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

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

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

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

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

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

Free Summer Meals for Kids

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

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

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

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

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

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

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

Balancing Energy and Hydration

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

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

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

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

Smart on-the-go snack options include:

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

Related Stories:

• Texas Summer Safety for Kids: Hydration, Heat Illness Signs and Sun Protection Tips
• Bridging the Gap: How Cook Children’s Health Plan is Transforming Las Vegas Trail
• From Our Kitchen to Yours: Inside the Demonstration Kitchen at the new neighborhood health center serving the Las Vegas Trail Area

Collin County Health Care Services has issued a health alert due to an increase in chickenpox (varicella) across the county. Chickenpox is an infection caused by varicella-zoster virus, leading to a fever and an itchy rash with spots all over the body.

Because it is highly contagious, chickenpox is a reportable condition in Texas and must be disclosed to the local health department. According to health officials, schools and childcare settings are high-risk environments for outbreaks. Prompt identification and exclusion of cases are critical to limiting transmission.

While chickenpox used to be a common illness in the United States, it has become much rarer due to the chickenpox vaccine which helps prevent the infection.

Cook Children’s Health Care System doctors know parents and caregivers may have questions about this, Laura Romano, D.O., a hospitalist at Cook Children’s and mom herself, addresses some concerns.

• I got chickenpox as a kid. Should I be concerned if my little one gets it?
  • One infection with chicken pox should give you lifelong immunity.
• How effective is the varicella vaccine?
  • Two doses give up to 98% protection and have decreased hospitalizations and death by over 97% since 1995!
• What if my little one only had one dose. What does that mean for them?
  • If your child has already had one dose of the chicken pox vaccine, they will most likely not need another one if they get an actual infection. Please talk with your pediatrician about this.
• What happens if someone is immunocompromised and is around someone who has varicella?
  • The most common complication is a skin infection caused by scratching at the lesions, which may require antibiotics to help treat. Other more serious complications include pneumonia, ataxia (difficulty walking), dehydration, or encephalitis (swelling of the brain). People who also have chicken pox are at risk for shingles later in life. Vaccination against chicken pox helps prevent against all these complications including the furture risk of shingles.
• What complications can arise from chickenpox?
  • The most common chickenpox complications are bacterial infections of the skin and soft tissues in children and pneumonia in adults.
• How do you treat chickenpox?
  • While there is not a single treatment for chicken pox, doctors focus on symptom relief. Doctors recommend Tylenol for fever, calamine lotion or oatmeal baths for itchiness. Lesions should go away in the 10-14 days. 

Symptoms of Chickenpox:

A mild fever may occur 1 to 2 days before rash onset, particularly in adults. In children, the rash is often the first sign of disease.

Seek immediate medical attention when your child:

• has trouble breathing
• has a severe headache
• is very drowsy or has trouble waking up
• has trouble looking at bright lights
• has trouble walking
• seems confused
• seems very ill
• has a stiff neck
• has a fever that lasts for more than 4 days
• has a bad cough
• has an area of rash that leaks pus (thick, yellowish fluid) or becomes red, warm, swollen, or sore
• is vomiting

March marks spring break for families and it is Poison Prevention Month. According to the 2024 Community Health Needs Assessment, one in two children live in homes where medications are not always locked up and four in seven children live in homes where cleaning products are not always stored in a locked area. 

“Unintentional poisoning can happen to anyone, at any age,” said Klaressa Broughton, poison prevention program coordinator at the Center for Community Health. 

In 2025, Cook Children’s saw an increase of poisoning encounters, with 1,031 compared to 818 in 2024. Broughton explains that the top poisoning for 2025 involved children of all ages from birth to 18 and were related to medication and unspecified non-drug poisonings.  

“By practicing Safe Dosing, Safe Storage, and Safe Disposal, you can create layers of protection for your household,” said Broughton. 

She adds having conversations with friends, caregivers and family can ensure kids stay safe while they explore someone else’s home. She suggests opening the conversation with: “Since the kids are at the “into everything stage”, do you mind if we double-check that medications and cleaners are out of reach?” 

Tips for Poison Prevention: 

Safe Medication Dosing 

• Follow the dosing directions listed on the medication by using the appropriate measuring items, such as a medicine cup or oral syringe.
• Double dosing is NOT twice as effective, and in many instances can cause internal damage.
• Adult medications may be too strong for children and should not be given in half doses. Only give medicine to your child that is intended for children.
• Print the medication schedule to keep the right dosage for your family. 

Safe Storage 

• Many people leave medications on bathroom and kitchen counters as well as bedroom nightstands as a visual reminder to take them. Avoid unintentional injury and store medication up high, locked, and out of reach.
• Hang purses and personal bags up high so children cannot reach prescriptions, vitamins, or other regularly used medications.
• Remember, when visiting friends and family, it is ok to have an open discussion about safe storage. 

Safe Disposal 

• DEA Drug Take Back Day is on April 25th from 10 a.m.-2 p.m.
• Visit a medication drop box at a local pharmacy. For more information on poison prevention, visit www.meddropbox.org.
• The best disposal option is to find a drug take-back location, which may be found in retail, hospital, pharmacies, and/or law enforcement facilities.
• Removing any unused or expired medication in the home can reduce the risk of access. 

 Related Stories:  

• Expert Tips for a Safe Spring Break: Car Safety

• Expert Tips for a Safe Spring Break: Water Safety
• Expert Tips for a Safe Spring Break: Aim for Safety

Cook Children’s Center for Community Health conducted the 2024 Community Health Needs Assessment (CHNA) to identify and prioritize health needs and resources available for children in the service area. The results indicate a complex set of factors that create obstacles in caring for children and accessing health services.

Every three years, the center compiles the CHNA by surveying and interviewing parents and caregivers in Cook Children’s service area. Survey responses came from more than 7,300 parents, caregivers, and community leaders in Collin, Denton, Grayson, Hood, Johnson, Parker, Tarrant, and Wise counties. That region encompasses almost 1.2 million children (0-17 years), according to U.S. Census estimates.

KEY FINDINGS

The 2024 survey showed about 390,100 children from birth to 17 years old live in households that sometimes or often couldn’t afford nutritious meals. 

Along with food insecurity, about 287,100 children have a caregiver who shared that they were unable to receive all needed health services for their child. Reasons cited include lack of insurance, high health care costs, transportation difficulty and the financial impact of parents missing work for their child’s medical appointments.

Barriers played a role in 139,600 children ages 1-17 not receiving needed dental care, and 79,900 children ages 6-17 going without needed mental health services. Immunization levels in the service area showed 89% of children up-to-date on vaccines. 

“What stands out most is how many families are dealing with overlapping challenges that all affect their children’s health and well-being,” said Mandy Wolever, Ph.D., Research/CHNA Manager at the Center for Community Health. “Caregivers shared that they’re constantly making tough choices -- between covering basic needs like food, housing and utilities——and trying to get their children the health care they need.”

Fewer caregivers reported they have a source of emotional support for raising their children. That finding aligns with the U.S. Surgeon General’s advisory in August 2024, calling attention to parental stress due to financial instability, work-life balance, lack of social support and other factors.

The struggle to put nutritious meals on the table or visit the pediatrician adds another layer of stress that impacts a child’s health and development, Wolever said.  

The top three health needs reported by caregivers were preventive health care, treatment for short-term illnesses and immunizations. Mental health care or counseling topped the list for community leaders, followed by wellness opportunities and preventive dental care.

Other takeaways from the parent/caregiver survey include:

• Eighty-four percent of children in the service area had “excellent” or 
  “Very good” health in 2024. That compares to 87% of children across Texas and 90% of children in the United States in 2022.
• In the past year, 1 in 5 children (about 217,700) in the service area experienced chronic or frequent dental problems. Children with poor or fair oral health are twice as likely to miss school due to dental problems.
• Approximately 237,000 children ages 6-17 have a diagnosed mental health condition such as anxiety, depression, or attention-deficit/hyperactivity disorder, according to their caregiver. Two out of every 5 children (about 304,100) have been bullied at school.
• Approximately 233,300 children received emergency care for an accidental injury.
• Asthma impacts 104,500 children in the service area. Asthma symptoms sent about one-fourth of those children to a hospital emergency department in the past year. 
• Almost 90% of children had continuous health insurance coverage for 12 consecutive months before completing the survey.

FROM DATA TO ACTION

These results, along with many other survey data points, give context to the center’s key priorities: children’s overall health and well-being, asthma, healthy lifestyles, caregiver support, injury prevention, mental health and oral health.

Becki Hale, AVP at the Center for Community Health, said takeaways from the survey will help the center respond to evolving needs in collaboration with more than 700 organizations across the region.

“We’re incredibly grateful to be part of such a strong, compassionate health care organization that invests and prioritizes giving back to the community and helping families thrive,” Hale said. “We also recognize that Cook Children’s is one of many partners committed to improving the health of our communities. Today’s health and social needs for families are too complex for any one entity to address alone. It takes all of us, working together.”

One example of how Cook Children’s utilizes the CHNA results in collaboration with others to implement innovative approaches that address the greatest needs: the Center for Community Health teamed up with Texas Health Resources in January 2025 to open a Good For You Healthy Hub at Fort Worth’s Eastside YMCA. The hub provides fresh fruits, vegetables and other nutritious foods for free to residents of the Eastside neighborhood.   

Chris Pedigo, senior vice president of system planning, health analytics and the Center for Community Health, pointed out that the CHNA provides insights that help Cook Children’s keep its Promise to improve the well-being of every child in our care and communities. 

“Our next steps include comparing this year’s results to those of previous years to identify areas where we’ve seen change, as well as identifying new communities that need focused programming,” Pedigo said.

Surveys were collected from a sample of households across the service area at large, not just Cook Children’s patients. Surveys were also collected from parents of special under-resourced populations, including those experiencing homelessness or living with an undocumented family member. The results are weighted to represent the actual population of children living in the service area.

The center takes steps to include a cross-section of the population through data collection and interviews. The team analyzed approximately 1.2 million data points, said Lauren Purvis, MPH, CPH, MCHES, Director of Child Health Evaluation.

“This approach can help partners feel confident using our data to inform their organization’s strategies to improve children’s health in their communities,” Purvis said.

Significant effort goes into developing and carrying out the research strategies that make the CHNA as inclusive and representative as possible.

“It’s important to us to gather a wide range of perspectives so we can thoroughly assess community needs,” Wolever said. “This approach helps us better understand how to support families and improve the well-being of children, ultimately living out our Promise.”

Regional Summits

Cook Children’s Center for Community Health is hosting two free, virtual Child Health Summits to share the survey findings with the media, community partners and other professionals.

• Part 1, May 6, 9-10:30 am: Cook Children's Child Health Summit Part 1 Registration, Tue, May 6, 2025 at 9:00 AM | Eventbrite

Focus areas: Overall Health and Well-being, Asthma and Healthy Lifestyles

• Part 2, June 3, 9-10:30 am: https://www.eventbrite.com/e/cook-childrens-child-health-summit-part-2-registration-1095338770749?aff=oddtdtcreator

Focus areas: Caregiver Support, Injury Prevention, Mental Health and Oral Health

For more survey results, please visit the data dashboard or contact CHNAFeedback@cookchildrens.org.

RELATED STORY

Parent Survey Underscores Need for Mental Health Focus

‘Tis the season… for viruses. They are the only things kids have no problem sharing. Let you play with my new toy? Nope. Have my cold? Sure! And I’ll throw in a stomach bug, too, just for fun. 

But it’s no laughing matter when your little one unknowingly brings home the latest viral bug. Sick days are inconvenient at best and scary if things take a turn for the worse. While respiratory illnesses such as RSV, flu, COVID and human metapneumovirus can lead to serious illness and hospitalization, especially for those with already weakened immune systems, most cases of viral infection can be managed at home. 

We asked Laura Romano, D.O., a hospitalist at Cook Children’s Medical Center, to give us her best tips to help parents better care for their sick kids at home and potentially save themselves a visit to the doctor, urgent care or emergency department. 

1. Stay hydrated. 

Dehydration can turn a run-of-the-mill viral illness into a serious one. Your child should be urinating at least once every 8 hours. Decreased urine output (fewer wet diapers), or slightly dry lips, are signs of mild dehydration. In more severe dehydration, urine output or wet diapers will significantly decrease below the child’s normal. A child may stop producing tears when they are crying, and their eyes can appear sunken. In infants, the soft spot on top of their heads will look decreased. If you are concerned about dehydration in your baby, call your pediatrician or bring your baby to an emergency room or urgent care. In older children, encourage fluids for a few hours. If there is no improvement, call your pediatrician. Electrolyte drinks can be helpful if you suspect your child is dehydrated or at risk of becoming dehydrated. If they aren’t interested in drinking, have them suck on a popsicle. 

2. Fever is our friend. 

Fever can be scary, but it’s not the enemy. It is the body’s natural way of fighting infection, and it’s safe in babies 3 months and up. Technically speaking, a fever isn’t a fever until your child’s temperature rises to 100.4 or above. A temperature above 100.4 in babies less than 2 months old is a medical emergency and needs to be evaluated in the emergency room. 

Check an infant’s temperature using a rectal thermometer. For older kids, use a forehead or ear thermometer until they are old enough to follow directions to keep a thermometer under their tongue. 

If fever is making your child uncomfortable, over-the-counter fever reducers such as acetaminophen and ibuprofen can help ease symptoms. Any fever lasting longer than four to five days, or one that continues to climb and does not break with fever reducers, should be evaluated by a physician. Otherwise, it’s safe to manage fever at home. 

3. Keep the air and sinuses moist. 

Respiratory viruses often come with lots of congestion, coughing and snot. Saline drops and suction help to moisten and clear congested nasal passages in babies. For bigger kids, have them blow their noses and stay hydrated to help thin the mucus. A cool-mist humidifier will keep the air moist and ease cough and congestion. This is especially helpful during nap times and at night.

4. Skip the cough syrup.

Most over-the-counter medications for cough and cold are not effective in young children, Dr. Romano says. Instead, stick to humidifiers and hydration. 

5. Know when to go. 

There is always a chance a viral infection such as RSV can cause respiratory distress or turn into a bacterial infection, like pneumonia. If your child’s condition is not improving or getting worse, call your pediatrician. 

If your child appears to be in respiratory distress, it’s time to go to urgent care or the emergency department. 

• Signs of respiratory distress:
  • Increased number of breaths per minute
  • Increased heart rate
  • Bluish color around the mouth, on the lips or on the fingernails. 
  • Pale or grayish skin
  • A grunting sound during exhale
  • Nose flaring
  • Chest appears to sink in with each breath
  • Head bobbing when breathing in
  • Change in alertness

6. Sharing is not always caring. 

If your child is sick, keep them home to limit the spread of infection to others. A good rule of thumb is to make sure your child is symptom-free, without medication, for at least 24 hours before returning to school or other activities. Your fellow moms in the preschool playgroup will thank you. So will your child’s daycare or school. 

Good hand hygiene remains one of the easiest ways to prevent the spread of viruses. Teach your child to cough or sneeze into their elbow and wash their hands immediately after. Stay up to date on your child’s vaccines to help reduce spread and illness severity. 

7. Go with your gut. 

You know your child best. If something seems off, don’t hesitate to call your pediatrician or get medical attention. These tips are meant to guide you and help ease your anxiety, but never underestimate what your gut is telling you about what your child needs.

I order a kid’s meal for my son at a seafood restaurant in Galveston, Texas. I tell the waiter to hold the fries. He gets a very odd look on his face and replies “But they come free with the meal." My response. “I understand that, but we don’t want them.”  

There is good evidence that meals eaten at home are healthier. One way we can improve the nutrition choices we make when we eat out is to avoid the pitfall of accepting the free choices that come with a meal and worse – encouraging our kids to finish them. 

I know I’ve had the experience of wanting only the sandwich at a restaurant, yet ordering the entire meal is actually cheaper. This comes with chips or fries and a drink that I don’t even really want, yet I end up picking a soft drink instead of a water because it is “free,” and also eating the chips that I didn’t plan to order.

I heard a news clip on the radio the other day about all inclusive restaurants and how many calories we tend to consume on these trips. I think we definitely get caught trying to get our money’s worth at all you can eat buffets. 

The excess calories consumed and the subsequent health consequences for ourselves and for our children can be quite costly in terms of our overall health. So the next time we try to find the best value in our meals while eating out – it might be in saying no to the free extras.

About the author

Kim Mangham, M.D., is a Cook Children's pediatrician at 1601 Keller Parkway in Keller, Texas. She earned her medical degree at University of Texas Southwestern Medical School in Dallas. She completed the pediatric residency program at University of Oklahoma Health Sciences Center in Oklahoma City. Her interests include breastfeeding education as well as disease and injury prevention. Dr. Mangham is board certified in pediatrics.