Newborn Screening…What’s the Meaning?

In 1968 the state of Tennessee started it’s state newborn screening program. It was designed to screen infants shortly after birth that may have a treatable condition that is not immediately recognizable. The current program consists of three parts :

*A blood sample that screens for inherited conditions that are treatable if identified early

*A hearing screen to be conducted prior to discharge to help identify congenital hearing loss

*The Critical Congenital Heart Disease (CCHD) screen that is conducted through a simple oxygen reading while in the newborn nursery

These three simple tests allow for early detection for a wide range of treatable conditions. These tests will routinely be performed in the newborn nursery and the results of these tests will be made available to you as they are completed. The genetic blood screen is sent to the state lab so those results are usually not available until after you are discharged home from the hospital. Your pediatrician will be able to access those results for you. More information can be found here.

Additionally, one of our own KPA families has worked tirelessly to see that Krabbe’s disease was listed on the newborn screen through an act known as the Mabry Kate Webb Act in 2015. To read more of the Webb family story visit Facebook.

The Very Hungry Caterpillar – A Bedtime Favorite for A Healthier Generation

As our children were growing up, Eric Carle was one of our favorite authors and his book, The Very Hungry Caterpillar, was often one of their choices at bedtime. Currently, the AAP is teaming up with The Alliance for A Healthier Generation along with this timeless book by Eric Carle to help families in their efforts to eat a healthier diet. The following link​ to the website provides the tools for this initiative.





It’s Not Too Late for Influenza (Flu) Vaccination

Per a December 28, 2017 American Academy of Pediatrics(AAP) alert, “Flu activity is increasing in the United States.  There have already been 8 pediatric deaths from influenza reported.  Vaccination is the most important step anyone can take to protect themselves and their loved ones against influenza and its complications.  It takes about two weeks after vaccination for immunity to develop in the body that protects against influenza infection.”

Children younger than 5 years of age, especially children younger than 2, are at an increased risk of hospitalization and complications due to influenza.  ​Therefore, the AAP and CDC recommend that all children 6 months and older receive a flu vaccine each year.  Pregnant women should also receive the influenza vaccine at any time during their pregnancy to protect themselves as well as their young infants during the first 6 months of life.

Since the flu vaccine isn’t 100% effective,  it’s important to take precautions to decrease the risk of infection.  These measure include frequent hand washing with soap and water and avoidance of crowds.

Two other recent articles related to vaccines worth reading are “Why Vaccines Matter in the November 2017 edition of National Geographic magazine” and “Simply Put:  Vaccination Saves Lives in the Autumn 2017 edition of Emory Health Digest.

Here’s to a Happy and Healthy 2018!

Cold Weather Problems

With the extreme weather we have had and will have this January, it’s important to keep in mind the dangers of very cold weather. Here are a couple:


Frostbite is the freezing of tissue.  It is caused by exposure to cold weather and is influenced by the degree of cold and length of time the tissue is exposed.  Cold water and cold surfaces can speed frostbite as well. Touching metal at 5 degrees F can cause frostbite in seconds. Crystals form in tissue and cells causing decreased blood perfusion, cell death and subsequent inflammation. The extent of the frostbite depends on how deep the freezing goes.  Initially fingers are red. They may be blistered. Tissue may progress to blue/purple and then black. What do you do if someone has frostbite? Get the person to a medical facility as quickly as possible.  Get the victim to a warm environment.  Take off wet clothes. Rewarm the affected area by placing in warm water only if you are sure it will not refreeze.  Refreezing causes more damage. Do not rub the area as this can also cause more damage. Do not use flames or stoves which can burn. There is no sensation in frostbitten tissue and burns can occur more easily.


Hypothermia occurs when the body’s core temperature drops below 95 degrees. Initially there is shivering, abnormal breathing, paleness, loss of coordination, and impaired judgment.  As their temperature drops more, there is altered mental status and then loss of consciousness.  These people need to be warmed quickly.  Get to a warm environment. Give warm liquids. Use thermal blankets. Try to warm their core with warm water bottles. Transport to a medical facility as quickly as possible. Prevention is the best thing. Wear warm clothes with lots of loose layers.  Wear a hat and gloves.  Drink lots of liquids.  No caffeine or alcohol.  Limit your time in the cold.  Never go out in the cold alone!

Winter weather can be a lot of fun, but be safe and be prepared and please call your pediatrician’s office if you have questions.

Children and Gun Safety

Guns are in more than one third of all U.S. households, so they’re a danger to children, whether you own one or not. That’s why it’s crucial to talk to children about the potential danger of guns – and what to do if they find one. If you do own a gun, keep it out of sight and out of reach. Make sure it’s locked and unloaded. Store ammunition in a separate place.

Talking to kids about gun safety: 

Teach kids to follow these rules if they come in contact of a gun:

  1. Stop what you are doing.
  2. Don’t touch the gun.
  3. Leave the area where the gun is.
  4. Tell an adult immediately.

If you have a gun in your home: 

  1. Unloaded firearms should be stored in a locked cabinet, safe, gun vault or storage case. The storage location should be inaccessible to children.
  2. Gun locking devices render firearms inoperableand can be used in addition to locked storage. If firearms are disassembled, parts should be securely stored in separate locations.
  3. Ammunition should be stored in a locked location — separate from firearms.
  4. Thoroughly double check firearms to confirm that they are unloaded when you place them and remove them from storage. Accidents could occur if anyone borrows a gun and returns it to storage while still loaded.

Gun safety outside your home: 

Gun safety doesn’t end when your child leaves your home. Kids can still come into contact with firearms at a neighbor’s house or under other circumstances.  Make sure you talk to your kids about gun safety outside your home.

When using a gun:

Gun use by children should always be under the supervision of an adult. According to the NRA and other gun organizations, four cardinal rules should be followed whenever using a gun:

  1. Always treat firearms as if they are loaded.
  2. Never allow a muzzle of any firearm to point to anything but an intended target.
  3. Never put your finger near a trigger until you are ready to fire it. Do not depend on a mechanical device – “the safety” – for safety.
  4. Always be sure of what is in front and behind the target. 

A word about BB and Non-Powder Guns:

Non-powder guns, such as ball-bearing (BB) guns, pellet guns, and paintball guns, are not regulated by the government, but can potentially cause serious injury.  The U.S. Consumer Product Safety Commission recommends that kids under 16 not use high-velocity BB guns or pellet guns. In addition, these guns should be used under adult supervision. Kids who use BB guns must know never to point it at anyone, including themselves. In addition, paintball guns have been known to cause traumatic eye injuries, so kids need to wear protective eye gear.

Note: Data from this article comes in part from KidsHealth. This website is a great resource for parents – so it’s worth bookmarking. It’s a nonprofit funded by the Nemours Foundation, and its content goes through a vigorous medical review by pediatricians and other medical experts. The site has earned four Webby Awards (Best Family/Parenting Site and Best Health Site on the Web), the Parent’s Choice Gold Award, the Teacher’s Choice Award for Family, and the International Pirelli Award for best educational media for students.



Keep the Holidays Happy-Toy Safety

With the holiday season upon us, here are a few reminders regarding toy safety.  Always make sure you child’s toy is age-appropriate.  Choking is one of the greatest hazards, especially for children less than 3 years of age.  Ingestion of button batteries and small magnets are particularly dangerous.  Be sure to remind older children with younger siblings to clean up their toys after playing.  In addition, make sure older children wear a helmet when riding their new bicycles and skateboards.  More Information



  Safe Disposal of Medications

It is very important that drugs be disposed of when no longer needed, and that it be done in a proper manner. Old medicines lose their potency and can even become toxic in some cases. Medicines in the house are also a potential source of poisoning for young children. The best way to dispose of drugs is at an approved disposal center. In Knox County there are at least 2 such places.

Knoxville Police Department, 800 Howard Baker Jr Ave., Knoxville 37915 and Walgreen’s Pharmacy, 121 North Northshore Drive, Knoxville 37919. Both are open 24-7.

Disposing of drugs in the sink or toilet can result in water pollution and possibly affect wildlife. Even disposal in a garbage landfill could, in the long run, have toxic effects. Please do what is safest both for your family and for our community by using approved sites to get rid of outdated or unneeded medications.


An Evening Moment

Darkness. Your senses sharpen. Sounds become clearer as you hear the far off howl of a coyote, the call of an owl. Leaves rustle with the sound of wind above and tiny feet below. More and more stars appear as your eyes adjust. The trees cast their shadows from the light of the moon. Shades of gray reveal your way as your feet glide you over an uneven ground. Shadows become sharper as your eyes adjust and the path becomes clearer. The canopy of trees deepen the darkness beneath them and when the sky reappears the stars have filled the sky with brilliant points of light. The stillness of the night that envelops me is interrupted by the low whine of my four legged companion. A reminder that tomorrow is waiting. Time to go back inside.

Tattoos and Piercings

The cultural phenomenon of tattooing and piercing is going strong.  For this reason, the American Academy of Pediatrics has recently released recommendations on these practices. On a daily basis in our office, I witness both forms of body art and oftentimes have had to treat complications related to them most commonly local skin infections. While the legal age for tattooing in most states is 18, piercings are often done during mid-adolescence. Because of this, we as parents and pediatricians need to be discussing potential risks of tattooing and piercing starting early in the teen years.

Click here for the AAP recommendations.  


Secondary/Dry Drowning

Although fall is just around the corner, parents are still concerned about  “dry drowning” or “secondary drowning.”  I would like to reassure parents that dry drowning, in the fantastical way the media has portrayed it, is not a true entity. Your child will not have an uneventful day playing in the pool, swallow a mouthful of water that causes no respiratory symptoms, and suddenly die 5 days later from a “dry drowning.” Here are a couple links to articles written by emergency room physicians that explore this issue.