While growth is exciting, Cook Children’s know it brings challenges that can impact team members, visitors, neighbors and our community. Cook Children’s want to share the ‘what and why’ about the work the health care system is doing to continue to serve children and families.

Growing with the Community

Fort Worth, the greater DFW metro area and the surrounding regions that rely on Cook Children’s for specialty pediatric care are growing. Cook Children’s is prepared to grow with them.

“North Texas is expanding rapidly, and we’re here to match that expansion,” said Spencer Seals, senior vice president of Real Estate, Construction, and Facilities Planning for Cook Children's Health Care System. “Through the West Tower and other construction projects, we are building future capacity.”

With population growth comes increased demand for Cook Children’s services. For example, as the largest Level IV NICU in North Texas, Cook Children's cares for critically ill babies from hospitals both nearby and hundreds of miles away.

Cook Children’s also has one of the busiest emergency rooms in the nation, treating broken bones, severely ill children and patients transported by plane, helicopter and ambulance in need of lifesaving care. It’s not uncommon to see 500 to 600 patients in a single day during the peak season, with many requiring admission to the Pediatric Intensive Care Unit (PICU).

As a result, beds in the PICU and NICU are frequently full, and children and families must wait for beds. To make sure Cook Children’s can be here for every child, the health care system created a 10-year plan designed to expand the campus and meet the needs of patients and families for decades to come.

Progress and Milestones

So far this year, Cook Children’s has made progress or completed numerous projects.

Kids’ Place
To make room for the West Tower expansion, the Kids’ Place Child Development Center - a daycare center for Cook Children’s staff - relocated from Southland Avenue to a new facility on Cook Children's Fort Worth campus along 9th Avenue between Cooper and Pruitt streets.

West Tower Infrastructure Takes Shape
Several foundational phases of the West Tower project are now complete.

Phase 1 of excavation, including installation of two tower cranes and construction of the basement structure, has been completed. The former Alliance for Children building has been demolished, and construction of the West Tower Garage is underway.

Meanwhile, crews continue expanding the South Utility Plant, which provides electrical power across the campus. As part of that work, teams excavated a major utility tunnel beneath 7th Avenue.

Building the Foundation

Much of the construction visible today is creating the infrastructure necessary to support the future West Tower.

The 10-story, 760,000-square-foot tower will house a new PICU, an expanded Heart Center and a Transitional Care Unit. It will also create opportunities to expand the NICU and Emergency Department within the existing hospital.

Many of the lane closures along 8th Avenue, Rosedale Street and throughout the Medical District have been necessary to relocate and upgrade utilities that support the future building. This work includes:

• Sewer lines

• Storm drains

• Internet access

• Irrigation

• Water flow

• Fire water

Teams are also relocating gas lines and Oncor power lines.

Cook Children’s hopes to wrap up the 8th road work by November.

After that, all West Tower construction should be contained to the Cook Children’s Fort Worth campus. There will still be construction on Rosedale, but that work is being done by the city on behalf of the entire Medical District.

As construction continues, Cook Children’s construction website is the best place to find up-to-date information of lane, road and sidewalk closures.

Seals explained that his team and their partners have done everything they can to mitigate the impact the construction has on the community, staff, and patients. For example, Cook Children’s avoided road closures on 7^th Avenue, where utility work needed to be done, by having crews tunneling beneath the street.

Still, Seals knows the lane closures and traffic can be a challenge. However, if Cook Children’s is going to grow with the community, the utility work was always a necessary growing pain.

“In order to meet the needs of the Cook Children’s system, we had to do this infrastructure work with or without the West Tower,” Seals explained. “And in order to expand the NICU, PICU and the Heart Center, we needed to add the tower. There is literally not enough room to do that without the West Tower addition.”

What to Expect Next

Before utilities can be connected to the West Tower, crews must lower portions of Terrell Avenue and 7th Avenue. This work will create the proper grade needed to manage stormwater around the future building. Terrell Avenue is expected to reopen to both pedestrian and vehicle traffic by summer 2027.

Over the next six months, Cook Children's expects to reach several additional milestones, including:

• Completion of utility work along 8th Avenue

• Continued construction of new parking garages

• Installation of three additional tower cranes

• Completion of the first of five major phases of West Tower construction

• Advancement of the second phase of basement construction

Looking Ahead

By late 2030, Cook Children’s will have added more than 200 beds in the West Tower, renovated parts of the hospital and built in extra space to prepare for future growth.

The West Tower reflects Cook Children’s growth - from 56 private rooms in the PICU to a state-of-the-art Heart Center, with everything a patient needs from surgery to discharge in contiguous space to more beds and spaces for families to heal.

With the space vacated in the existing hospital, Cook Children’s is undertaking a 155,000 square-foot renovation, including more cancer services, highly specialized interventional radiology and the addition of 37 NICU beds to bring the total to nearly 150 beds.

For more than a century, Cook Children’s has risen to meet the needs of the moment - the health care system has expanded its campus, evolved its technology and added services to improve the health and well-being of all children in its care. This expansion is a continuation of the system’s Promise, “Everything for the child.”

Cook Children’s appreciates your patience. You can read more about the expansion in this story, which is updated with the latest construction impacts.

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Cook Children’s Looks to Expand Medical Campus to Keep Up with Unprecedented Growth in Fort Worth

Resources and tips for finding immunizations for children:

Navigating vaccines can feel overwhelming. Talk to your pediatrician.

• Schedule an appointment through Cook Children's.
• Find your nearest Texas Department of State Health service clinic for information on clinics.
• Call 211 for help.
• Call Tarrant County Public Health at 817-248-6299 to make an appointment or to find a walk-in clinic.
• Check with your local school district for vaccine events.

Raising a child brings up endless questions, especially when it comes to their health and well-being. As back-to-school season approaches, immunizations may be top of mind for families, and searching for clear, honest answers about what goes into their child's body and why. With so much conflicting information online, sorting facts from fear can feel overwhelming. Cook Children’s Health Care System helps parents and caregivers cut through the noise with trusted guidance from medical experts who are parents themselves.

Among the recommended immunizations, the RSV medication often raises questions.

Hospitalist Laura Romano, D.O., explains the key facts about RSV and the medication that prevents it.

What is RSV?

Respiratory syncytial virus, or RSV, is a highly contagious virus that causes upper and lower respiratory symptoms in people of all ages. Symptoms range from a stuffy nose to difficulty breathing. While most cases are mild, severe infections can cause bacterial pneumonia or require hospitalization for oxygen therapy and intravenous fluids. Premature infants and babies with underlying heart or lung conditions face the highest risk.

Can RSV be prevented?

Yes! Pregnant women can receive an RSV vaccine to protect their babies, or infants can receive a preventive immunization during the winter. Some children qualify for more than one immunization so ask your pediatrician if your child needs a second dose. Thanks to maternal vaccines and infant immunizations, hospitals - including Cook Children’s - are seeing a drop in RSV hospitalizations.

What would you like families to know about RSV and its immunization?

RSV while mild for many can be fatal for some. RSV can affect everyone from young babies to our grandparents and can be fatal in both cases.

RSV is mild for most people but it can be fatal for some. RSV affects individuals of all ages - from infants to older adults - and can be deadly for high-risk populations across both groups.

Here's an edited Q&A from the conversation.

Q: What's one of the biggest misconceptions parents have about sports injury prevention?

Bass: Many parents focus on game day. They focus on when the whistle blows or when the competition starts. What often gets overlooked is everything that happens before that. Preparation, practice habits, warmups, conditioning and recovery all play an important role in helping reduce injury risk and improve performance.

Q: What does a good injury prevention routine look like before practice or a game?

Bass: It starts with a proper warmup. We want to warm up before we stretch, not stretch before we warm up. The goal is to create blood flow, get muscles and joints ready to perform, and make warmups a consistent part of every practice routine.

Sports are all about routines, and creating healthy routines can help reduce injury frequency.

Q: Does playing one sport year-round increase injury risk?

Bass: Research suggests that sports specialization can contribute to higher injury rates and burnout. Younger athletes should be encouraged to participate in multiple sports.

As young athletes grow and mature, their interests usually become clearer. In many cases, specialization happens naturally over time rather than needing to happen at a very young age.

The goal should be helping kids enjoy sports while developing a variety of skills.

Q: What are some signs that an athlete may be pushing too hard?

Bass: Parents and coaches should pay attention to changes in performance, soreness, swelling, stiffness and limping.

Athletes are often pleasers. They don't want to disappoint coaches, teammates or parents, and sometimes they don't immediately report that something is hurting.

That's why communication is so important. The earlier we identify a problem, the more options we have to help the athlete recover and continue participating safely.

Q: Why is it important for athletes to be honest about injuries?

Bass: Many athletes worry that reporting an injury will immediately take them out of competition. What I want them to understand is that athletic trainers and sports medicine professionals are advocates for the athlete.

Our goal is not to keep them from participating. Our goal is to help them recover, perform at their best and stay healthy over the long term.

Building trust helps athletes feel more comfortable speaking up when something doesn't feel right.

Q: What should parents know about concussions?

Bass: Concussions are medically classified as traumatic brain injuries, and they deserve serious attention.

One of the most important things parents need to know is that no two concussions are exactly alike. A concussion may look very different from athlete to athlete. Some athletes may experience headaches. Others may become sensitive to light or sound. Some may struggle with sleep, concentration or mood changes.

If symptoms develop after a collision, fall or impact, it's important to have the athlete evaluated by a medical professional.

Q: Can athletes drink too much water?

Bass: Parents ask that question quite a bit.

While it is technically possible to overhydrate under certain circumstances, most young athletes are much more likely to be under-hydrated than over-hydrated.

Hydration should be consistent throughout the day. Athletes should not wait until they feel thirsty to start drinking fluids, especially during practices and competitions in hot weather.

Q: Is heat illness preventable?

Bass: Heat illness is one of the most preventable sports injuries we see.

Proper hydration, acclimatization to heat, regular breaks and recognizing warning signs early can make a tremendous difference.

Parents should pay attention to symptoms like headaches, cramping, fatigue, dizziness and unusual behavior changes during or after physical activity in the heat.

When athletes begin experiencing heat-related symptoms, it's important to cool them down, rehydrate and seek medical attention when necessary.

Q: What's one thing every athlete should do before practice?

Bass: Say thank you.

Thank the parents, caregivers, coaches, teammates and everyone else who helps make it possible for you to participate.

Playing sports is a privilege, and gratitude is something every athlete can carry with them onto the field, court or track.

The Bottom Line

Preventing sports injuries isn't about one single technique or piece of equipment. It starts with consistent habits: proper warmups, good nutrition, hydration, recovery and honest communication when something doesn't feel right.

By helping young athletes build healthy routines and recognize warning signs early, parents can play an important role in keeping kids healthy, safe and in the game.

Parents are navigating conflicting opinions, social media discussions and misinformation. In the latest episode of For Kids' Sake, Alice Phillips, M.D., pediatrician and medical director for Ambulatory Quality at Cook Children's, discusses how families can find trustworthy information, understand immunization recommendations and feel confident asking questions and learn about the Cook Children’s Comfort Menu, a program designed to reduce fear and discomfort during vaccines and medical procedures.

Here's an edited Q&A version of the conversation.

Q: How should parents navigate all the information they're seeing about immunizations?

Dr. Phillips: First, please take a deep breath and pause and think, “who are my trusted sources?” and identify those. If something you read online sounds questionable, trust your instincts and bring those questions to your pediatrician. Parents don't have to sort through everything alone. We’ve been with you through sleepless newborn nights, potty training and maybe even scares at the hospital.

We’re here to help guide you through all of this information overload that we’re experiencing right now.

Q: Has anything changed about childhood immunization access?

Dr. Phillips: No. Families still have access to the same vaccines and should continue routine well-child visits. If your child is preparing for daycare, preschool or kindergarten, it's important to stay on track with those appointments and immunizations.

Q: What about delaying or spreading out immunizations?

Dr. Phillips: Parents have always had that option, but research has not shown delayed schedules to be safer. Delaying immunizations can create additional visits, increased costs and more stress for both children and families. If we did every shot separately, that is getting close to 30 or more visits for that child. That equals more time off work for families, trying to manage busy schedules, and a

Possibility that your child becomes scared of going to the doctor because they associate every visit with a shot.

Q: What is the Comfort Menu, and how can it help children who may struggle with shots or medical procedures?

Dr. Phillips: The Comfort Menu is a program developed by Cook Children's that helps children experience as little physical and emotional discomfort as possible during procedures like immunizations. We know shots can be scary, and we want to make the experience easier for both children and parents.

The Comfort Menu includes distraction techniques, toys, comfort positioning, parent involvement and tools that can help reduce discomfort. Sometimes parents naturally do some of these things themselves, like playing a child's favorite video during a shot. We also have other resources available, including numbing sprays and specialized comfort tools.

The program isn't limited to immunizations. It can also be used for IV starts, procedures and other situations where a child may feel anxious or afraid. For children who need additional support, we may involve Child Life specialists and other team members to help create a more positive experience.

The goal is simple: helping children feel as comfortable, supported and safe as possible during medical care.

Q: How are vaccines tested before they're approved?

Dr. Phillips: Vaccines go through extensive testing, including animal studies and three phases of human trials that evaluate safety and effectiveness. After FDA review, Cook Children's takes one step further and also conducts its own internal review process before adopting new vaccines. It's not a rubber stamp, we analyze all the evidence and research and a vaccine goes through these multiple steps before it’s ever introduced.

Q: You've shared that immunization is personal for you. Why?

Dr. Phillips: I’m very passionate about the pneumococcal vaccine because I’ve had two patients pass away from pneumococcal disease. Once it happens, it happens fast and it’s a hard bug to stop and it’s very powerful.

When the pneumococcal vaccine was first introduced, my own daughter was nine months old and received the very first dose given in my clinic. That's how strongly I believed then, and continue to believe today, in the protection vaccines provide.

I was willing to give my baby the first dose because it is an amazing thing, that we have these to save our kids. We aren’t just doctors, nurses or staff. We are moms too and in the end, we all want our kids to grow up happy and healthy and we have to focus on that.

*Additional information about the pneumococcal vaccine:
It protects against bacteria that can cause ear infections, pneumonia and other serious illnesses. The vaccine helps your immune system recognize and fight these germs before they can make you sick.

Q: Is it okay for parents to have questions?

Dr. Phillips: Absolutely! 100%. You ask questions about diapers, why wouldn’t you ask questions about vaccines?

Immunization science is complicated. Parents should feel comfortable asking questions and discussing concerns with their pediatrician. Don’t be afraid to ask questions.

Q: Is delaying immunization safer?

Dr. Phillips: No. Some diseases pose their highest risk during the first 12 months of life. Delaying immunization may leave children unprotected during their most vulnerable period.

Q: What's one of the biggest immunization myths?

Dr. Phillips: That vaccines are more dangerous than the diseases they prevent. Many vaccine-preventable illnesses can cause serious complications, and some can become life-threatening very quickly.

Q: Where should parents go for trustworthy information?

Dr. Phillips: Start with your pediatrician and evidence-based resources. If you see something online and aren't sure about it, bring it to your doctor and discuss it together.

Q: What would you say to a nervous parent?

Dr. Phillips: Every time I hear or read something new, I think, “Man. Parents must not just be nervous, they must be scared too.”

You're doing good work. You want what's best for your child. Keep asking questions and when you’re hearing something strange, lean on trusted medical professionals who can help you navigate those decisions.

Q: What is one thing parents should never feel embarrassed to ask?

Dr. Phillips: Anything. There are no bad questions.

And also flipping that on its head, parents should not be afraid to hear questions from us. When a family comes to me and they are worried about vaccines and don’t know what to do, I try to ask lots of questions about their worries and fears.

That is how we solve these problems and get to a solution that we’re all happy with.

Final Thoughts

Dr. Phillips: These are difficult times for many families. We understand that. Pediatricians and parents share the same goal: helping children grow up healthy and protected. We want families to know we're here to help.

Raising a child brings up endless questions, especially when it comes to their health and well-being. As back-to-school season approaches, immunizations may be top of mind for families, and searching for clear, honest answers about what goes into their child's body and why. With so much conflicting information online, sorting facts from fear can feel overwhelming. Cook Children’s Health Care System helps parents and caregivers cut through the noise with trusted guidance from medical experts who are parents themselves.

Among the recommended shots, the pertussis vaccine often raises questions.

Hospitalist Laura Romano, D.O., explains the key facts about pertussis (whooping cough) and the vaccine that prevents it.

What is pertussis?

Pertussis, a highly contagious bacterial infection, causes a severe, long-lasting cough which can sometimes end in a "whooping" sound when a child breathes in. The illness is also known as whooping cough or the “100-day cough.”

In older children and adults, pertussis typically causes only a low-grade fever and a prolonged cough. However, the disease can be fatal in infants. In babies, pertussis can cause difficulty breathing, apnea (when a baby stops breathing) due to coughing and respiratory failure. The infection can be fatal even when treated with antibiotics.

How can the disease be prevented?

Pertussis is very contagious. Vaccinating newborns is the best way to protect them. New parents, grandparents, or aunts and uncles should also receive a Tdap vaccine before welcoming a new baby home.

What would you like families to know about Pertussis or its vaccine?

As a medical community, we have watched pertussis vaccination rates steadily decline in recent years, leading to outbreaks in states like Kentucky. In that outbreak, three babies died from respiratory failure. Pertussis has proven to be fatal to at-risk infants and unvaccinated children.

RELATED STORIES:
Cook Children's Back to School Checklist
What Families Should Know About Hepatitis B
Back-to-School Breakdown: Preparing for Class with the MMR Vaccine
What Families Should Know about Human papillomavirus (HPV)

Q: How can parents tell the difference between a child who is occasionally distracted and one who may have ADHD?

Dr. Watkins: The biggest difference is consistency across multiple settings. Children with ADHD often struggle not just at home, but also at school, during extracurricular activities and in other environments.

Parents and teachers may notice difficulties staying seated, following directions, waiting their turn, staying organized or completing tasks. Teachers often report that these children require more redirection to stay focused and on task.

Q: What are some common signs of ADHD that caregivers and teachers may notice?

Dr. Watkins: ADHD symptoms generally fall into three categories: inattention, hyperactivity and impulsivity.

Signs may include:

• Frequent daydreaming
• Becoming distracted easily
• Needing repeated reminders to stay on task
• Excessive fidgeting
• Difficulty remaining seated
• Trouble standing in line or waiting their turn
• Blurting out answers
• Interrupting conversations or activities
• Difficulty organizing schoolwork or belongings

These behaviors occur more frequently and persistently than what would typically be expected for a child's age.

Q: At what age can ADHD be diagnosed?

Dr. Watkins: According to the American Academy of Pediatrics, ADHD can typically be diagnosed starting around age 4. Before that age, many behaviors associated with ADHD, such as impulsivity, high energy and short attention spans, are also normal parts of early childhood development.

Most children in the United States are diagnosed between ages 6 and 7, often after concerns are raised by teachers.

Q: If parents are concerned about ADHD, where should they start?

Dr. Watkins: Start by gathering information from the people who spend the most time with your child. Teachers are often the first to notice patterns because they work with many children and can compare developmental behaviors across age groups.

Parents know their children best, though, and their observations matter too. Coaches, dance instructors, childcare providers and other trusted adults can also provide valuable insight.

Once concerns are identified across multiple settings, families should talk with their pediatrician or primary care provider about an evaluation.

Q: What if a child is homeschooled?

Dr. Watkins: It can be more challenging because there are fewer opportunities for comparison. However, parents can still look for patterns.

Is your child taking significantly longer to complete assignments than siblings or peers? Are they becoming distracted more frequently during lessons? If they participate in homeschool co-ops, sports, church activities or other group settings, do they require more redirection than other children their age?

Looking at behavior across different environments remains important.

Q: What is a 504 Plan?

Dr. Watkins: A 504 Plan provides accommodations that help students access learning more successfully in the classroom.

Examples may include:

• Preferential seating near the teacher
• Modified assignments
• Frequent check-ins for understanding
• Small-group testing
• Additional support with organization
   

Creating a 504 Plan typically involves collaboration among parents, teachers, school staff and the child's healthcare provider.

Q: How is an Individualized Education Program (IEP) different from a 504 Plan?

Dr. Watkins: An IEP, or Individualized Education Program, falls under special education services and is intended for students who require more comprehensive support.

While a 504 Plan focuses on accommodations, an IEP provides specialized educational services and goals tailored to a student's needs. The process is more involved and often includes formal evaluations from educational specialists, school psychologists or speech-language pathologists.

Because of those evaluations and planning requirements, IEP implementation typically takes longer.

Q: What is the Child Find program, and how can it help families?

Dr. Watkins: Child Find is part of the Individuals with Disabilities Education Act and requires public schools and charter schools to identify and evaluate children who may need special education services.

The program serves children from birth through age 21. Younger children may qualify for early intervention services, while school-aged children can receive evaluations and support through the public school system.

Parents who have concerns can discuss them with their child's pediatrician or teacher to begin the process.

Q: Are children being overdiagnosed with ADHD?

Dr. Watkins: Parents are exposed to an overwhelming amount of information, and much of it can be contradictory.

Rather than focusing on debates about overdiagnosis, it's important to focus on the child in front of you. If a child is struggling academically, socially or emotionally, an evaluation can provide answers and guidance.

On the other hand, not every energetic, daydreaming or quirky child has a disorder. Every child has unique traits and develops differently.

Q: What's the biggest misconception about ADHD?

Dr. Watkins: One of the biggest misconceptions is that children with ADHD are behaving badly on purpose.

ADHD is a neurodevelopmental disorder. Many of the behaviors associated with it stem from impulsivity and difficulty regulating attention, not deliberate defiance. These children are not trying to be disruptive. Their brains simply process information differently.

Q: Is it better to wait and see or ask questions early?

Dr. Watkins: Both.

If you're concerned, ask questions early. Gathering information helps you understand what to watch for and what may be developmentally appropriate. Then you can continue observing your child with better context and guidance.

There's no harm in learning more.

Q: Should parents worry if their child learns differently than other children?

Dr. Watkins: No. Every child learns differently.

Differences in learning styles do not automatically signal a problem. The key question is whether the child is thriving and progressing or struggling significantly compared to expectations for their age and environment.

Q: What's one thing you wish every child could hear from the adults in their life?

Dr. Watkins: “You're doing a good job.”

It's easy for adults to focus on correcting behaviors, improving grades and helping children meet expectations. But being a kid is hard. Children need encouragement, reassurance and reminders that they're loved and valued for who they are, not just for what they accomplish.

Q: What's your message to parents who worry they're not doing enough?

Dr. Watkins: If you're concerned about your child, showing up, asking questions and looking for ways to support them, you're doing enough.

Parents often put tremendous pressure on themselves, but perfection isn't the goal. Being a caring, engaged and "good enough" parent matters far more than having all the answers.

Final Thoughts?

Dr. Watkins: In today's world, it's easy to assume every challenge means something is wrong with your child. But sometimes kids are simply kids. They may be energetic, distracted, imaginative or a little wiggly, and that's perfectly normal.

Pay attention to patterns, trust your instincts and seek guidance when concerns arise. Most importantly, remember that every child develops in their own way and deserves support, understanding and encouragement along the way.

Resources and tips for finding immunizations for children:

Navigating vaccines can feel overwhelming. Talk to your pediatrician.

• Schedule an appointment through Cook Children's.
• Find your nearest Texas Department of State Health service clinic for information on clinics.
• Call 211 for help.
• Call Tarrant County Public Health at 817-248-6299 to make an appointment or to find a walk-in clinic.
• Check with your local school district for vaccine events.

Raising a child brings up endless questions, especially when it comes to their health and well-being. As back-to-school season approaches, immunizations may be top of mind for families, and searching for clear, honest answers about what goes into their child's body and why. With so much conflicting information online, sorting facts from fear can feel overwhelming. Cook Children’s Health Care System helps parents and caregivers cut through the noise with trusted guidance from medical experts who are parents themselves.

Among the recommended shots, the Human papillomavirus (HPV) vaccine often raises questions.

Hospitalist Laura Romano, D.O., explains the key facts about HPV and the vaccine that prevents it.

What is HPV?

HPV is a viral infection that causes flesh-colored warts on certain mucous membranes, most commonly affecting the mouth, throat and genitals.

HPV infections can lead to cervical cancer in women, as well as head-and-neck and anal cancers in both men and women

Most people with HPV have no symptoms and don't realize they carry the virus, yet they can still pass it to others.

How can the disease be prevented?

Vaccinating older children and teenagers can provide lifelong protection against HPV and helps prevent several types of cancer as well.

What would you like families to know about the virus or the vaccine?

Vaccinating boys and girls offers lifelong protection against a virus that can cause warts but also against deadly cancers. The vaccine protects your child now and helps safeguard their future partners down the road.

Last year, for the first time, the United Kingdom announced zero deaths from cervical cancer among women under age 30. Australia and New Zealand have seen similar results alongside increased vaccination rates.

Other countries have also reported declines in cervical cancer among women, as well as head and neck cancer among men.

RELATED STORIES:
Cook Children's Back to School Checklist
What Families Should Know About Hepatitis B
Back-to-School Breakdown: Preparing for Class with the MMR Vaccine

As summer winds down and school begins, families face the challenge of shifting back to structured routines. In the first episode of For Kids' Sake, a new

Q: What's at the top of the back-to-school checklist for families?

Dr. Arnaout: Sleep. During the summer, schedules often disappear. Bedtimes get later and routines become more relaxed. Before school starts, it's important to help kids get back on track because sleep affects attention span, mood, decision-making and learning.

The best approach is to start a few weeks before school begins. Move bedtime earlier by 10 to 15 minutes every few days and gradually adjust wake-up times. Small changes can make the transition much easier.

Q: How much sleep do school-aged children need?

Dr. Arnaout: Most school-aged children need about nine to 12 hours of sleep each night, depending on their age and individual needs. A typical 10-year-old should be getting somewhere between nine and 11 hours.

If caregivers are unsure whether their child is getting enough sleep, it's always a good conversation to have with their pediatrician.

Q: What is something parents often overlook during back-to-school season?

Dr. Arnaout: Emotional readiness.

During the summer, many families relax routines. There may be more screen time, more snacking and less structure overall. Going back to school requires kids to adjust to schedules and responsibilities.

A few weeks before school starts, begin reintroducing routines such as regular meals, consistent bedtimes, and limits on screen time. That gradual transition can make a big difference.

Q: School vaccines can feel overwhelming. What should parents know?

Dr. Arnaout: There are several recommended immunizations for school-aged children, and your pediatrician can help you understand what's appropriate for your child.

One vaccine I remind parents about every year is the flu vaccine. The flu spreads easily in schools. While a flu shot may not prevent every case of flu, it's very effective at reducing the risk of serious illness, hospitalization and death.

We typically begin receiving flu vaccines in our offices around the end of August, and I generally recommend getting vaccinated in September or October.

Q: How can parents help children who are nervous about going back to school?

Dr. Arnaout: First, don't dismiss their worries. It's easy to say, "You'll be fine," but it can be more helpful to ask, "What's your biggest concern?" Let them talk about what they're feeling.

One of my favorite strategies is doing a practice run. Visit the school if possible. Walk the halls, find the classroom, visit the cafeteria, locate the bathrooms and meet the teacher. When kids know what to expect, school feels much less intimidating.

An anxious child often benefits greatly from preparation and planning.

Q: What are some signs that a child may be experiencing anxiety about school?

Dr. Arnaout: Anxiety doesn't always look obvious. Some children become quieter. Others may have trouble sleeping. They may complain of stomachaches or headaches.

These symptoms are real. Stress can affect the digestive system and lead to physical discomfort. If you're seeing more tummy aches, headaches, difficulty sleeping or changes in behavior as school approaches, anxiety may be part of what's going on.

The good news is that these feelings are normal. Most people experience stress and worry at times, and parents can help by offering support and preparation.

Q: What emotional skills help children succeed during the school year?

Dr. Arnaout: For younger children, skills like empathy, patience, listening and following directions are incredibly important.

Simple games can help build these skills. Games like Simon Says or Red Light, Green Light teach children to listen carefully, pay attention and follow instructions.

Reducing screen time before school starts is also helpful. Screens can affect attention and behavior. Instead, encourage activities like coloring, drawing, reading or creating stories. These activities help children practice focusing and creativity.

For older children, emotional readiness often involves organization and routine. Helping them clean their rooms, organize school supplies, set up study spaces or use planners can help them feel more prepared and confident.

Q: Is it okay for children to have a desk in their bedroom?

Dr. Arnaout: It depends on the home and the space available. In our house, we've found that our children are less distracted when they have a quiet area to work. The key is maintaining boundaries. Homework happens at the desk, but the bed remains for sleep. Once homework is done, we leave the room and move on to other activities.

Q: How should families think about germs and illnesses when school starts?

Dr. Arnaout: Young children have developing immune systems, and part of growing up involves being exposed to new germs. Schools bring children together, and illnesses are inevitable.

That's why vaccines are important. It's also why good hygiene habits matter. Teach children proper handwashing and how to use hand sanitizer appropriately. Those simple habits can go a long way.

Q: What should parents keep on hand during cold and flu season?

Dr. Arnaout: A few basics can make life easier:

• Tissues
• Hand sanitizer
• Acetaminophen (Tylenol)
• Ibuprofen
• Antihistamines
• A good thermometer
• Your pediatrician's phone number

Remember that pediatric offices often have nurses available to answer questions after hours. Illnesses rarely happen at convenient times, so it's helpful to have a plan before you need it.

Q: In our "Asking for a Friend" segment, a listener asks: Is it okay if my child eats the same lunch every day?

Dr. Arnaout: Yes. Many children are creatures of habit and prefer familiar foods. Try to offer variety at other meals and on weekends, but don't stress if your child chooses the same lunch repeatedly. There are bigger things for parents to worry about.

Q: What's the biggest sleep mistake parents make?

Dr. Arnaout: Screens in the bedroom. Many parents believe children need a television, tablet, or other screen to fall asleep, but screens interfere with sleep quality. The light from screens signals the brain that it's daytime and can affect melatonin production.

Make the bedroom as dark as possible. Avoid screens before bedtime. Instead, read books, tell stories or listen to calming activities that promote sleep.

Q: What's one of the best ways to reduce first-day-of-school stress?

Dr. Arnaout: Do a practice run. Visit the school if possible. If that's not an option, look at pictures of the school, the classroom or the teacher online. Familiarity helps children feel more comfortable and confident.

Q: What about parents who are nervous on the first day?

Dr. Arnaout: Parents experience first-day jitters too. When my children started school, I was nervous because they were no longer under my constant watch. One thing that helped was walking through the day's schedule.

I'd remind them, "You're going to have lunch, then recess, then class, and then I'll be there to pick you up."

Parents can do the same for themselves. Focus on how you'll spend your day and keep yourself occupied rather than dwelling on the separation.

Q: What's one health habit that pays off all year long?

Dr. Arnaout: Handwashing. Teaching children how to wash their hands properly and regularly is one of the most effective ways to reduce illness throughout the year.

Final Thoughts?

Dr. Arnaout: If you care enough about your child to listen to a podcast about getting ready for school, you're already doing a great job.

Give yourself some grace. Let go of the guilt.

You've got this.

For Kids’ Sake and its Spanish-language companion, Por Su Bienestar, debut today as extensions of Checkup Newsroom, Cook Children’s award-winning source for pediatric health news since 2014.

The podcasts bring Cook Children’s physicians, specialists and clinicians into conversations about the health topics families are talking about most. Guests will offer clear, balanced perspectives and understand the thoughtful decisions parents make every day.

"Our goal is to give caregivers trusted information directly from the people who care for children every day," said Chelsea Kretz Howell, director of Public Relations at Cook Children’s and host of For Kids’ Sake. "Families are constantly sorting through information online. These podcasts create a place where they can get clear answers to the questions that matter most."

The first episodes focus on back-to-school health and wellness, including immunizations, establishing healthy routines and helping children manage first-day anxiety. Future episodes will explore a wide range of pediatric topics, from seasonal illnesses and safety concerns to mental health, nutrition and emerging health trends.

Each episode features conversations with Cook Children’s experts who break down the latest pediatric health news and offer practical takeaways families can use at home. Episodes also include an "Asking for a Friend" segment, where clinicians answer listener-submitted questions and common concerns families may hesitate to ask.

"Providing trustworthy health information in both English and Spanish allows us to better serve the diverse families in our communities," said Lourdes Vazquez, multimedia storyteller at Cook Children’s and host of Por Su Bienestar. "We want parents and caregivers to feel informed, supported and confident when making decisions about their children's health."

New episodes of For Kids’ Sake will be released weekly, while Por Su Bienestar will publish new episodes every other week. Both podcasts will be available in video and audio formats.

Parents, grandparents, guardians and caregivers can watch full episodes on the Cook Children’s YouTube channel. The podcasts are currently available on all major podcast platforms, including Apple, Spotify, Google Podcasts, as well as through Checkup Newsroom. Follow Cook Children’s Instagram page @Cookchildrens, @ForKidsSake, @PorSuBienestar to submit questions to be addressed on the shows.

Media Contact

Chelsea Kretz Howell
Director, Public Relations
chelsea.kretz@cookchildrens.org

Resources and tips for finding immunizations for children:

Navigating vaccines can feel overwhelming. Talk to your pediatrician.

• Schedule an appointment through Cook Children's.
• Find your nearest Texas Department of State Health service clinic for information on clinics.
• Call 211 for help.
• Call Tarrant County Public Health at 817-248-6299 to make an appointment or to find a walk-in clinic.
• Check with your local school district for vaccine events.

Raising a child brings up endless questions, especially when it comes to their health and well-being. As back-to-school season approaches, immunizations may be top of mind for families, and searching for clear, honest answers about what goes into their child's body and why. With so much conflicting information online, sorting facts from fear can feel overwhelming. Cook Children’s Health Care System helps parents and caregivers cut through the noise with trusted guidance from medical experts who are parents themselves.

Among the required school shots, the Hepatitis B vaccine often raises the most questions, especially when it comes to why infants and young kids need protection so early.

Hospitalist Laura Romano, D.O., explains the key facts about hepatitis B and the vaccine that prevents it.

What is Hepatitis B?

Hepatitis B is a serious liver disease that is caused by the hepatitis B virus (HBV).

In adults, hepatitis B is usually spread through blood or intimate contact. In young children, however, the virus usually spreads through contact with infected bodily fluids. Transmission most commonly occurs during labor and delivery, but it can also happen through everyday activities, such as sharing a toothbrush or being bitten by a person who has the virus.

People infected with hepatitis B can spread the virus even if they show no symptoms. In fact, children often remain asymptomatic for years while still being contagious. This is especially concerning because infants and young children are more likely than adults to develop chronic, lifelong liver conditions, including permanent liver damage, cirrhosis (severe scarring), and liver cancer.

Treatment options for chronic hepatitis B are limited and focus primarily on halting the progression of liver damage rather than curing the virus itself. For severe cases where the liver has sustained significant damage, a liver transplant may ultimately be necessary.

How can the disease be prevented?

The most effective way to prevent hepatitis B is through vaccination. The vaccine is highly protective, offering about 95% effectiveness in preventing both acute and chronic infections. Since its routine inclusion in infant immunization schedules, rates of hepatitis B cases and associated liver cancer have steadily declined.

What would you like families to know about the hepatitis B vaccine and HBV?

• Hepatitis B is often misunderstood as a disease that only affects people engaging in high-risk or illegal behaviors. Anyone can contract the virus through everyday actions such as sharing a razor or toothbrush with someone who has the infection, even if that person shows no symptoms.
• Prenatal screening and maternal immunity testing alone are not enough to protect all children from hepatitis B. History has shown that targeting only 'high-risk' infants leaves gaps, leading to ongoing infections in both mothers and children that universal vaccination prevents.
• While some countries delay hepatitis B vaccination until children are older, their social and health care infrastructure differs significantly. Longer parental leave in those countries means children spend less time in daycare, where early exposure can occur. Also, universal health care access allows these countries to detect acute infections quickly and manage chronic cases more effectively.

Related Stories:

• Mindful Monday Medicine: Back to School Checklist

• Prioritizing Firearm Safety and Youth Well-being in Fort Worth

• Heat Safety for Kids: Hydration, Heat Illness Signs and Sun Protection Tips

For Stephanie Acord, M.D., a pediatric neurologist specializing in neuromuscular disorders at Cook Children’s, those first conversations with parents are much more than explaining a diagnosis.

“For these families, the biggest thing is trying to learn to trust us,” said Dr. Acord. “We are going to do anything and everything that we can to get their child the best type of treatment, to have the best outcomes possible.”

That trust is especially important because with SMA, time matters.

Before Texas added SMA to its newborn screening panel in 2021, many children were diagnosed only after symptoms began to appear or older siblings were also diagnosed with SMA. Today, newborn screening allows specialists at Cook Children’s to identify babies much earlier and begin evaluating treatment options before symptoms develop.

“Besides stroke, where every minute counts, in the SMA world, essentially every day counts,” Dr. Acord said.

SMA is caused by a genetic change that prevents the body from producing enough survival motor neuron (SMN) protein, which keeps motor neurons healthy. There are five types of SMA categorized by disease severity and the age at which symptoms begin. Even though no cure exists for this condition, there are four different types of medication that are currently approved by the U.S. Food and Drug Administration (FDA) to treat SMA. One of them is SPINRAZA®, a treatment medication that was first approved by the FDA back in December of 2016.

Because Jesse’s newborn screening identified him early, his care team immediately began confirmatory testing while working to start treatment without unnecessary delays.

Rather than waiting weeks for additional approvals, Jesse began taking Evrysdi®, an oral medication that served as a bridge while the team secured authorization for a gene therapy medication called Zolgensma®. Jesse continued his oral medication as physicians closely monitored his progress.

Although Jesse continued to make progress with the first two treatments, Dr. Acord believed he could benefit from the third treatment, SPINRAZA®.

At Jesse’s one-year follow-up appointment, he had not yet reached some of the developmental milestones his care team had hoped to see. After several conversations and close follow-up visits with his family, Dr. Acord recommended adding the third treatment medication that Jesse had not yet received.

On March of 2026, before Jesse’s scheduled treatment appointment, the FDA announced the approval of a higher-dose regimen of SPINRAZA® for eligible patients. The approval did not introduce a new medication. Instead, it expanded dosing for an existing therapy that has been used to treat SMA since 2016, allowing eligible patients to receive a larger dose over a shorter period.

Recognizing the potential benefit, Dr. Acord and her team immediately contacted Jesse’s parents and discussed the newly approved dosing option.

“For Jesse, that meant he was getting more medication in a shorter period of time,” said Dr. Acord.

After discussing the risks and benefits, Jesse’s parents agreed.

Jesse became the first patient in Texas and only the second in the United States, to receive the newly approved higher-dose regimen at Cook Children’s.

“Instead of having to undergo four lumbar punctures, which are more invasive procedures, within a two-month period on the regular standard dosing regimen, he was going to undergo two of those, within a two-week period, but essentially get double that dose within two weeks compared to over two months,” Dr. Acord explained.

Within weeks of the first dose, Jesse’s family noticed changes. He began pulling himself up to stand, cruising along furniture, and clapping his hands. He even attempted to climb stairs. His family quickly learned how to appreciate the little things children normally do, and they took nothing for granted.

For Dr. Acord, those moments never lose their significance either.

“When children come walking in or they just walk across the room for the first time, your mouth hits the ground, and you're just like, ‘this is why I do what I do,’” said Dr. Acord.

Today, watching Jesse continue reaching new milestones gives the family hope they could not have imagined during those first frightening days after his diagnosis.

“I'm glad I took the chance on trying something new, because I just want to give him the best opportunity to walk,” said Lupe Vasquez, Jesse’s mother.

Looking back, she hopes other parents facing an SMA diagnosis will give themselves grace.

“I would tell [other parents] that they're not alone. I know exactly how it feels whether it's SMA or another disease.” Lupe said. “Take care of your mental health… you have to make sure that you are okay too.”

Thanks to early screening, medical innovation, and a team committed to finding every possible advantage, Jesse’s journey is just beginning. Each new milestone serves as a reminder that, for children with SMA, every small step forward can change the course of a lifetime.

Resources and tips for finding immunizations for children:

Navigating vaccines can feel overwhelming. Talk to your pediatrician.

• Schedule an appointment through Cook Children's.
• Find your nearest Texas Department of State Health Service Clinic.
• Call 211 for help.
• Call Tarrant County Public Health at 817-248-6299 to make an appointment or to find a walk-in clinic.
• Check with your local school district for vaccine events.

Just weeks before students return to the classroom, the Texas Department of State Health Services (DSHS) issued a health alert following four reported cases of measles in July. According to DSHS, all four cases occurred within a single family after a family member traveled out of state.

With back-to-school season underway, pediatricians at Cook Children’s Health Care System are sharing key information about how measles moves through communities and how families can protect their children.

Measles is highly contagious. One infected person can potentially infect 12 to 18 unvaccinated individuals. The virus spreads through infectious respiratory droplets and airborne transmission (from coughing or sneezing), where tiny droplets can remain suspended in the air.

Cook Children’s experts say the best way to prevent getting and spreading the virus is to get the measles, mumps and rubella (MMR) vaccine.

The MMR vaccine is required by most school districts and Cook Children’s understands that navigating conflicting information about vaccines can feel overwhelming. Mary Suzanne Whitworth, M.D., medical director of Cook Children’s Infectious Diseases, explains the key facts about the measles and the MMR vaccine.

What is measles

Measles is a viral infection caused by the rubeola virus, which is not the same as rubella. The virus is very small, which makes it more contagious. It can remain in the air of a room for up to two hours after an infected patient leaves. Measles symptoms typically appear seven to 14 days after infection.

Symptoms include:

• Rash
• Fever, sometimes over 104º Fahrenheit or 40 º Celsius
• Runny nose
• Cough
• Red, watery eyes
• Sore throat
• Tiredness

Complications can include ear infections, diarrhea, pneumonia and, in rare cases, brain damage or death.

How can measles be prevented?

Vaccination is the most effective way to prevent measles. The first dose of the MMR vaccine is typically given to children on their first birthday (12 months old), followed by a booster at age 4. Talk to your pediatrician about questions and concerns. Children traveling outside the United States may be able eligible to receive the vaccine before their first birthday.

Because measles remains airborne for up to two hours, if 10 unvaccinated children are in a room with one infected child, nine of them will likely contract the virus.

In addition to getting vaccinated, the spread of measles can be mitigated by proper hygiene. This includes:

• Handwashing
• Covering your mouth and nose when you cough or sneeze
• Avoid sharing drinks or eating utensils
• Disinfect frequently touched surfaces

What would you like families to know about measles and the MMR vaccine?

Measles was declared eliminated from the United States in 2000. However, measles immunization rates have declined in recent years due to missed checkups during the pandemic, parental concerns and vaccine misinformation.

Measles also remains common in many parts of the world. Most recent U.S. cases stemmed from unvaccinated travelers returning from abroad. This drop in vaccination coverage makes communities vulnerable to disease resurgence.

Related Stories

• Mindful Monday Medicine: Back-to-School Checklist

• Top 10 Questions Parents Ask About Vaccines

• Measles Mythbusting with Laura Romano, D.O.

Wellness

• Schedule a Check-up: The American Academy of Pediatrics (AAP) recommends annual checkups from age 3 through adolescence. Schedule early to secure an appointment before the school year starts.
• Mental Health: Have open and honest conversations with children about their concerns. Speak with the pediatrician on tools to help with anxiety.
  • Parenting & Back-to-School: Emotional Safety Starts at Home
  • Raising Joy Podcast: Back to School Anxiety
• Oral health: Children should visit the dentist every six months. Make sure kids brush twice a day for two minutes and floss daily. Make an appointment.
• Update child vaccinations: Navigating vaccines can feel overwhelming. Talk to your pediatrician. The Texas Department of State Health Services requires certain immunizations before children can attend school.
  • To schedule an appointment, visit Cook Children's website or your county's health department website.
  • If a child is not of school age but attends daycare, other requirements may apply.

  • College students are required to receive the meningococcal vaccination.

    

• Sport physicals: The annual UIL pre-participation physical evaluation form applies to middle school and high school students. Sports physicals give doctors the opportunity to check for a variety of concerns, from vision issues and asthma to a lingering sprain or even a serious heart condition.

Healthy Routines

• Sleep: Sleep fuels a child's memory and concentration. Without consistent rest, children struggle to focus in class and retain what they learn, impacting their academic performance.
• Key elements for building a bedtime routine:
  • Establish a consistent schedule by going to bed at the same time each night.
  • Limit screen time at least one hour before bedtime.
  • Keep bedrooms quiet, cool and dark.
  • Create a calming routine, such as reading together.
• Transportation safety:
  • E-Bike and E-Scooter safety: Always wear a helmet.
  • Driving: Drive slowly through school zones and watch for pedestrians.
  • Car Safety: Ensure your child is in the correct car seat or booster for their age and size.
• Nutritious meals: Plan balanced breakfasts and lunches to keep energy levels stable throughout the day.
• Screen time: According to the American Academy of Child and Adolescent Psychiatry, children ages 8 to 18 in the United States spent an average of 7.5 hours a day using screens in 2025. Set clear daily limits for non-academic screen use.

Make a Plan

• Virtual care: If school district offers it, sign up for the Cook Children’s School-Based Virtual Health Program.
• Allergy action plan: Provide updated emergency allergy plans and medications to the school nurse.
• Medication management plan: Submit required doctor authorization forms for any daily or emergency medications needed during school hours.

To a parent living through their most terrifying moment, only one thing matters - that help is on the way for their child experiencing a medical crisis. Nothing brings relief like the sight of

With a moment’s notice, this team of critical care experts can be wheels up in one of Cook Children’s air ambulances to travel to points all over the United States, Canada and Mexico. While these aircraft are known to air traffic controllers by their unique call signs, to the anxious parents waiting on the ground, these identifiers are more than a string of letters and numbers. They are a declaration of the help and hope on the way.

“We’re walking in on a family’s worst and darkest day, and we are always cognizant of that,” said Deana McLelland, RN, Cook Children’s Teddy Bear Transport nurse. “They are always relieved to see us. I like to say our name is ‘Oh good, they’re here’ because that’s what we always hear when we walk in to pick up the tiniest of babies or the sickest of kids. I love taking care of them and feel so lucky that this is my job. I get emotional just talking about it.”

McLelland has been doing this job for 29 years. She is an original member of the Teddy Bear Transport team, having joined during its start up after working as a critical care nurse at Cook Children’s Medical Center for 6 years.

In May, she climbed aboard and began flying the friendly skies in a new addition to Cook Children’s fleet of mobile intensive care units - a Pilatus PC24 twin engine jet. The aircraft replaces one of two Cook Children’s airplanes currently in operation and enhances the health system’s ability to transport sick and injured children to Cook Children’s Medical Center for care.

“Our older airplane, which is a 1982 Beechcraft King Air twin turboprop, has served us well, but it’s time to retire,” said Stacy Putman, Cook Children’s director of Transport. “Now, we’ll have two jets to transport children from all over the country and even internationally from Canada and Mexico.”

Rapid Response

In emergency medicine, every minute counts. Cook Children’s new jet is bigger and faster than its turboprop predecessor, and can travel further distances before needing to refuel. To sick children and anxious parents, this means they get the help they need sooner.

Teddy Bear Transport averages about 30 flights per month. Many of those bring children back to North Texas to receive care close to home after becoming sick or injured while traveling. Premature babies or critically ill children from rural areas of Texas and surrounding states who need advanced care in Cook Children’s neonatal, pediatric or cardiovascular intensive care units are transported by air, too. Teddy Bear Transport also regularly flies infants diagnosed with a rare and severe genetic disorder called congenital hyperinsulinism (HI) to Cook Children’s Hyperinsulinism Center, one of only six HI Centers of Excellence in the world. Congenital hyperinsulinism can lead to dangerously low blood sugar in infants. Without timely intervention, these infants are at risk of seizures and permanent brain damage.

Cabin Features

The new jet joins a transport fleet that includes a Cessna Citation Encore+ jet, an American Eurocopter 145 helicopter and six specialty/critical care ambulances. All are equipped with medical technology comparable to what is used in neonatal and pediatric intensive care units.

“We are a mobile ICU,” Putman said. “So everything we can do in our pediatric or neonatal ICU, we can do in the airplane. We can even transport cardiovascular ICU patients on ECMO (advanced life support).”

Every transport carries a team that includes a nurse, paramedic and respiratory therapist. They are the elite of the elite when it comes to pediatric emergency medicine, as they must be as proficient in caring for a micro-preemie born at 21-weeks as they are at caring for an 18-year-old teenager. Expert skill is a must, coupled with the composure to deliver care while flying through the air or traveling the highways below.

In addition to having a little extra in-flight leg room for the transport team, the bigger plane allows for more equipment, staff and passengers when needed.

“When we transport kids on ECMO, it doubles our equipment and our on-board staff,” McLelland said. “This jet gives us more room to take anyone we need with us, and that includes parents. In the past we’ve only been able to take one parent with us because of our team configuration, but this allows us the seating to bring two with us if necessary. Sometimes that child’s survival is on the line and we don’t feel good about leaving one parent behind if we don’t have to, so this is a really important feature for keeping the family together in these critical moments.”

Engineered for Safety

In addition to its critical care capabilities, both of Cook Children’s jets are equipped with leading-edge safety features, including a Wide Area Augmentation System (WAAS) and Traffic Collision Avoidance System (TCAS). The WAAS enhances GPS navigation, turning it into a precision guidance system that allows aircraft to land in lower visibility and at smaller regional airports, like those in rural areas frequented by Teddy Bear Transport. One of the most important safety features of modern-day jets, the TCAS prevents potential mid-air collisions by giving pilots a heads up warning of aircraft in the area and, if needed, escape guidance to avoid collision.

Other on-board assists, like a Nexrad weather radar and a terrain warning system, guide pilots in flying above storms, avoiding dangerous wind sheer and navigating obstacles on the ground.

Grounded, But Not For Long

Even after 29 years, McLelland says her job never gets old.

“Every time that motor starts, my heart skips a beat,” she said. “Every day is a new place, a new diagnosis and a new family, and I love the variety. I still say I cannot believe I get paid to do this job.”

When a breast cancer diagnosis last year temporarily grounded her, McLelland persevered and returned to work in March after a six-month leave of absence.

“When all of this cancer stuff started, my doctor asked what three things scared me the most,” McLelland said. “I told him leaving my job was one of them and he assured me I would go back to the work I love. I could not wait to get back. I’m really lucky to get to do it for as long as I have, and I’m not done.”

McLelland can’t wait to step aboard for her first transport in the new plane. Although flying on new wings, her wheels-up preparation will be the same as it has been for two decades—suit up and pray up.

“Every single morning on the way into work, I pray for my patients and their families,” she said. “And I pray for my crew that we will be wise and discerning and tender and take good care of the children we transport.”

Teddy Bear Transport by the Numbers:

• Operates 24/7/365

• 4,100 transports annually

• 10,000 referral calls handled each year by dispatch

• Staff includes 60 neonatal/pediatric nurses, paramedics and respiratory therapists

Daniel was born with beta thalassemia major, a genetic blood disorder that prevents his body from producing healthy, functional hemoglobin.

“His red blood cells can't carry oxygen, so every 21 days, we come here for what we call a ‘refill’ for him to get about two units of donor red blood cells,” said Allison Wendler, Daniel’s mom.

For six to eight hours the infusion center becomes Daniel’s playground.

“He gets to play Roblox most of the day. He also gets to play on the Xbox and the PS5,” said Allison. “Steve, the therapy dog, comes a lot of times on Friday, and we love visiting with Steve.”

Timothy L. McCavit, M.D., MSCS, a pediatric hematologist at Cook Children's, has treated Daniel since he was adopted seven years ago. He has watched Daniel grow and thrive thanks to blood donors.

“Regular access to blood allows him to be a normal child,” said Dr. McCavit.

Each transfusion Daniel receives comes from donors through Carter BloodCare. Behind every unit of blood, there is a donor with a unique story.

On Tuesday, for the first time, Daniel and his family met some of the people who help keep him alive.

Two Parallel Journeys, One Perfect Match

Jeff Noble has been donating blood for the past six years. His own medical diagnosis requires him to do so.

“I have too much iron in my blood,” said Noble.

Noble was one of six donors who attended a special celebration for Daniel hosted by Carter BloodCare. The surprise reveal allowed Daniel’s donors to see the real-world, daily impact of their selflessness.

“Daniel would not be alive today if it weren't for donors,” said Allison.

Because of Noble and donors like him, Daniel doesn’t just survive; he thrives. He recently attended basketball camp and won the game ball for playing the best offense and defense.

Dr. McCavit hopes Daniel’s story encourages others to donate and lead community blood donation drives.

“Because the need is never ending,” said Dr. McCavit.

A Critical Shortage

Carter Bloodcare reports it is currently experiencing a critical blood shortage, with less than a single day’s supply of certain blood types on the shelves.

Dr. McCavit encourages anyone who is able to donate, noting that it’s a quick and easy process.

“I donate regularly, so I absolutely try to put my money where my mouth is in terms of encouraging people to donate,” said Dr. McCavit.

Cook Children’s utilizes blood transfusions for its most vulnerable patients, from premature infants weighing less than two pounds to teenagers. Dr. McCavit explained that blood transfusions are used in a variety of settings from the intensive care unit, operating rooms, the emergency department, and for children undergoing treatment for cancer and other blood disorders.

Fast Facts on Blood Donation:

• One donation can save up to three lives.

• Every 2 seconds, someone needs blood.
• Only 3% of eligible Americans donate blood.

To Donate visit Carter BloodCare.

As visitors poured in from around the world, Cook Children’s Health Care System provided top-notch medical care not just for residents, but for traveling fans with children who may have needed unexpected care. Cook Children’s treated more than 200 visiting families in its Urgent Care centers over the course of the event.

Between the heat and the fandom, the summer games would bring the health system launched the "World Cup Wednesday" public health series. For nine weeks leading up to the tournament, this series provided families with essential resources on injury prevention, heat and water safety tips, and more.

While soccer matches in North Texas have come to an end, the impact of keeping global and local visitors safe will live long after the fans have gone home.

Cook Children’s Health Care System is seeing a steep increase in serious injuries associated with these vehicles, including skull fractures, facial fractures, finger amputations and severe extremity fractures.

According to Cook Children's trauma registry data, injuries surged during the first half of 2026 compared with all of 2025. E-bike-related trauma cases increased 500%, rising from eight to 48 cases, while e-scooter injuries climbed 97%, from 29 to 57 cases. Because the trauma registry captures only the most severe injuries, the total number of emergency department visits is even higher.

This surge also saw a widening age gap: while the age range for these injuries so far in 2026 spans 4 to 17 years, the prior year saw a narrower range of 10 to 16 years for e-bikes and 4 to 17 for e-scooter injuries.

During the first two weeks of summer break alone, Cook Children’s treated 25 patients for e-bike and e-scooter injuries and 16 children for other personal electric vehicles. Many of those patients required admission to the Pediatric Intensive Care Unit (PICU).

“With e-bikes, kids are often not wearing appropriate protective gear or helmets,” said Taylor Louden, M.D., medical director of emergency services at Cook Children’s Medical Center – Fort Worth. “Sadly, we have had children struck by cars while riding on the road because they do not understand basic traffic laws.”

The U.S. Consumer Product Safety Commission (CPSC) recommends that children younger than 12 should not operate any e-bike capable of traveling faster than 10 mph.

Dr. Louden emphasized the importance of proper helmets.

“Always wear a helmet when riding anything with wheels,” said Dr. Louden, “For these faster e-bikes, we recommend a BMX-style helmet with face protection.”

Under the Texas Transportation Code, an e-bike is a bicycle with fully operational pedals, a motor of less than 750 watts, and an assisted top speed of 28 mph or less. Texas classifies e-bikes into three categories. While there are no age restrictions for riding a Class 1 or Class 2 e-bike, riders must be at least 15 years old to operate a Class 3 e-bike.

Sharon Evans, trauma injury prevention manager for Cook Children's, said families should remember that e-bikes and e-scooters are vehicles, not toys.

Evans and Dr. Louden offer the following safety tips for families:

Summer Ride Safety for E-Bikes and E-Scooters

• Adult supervision: Children should not ride these vehicles without direct adult supervision. Children younger than 12 should not operate them.
• Always wear a helmet: Make sure your child wears a properly fitted helmet. Helmets are the most important piece of safety equipment, but not all helmets are designed for e-bikes and e-scooters. Check the safety standards below to ensure children are wearing the appropriate helmet for the vehicle’s speed.
  • CPSC: All bicycle helmets sold in the U.S. must meet this standard. These are best for traditional bicycles and low-speed scooters.
  • ASTM F1952: Provides more protection than a standard bicycle helmet and may be good choice for riders traveling at speeds below 20 mph.
  • NTA 8776: Designed specifically for e-bike and e-scooter riders. This is the preferred choice for riders travelling at speeds above 28 mph.
  • DOT FMVSS-218: Provides the highest level of protection on this list and is best suited for higher speeds above or riding near heavy traffic.
    
• Perform a safety check before every ride:
  • Check the tires. Ensure they are inflated to the recommended pressure listed on the sidewall.
  • Test brake levers. Squeeze the brake levers while rolling the vehicle forward and backward.
  • Inspect vehicle. Check for loose parts or anything that appears damaged or abnormal.
    
• Follow the rules of the road:
  • Always ride on the right, in the same direction as traffic. Use the bike lane when available.
  • Stop and look both ways before entering a street or crossing an intersection.
  • Stop at all intersections.
  • Obey all traffic lights and signs.
  • Stay aware of your surroundings. Do not talk on the phone, text, or wear earbuds while riding.
    
• Night rides: Wear bright, reflective clothing and ensure the e-bike or e-scooter is equipped with light and reflectors.

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• What Parents Needs to Know About E-Bike and E-Scooter Safety
• A Families Guide to Summer Snacks and Hydration
• Heads Up: Helmet Tips for Safer Bicycling
  

Weight is one of the most personal things people carry and one of the hardest topics to talk about, especially for kids growing up and still learning who they are. When weight gain or fluctuations are out of one’s control, it can also become overwhelming and cause feelings of hopelessness. In those times, often the best action to take is to seek medical support. 

That’s exactly what Leslie Tewell did for her now 15-year-old son, Blain Tewell. Seeing Amani Terrell, M.D., Board Certified Pediatrician and Obesity Medicine Specialist with Cook Children’s Pediatrics Keller Parkway changed Blain’s life.

Obesity Medicine Care at Cook Children's - Keller Parkway

After 12 years of helping patients at Cook Children’s Pediatrics Keller Parkway, Dr. Terrell’s recent transition into obesity medicine felt natural. Year after year during routine checkups, she noticed children struggle with their weight and knew that many providers lacked the tools to truly help them. Too often, the advice was “exercise and eat healthy” and she wanted to do more. Now board-certified by the American Board of Obesity Medicine, she brings specialized expertise to every patient she sees.

“The sad reality is that 1 of every 4 children in North Texas has an obesity diagnosis,” Dr. Terrell said. “And most people don’t realize that obesity is a biological response.”

This perspective helps her patients understand their weight challenges go far beyond diet choices. Blain has been seeing Dr. Terrell for more than 10 years now and appreciates her thoughtful approach, not just focusing on one aspect of his health.

“Dr. Terrell’s consistency has been the most helpful and the way she takes time to understand me as a whole person,” Blain said.

Learning Throughout the Weight Loss Journey

Blain and Leslie have learned that weight loss takes time and that it’s important to focus on Blain’s well-being and health, not just numbers.

“I’ve learned more about making balanced choices and listening to my body,” Blain said. “My mom and I both learned the importance of patience and the encouragement I’ve needed along the way.”

Dr. Terrell has also helped Blain build his confidence and self-awareness.

“Blain is a very sweet young man,” Dr. Terrell said. “Awareness is important and with his biology and family history of health challenges, he’s at a higher risk for heart disease and type 2 diabetes. He’s now maintaining healthy lifestyle habits, and he feels a lot better and is happier with his progress.”

Paying attention to his nutrition, exercising, and learning about medication options including GLP-1 (Glucagon-Like Peptide-1) have also helped Blain.

GLP-1 is a naturally occurring hormone that helps regulate blood sugar and appetite. The medications reduce hunger, increase feeling full, and improve blood sugar control and have become common as an effective way to help patients lose weight.

Developing New Habits and Everyday Routines

Throughout the last year, Blain has been focusing on small habits that are easier to sustain -regular routines, being mindful of calories, and staying active in ways that are more manageable for him.

Having parental guidance, support and understanding makes it easier for kids to take steps and reach their goals. Leslie has tried to keep things balanced and not overwhelming. Her goal as a parent has been to support Blain and help him build lifelong habits, ensuring he feels encouraged and capable of his hopes and aspirations.

“Kids are looking for a better quality of life,” Dr. Terrell said.  “And the kids that are most successful in their goals are the ones who have their whole family involved.”

Kids often do better when their parents exercise with them, help them make healthier eating choices, and set goals together that are challenging but attainable.

Healthy Advice for Families

A lot of kids feel pressure about their weight challenges. They can even be afraid to talk with close relatives. It’s important for kids to feel safe opening up about their weight and what they are experiencing in school, and during regular daily activities.

“Take things one step at a time and focus on progress, not perfection,” Leslie said. “Most importantly, keep the focus on encouragement and overall well-being rather than pressure.”

Dr. Terrell also wants parents to understand that obesity is often a biological factor, not a result of willpower or poor parenting. She encourages parents to speak up and to share their concerns about their child’s weight with their doctor. They can even ask their doctor to speak with them in private.

“Sometimes talking about weight is triggering and we want to make sure everyone feels comfortable so we can learn about what their concerns are,” Dr. Terrell said.

Although it’s often difficult in the moment, it’s worth taking the time to have the conversation, especially when it can drastically improve a child’s health and well-being and even have a positive effect on the whole family.

“A lot of times the students are receiving a lot of their meals at school but in the summer months that primarily falls on the parent,” said Maya Rashad, nutrition program coordinator at Cook Children’s Health Care System.

According to data from the Cook Children’s Center for Community Health 2024 Community Health Needs Assessment, about 390,100 children from birth to 17 years old live in households that sometimes or often couldn’t afford nutritious meals. 

To help address those needs Cook Children’s Health Care System's Nourishing Communities program partners with R.E.D. Mobile Market, the Good for You Healthy Hub, and other Texas Health Resources Healthy Hubs to fight food insecurity and continue expanding community partnerships.

Free Summer Meals for Kids

Healthy breakfast, lunch, or to-go meals are available to children 18 and under all summer long.

• Fort Worth ISD Summer Food Program: Schedules and school locations
• USDA Summer Meals Site Finder: Find local distribution sites near you

“Healthy diet is the foundation of a healthy life,” said Rashad.

To put those words into action, Rashad hosts cooking classes twice a week at the Las Vegas Trail Neighborhood Health Center focusing on eating healthy while on a budget.

Lily Han, M.D., a pediatrician at Cook Children’s Windhaven and Rashad share practical tips families can use to stay healthy during the summer without breaking the bank.

“The summer is a great time to introduce new fresh, colorful and fun foods,” said Dr. Han.   

 One key strategy is choosing seasonal produce. Look for fruits and vegetables at their peak, like berries, avocados, watermelons and tomatoes.

Balancing Energy and Hydration

Nutrition during the hot summer months is also about maintaining proper hydration. With children constantly on the move between sports clinics, day camps, pool days and play dates, structured eating can easily slide.

Dr. Han said it is important for families to aim for three meals a day and two to three snacks to keep energy levels stable.

“Keep in mind you are fueling for both energy and hydration,” said Dr. Han.

Experts recommend keeping easy, ready-to-eat items on hand to curb hunger, stabilize blood sugar levels and provide sustained energy throughout long days of play.

Smart on-the-go snack options include:

• Trail mix
• Nut butter and whole grain crackers
• Frozen yogurt tubes
• Veggie sticks and fresh fruit
• Granola and cheese sticks

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As pediatric experts, Cook Children’s Health Care System know that protecting a child's health is about preventing emergency room visits just as much as treating illness. Ahead of the major soccer tournament, the system launched "World Cup Wednesday," a weekly healthcare series providing local and international visitors with essential resources on injury prevention, heat safety, water safety and guidance on when to utilize urgent care versus the emergency department.

The hottest time of the year in Texas is here, with temperatures regularly ranging from 80-100 degrees between June and August. Medical experts from Cook Children’s Health Care System advise caregivers and parents on what to know before attending outdoor activities or fan watch parties.

“Children can't cool off the body as well as adults,” said Monica Herrera, M.D., a pediatrician at Cook Children’s Pediatrics Windhaven, “it's important that we keep them hydrated.”

Dr. Herrera emphasizes that hydration is key during these months, as well as protecting children's skin from the sun and mosquitoes.

Learn the signs of heat-related illnesses

Spending too much time in the heat without proper hydration can lead to heat exhaustion and heatstroke. Dr. Herrera said learning the signs for heat-related illness is important, so caregivers know when to seek medical attention.

Symptoms include:

• Feeling faint or confused: A child may begin acting disoriented.
• Walking unsteadily and losing coordination.
• Headache
• Abnormally warm skin: Feels hot to the touch.
• Lack of urination: No wet diapers or bathroom use in eight hours.
• Nauseous and vomiting
• Shallow breathes: The body uses shallow breathing to try to shed excess heat.
• Muscle cramps: A child may complain that their legs hurt.
• Numbness

If a child exhibits these symptoms, seek immediate medical attention.

Preparedness is the number one way to avoid heat-related illness and Dr. Herrera says it starts with hydration.

Hydration Tips

Babies under 6 months old should generally be kept indoors. However, if an infant is outside, Dr. Herrera recommends they stay hydrated with formula or breastmilk. Babies under 6 months should not be given water.

“The breast milk has everything that the baby needs as does formula,” said Dr. Herrera. “If you're outside for a prolonged period they really need to be drinking every 20 minutes.”

As children get older water becomes the priority for hydration, but there are other tricks if your little one isn’t fond of H20. While water is best, other caffeine-free fluids and water-rich foods can help count toward hydration.

“Fluids don’t always come in the form of liquid,” said Dr. Herrera.

Alternative hydration sources:

• Ice cream
• Popsicles
• Snow cones
• Crushed Ice
• Fruits (Watermelon, grapes and cantaloupe) are an excellent source of hydration
• Soft liquids (such as yogurt, applesauce)

How do you know if your child is hydrated?

Check their urine. Urine is the best indicator of hydration status for both children and adults. A well-hydrated child's or adult’s urine should be clear to a light yellow, similar to a light lemonade color. If the urine is dark yellow or tea-colored, dark orange, more fluids are needed.

Sun protection

While hydration is critical, protecting a child’s skin is a close second. Dr. Herrera explained that children’s skin is sensitive and can burn when exposed to the sun for a prolonged period. While sunblock Sun Protection Factor (SPF) ratings range in coverage from SPF 10 to 80, Dr. Herrera recommends choosing products with two active ingredients: zinc oxide or titanium dioxide and use a sunblock of SPF 30.

Babies under 6 months of age should not have sunblock applied. Instead, keep them in the shade and dress them in a wide-brimmed hat.

Sunblock recommendations for 6 months and older:

• Choose a mineral-based sunscreen.
• Use SPF 30
• Apply 15 to 30 minutes prior to going outside.
• Reapply every two hours.
• Avoid sunscreens containing oxybenzone.
• Choose lotions over aerosol sprays to ensure total skin coverage.

Staying Cool in the Sun

• Dress children in light-colored, loose-fitting clothing.
• Choose breathable, absorbent materials.
• Avoid sitting directly in the sun. Seek shade when possible.
• Use cool mist sprays for quick relief.

Mosquitos

Summer heat in Texas also brings mosquitoes, which thrive around stagnant water and in hot, humid climates.

“Mosquitoes, as we know, can carry viruses which can cause severe infections and serious complications,” said Dr. Herrera. “We want to avoid mosquito bites if at all possible.”

The most effective line of defense is insect repellent.

Finding the best repellent:

• DEET is the most effective option.
• For infants up to 2 years of age, use a maximum of 10% DEET.
• For children older than 2, a maximum of 30% DEET.
• Apply repellent only to exposed skin or on top of clothing. Do not apply it underneath clothing.
• If concerned about applying directly on the skin, apply repellent on clothing instead.

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According to Daniel Guzman, M.D., a pediatric emergency medicine physician with Cook Children’s Health Care System, children are treated in emergency departments every year for fireworks-related injuries, including burns, eye trauma and hand injuries. While many families associate these injuries with the person lighting the fireworks, children and other bystanders can also be at risk.

Although fireworks are a beloved Fourt of July tradition, Cook Children’s Health Care System, encourages families to celebrate safely and understand the risks fireworks can pose to children.

What type of fireworks injuries do children often experience?

Fireworks can cause serious injuries in a matter of seconds. Even legal consumer fireworks can burn at temperatures high enough to cause severe skin damage.

Some of the most common fireworks-related injuries include:

• Burns to the hands, fingers and face
• Eye injuries that can threaten vision
• Cuts and lacerations
• Hearing damage from loud explosions
• Falls or other injuries while running away from fireworks

Sparklers aren’t as safe as they seem

Sparklers are often considered a safer option for young children, but they can be surprisingly dangerous.

 “Many parents feel that sparklers are safe because they don’t explode, however, the risk for burns is significant because they can reach 2000˚F (1093˚C) which is hot enough to melt some metals and cause severe burns.” said Dr. Guzman.

 Young children may accidentally touch the hot wire, wave sparklers near others, or drop them onto bare feet. Using glow sticks instead of sparklers is a safer, brighter, and more fun way to celebrate.

Fireworks safety tips for families

The safest way for children to enjoy fireworks is by attending a professional public display rather than using fireworks at home according to Dr. Guzman.

If your family chooses to use legal consumer fireworks, help reduce the risk by following these safety tips:

• Never allow young children to handle or light fireworks.
• Keep children and pets a safe distance away from fireworks.
• Ensure a sober adult supervises all fireworks.
• Read and follow all instructions on the packaging.
• Never relight a firework that doesn’t ignite properly.
• Keep a bucket of water or a garden hose nearby.
• Never point or throw fireworks toward another person or pet.
• Never carry fireworks in your pocket.
• Soak used fireworks in water before throwing them away.
• Avoid homemade or illegal fireworks.

What should you do if a child is injured?

If a child is burned by fireworks, move them away from the source of the injury. Cool the burn with cool water as soon as possible, remove clothing from the burned areas and apply a gauze bandage or clean, soft cloth. Seek medical care attention right away, especially for burns involving the face, hands, feet, joints or large areas of skin.

If a child has an eye injury, “do not rub the eye or attempt to wash it out; call 911 or go to the nearest emergency department,” said Dr. Guzman.

Other Fourth of July safety reminders

Fireworks aren’t the only risk during Independence Day celebrations. Parents can also help keep children safe by:

• Never leaving children unattended near pools, lakes or other bodies of water.
• Making sure children wear properly fitted life jackets when appropriate.
• Keeping kids hydrated, especially during extreme heat.
• Taking frequent breaks from outdoor activities.
• Applying and reapplying sunscreen throughout the day.
• Grilling outdoors only, keeping children at least 3 feet away from hot grills.
• Keeping matches, lighters and lighter fluid out of children’s reach.

The safest celebration is a prepared one

The Fourth of July should be remembered for time with family, not a trip to the emergency department. Choosing professional fireworks displays, supervising children and practicing simple safety precautions can help families enjoy a fun and memorable holiday while reducing the risk of serious injuries.

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That advocate was Eliza Head, a clinical coordinator for Global Health Services (GHS). First, Eliza used her experience with international insurance companies to obtain the necessary approval for coverage. Then she made an appointment for 6-year-old Sofia to see pediatric gastroenterologist Clifton Huang, M.D. in Fort Worth.

Santiago Morett and Cristina Domenech Fernandez are grateful for the support they received before, during and after their daughter’s two-day visit to Cook Children’s Medical Center- Fort Worth in February 2026. Eliza was there to greet them and show them to the registration desk, food court, playground and Peaks Tech Zone to download the MyCookChildren’s app.

Eliza also accompanied the family to Sofia’s appointment and procedure with Dr. Huang. Santiago and Cristina speak English as a second language, but they weren’t familiar with some of the medical terms. Because Eliza is bilingual and a certified medical interpreter, the family relied on her for accurate translation in their native Spanish.

“Eliza was so kind and reassuring,” Santiago said. “She made it so easy for us so we could focus on Sofia and not worry about anything else.”

Cook Children’s reputation for clinical expertise, leading-edge technology and innovative research draws patients from across the United States and around the world. GHS makes the journey of international patients easier.

Thanks to Dr. Huang’s state-of-the-art technique, Sofia and her family found some answers and relief for her gut issues. They also encountered kindness and a touch of Cook Children’s magic. Sofia’s story reflects how GHS delivers the Cook Children’s Pinky Promise -- Everything for the Child – to international patients.

Making Connections

When Sofia began complaining of tummy aches in 2025, her pediatrician in Mexico City prescribed probiotics and medications that treat acid reflux. Better for a while, her pain returned. A pediatric gastroenterologist did a colonoscopy that showed seven polyps, or growths, in the lining of her intestines. The polyps were removed and weren’t cancerous. But her parents were still concerned.

Sofia underwent a second colonoscopy, four months after the first one, in hopes of finding the cause of blood in her stool. The colonoscopy discovered six more polyps. That’s when the pediatrician recommended that Sofia get checked out at Cook Children’s. Sofia’s pediatrician had met Dr. Huang in 2025 at an immersive academic experience hosted by Cook Children’s at the Fort Worth medical center.

“He personally knew Dr. Huang and thinks he’s one of the best in the world for strange diseases in gastrointestinal tracts in kids,” Santiago said.

So, Santiago and Cristina called GHS. Monica Martina, M.D., a pediatrician and liaison for Cook Children’s in Latin America, obtained Sofia’s medical records to share with Dr. Huang. Eliza, meanwhile, worked with Payor Relations and the international insurance company to cover the costs of treatment. With the paperwork in place, Sofia’s journey to Cook Children’s had begun.

Trailblazing Technology

At their initial visit with Dr. Huang, he explained a minimally invasive technique to get a closer view of Sofia’s intestines. The technology, called confocal laser endomicroscopy (CLE), uses light and lenses to magnify tissue up to 1,500 times. Cook Children’s is one of only a few pediatric centers in the United States with CLE for gastrointestinal diagnosis and therapy.

“Technology added to the current endoscope technique puts us in a better position to assess the patient,” he said. “You have a live microscope and a better way to understand how the bowel tissue looks.”

Dr. Huang, a native of El Salvador, spoke Spanish with the family. He told them a probe would go through the endoscope working channel into Sofia’s gut, the view would be greatly magnified, and he’d be able to spot in real time any abnormal tissue that mostly is seen through processing of biopsies. He assured them a precise, thorough, risk-free inspection.

Her procedure on Day Two revealed a polyp that Dr. Huang believes wasn’t caught during Sofia’s earlier colonoscopies in Mexico. Everything else looked good. After a popsicle and apple juice, Sofia was discharged.  She and her family toured the Fort Worth Stockyards the following day. And the day after that, they headed home.

Follow-up Support

A few weeks later Dr. Huang spoke with Sofia’s parents to let them know the biopsy of the polyp came back cancer-free. Dr. Huang recommended repeating the endomicroscopy in a year. Call Eliza, he said, to set up the appointment. 

Dr. Huang also diagnosed an enzyme deficiency that was interfering with Sofia’s ability to absorb sugar. The resulting inflammation was the cause of her tummy aches, Dr. Huang explained. He advised that they consult with a local dietitian to limit how much fruit and sugar Sofia eats.   

She feels much better these days. What does she want other kids to know about Cook Children’s? “The hospital is amazing, the playground is so much fun, and the doctors and nurses are very kind. They make you feel better and make sure nothing hurts.”

Dr. Huang reassured Santiago and Cristina that Sofia’s prognosis is good. Cook Children’s gave them the comfort of expert medical care as well as empathy and attention to detail. They appreciated how Child Life specialists kept Sofia entertained with toys and stickers. All the staff showed concern for Santiago and Cristina too, making sure they understood everything.

“I saw Sofia happy and secure, and she was very relaxed and smiling and talking to everyone,” Cristina said. “I was like this is OK, this is a safe place. It was a hospital, and I was afraid, but it was a great experience. I want to go again.” 

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That assistance includes help with insurance approval, scheduling appointments, language translation and lodging in Fort Worth. It’s practical support for tasks such as retrieving and sending medical records and navigating transportation.

Leading specialties that attract international patients to Cook Children’s include cardiovascular surgery, endocrinology, gastroenterology, hematology and oncology, neurology and neurosurgery, and orthopedics.

Awareness of Cook Children’s has grown in part due to events organized by Monica Martina, M.D. and Ana Paula Cuevas-Rivas, M.D. in their role as liaisons for Cook Children’s business development in Latin American countries. Several specialists from Cook Children’s have presented their work in medical conferences around the world, offering their expertise and support.

Relationships are also being built in the Middle East. A representative based in Dubai works in the United Arab Emirates, Saudi Arabia and Oman on behalf of Cook Children’s. Bassima Dalle facilitates conferences, meetings and speaker engagements between dignitaries in the Middle East and Cook Children’s specialists. Patients have come to Cook Children’s from Bahrain, Egypt, Israel, Kuwait and Pakistan. 

Patients have also traveled to Cook Children’s from European countries -- Germany, Greece, Ireland, the United Kingdom, Romania and Hungary – as well as many countries in Latin America.

In Fort Worth, meanwhile, pediatricians from Mexico travel to Cook Children’s for an immersive academic experience sponsored by HiPP Organic, an infant formula company. These gatherings give small groups of Mexican pediatricians a chance to form trusted relationships with their counterparts at Cook Children’s.

Cook Children’s pediatric gastroenterologist Clifton Huang, M.D. is one of what the GHS staff calls their champion physicians. Dr. Huang has tremendous respect for his colleagues abroad and appreciation for their collaboration. Before accepting an international patient, GHS works to ensure that Cook Children’s can offer a solution that isn’t available in their own country.

Access to molecular imaging puts Cook Children’s at the forefront of technology, Dr. Huang said. Advantages include fewer procedures, quicker answers and personalized therapy. “These are the things we are doing at Cook Children’s.”

What to Expect

Sometimes the first contact starts when a physician refers their patient to Cook Children’s. Sometimes the parents reach out directly. After the case is reviewed by GHS and accepted by a Cook Children’s physician, the family receives a plan of care.

The GHS team works to overcome barriers. They handle the approvals from the insurance or embassy, and if neither is involved, GHS provides a cost estimate to the family. GHS also provides guidance on visas when needed.

Here’s what else international families can expect from GHS:

• Information, resources and a checklist of items to bring, such as a list of prescriptions

• A clinical coordinator assigned to your family as a main point of contact

• Appointments with all specialties your child needs

• Translation services available in Spanish, Mandarin, Arabic, Portuguese, Italian and French

• Communication with your primary physician for seamless continuation of care

As a clinical coordinator for GHS, Eliza Head serves as a dedicated patient advocate – a vital bridge between international families and our clinical teams – and coordinates operational logistics. Clinical coordinators manage the entire continuum of care for international families, not only for Cook Children’s, but with their home country providers too.

“It’s a full VIP concierge service for our international patients,” Eliza said. “We take them under our wing.”

Eliza accompanies her families to their appointments at the Fort Worth medical center. Because she is bilingual and a certified medical interpreter, Spanish-speaking families can rely on her for accurate translation. She shows families around the medical center, including the Family Health Library.

Eliza also prepares continuing education materials to send home after the visit. With parental consent, GHS shares the child’s records with the referring physician in their home country. 

Hospitality matters too. International patients visit Build-a-Bear, courtesy of GHS, to create a special keepsake. GHS also recommends a list of area attractions to see.

It’s rewarding, Eliza says, to help handle logistics so that parents can focus on their child. She pointed out the joy of seeing a patient with cerebral palsy take their first steps with a gait trainer. “We’re changing lives, and that’s what’s awesome.”

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A subtle strength takes root.

It’s found in every supportive smile

And every brave pursuit.

It’s the anchor guiding the way,

A heart so proud and true—

The hope at Cook Children’s

Starts with fathers like you.

This Father’s Day weekend, Cook Children’s celebrated the incredible dads, father figures, and caregivers who bring strength and hope to patients every single day. Festivities span the entire health care system, bringing families together for meaningful quality time at medical center campuses in Prosper and Fort Worth. 

At the medical center in Fort Worth, the system's tiniest treasures celebrated their very first Father’s Day with their families in the Neonatal Intensive Care Unit (NICU). Across town at the Prosper campus, families gathered in the atrium to create handcrafted picture frames, unique artwork, and lasting memories.