Virtual Curbside

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 common clinical scenarios, including the impact of maternal fentanyl administered via epidural on newborn toxicology results, and how in utero SSRI exposure may present with symptoms such as apnea, posturing, or seizure-like activity. The conversation further examines the effects of prenatal THC exposure, addressing common misconceptions, potential neonatal impacts, and the persistence of THC in breastmilk.Throughout the discussion, the emphasis remains on careful clinical assessment, clear communication with families, and a

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 conversation explores the limitations of testing and how results should be interpreted in the clinical and social context of each family.We also discuss discharge planning, including referrals to primary care pediatricians and child welfare agencies when appropriate, and what clinicians and families can expect regarding developmental follow-up. Throughout the episode, Dr. Fung emphasizes the importance of a nonjudgmental, supportive approach that fosters trust and promotes the best outcomes for infants and their caregivers.Have a

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 conversation explores the limitations of testing and how results should be interpreted in the clinical and social context of each family.We also discuss discharge planning, including referrals to primary care pediatricians and child welfare agencies when appropriate, and what clinicians and families can expect regarding developmental follow-up. Throughout the episode, Dr. Fung emphasizes the importance of a nonjudgmental, supportive approach that fosters trust and promotes the best outcomes for infants and their caregivers.Have a

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 coordination with caregivers. Finally, we explore the important role of the primary care pediatrician in follow-up—monitoring growth and development, supporting families, and coordinating ongoing services to promote the best possible outcomes for these infants. Have a question? Email questions@vcurb.com. They will be answered in week four.For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requiremen

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 pregnancy and the postpartum period. Together, this episode provides a foundational understanding of NOWS to help clinicians recognize symptoms early and deliver informed, compassionate care to both infants and their families. Have a question? Email questions@vcurb.com. They will be answered in week four.For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Me

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 in children and adolescents. This episode offers clear, practical guidance to support safe evaluation, counseling, and management of pediatric eye concerns. Have a question? Email questions@vcurb.com. We will have a new topic next week.For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, Americ

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 evaluation and management. This episode equips pediatricians with practical tools to accurately assess red eye complaints and determine when further intervention is needed. Have a question? Email questions@vcurb.com. They will be answered next week.For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas C

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 pitfalls—highlighting how improper dosing or technique can limit effectiveness. This discussion is designed to support evidence-based decision-making and safe, effective management of bacterial conjunctivitis in children. Have a question? Email questions@vcurb.com. They will be answered in week four.For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medica

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 control, and guidance on school and daycare attendance. This discussion is designed to help pediatricians confidently diagnose viral conjunctivitis and provide clear, evidence-based reassurance to families. Have a question? Email questions@vcurb.com. They will be answered in week four.For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through

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 development. The conversation examines how well-intentioned adult control can sometimes undermine resilience, and how supporting a child’s sense of agency can improve mental health, learning, and long-term well-being. Listeners will gain practical insights into how pediatricians can reinforce these principles in conversations with families—and how clinicians themselves can think differently about success, pressure, and development in children and teens.No credit available for this episode. See vcurb.com for additional episod

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, including when transfer to a higher level of care is warranted and how to make those decisions in real-world practice. This episode offers practical guidance to support timely recognition, appropriate management, and improved outcomes for infants at risk. For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas C

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 increases, and the critical role of early recognition.We also explore high-risk presentations, including hydrops fetalis, and discuss delivery room considerations and coordination with Neonatal Resuscitation Program (NRP) protocols. Emphasis is placed on interdisciplinary collaboration between obstetrics, neonatology, hematology, and pediatrics to ensure timely intervention and continuity of care for affected infants.Have a question? Email questions@vcurb.com. They will be answered next week.For more information about availabl

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 together to guide clinical decision-making. The discussion closes with practical guidance on when pediatricians should involve hematology or neonatology to ensure timely, coordinated care for infants at risk of significant disease. Have a question? Email questions@vcurb.com. They will be answered in week four.For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado

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 the risk of this preventable condition. Have a question? Email questions@vcurb.com. They will be answered in week four.For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP.  Kansas Chapter, American Academy of Pediatrics is accredited by the Co

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 families live far from surgical centers and rely on their primary care provider to coordinate ongoing care. Listeners will gain practical insights into communication, expectation-setting, and supporting families throughout the treatment journey. Have a question? Email questions@vcurb.com.For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society throug

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 and treatment. Together, the conversation highlights the importance of individualized goals, interdisciplinary follow-through, and continuous reevaluation to ensure each child progresses toward their highest potential. Have a question? Email questions@vcurb.com. They will be answered next week.For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Soci

In this episode, host Paul Wirkus, MD, FAAP and Shawn Mendenhall, MD continue our discussion on upper extremity spasticity—focusing on individualized surgical planning. Our guests explore the range of surgical options available, emphasizing how treatment decisions should be tailored to each child’s functional goals, pattern of spasticity, and overall care plan. The conversation highlights the importance of interdisciplinary collaboration and setting realistic expectations to achieve meaningful improvements in movement and quality of life. Have a question? Email questions@vcurb.com. For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP.  Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to pr

This week’s episode with host Paul Wirkus, MD, FAAP and Shawn Mendenhall, MD focuses on recognizing and correctly identifying upper extremity spasticity in pediatric patients. Our discussion covers key clinical features, surgical updates, common causes, and practical assessment techniques to distinguish spasticity. Understanding these nuances is essential for accurate diagnosis and timely intervention to improve function and quality of life. Have a question? Email questions@vcurb.com. For more information about available credit, visit vCurb.com.ACCME Accreditation StatementThis activity has been planned and implemented in accordance with the accreditation requirements and policies of the Colorado Medical Society through the joint providership of Kansas Chapter, American Academy of Pediatrics and Utah Chapter, AAP.  Kansas Chapter, American Academy of Pediatrics is accredited by the Colorado Medical Society to provide continuing medical education for physicians. AMA Credit Designation StatementKansas Chapter,

In this week’s episode, host Paul Wirkus, MD, FAAP, is joined by Arianna Nunez and Faith Smart. In this episode, youth with lived experience in foster care share their perspectives on medical care - what worked, what didn’t, and what they wish healthcare providers understood. They reflect on the importance of being spoken to directly, knowing what to expect during exams, and feeling respected as active participants in their own care. Their insights offer valuable guidance for pediatricians seeking to provide trauma-informed, patient-centered care to children and adolescents in foster care. Book: Fostering Health: Health Care for Children and Adolescents in Foster CareWebsite: https://www.aap.org/en/patient-care/national-center-for-relational-health-and-trauma-informed-care/?srsltid=AfmBOoq4VarhOPz_mPemtMkydrWGDgwNj6JGH-RdqPp98oyzzccmnRAYDr. Mary Crane Fund for Lived Experience: https://aapnational.donorsupport.co/page/COFCAKC1999 CollectiveFirst Star AcademyHave a question? Email questions@vcurb.com. For more

In this week’s episode, host Paul Wirkus, MD, FAAP, is joined by Kristine Fortin, MD. They will focus on what it takes to optimize care for children and youth in foster care. Our guest discusses how pediatricians can apply trauma-informed practices to foster trust, enhance communication, and address the distinct healthcare needs of this population. The conversation also explores common barriers foster youth face in accessing consistent, coordinated care - and highlights resources available to support pediatricians in providing compassionate, comprehensive care. Book: Fostering Health: Health Care for Children and Adolescents in Foster CareWebsite: https://www.aap.org/en/patient-care/national-center-for-relational-health-and-trauma-informed-care/?srsltid=AfmBOoq4VarhOPz_mPemtMkydrWGDgwNj6JGH-RdqPp98oyzzccmnRAYDr. Mary Crane Fund for Lived Experience: https://aapnational.donorsupport.co/page/COFCAKCHave a question? Email questions@vcurb.com. For more information about available credit, visit vCurb.com.Acknowled