Let’s Swim!

It’s summer time, which means it’s swim time in Tennessee.  In East Tennessee, there are many opportunities to spend time in the water.  Seven lakes and several rivers in our area cover over 200,000 acres.  There are more than thirty competition swimming pools and hundreds of home and neighborhood pools in Knox and the surrounding counties. Whether spending time on the lake, rafting down a local river, or attending a friend’s pool party, children will be in and around water throughout their childhood. With all this exposure to water, children should learn how to swim. There are several local swim instructors that offer formal swim lessons, and children are never too old to learn. Swimming is an activity that can be enjoyed for a lifetime and that can help children be safer around the water.

My Son Loves to Fish…

Heard of Fortnite? Snapchat? Instagram? I’d bet your child knows! The American Academy of Pediatrics recommends a maximum of 2 hours of screen time per day. Today’s children are spending an average of 7 hours a day on entertainment media, including televisions, computers, phones and other electronic devices. The AAP and HealthyChildren.org have developed a Family Media Use Plan that can help you and your child/children create healthy media choices.  Check this out…

Better yet…take some time out of your busy schedules to interact with your children. Go to their band/chorus/orchestra concerts, ballgames, plays/recitals, etc. It means more to them then you may think! Find a hobby that you can enjoy with your children. My son loves to fish, and thankfully, so do I! Tennessee recently had its annual Fish For Free week. It’s a great opportunity to spend some quality time outdoors (away from screens) with your child. Even if you spend most of it untangling line! Have a great summer!

Rainy Days and a Far-Off Adventure

Growing up, one of the things I looked forward most to during summer vacation was having an unlimited amount of free time to read. I remember lazy rainy days tucked into a chair, nose buried deep in some far-off adventure. There was also the intense research of finding just the right books to take on the long-awaited beach trip. I have always enjoyed reading and still do, although I must admit as an adult, there seems to be less time to fit it into my schedule!

Unfortunately, our kids today are more interested in video games, TV, YouTube and their other electronic devices than actual books I get the sense that they feel like reading is a chore, and I understand that what they are required to read for school is not that entertaining.  Summer is the perfect time to introduce them to pleasure reading: take a trip to the library and let them pick out something they really want to read. Then when the rainy days hit or they’re just tired of going to the pool, there will be something enriching for them to do.

A few suggestions, according to age:

Age 3-5

After the Fall by Dan Santat

Can I be your dog? By Troy Cummings

Green Eggs and Ham by Dr. Seuss

Age 6-8

The Jada Jones Series: Class Act by Kelly Starling Lyons

Fish are not afraid of doctors by J.E. Morris

Where the wild things are by Maurice Sendak 

Age 9-12

Diary of a Wimpy Kid series by Jeff Kinney

Daring Dreamers Club #1: Milla Takes Charge by Erin Soderberg

Harry Potter series books 1-3 by J.K. Rowling

The Legend of Greg by Chris Rylander

The Importance of Reading with Your Child

It has been about a year since I last blogged for KPA. At that time, I was expecting my first child. Now, I have a 10 month old daughter!  I could probably devote this entire blog to how time goes by so much more quickly after becoming a parent, but all of you probably already know that!

Instead, I’ll mention that I’ve recently often thought to myself, “What should I be doing with my child? What types of activities should I be exposing her to for her learning and development?” There are numerous answers to these questions but a fantastic answer is always going to be: read to your child, there are so many reasons why!

  • It will actually help with vocabulary later. It allows you as a parent to talk with your children and probably use words you would not use in daily conversation (children’s books use such fun language)!  The more language and words children hear before the age of  3, the better they tend to do in school with reading. A larger vocabulary helps children with schoolwork because they spend less time understanding what they’re reading and less decoding the words they are reading.  This means even reading comprehension is better.
  • Reading to your child often opens new doors for conversation and play. If you are reading  fiction, it will always lead to more conversation and questions.  It’s great for your child to be imaginative and creative.
  • It gives children a model on how to do kindergarten foundation reading concepts. They will already know how books work, the structure, how to read left-to-right, top-to-bottom, and even how to turn pages.
  • You can model good reading to your child. You will model fluent and expressive reading so that your child will pick up on pauses, the rise and fall of your voice in speaking, and patterns of rhythm and sound.
  • It is so much fun! What better way to interact with your child and bond.

A few quick tips for reading to your child based on age:

Before 6 months:

Think about reading more as exploring the concept of books.  Read sturdy books; allow your child to chew on them.  You can even read magazines or books you are reading yourself because they still get the benefit of hearing the sounds of language.

6-12 Months:

Talk about pictures.  Encourage pointing to things on the pages.  Let your baby turn the pages.  If your baby gets bored or distracted, don’t stress about not finishing the book.

12-18 months:

Use dramatic reading with different voices and big expressions and gestures.

18 months to 3 years:

  • Help your child become the storyteller. Each time you read the same book, do less reading yourself, and let your child talk more.  You can point and ask questions. Make it interactive!
  • Read alphabet books and rhymes so your child gets to hear the sounds of different letters.
  • Sound out words, syllable by syllable. This can help your child link letters and their sounds which can help decode words later and help with spelling.

4-5 years:

  • Have your child read aloud what they know. Point out words you know that they know which will help with word recognition and comprehension.
  • Ask questions about the story while you read. Reread parts your child maybe did not understand.  Ask questions about the plot of the story.  Research shows how important conversation during reading is.

I hope I have given you a new zest for reading with your child.  Please remember how important it is to read together every day, even if it is just for 5-10 minutes.  The benefits are numerous!

A very special thanks to my sister (also a wonderful aunt to my daughter), who helped me with my post.  She has been a first grade teacher for 8 years.  Her passion for reading and early education amazes me daily!

“Media, Media Everywhere and Not a Drop to Drink!”

Everywhere you look, there they are.  iPhones,  iPads, video games, e-readers. The list keeps getting bigger and bigger. Not a day goes by when I don’t see a child staring down at their parents’ phone while walking down our office hallway to their exam room. Teenagers are looking at their phone while I’m trying to have a conversation with them during their checkup. Phones are pinging with text messages and voicemails. What are we to do?

Parents may feel that they are fighting a losing battle against media and their kids. Help is on the way! The American Academy of Pediatrics has a great article about helping children develop a healthy relationship with media. Find out how here.




Spring Break, Sakura and Hanami

This year I had the opportunity to travel to Japan with my college age daughter for her spring break.  Her break fell the last week of March and when she was planning her trip she said “wouldn’t it be great if the cherry blossoms were blooming while we were there!”  Well, we were unaware that it would be the peak week for the blooms in Tokyo and Kyoto.  We were also unaware of what a big deal this time of year is for the Japanese people. 

The cherry blossoms are small delicate pale pink flowers that are known as “sakura”.  The springtime bloom is a lavish spectacle that only lasts one to two weeks after which the blooms fall like snow to the ground and wither.  There are so many cherry trees of various colors and varieties throughout Japan that every city has streets and canals lined with flowering trees.  It really is so beautiful that words and photos don’t do them justice! The tradition of enjoying the blooms with outdoor parties and picnics under the trees is called “hanami”.  It is a tradition as old as the trees and was established as a ritual as early as 710.  Today it is a national pastime with deep cultural and religious roots. Everyone stops and gathers to picnic, drink sake and eat sakura flavored desserts, candies and drinks under the trees. The celebrations go on all day and into the night with paper lanterns lighting the trees.  Women in beautiful kimonos and gowns pose for photos and families gather for family portraits. 


The sakura signals the beginning of spring, a time of renewal and optimism.  The blooming coincides the beginning of the Japanese calendar year and brings new hope and dreams.  When the cherry blossoms are in bloom the future is bursting with possibilities. The sakura is also a metaphor for life, the brief brilliant blooming is followed by the inevitable fall.  They are tied to Buddhist themes of mortality, mindfulness and living in the present. The sakura is a visual reminder of the transience of life and impermanence.  So, if you are in Japan during this time you don’t walk past a blooming tree today without taking in it’s beauty because tomorrow it might be gone. The intensity of this experience was surprising to my daughter and I.  Now that we have been home a few weeks, we are still trying to take it all in! 

As I write this blog, the dogwoods, red bud trees, azaleas and flowers are all exploding into blooms here in Knoxville.  I hope that you will take time with your children to get out and enjoy this special time of year and cherish this time with your family and friends!!  

Watch Out for Spring Fever!

Springtime is here, and with longer warmer days many of us have begun to suffer from what is referred to as “Spring Fever”. We all know what it feels like. We’ve all surely experienced it at one time or another, and many of us have done so on a yearly basis for decades.  Webster’s Dictionary defines Spring fever as “a lazy or restless feeling often associated with the onset of Spring”.  For many of us a “lazy or restless feeling” does not adequately describe the pain and torture of being cooped up inside an office with only windows to look out and see the beauty that Mother Nature has bestowed on us with brightly colored flowers and trees, and birds, and warm sunshine beaming down.  Oh, the pain! I want to be outside.  Nope! Sorry, seven more hours to go. 

Yes, Spring fever is a painful affliction, that is, modern-day Spring fever.  But, it is not a disabling or fatal disease as it was two or three centuries ago.  Spring fever, also known as “Spring Disease” in the 1700’s and 1800’s, was an illness that usually occurred in the Springtime and involved fatigue,  malaise, easy bruising, bone pain, hemorrhaging of the scalp and gums, and poor wound healing.  If left untreated, (which most cases were, until a miraculous cure was discovered) it lead to jaundice, seizures, neuropathy, and death.  Many thousands of people died from old fashioned Spring fever (Spring Disease) prior to the discovery of adequate treatment.  In the mid 1700’s a Scottish physician named Dr. James Lind discovered that the terrible illness formerly known as Spring Disease (but at that time was referred to as scurvy), could be successfully treated by the ingestion of oranges, lemons, and limes.  Ascorbic (citric) acid, or vitamin C, was yet to be discovered, and no one knew why these fruits worked to cure scurvy, only that the treatment was undeniably curative.  The illness “land scurvy” usually occurred in the Spring of the year, and more commonly in urban areas, which were largely void of fruits and vegetables (and especially citrus fruits) during the winter. The more agricultural areas of the world had better access to fruits and vegetables that were stockpiled during warm months to be consumed during the winter. Since transportation of food and food storage were more of a problem for urban dwellers in the 1700’s and 1800’s, these people were at much higher risk for developing land scurvy as their vitamin C levels became depleted during the winter months with no available fruits and vegetable for consumption.  By Springtime, they became ill with the disease.  “Sea scurvy” on the other hand, occurred throughout the year, and was thought to be a different illness than land scurvy.  Sailors made long voyages encompassing months of time at sea during this era.  Their diets on board ship rarely included fruits and vegetables, and thus, after many months at sea with vitamin C deficient diets, they developed sea scurvy.  Many thousands of sailors died from this disease before Dr. Lind’s discovery.  Dr. Lind himself had served in the Royal British Navy and had witnessed the suffering and deaths of countless sailors.  His discovery led to British ships being stocked with limes for ingestion by the sailors to prevent scurvy.  As a result, British sailors were eventually referred to as “Limeys”.  Land scurvy and sea scurvy were ultimately found to be the same disease, although the exact cause of the disease would remain a mystery until 1932 when ascorbic acid (vitamin C) was discovered by scientists in the U. S. and Hungary simultaneously. However, by the time the disease scurvy was adequately described and the exact cause was elucidated, Dr. Lind’s discovery of a cure nearly 200 years prior was a well accepted and practiced medical miracle. 


Top 10 Things I Miss Since Becoming a Mother (almost 7 years ago)

  1. Privacy in the bathroom
  2. Sleep
  3. Finishing a thought
  4. Finishing a sentence (finishing anything for that matter)
  5. Being early for ANYTHING
  6. Being on time for ANYTHING
  7. My left arm (typically occupied by my son)
  8. Making dinner with two arms (since my son insists on being in my arms while I make dinner)
  9. Having a clean, uncluttered car (we could live out of our car for a week!)
  10. Having a clean, uncluttered house

I am often reminded by wise mamas that these exhausting early years are “just a season” and “will be over before (I) know it.”  My favorite is “the days are long but the years are short.”  This quote from Gretchen Rubin gives a nod to the daily struggles of motherhood but implores us to savor each and every day with our children as these years are fleeting. I admit it, I often have a hard time reveling in sleepless nights, aching arms, and mommy brain. I wish I could. I know those wise mamas are right but it doesn’t make this season any easier. I found this all-too-true blog post on this very subject and I want to share it with you.  Grab a tissue before reading! Here’s hoping, whatever stage of motherhood we are in, we will remember. Remember the daily struggles as a young mama caring for young children and the bittersweet heartache when we realize our once needy babies don’t need us anymore.

Read blog here…


Limitations of Convenience

Today’s times are busy. Likely, your family has 1-2 working parents, multiple children going different directions, homework, sports, music classes, etc. As a full-time working mom of three children, I understand.  Convenience is important to make this busy machine of life run smoothly. I take advantage of convenience services for grocery and food delivery, walk- in haircuts, drive through food and medicine pickup, and oil changes for my car.  Convenience in healthcare, however, can come at a price.

I am concerned about children being evaluated by providers at walk-in clinics, urgent care centers and via telemedicine services.  Many of these providers have a very little pediatric experience. These providers are not well trained to recognize pediatric illnesses nor use and dose medications appropriately.  Commonly, I find my patients have been prescribed medications not routinely used in children and at the wrong dosage. Not to mention, failure to recognize life threatening conditions such as asthma exacerbations and croup.  

As a mom and a pediatrician, I would encourage our families to avoid these clinics whenever possible.  If you are out of town, many areas have pediatric focused clinics that are available. Plan ahead and have those numbers on hand in case of emergencies.  Our KPA locations are open early and late most days of the week to accommodate seeing our patients the same day. Our physicians are board certified with years of experience in the care and health of children.  Please choose superior healthcare for your family and allow us to do what is best for your kiddos! I don’t choose anything less for my own family.

This week’s unseasonably warm weather has likely whetted your appetite for more. In addition, for those of you with school-aged children, Spring Break is rapidly approaching. Some of you will travel to the beach. Some of you will enjoy a local “staycation.” Regardless,  you and your children will likely be spending more time outdoors. I want to remind all of you to stay safe. With that in mind, here are some helpful safety tips from the American Academy of Pediatrics.