Newborn Care

Understanding Newborn Care

The staff at Magnolia Family Medicine & Wellness understands the whirlwind of activity that a newborn brings to your life, and we are happy to answer any questions regarding pediatrics care or any concerns you may have. At first, newborn care might seem limited to round-the-clock feeding, bathing, diapering and soothing — but there’s more to ensuring newborn health than these basics. Other newborn health concerns might include caring for your newborn’s skin, decoding your newborn’s cries and promoting your newborn’s development.

Remember, part of taking good care of your newborn involves caring for yourself. Sneak in as much sleep as possible, and don’t be afraid to ask for help when you need a break. Newborn care can turn your life upside down, and newborn health concerns can sometimes seem overwhelming. Appreciate the joy your newborn brings to your life — and cope with everything else one day at a time.

Basic Newborn Care

Skin-to-Skin Care

There are many benefits to keeping babies close to their parents. We encourage you to hold your newborn baby naked (except for a diaper) on your own skin, with a blanket covering you both, during your awake and alert times.

Babies who are frequently held skin-to-skin:

  • Are more likely to latch onto the breast and to breastfeed easily
  • Have more stable and normal skin temperatures, heart rates, and blood pressure
  • Have better blood sugars
  • Are less likely to cry

Breastfeeding Support

We encourage all mothers to breastfeed their infants. Part of ensuring success is to avoid giving formula, bottles or pacifiers to healthy newborns. However, if there is a medical reason to give the baby a supplement, we will discuss options with you.

Delayed First Bath

A creamy, protective substance called vernix is present on the skin of many newborn babies. We often give a first shampoo, but intentionally do not bathe babies in their first few days because leaving this substance to absorb into your baby’s skin helps protect against dryness and bacterial infections.

Vitamin K and Erythromycin Eye Ointment

Your baby will typically receive a Vitamin K injection and an antibiotic eye ointment shortly after birth. Vitamin K protects against rare but serious bleeding problems, and erythromycin prevents bacterial infections that can be present in the birth canal.

If you wish, you can delay these by an hour or so to keep your baby skin-to-skin. However, because the Vitamin K protects the baby from bleeding problems in the first 24 hours, it’s best to give it as early as possible (within an hour after birth).


The first time you hold your newborn in the delivery room is a great time to start breastfeeding. At the beginning, your body will produce small amounts of a special milk called colostrum that will help protect your baby from infection. (Your baby’s tummy is very tiny, so he or she only needs these small amounts to fill up. As his or her tummy grows, your milk will change and you’ll produce more of it.)

Health Screenings

Screening identifies most of the babies born with disorders, so that treatment can start right away. A heel prick is used to take a few drops of the baby’s blood and send it for testing.

Your baby will stay with you during these screenings. However, if your baby requires any additional testing in another area of the hospital, you or a family member are always welcome to accompany your baby.

Breastfeeding Help

Understanding Breastfeeding

Breastfeeding is a great way for a mother to bond to her newborn that also provides many benefits for both of them.

Furthermore, most babies are ready to begin breastfeeding within the first 2 hours after birth. The American Academy of Pediatrics recommends that babies be exclusively breastfed until 6 months of age. After that, they recommend introducing appropriate foods (while also breastfeeding) until the baby is one year old.

Benefits of Breastfeeding

Breastfeeding your newborn comes with many benefits. Most importantly, it’s a good source of nutrition. For example, breast milk contains essential nutrients, antioxidants, enzymes, and other components that protect your baby from illnesses.

Breastfed babies typically grow into healthier children with fewer instances of pediatrics medical issues and improved immunity to infections.

Breastfeeding can also benefit new mothers:

  • Skin-to-skin contact is a great way for a mother to bond to her newborn.
  • Also, it produces oxytocin, a soothing hormone, that reduces stress in nursing mothers.
  • Women who breastfeed are at a lower risk of breast cancer, ovarian cancer, endometriosis, and other issues.

Tips for Breastfeeding

Breastfeeding doesn’t always come naturally to new mothers. However, with a little patience and a few tips, you will be breastfeeding your baby in no time.

Be patient

At first, breastfeeding can be challenging for both the mother and the baby, and it can take time and patience before both are comfortable. Therefore, it’s important to stay relaxed and try not to get frustrated when difficulties arise.

Get in a comfortable position

Different breastfeeding positions can help your baby latch on better and more effectively empty your breasts.

Four commonly used positions include:

  • the cradle hold
  • cross-cradle hold
  • football hold
  • the side-lying position.

Take the time to figure out which position works best for you and your baby.

Listen to your baby

There’s no hard and fast feeding schedule for newborns–every baby is different! So, it helps to pay attention to your baby and notice signs of hunger. If your baby is hungry they may suck on their fingers, clench their hands, or pucker their lips.

Ask for help

However, if you’ve tried everything and still can’t get the hang of breastfeeding, there’s no shame in asking for help. Reach out to your healthcare provider or our pediatrics staff for guidance and support.

Wellness Check Ups

Understanding Wellness Check Ups

During pediatrics wellness checkups, your health care provider will assess your child’s physical and emotional development, give guidance and immunizations (shots), and do any needed tests.

In addition, this is a great time to talk with your health care provider about concerns or questions you have about your child’s development (physical, mental or social). If your child does not reach a certain milestone for his or her age, don’t worry. Your health care provider can help you recognize signs if you think your child may have a developmental delay.

Your child will need pediatrics wellness checkups at ages:

2 weeks, 2 months, 4 months, 6 months, 9 months, 12 months, 15 months, 18 months, 2 years, 2 1/2 years, 3 years, 4 years and 5 years.

However, if you have a concern or question in between well checkups, please call our office. For an emergency, call 911 or go to the nearest hospital.

Importance of Wellness Check Ups

Benefits of pediatrics wellness check ups include:

Tracking your child’s growth and development

Your health care provider will review your child’s growth since the last visit and talk with you about your child’s development. Specifically, these visits are a time to review and discuss each of the important areas of your child’s development, including physical, cognitive, emotional, and social development.

Opportunity to talk about prevention

For many children in the United States, the most common cause of harm is a preventable injury or illness. The well-child visit is an opportunity to review critical strategies to protect your child from injury, such as reviewing car seat use and safe firearm storage.

Ensure your child is protected from infectious diseases

Part of your child’s pediatrics wellness check up involves reviewing and updating his or her immunizations. Also, if there is a family history of a particular illness, parents can discuss strategies to prevent that illness for their child.

Instill Healthy Behaviors

Healthy behaviors are important to instill at a young age, The pediatrics well-child visit is a time to review these important behaviors, such as sleep, nutrition, and physical activity habits.

What Happens During Wellness Check Ups

During a pediatrics wellness check up, your doctor will:

  • Perform a physical exam
  • Give the child any necessary shots (immunizations or vaccinations)
  • Track how your child is growing and developing
  • Talk about illness prevention, diet and physical fitness, and health and safety issues
  • Discuss how to handle emergencies and sudden illness

However, make sure your doctor isn’t doing all the talking. The wellness visit is your best opportunity to bring up any worries about your child’s growth and development, especially if your child is not reaching important milestones. Remember, your doctor may be an expert in children’s health, but you are the expert on your child.

Also, don’t be afraid to ask questions, medical or otherwise. Our pediatrics providers can give you valuable advice on how to promote your child’s learning and development, how to potty train, tips on playground safety, and more.

Sports Exams & Physicals

Sports Exams for Athletes

Whether your child is an athlete whose team requires sports physicals, or they just need a yearly pediatrics physical for school, Magnolia Family Medicine & Wellness is here to help.

In fact, the American Academy of Pediatrics recommends annual Early Periodic Screening Diagnosis & Testing (EPSDT) to ensure proper development, early medical issue diagnoses, and regular athletic testing.

In addition, sports physicals and pediatrics wellness checkups are required for athletes entering the seventh and ninth grades prior to sports participation.

Located in Manchester, Tennessee, Magnolia Family Medicine & Wellness is a local family doctor’s office that can perform sports exams and physicals for you and your family.

Typical Screening Procedure

  • History Form
  • Physical Examination Form
  • Clearance Form
  • Athletic Participation

Medical History Form

Prior to seeing your pediatrics physician, you and your child will fill out the History Form. This is a basic pre-appointment form that asks questions about medicines and allergies, heart health, family history, bones and joints, and any potential medical issues.

Specifically, this form helps to give your pediatrics healthcare provider some basic background information about your student prior to the exam. In addition, this is an important time to list any events in one’s health history that could require further review or discussion with a healthcare provider.

Physical Examination Form

Next, the physical examination will include a review of several health indicators, including pulse, lung function, and vision function.

In concluding the exam, the pediatrics health care provider will:

(1) clear the student for all sports without restriction

(2) clear for sports without restriction, but with recommendations for further evaluation or treatment

(3) not provide immediate clearance.

Clearance Form

Furthermore, upon discharge, the student and parent will be provided with a clearance form that summarizes the exam findings. Subsequently, this form can be used in lieu of the physical exam form and health history form; it may be an appropriate alternative for any circumstances in which HIPAA concerns are an issue.

Consent for Athletic Participation & Medical Care

Finally, the parent or legal guardian of the student athlete will fill out a form detailing allergies, medications, insurance information, and emergency contact information. In addition, this form acknowledges legal responsibilities and protocols in the event of injury.

Vaccines & Immunizations

Understanding Vaccines & Immunizations

Vaccines are an important way to protect your baby and children from life-threatening diseases. They work best when they are given at certain ages, with some vaccines given over a series of properly spaced doses. Thus, they are started at birth and many are required before starting school.

Vaccines work by imitating infection of a certain disease in your child’s body. This prompts your child’s immune system to develop weapons called antibodies. So that, these antibodies can fight the disease that the vaccine is meant to prevent. With antibodies in place, your child’s body can defeat future infection from the disease.

Diseases that vaccines prevent can be very serious—even deadly—especially for infants and young children.

Vaccines reduce your child’s risk of infection by working with their body’s natural defenses to help them safely develop immunity to disease. Furthermore, immunizations have helped improve the health of children in the United States. Most parents today have never seen first-hand the devastating consequences that vaccine-preventable diseases have on a family or community. Although most of these diseases are not common in the United States, they still exist around the world, so it is important to protect your child with vaccines.

Most Common Vaccines are:
DTaP = Diphtheria, Tetanus, and Pertussis
Hib = Haemophilus influenzae type b
MMR = Measles, Mumps, Rubella

Vaccination Schedule


Age Vaccinations (# in series)
  • Hepatitis B (1)
2 Months
  • Hepatitis B (2)
  • DTaP (1)
  • Hib (1)
  • Polio (1)
  • Pneumococcal (1)
  • Rotavirus (1)
4 Months
  • DTaP (2)
  • Hib (2)
  • Polio (2)
  • Pneumococcal (2)
  • Rotavirus (2)
6 Months
  • Hepatitis B (3)
  • DTaP (3)
  • Hib (3)
  • Polio (3)
  • Pneumococcal (3)
  • Rotavirus (3)
12 to 18 Months
  • DTaP (4)
  • Hib (4)
  • Pneumococcal (4)
  • MMR (1)
  • Varicella (1)
  • Hepatitis A (1)
18 to 24 Months
  • Hepatitis A (2)
4 to 6 Years
  • DTaP (5)
  • Polio (4)
  • MMR (2)
  • Varicella (2)
Yearly after 6 Months
  • DTaP (5)
  • Polio (4)
  • MMR (2)
  • Varicella (2)

DTaP = Diphtheria, Tetanus, and Pertussis
Hib = Haemophilus influenzae type b
MMR = Measles, Mumps, Rubella

Reasons to Get Immunizations

Immunizations protect you or your child from dangerous diseases. In addition, they help reduce the spread of disease to others. They are often needed for entrance into school or daycare. And they may be needed for employment or for travel to another country.

Because proof of immunization is often a prerequisite for enrollment in school or day care, it’s important to keep your children up to date on their vaccines. Subsequently, the benefit of doing so is that your children will be protected from diseases that could cause them serious health problems.

The recommended pediatrics immunizations for children 0-6 years of age include:

  • Hepatitis B
  • Rotavirus
  • Diphtheria, tetanus, pertussis
  • Haemophilus influenzae type B
  • Pneumococcal
  • Poliovirus
  • Influenza
  • Measles, mumps, rubella
  • Varicella (chickenpox)
  • Hepatitis A
  • Meningococcal (for certain high-risk groups)

At one time, each of the diseases addressed by these vaccines posed a serious health threat to children, taking their lives by the thousands; however, today most of these diseases are at their lowest levels in decades, thanks to immunizations.

It’s important to keep your child’s pediatrics immunizations on schedule and up to date, but if your child misses a scheduled dose he or she can “catch up” later.

Risk Factors of Vaccinations

Vaccine-preventable diseases are much less common than they used to be, thanks to vaccination. But they have not gone away. Outbreaks of some of these diseases still occur across the United States. When fewer babies get vaccinated, more babies get sick.


(the ‘D’ in DTaP vaccine)
Signs and symptoms include a thick coating in the back of the throat that can make it hard to breathe.
Diphtheria can lead to breathing problems, paralysis and heart failure.
About 15,000 people died each year in the U.S. from diphtheria before there was a vaccine.


(the ‘T’ in DTaP vaccine; also known as Lockjaw)
Signs and symptoms include painful tightening of the muscles, usually all over the body.
Tetanus can lead to stiffness of the jaw that can make it difficult to open the mouth or swallow.
Tetanus kills about 1 person out of every 10 who get it.


(the ‘P’ in DTaP vaccine, also known as Whooping Cough)
Signs and symptoms include violent coughing spells that can make it hard for a baby to eat, drink, or breathe. These spells can last for several weeks.
Pertussis can lead to pneumonia, seizures, brain damage, or death. Pertussis can be very dangerous in infants.
Most pertussis deaths are in babies younger than 3 months of age.

Hib (Haemophilus influenzae type b)

Signs and symptoms can include fever, headache, stiff neck, cough, and shortness of breath. There might not be any signs or symptoms in mild cases.
Hib can lead to meningitis (infection of the brain and spinal cord coverings); pneumonia; infections of the ears, sinuses, blood, joints, bones, and covering of the heart; brain damage; severe swelling of the throat, making it hard to breathe; and deafness.
Children younger than 5 years of age are at greatest risk for Hib disease.

Hepatitis B

Signs and symptoms include tiredness, diarrhea and vomiting, jaundice (yellow skin or eyes), and pain in muscles, joints and stomach. But usually there are no signs or symptoms at all.
Hepatitis B can lead to liver damage, and liver cancer. Some people develop chronic (long term) hepatitis B infection. These people might not look or feel sick, but they can infect others.
Hepatitis B can cause liver damage and cancer in 1 child out of 4 who are chronically infected.


Signs and symptoms can include flu-like illness, or there may be no signs or symptoms at all.
Polio can lead to permanent paralysis (can’t move an arm or leg, or sometimes can’t breathe) and death.
In the 1950s, polio paralyzed more than 15,000 people every year in the U.S.

Pneumococcal Disease

Signs and symptoms include fever, chills, cough, and chest pain. In infants, symptoms can also include meningitis, seizures, and sometimes rash.
Pneumococcal disease can lead to meningitis (infection of the brain and spinal cord coverings); infections of the ears, sinuses and blood; pneumonia; deafness; and brain damage.
About 1 out of 15 children who get pneumococcal meningitis will die from the infection.

Children usually catch these diseases from other children or adults, who might not even know they are infected. A mother infected with hepatitis B can infect her baby at birth. Tetanus enters the body through a cut or wound; it is not spread from person to person.

Risk Factors of Not Getting Immunizations

The threat of death by disease isn’t the only medical consequence of skipping vaccinations.

Differences in Medical Care

An unvaccinated child faces lifelong differences that could potentially put him or her at risk. Every time you call 911, ride in an ambulance, go to the doctor or visit the hospital emergency room, you must alert medical personnel of your child’s vaccination status so he or she receives distinctive treatment. Because unvaccinated children can require treatment that is out of the ordinary, medical staff may be less familiar, and less experienced, with the procedures required to appropriately treat your child.

Pregnancy Complications

Women who are pregnant but not vaccinated can be vulnerable to diseases that may complicate their pregnancy. For example, a pregnant woman who contracts rubella in the first trimester may have a baby with congenital rubella syndrome (CRS), which can cause heart defects, developmental delays and deafness.

Putting Others at Risk

People who choose not to vaccinate their children also put others at risk if their child isn’t vaccinated and becomes ill. Special groups of people cannot be vaccinated, including those with compromised immune systems (e.g. those with leukemia or other cancers). Subsequently, these people rely on the general public being vaccinated to lower their risk of exposure.

Sick Visits

Importance of Sick Visits

We know that illnesses aren’t planned and it can be difficult to get an appointment at the last minute. Our urgent care visits can help when those unplanned illnesses arrive. We are glad to offer same day appointments for when you are sick or have an urgent problem. They are available every weekday.  These appointments aren’t for every type of problem. They are only for those minor yet urgent problems.

Here are of some examples of the types of problems we can treat during our Urgent Care Visits:

  • Colds and Coughs
  • Fever
  • Flu
  • Headaches and Migraines
  • Sprains and Strains
  • Upper Respiratory Conditions (Bronchitis, Sinus Infections)
  • Urinary Tract Infections
  • Other common illnesses

Common Reasons for Sick Visits

We understand as a parent, a sick child is always a concern. Whether it is your toddler or teenager, the staff at Magnolia Family Medicine & Wellness is available to help your child get well quickly. Whether it is the stomach bug, flu, a cut that needs sutures or the common cold, our pediatrics staff offers the best of care for your child to allow them to return home and to school comfortable and well.

Common pediatric sickness symptoms are:

  • Abdominal pain
  • Chest pain
  • Cough
  • Continuous crying
  • Cuts, scrapes or bruises
  • Decreased intake of fluid (Dehydration)
  • Diaper rash
  • Diarrhea
  • Ear congestion and discharge
  • Swollen or irritated eyes
  • Headache
  • Heat rash
  • Lack of appetite (not eating or taking breast milk)
  • Sore Throat
  • Irregular looking urine or stool
  • Vomiting

Ear Infections

Understanding an Ear Infection

An ear infection (acute otitis media) is most often a bacterial or viral infection that affects the middle ear, the air-filled space behind the eardrum that contains the tiny vibrating bones of the ear. Children are more likely than adults to get ear infections.

Ear infections frequently are painful because of inflammation and buildup of fluids in the middle ear.

Often times ear infection heal on their own, treatment may begin with managing pain and monitoring the problem. Ear infection in infants and severe cases in general often require antibiotic medications. Long-term problems related to ear infections — persistent fluids in the middle ear, persistent infections or frequent infections — can cause hearing problems and other serious complications.

Causes of an Ear Infection

An ear infection occurs when one of your eustachian tubes becomes swollen or blocked, causing fluid to build up in your middle ear. Eustachian tubes are small tubes that run from each ear directly to the back of the throat.

Causes of eustachian tube blockage include:

  • Allergies
  • Colds
  • Sinus infections
  • Excess mucus
  • Smoking
  • Infected or swollen adenoids (tissue near your tonsils that traps harmful bacteria and viruses)
  • Changes in air pressure

Signs & Symptoms of an Ear Infection

The onset of signs and symptoms of ear infection is usually rapid.


Signs and symptoms common in children include:

  • Ear pain, especially when lying down
  • Tugging or pulling at an ear
  • Difficulty sleeping due to pain
  • Crying more than usual
  • Acting more irritable than usual
  • Lack of response to sounds
  • Loss of balance
  • Fever of 100 F (38 C) or higher
  • Drainage of fluid from the ear
  • Headache
  • Loss of appetite


Common signs and symptoms in adults include:

  • Ear pain
  • Drainage of fluid from the ear
  • Diminished hearing

These symptoms might persist or come and go. Symptoms may occur in one or both ears. Pain is usually more severe with double ear infection (infection in both ears).

Chronic ear infection symptoms may be less noticeable than those of acute ear infections.

Children younger than 6 months who have a fever or ear infection symptoms should see a doctor. Always seek medical attention if your child has a fever higher than 102°F (39°C) or severe ear pain.

Treatment for an Ear Infection

Most mild ear infections clear up without medical treatment however acute and chronic infections need specialist attention.

Some of the following methods are effective in relieving the symptoms of a mild ear infection:

  • Apply a warm cloth to the affected ear.
  • Take over-the-counter (OTC) pain medication such as Ibuprofen (Advil) or Acetaminophen (Tylenol).
  • Use OTC or prescription ear drops to relieve pain.
  • Take OTC decongestants such as Pseudoephedrine (Sudafed).

If your symptoms get worse or don’t improve

you should schedule an appointment with us and one of our pediatrics specialists can help you get checked and treated. Antibiotics may be prescribed if your ear infection is chronic or doesn’t appear to be improving.

It’s important to finish your entire course of antibiotics if they’re prescribed.

Surgery may be an option if your ear infection isn’t eliminated with the usual medical treatments or if you have many ear infections over a short period of time. Most often, tubes are placed in the ears to allow fluid to drain out.

In cases that involve enlarged adenoids, surgical removal of the adenoids may be necessary.

Sore Throat

Understanding a Sore Throat

A sore throat is pain, scratchiness or irritation of the throat that often worsens when you swallow. The most common cause of a sore throat (pharyngitis) is a viral infection, such as a cold or the flu. Typically, a sore throat caused by a virus resolves on its own.

Most sore throats are caused by infections or by environmental factors like dry air. Although a sore throat can be uncomfortable, it’ll usually go away on its own. Pain in the throat is one of the most common symptoms and accounts for more than 13 million visits to doctor’s offices each year.

Strep throat (streptococcal infection), a less common type of sore throat caused by bacteria, requires treatment with antibiotics to prevent complications. Other less common causes of sore throat might require more complex treatment.

Causes of a Sore Throat

Sore throat may be caused by either injury or infection.

Here are some of the most common sore throat causes in pediatrics:

Colds, the flu, and other viral infections

  • the common cold
  • Influenza — the Flu
  • Mononucleosis, an infectious disease that’s transmitted through saliva
  • Measles, an illness that causes a rash and fever
  • Chickenpox, an infection that causes a fever and an itchy, bumpy rash
  • Mumps, an infection that causes swelling of the salivary glands in the neck

Strep throat and other bacterial infections

Bacterial infections can also cause sore throats. The most common one is strep throat, an infection of the throat and tonsils caused by Group A Streptococcus bacteria.

In particular, strep throat causes nearly 40 percent of sore throat cases in children (3). In addition, tonsillitis, and sexually transmitted infections like gonorrhea and chlamydia can also cause a sore throat.


When the immune system reacts to allergy triggers like pollen, grass, and pet dander, it releases chemicals that cause symptoms like nasal congestion, watery eyes, sneezing, and throat irritation.

Excess mucus in the nose can drip down the back of the throat. This is called postnasal drip and can irritate the throat.

Dry air

Dry air can suck moisture from the mouth and throat, and leave them feeling dry and scratchy. In particular, the air is most often dry in the winter months when the heater is running.

Smoke, chemicals, and other irritants

Many different chemicals and other substances in the environment irritate the throat, including:

  • Cigarette and other tobacco smoke
  • Air pollution
  • Cleaning products and other chemicals


Any injury such as a hit or cut to the neck, can cause pain in the throat. Likewise, getting a piece of food stuck in your throat can also irritate it.

Repeated use strains the vocal cords and muscles in the throat. For example, you can get a sore throat after yelling, talking loudly, or singing for a long period of time.

Gastroesophageal Reflux Disease (GERD)

Gastroesophageal Reflux Disease (GERD) is a condition in which acid from the stomach backs up into the esophagus — the tube that carries food from the mouth to the stomach.

The acid burns the esophagus and throat, causing symptoms like heartburn and acid reflux — the regurgitation of acid into your throat.


A tumor of the throat, voice box, or tongue is a less common cause of a sore throat. However, when a sore throat is a sign of cancer, it doesn’t go away after a few days.

Signs & Symptoms of a Sore Throat

The symptoms of a sore throat can vary depending on what caused it.

A sore throat can feel:

  • Scratchy
  • Burning
  • Raw
  • Dry
  • Tender
  • Irritated

It may hurt more when you swallow or talk. Your throat or tonsils might also look red.

Sometimes, white patches or areas of pus will form on the tonsils. These white patches are more common in strep throat than in a sore throat caused by a virus.


Common infections causing a pediatric sore throat might result in other signs and symptoms, including:

  • Fever
  • Cough
  • Runny nose
  • Sneezing
  • Body aches
  • Headache
  • Nausea or vomiting

Treatment for a Sore Throat

You can treat most pediatric sore throats at home. Get plenty of rest to give your immune system a chance to fight the infection.

To relieve the pain of a sore throat:

  • Gargle with a mixture of warm water and 1/2 to 1 teaspoon of salt.
  • Drink warm liquids that feel soothing to the throat, such as hot tea with honey, soup broth, or warm water with lemon. Herbal teas are especially soothing to a sore throat (5).
  • Cool your throat by eating a cold treat like a popsicle or ice cream.
  • Suck on a piece of hard candy or a lozenge.
  • Turn on a cool mist humidifier to add moisture to the air.
  • Rest your voice until your throat feels better.

Over the Counter Medicines

You can take medicines to relieve the pain of a sore throat, or to treat the underlying cause.

Over-the-counter medications that relieve throat pain include:

  • Acetaminophen (Tylenol)
  • Ibuprofen (Advil, Motrin)
  • Aspirin

Don’t give Aspirin to children and teenagers, as it’s been linked to a rare but serious condition called Reye’s Syndrome in pediatric patients.

You can also use one or more of these treatments, which work directly on the pain of a sore throat:

  • a sore throat spray that contains a numbing antiseptic like phenol, or a cooling ingredient like menthol or eucalyptus
  • throat lozenges
  • cough syrup

If the sore throat is not relieved using home remedies and over-counter-medicines, make sure to visit our pediatrics providers to be checked out and avoid serious infection complications.


Understanding the Flu

Influenza is a viral infection that attacks your respiratory system — your nose, throat and lungs. Although it is commonly called the flu, influenza is not the same as stomach “flu” viruses that cause diarrhea and vomiting. Commonly known as “Flu” it is caused by viruses that pass through the air and enter your body through your nose or mouth. Between 5% and 20% of people in the U.S. get the flu each year. The flu can be serious or even deadly for elderly people, newborn babies, and people with certain chronic illnesses.

Signs & Symptoms of the Flu

Flu signs and symptoms usually come on suddenly.


People who are sick with flu often feel some or all of these symptoms:

  • Fever* or feeling feverish/chills
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Muscle or body aches
  • Headaches
  • Fatigue (tiredness)
  • Some people may have vomiting and diarrhea, though this is more common in pediatrics than adults.

Risk Factors of the Flu

For most people, influenza resolves on its own. However, sometimes influenza and its complications can be deadly.


People at higher risk of developing flu complications include:

  • Pediatrics patients under age 5, and especially those under 2 years
  • Adults older than age 65
  • Residents of nursing homes and other long-term care facilities
  • Pregnant women and women up to two weeks postpartum
  • Those with weakened immune systems
  • Individuals who have chronic illnesses, such as asthma, heart disease, kidney disease, liver disease and diabetes
  • People who are very obese, with a body mass index (BMI) of 40 or higher

Treatment for the Flu

Usually, you’ll need nothing more than bed rest and plenty of fluids to treat the flu. However, in some cases, your child’s pediatrics provider may prescribe an antiviral medication, such as Oseltamivir (Tamiflu) or Zanamivir (Relenza). If taken soon after you notice symptoms, these drugs may shorten your illness by a day or so and help prevent serious complications.

Oseltamivir is an oral medication. Zanamivir is inhaled through a device similar to an asthma inhaler and shouldn’t be used by anyone with respiratory problems, such as asthma and lung disease.

Antiviral medication side effects may include nausea and vomiting. These side effects may be lessened if the drug is taken with food. Oseltamivir has also been associated with delirium and self-harm behaviors in teenagers.

Some strains of influenza have become resistant to Amantadine and Rimantadine (Flumadine), which are older antiviral drugs.


More reasons to see your pediatrics provider for a cough include:

  • Productive cough with mucus that is yellow, green, or tan lasting more than a week, or is accompanied by a fever.
  • Coughing up blood.
  • Short of breath and wheezing.
  • Night sweats or fevers at night.
  • Whooping cough symptoms, including constant coughing and making a whooping sound when trying to breathe, especially in children under 1 year old.
  • A cough lasting more than three weeks.
  • A child with a cough and fever over 102 F
  • Croup in children
  • Infant that is coughing for more than a few hours


Understanding ADHD

Attention deficit hyperactivity disorder (ADHD) is a behavioral disorder that includes symptoms such as inattentiveness, hyperactivity and impulsiveness.

ADHD affects children and teens and can continue into adulthood. Attention Deficit Hyperactivity Disorder is the most commonly diagnosed mental disorder in pediatrics. Children with ADHD may be hyperactive and unable control their impulses. Or they may have trouble paying attention. Consequently, these behaviors interfere with school and home life.

Symptoms of ADHD tend to be noticed early on in life and may become more noticeable when a child’s growth and circumstances change, such as when they start school. Most cases are diagnosed when children are 6 to 12 years old.

Signs & Symptoms of ADHD

The symptoms of ADHD in pediatrics patients can be divided into 2 types of behavioral problems: inattentiveness, and hyperactivity and impulsiveness.

Most people with ADHD have problems that fall into both these categories, but this is not always the case.

For example, some people with the condition may have problems with inattentiveness only, but not with hyperactivity or impulsiveness. This type of ADHD is also known as attention deficit disorder (ADD). ADD can sometimes go unnoticed because the symptoms may be less obvious.

Symptoms in children and teenagers:

The symptoms of ADHD in children and teenagers are definite, and they’re commonly noticeable before the age of 6. In particular, they occur in more than one situation, such as at home and at school.

Inattentiveness (lack of attention)

The main signs of inattentiveness are:

  • Having a short attention span and being easily distracted
  • Making careless mistakes – for example, in schoolwork, office work or even simply in household chores
  • Appearing forgetful or easily losing things
  • Being unable to stick to tasks that are tedious or time-consuming
  • Appearing to be unable to listen to or carry out instructions
  • Constantly changing activity or task
  • Having difficulty organizing tasks

Hyperactivity and impulsiveness

The main signs of hyperactivity and impulsiveness are:

  • Being unable to sit still, especially in calm or quiet surroundings
  • Constantly fidgeting
  • Being unable to concentrate on tasks
  • Excessive physical movement
  • Excessive talking
  • Being unable to wait their turn
  • Acting without thinking
  • Interrupting conversations
  • Little or no sense of danger

These symptoms can cause significant problems in a child’s life, such poor school performance, poor social interaction with other children and adults, and problems with discipline.

As ADHD is a developmental disorder, it’s believed it cannot develop in adults without it first appearing during childhood. Thus, it’s known that symptoms of ADHD often persist from childhood into a person’s teenage years and then adulthood.

Also, any additional problems or conditions experienced by children with ADHD, such as depression or dyslexia, may also continue from pediatrics into adulthood.

Causes of ADHD

The exact cause of ADHD is not fully understood, although a combination of factors is thought to be responsible.


ADHD tends to run in families and, in most cases, it’s thought the genes you inherit from your parents are a significant factor in developing the condition. Research shows that parents and siblings of a child with ADHD are more likely to have ADHD themselves. However, it is always not a guarantee that when one or two of your nearest kin has ADHD, automatically you also have ADHD.

Brain function and structure

Research has identified a number of possible differences in the brains of people with ADHD from those without the condition, although the exact significance of these is not clear.

For example, studies involving brain scans have suggested that certain areas of the brain may be smaller in people with ADHD, whereas other areas may be larger.

Other studies have suggested that people with ADHD may have an imbalance in the level of neurotransmitters in the brain, or that these chemicals may not work properly.

Groups at risk

Certain groups are also believed to be more at risk of ADHD, including people:

  • Premature Born (before the 37th week of pregnancy) or with a low birthweight
  • With epilepsy
  • With brain damage – which happened either in the womb or after a severe head injury later in life

Treatment for ADHD

Treatment and medication for attention deficit hyperactivity disorder (ADHD) can help relieve the symptoms and make the condition much less of a problem in day-to-day life.

ADHD can be treated using either medication or therapy, or a combination of both is often deemed the most effective.

Treatment is usually arranged by a pediatrics specialist, such as a pediatrician or psychiatrist, although the condition may be monitored by a GP.


There are 5 types of medication licensed for the treatment of ADHD:

  • Methylphenidate
  • Dexamfetamine
  • Lisdexamfetamine
  • Atomoxetine
  • Guanfacine

These medications are not a definitive cure for ADHD but may help someone with the condition concentrate better, be less impulsive, feel calmer, and learn and practice new skills.

Some medications need to be taken daily, but some can be taken just on school days. In addition, treatment breaks are occasionally recommended to assess whether the medication is still needed.


Understanding Anxiety

In an Anxiety disorder, your fear or worry does not go away and can get worse over time. It can heavily affect your life to the extent that it can interfere with daily activities like school, work and/or relationships. Fear, stress, and anxiety are normal feelings and experiences, but are completely different if it is experienced frequently especially if it causes long-suffering.

Anxiety disorders reflect disorders that share a general feature of excessive fear (i.e. emotional response to perceived or real threat) and/or anxiety (i.e. anticipation of future threat) and demonstrate behavioral and functional disturbances as a result. For example, panic attacks are one of the most common feature that can occur in the context of many anxiety disorders and reflect a type of fear response.

Causes of Anxiety

Anxiety isn’t developed or caused by a single factor but a combination of multiple things. There are multiple factors that play a role, including personality factors, difficult life experiences and physical health.

Family History

Some people who experience anxiety conditions may have a genetic susceptibility towards anxiety and these conditions can sometimes run in a family. However, having someone blood related, experience anxiety or other mental health condition doesn’t mean you’ll automatically have or develop anxiety.

Personality Factors

Research says that some people with certain personality traits are more likely to have anxiety. For example, children who are perfectionists, easily worried, nervous, shy, lack self-esteem or controlling, sometimes develop anxiety during the stages of their life.

Stressful Events or Environments

In addition, anxiety conditions may develop because of one or more stressful life events or surrounding.

Common triggers include:

  • Work stress or job change
  • Change in living arrangements
  • Pregnancy and giving birth
  • Family and relationship problems
  • Major emotional shock following a stressful or traumatic event
  • Verbal, sexual, physical or emotional abuse or trauma
  • Death or loss of a loved one.

Physical Health Problems

Chronic physical ailments can also contribute to anxiety conditions or impact on the treatment of either the anxiety or the physical illness itself.

Common serious conditions associated with anxiety conditions include:

  • Diabetes
  • Asthma
  • Hypertension and heart disease
  • Cancer
  • Some physical conditions can mimic anxiety conditions, like an overactive thyroid. It can be useful to see a doctor and be assessed to determine whether there may be a medical cause for your feelings of anxiety.

Other Mental Health Conditions

While some people may experience an anxiety condition on its own, others may experience multiple anxiety conditions, or other mental health conditions. Depression and anxiety conditions often occur together. Therefore, it’s important to check for and get assistance for all these conditions at the same time.

Substance Use

Some people who experience anxiety may use alcohol or other drugs to help them manage their condition. In some cases, this may lead to people developing a substance use problem along with their anxiety condition. Alcohol and substance use can aggravate anxiety conditions particularly as the effects of the substance wear off. Therefore, it’s important to check for and get assistance for any substance use conditions at the same time.

Signs & Symptoms of Anxiety

It’s normal to feel anxious about moving to a new place, starting a new job, or taking an exam. This type of anxiety is unpleasant, but it may motivate you to work harder and to do a better job. Ordinary anxiety comes and goes, but does not interfere with your everyday life.

On the other hand, anxiety disorder, the feeling of fear may be with you all the time. It is intense and sometimes debilitating and does not go away.


Common anxiety signs and symptoms include:

  • Feeling nervous, restless or tense
  • Having a sense of impending danger, panic or doom
  • Having an increased heart rate
  • Breathing rapidly (Hyperventilation)
  • Sweating
  • Trembling
  • Feeling weak or tired
  • Trouble concentrating or thinking about anything other than the present worry
  • Having trouble sleeping
  • Experiencing Gastrointestinal (GI) problems
  • Having difficulty controlling worry
  • Having the urge to avoid things that trigger anxiety

Treatment for Anxiety

Anxiety Disorder treatments will consist of a combination of psychotherapy, behavioral therapy, and medication. This also depends on your anxiety case. Therefore, it may be one treatment or it could be a combination of.

Alcohol dependence, depression, or other conditions can sometimes have such a strong effect on mental well-being that treating an anxiety disorder must wait until any underlying conditions are brought under control.


In some cases, a person can treat an anxiety disorder at home without clinical supervision. However, this may not be effective for severe or long-term anxiety disorders.

There are several exercises and actions to help a person cope with milder, more focused, or shorter-term anxiety disorders, including:

  • Yoga for anxiety

    Yoga can reduce the effects of an anxiety disorder.

  • Stress management

    Learning to manage stress can help limit potential triggers. Organize any upcoming pressures and deadlines, compile lists to make daunting tasks more manageable, and commit to taking time off from study or work.

  • Relaxation techniques

    Simple activities can help soothe the mental and physical signs of anxiety. These techniques include meditation, deep breathing exercises, long baths, resting in the dark, and yoga.

  • Exercises to replace negative thoughts with positive ones

    Make a list of the negative thoughts that might be cycling as a result of anxiety, and write down another list next to it containing positive, believable thoughts to replace them. Creating a mental image of successfully facing and conquering a specific fear can also provide benefits if anxiety symptoms relate to a specific cause, such as in a phobia.

  • Support network

    Talk with familiar people who are supportive, such as a family member or friend. Pediatrics support group services may also be available in the local area and online.

  • Exercise

    Physical exertion can improve self-image and release chemicals in the brain that trigger positive feelings.


A standard way of treating anxiety is psychological counseling. This can include cognitive-behavioral therapy (CBT), psychotherapy, or a combination of therapies.


CBT aims to recognize and change harmful thought patterns that form the foundation of anxious and troublesome feelings. In the process, practitioners of CBT hope to limit distorted thinking and change the way people react to objects or situations that trigger anxiety.

For example, a psychotherapist providing CBT for panic disorder will try to reinforce the fact that panic attacks are not really heart attacks. Exposure to fears and triggers can be a part of CBT. This encourages people to confront their fears and helps reduce sensitivity to their usual triggers of anxiety.


A person can support anxiety management with several types of medication.

Medicines that might control some of the physical and mental symptoms include antidepressants, benzodiazepines, tricyclics, and beta-blockers.


A doctor may prescribe these for certain people with anxiety, but they can be highly addictive. These drugs tend to have few side effects except for drowsiness and possible dependence. Diazepam, or Valium, is an example of a commonly prescribed benzodiazepine.


Antidepressants are commonly prescribed to help with anxiety, even though they also target depression. People often use serotonin reuptake inhibitors (SSRI), which have fewer side effects than older antidepressants but are likely to cause jitters, nausea, and sexual dysfunction when treatment begins.

Other antidepressants include Fluoxetine, or Prozac, and Citalopram, or Celexa.


This is a class of drugs older than SSRIs that provide benefits for most anxiety disorders other than OCD. These drugs might cause side effects, including dizziness, drowsiness, dry mouth, and weight gain. Imipramine and Clomipramine are two examples of tricyclics.

Additional drugs a person might use to treat anxiety include:
  • Monoamine Oxidase Inhibitors (MAOIs)
  • Beta-blockers
  • Buspirone

Seek medical advice if the adverse effects of any prescribed medications become severe.


Understanding Depression

Depression is a common and serious mental illness that negatively affects your behavior, ex., how you feel, the way you think and how you act however this medical condition is treatable. It causes feelings of extreme sadness/or a loss of interest in activities or life once enjoyed. Depression can lead to a series of emotional and physical problems which decreases ones ability to function at school and at home.

Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn’t worth living.

Depression isn’t a weakness and it’s not as easy as snapping out of it. This mental condition may require long-term treatment; however, don’t get discouraged as there is a treatment for this illness. Most people with depression feel better with medication, psychotherapy or both.

Signs & Symptoms of Depression

Depression comes in multiple types and many of them have similar recognizable symptoms.

Here is a general idea of what comprises depression:

  • Constant feelings of sadness, hopelessness, worthlessness, or emptiness
  • Irritability, frustration, or restlessness
  • Loss of interest in activities or hobbies that used to be enjoyable
  • Difficulty sleeping, sleep disturbances, or sleeping too much
  • Fatigue and lack of energy
  • Difficulty thinking clearly, remembering, concentrating, or making decisions
  • Appetite or weight changes
  • Recurrent thoughts of death or suicide
  • Physical symptoms, such as, headaches, stomachaches, or back pain

Depression is a Mood Disorder.

You may think that these are quite common experiences you may have encountered once or multiple times. However, experiencing some combination of these symptoms for a period of at least two weeks likely signifies that you are in the midst of a depressive episode. Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest.

Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn’t worth living. Depression isn’t a weakness and it’s not as easy as snapping out of it. This mental condition may require long-term treatment. But don’t get discouraged as there is a treatment for this illness. Most people with depression feel better with medication, psychotherapy or both.

Risk Factors of Depression

Depression can affect anyone even those who seem appear to be normal, lively and happy.

Several factors can play a role in depression:


Family history of depression may make it more likely for you to get it. It’s thought that the condition can be passed down.

Death or loss

Sadness and grief are normal reactions to loss; however such big stresses can bring triggers of depression, like thoughts of suicide or feelings of worthlessness.


Personal troubles or disputes with family or friends may lead to depression.


Past physical, sexual, or emotional abuse can bring it on, as well.

Life events

Sometimes, even good things, like moving or graduating, could make you depressed. This is caused by the sudden change on environment which triggers the feeling of loneliness.

Depression pairs with, or can be a reaction to, another illness.

Examples include:

  • Sleep problems
  • Chronic pain
  • Anxiety
  • ADHD


Depression can be a side effect of some medical drugs you take for another condition.

Substance abuse

A common cause of depression is substance abuse. Some people rely on drugs to relieve emotional stresses which may result to abuse later on.

Other problems:

Things like social isolation due to another illness or separation from a family or social group can lead to depression.

Treatment for Depression

Most fear that depression may impact their whole lives forever. However, even the most severe depression is treatable. In addition, learning about the depression treatment options will help you decide which approach is the best for you.

Psychological treatments for depression

Also known as talking therapies, psychological treatments help you by changing your thinking patterns and improve your coping skills on how to deal with life’s stresses and conflicts. Psychological therapies can also help you stay well by identifying and changing unhelpful thoughts and behavior.

Medical treatment for depression

These are commonly known as antidepressant medication. There’s a lot of misinformation about antidepressants however it is seen as the most useful in the treatment of moderate to severe depression and some anxiety disorders.

Each treatment works differently for different people. Some may do well on one and some others may not. Also, there are cases that medications may be incorporated with psychological treatment to maximize the effectivity of the treatment.

It’s important to remember that recovery doesn’t happen overnight and it can take time, some takes years. Just as no two people are the same, neither are their recoveries. Be patient and go easy on yourself and we’ll be here to help you.

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