleep can be improved without special eyeglasses. You don’t need to spend extra money on blue light glasses to improve sleep— simply decrease evening screen time and set devices to night mode.
  • Digital eye strain is not caused by blue light. The symptoms of digital eye strain are linked to how we use our digital devices, not the blue light coming out of them.

Computer/digital eye strain

While using devices will not damage your eyes permanently, staring at them for a long time can cause temporary discomfort. People experience eye strain in different ways, but symptoms can include:

The reason we get digital eye strain is that we blink less when we stare at our devices.

Normally, humans blink around 15 times per minute—but this “blink rate” can be cut in half when staring at screens or doing other near work activities (like reading). To reduce eye strain:

  • Take frequent breaks by using the “20-20-20” rule. Every 20 minutes look away from your screen and look at an object 20 feet away for at least 20 seconds. This gives your eyes a chance to reset and replenish themselves.
  • Use artificial tears to lubricate your eyes when they feel dry.
  • Keep your distance. Sit about 25 inches or at arm’s length from your screen and adjust its height so you’re looking slightly downward at it.
  • Reduce glare and brightness. Devices with glass screens can cause glare. To reduce glare, consider a matte screen filter for your device. Adjusting the brightness and contrast of your screen and dimming the lighting near your screen can also help reduce eye strain.
  • Wear eyeglasses. If you wear contact lenses, you already know they can increase dryness and irritation. To reduce these symptoms, try wearing eyeglasses instead when working on a computer for longer periods.

Sheryl Menacker, MD
©2020 Two Peds in a Pod®

Dr. Sheryl Menacker, of Tri-County Eye Physicians, is a certified Diplomate of the American Board of Ophthalmology, a Fellow of the American Academy of Ophthalmology, member of the American Association for Pediatric Ophthalmology and Strabismus, and examiner for the American Board of Ophthalmology. In addition to general pediatric ophthalmology, Dr. Menacker has a specialty interest in treating individuals with disabilities. She holds a clinical appointment at the University of Pennsylvania School of Medicine and Emory University, where she is an active teacher and lecturer. 




Teen vegetarian diet basics

teen vegetables

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®




Is your child sick? When to call the doctor

fever in children: when to call the doctor

Unfortunately, it is sick season. Fortunately, we have a great post to help you know when you need to call the doctor about your child’s illness. 

Julie Kardos, MD and Naline Lai, MD

©2018 Two Peds in a Pod®




Coughing out germs? Natural remedies for kids

It would be nice to have some natural remedies for kids when they "cough out germs."

“coughing out germs”

Recently a 6-year-old patient handed me this drawing of “a person coughing out germs.”

The artwork reminds us that a cough can be a good thing. A cough dislodges mucus from the airway and can help prevent pneumonia.

However, coughs can spread germs and make kids feel plenty uncomfortable.  And, frustrating for parents, many over-the-counter medicines are not recommended for kids.

Looking for natural remedies for kids? Look no further than your kitchen.

Julie Kardos, MD and Naline Lai, MD

©2018 Two Peds in a Pod®