The Cook Children's Fostering Health Program serves more than 2,000 children from across North Texas and as far west as Stephenville. In March, the Clinic helped more than 200 children, a record number for the program.

“Our clinic functions as a primary care medical home and offers complete health care for children in foster care through age 21,” said Brittany Schoonover, pediatric nurse practitioner for the Fostering Health Program.

It begins with trauma-informed care.

“We recognize when a child is removed from a home that in itself is trauma,” explained Keirsten Velez, LMSW, a social worker for the Fostering Health Program. “Sometimes we see the child the day after it happens, so our goal is to empower the child.”

That empowerment includes involving children in their own health journey while helping caregivers navigate the foster care system.

“There are a lot of nuances that come with providing medical care for a kiddo in foster care,” said Velez. “For example, most agencies require the foster parent to have a nine-page form completely filled out and signed at the end of every medical visit.”

Even before the first exam, the team works to fill the gaps in a child’s medical history by tracking down records from schools, hospitals and previous pediatricians.

“Often times we find fragmented care where the child had initial medical exams but often not follow up care,” explained Schoonover. “Our clinic is helpful to connect the dots and put the puzzle pieces together to be able to provide the best care for the child.”

Velez noted often placements occur with limited time or funds for foster parents to prepare for the child’s arrival. The team strives to address immediate needs, providing patients with essentials such as clothes, toys, and diapers, while also serving as a bridge to long-term support through Cook Children’s and community support.

“We try to make navigating the system easier for the caregivers,” said Velez, “We're kind of advocating alongside of them for what they may need.”

The support does not end when a child’s case closes. Schoonover and the team ensure continuity of care by providing families with information about new pediatricians and specialists.

“We’ll send over whatever they need to the new doctor, we want to keep the continuity of care that they have had here in their medical home,” said Velez.

‘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.