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-Threatening Events (ALTE), and more recently, Brief Resolved Unexplained Events (BRUE) and Functional Ne...
Jun 02, 2026•28 min•Ep. 385
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 weeks of life and how clinicians can help families distinguish typical infant behavior from signs that...
May 26, 2026•13 min•Ep. 387
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 limitations of imported formulas. The conversation also explores how manufacturing and safety standards diff...
May 19, 2026•19 min•Ep. 384
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 us about their role in infant nutrition and gut health. The conversation also compares different pro...
May 12, 2026•26 min•Ep. 383
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 rare but serious risks such as botulism - and discuss why recalls, while essential, can be complex f...
May 05, 2026•21 min•Ep. 382
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 anxiety and panic can manifest in avoidance behaviors and how to support families in getting children ...
Apr 28, 2026•18 min•Ep. 381
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, trauma, and ADHD—can influence presentation, severity, and treatment outcomes. The conversation emphasiz...
Apr 21, 2026•24 min•Ep. 380
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 dynamics in both the development and management of symptoms, along with evidence-based treatment appr...
Apr 14, 2026•24 min•Ep. 379
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 prediction, emphasizing the importance of ongoing assessment rather than relying on a single point in time. W...
Apr 07, 2026•27 min•Ep. 378
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 leadership principles apply to pediatric practice. The conversation highlights how low-ego, high-drive le...
Mar 31, 2026•19 min•Ep. 377
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, cinnamon, and detergent pods - and the real dangers associated with these ingestions. The conversat...
Mar 24, 2026•18 min•Ep. 376
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 conversation also highlights common pitfalls, including the risks of relying on internet searches or AI t...
Mar 17, 2026•18 min•Ep. 375
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, hydrocarbons, and cleaning agents. The conversation emphasizes early recognition, appropriate initial...
Mar 10, 2026•34 min•Ep. 374
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 control system works - how calls are triaged, who provides guidance, and how centers collaborate across t...
Mar 03, 2026•20 min•Ep. 373
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 testing is considered diagnostic and how results may have reporting implications. We also explore commo...
Feb 24, 2026•18 min•Ep. 372
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 methods - such as urine, meconium, and umbilical cord testing - can and cannot tell us. The conversatio...
Feb 17, 2026•19 min•Ep. 371
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 methods - such as urine, meconium, and umbilical cord testing - can and cannot tell us. The conversatio...
Feb 17, 2026•19 min•Ep. 371
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. The conversation also addresses discharge planning, including criteria for safe transition home and c...
Feb 10, 2026•25 min•Ep. 370
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 highlights the role of specialized clinics and coordinated care models that support mothers during ...
Feb 03, 2026•24 min•Ep. 369
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 massage is effective for clearing duct obstruction and important considerations for contact lens use ...
Jan 27, 2026•22 min•Ep. 368
In this episode, we turn our focus to allergic conjunctivitis. Host Paul Wirkus, MD, FAAP and Ophthalmologist Mitchell Strominger, MD guests review the clinical features of ocular allergy and discuss how characteristics such as discharge and symptom patterns can help distinguish allergic conjunctivitis from viral, bacterial, and other etiologies. The conversation also covers important mimics and red flags, including chemical conjunctivitis, corneal abrasions, and foreign bodies, with guidance on...
Jan 20, 2026•34 min•Ep. 367
This week’s episode focuses on bacterial conjunctivitis and practical considerations for pediatric care. Host Paul Wirkus, MD, FAAP and Ophthalmologist Mitchell Strominger, MD discuss key principles of infection control, how to recognize concerning findings and distinguish uncomplicated conjunctivitis from more serious conditions such as orbital cellulitis, and when escalation of care is necessary. We also review the appropriate use of antibiotics, including selection, administration, and common...
Jan 13, 2026•24 min•Ep. 366
This month we begin a new series on common pediatric eye issues, starting with viral conjunctivitis. In this episode, host Paul Wirkus, MD, FAAP and Ophthalmologist Mitchell Strominger, MD review the clinical features that help distinguish viral conjunctivitis from other causes of red and pink eye, discuss typical disease course, and address common misconceptions around treatment and contagion. They also explore practical counseling points for families, including symptom management, infection co...
Jan 06, 2026•21 min•Ep. 365
In months with five weeks, The Virtual Curbside steps away from clinical topics for a pediatric book club discussion. This month, we explore The Self-Driven Child: The Science and Sense of Giving Your Kids More Control Over Their Lives by Ned Johnson and William Stixrud. Our hosts Paul Wirkus, MD, FAAP and Angelo Giardino, MD, FAAP, reflect on the science behind autonomy, stress, and motivation, and discuss how the book’s core themes intersect with pediatric care, parenting, and adolescent devel...
Dec 30, 2025•23 min•Ep. 363
In this Q&A episode, host Paul Wirkus, MD, FAAP and guest Tim Bahr, MD, FAAP address important clinical questions surrounding hyperbilirubinemia, with a focus on longer-term complications and complex presentations. The discussion explores outcomes associated with severe or prolonged hyperbilirubinemia, including cases with late presentation or persistent jaundice, and how these scenarios may differ from typical newborn courses. We also review key considerations for escalation of care, includ...
Dec 23, 2025•16 min•Ep. 364
In Episode 3 of our hemolytic disease of the fetus and newborn (HDFN) series, host Paul Wirkus, MD, FAAP and guest Tim Bahr, MD, FAAP focus on clinical management and emerging consensus around care. Our discussion reviews key elements of the recently published consensus paper, including proposed guidelines for evaluation, monitoring, and treatment across the perinatal and neonatal periods. They address management of hyperbilirubinemia and anemia, escalation of care when disease severity increase...
Dec 16, 2025•25 min•Ep. 362
This week’s episode host Paul Wirkus, MD, FAAP and guest Tim Bahr, MD, FAAP take a deep dive into evaluating newborn jaundice and identifying early signs of hemolysis. We walk through the key elements of maternal testing that set the stage for newborn risk assessment, then explore how to interpret bilirubin trajectories to distinguish normal patterns from concerning trends. Our guests also review the role of the reticulocyte count, what a peripheral smear can reveal, and how these tools come tog...
Dec 09, 2025•21 min•Ep. 361
This week’s episode focuses on alloimmunization the prevention of hemolytic disease of the fetus and newborn (HDFN). Our host Paul Wirkus, MD, FAAP and Tim Bahr, MD break down the immunologic mechanisms behind HDFN, discuss how maternal sensitization occurs, and explain why timely screening and prophylaxis are essential. We review current recommendations, practical considerations for pediatric and perinatal providers, and the role of coordinated care across obstetrics and pediatrics to reduce th...
Dec 02, 2025•22 min•Ep. 360
In this Q&A episode, host Paul Wirkus, MD, FAAP and Shawn Mendenhall, MD address common clinical questions related to managing upper extremity spasticity in children. The conversation explores how to balance orthopedic readiness and bone maturity with developmental readiness and family goals - highlighting the importance of individualized timing and shared decision-making. They also discuss the collaborative relationship between general pediatricians and subspecialists, particularly when fam...
Nov 24, 2025•21 min•Ep. 359
In the third episode of our upper extremity spasticity series, host Paul Wirkus, MD, FAAP and Shawn Mendenhall, MD focus on what success truly looks like - both in the short term and long term. Our guests discuss how to measure meaningful outcomes for children, from functional gains to improved comfort and participation in daily activities. We also look ahead to the future of spasticity care, exploring emerging approaches, evolving surgical techniques, and innovations that may improve assessment...
Nov 18, 2025•20 min•Ep. 358