Q: What does a safe sleep environment look like for a newborn?

Dr. Kinloch: Safe sleep should be simple and honestly a little boring. A newborn should sleep:

• Alone
• On their back
• In a crib or bassinet
• On a firm mattress with a fitted sheet

That means no pillows, blankets, stuffed animals or other loose items in the sleep space.

Q: What about blankets?

Dr. Kinloch: Newborns should not sleep with blankets. Loose bedding can create suffocation and strangulation risks, which is why pediatricians recommend keeping the sleep environment completely clear.

Q: When is it time to stop swaddling?

Dr. Kinloch: As soon as babies start showing signs that they may roll over. If they're beginning to roll during tummy time, it's time to stop swaddling. Once they're actively rolling and pulling up, caregivers should also move them from a bassinet to a crib if there is a risk of falling.

Q: Why is bedsharing discouraged?

Dr. Kinloch: Bedsharing increases the risk of Sudden Infant Death Syndrome (SIDS) and other sleep-related deaths. Several factors can increase risk, including:

• Caregiver fatigue
• Alcohol use
• Certain medications
• Prematurity
• Tobacco exposure
• Sleeping on couches or recliners

In fact, sleeping with an infant on a couch or recliner is among the highest-risk situations.

Q: If babies love sleeping on caregivers, what should families do?

Dr. Kinloch: It's perfectly normal for newborns to want to be held. Caregivers should respond when infants cry, especially during the early weeks and months. Holding, comforting and responding to babies is not creating bad habits. As children grow, families can begin gently encouraging self-soothing while continuing to respond to their needs appropriately.

Q: What should caregivers know about newborn sleep patterns?

Dr. Kinloch: Babies are active sleepers. They grunt, wiggle, move and make noises throughout the night. Not every sound means they need intervention. Sometimes pausing briefly before immediately picking a baby up allows them to settle themselves back into sleep.

Q: How does safe sleep change as children become toddlers?

Dr. Kinloch: The focus shifts. With infants, we're protecting them in the sleep environment.

With toddlers, we're protecting them from themselves. That means:

• Lowering crib mattresses
• Securing furniture to walls
• Covering outlets
• Removing cords and hazards
• Transitioning to toddler beds when climbing begins

Q: When should families talk to their pediatrician about sleep concerns?

Dr. Kinloch: Anytime sleep is affecting a family's quality of life. Other warning signs include:

• Breathing problems while sleeping
• Color changes
• Persistent unusual movements
• Loud snoring
• Pauses in breathing
• Excessive daytime fatigue
• Chronic mouth breathing

If something feels off, it's always appropriate to check with your pediatrician.

Q: What about sleep aids?

Dr. Kinloch: Families should always talk with their pediatrician before starting sleep products or supplements. Not every product has strong evidence behind it, but providers can help families weigh risks and benefits.

Q: What's the best way to build healthy sleep habits?

Dr. Kinloch: Consistency. Whether it's bath, book and bed, dimming lights at the same time every evening or creating a calming bedtime routine, consistency helps children learn what to expect.

It may not work overnight, but routines become powerful over time.

Final Thoughts

Dr. Kinloch: Safe sleep is about more than where a baby sleeps. It's also about making sure caregivers have support when they're exhausted. Ask for help. Give yourself grace. Create safe sleep environments. That's one of the most important families can do.

Q: What's the difference between being shy and having social anxiety?

Dr. Pyrc: Everyone has a different social battery. Some children are naturally introverted or shy, while others thrive in social settings. Social anxiety becomes concerning when it starts interfering with daily life. If a child wants friends, wants to attend activities, or needs to participate in school but anxiety prevents them from doing those things, it may be more than simple shyness.

Q: What are some early signs of social anxiety?

Dr. Pyrc: Younger children often express anxiety physically before they can explain it emotionally.

Signs may include:

• Frequent stomachaches
• Frequent headaches
• Clinginess with caregivers
• Avoidance of social situations
• Reluctance to attend school, parties or activities

Many children simply say they want to stay home without understanding that anxiety may be driving those feelings.

Q: Has social anxiety become more common?

Dr. Pyrc: Yes. Today's children often have fewer opportunities for unstructured social interaction than previous generations. More screen time, highly scheduled activities and fewer opportunities to independently practice social skills can contribute to increased anxiety. The pandemic also played a significant role by limiting in-person interactions during key developmental periods.

Q: Are some children more likely to develop social anxiety?

Dr. Pyrc: Social anxiety can run in families, and caregiver anxiety may also influence how children view situations. Children often look to trusted adults to determine whether something is safe or dangerous. If caregivers appear highly anxious about social situations, children may begin to interpret those situations as threatening too.

Q: How can caregivers support anxious children without encouraging avoidance?

Dr. Pyrc: One of the most important things caregivers can do is lend confidence. Children benefit from hearing:

• "You've got this."
• "You can do hard things."
• "I'll support you."

When adults consistently rescue children from anxiety-provoking situations, children may interpret that as confirmation that the situation was too scary to face.

Q: What can families practice at home?

Dr. Pyrc: Role-playing can be extremely helpful. For example, if a child is nervous about giving a presentation, families can recreate the situation at home and practice repeatedly. It's also helpful to encourage participation in activities that align with a child's interests. Shared interests create natural opportunities for conversation and friendship.

Q: When should caregivers seek professional help?

Dr. Pyrc: If anxiety is interfering with a child's daily functioning, it's worth seeking support.

Examples include:

• Missing significant amounts of school
• Frequent anxiety-related physical complaints
• Social isolation
• Difficulty making or maintaining friendships
• Avoiding important activities

Because counseling takes time and waitlists can be long, early intervention is often beneficial.

Q: My child doesn't want to attend birthday parties or school events. Should I push or back off?

Dr. Pyrc: Caregivers should try to understand why the child is reluctant. Ask questions and explore specific concerns. Then work together to create a plan. In many cases, helping children gently face manageable fears builds confidence over time. Avoidance often makes anxiety stronger.

Q: What's one thing caregivers often misunderstand about anxiety?

Dr. Pyrc: Anxiety doesn't always look frantic or emotional. Many anxious children appear withdrawn, shut down or oppositional when they're actually feeling overwhelmed and scared. Connecting with the child before assuming defiance can make a tremendous difference.

Final Thoughts

Dr. Pyrc: Parenting is hard. Give yourself grace. Most caregivers are doing the best they can. Supporting children through anxiety isn't about being perfect. It's about staying connected, offering encouragement and reminding children that they can do hard things.

Since opening its doors on Aug. 5 2025 to July 2026, the Neighborhood Health Center serving the Las Vegas Trail area has welcomed more than 18,000 patient visits between JPS Health Network and Cook Children’s. The center connected thousands more community members with behavioral health visits, nutritious food, workforce training and community resources. In an achievement that cannot be conveyed by numbers alone, the center has also become a gathering place for residents and partners alike.

Partners in Purpose

The center is a first-of-its-kind partnership among JPS Health Network, Cook Children’s Health Care System, the City of Fort Worth and WestAid. More than just a clinic, it serves as a community hub, dedicated to improving health, strengthening family foundations, and providing financial stability.

At the core of the center’s mission is providing health care to people of all ages in the Las Vegas Trail area. The partnership between JPS Health Network and Cook Children’s gives every generation of the household access to access to a medical home with adult and pediatric primary care services. Cook Children’s welcomed nearly 1,500 new patients into our health care network, providing close-to-home pediatric care for the area.

“This partnership was born of our shared vision with Cook Children’s to deliver health care for the whole family that would create a transformational impact in a community with critical health care needs,” said Joy Parker, senior vice president of operations at JPS Health Network, in July of last year.

The clinic took over one year to plan and 18 months for construction.

“We knew the community needed our joint services and we were dedicated to getting it right,” said Chris Pedigo, senior vice president and chief strategy, education and community health officer at Cook Children’s.

The center’s comprehensive approach to health also includes behavioral health and social services. Since the neighborhood health center opened, Cook Children’s has referred 624 patients for behavioral health services and 379 patients for additional social services and community resource needs.

A key piece of the neighborhood center’s mission is community engagement through partnerships. The center provides a variety of programs designed for, and by, the people of Fort Worth. For example, the center partners with Tarrant County College to offer workforce development programming. From September 2025 to July 2026, 25 people enrolled in the program, where they were empowered with the skills, confidence, and professional support needed to begin a rewarding career supporting the health care industry in non-clinical roles.

The center’s partnership with the WestAid pantry helps provide nutritious food, education and support for families facing food insecurity. When construction of the neighborhood health center started, the pantry section of the building was specifically built to fit WestAid’s capacity and vision. The result is an intuitive space where people can easily shop for their groceries. From October 2025 through July 2026, the pantry provided nearly 13,363 shopping trips. Staff also prepared 6,854 sack lunches for people who are unhoused.

When the pantry opened last year, William Pherigo, MRE, then-executive director of West Aid, said the partnership with the neighborhood health center was a natural fit.

“Food is medicine, so it just makes sense with how important food and nutrition are to health that West Aid is located at the center,” Pherigo said. “It just completes the health and wellness circle there.”

The center goes beyond providing food for residents. The Demonstration Kitchen, led by Cook Children’s NHC Dietitian and Nutrition Coordinator Maya Rashad, provides hands-on learning for Las Vegas Trail residents. In its first nine months, the Demonstration Kitchen held 42 cooking classes with 437 attendees. The reviews are overwhelmingly positive: 100% of participants said they learned something new and would recommend it to others.

Nurturing Neighborhoods

About 7,000 Cook Children’s Health Plan members reside in the Las Vegas Trail corridor. When the center opened its doors, Community Health Worker (CHW) Sky Ramos became Cook Children’s first-ever clinic-based CHW. She provides face-to-face support and connects members with resources that help meet their health and social needs. However, Health Plan services are also available to anyone who needs them, including people who need help completing food and health program applications. So far, the neighborhood health center has helped 79 members apply for Medicaid, TANF, SNAP and WIC appointments. The center has participated in 82 events led or hosted by community partners.

Cook Children’s Center for Community Health provided a variety of services and resource for the community at the center, including:

• 584 dental screenings and $32,236 in dental treatment procedures.
• Over 100 summer events
• 60 tours of the Neighborhood Health Center to introduce community partners and families to available services.

“To further support the community, the Center for Community Health (C4CH) coordinated more than 100 educational summer activities during June and July attracting over 200 children and families,” Pedigo said. Topics ranged from tips on feeding your toddler to child yoga classes and education on micro gardening. The C4CH also checked 46 car seats.

“Our dedication to providing outstanding medical care and education to the children and families of Las Vegas Trail is unwavering,” Pedigo said.

Community groups are able to use the center when needed. IDEA Rise, the Fort Worth ISD, Western Hills-area schools and other community organizations have used the space for meetings and events. The Fort Worth police department also uses the space as a place to take breaks without having to leave their designated coverage area. The Fort Worth police department storefront is home to FWPD’s Crime Free Multi-Housing Program, which works to strengthen security in the area’s many apartment communities.

A Hopeful Future

In just one year, the Neighborhood Health Center has become a trusted resource for thousands of children and families in the Las Vegas Trail Neighborhood. What began as a shared vision among community partners its first year has evolved into a thriving hub for health, wellness, education and connection, laying the foundation for an even greater impact in the years ahead.

“LVT has not only brought residents and community partners together, it has also provided a special opportunity for our Cook Children’s colleagues to actively experience our values of collaboration, generosity and imagination,” said Veronica Tolley, vice president of Primary Care and Specialty Services. “In this first year, employees from all areas of our system have poured their time and energy into LVT by participating as volunteers, mentors and supporters in events like gallery night showcasing local student art, community egg hunt, mock interviews for training center, demo kitchen classes, holiday festivities, and countless other events. Thank you to everyone for embracing togetherness and delivering moments of magic to LVT!”

Q: Why did you begin creating online content for families?

Dr. Smith: Early in my career, I noticed caregivers were looking online for answers but often struggled to find reliable, practical information. Rather than criticizing families for searching online, I felt pediatricians had an opportunity to meet families where they are and provide trustworthy guidance in a way that's approachable and easy to understand.

Q: Have the questions caregivers ask changed over the years?

Dr. Smith: Absolutely. Many families arrive at appointments having already researched symptoms and tried reasonable first steps at home. Because of that, conversations in the office have become more nuanced. Instead of asking what to do first, families are often asking what to do next after those first solutions haven't worked.

Q: What concerns do caregivers commonly bring up that may seem small at first?

Dr. Smith: One common topic is behavior and communication. Families often notice that their child seems different at home than at school. Instead of asking broad questions like "How was your day?" caregivers can ask more specific questions:

• What was the best part of your day?
• Was anything frustrating today?
• Who did you sit with at lunch?

Those thoughtful questions often open the door to deeper conversations.

Q: What is one of the biggest misconceptions about parenting?

Dr. Smith: Many caregivers believe there is a perfect parenting handbook that everyone else somehow received. The reality is that parenting isn't about following an exact set of instructions. Children are constantly growing, changing and developing. Caregivers are learning right alongside them. The goal isn't perfection. It's engagement, flexibility and growth.

Q: Why are so many families feeling anxious today?

Dr. Smith: Information overload. Technology has made parenting resources more accessible, but it has also created an environment where caregivers feel pressure to know everything and get everything right. Social media often shows only the highlights of family life, creating unrealistic expectations and fueling perfectionism.

Q: Are caregivers putting too much pressure on themselves?

Dr. Smith: In many cases, yes. Parents often arrive at checkups wondering if they're doing everything correctly. While it's normal to seek reassurance, unrealistic expectations can lead to unnecessary stress, anxiety and self-doubt. Most families are doing far better than they realize.

Q: What's one symptom families tend to worry about too much?

Dr. Smith: Rashes. While some rashes require medical attention, many are harmless and resolve on their own. Context matters. A child acting normally is usually reassuring, while a child who appears ill should be evaluated.

Q: What's your best advice for busy families?

Dr. Smith: Eat together whenever possible. Shared meals create opportunities for connection, healthy habits and meaningful conversations. Putting away phones and focusing on one another may be one of the most valuable things families can do for their children's long-term physical and mental health.

Final Thoughts

Dr. Smith: You're probably doing better than you think. Children don't need perfect caregivers. They need adults who love them, support them and continue showing up each day.

Dylan had already undergone more than a year of dialysis, a filtering process that removed waste and extra fluids from his blood. Each dialysis treatment took almost four hours, three days every week, which interfered with school. And he missed certain foods he couldn’t eat.

Dialysis was necessary but wasn’t easy. That’s why Dylan decided to pursue a transplant at the recommendation of Cook Children’s nephrologist Randa Razzouk, M.D., M.S., a specialist in kidneys and high blood pressure. In February 2026 he was placed on a national waiting list for a kidney from a deceased donor.

He didn’t wait long. On March 17, 2026, the Cook Children’s Kidney Transplant Program called to say an available kidney was a good match. Later that night Dylan underwent surgery at Cook Children’s Medical Center – Fort Worth to receive the new kidney and a new lease on life.

“I feel very good. I can swim, I can eat, I can actually walk fully,” he said. ”Before, I was too weak and too tired. Now I feel energized.”

Dylan named his new kidney “Clover” in the spirit of the transplant occurring on St. Patrick’s Day. Another fun fact? Dylan was the 250^th patient to receive a kidney transplant at Cook Children’s since the program started in 1993.

The kidney transplant team at Cook Children’s involves pediatric surgeons, urologists, nephrologists, infectious disease doctors, pharmacists, therapists, social workers, child life specialists, dietitians and other experts in treating the unique needs of children and teens. Intensive follow-up helps ensure that the transplanted kidney functions properly. Here’s what to know.

Experience and Excellence

Most people have two kidneys, the organ that produces urine. The kidney performs other roles too, helping manage blood pressure and making red blood cells.

“It actually does a lot of different things,” said Robert Gillespie, M.D. MPH, medical director of kidney transplantation at Cook Children’s. “It filters out the blood and removes all the metabolic waste products, sort of like the exhaust from your car. It gets rid of any extra fluid and extra water you don’t need. All that goes out in the urine.”

A child born with abnormalities of the urinary tract might need a kidney transplant, he said. Another factor could be autoimmune disease that leads to scarring of the kidney.

Cook Children’s aims to provide a transplant before advanced renal failure occurs, Dr. Gillespie said. But sometimes renal failure develops too quickly. Once renal failure sets in, the patient will need dialysis at home overnight every night or at a dialysis center three days a week.

“There’s a lot of disruption to their lifestyle, which is especially difficult in childhood when you’re trying to attend school regularly,” he said. “The goal is always to do a preemptive transplant before they need dialysis.”

Julie Rudd, renal transplant coordinator, started working at Cook Children’s in 1992. Julie has met or helped care for all 250 patients who received kidney transplants over the years. She sees a dramatic change in energy level, appetite, cognitive ability and how much better they feel overall.

The Cook Children’s Kidney Transplant Program draws patients from across Texas and nearby states. Ages range from 2-18 years.

Steps in the process include:

• Run extensive tests to ensure potential donor kidneys are compatible with the patient's body.

• Determine if a suitable living donor is available (often a parent). If not, the patient can be placed on a list for a deceased donor’s kidney.

• Perform the transplant, which connects blood vessels from the new kidney to the patient’s vein and artery. The ureter, a tube that carries urine, connects to the patient’s bladder.

• Give instructions for taking the medications, called immunosuppressants, needed to help the body accept the new kidney.

• Follow up with frequent appointments to monitor the kidney’s function and watch for signs of rejection.

Cook Children’s also helps patients when the time comes to make the transition to adult care for their transplanted kidney.

The program benefits from a comprehensive approach and continuity of care provided by the same specialists before and after transplant. Hitting the 250 mark is an accomplishment, along with the track record of transplant success dating back to 1993.

“Cook Children’s stands out for the volume and length of time we’ve been doing it,” Dr. Gillespie said. “You want a program that does a good number of transplants to develop and maintain that expertise.”

Beyond Dialysis

One day at school in 2022, Dylan complained of a headache and dizziness. The school nurse took his blood pressure – it was alarmingly high – and Dylan was rushed to the Emergency Department at Cook Children’s Medical Center. Tests found protein and blood in his urine and inflammation of his kidneys. A kidney biopsy showed scarring.

Dylan had previously been diagnosed with Henoch-Schonlein purpura, a disease that causes small blood vessels to swell and leak. Dr. Razzouk diagnosed a related condition called IgA nephropathy, an autoimmune disease that causes IgA proteins to get trapped in the kidneys, damaging their blood-filtering vessels.

Under Dr. Razzouk’s care, Dylan received medication to lower blood pressure, diuretics to reduce swelling, and steroids to treat inflammation. Dialysis began in 2024 after a particularly severe episode of high blood pressure on vacation landed him in intensive care at a Houston hospital.

Back home to Fort Worth, Dylan came the Cook Children’s Dialysis Unit on Mondays, Wednesdays and Fridays. He couldn’t eat potatoes, bananas, chocolate and foods high in sodium because of dialysis restrictions. He’d get out of breath just by walking. His kidneys weren’t going to heal.

On several occasions Dr. Razzouk talked to Dylan about pursuing a transplant. He was a good candidate, Dr. Razzouk believed, because he was medically stable and had strong family support. Dylan also understood the long-term responsibility of taking the medication that a transplanted kidney requires.

Trulaina Banks said the decision was entirely up to her son. She’d support him whether he chose to remain on dialysis or seek a transplant. Dylan thought it over and came to the conclusion that dialysis had his life on hold, Trulaina said. He was ready to move forward with transplant.

After extensive evaluation, Dylan’s name went on the wait list for a kidney. A match came up through the donor registry, and Cook Children’s transplant surgeon Tariq Khan, M.D. put the kidney in place. Dylan still has his original kidneys, plus a C-shaped scar at the site of the incision.

Dr. Razzouk said Dylan has no more restrictions on diet or fluid intake. His blood pressure is healthier. Quality of life has improved. For Dylan’s transplant and the 249 transplants that came before it, she gives credit to the collaboration and communication of the entire transplant team.

“We provide excellent care,” she said. “We provide compassionate care.”

Trulaina advised parents to learn the facts, be honest with their child, and support them as partners in the transplant process.

“It’s going to be a tough road, but as long as you keep your faith, we’re going to get there together to where this road is smooth,” she said. “Believe in your team. Dr. Razzouk’s eye will always be on Dylan to make sure he’s good.”

Dylan sets an alarm to remember to take his daily medications. He doesn’t know the name of his donor. But he’s very grateful and wants to do what he can to keep the kidney working. He would urge any teens on dialysis to consider if a transplant might be right for them.

“Your story isn’t over,” he said. “Don’t give up.”

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The Ambassador: Following Two Kidney Transplant, Patient Hopes His Story Will Inspire

Cook Children's Health Care System earned national recognition in five specialties on the 2026-27

The recognition includes the 19th consecutive year that Cook Children's Neurology & Neurosurgery program has been nationally ranked. Notably, the program has appeared in the rankings every year since U.S. News & World Report introduced pediatric specialty rankings in 2008, reflecting nearly two decades of consistent excellence in caring for children and families.

Cook Children's was recognized in the following specialties:

• Behavioral Health (Top 50)
• Cancer (No. 41)
• Cardiology & Heart Surgery (No. 47)
• Diabetes & Endocrinology (No. 36)
• Neurology & Neurosurgery (No. 44)

For Scott Perry, M.D., head of Neurosciences at Cook Children's, the milestone reflects the dedication and expertise of teams across the organization.

"Nineteen consecutive years of national recognition reflects the strength and consistency of our neuroscience program and the exceptional teams who care for children every day," Dr. Perry said. "Maintaining that level of excellence since the rankings began in 2008 speaks to the culture of collaboration, innovation and clinical expertise that defines Cook Children's. While the health of children and their families is our focus, not rankings, it is gratifying to see the quality of care provided by our physicians, nurses, therapists and support teams recognized on a national level.”

The annual rankings evaluate pediatric centers nationwide using measures such as clinical outcomes, patient safety, infection prevention and the availability of specialized care resources.

Matthew Carroll, M.D., MHA, MSHQS, chief quality officer at Cook Children's, said the rankings process is most valuable as a tool for continuous improvement.

"The value of the U.S. News process is that it encourages us to take a close look at how we care for patients and where we can continue to improve," Dr. Carroll said. "Our focus has always been on meaningful improvements that enhance safety, quality and outcomes for children. Recognition is always appreciated, but the true measure of success is the impact our teams make every day on children and families as we deliver on our Promise."

Q: If families could focus on just one nutrition habit, what would it be?

Rashad: Start by eating together more often. Family meals allow caregivers to model healthy habits and teach children about nutrition in a natural way. When families eat together regularly, children learn what balanced meals look like and are more likely to carry those habits with them outside the home. The specific meal doesn't matter. Choose whichever works best for your family and schedule.

Q: What makes a healthy snack?

Rashad: Snacks aren't bad. They should simply help children meet their nutrition goals.

A good snack includes:

• A fruit, vegetable or whole grain
• Ideally two food groups
• A combination of carbohydrates and protein for staying power

For example, popcorn and nuts can provide both fiber and protein while helping kids feel fuller for longer.

Q: How can families avoid being influenced by unhealthy food marketing?

Rashad: Food companies do an excellent job marketing products to children. Bright packaging and well-loved characters can make certain foods appealing, but caregivers can make healthy foods fun too. Using fruit and vegetable cutters, creating playful presentations and involving children in food preparation can make nutritious options more exciting without relying on packaged snacks. Just because a food is healthy, doesn’t mean it has to be serious.

Q: What if families don't have time to prepare everything from scratch?

Rashad: Don't be afraid of convenience. Healthy eating doesn't require homemade pasta and sauces and scratch-made meals every night. Convenience items can be part of a healthy routine.

Examples include:

• Rotisserie chicken
• Frozen vegetables
• Microwavable whole grains
• Prepackaged healthy snacks

The goal is to combine convenience with nutritious additions to create meals that fit real life.

Q: Is healthy eating always more expensive?

Rashad: Not necessarily. Canned and frozen foods are often affordable, nutritious options.

Frozen vegetables are typically harvested at peak freshness and frozen immediately, which can preserve nutrients, oftentimes meaning it has more nutrients than fresh produce. Canned foods can also fit into a healthy eating plan, especially when choosing low-sodium versions or rinsing canned products before use.

Another budget-friendly strategy is incorporating more plant-based foods such as:

• Beans
• Lentils
• Plant proteins

Families can even stretch grocery budgets by combining lentils with ground beef in recipes.

Q: What should families know about food safety?

Rashad: Practice basic food safety without avoiding fruits and vegetables altogether.

Good habits include:

• Washing hands before food preparation
• Washing hands after using the bathroom
• Properly cooking foods when appropriate

Families shouldn't allow concerns about foodborne illness to discourage fruit and vegetable consumption.

Q: Why is it important to involve children in cooking?

Rashad: Kids can begin helping in the kitchen much earlier than many people think.

Even children as young as two years old can participate by:

• Rinsing produce
• Removing stems from fruits
• Assisting with simple food preparation

Cooking builds confidence, teaches life skills and helps children develop a healthier relationship with food.

Q: How many times should a child be exposed to a food before deciding they don't like it?

Rashad: Research shows it can take 10 to 15 exposures. Exposure doesn't mean eating the food every time. Simply seeing it, helping prepare it or having it on their plate counts. Caregivers should:

• Remain patient
• Stay positive
• Ask questions
• Avoid pressure

Treat unfamiliar foods with curiosity rather than frustration. If a child doesn’t want to eat something and ask them why and turn it into a conversation.

Q: What's the biggest nutrition myth parents should know?

Rashad: Nutrition isn't supposed to be perfect. Many caregivers focus too much on perfection when consistency matters more. A healthy pattern includes:

• Variety
• Small sustainable changes
• Flexibility
• Grace for yourself and your family

Final Thoughts?

Rashad: Nutrition should be a family affair. The more families involve children in meal planning, cooking and conversations about food, the more likely healthy habits will stick for the long term.

Editor's note: Patient-specific details have been removed to protect privacy.

In the dark, uncertain hours following Sept. 11, 2001, the United States was under an unprecedented, total military lockdown. Civilian aviation had vanished. Air traffic control screens were completely blank, commercial tarmacs were dark, and the sky belonged exclusively to heavily armed military fighter jets.

Yet hundreds of miles away, a critically ill infant needed specialized care available at Cook Children’s Medical Center in Fort Worth. A ground ambulance would take hours, making air transport essential. It was a literal matter of life or death, requiring a miracle just to get off the ground.

While the rest of the nation held its breath, the dispatchers and command at Cook Children’s waged a frantic battle on the phones, coordinating directly with the Federal Aviation Administration (FAA) and military command. Recognizing the stakes, authorities granted the Teddy Bear Transport crew a historic, highly exclusive emergency waiver.

Approximately 48 hours after the nation was attacked, pilots Todd Stephens and Ray Crain stepped into the cockpit of the King Air 200 along with the Neonatal Critical Care Team. When they advanced the throttles and lifted off into the North Texas night, they became one of the only civilian flight crews permitted into United States airspace.

The crew flew into a historical vacuum. Surrounded by eerie, echoing silence on the radio, looking down at completely dark, abandoned commercial runways, and flying with the watchful eyes of NORAD tracking their every move, Todd and Ray pressed onward through the empty sky.

As they neared their destination, the true magnitude of their mission became visually striking. Out of the darkness, two military fighter jets scrambled from a nearby base and dropped into formation, flanking the Teddy Bear Transport plane. Escorted closely by the roaring, heavily armed fighters through a locked-down sky, Todd and Ray piloted the medical aircraft safely to its destination under the protective watch of the United States military.

They flew not out of comfort, but out of a profound duty to a child they had never met. Because of their courage, skill, and willingness to fly when the world was gripped by fear, they safely retrieved that newborn. They delivered the baby to the intensive care unit in Fort Worth and gave a family a lifetime of birthdays.

As we mark the 25th observance of 9/11, we honor the crew of that flight. Todd Stephens, Ray Crain and Cook Children’s stand as a shining reminder that even in humanity’s darkest and quietest moments, heroes will always find a way to bring light, hope and life back into the sky.

Written by Marc Mazade, M.D., MPH, medical director of Infection Control and Prevention at Cook Children's

My high school basketball coach insisted that we get a flu vaccine every year. He knew that flu is much more than just a cold.

Flu is like getting hit by a train. He knew that recovery could take a couple of weeks.

Flu vaccines might make you feel bad for a day, but feeling bad is a sign that our immune systems are working. That’s much better than getting knocked out of the game, missing a week of band competition, missing the big trip, or staying in bed while others exchange holiday gifts and treats.

Flu season can run from November to May, so getting the flu vaccine in fall provides the longest protection from flu.

During the last flu season, nearly 6,000 kids came to the emergency department and nearly 600 kids were hospitalized with flu at Cook Children’s Medical Center in Fort Worth (some would say an average season).

Keeping folks out of the hospital is the main benefit of getting a flu vaccine, but not the only one. Because flu is passed between friends at school then spreads to family members, immunizing kids is key to controlling flu outbreaks.

Closing hard-hit schools worsens hospital staff shortages as working parents must take off work to be with their kids, even when their kids aren’t sick. That can mean longer waiting times for patients and more shifts for exhausted health care workers.

In 2025, the seasonal flu story got more interesting. An escape virus erupted onto the scene like a flash fire!

Scientists found that “Subclade K” is a strain of influenza A (H3N2) that binds better to the membranes in our noses and is less sensitive to some antibodies (stuff that Infectious Diseases doctors love to chat about).¹ Improved viral fitness means that chances are good that this escape virus will keep coming back until it is knocked off by a more fit flu strain.

A big question last year was, “How effective are influenza vaccines going to be against the escape virus?”

Thankfully, vaccine protection against hospitalization was pretty good, even among adults. But something extraordinary happened in kids who took the vaccine. While the vaccine protected adults against mild, moderate and severe flu only 32-39% of the time, kids were protected 70-79% of the time.

It seems that children get more “bang for the buck” from influenza vaccine than adults. Also, for those who were not exposed to flu last year, this year’s influenza vaccines provide better protection against the escape virus.

My coach made sure we got our flu shots because he didn’t want us watching from the sidelines. Years later, the science supports that same advice. Children receive remarkable protection from influenza vaccination, helping them avoid serious illness, stay out of the hospital and remain where they belong: in school, with their friends and families, and in the game.

¹Al-Natour, L.M. 16 June 2026. Emerging Influenza A (H3N2) Subclade K: A narrative review. Natural Resources for Human Health, 6(3s). Pages 678-687. https://nrfhh.com/index.php/journal/article/view/522

Q: How much screen time is too much for a child?

Dr. Greenhaw: In a new policy statement, “Digital Ecosystems, Children, and Adolescents”, the American Academy of Pediatrics has moved away from strict time limits because they often create conflict within families. That said, there are still some general guidelines.

For children younger than 18 months, screen use is discouraged except for things like video chatting with family. For toddlers and preschool-aged children, small amounts of high-quality content may be appropriate, but the recommendation is still to keep it fairly limited.

As children get older, screens become harder to avoid entirely, but probably not nearly to the extent most kids use them today. Research shows average screen use increased dramatically after COVID, and many children are spending far more time on screens than recommended.

Q: Why are babies and young children so captivated by screens?

Dr. Greenhaw: It's actually neuroscience.

A baby's job is to learn about the world, and their brains are designed to orient toward things that are new, exciting and stimulating. Screens provide a constant stream of novel stimuli, so they're almost perfectly designed to capture a baby's attention.

The challenge is that babies learn best from real-world experiences and interactions with other people, not from a two-dimensional screen.

Q: Is educational content really different from other types of screen time?

Dr. Greenhaw: Kind of.

Many parents assume educational content is automatically beneficial, but the research is more nuanced. Some studies show that educational content can be helpful in small amounts, but the benefits tend to plateau after about 30 minutes per day.

Beyond that point, children begin experiencing more of the same risks associated with screen use in general.

It's also important to examine how the app or platform is designed. If it's loaded with advertisements, endless scrolling, autoplay features or in-app purchases, it's probably focused more on keeping your child engaged than supporting learning.

Q: What should parents know about "engagement-based design"?

Dr. Greenhaw: Many platforms are intentionally designed to keep users engaged for as long as possible.

Social media platforms, videos that automatically play the next video and apps that constantly encourage purchases all use strategies that keep children coming back.

If an app's primary goal is holding a child's attention rather than supporting development, that's something parents should pay attention to.

Q: What are the biggest concerns associated with excessive screen use?

Dr. Greenhaw: One helpful question for parents is: “What are screens replacing?”

Sleep is probably the biggest concern. When screens interfere with sleep, that can affect learning, mood and overall health.

The effects can also look different depending on a child's age.

For younger children, excessive screen use has been linked to language difficulties and attention problems. For preteens, screens can begin replacing opportunities to learn emotional regulation and face-to-face social skills. For teenagers, excessive use is associated with increased risks for depression, disordered eating and suicidal thoughts.

Q: What about educational screen use for schoolwork?

Dr. Greenhaw: Most of the concerns involve entertainment-based media rather than school-related work.

If a child is genuinely using their device to complete assignments, that's generally not where we're seeing the biggest problems.

What I recommend is having homework happen in a common area of the home where parents can casually supervise how devices are being used.

Q: How can parents tell when screen use is becoming a problem?

Dr. Greenhaw: The framework actually looks a lot like addiction.

Warning signs include:

· Becoming preoccupied with devices

· Constantly thinking about when they'll get screen time again

· Significant meltdowns when screens are removed

· Irritability when they can't use a device

· Giving up other activities they previously enjoyed

· Declining school performance

· Pulling away from friends and family

When screens start getting in the way of everyday life, that's a signal that the relationship may be becoming unhealthy.

Q: Do parents' screen habits really affect their children?

Dr. Greenhaw: Absolutely.

Research consistently shows a direct relationship between parent screen use and child screen use. Some studies suggest that for every additional hour a parent spends on a smartphone, children spend about 20 more minutes on screens as well.

Part of that is modeling. Kids watch what we do.

There's also a relationship component. When parents become absorbed in devices, children naturally seek attention. That can create a cycle where parent stress increases, device use increases and children act out to reconnect.

Q: If screens feel like they've taken over family life, where should parents start?

Dr. Greenhaw: First, give yourself grace.

These platforms are designed to capture our attention. This isn't simply about willpower.

One of the easiest places to start is creating screen-free zones, especially bedrooms. Sleep is one of the biggest things screens interfere with.

I recommend creating a family charging station somewhere outside bedrooms and having everyone, including parents, charge devices there at night. Ideally, devices should be put away at least an hour before bedtime.

Q: What's the American Academy of Pediatrics' approach to reducing screen time?

Dr. Greenhaw: They talk about something called "crowding in."

Instead of focusing only on taking screens away, focus on adding activities that naturally replace screen time. Family dinners, sports, physical activity, board games, time with friends and family interactions all help crowd out unnecessary screen use while supporting healthy development.

Q: Why is the dinner table such an important place to put devices away?

Dr. Greenhaw: Conversation is how children learn to communicate.

Think of a conversation like a volleyball game. One person serves the ball, the other person sends it back, and the interaction continues. When a parent continually looks at a phone during that exchange, it's like letting the volleyball drop.

Screens interrupt opportunities for children to practice communication, social awareness and emotional connection.

Q: What's your advice for parents working from home?

Dr. Greenhaw: Keep work and family time as separate as possible.

Young children may not understand every detail of a parent's job, but they can understand simple, consistent messages like, "Mommy is working right now," and later, "Mommy is done working and available now."

Consistency helps children understand expectations and reduces confusion.

Q: Many parents feel guilty about screen time. What would you say to them?

Dr. Greenhaw: Most families are struggling with this.

The majority of households aren't perfectly meeting screen-time recommendations, and parents should know they're not alone.

The goal isn't perfection. The goal is being intentional about your screen use and being present when you're with your children.

Q: What's the one screen-time rule every family should have?

Dr. Greenhaw: No screens at the dinner table.

Q: True or false: Educational content gets a free pass on screen-time limits?

Dr. Greenhaw: False.

Q: What's the biggest myth about screen time?

Dr. Greenhaw: That the amount of time matters most.

What children are doing on screens and what those screens are replacing often matters more than the number of minutes they're using them.

Q: When should a child get their first phone?

Dr. Greenhaw: This is complicated, and every child is different.

Parents should start talking about digital media literacy early so children understand things like advertising, algorithms and how platforms are designed to keep users engaged.

If you're looking for a general guideline, most children 12 and younger probably don't need a smartphone. A basic phone that allows calls and texts may meet most families' needs without introducing all the risks that come with smartphones and social media.

Final Thoughts?

Dr. Greenhaw: Focus less on the amount of time and more on what the device is getting in the way of. Ask yourself:

· What is my child doing on the device?

· Is it causing problems at home, school or socially?

· What activities is it replacing?

We can all become anxious about screen-time numbers, but those broader questions often matter much more than the clock.

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.

RELATED STORIES
Let the Sunshine In: Cook Children's Advances Legacy of Healing and Hope with New Patient Tower
Cook Children’s Unveils Plan to Expand Critical Care to Meet Community Demand
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.

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What Families Should Know About Hepatitis B
Back-to-School Breakdown: Preparing for Class with the MMR Vaccine
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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.

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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.

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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.