People will see temperatures from 7 degrees to 17 degrees, with wind chills as low as minus 10 degrees. Families need to take precautions. 

Keep Warm 

Babies less than a year old should not sleep in a cold room because they lose body heat more easily than adults, according to the Centers for Disease Control and Prevention (CDC). Yet, it is important to keep infants warm safely. 

• Do not have any pillows or other soft bedding in the crib or bassinet.  
• For sleep, dress babies in footed pajamas, one-piece wearable blankets, or sleep sacks. 
• Make sure newborns are dressed appropriately. Dress them in layers and cover their heads, hand,s and feet. 
• For the most warmth, dress your little ones in wool instead of cotton.  
• Essential winter items include hats and gloves, as well as sweatshirts or T-shirts that can be layered under overcoats or jackets. 
• It is important to remember to take off winter coats and jackets when the child is in the car seat.  

Know the Signs of Hypothermia 

 According to the CDC, hypothermia, or abnormally low body temperature, "is a dangerous condition that can occur when a person is exposed to extremely cold temperatures." This is a medical emergency, and treatment should be sought immediately. 

 Symptoms of hypothermia include: 

• Blue skin, shivering, and a cool chest and stomach are signs that children may be dangerously cold. If you see these signs, take action immediately to get kids out of the cold. Seek immediate medical attention if you are not able to warm the body. 
• Victims of hypothermia can include babies sleeping in cold rooms. 

 Warning signs for infants include: 

• Bright red, cold skin 
• Very low energy 

 Warning signs for adults include: 

•  Shivering, exhaustion 
• Confusion, fumbling hands 
• Memory loss, slurred speech, drowsiness 

Winter Heating Safety  

Keeping warm in frigid temperatures is important, but do so safely. Make sure to have functioning carbon monoxide detectors and fire alarms installed in areas that will wake you up. If you are unable to keep safely warm in your own home, check local resources for warming shelter information. Seek medical attention if you suspect carbon monoxide poisoning. 

•  Use electric space heaters with automatic shut-off switches. 
• Keep heat sources, like space heaters, at least 3 feet away from drapes, furniture, bedding, or other flammable materials. Never cover your space heater. 
• Do not leave children unattended near a space heater. 
• Make sure that the cord of an electric space heater is not a tripping hazard, but do not run the cord under carpets or rugs. 
• Avoid using extension cords to plug in your space heater. 
• Use fireplaces, wood stoves, or other combustion heaters only if they are properly vented to the outside and do not leak gas from the flue or exhaust into the indoor air space. 
• Do not use anything, such as a barbecue grill or propane tank to heat your home. 
• Do not run a vehicle inside of a garage attached to your home. 
• Do not heat your home with a gas oven or stovetop. 
• Do not burn charcoal inside your home. 

 Signs of carbon monoxide poisoning can include: 

• Headache 
• Nausea 
• Dizziness 
• Vomiting 
• Upset Stomach 
• Chest Pain 
• Confusion 

Car safety in frigid temperatures

Proper car seat use is one of the most critical ways parents can keep their young children safe when driving during inclement weather conditions.  

 Here are a few safety tips to consider: 

• Do not strap your children into their car seats with their heavy coats on. In a crash, padding from a coat or thick layers will flatten out, leaving room under the car seat harness. This increases the risk of a child slipping through the straps and being thrown from the car seat. Instead, dress your child in thin layers. Once buckled up, slip the coat on backward with the sleeves on the child’s arms. This way, the coat acts as a blanket and does not affect the fit of the harness. 
• Give yourself extra time to get where you are going. Do not forget to account for traffic.  
• Pack an emergency bag for your car. It’s a good idea to have blankets, warm clothing, hats, and gloves available in case you become stuck in winter weather. You will also want to have nonperishable snacks packed away. 
• Avoid overpasses if possible. Plan alternate routes to your destination and avoid high-traffic areas when possible. 
• Give yourself enough space from the car in front of you to gradually brake. When weather conditions are poor, give yourself double the time it normally takes to come to a complete stop. 

De acuerdo a NWS se espera entre 3 a 6 pulgadas de nieve al norte de la I-20.

Lo mejor que uno puede hacer es tener un plan para mantener a todos en su familia seguros y calientitos.

Siga estos consejos de MedStar en preparación para el tiempo invernal:

• Asegúrese de tener números de teléfono importantes anotados, incluyendo sus proveedores de atención médica, farmacia y veterinario.
• Asegúrese de tener suficiente medicamento a la mano para varios días.
• Si depende de dispositivos médicos en su hogar, tenga un plan de respaldo en caso de que se quede sin electricidad durante un período prolongado, como un generador o paquete de baterías y el equipo de oxígeno.
• Tenga un plan de comunicación para su familia.
• Sepa cómo obtener información confiable durante la tormenta.
• Reúna suministros por si necesita quedarse en casa por varios días sin electricidad.

Abríguese 

• Asegúrese de que los recién nacidos estén vestidos apropiadamente. Vístalos en capas y cúbrales la cabeza, las manos y los pies.
• Para mantenerlos más calientitos, vista a sus pequeños con lana en lugar de algodón. Los artículos esenciales de invierno incluyen gorros, guantes, sudaderas o camisetas que pueden colocarse debajo de abrigos o chaquetas.
• La piel azul, los escalofríos, el pecho y el estómago frío son señales de que los niños pueden tener un frío peligroso (hipotermia). Si ve estos signos, tome medidas de inmediato para sacar a los niños del frío. Busque atención médica inmediata si no puede calentar el cuerpo. 

Esté atento a los síntomas de hipotermia.

Según los Centros para el Control y la Prevención de Enfermedades (CDC, por sus siglas en íngles), la hipotermia, o temperatura corporal anormalmente baja, "es una condición peligrosa que puede ocurrir cuando una persona se expone a temperaturas extremadamente frías".

Las señales de advertencia para los adultos incluyen:

• Tiritar
• Sentirse agotado o muy cansado
• Confusión
• Torpeza con las manos
• Pérdida de la memoria
• Habla enredada
• Somnolencia

Las señales de advertencia para los bebés incluyen:

• Piel fría y de color rojo brillante
• Muy poca energía

Entre las víctimas de la hipotermia se encuentran los bebés que duermen en habitaciones frías.

Si hay un apagón, tenga mucho cuidado con el monóxido de carbono.

Durante la tormenta invernal de Texas en febrero de 2021, Cook Children's trató a 13 pacientes por intoxicación por monóxido de carbono en una noche.

Consejos para proteger su familia durante este tiempo:

• No utilice una parrilla o un tanque de propano para calentar su casa, ni nada similar.
• No prenda su vehículo dentro de un garaje adjunto a su casa con la puerta cerrada.
• No caliente su casa con un horno o estufa a gas.
• No queme carbón dentro de su casa.
• Busque atención médica si sospecha que ha sufrido una intoxicación por monóxido de carbono.
• Asegúrese de que los detectores de monóxido de carbono de su casa funcionen correctamente y estén instalados en áreas que lo despierten si suena la alarma.
• Busque recursos locales, como refugios para calentarse.

Los signos de intoxicación por monóxido de carbono pueden incluir:

• Dolor de cabeza
• Náuseas
• Mareos
• Vómitos
• Malestar estomacal
• Dolor de pecho
• Confusión
• Síntomas similares a los de la gripe

Los asientos de seguridad en el invierno

El uso adecuado de la silla de seguridad del auto es una de las formas más importantes en que los padres pueden mantener seguros a sus hijos pequeños, especialmente cuando conducen en condiciones climáticas adversas.

• No abroche a sus hijos en la silla de seguridad del coche con su abrigo. En caso de un accidente, el relleno de un abrigo o de capas gruesas se aplanará, dejando espacio debajo del arnés de la silla de seguridad. Esto aumenta el riesgo de que un niño se resbale a través de las correas y salga a través del asiento del coche. En su lugar, vista a su hijo con capas finas. Una vez abrochado el cinturón, deslice el abrigo hacia atrás con las mangas sobre los brazos del niño. De esta manera, el abrigo actúa como una cobija y no afecta el ajuste del arnés.
• Programe tiempo adicional para llegar a su destino. Y no olvide tomar en cuenta el tráfico.
• Prepare una bolsa de emergencia para su auto. Es una buena idea tener cobijas, ropa de invierno, gorros y guantes disponibles en caso de que se quede atrapado. También tenga alimentos no perecederos guardados.
• Evite los puentes elevados, si es posible. Planifique rutas alternativas para llegar a su destino y evite las zonas de mucho tráfico.
• Deje suficiente espacio con el vehículo que va delante para frenar gradualmente. Cuando las condiciones meteorológicas sean adversas, se toma para frenar el doble de tiempo que
• normalmente se necesita para detenerse por completo.

This is resulting in longer wait times. Our emergency department is seeing between 400-500 children each day. Our Urgent Cares are seeing 600-700+ children each day.

A high number of our hospital admissions are RSV cases. RSV can range from mild upper respiratory tract infections to severe lower respiratory tract disease, including bronchiolitis or pneumonia. The increase in RSV and influenza A is happening much earlier this year.

From Oct. 2 to Oct. 8, there were 210 positive RSV cases at Cook Children’s, a positivity rate of 24%.

One week later (from Oct. 9 to Oct. 15), there were 288 positive RSV cases, a positivity rate of 29%. During the same time period, there were 47 positive influenza A cases, a 4.7% rate.

RSV cases normally spike much later in the respiratory season, such as in December or January.

RSV is a very common respiratory virus. Some children require hospitalization, but most do not.

Parents should not go to the Urgent Care or Emergency Department for only a flu or a COVID test. See your pediatrician, who can test for flu, RSV, strep throat and COVID. Adults can also use at-home tests or tests at a pharmacy.

Laura Romano, D.O., a hospitalist at Cook Children’s, urges parents to keep their children at home when they are sick to prevent the spread of illness, especially to vulnerable populations. Flu, COVID and rhinovirus are also circulating in our community.

Last year, more people were wearing face masks and children were more likely to stay home while sick. This year, parents are sending their children to daycare and school for the first time following two years of the pandemic, Dr. Romano said. Children who haven’t been previously exposed to respiratory viruses are getting sick.

There are limited treatments for RSV; most are available for premature infants, infants with other lung diseases, infants who are considered immunocompromised, or patients with a congenital heart disease.

What are the symptoms of RSV?

In infants younger than six months, RSV infection may result in symptoms of irritability, poor feeding, lethargy, and/or episodes where they stop breathing with or without fever.

In older infants and young children, a runny nose and decreased appetite may appear one to three days before cough, often followed by sneezing, fever, and sometimes wheezing. RSV, COVID, and the flu can all worsen a child’s asthma and lead to an increase in asthma symptoms such as wheezing, waking up at night coughing, and shortness of breath.

Symptoms in adults are typically consistent with upper respiratory tract infections, including runny nose, sore throat, cough, headache, fatigue, and fever. RSV can be a very serious illness for anyone who is immunocompromised. But for most children, it is a minor upper respiratory infection.

If parents begin to see any RSV symptoms in their child, it is important to keep them well hydrated.

Call your pediatrician if:

• You are concerned that your child might have been exposed to either the flu, RSV, or COVID.
• If your child is experiencing mild respiratory symptoms but is not having difficulty breathing and is well-hydrated.
• If you need to have your child tested for RSV, the flu, or COVID.

Seek immediate medical care if:

• Persistent fever for more than two or three days. However, any temperature greater than 100.4 in an infant under two months of age is considered a medical emergency.
•  Concerns for dehydration.
•  In dehydrated babies, parents will see fewer wet diapers or a lack of tears. Their flat spot can also appear more sunken.
• Breathing faster than usual or can see the skin between the ribs being sucked in.
• If your child is requiring frequent use of their albuterol rescue inhaler or is having worsening asthma symptoms.

Prevention

•  Get the flu vaccine and stay up to date on the vaccine schedule from the Centers for Disease Control and Prevention.
• Get the COVID vaccine.
• Teach your children to cough or sneeze into their elbow.
• Use hand sanitizer.
•  If you’re sick, wear a mask in public and stay home.

As you can imagine, this has led to frustration for those seeking care. Our exhausted staff has heard an abundance of complaints and mean comments that are discouraging when they are working so hard to serve our patients and families. Unfortunately, they are outmatched by the demand.

Here’s what we know:

1. The vast majority of patients in our UCCs and ED have upper respiratory infections like colds.
2.  Most COVID-19 tests are coming back negative.
3.  All of our pediatrician offices offer COVID testing and it’s safe to wait one to two days for COVID testing if you plan to keep your child at home.
4. If your pediatrician does not have available appointments for your child’s cold symptoms, there are at-home COVID-19 tests available in stores currently.
5. Minor concerns like sore throat, cough, low-grade fever, diarrhea and other stomach problems are issues your pediatrician can help with.
6. The ED should only be used for severe symptoms and injuries.
7. The UCC should be used for moderate symptoms and injuries.

Media partners: If you are interested in telling this story, please contact Public Relations Manager Kim Brown at Kim.Brown3@cookchildrens.org or at 682-885-1080, 817-266-3728

For information about some common questions we hear, take a look at these articles:

• My Child's Fever Isn't Going Away. Should I Be Worried? (checkupnewsroom.com)
• Fever, Headaches and Stomach Pain. When Should You Be Concerned? (checkupnewsroom.com)
• Does My Kid Have Allergies, COVID, a Cold or the Flu? (checkupnewsroom.com)
• 5 Reasons Why Your Child's Coughing Is A Good Thing (checkupnewsroom.com)
• Let's Learn About Fevers (checkupnewsroom.com)
• How Much Sickness Is Too Much? (checkupnewsroom.com)

Spring is officially here! Along with the start of spring, allergies are starting back up again as well. However, at Cook Children’s there has been an increase in flu cases at CCHCS this past month and the cold season isn’t over just yet along with the COVID-19 pandemic.

Let’s figure out how to tell if your child has a cold, the flu, allergies or COVID-19.

Right now, your child’s sneezing, cough or fever may just scratch the surface as to which of the four it could be.

“Even though it’s spring, parents need to keep in mind some of those winter viruses are still circulating. There are a lot of respiratory viral illnesses still going around that we associate with the wintertime,” said Bianka Soria-Olmos, D.O., pediatrician at Cook Children’s Haslet Office said. “In Texas, the weather is not full on spring, it is still cold outside some days.”

Allergies

Allergies are caused by pollen and the environment.

“Allergies usually do not have any of the symptoms that viruses usually cause fever, body aches, or overall general ill feeling,” Dr. Soria-Olmos said. “Most kids with allergies are going about their normal day other than the nuance of symptoms. The overlapping makes things confusing.”

Cold, Flu or COVID?

Symptoms of the common cold, the flu and COVID are very similar. The main way to tell the difference is through testing.

Each of these is a virus that affects the body and can affect the way kids act. A fever is the most common symptom to monitor between the cold, flu and COVID-19.

Cold and flu typically come with additional symptoms such as a decrease in appetite, fatigue, chills, etc. Sometimes you can have a cold without fever. Flu typically causes an increase in temperature.

Parents of children under the age of 2, should contact their pediatrician if the fever continues for more than 48 to 72 hours. This is to help determine if the doctor should see the child and or if a parent can continue supportive care at home.

Although we have seen fewer COVID-19 cases in the community, it is still something to think about as a cause of fever, cough and nasal congestion or sore throat.  

“Testing is the main way to help us determine between different causes of similar symptoms,” Dr. Soria-Olmos said.

Dr. Soria-Olmos encourages parents to speak with their pediatrician on how to treat their child and identify the cause of their symptoms.

After last February’s big freeze and mass power outages, it’s understandable to be a little uneasy about the forecast. But thankfully, this cold plunge isn’t expected to last as long as last year’s storm.

Still, it’s a good idea to have a plan in place.

Take these tips from MedStar on what a winter weather plan should include:

• Make sure that you have important phone numbers, including for your health care providers, pharmacy, and veterinarian.
• Assure you have enough medication for several days on hand.
• If you rely on medical devices in your home, have a backup plan in case you lose power for an extended period of time, such as a backup generator or battery pack and backup oxygen bottles.
• Have a communication plan for your family.
• Know how to get reliable information during the storm.
• Gather supplies in case you need to stay home for several days without power.

If the power does go out, be very cautious of carbon monoxide.

During last February’s winter storm, Cook Children’s treated 13 patients for carbon monoxide poisoning in one night. Sam Selby, D.O., worked the overnight shift in the emergency department on Feb. 15, 2021 and saw families use propane or diesel-burning engines that are meant for outside use with adequate ventilation.

In this Checkup Newsroom article, he described families using generators inside or too close to their homes or garages to keep warm. Generators emit fumes and can cause carbon monoxide poisoning.

“Carbon monoxide poisoning prevents your blood from being able to bind to or carry oxygen. You suffocate while you are still breathing,” Dr. Selby explained. 

Here are some additional ways to keep your family safe during this time:

• Don’t use anything such as a BBQ grill or propane tank to heat your home.
• Don’t run a vehicle inside of a garage attached to your home.
• Don’t heat your home with a gas oven or stovetop.
• Don’t burn charcoal inside of your home. 
• Do seek medical attention if you suspect carbon monoxide poisoning.
• Do ensure the carbon monoxide detectors in your home are properly functioning and installed in areas that will wake you if it alarms.
• Do check for local resources, such as warming shelters, to keep your family safe. 

The best bet during winter weather is to stay off the roads. 

If you have to travel, have a plan in place to keep yourself and your child safe.

Proper car seat use is one of the most critical ways parents can keep their young children safe when driving during inclement weather conditions.

“The injuries we see from car wrecks are because parents are making the same mistakes over and over with car seats,” explains Sharon Evans, trauma injury prevention coordinator at Cook Children’s.

She reminds parents to keep children calm and quiet when traveling, whether that means playing their favorite music, letting them bring a safe toy, or talking with them before leaving home.

“Children can read your emotions,” she said. “If you’re uptight, they will be able to sense it.”

More to consider before getting behind the wheel:

1. Don’t strap your children into their car seats with their heavy coats on. In a crash, padding from a coat or thick layers will flatten out, leaving room under the car seat harness. This increases the risk of a child slipping through the straps and being thrown from the car seat. Instead, dress your child in thin layers. Once buckled up, slip the coat on backward with the sleeves on the child’s arms. This way, the coat acts as a blanket and doesn’t affect the fit of the harness.
2. Give yourself extra time to get where you are going. And don't forget to account for traffic. 
3. Pack an emergency bag for your car. It’s a good idea to have blankets, warm clothing, hats, and gloves available in case you become stuck in winter weather. You’ll also want to have nonperishable snacks packed away.
4. Avoid overpasses if possible. Plan out alternate routes to your destination and avoid high traffic areas when possible.
5. Give yourself enough space from the car in front of you to gradually brake. When weather conditions are poor, give yourself double the time it normally takes to come to a complete stop.

Want to know more about winter weather safety? 

Check out these articles from Checkup Newsroom contributors:

• Cold Weather and Kids. How to Keep Your Family Safe at Home, Outside and in the Car. 
• Bracing for Freezing Weather: Plan Ahead to Protect Your Family on the Road
•  Common Winter Mistakes Parents Make
• Cook Children’s Sees Spike in Carbon Monoxide Poisoning Patients During Freezing Temperatures

Positive cases now account for 31% of tests throughout Cook Children’s Health Care System, about 600 a day. It’s the highest number seen at Cook Children’s since the pandemic began in March 2020 and surpassing the height of the delta surge in September. As of Tuesday, 33 patients were hospitalized, with three being treated in the Pediatric Intensive Care Unit (PICU).

The latest explosion in COVID-19 cases may be fueled by both the omicron and delta variants at work, according to a report released last week by the Centers for Disease Control and Prevention (CDC). As of the week ending Dec. 25, omicron appeared as the dominant variant, but the delta variant still comprised roughly 40% of reported cases, the report states.

Mary Suzanne Whitworth, M.D., medical director of Infectious Diseases at Cook Children’s, was interviewed on “CBS Mornings” this week. She says the hospital’s pediatricians and clinics have seen children and teens of all ages testing positive.

“It’s really anywhere on the spectrum,” she says of the recent spike. “We’ve had some babies who were only a few weeks old.”

Other children’s hospitals in Texas and across the country have seen a similar uptick in sick children overwhelming the health care system. More than 325,000 positive cases were reported during the week ending Dec. 30, the American Academy of Pediatrics reported, adding it was the nation’s highest increase in child COVID cases since the pandemic began. The unprecedented number represents a 64% jump from reported cases the previous week.

Top health officials in the country have voiced predictions that a surge may continue as a result of holiday gatherings and vacations but expect it to peak by the end of January based on how the omicron variant behaved in South Africa last month.

With numbers of child cases still on the rise, parents are grappling to address all things COVID. Here’s what families need to know:

How can you tell the difference between COVID and the common cold or the flu? Basically, it’s tough to distinguish between them.

Similar to a cold, the most common symptoms of the omicron variant (found to be much more transmissible) are sore throat, cough, fatigue, congestion and runny nose. The delta variant (thought to cause more severe illness) also generally presents with common cold-like symptoms, such as cough, fever or headache, but also may cause a significant loss of smell.

To complicate matters, COVID-19 also shares some common symptoms with the flu, according to the CDC. Both can show a wide-range of symptoms, including sore throat; fever and chills; headache; cough; shortness of breath or difficulty breathing; fatigue; runny or stuffy nose; body or muscle aches; vomiting and diarrhea; and a change or loss of taste or smell, though that appears more prevalent in COVID.

Since it can be difficult to distinguish between the cause of these symptoms, a test is the best way to determine what it is. COVID testing can be done at home (although tests may be difficult to find right now), at a laboratory or at a test site provided in your area.

 “At this point, it’s probably best to assume you are positive until you are proven otherwise,” says Marc Mazade, M.D., director of Infection Control at Cook Children’s. If family members are having symptoms, they should get tested as soon as possible, which may take longer than usual.

See the CDC website for additional guidelines on who and when someone should get tested.

 Are vaccines the best way to keep my kids from getting seriously ill with COVID-19?

Yes. As it stands, COVID-19 vaccinations are highly effective at preventing severe illness, hospitalizations and death, the CDC reports. And the emergence of the highly contagious variant omicron and its ability for breakthrough infections further emphasizes the importance of vaccination and boosters, the report states.

Children ages 5 and up are eligible for COVID-19 vaccines. This week the Federal Drug Administration (FDA) approved an additional Pfizer booster shot for children ages 12-15, and an additional dose for certain children ages 5-11 if they are immunocompromised.

Cook Children’s pediatrician Diane Arnaout, M.D., encourages eligible children to get COVID-19 vaccines and boosters.

“Don’t let the number of shots worry you,” she says to parents who may have concerns. “There are lots of vaccines that require boosters, and I give them to your kids throughout their early years at timed intervals to make sure they’re protected into adulthood.”

The second, third and fourth shots do what their name says, Dr. Arnaout says. They boost the antibody response to a certain antigen and assure a large portion of the population develops immunity, she says.

“Some shots give us long-term immunity with just two doses and others with five. It just depends on the nature of the vaccine,” she says. “Sometimes viruses mutate so quickly, we need a slightly adjusted vaccine every year to help us fight what’s circulating that year, like the flu shot.”

Although it’s difficult to know at this point, she says, the COVID vaccine may someday become like the annual flu shot.

“Again, we are building this boat as we float in it,” Dr. Arnaout says. “I admire and thank all the scientists, doctors and data collectors who are helping us with this guidance.”

“When will this cough ever go away?”

These and similar questions have been the topic of the last month at my practice.

And while I know parents are annoyed and I’m annoyed and the kids are annoyed - everyone’s annoyed - most of the time we don’t need to be concerned.

Here’s why I think kids have been sick A LOT for the last few months:

1. Cold and upper respiratory virus season were delayed due to masks and social distancing-which are starting to go away.
2. A season of terrible weather changes from hot to cool, dry to wet and everything in between and back again.
3. A wicked allergy season which tons of mountain cedar, pollen, grass, mold, etc. (Thanks to all the rain.)
4. The beginning of summer illness season with lots of fevers and rashes and insect bites and swimmer’s ear.

We see all four of these things every year, but we usually see them spread out over six months instead of crammed into two.

So what do we do?

Try to keep calm. Several mild illnesses don’t necessarily mean something bad is happening-it’s usually just bad luck.

Talk with your doctor. If you’re worried something else is going on, ask your doctor.

Consider testing if in addition to several mild illnesses, you have some severe illness or mild illness that doesn’t respond to typical treatments.

Know your babies' limits and plan ahead when making a trip outside so you can keep them well this winter.

Bundle Up

Before infants head outdoors, make sure they are wearing fresh diapers and are insulated against the cold and wet. 

"A good rule of thumb is to dress newborns in as many layers as you're wearing," said Diane Arnaout, M.D., FAAP, a Cook Children's pediatrician in Willow Park. "That includes covering their heads, hands and feet. Those areas can lose a lot of heat and be harder to keep warm."

As a mom of young children, Dr. Arnaout has first-hand experience in facing area winters with a newborn. She recomends using socks to keep tiny hands and feet warm, knit hats for infant heads and sunglasses to keep the bright winter sun out of little eyes.

Pay Attention

It's important to regularly check on newborns while you're together outdoors. Babies tend to fuss when they're uncomfortable, so if they are crying or restless while you're out and about, it may be time to move outside. 

To see if infants are getting too cold, check their ears, nose, hands and feet regularly. If your own nose or ears are cold or your lips and becoming chapped, odds and it's too cold outside for babies.

Blue skin, shivering and a cool chest and stomach are signs that children may be dangerously cold. If you see these signs, take action immediately to get kids out the cold. Seek immediate medical attention if you're not able to warm the body.

About the source

Dr. Diane Arnaout joined the Cook Children's Willow Park practice in 2011. Dr. Arnaout was born and raised in the Dallas-Fort Worth area. She served as a leader on the medical education committees during her internship and residency in pediatrics at the University of Texas Health Science Center in the Texas Medical Center at Houston, Texas.

At Home

• Don’t put blankets or other loose bedding in your infant’s sleeping environment. Instead, babies should wear one-piece sleepers or sleep sacks to keep warm while avoiding the risk of suffocation. For more information on SIDS, suffocation and co-sleeping dangers, click here.
• Make sure your home has working carbon monoxide detectors on every level, especially near bedrooms. They should be located at least 15 feet away from fuel-burning appliances. You can find more information about carbon monoxide dangers in this Checkup Newsroom story from 2015.
• Have a fire escape plan ready in case of a house fire. Make sure the whole family knows what to do if the unimaginable happens.

In the Car

• Don’t put your child in a car seat with a heavy coat on. In a crash, padding from a coat or thick layers will flatten out, leaving room under the car seat harness. This increases the risk of a child slipping through the straps and being thrown from the car seat. Instead, dress your child in thin layers. Once buckled up, slip the coat on backwards with the sleeves on the child’s arms. This way, the coat acts as a blanket and doesn’t affect the fit of the harness.
• If using a blanket over a newborn in a car seat, tuck it several inches below the child’s chin to ensure it won’t become a source of suffocation.
• Be mindful of road conditions which may increase the risk of a collision. 
• Pack an emergency bag for your car. It’s a good idea to have blankets, warm clothing, hats and gloves available in case you become stuck in winter weather. You’ll also want to have non-perishable snacks packed away.

When Outside

• Make sure newborns are dressed appropriately. "A good rule of thumb is to dress newborns in as many layers as you're wearing," said Diane Arnaout, M.D., FAAP, a Cook Children's pediatrician in Willow Park. "That includes covering their heads, hands and feet. Those areas can lose a lot of heat and be harder to keep warm."
• For the most warmth, dress your little ones in wool instead of cotton. Essential winter items include hats and gloves, as well as sweatshirts or T-shirts that can be layered under overcoats or jackets. “Infants have the same temperature intolerance as adults, but they lose more heat through their heads,” said Frank McGehee, M.D., a Cook Children’s pediatrician at Fort Worth (Magnolia). “A hat is one of the most important pieces of winter clothing for infants.”
• Blue skin, shivering and a cool chest and stomach are signs that children may be dangerously cold. If you see these signs, take action immediately to get kids out of the cold. Seek immediate medical attention if you're not able to warm the body.

Recognizing Hypothermia

According to the Centers for Disease Control and Prevention (CDC), hypothermia, or abnormally low body temperature, "is a dangerous condition that can occur when a person is exposed to extremely cold temperatures. Stay safe this winter by learning more about hypothermia, including who is most at risk, signs and symptoms, and what to do if someone develops hypothermia." To learn more about the warning signs of hypothermia, click on this site from the Centers for Disease Control and Prevention (CDC).

Warning signs for adults include:

• Shivering, exhaustion
• Confusion, fumbling hands
• Memory loss, slurred speech drowsiness

Infants:

• Bright red, cold skin
• Very low energy

Victims of hypothermia can include babies sleeping cold rooms.

1. They don't leave enough time for their commute. Even if the roads get mildly slippery and you were born and raised in North Dakota, keep in mind that us native Texans pretty much absolutely freak out about winter weather. We'll either be taking it too slow or driving like a maniac. Give yourself some extra time to get the kids to school.
2. They leave their kids puffy coats on in the car. Car seats are not meant to be buckled around big puffy jackets. Take them off and use them as a blanket before you take off. Read more about this here. Give your child an extra second to put it back on in the school drop off line. (Yet another reason to see No. 1 above).
3. They forget to take care of their kid's skin. Get outside and play in the cold weather, but remember that sun and snow can still cause significant sunburns. Apply sunscreen like you're at the beach. Cold wind can also lead to dry, red cheeks in children of all ages. Apply some vaseline to the cheeks after being outside and at the first sign of irritation.
4. They ran out of their child's albuterol. Weather change can be a significant risk factor for children with asthma. A sharp drop in temperature often bring the wheezers into the office in droves. Make sure you have inhalers or albuterol for your nebulizer on hand (and not expired).
5. They worry about things that don't really matter. "Cover their head so they won't catch a cold." "Don't let them outside with a wet head." Here is more information about these and many other Winter Wives' Tales.

Now that you know some of my big tips for keeping your child safe when the weather turns cold, stay safe and enjoy the winter while you can!

“Wear shoes outside.”

“Put on your hat.”

Does any of this really matter? Is any of it true?

Between well-meaning friends and family members and the wealth of websites devoted to health, parents are bombarded with tips and tricks to keep their kids healthy year round, but especially during the winter. This can make separating fact from fiction difficult.

Not all old wives’ tales are fictitious – some are grounded in truth. However, if you have questions or hear health advice that doesn’t make sense to you, always ask your children’s pediatrician before acting on the information or simply believing a statement is true.

Let’s take a look at the facts on these weather health myths.

Myth 1: Sudden changes in the weather make you sick

One day you are wearing shorts and the next day you are dragging out all of your winter gear. Welcome to Texas. So doe the fluctuating weather make you sick? In general terms, the answer is no. I know no matter how much science I use in my answer, many of you won't believe me. The truth is there's no scientific proof that changes in the weather will make you sick or keep you from getting better. 

But as usual there are exceptions. The changes in the weather can be really hard on your child's skin. Moisturizing children's skin during the winter is important and that includes wearing protective lip balm. Also, make sure your child uses sunscreen when playing outside whether it's cold or hot outside. 

The other concern would be kids with asthma. People have different triggers for their asthma. The most common ones tend to be weather changes, viral infections and exposure to certain allergens. Cold, dry air can cause bad flare-ups and viral infections are the most common trigger this time of year. Parents should stress to their children the importance of handwashing, especially this time of year.

Myth 2: If children go outside with wet hair or without shoes, they’ll get sick.

Many people believe that cold temperatures are responsible for the spike in illness that typically occurs during late fall and the winter months. People get sick in the winter because they spend more time in close proximity to one another, not because they’ve been exposed to cold weather.

The truth is it’s not really going to matter that much if your kids go outside without socks and shoes – except maybe if you don’t want dirty feet or if it’s extremely cold, your child runs the risk of frostbite.

It’s true we do see more colds, flu and flu-like viruses during the winter. Both the life cycle of common viruses and the fact that people are more likely to be clustered inside their homes and schools when it’s cold outside, which causes viruses to circulate, contribute to this increase.

Myth 3: People lose most of their body heat throughout their heads, so children should wear hats while playing outside in cold weather.

This tale originated in response to several studies conducted by the United States Army in the 1950s. Further research has since debunked this claim, but it’s true that your face, chest and head get colder faster when you’re exposed to winter weather.

Your face is particularly sensitive to the cold. If your children’s faces are cold while playing outside, they should wear warmer clothes. But colds come from germs – not cold temperatures – so children aren’t going to get sick if they don’t wear a hat.”

Myth 4: Feed a cold and starve a fever.

We’ve all heard this and probably most of us can’t even keep the saying straight. But there’s no scientific evidence to support the idea that children should fast when running a fever. Children who are sick should eat when they feel up to it and drink plenty of fluids to prevent dehydration.

Even if children don’t feel hungry, we ask parents to encourage their kids to drink as many liquids as they can. I’ve also heard an old wives’ tale that says you shouldn’t drink milk if you’re running a fever, but milk works as well as other fluids when it comes to keeping kids hydrated. Other good choices include water, Pedialyte and Gatorade.

Myth 5: All fevers should be treated with medicine because high fevers are dangerous.

As parents, it’s only natural to rush to the medicine cabinet at the first sign of a high temperature, but fevers aren’t always a cause for concern. In fact, they help your child’s body fight infection. According to the American Academy of Pediatrics, children’s demeanors are often better indicators of illness severity than the numbers on the thermometer. If children aren’t fussy or complaining of feeling badly, there’s no need to treat a fever unless their doctor says otherwise.

Myth 6: You can’t prevent your child from catching a cold.

While there’s no cure for the common cold, you can take steps that will reduce your child’s risk. In this case, grandma is right. These are the same steps she told you. Wash your hands after you sneeze. Wash your hands after you blow your nose. Wash your hands after you eat. See a theme? Children should sneeze into the crook of their elbow and not their hands. They should blow their nose to get rid of the mucus. For children too young to blow their noses, parents should use a blue bulb syringe and drain the child’s nose with salines. If a cold lasts longer than a week, bring your child in to see his or her pediatrician. It could possibly be a sign of acute sinusitis and may need to be treated differently than the common cold.

Don’t buy into the weather myths. Here are some tips for preventing health issues:

• Help your child eat healthy and get good sleep.
• Get your child up and active in some way every day.
• Teach your child to wash their hand and cover their coughs.
• Get your child a flu shot (it’s still not too late).

The time has come. You and your kids spent time at the park on a beautiful spring afternoon. A few hours later, at home, the symptoms start (cue M. Night Shyamalan strange horror music). Or heck, for those really allergic, the symptoms began at the park!

• Itchy, watery eyes
• Congestion
• Draining, watery, itchy nose
• Sneezing
• Itchy roof of mouth (is this just me? Seriously? Anyone else get this?)
• Clearing the throat
• Coughing
• Complaining of a sore throat (this is due to drainage)

Congrats. See that bright green dust coating your trash cans and car? That’s pollen, and it’s now stuck to all the tiny hairs inside your nose, throat, and lung airways.

And the symptoms you’re having? That’s your body reacting to the certain pollens it doesn’t like.

Kids don’t really get seasonal (grass, plant and tree) allergies until at least age 2. I always tell parents, “your kiddo has to be EXPOSED to the planet’s seasons a few times before it can become allergic to them!”

Your child can become allergic to things like foods, pets, mold, and dust earlier than age 2 – because these are things they are exposed to daily in their home.

To help control your kid’s symptoms, there are a lot of over-the-counter medications you can try.

Listen – I’m a doc that usually says “less is more” when it comes to medication. But I do usually recommend daily meds for kids who suffer allergies, because I don’t want it to affect their happiness, or ability to get good exercise.

Start with a daily antihistamine – Allegra, Claritin, Xyzal, Zyrtec, Benadryl. If your child suffers from a lot of nasal problems like sneezing and congestion, add on a nasal steroid spray like Flonase or Nasacort.

There are also many types of antihistamine eye drops out there you can use daily to treat or prevent the itchy and watery eyes.

Here’s the thing – they’re often PREVENTATIVE. So, use them DAILY during the times of year you or your child suffer to PREVENT the symptoms from showing up.

You can dive further into treatment with your pediatrician – there are a few prescription options you can try to further help the problem.

If your child has asthma, it’s even more important to come up with a treatment plan with your pediatrician. These kids sometimes can have full-on asthma attacks this time of year if that’s a common trigger for them.

And do what an old, wise allergist once told me – “the minute you and your kids come in from playing outside, hold your heads over the sink, and spray nasal saline up in the nose to irrigate the nose and rinse out all the pollen!” You could also try this in the shower.

Makes sense to me! Try it! And good luck out there!

But, does your child have a cold or allergies?

After all, the mountain cedar pollen count is the highest it's been all season in North Texas and is in the "very high" category for the first time since January 2017. 

We're also in the middle of the cold and flu season. 

Determining the difference between colds and allergies can be very difficult, but knowing which it is can be helpful for treatment, expectations for how long it should last and for determining if your child is contagious.

Colds are caused by viral infections which are spread from person to person. They can occur year round but are going to be more common in winter months. Symptoms usually last 3 days to 2 weeks but remember that kids can get several colds per year so it’s possible for them to be sick for long periods if they catch a few colds back to back.

Allergies are caused by an overreaction of the immune system to allergens. Dust, pollen or molds can all be potential triggers. Allergies can occur year-round depending on what your child is sensitive to. Usually fall and spring are busy allergy seasons but pollen counts were moderate to high many days in December.

So, how can you tell the difference?

Symptoms with a cold usually build up over a few days but allergic symptoms can start quickly after the child is exposed to the substance they are allergic to.

Here are some of the symptoms that can be present and whether they are more likely a cold or allergies:

This time of year, if your child has cold symptoms but also have significant body aches or high fever, you should also consider if they might have flu (because they probably do).

Treatment for colds is treating the symptoms. Nasal saline and suction for babies. Honey for kids over 1. Make sure they are drinking plenty of fluids and getting rest.

Treatment for allergies should usually start with a long acting antihistamine like Zyrtec or Claritin. If that doesn’t seem to be helping, talk with your doctor.

Both allergies and colds share a lot of similar symptoms:

• Sore throat
• Runny nose 
• Sneezing 
• Coughing 
• Feeling tired 
• Feeling achy

Honestly, it can be hard even for us to tell the difference when we examine kids.

HOWEVER, you don't get a fever with allergies. If you have a little fever (or a big fever), that's most likely a cold.

ALSO,  "itchiness" in general of nose and eyes, makes me think more allergies than cold.

AND, the time is important - Did  it come on really quickly? That's most likely a cold. Has it been going on for months with a slow onset? Most likely allergies.

Both allergies and colds can make you more susceptible to other problems like ear infections and sinus infections. That's why we say if your symptoms are lasting longer than 2 weeks, come in and see us so we can help.

"How do I know what to do?" Well, that depends on a lot of things.

Is your child under age 1? If so - this is more likely a cold than allergies (a child has to be alive longer than a year to develop allergies to their environment). Elevate the head of their crib. Stick a blanket under the mattress. Would you want to lay flat on your back with a bad cold? Suck out all that snot with a Nose Frida (dont knock it til you try it). Use saline drops. Tylenol (or ibuprofen if over 6 months) for the headaches and throat pain. Run a hot shower and sit in a steamy bathroom for a bit. And lots of lovins. There ain't much you can do for the tiny ones. They just have to push through it.

If they're over age 1 and they have what seems to be a cold, try some honey along with all of the above. It's been proven to help just as much as medication. There are some over-the-counter medications that have honey in them too. I wouldn't try cold medicines until they're at least 4. Studies don't even show that they help much.

If it's allergies - you have lots of over the counter options like Benadryl, Zyrtec, Claritin, and Allegra. Some nose sprays are also very helpful and we can prescribe those in the office. And there is a prescription medication called montelukast that I find can help some kids.

Also, a wise allergist once told me that if you rinse out your kid's nostrils when they come indoors, it helps a lot (it washes away all the allergens/pollens clinging to the hairs in the nose and really helps symptoms go away faster). You could also try nasal saline spray here and just have them hold their head over the sink.

Hugs!

Dr. Diane

“Despite being a staple in pediatric care for decades, cough medicines don’t work,” said Justin Smith, M.D., a Cook Children’s pediatrician. “Since being first approved for use in children in 1976, they have failed to prove their effectiveness for acute cough.”

This message is echoed in a new video released by the American Chemical Society. In it, the narrator explains how antitussive drugs are supposed to block the body’s cough reflex. But most studies have found no evidence that over-the-counter medications actually work. Often, they proved no different than a placebo.

Not only do they not work, they can have serious side effects. Thousands of children are sent to the emergency room every year due to accidental overdoses on cough medicine. More than half of those are children under the age of six.

“I don’t give my children cough medicine and I don’t prescribe it for my patients,” said Dr. Smith. “Instead, parents need to know that keeping a child hydrated can help with a cough. By drinking plenty of fluids, kids are able to thin out any extra mucus triggering their cough.”

Dr. Smith says humidifiers are also helpful for children. You can place one in their bedroom while they’re sleeping to ease their breathing.

“In medicine, you have to weigh the risk with the reward. For cough medicines, there are numerous risks and possibly zero benefit.”

About the Source
Justin Smith is a pediatrician and the Medical Advisor for Digital Health for Cook Children's in Fort Worth, Texas. He has an active community on both Facebook and Twitter as @TheDocSmitty and writes weekly for Cook Children's checkupnewsroom.com. His interest in communications started when he realized that his parents were relying more on the internet for medical information. He believes that strategic use of social media and technology by pediatricians to connect with families can deepen their relationship and provide a new level of convenience for both of their busy lifestyles. Dr. Smith’s innovative pediatric clinic, a pediatric clinic “designed by you,” is set to open in Trophy Club in 2017.

Fast forward five years and I have learned that my kids can decide for themselves what to wear to keep warm. I let them step outside in the morning and advise them that they might want pants or a jacket, but I let them decide.

Tuesday, they both went to school in shorts, but took a fleece. It was 40 degrees outside. Wednesday was the same.

They might wear pants when the temperature hits 20 degrees… maybe.

Beyond infancy, kids can self-regulate what they wear for warmth. As parents, it’s our job to provide the right clothes and then let them decide.

I encourage my parents to get their kids outside even in cold weather. If it’s above freezing, a jacket is often all they are going to need if they are active. Below freezing, a hat and gloves can be added/offered, but don't be surprised if they come off once your child is active.

Finally, even your toddler can go out and play in the cold for 30 to 60 minutes. Don't be afraid of the cold. There are wonders to discover out there and kids need to be outside. It’s good for their bodies, minds and souls. 

Related Stories

• Can I Take My Newborn Out In The Cold?
• Winter Old Wives Tales: Separating Fact From Fiction

About the author

Vanessa Charette, M.D., has been a pediatrician at Cook Children's for 10 years and is located in Fort Worth. Dr. Charette embraces the many components that contribute to health nutrition, physical activity, emotional, psychological stresses and the environment. As your pediatrician she will spend time with you discussing nutrition, child development and take the time to address any concerns you have about your child's health.

What are the most common causes of a runny nose? How do you treat one? When should you call a pediatrician?

Doc Smitty is back with the latest My Kid Minute. Watch the video to find out all the answers.

Ensure school-age children know when to wash - before eating and after playing on a playground at recess, using the restroom, and coming into contact wiht friends and classmates. Teach kids that it's important not to chew their fingernails or touch their faces.

"Hand-to-mouth transmission is a major way children are infected by viruses," said Vanessa Charette, M.D., a Cook Children's pediatrician in Fort Worth. "Keeping hands out of the mouth is a difficult behavior for certain children to master, but it's important that they do."

Little hands can pick up a lot of germs. At any given time, you have close to 150 different bacteria living on your hands, and 80 percent of illnesses are spread by direct human contact. For kids, stomach bugs, strep throat and other bacterial illnesses can spread quickly, particularly in environments such as schools and day cares.

"I also tell young children to keep their hands below their neck. They don't rub their eyes, such their fingers or pick their nose," said Kim Mangham, M.D. a Cook Children's pediatrician in Keller. "Kids can have all the germs in the world living on their hands, but they don't put their hands in their mouth, nose or eyes, they won't get sick."

Having trouble convincing your children to get with the hand hygiene program? Let them know that fighting the spread of germs can be pretty cool. A recent study published in the American Journal of Infection Control concluded that fist bumping transmits far few bacteria than handshaking.

As someone who lives with asthma, I’m proof that the condition does not have to slow you down. It’s important for most children to know they can still partake in all of the fun activities of other kids, just as long as they properly take their medicine.

I join about 10 percent of the general population who are asthmatics. Children have an even greater incidence of suffering from asthma, and the prevalence of asthma is increasing in both adults and children.

First let’s define asthma. Asthma is a condition caused by narrowing of the small air tubes in the lungs with inflammation and constriction of the smooth muscle surrounding the small air tubes.

There are many symptoms of asthma, including wheezing, shortness of breath and exercise intolerance. Some people complain of “tightness in their chest.” The symptoms do vary with the severity of the asthma and whether the person is having an asthma attack.

Anyone who has the condition knows about the triggers that can cause an asthma flare. The most important factor is the common cold; viral upper respiratory infections are the most common reason for an asthma attack in both adults and children. Allergies are the second most important trigger but other factors like, exercise and weather changes can cause trouble as well.

To measure whether your child’s asthma is under control, I use the “Rule of Twos.” Your asthma is not under control if:

• You have to use albuterol more than twice a week on average during the daytime, or twice a month on average at night.
• You have to use oral steroids more than twice a year.
• You go through two albuterol puffers a year.
• When your asthma is not under good control, I would either add an inhaled steroid or increase the dose of the inhaled steroid.

Discuss this with your pediatrician and make sure you have an asthma plan. Teach the plan to your children as they grow up to help prevent asthma attacks.

The most effective preventive medication is an inhaled steroid, which comes in both a puffer form and in the nebulizer. This medication needs to be taken on a daily basis to prevent inflammation, which narrows the small air tubes.

All of the research over the past 20-30 years has shown that if asthmatics take their preventive medication regularly their asthma improves. Another helpful measure is avoidance of allergy triggers such as, dust mites and cat dander, which are the two most common allergens in our society.

The mainstay of treatment for an asthma flare is a drug called albuterol. It comes in several forms, but it is mainly used in a “puffer” or metered dose inhaler, or in a solution that is used in a nebulizer.

This medication is a bronchodilator which opens up tight airways. The other commonly used medication is an oral steroid such as, prednisone which decreases inflammation in the small air tubes.

I wouldn’t describe living life with asthma as easy and it does come with challenges. But if you take care of yourself, follow your medication treatment prescribed by your Cook Children’s pediatrician and avoid triggers as best you can, children should be able to live normal and productive lives.

They may even become a pediatrician themselves someday and take care of other kids with asthma.

Along with vaccinations, hand-washing is one of the most effective ways to prevent flu. Alcohol based hand sanitizers are not effective against enterovirus 68, only good, old fashioned hand-washing.

Hand hygiene is especially important while children are attending school, where nearly every interaction carries the possibility of transmitting viruses.

“Children should wash their hands before and after going to the bathroom, as well as before eating or drinking,” Frank McGehee, M.D., a Cook Children's pediatrician in Fort Worth, said. “They should work the soap into a good lather and scrub for at least 20 seconds—the amount of time it takes to hum ‘Twinkle, Twinkle, Little Star.’ Have them scrub especially well around fingernails and jewelry.”

It’s also a good idea to have children wash their faces frequently during flu season.

Sometimes it's difficult to make your child take the time to wash his or her hands. How do you get your children to wash their hands? We would love to hear from you.

When I came home from the hospital with my new bundle of joy last fall, the first two weeks were filled with the tasks of survival – learning to feed my son, making sure he was growing appropriately, entertaining family and friends who wanted to meet him, catching a snooze here and there, and establishing a routine. After those two weeks ended and I had barely left my house, my next plan of action was: Operation Mama Sanity! I needed to get out!

Everyday in my office I have parents who ask me when they can take their newborn babies out and about, and get into the swing of life with their new child. My answer is always the same: now! But … with a few rules.

From day one it is absolutely fine to get out into the fresh air and go for a walk in the park, or in your neighborhood, if the weather permits.Try not to go out on extremely hot or extremely cold days, and as a rule of thumb, dress your little one in as many layers as you are wearing. Make sure the baby is not exposed to direct sunlight. Most strollers these days come with a nice shade for this purpose, or you can use an umbrella.

If you’d like to go out where there are a lot of people, like a busy restaurant, grocery store, or mall, I always tell parents to try to keep their infant’s seat completely covered by a light blanket.This serves a few purposes. First, a baby’s immune system before age 6-8 weeks is still immature. If someone at the next table sneezes or coughs, its best to have this protective canopy over them so viruses and bacteria are less able to come in contact with her. Also, it keeps the baby hidden as a deterrent to well-intentioned patrons from touching your sweet little one. As nice as that is, it’s best if people don’t touch your baby during those careful first weeks. 

If it’s holiday season and you and your new baby are expected at the family get-together, don’t fret. Just politely ask that everyone wash their hands before they hold her. If you’re too shy to ask them yourself – do what I tell my patients to do – blame me! Say, “My pediatrician says everyone has to wash their hands before holding her!”  This way no one can get their feathers ruffled. Carrying a small bottle of hand sanitizer and offering it to everyone is also a great and easy way to get germy hands cleaned. If someone appears to be sick and you don’t want that person to hold your baby at all, don’t. It’s Ok. You can blame that on your pediatrician too.

Don’t be afraid to go out with your new baby – she and YOU need it! Getting fresh air, exercise and social interaction in those first few months is vital to parents, and happy parents make happy babies. 

Hope my two cents help you muster the courage to venture out! And remember, many pediatricians have slightly differing opinions about these things, so it’s best to speak with yours if you have questions.

About the author:

Dr. Diane Arnaout joined the Cook Children's Willow Park practice in 2011. Dr. Arnaout was born and raised in the Dallas-Fort Worth area. She served as a leader on the medical education committees during her internship and residency in pediatrics at the University of Texas Health Science Center in the Texas Medical Center at Houston, Texas.