Virtual Curbside

This month we begin a new series on Postural Orthostatic Tachycardia Syndrome (POTS), exploring the diagnosis and management of this increasingly recognized condition in pediatric patients. In this episode, host Paul Wirkus, MD, FAAP and guest Kirti Sivakoti, MD, provide an overview of POTS before discussing current approaches to diagnosis and recent updates in the field. We review the diagnostic...

In months with five weeks, The Virtual Curbside takes a break from clinical topics for a pediatric book club discussion. This month, host Paul Wirkus, MD, FAAP, is joined by regular book club guest Angelo Giardino, MD, FAAP, and a special guest, fifth-grader Harry Thatcher, to discuss The Anxious Generation: A Graphic Novel by Jonathan Haidt. Together, they explore the book's central themes throug...

In this Q&A episode of our pediatric neurology series, we answer listener questions about some of the most rapidly evolving areas in neurology and genetics. The discussion begins with the relationship between child abuse evaluations and Brief Resolved Unexplained Events (BRUE), including important considerations when assessing infants with unexplained symptoms. Host Paul Wirkus, MD, FAAP and g...

In this episode of our pediatric neurology series, host Paul Wirkus, MD, FAAP and guest Josh Bonkowsky, MD explore the rapidly evolving field of gene therapy and its potential to transform the care of children with neurologic disorders. Our guest explains the science behind gene therapy, including how these treatments work to target the underlying causes of genetic disease. The conversation also e...

In Episode 2 of our pediatric neurology series, we explore how advances in diagnostic technology have transformed the field of neurology. Our guests discuss the evolution of neurologic evaluation - from early ultrasound imaging to CT and MRI - and how modern imaging has revolutionized the ability to diagnose and understand neurologic disease in children. Host Paul Wirkus, MD, FAAP and guest Josh B...

This month we begin a new series on pediatric neurology issues, starting with a discussion with Josh Bonkowsky, MD, PhD, about his book Dancing Eyes, Dancing Feet . In this episode, our host Paul Wirkus, MD, FAAP and Dr. Bonkowsky trace the evolution of how clinicians understand and approach unexplained events in infants and children - from Sudden Infant Death Syndrome (SIDS) to Apparent Life-Thre...

In this Q&A episode of our infant formula and nutrition series, host Paul Wirkus, MD, FAAP and guest Steve Abrams, MD address common questions pediatricians hear from families during the newborn period. The discussion explores the role of lactose in infant formula, including when lactose-free options may - or may not - be appropriate. We also talk about normal newborn fussiness in the first we...

In this episode of our infant formula and nutrition series, host Paul Wirkus, MD, FAAP and guest Steve Abrams, MD take a closer look at formula regulation, importation, and the growing influence of social media on infant feeding decisions. Our guests discuss the FDA registration process for infant formulas, what it means when products are not FDA registered, and the potential benefits and limitati...

In Episode 2 of our infant formula and nutrition series, host Paul Wirkus, MD, FAAP and guest Steve Abrams, MD explore the question many families ask: how closely should infant formula resemble breast milk, and does it matter? Our guests discuss the science behind common formula ingredients, including oligosaccharides, prebiotics, postbiotics, and lactose, and review what evidence currently tells...

This month we turn our focus to infant formula and nutrition, beginning with a discussion of formula safety and supply. In this episode, our host Paul Wirkus, MD, FAAP and guest Steve Abrams, MD revisit Operation Fly Formula and the broader challenges of maintaining a safe and reliable formula supply in the U.S. We review safety concerns related to contamination - including bacteria, viruses, and...

In this Q&A episode of our psychiatric “grab bag” series, host Paul Wirkus, MD, FAAP and Jeremy Kendrick, MD tackle common and challenging scenarios related to panic and anxiety in pediatric patients. The discussion clarifies how panic disorders differ from OCD, helping clinicians distinguish overlapping symptoms and guide appropriate treatment. We also address school refusal, exploring how an...

In the third episode of our psychiatric “grab bag” series, we focus on the “angry adolescent” and the complex factors that can drive irritability and behavioral outbursts. Host Paul Wirkus, MD, FAAP and Jeremy Kendrick, MD discuss Disruptive Mood Dysregulation Disorder (DMDD) and how it differs from other mood and behavioral conditions. We explore how coexisting factors—such as substance use, trau...

In this episode of our psychiatric “grab bag” series, we focus on panic disorders and how they present in pediatric patients. Host Paul Wirkus, MD, FAAP and Jeremy Kendrick, MD discuss the differences between panic and general anxiety, helping clinicians recognize key features that distinguish acute panic episodes from broader anxiety conditions. The conversation also explores the role of family d...

This month we shift to a psychiatric “grab bag” series, beginning with a focused discussion on suicide risk assessment in pediatric practice. Host Paul Wirkus, MD, FAAP and Jeremy Kendrick, MD review how to ask about suicide in a direct, developmentally appropriate way and explore the differences between passive thoughts and active risk. The conversation also addresses the limits of risk predictio...

In months with five weeks, The Virtual Curbside steps away from clinical topics for a pediatric book club discussion. In this month’s book club episode, we explore Humbitious: The Power of Low-Ego, High-Drive Leadership by Amer Kaissi. Our hosts Paul Wirkus, MD, FAAP and Angelo Giardino, MD, FAAP reflect on the concept of “humbition” - balancing humility with ambition - and discuss how these leade...

In this Q&A episode of our Poison Control series, Host Paul Wirkus, MD, FAAP and guest Michael Moss, MD address emerging trends and high-risk behaviors contributing to pediatric and adolescent poison exposures. Our experts discuss substances sometimes used in social media challenges - including diphenhydramine, combination cold medications like NyQuil, and household items such as salt, nutmeg,...

In recognition of Poison Prevention Week , this episode of our Poison Control series focuses on practical strategies to prevent pediatric poison exposures. Host Paul Wirkus, MD, FAAP and guest Michael Moss, MD, discuss the importance of safe medication and household product storage, correct medication dosing, and how tools such as pill imprint codes can help identify unknown medications. The conve...

In this episode of our Poison Control series, host, Paul Wirkus, MD, FAAP and guest Michael Moss, MD, focus on several high-risk exposures commonly encountered in pediatrics. Our guests review toxic thresholds for medications such as acetaminophen, discuss the dangers of prescription medication ingestions, and highlight particularly hazardous household items, including button batteries, magnets, h...

This month we turn our attention to Poison Control, beginning with an overview of why children are uniquely vulnerable to toxic exposures. In this episode, our host, Paul Wirkus, MD, FAAP and guest Michael Moss, MD review common pediatric ingestions, household risks, and explain factors that increase children's vulnerabilities. We also take a behind-the-scenes look at how the nation’s poison contr...

In this Q&A episode of our neonatal opioid withdrawal syndrome (NOWS) series, we address challenging and nuanced clinical questions surrounding withdrawal, toxicology testing, and newborn exposures. Our host, Paul Wirkus, MD, FAAP, and guest Camille Fung, MD, review the early signs of withdrawal and discuss the process of obtaining consent for neonatal toxicology screening, clarifying when tes...

In this episode, we continue our series on neonatal opioid withdrawal syndrome (NOWS) with a discussion of substance exposure in the perinatal period and the practical considerations surrounding testing and discharge planning. Our host, Paul Wirkus, MD, FAAP and guest Camille Fung, MD review the fundamentals of prenatal substance exposure and the rationale for testing, including what different met...

In this episode, we continue our series on neonatal opioid withdrawal syndrome (NOWS) with a discussion of substance exposure in the perinatal period and the practical considerations surrounding testing and discharge planning. Our host, Paul Wirkus, MD, FAAP and guest Camille Fung, MD review the fundamentals of prenatal substance exposure and the rationale for testing, including what different met...

In this episode, we continue our discussion of neonatal opioid withdrawal syndrome (NOWS), focusing on clinical features, treatment, and care after discharge. Our host, Paul Wirkus, MD, FAAP and guest Camille Fung, MD review the signs and symptoms clinicians use to recognize and assess withdrawal, along with current approaches to medication management and supportive care in the hospital setting. T...

This month we are focusing on neonatal opioid withdrawal syndrome (NOWS), with an emphasis on the underlying physiology and clinical presentation. Our host, Paul Wirkus, MD, FAAP and guest Camille Fung, MD review the mechanisms of opioid exposure and withdrawal, including neuroexcitability and the gastrointestinal and autonomic manifestations commonly seen in affected newborns. The discussion also...

In this Q&A episode, Host Paul Wirkus, MD, FAAP and Ophthalmologist Mitchell Strominger, MD address common clinical questions related to pediatric red eye presentations. The discussion covers key elements of the differential diagnosis, including how to approach cloudy corneas and other concerning findings. We also review practical questions pediatricians frequently encounter, such as whether m...