Does your baby have a white tongue? Think Thrush

White curds that don’t wipe off can be indicative of thrush.

You find cottage cheese like curds coating the inside of your baby’s tongue and inner cheeks and try to wipe them off to no avail. It’s not breast milk, not formula. It’s thrush.

Thrush, fancy medical name Oral Candidiasis, is caused by an overgrowth of yeast, called Candida. Although not painful, it may cause discomfort akin to having a film of cotton coating the inside the mouth. 

We ALL have yeast, which is a type of fungus, on our bodies. Usually we have enough bacteria on our bodies to suppress the growth of yeast, but in cases when there is less than usual bacteria present such as in young babies or in kids who are on antibiotics, Candida can emerge. For older kids using inhaled steroids for asthma, failure  to rinse out the mouth after medication use also promotes an environment conducive to thrush. 

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What do ringworm, jock itch, and athlete’s foot all have in common?

Ringworm can appear anywhere there is skin- even on the eyelid.

What do ringworm, jock itch, and athlete’s foot all have in common? They are all names for the same type of fungal infection- just in different parts of the body.

These infections, caused by fungi called dermatophytes, fall into the mostly-harmless-but-annoying category of childhood skin rashes. Ringworm (tinea corpus), occurs on the body. Athlete’s foot (tinea pedis) occurs on feet, and Jock itch (tinea cruris) occurs in the groin area.

The name “ringworm” comes from one of the typical appearances of a dermatophyte rash. Often, there is a pinkish, slightly raised ring around an oval patch of flesh or light-pink colored, slightly scaly skin. Sometimes the patch is slightly itchy, but not as itchy as allergic reactions like insect bites.

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How to socialize your preschooler without preschool

how to socialize without school

Emma’s parents were hopeful that Emma could start preschool this winter, but with the slow COVID-19 vaccine roll out, Emma’s parents chose to keep her home just a little longer. Grandparents come over every day, but three-year-old Emma does not have interaction with other children. Her parents are confident that they can teach Emma shapes and numbers, but are concerned about her social and emotional development. For those in the same shoes as Emma’s parents, we share ways to socialize your preschooler without preschool.

Preschool has not changed much since you were three or four years old. There is still circle time, show-and-tell, and cubbies to hang little coats in. And games, lots of fun and games. But as early childhood educators will tell you, there is a method to their madness. In particular, the fun and games encourage social and emotional growth.

Fun and games

Unlike a two year old, three and four-year-old children are capable of turn-taking and rule-following. These skills help preschoolers form friendships and learn to get along with others. At home, parents can teach their preschoolers simple games that involve turn-taking. Don’t be tempted to bend the rules to allow your child to win every game of Candy Land®. Whether you lose or win, you will model “good winning” and “good losing.” For instance, if you win, say “Good game!” If you lose, say “Oh, I lost, but I had fun playing!” Fast forward a few years and you can avoid having the kid who is a poor sport and can’t move on from a loss.

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How to move your child from crib to bed

transition toddler into a bed

A family asked, “My toddler figured out how to climb out of the crib! How do I transition him into a bed?”

Some kids never climb out of their cribs, but sometimes families need the crib for a new sibling. If this is the case, consider if you really need the crib right away. Using a bassinet for the new baby allows the big brother/sister to get used to having a baby around. Many older siblings regress after the birth of a sibling and it can be useful to keep the older one in a crib for just a little bit longer, then use the new bed as a reward for “helping” or as a token of increased status.

The scariest part of putting your child into a bed is that your child now has access to his entire bedroom.

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High calorie foods for underweight children

High calorie food for underweight children

Your child’s pediatrician charts your child’s height and weight in order to determine whether he is growing appropriately.  Some kids are underweight. These kids use more calories than they take in.

Here are ways to increase calories. Remember, it’s not as simple as demanding that your child eat more of her noodles. Instead of trying to stuff more food into your child, increase the caloric umph behind each meal.

Make every bite count:  

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When will kids get a COVID-19 vaccine?

As the year 2020 comes to a close, we are grateful, as pediatricians caring for your children, that we received our first doses of COVID-19 vaccine.

There is hope!  COVID-19 vaccines have arrived and more than two million adults have safely received a vaccine. Now that vaccinations are reaching adults, many families wonder when COVID-19 vaccines will be available for their children.

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Dry, cracked hands are for lizards

Dry, cracked hands: treatment and prevention

In addition to pocket-sized hand sanitizer, I recently got my kids pocket-sized moisturizer to help their dry, cracked hands. 

Between diligent handwashing and falling temperatures in Pennsylvania, we are experiencing annoying, itchy skin changes. We’ve blogged about this before-Dr. Lai and I are used to washing our hands twice for every patient we see in the office-once before examining them and once again afterward. I have a jar of moisturizer on my desk that I frequently dip into between patients. Now I remind my kids to do the same between hand washings.

Here are some remedies to help treat dry, cracked hands: 

  • Petroleum jelly, such as Vasoline or Aquaphor, works great to moisturize and heal cracks in the skin. Apply at bedtime. Ointments are greasy, so during the day your kids might prefer using a fragrance-free moisturizing cream such as CeraVe or Aveeno.
  • If itchy, add hydrocortisone 1% ointment to your kids’ daily or twice daily hand-care regime. Sometimes, for kids with underlying eczema, pediatricians prescribe a stronger type of hydrocortisone to help with more severe skin cracking and itching from dryness. Ointment tends to sting less than cream.
  • Mix equal parts of moisturizing ointment and hydrocortisone ointment, smear, and put socks over hands to lock in moisture. This works best as a bedtime routine to help decrease the subconscious scratching and picking that occurs during sleep.
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Holiday Gifts for school-age kids 2020

2020 gift ideas for kids
Holidays 2020 style: Oops. I must have been wearing my mask when I told your grandmother that you wanted a “new fur cat.” I think she heard “new fur hat.”

We’re bringing back our popular holiday gift guide based on ages and developmental stages. As always, we will concentrate on non electronic options, as well as pandemic-friendly ideas.


What’s happening: Kids at this age can hop up and down on one foot and they start having a better sense of time. They tell simple stories, can tell real from make-believe and can swing and climb.

Ideas: Clocks, calendars, and games that require some balance like Twister® are all hits. Games with simple rules such as checkers and puzzles with large pieces are developmentally within reach. They may enjoy reading books with very simple sentences on their own. Foster creativity with colored papers, crayons, markers, stickers, and water-color paints.

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Is it COVID or a cold?

COVID or cold
Viral lamentations: imagine an elephant’s woes when a cold ends up in their nose

In the age of the COVID-19 pandemic, we can no longer say easily that your child with cold symptoms has a simple cold. Pre-pandemic, it was so easy to say, “Of course they can go to school with a cold. Most kids can participate and be perfectly happy despite their stuffy nose or mild cough.” We pediatricians often spent time reassuring parents about colds.

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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
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