"We are pleased to welcome Amy to Cook Children's," said Rick W. Merrill, President and CEO of Cook Children's Health Care System. "Her extensive experience at the national level, coupled with her deep understanding of the unique needs of children's hospitals, will be invaluable as we continue to advance our Promise to improve the health of every child. Amy's passion for collaboration and her strategic vision align perfectly with our values and our aspirations for the future."

This appointment marks an exciting new chapter for Cook Children's, building upon the strong foundation established by her predecessor Keith Holtz, who will be retiring in early 2026.

"I am incredibly grateful to join Cook Children’s and the talented teams here to make meaningful contributions to children’s health care and to each child and family we serve,” Amy shared. “My work has given me an extraordinary opportunity to get to know many children’s health systems, and Cook Children's stands out for its commitment to exceptional care, its truly remarkable culture, and the many opportunities we have to grow as an integrated delivery system serving children."

Amy envisions Cook Children's growth through innovative research, strategic expansions, and leveraging its programs and diverse portfolio to reach and serve more families. She is particularly focused on elevating its national profile by showcasing its exceptional work and collaborative ethos, a key differentiator in health care.

Amy will report to the president and CEO, providing executive leadership for a broad range of areas including strategy; community health; patient, family and team experience; marketing, public relations and communications; human resources, and more. Known as a natural connector, Amy is committed to building strong relationships and fostering teamwork, and she is also a dedicated coach and mentor.

Prior to joining Cook Children's, Amy served as President of the Children's Hospital Association (CHA) based in Washington, DC. Her career also includes more than a decade as a partner in a boutique health care strategy firm and administrative roles in a children’s hospital. Her extensive experience, strategic perspective, and deep-rooted commitment to Cook Children's Promise will be instrumental as the system continues to advance children’s health and health care.

After an extensive search, Cook Children’s chose Dr. Edgington based on his experience and success in leadership, endowment growth, donor engagement and strategic partnerships. He began at Cook Children’s on April 21, taking the fundraising helm for an ambitious $1.25 billion expansion project at Cook Children’s Medical Center – Fort Worth.

“As we embark on the largest fundraising campaign in the history of Cook Children’s, Kyle brings an expertise that makes him an ideal fit for our organization,” said Rick W. Merrill, president and CEO of Cook Children’s Health Care System.

“His skillset and proven leadership will be key to raising the capital campaigns required to expand and enhance our flagship medical center,” Mr. Merrill said. “We look forward to Kyle’s vital impact steering the fundraising effort for this transformative project.”

Dr. Edgington, a Fort Worth native, comes to Cook Children’s after 16 years at the University of Texas at Dallas, where he held multiple teaching and administrative leadership roles. Most recently, as Vice President for Development and Alumni Relations for the university, he oversaw a 110-member team and a $15 million budget. Just a few of his achievements include:

• Spearheading "New Dimensions: The Campaign for UT Dallas," which to date has raised $440 million toward a $750 million goal;
• More than doubling the university’s endowment, now valued at $868 million; and
• Boosting annual gift count by 183% and donor count by 70%.

Dr. Edgington holds a Ph.D. in Public Affairs from The University of Texas at Dallas, an MBA from Wayland Baptist University, and a bachelor’s degree from Texas Tech University. In addition to his professional success, he has a long history of serving children in North Texas as a volunteer. He is a past president for Big Brothers Big Sisters Lone Star Foundation, as well as a head youth basketball coach for Allen Sports Association.

“Philanthropy is one of the oldest and most cherished traditions in health care, and few places embody its spirit more profoundly than Cook Children’s. I am excited to join the organization during such a pivotal season of growth and look forward to the impact our work together will have in the community and beyond,” Edgington said. 

In November 2024, Cook Children’s unveiled a 10-year master plan, including the new West Tower, to help meet pediatric health care needs for the growing population of North Texas.  The West Tower is a 760,000-square-foot expansion on the campus of our flagship medical center in Fort Worth. This project will increase capacity for critical care, cardiology and transitional care. This expansion also creates next level operating rooms with technology and equipment to support advanced programs like orthospine, neurosurgery, cardiothoracic surgery, robotics and more. This tower will be home to leading edge pediatric care, research and innovation demonstrating our commitment to building a healthier future for families in our community and for generations to come.

Sources of financing to build the West Tower will include a mix of operations, bonds and philanthropic support.

“We pledge at Cook Children’s to do everything we can for the health and well-being of the children in our community,” Mr. Merrill said. “Making our Fort Worth medical center bigger and better helps us fulfill that Promise. We’re looking to the future and taking steps to deliver the state-of-the-art facilities that will allow us to continue providing exceptional care for children in our region and beyond.”

Cook Children’s has six negative-pressure rooms to care for children with the virus. Rooms have space for family members and specialized air ventilation systems that pull air inward, preventing recirculation.

Dr. Whitworth hopes the rooms will not be needed.

“If everyone gets vaccinated, we won’t have this crisis,” Dr. Whitworth said. “This is preventable.”

Read the full story here.

Watch Dr. Whitworth's interview here.

Alice Phillips, M.D., medical director for Abulatory Quality at Cook Children’s, said families can protect their babies by making sure everyone else is up to date on their immunizations.

“It’s very similar to advice we give them for other vaccine-preventable diseases. We want to cocoon that baby in protection,” Dr. Phillips said. “That’s what’s so critical for families and for the community to understand about vaccines: What we all do protects those infants who can’t get vaccinated yet.”

Read the full story here.

"There's really no reason why we should have to go through this again," said Dr. Morrow. “We're all really sad about it, we're really, really concerned because we've done this already."

She's been with the health care system for 38 years and was around in 1989 when a measles outbreak impacted the entire state.

"I ended up with about about 9 or 10 children with measles," recalled Dr. Morrow. "Every child that I diagnosed was admitted to the hospital."

The current outbreak and the news of a school-age child dying from measles in West Texas has many parents calling Dr. Morrow's clinic to check their kid's vaccination status, she said.

"Get vaccinated. The vaccine is extremely effective. It's one of the most effective vaccines that we have in our armamentarium of protected kids," said Dr. Morrow.

Read the full story here.

Measles is "probably the most infectious contagious disease on the planet," said Dr. Whitworth.

"We know that about 40% of kids under the age of five who get measles are gonna wind up in the hospital, and nobody wants that," Dr. Whitworth said.

Read the full story here.

In the primary 2024 PGA TOUR season, Hoge led the tour in number of birdies with 314 total. A birdie is a score of one-under par on a hole, meaning you finished the hole in one stroke less than expected. 

Hoge’s birdie campaign, “Birdies for Basic Needs,” benefits Cook Children’s Case Management department. 

The Cook Children's Case Management team plays an integral role in delivering the family-centered care that distinguishes Cook Children's. When a child has an unexpected medical emergency or experiences a prolonged illness, being in the hospital can disrupt the family’s ability to meet their basic needs. Meals, housing, utility bills – those things essential in life – can leave a family vulnerable when faced with unexpected medical bills or costly prescriptions. Being present with a sick child means being away from work – for days, weeks, even months at a time – which can affect a family’s income. This is where Cook Children’s donor-funded Case Management team comes into play by helping to provide for families’ basic needs so they can focus on the healing of their child. 

For the 2025 PGA TOUR season, Hoge encourages others in the corporate and golf communities to participate in the “Birdies for Basic Needs” campaign. Join him in providing basic needs for families by clicking here.

In 2022, Hoge and his wife, Kelly, gave a transformational gift to Cook Children’s, providing the largest single donation to Case Management to date. In 2024, Cook Children’s became an official partner of Hoge. Because both parties are located in Fort Worth and have a passion for excellence and giving back, it seemed a natural fit for a purpose-driven partnership. 

“Beginning the formal partnership with Cook Children’s last year was really exciting. We always wanted to work on a campaign to help drive donations to their important mission” Hoge stated. “After sitting with the team, we created the Birdies for Basic Needs Campaign, where I’ll be supporting the Case Management department of Cook Children’s. I hope you’ll join me in participating in the campaign and following along this season. Together with Cook Children’s, we can give children and their families the support they need during hard times.” 

Cook Children's and Texas Health Resources share a child care center known as Kids' Place.

Kids’ Place allows parents like Anne Kirk, M.D., a pediatric hospitalist and medical director for quality and safety provider education at Cook Children's, to work and know their children are safe and nearby. The center provides flexible hours, a crucial benefit for health care workers with unpredictable schedules.

"I think because they cater to nurses and physicians, they kind of understand our lifestyle a little bit better. They, I think in some ways, are just kind of more understanding of our intense schedules... (which) makes me feel more comfortable leaving my kiddo," Dr. Kirk said. "I think being a first-time mom, I was very anxious about being away from my baby, and having him just across the street has helped me mentally so much to not be nervous and worried about him. So it's really worked out amazingly for us."

View the full story here.

Press Ganey is a global leader in health care experience solutions and collaborates with more than 41,000 health care facilities to enhance overall safety, quality and experience of care.

This is the second year in a row that Press Ganey has awarded Cook Children’s with the Guardian of Excellence for Patient Experience award. Each of these awards reflect Cook Children’s dedication to experience for the entire Cook Children’s system.

“These awards really speak to our commitment to our people and to caring,” said Megan Chavez, Vice President of Cook Children's Experience. “It’s in the way we care. If you come here, health care doesn't feel so scary. You know that you're circled with people that want the best for your child and for you. If you’re a staff member or physician, you can focus on being your best, because you're surrounded by a team of people that want the best for you.”

The system analyzes feedback from patients, families and employees to determine areas that are impacting patients, families and employees the most. That analysis leads to highlighting areas that need focus and action.

For example, Chavez said as an organization, we doubled down on strengthening team dynamics this year. This was all about understanding what strong teamwork looks like for our patients and families, she said, and demonstrating to patients that staff are working together among themselves and alongside families to deliver care. For employees, internal teamwork has a huge impact on personal experience and creating a safe environment. For patients and families, seeing that teamwork amidst staff and being included in care collaboration makes a major difference in care experience.

“We know that we're exceptional at what we do from a clinical perspective,” Chavez said. “That is coupled with not only what we do, but how we do it; the way that we really honor the human experience in healthcare protects both the person giving the care as well as the person receiving the care.”

Patient Experience Champions, made up of a group of frontline staff, work to identify areas and behaviors to focus on for patients. For example, the Urgent Care Patient Experience Champions implemented the Ambulatory Experience Bundle, in which they pinpointed physician and staff behaviors that mean the most to families and patients in that setting.

Along with staff groups like the Patient Experience Champions, 17 Family Advisory Councils made up of parent volunteers help us understand parents’ perspectives. These volunteers also serve on committees to help bring that parent voice to what we do. Last year, a Hispanic Family Advisory Council and Task Force was established to understand what the Cook Children’s experience looks like when English isn't someone’s primary language. One of the tactics identified is that Spanish-speaking families interacted the most with Environmental Services staff and created a resource guide for those staff members to help support families in these conversations.

Employee Experience

The Employee Experience and Physician Employee Experience Awards exemplify Cook Children’s emphasis on supporting staff. As with patient experiences, “this comes from listening to our people,” Chavez said. We have experts from Team Experience, Human Resources, Employee Connections, Nursing Excellence, Physician Wellness, and others that collaborate together routinely to listen and make improvements on what matters most to our staff.

For example, in 2024, it was noted that negative situations between patients, family members and employees were a concern among staff. Because of this, work was done to analyze what causes a breakdown between providers and patients’ family members and implementing programs to ease those tensions. As a result, multi-disciplinary huddles were designed and implemented to intervene quickly and ensure not only patient family needs were addressed but that staff were being supported during these often stressful situations.

In addition, a refreshed perspective on compensation, enhanced benefits and leadership coaches that provided coaching to 44 leaders in 2024 were all in response to the feedback heard from staff. 

For physicians, Physician Wellness Advocates and our Information Services partners help identify what is or is not working well and integrate improvements, such as using AI to help document during a patient exam to allow the physician to do what they do best, which is be present with the patient instead of head down at a computer.

Overall, we are proud to have received these honors, which reflect our Promise to improve the well-being of every child in our care and our communities.

“This culture that we hear so much about, even in light of all the growth that we're experiencing, is what's going to really keep the flames of Cook Children’s lit and keep these blue peaks bright,” Chavez said. “And so we need to keep having our culture be our True North, and our values truly guide all of our decision making. And that only comes from listening to our people.”

“Instead of growing straight, it starts to grow in a more curved way, so that your leg becomes bowed out to the side,” said Dr. LaMont, one of the surgeons involved with Smith’s care.

Dr. LaMont said the best option for Smith was to have his left leg intentionally broken, with pins inserted into the bone to help straighten his leg over a matter of months.

Smith had the surgery immediately following his junior season at North Crowley High School in Fort Worth.

“It definitely taught me to just never take anything for granted,” Smith said. “And it really taught me that I can do anything I put my mind to.”

View the full story here.

Iann Ledesma spent nearly half of his first year of life in the Neonatal Intensive Care Unit (NICU) at Cook Children’s Medical Center in Fort Worth. For 193 days, his mother, Giselle, rarely left her son’s side. Having had two previous miscarriages, she relished every moment with her newborn, not knowing if her baby would live to be held again.

“It was challenging since I had previous miscarriages,” Giselle said. “With my first baby, he was a 16-weeker, he just passed in my hands. So it was challenging for me to hold Iann when he was very tiny because he would give me flashbacks.”

Even so, Giselle says holding him was a dream come true.

Iann was born prematurely at just 22 weeks, which is considered the edge of fetal viability. As the only Level IV NICU in Tarrant County, Cook Children’s is equipped with the highest level of neonatal care available. Families with critically ill or premature babies come to Cook Children’s from all over the city, region, state and beyond when their infants need complex care.

However, the unit is bursting at the seams.

As recently as September, 102 of Cook Children’s 106 NICU beds were filled—an unprecedented level of demand that shows no signs of easing given Fort Worth’s population boom. Cowtown is now the 12th largest city in the United States, with 59 people moving to the city every day. As Fort Worth’s population grows, so does the demand for pediatric critical care.

Big Growth Fuels Big Plans

Cook Children’s Medical Center has been a fixture in Fort Worth and a trusted leader in pediatric health care for 106 years, consistently rising to meet the needs of the children and families in the communities it serves. To keep pace with current and projected growth in the area, the health system is preparing to meet the moment once again by embarking on a 10-year master plan to expand and enhance its Fort Worth medical center.

“Our place in this world is to be there when kids need us, and to provide that necessary support for that family and that child so that they’re able to have as productive of a life as they possibly can,” said Stan Davis, president of Cook Children’s Medical Center. “So the belief is we do that by having the facilities, having the physicians and caregivers, having the technology, but also having the heart and the commitment of our community and our team to be able to do that when it’s necessary. That’s why we’re here. We stand in the middle of being able to and not being able to provide that necessary critical care.”

The plan includes a new 700,000-square-foot medical tower, known for now as the West Tower, which will add another signature blue peak to Cook Children’s flagship campus and Fort Worth’s skyline. It will be a seamless extension of the existing medical center, connected both above and below ground, and make way for an expansion of the NICU with an additional 37 beds. It also allows for an expansion and redesign of the Pediatric Intensive Care Unit (PICU), and increases capacity for Hematology/Oncology services and research, as well as additional operating rooms and imaging services.

“We have capacity issues in these areas we’re expanding,” Davis said. “We, unfortunately, from time to time have had to divert kids to other places as far away as San Antonio, Oklahoma and Louisiana. We feel like we provide the best care possible for the kids in our community. In order to do that, we need to have the facilities and the accommodations to keep kids here and close to their home.”

Giselle and her husband, Franco, live in Arlington. She says having access to Cook Children’s expert level of care and technology close to home gave them hope for Iann’s future.

“At the beginning, we didn't know what to expect from Cook Children's, to be honest,” Giselle said. “But now I can tell you that if they didn't have a bed for Iann, I would feel hopeless, because I know from my experience that's where miracles happen.”

Connecting the Dots to Peaceful Healing

Much like the NICU, the PICU is experiencing ever-growing patient volumes. During busy sick seasons, it’s not uncommon to see 500 to 600 patients in a single day in the Emergency Department (ED), with many requiring admission to the PICU. Respiratory illness is the top driver of PICU admissions, followed by neurologic injury and disorders of the endocrine system.

“If we don’t have adequate beds in the PICU, kids end up waiting or being held in the ED, which is not the ideal environment for them. They need to be in that critical care environment,” Davis said.

But Cook Children’s isn’t just building to increase bed space. It’s evolving, innovating and advancing to connect the dots between health care delivery and an enhanced patient and family experience.

The medical center’s current 20-year-old ward-style PICU, where nothing more than a curtain separates patient beds, is no longer conducive to the type of experience Cook Children’s believes in giving patients and families. One that balances expert medical care with the creature comforts that support healing of the whole person. 

For example, children in neighboring PICU beds and their families often absorb the sights, sounds and intensity of another child’s situation, especially when there is an emergency. In an already high-stress and emotionally charged environment, this can be a source of increased anxiety and fear for patients and families.

The redesigned PICU will feature 56 private rooms where patients can heal peacefully. Plans call for ample natural light in each room to aid in sleep cycles and support the mental health of patients and their families.

“One thing that always gets asked of me is ‘Are we building for the future?’ Yes, we are,” said Spencer Seals, Cook Children’s vice president of Construction and Real Estate. “While this tower is over 700,000 square-feet, we have about 160,000 square-feet of shell space. What that means is, as we’re going through the programming of everything that has to go in this tower for this campus, we want to make sure that we have the ability to continue to expand services and continue to serve that growing population in Fort Worth.”

Big Steps for Iann and Cook Children’s

Just as Cook Children’s takes a big step forward in its growth, Iann is making significant strides towards his future, too. Now 19 months old, he’s crawling and pulling up to stand. He’ll be walking in no time, his proud mom says.

“It's just been amazing that he's getting things done, but it's on Iann's timing,” Giselle said with a chuckle. “We learned that from the beginning.”

As Iann continues to make progress at his own pace, Cook Children’s is advancing with a similar sense of purpose—one that ensures every child will have access to the care they need when they need it most.

“It’s an ambitious plan, but it’s exactly what we need to support the growing population and demand for services in our area,” said Rick W. Merrill, president and CEO of Cook Children’s Health Care System. “Kids and families rely on us, and have for more than a century, and we want to make sure we’re in a position to continue to be a beacon of hope, where every child receives the care they deserve now and for generations to come.”

About Cook Children's

Cook Children’s is more than a health care system: we strive to be an extension of your family, growing with your child from their first steps to adulthood. By collaborating to deliver on our Promise—to improve the well-being of every child in our care and our communities, we connect the dots for our patients. Between primary and specialty. Between home and medical home. Between short-term care and long-term health.

Based in Fort Worth, Texas, we’re 10,000+ dedicated team members strong, passionately caring for over 2 million patient encounters each year. Our integrated, not-for-profit organization spans two medical centers (including our state-of-the-art location in Prosper), two surgery centers, a physician network, home health services and a health plan. It also includes Child Study Center at Cook Children's, Cook Children's Health Services Inc., and Cook Children's Health Foundation. In 2024, Forbes named Cook Children’s the top health care employer in the U.S., and third on the list of ‘America’s Best Large Employers.’

And our impact extends beyond the borders of Texas. We proudly treat children from virtually every state in the nation and 32 countries. By seeing the world through the eyes of children and their families from all backgrounds, we’re able to shape health care suited to them: connected by kindness, imagination and respect—with an extra dose of magical wonder.

Discover more at cookchildrens.org.

Federal safety officials have recalled the Fisher-Price Snuga Swings and revised their standard for nursing pillows, two moves intended to guard infants against unsafe sleep spaces.

The U.S. Consumer Product Safety Commission (CPSC) and Fisher-Price announced the Snuga Swings recall in October 2024. The swings aren’t designed for sleep. According to the CPSC, the deaths of five babies were reported from 2012-2022 when the swings were being used for sleep. Bedding such as blankets had been added to the swing in most of those fatalities.   

In September 2024, the CPSC issued a new safety standard for nursing pillows to prevent sleeping infants from suffocation, entrapment and falls. The commission knows of 154 infant deaths and 64 injuries from 2010-2022 associated with nursing pillows.

“Your child should be sleeping on a flat, non-inclined mattress,” said Sharon Evans, Cook Children’s Trauma Injury Prevention Coordinator. “Any more than a 10% incline poses a suffocation risk to your baby.  They can get in the chin-to-chest position and have a difficult time breathing. Swings, bouncers, or propping them up in a pillow is unsafe for sleep.”

The U.S. Centers for Disease Control and Prevention (CDC) reported about 3,700 infants younger than one died due to sudden unexpected infant deaths (SUID) in 2022. The report indicates that 28 percent of those deaths were due to accidental suffocation and strangulation in bed. 

Through early November, nine sleep-related deaths were recorded at Cook Children’s in 2024. In the past three years, Cook Children’s has seen several infant fatalities due to sleeping on a nursing pillow.

The safest way for babies to sleep is on their back, on a firm surface with a tight-fitted sheet, in a crib or bassinet, or pack ‘n play with no pillows, blankets, bumper pads, or toys. No other children or adults should share the sleep space.

Evans said caregivers should lay their babies down in a safe sleep environment – not the couch, swing, car seat, or an adult bed – when it’s time for sleep.

“There’s just as much risk to your baby when they are taking a nap as when they sleep overnight,” Evans said. “Every sleep time needs to follow safe sleep practices.”

The new CPSC safety standard for nursing pillows relates to labeling, firmness, seam strength, and restraints. It applies to pillows designed to position and support an infant while feeding. The rule is scheduled to take effect in April 2025.

“Nursing pillows are intended to be used for feeding when both the infant and the caregiver are awake, and the caregiver can ensure that the infant’s airways are not covered by the pillow,” according to the CPSC. Injuries occur when a sleeping infant rolls face down on the pillow or their neck falls forward or back, preventing their ability to breathe.

The new standard adds this statement to the label: “Move baby to an infant sleep product, like a crib or bassinet, if baby falls asleep or if you feel drowsy.” 

 RELATED STORIES:

Popular Weighted Sleep Sacks Pulled From Shelves After Suffocation Risk Identified

Winter Warning: Blankets Pose Risk to Safe Infant Sleep

The Texas Department of State Health Services has not reported an outbreak.  

Cook Children’s pediatricians Devona Martin, M.D., and Jenica Rose-Stine, D.O., say they have seen a surge in cases at their primary care clinic in Willow Park, Texas.  

“Over the past few months, we have noticed a big increase in the number of cases of salmonella,” Dr. Martin said. “This usually presents as diarrhea that has blood or mucus and fever. Each case is reported to the Health Department to try to track down a cause, but a common source has not been identified.”  

Since July, the Emergency Department at Cook Children’s Medical Center – Fort Worth has also reported increased numbers of patients with salmonella.  

“In the ED, we usually see less than 20 patients per month with a diarrheal illness caused by salmonella,” said Stephanie Felton, D.O., associate medical director of the Cook Children’s Emergency Department. “In the month of July, we had 43 positive cases. We had 59 in August, 71 in September, and 74 in October.”  

Last week at Cook Children’s, 11 out of 229 patients tested for Salmonella were positive, resulting in a 5% positivity rate.  

Dr. Felton, Dr. Martin, and Dr. Rose-Stine provide answers to commonly asked questions about Salmonella.  

What is salmonella?  

Salmonella is a bacteria that can cause gastrointestinal illness and fever called salmonellosis. It is one of the most common causes of foodborne illness in the United States.  

What is the difference between salmonella and E. coli?  

Although salmonella and E. coli cause similar illnesses, they are different kinds of bacteria. E. coli more commonly produces a toxin that can lead to kidney damage, a condition called hemolytic uremic syndrome. This isn’t seen as often with salmonella.  

What are the symptoms of a salmonella infection?  

Symptoms of salmonellosis are diarrhea with blood and/or mucus, vomiting, abdominal cramps, and fever. 

How do children contract salmonellosis?  

Salmonella infection can be contracted by consuming contaminated food products, including poultry, eggs, produce, infant formula, and water. It can also be spread through contact with infected animals, like reptiles and birds, or other people who are infected if strict hand hygiene isn’t followed.  

Is salmonella contagious?  

Yes, salmonella is contagious and can be spread by person-to-person contact or by touching contaminated surfaces. The incubation period usually is between eight and 72 hours following exposure. You may be asymptomatic during this time.  

Salmonella is not as contagious as the viral stomach bugs we often see.  

How can parents and caregivers prevent infection?  

We can prevent infection with proper hand washing, especially before eating and after touching animals. Make sure that your counter spaces and sinks are clear of any bottles, sippy cups, or dishware before washing any fruits or vegetables. Cook and prepare all poultry and meat products appropriately. 

Only use FDA-approved formulas for your infants. Thoroughly clean all bottles, pacifiers, and toys before handing them to your children.  

How are salmonella infections treated?  

Treatment primarily involves rehydration and rest. Infants less than three months old or children with moderate to severe illness may receive antibiotics. These infections usually clear on their own.  

What should parents do if they think their child has a salmonella infection?  

If you are worried about your child having salmonella, please contact your primary care physician. He or she can run stool studies to confirm the diagnosis.  

Unless your child has blood, mucus, or fever with their diarrheal illness, it’s likely a stomach virus and not salmonella. Keep your child at home and make sure they hydrate!  

If your child is acutely ill or if you are concerned about dehydration or prolonged fevers (100.4 degrees Fahrenheit for five days or greater) please bring your child to the Emergency Department for an evaluation.  

The report, released today, analyzed data from 108 children’s hospitals and surveyed thousands of pediatric specialists.

The following Cook Children’s specialties were named among the top programs:

·         Pediatric Behavioral Health – Top 50

·         Pediatric Cancer - #37 in the nation

·         Pediatric Cardiology - #37 in the nation 

·         Pediatric Endocrinology - #44 in the nation

·         Pediatric Neurology and Neurosurgery - #45 in the nation

·         Pediatric Orthopedics - #24 in the nation

·         Pediatric Pulmonology - #48 in the nation

This is the first year for U.S. News & World Report to include Pediatric Behavioral Health as “Top 50” programs and Cook Children’s was named to the inaugural list. Other highlights include Cook Children’s Cardiology jumping to #37 and Cook Children’s Orthopedics moving an impressive 16 spots in the rankings, from #40 last year to #24.

“We’re thrilled to see our Pediatric Behavioral Health services recognized on a national level,” said Kia Carter, M.D., co-medical director of Inpatient and Consultation Liaison Psychiatric Services. “Our team's expertise in child and adolescent mental health is unparalleled. These rankings reflect our commitment to providing evidence-based care that empowers young people to thrive.”

U.S. News & World Report evaluated children’s hospitals based on a variety of factors, including quality of care, clinical research programs, services and surgeries performed, patient and family involvement and access to resources, staff dedication, recognition as a Nurse Magnet Hospital, and more.

For Cook Children’s Health Care System as a whole, the rankings highlight longstanding excellence in a variety of areas. 

"It's a tremendous honor to be recognized by U.S. News & World Report once again," said Rick W. Merrill, President and CEO of Cook Children's. "This recognition is a testament to the exceptional work of our doctors, nurses, and staff, who consistently strive to provide the best possible care for every child, every day. Our dedication to our promise and values, combined with our strong culture, sets us apart, and we're proud to be named a top children's hospital."

Rebekah Jones, who has had four children on Cook Children’s Health Plan, knows too well how big of a difference consistent, quality medical care can make.

Rebekah, who has been a nurse at Cook Children’s for 20 years, is the mother of four children with medical complexities. In 2017, her adopted son, Danny, passed away. After he died, Rebekah decided to foster medically challenged kids and has since adopted three of those children.

As a staff member and mother of patients, Rebekah has seen every aspect of Cook Children’s care. For her, the key to the quality care at Cook Children’s is the relationships that Cook Children’s physicians and providers build with kids over time.

“I am a little biased because I love Cook (Children's) and I think it is the best hospital in the world. And Cook Children’s is our home,” she said. “Part of it is just building that relationship, having doctors that trust you, listen to you, that you can call and say, ‘Hey, like something's not right,’ and you know they would just listen to you and believe you.”

Those relationships are not easily replicated. Rebekah worries if Cook Children’s Health Plan loses essential state funding, her children will have to start all over with new physicians, providers and therapists. She has some experience with having to coordinate with a new medical facility; in 2013 she had to transfer some of Danny’s care to another hospital to be put on the list for a heart transplant. The providers there did not know her or Danny, and in a way, it felt like starting over. Anytime you move medical care, she said, you face the headache of paperwork and trying to find new providers and schedule with all of them. Even the testing and data in a patients’ medical file might need to be repeated at the new medical facility.

For Rebekah’s three children, the relationships built at Cook Children’s under Cook Children’s Health Plan are essential to their quality of life. Because of the Texas Health and Human Services Commission plans to deny Cook Children’s that funding, Rebekah and her kids are in a sort of medical care limbo, wondering what will happen next.

This innovative series explores the fascinating connection between art, science, and creativity. The first episode, now streaming on PBS.org, dives into the work we're doing with Spikelangelo, the painting robot that helps children with epilepsy heal and recover through artistic expression.

“Confluence explores the enduring--and often surprising connections between three of the most essential aspects of the human experience: art, science, and creativity. A range of stories are told by a terrific array of characters, some well-known and others will be wonderful discoveries for audiences.”

Tune in to see the power of art and science coming together to make a difference in the lives of our patients!

Fort Worth, Texas – Patient care at Cook Children’s Health Care System is not being impacted by global technology issues. Our IT teams have been working throughout the night responding to this incident. 

The bulk of our response has been troubleshooting technology, rebooting computers, and stabilizing systems. We have emergency IT response teams on-site across the system and we are doing everything possible to ensure there is no interruption to patient care nor delays or inconveniences to families.

We stand by our promise to do everything for the child. Please follow @CookChildren’s on social media for all the latest updates.

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Newsweek, in collaboration with Plant-A Insights Group, conducted a large-scale employer study to recognize the nation’s top workplaces. The study encompassed over 1.5 million comprehensive company reviews from more than 250,000 employees, showcasing the best places to work across all industries in the United States.

“Being named one of the best workplaces in America by Newsweek is an incredible honor and a testament to the unwavering dedication of our remarkable team at Cook Children’s,” said Rick W. Merrill, President and CEO of Cook Children’s Health Care System. “Our employees are the heart and soul of this organization, and their compassion, resilience, and commitment to our Promise inspire me every day.”

The selection process for America’s Greatest Workplaces 2024 involved a rigorous five-stage evaluation. Initially, HR professionals were interviewed to identify key drivers of employee satisfaction. Following the interviews, a main employee survey gathered reviews from U.S. employees familiar with their employers. Additionally, an elaborate desk research project was conducted, collecting 15 KPIs relevant to a great employee experience, including social media reviews and information on corporate culture, work-life balance, and career opportunities.

“Finding a great workplace is an important decision that needs to factor in pay, respect, training and advancement as well as healthy work-life balance. Newsweek and market-data research firm Plant-A Insights are proud to publish ‘America’s Greatest Workplaces 2024,’ the second annual ranking that highlights companies which are committed to offering a positive and supportive working environment,” said Nancy Cooper, Global Editor in Chief of Newsweek.

Fostering a Nurturing Workplace and Exceptional Patient Care

In recent years, Cook Children’s launched several initiatives to uphold these gold standards, ensuring a healthy and happy workforce.

Through internal surveys and listening sessions, Cook Children’s identified burnout among employees at all levels and responded by implementing programs aimed at reducing stress and supporting employee well-being both on and off the job. This approach fosters a culture where employees feel like family and are encouraged to see the world through the eyes of others, be it patients, family, or staff.

Employee feedback has been instrumental in developing initiatives such as Employee Resource Groups, which support the diverse faces and voices within the organization. Cook Children’s comprehensive employee benefits includes primary care and mental health counseling for staff and their families, tuition reimbursement for career development, and expanded parental leave.

These efforts are designed to connect the dots for employee well-being, facilitating the delivery of safe, kind, respectful, collaborative, generous, and imaginative care to patients and their families.

“We have always strived to create a supportive, family-like environment where every employee feels valued and included," said Mr. Merrill. “This recognition reflects our collective efforts to make Cook Children’s not only a place of healing and hope for children but also a nurturing workplace for those who devote their lives to this vital mission. Thank you to each and every one of our employees for making Cook Children’s such a special place.”

Cook Children’s is proud to announce a new sponsorship agreement with PGA Tour professional golfer, Tom Hoge. This multi-year partnership aligns our passion for excellence and giving back to the community.

Hoge, a Texas Christian University alumnus and resident of Fort Worth with his wife Kelly, has cemented a place on the national golf scene, following his initial win on TOUR at the famed 2022 AT&T Pebble Beach Pro-Am. His dedication and talent mirror Cook Children’s commitment to providing exceptional health care to children and families. The Hoge family are dedicated supporters of Cook Children’s patient support services, making this a true purpose-driven partnership. Their shared values and Tom’s desire for active involvement with patients solidify the foundation of this meaningful relationship.

“Cook Children’s is one of the many reasons Kelly and I are proud to call Fort Worth home,” Hoge commented. “We are immensely proud to have a best-in-class opportunity for children to receive health care right in our backyard. Anything I can do to further the mission and platform of Cook Children’s through this partnership will be a great honor.”

Fans can look forward to seeing Tom sporting Cook Children’s logo on his left arm shirtsleeve as he competes throughout the PGA Tour season. He will also be participating in Cook Children’s annual BedPan Open on Tuesday, May 21, just before the 2024 Charles Schwab Challenge at Colonial Country Club.

“The Hoge family’s continued support of our patients makes this partnership a natural fit,” said Grant Harris, Senior Vice President, Chief Development Officer, Cook Children’s Health Foundation. “Our national recognition as a premier pediatric health care organization has grown parallel to Tom’s recognition on the PGA tour, and we’re thrilled to reach these new heights with such a dedicated partner on our team.”

As Hoge continues to ascend the golf rankings, Cook Children’s continues to garner national recognition and awards for health care excellence. This partnership creates a ripple effect of positive impact within the Fort Worth community and beyond. Join us in celebrating this exciting partnership and wishing Tom a very happy birthday on May 25!

If you need to reach us, please turn on “Wi-Fi calling” on your phone to call our main line (682-885-4000) or use your MyCookChildren’s account to reach your children’s care team.

MyCookChildren's Patient Portal

Cook Children’s Health Care System earned a top spot on Forbes America’s Best Large Employers 2024 list, debuting at No. 3 out of a lineup of 600. The rank acknowledges something we already knew — Cook Children’s is one of the best places to work among all large businesses across all industries nationwide.

Cook Children’s was also named No. 1 in the health care and social industry category among large employers on the list. View the entire list here.

Rankings are determined by a survey of thousands of Americans working for large companies defined as having more than 5,000 employees. The survey was administered by a national market research firm. Respondents remain anonymous and the companies on the list do not pay a fee to be included.

“It’s a huge honor to be recognized in this way on such a national level because it speaks directly to the culture we are working so hard to build here. One where our employees feel valued, supported and connected to our Promise, to our patients and to each other,” said Rick Merrill, Cook Children’s president and CEO. “It’s our people that make this place magical, and now the entire country is getting a glimpse of that magic.”

A number of criteria was used in the survey to evaluate companies, including working hours, gender pay equity, opportunities for training and promotion, workload expectations, parental leave benefits, the degree of diversity on the management team and whether employees would recommend the company to their friends and family, according to Forbes. 

In recent years, Cook Children’s launched a number of initiatives to promote many of these gold standards for growing a healthy and happy workforce.

Healthy and Happy Employees Lead To Excellence

Working in health care can be personally and professionally fulfilling, but it’s no secret that it can also be hard. The COVID-19 pandemic took a toll on health care workers across the globe, and exposed the burnout weighing on physicians, nurses and staff. Several internal surveys and listening sessions gave us a glimpse into the burnout Cook Children’s employees at all levels of the organization were experiencing.

“Our listening strategy is an investment in our people. Honest feedback helps us discover opportunities to improve and helps bring together leaders and teams to collaborate on solutions. No matter what your role is at Cook Children’s, your well-being matters,” said Kathy McLean, Cook Children’s Vice President of Brand and Team Experience.

In response, we are making meaningful changes and developing programs that reduce stress, support employee well-being both on and off the job, and cultivate a culture where employees feel like family.

“When we use our culture to build everything – from system strategies to our day-to-day work – we can deliver care that puts our employees and the children at the forefront of everything we do,” Kathy said.

It all starts with seeing the world through the eyes of others, whether it’s patients, family or staff. This gives our team members a unique perspective on where things are working well, as well as the opportunities for growth. Our employee feedback has been the catalyst for initiatives like the Employee Resource Groups supporting the many faces and voices within our organization.

In all of our employee benefit efforts — from providing primary care and mental health counseling for staff and their families, to supporting career development through tuition reimbursement, to expanded parental leave — our goal is to connect the dots for employee well-being. We know that helps pave the way for the safe, kind, respectful, collaborative, generous and imaginative care of our patients and their families. A healthy, valued and supported workforce allows us all to deliver on our shared Promise of “Everything for the child.”

“You cannot pour from an empty cup,” Megan said. “We believe in protecting the noble profession of caring for others by protecting our staff’s well-being and allowing them the autonomy they need to bring their best self to the job. We have the honor of caring for families, often on their worst day. That can take a toll, and we recognize and support the healing needed to continue to be present for the next situation we will encounter.”

Acknowledging Cook Children's commitment to patient satisfaction, the 2023 Press Ganey Human Experience Guardian of Excellence Award® places our medical center in the top 5% of health care providers nationwide.

In acknowledging the tireless efforts of all teams involved, Megan Chavez, Vice President of Cook Children's Experience, highlights the dedication that led to this achievement.

"An award of this magnitude is only achieved through the dedicated efforts of our teams," says Chavez. "This is an award for all of our teams. What happens in the hospital is very much informed by what our families experience at the doctor’s office, in the emergency room, urgent cares, at home and through their health plan."

Press Ganey, a global leader in health care experience solutions, collaborates with more than 41,000 health care facilities to enhance overall safety, quality, and experience of care. Patrick T. Ryan, CEO, and chairman at Press Ganey highlights Cook Children's as a "top-performing leader in health care," emphasizing our commitment to delivering exceptional patient care.

Meanwhile, the AACN's Silver Beacon Award for Excellence recognizes Cook Children's PICU for its effective approach to policies, procedures, and processes, including strong engagement of staff and key stakeholders.

Terry Davis, President of AACN, commends the exemplary efforts of PICU caregivers for consistently exceeding the high standards set forth by the Beacon Award for Excellence.

“These dedicated health care professionals join other members of the exceptional community of nurses who set the standard for optimal patient care,” Davis said. “The Beacon Award for Excellence recognizes caregivers in stellar units whose consistent and systematic approach to evidence-based care optimizes patient outcomes. Units that receive this national recognition serve as role models to others on their journey to excellent patient and family care.”

“At Cook Children's Medical Center, we strive to provide excellent patient care and the silver-level Beacon Award reflects our commitment to strong leadership, staff engagement, effective communication, using evidence-based practices, and demonstrating quality outcomes,” said Cheryl Petersen, Senior Vice President and Chief Nursing Officer at Cook Children’s. “These are all part of our Promise to improve the well-being of every child we care for and in the communities we serve.”

The combined acknowledgment from Press Ganey and AACN further underscores Cook Children's unwavering dedication to delivering exceptional health care experiences. In alignment with our guiding Promise, we solidify our position as a leader in patient care, ensuring that every child's life is treated as sacred and improved through our compassionate and innovative approach.

About Press Ganey: Press Ganey, the leading Human Experience (HX) healthcare performance improvement company, offers an integrated suite of solutions that address safety, clinical excellence, patient experience and workforce engagement. The company works with more than 41,000 healthcare facilities in its mission to reduce patient suffering and enhance caregiver resilience to improve the overall safety, quality and experience of care. Press Ganey is a PG Forsta company.

About the Beacon Award for Excellence: Established in 2003, the Beacon Award for Excellence offers a road map to help guide exceptional care through improved outcomes and greater overall patient satisfaction. U.S. and Canadian units where patients receive their principal nursing care after hospital admission qualify for this excellence award. Units that receive the Beacon Award for Excellence meet criteria in six categories: leadership structures and systems; appropriate staffing and staff engagement; effective communication, knowledge management, and learning and development; evidence-based practice and processes; and outcome measurement. To learn more, visit www.aacn.org/beacon or call 800-899-2226.

About the American Association of Critical-Care Nurses: Founded in 1969 and based in Aliso Viejo, California, the American Association of Critical-Care Nurses (AACN) is the largest specialty nursing organization in the world. AACN represents the interests of more than half a million acute and critical care nurses and includes more than 200 chapters in the United States. The organization’s vision is to create a healthcare system driven by the needs of patients and their families in which acute and critical care nurses make their optimal contribution. To learn more about AACN, visit www.aacn.org, connect with the organization on Facebook at www.facebook.com/aacnface or follow AACN on Twitter at www.twitter.com/aacnme.

Of the more than 800 patients tested for RSV last week at Cook Children’s, more than 200 (29%) were positive. Four percent of those tested for COVID-19 were positive. The Emergency Department (ED) at Cook Children’s in Fort Worth is treating more than 500 patients a day. An additional 800 patients a day are seeking treatment at one of Cook Children’s seven Urgent Care Centers (UCCs). The influx is leading to over-crowded waiting rooms and long wait times across the board.

These numbers are expected to climb as we move closer to peak respiratory illness season, typically December through January.

Parents and caregivers can help reduce the stress on the system by knowing when to call your child’s physician and when to seek emergency care. Doctors say following these guidelines can reduce traffic to EDs and UCCs, reduce wait times for patients and reduce your child’s exposure to viruses.

Many viral respiratory illnesses can be treated at home with rest and lots of hydration. If you are concerned, call your pediatrician first if your child is experiencing mild symptoms without difficulty breathing or dehydration, or for illness-related symptoms (ear pain, sore throat, diarrhea or vomiting, rash, cough or other non-urgent health concerns). The pediatrician’s office can help you decide what steps to take.

In many cases, physicians can assess and treat a patient via a virtual health appointment. Not only is this a convenient option that saves time, but it keeps you and your child out of a waiting room where they could pick up another virus on top of the one they already have.

Download the MyCookChildrens app to schedule a virtual health/telemedicine appointment here.

Parents should not go to Urgent Care or the Emergency Department for an RSV, flu or COVID test. Your pediatrician can test for all of these.

When to Seek Immediate Care:

●      Any temperature greater than 100.4 in an infant under two months of age is considered a medical emergency. If your child has a fever for more than three days, contact your pediatrician or visit an urgent care center. 

●      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.

●      Your child is breathing faster than usual or you 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.

Signs and Symptoms

Symptoms of RSV in infants younger than 6 months may include:

●     Irritability

●     Poor feeding

●     Lethargy

●     Episodes where they stop breathing

●     Fever

Infants and children over 6 months may experience:

●     Runny nose

●     Loss of appetite

●     Cough

●     Sneezing

●     Fever

●     Sometimes wheezing

Flu and COVID-19 share similar symptoms as RSV and may also include sore throat, headaches, body aches, chills and change/loss of taste and smell.

Practice Prevention

When it comes to respiratory illnesses, prevention is always the best medicine, especially as we approach the holidays and the many indoor gatherings they bring. Vaccines can help reduce the spread and severity of illness and prevent hospitalization. It’s not too late to get your child’s flu shot or COVID vaccine. Call your pediatrician to make an appointment.

Remind your children to practice healthy habits such as washing their hands and coughing into a tissue or their elbow. If you or your child feels sick, stay home to prevent spreading illness, take time to rest and stay hydrated with lots of fluids.

Getting back into a routine after a long summer break can be tough for kids of all ages. In this episode of Raising Joy, we talk to Cook Children's psychologist, Whitney Appleby, Ph.D., about all things school. Dr. Appleby shares her expert advice on how to help kids get a good night's sleep, create a healthy routine, manage anxiety, and avoid burnout. As a mom of three, she knows the struggle is real, but she also knows that with a little planning and effort, we can set our kids up for a successful school year.

If you're looking for some helpful advice on how to get your kids back into a school routine, be sure to listen to this episode of Raising Joy!

Raising Joy is part of Cook Children’s Health Care System’s Joy Campaign, a communications initiative aimed at preventing youth suicides. For more information about the Joy Campaign, visit cookchildrens.org/joy. For information about resources, view the crisis resource sheets below (available in English and Spanish). A PDF version is also linked under “Downloads.” 

New episodes of the Raising Joy podcast will be available each Tuesday. It is currently available on all major streaming platforms including Apple, Spotify and Google Podcasts.

Enrolling a child in day care might raise a few concerns or unknowns about the steps the facilities take to protect the kids they serve from illness and injury.

It’s important for parents to know that the Texas Health and Human Services Commission (HHSC) sets rules that state-licensed day care operators, including in-home day cares, must follow. Those rules aim to minimize the risks for infants, toddlers and older children while playing, eating and sleeping at day care. The goal is to make the settings as sanitary and hazard-free as possible.

Across the state, there are about 8,300 licensed child care centers and in-home day cares with a combined capacity for more than 997,000 children. Sharon Evans, trauma injury prevention coordinator at Cook Children’s, advises parents to make sure the facility they choose is licensed and subject to the regulations.

“Day care regulations are in place to keep your child as safe as possible. However, Cook Children’s still sees broken bones and head injuries from day cares due to kids playing,” Evans said.  

The HHSC requirements are published in Minimum Standards for Child-Care Centers, which was revised in March 2023. You’ll find specifics on many topics – from food allergies and first aid to fever and fire drills – in the updated manual. Sections cover illness protocol, required immunizations, playground equipment and much more in 294 pages.

Here’s a shorter and simplified look at a few key requirements.

Parents will need to provide:

Medical information at admission: Name, address and phone number of the child’s physician; authorization for emergency medical care; an emergency plan for any severe allergic reactions; a statement of any special care needs.   

Health statement: Signed by a health care professional who has examined the child in the past year. It says the child can participate in the day care’s program.

Routine vaccinations: Immunize by 3 months old for diseases including polio, hepatitis B and diphtheria, tetanus and pertussis (DTaP). Booster shots are due for older children. The day care must keep a copy of every child’s up-to-date shot record on file.  Learn more here.

Licensed day cares are required to provide:

Caregiver training: Before they start the job, with 24 hours of additional training each year. Certification in pediatric first aid and pediatric cardiopulmonary resuscitation (CPR) is also required. “Ongoing training provides caregivers an opportunity to learn the newest techniques for addressing children’s behaviors, to discover the latest findings on what children need as they develop, and to refresh and re-energize their skills,” the manual says.

Communication for any injuries: The day care will let you know about minor scratches and cuts when you pick up your child. An Incident/Illness Report must be filled out for injuries.

Infant safe sleep practices: Infants are always placed on their backs, by themselves, in a crib that meets federal regulations. Bean bags, waterbeds and foam pads may not be used. No pillows, blankets or soft toys can be in the sleep space. If your infant falls asleep in their car seat on the way to day care, they’ll be moved out of the seat and into a crib.

Sanitization: Toys that have been in a child’s mouth; potty chairs; sleeping spaces; table tops; anything soiled or contaminated. 

Proper handwashing: For employees upon arrival for the day; before handling food or medication; before feeding a child; after a diaper change or assisting a child with toileting; after wiping a child’s nose, mouth or sores; after their own trips to the bathroom. The children also must wash their hands frequently throughout the day.  

Guidelines for illness: Don’t bring your child to day care with an oral temperature above 101 degrees or ear temperature above 100 degrees. Other exclusions include lethargy, abnormal breathing, uncontrolled diarrhea, vomiting twice or more in 24 hours, rash with fever, or mouth sores with drooling.  A child may return after being symptom-free for 24 hours.

Safeguards on the premises: Childproof covers on electrical outlets; televisions anchored so they can’t tip over; heaters out of children’s reach; no access to firearms. Smoke detectors, carbon monoxide detectors, fire extinguishers and sprinkler systems are required. No use of alcohol, drugs, tobacco products or e-cigarettes is permitted by anyone on the property. 

Medication: In the original container, labeled with your child’s name, and not past the expiration date. The employee who administers the medicine will record the date, time and dosage given.

Safe handling for food allergies: Employees who prepare and serve food will be made aware of the known food allergies. Foods listed on a child’s emergency plan will be posted wherever food is prepared and where the child spends time.

Best Children’s Hospitals list for 2023-2024.

The report, which was released today, uses clinical data to measure patient safety, infection prevention and adequacy of nurse staffing. Out of 284 children’s hospitals in the U.S., only 90 ranked in at least one of the 10 pediatric specialties evaluated. The following Cook Children’s specialties were named among the top programs:

• Pediatric Cancer - #30 in the nation
• Pediatric Diabetes and Endocrinology - #31 in the nation
• Pediatric Neurology and Neurosurgery - #36 in the nation
• Pediatric Orthopedics - #40 in the nation
• Pediatric Pulmonology and Lung Surgery - #48 in the nation

Cook Children's Hematology and Oncology program jumped an impressive 20 spots in the rankings, from #50 in 2022-2023 to #30 in 2023-2024.

 “We are focused every day to improve the lives of the patients we serve and enrich the care of children all over the world. We do this by providing innovative care and contributing to the science of future cancer therapies,” said Donald Beam, M.D., medical director of Hematology and Oncology. “We will continue to strive to improve every day, growing beyond what we are and stepping to the future.”

For Cook Children's Health Care System as a whole, the rankings demonstrate a longstanding commitment to excellence in pediatric care.  

"For more than 105 years, Cook Children's has been committed to improving the well-being of every child in our care. We are honored to see our mission validated yet again by U.S. News and World Report,” said Rick W. Merrill, President and CEO of Cook Children’s Health Care System. “With our newest medical center in Prosper now open, we look forward to making an impact in the lives of even more children and families.” 

Cook Children’s also ranked #3 in Texas and #4 in the Southwest on the U.S. News and World Report “Best Regional Hospitals” list. 

The first vaccine to protect babies from the respiratory syncytial virus (RSV) is one step closer to approval after the Food and Drug Administration’s advisory committee met to discuss the efficacy and safety of the vaccine.

If approved by the FDA later this year, this could be the first vaccine to protect infants from RSV, which is a leading cause of hospitalization for infants. The vaccine would be issued to expecting mothers during the second or third trimester of pregnancy to prevent RSV and prevent severe RSV from birth through six months of age.

The Centers for Disease Control and Prevention is also weighing recommendations for a monoclonal antibody for babies and toddlers, as well as a RSV vaccine for older adults.

Virtually all children get an RSV infection by the time they are 2 years old. RSV is a common respiratory virus that usually causes mild, cold-like symptoms. Most people recover in a week or two, but RSV can be serious, especially for infants and older adults. RSV can also cause severe illnesses such as bronchiolitis and pneumonia. The risk is especially high for premature infants.

Some children require hospitalization, but most do not. Currently, there is no vaccine to prevent RSV infection. To prevent RSV infection, Cook Children’s encourages children to continue health habits learned in the pandemic, including hand hygiene, coughing/sneezing into a tissue and staying home if you or your child feel sick.

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

In fall 2022, Cook Children’s experienced an early spike in RSV and influenza A cases. Our Emergency Department and Urgent Care Centers were overwhelmed with patients. By November 2022, our patient census was full across the board due to many patients with flu, RSV and respiratory illnesses. If patients were inoculated with the RSV vaccine, this could help alleviate stress on our health care system by keeping children out of the hospital.

During the FDA’s advisory committee meeting, the discussions were complicated so the recommendations were split to vote on efficacy and safety. They unanimously approved based on the efficacy of the vaccine. However, based on available safety results, the decision was split (10 would approve, 4 would oppose).

The vaccine had serious safety concerns in the elderly patient trials that were submitted with 1 patient out of 2,500 having Guillain-Barre syndrome and another with acute disseminated encephalomyelitis (ADEM), both serious central nervous system diseases. Both diseases occur outside of trials in this population, but they are also known to be rarely related to both vaccines and due to the diseases they help prevent. There are post-marketing studies in place in elderly patients to further evaluate the exact risks of these diseases.

Additionally, a pregnancy trial was in progress but it was paused due to safety concerns. In addition to the diseases noted, there were more preterm births in the vaccine group. These were mostly babies born a week or two early which is generally safe, but due to the trend, the trial was paused while the safety is better assessed.

Nicholas Rister, M.D., of the Cook Children's Infectious Disease team, shares what parents and caregivers need to know.

Why should I consider getting the RSV vaccine? Is it safe?

Right now, the vaccine is only approved for elderly patients over the age of 60. People in this age range should talk with their doctor about the vaccine.

There is an ongoing discussion about making the vaccine available for pregnant women so that the antibodies it induces can be passed to their infants via the placenta. It has been difficult to develop an RSV vaccine for very young infants since they do not react readily to the vaccines that have been developed. However, young infants are the group most at risk for severe and prolonged disease with RSV so providing them protection via their mother is an important opportunity.

The safety questions are the issue here. Right now, the vaccine is not approved for pregnant women so it is not an option. However, the vaccine appears very effective so it may still gain approval in some form once the exact risks are better understood.

Importantly, this is not a vaccine that is going to be mandated for pregnant women. The ethical issues with having a person get a vaccine (the mother) to provide protection for someone else (the infant) and the risks assumed between them is going to make this a more nuanced discussion between OB/GYNs, pediatricians, and families.

How long and how strong is the protection against RSV infection if vaccinated?

Initial results from pregnancy trials showed 82% protection from severe RSV disease from 0-3 months of life and still 69% percent at 6 months of life. While this doesn’t prevent disease or even all severe disease, since RSV is so common in infants and particularly dangerous in preterm infants, this level of protection is very significant and dramatic.

What should parents of toddlers and young children know about the RSV vaccine since, if approved, it would only pertain to pregnant women?

RSV is a very low-risk infection for children outside of the first year or two of life and in younger adults. Until vaccine risks are clarified, there likely will be no push for using this vaccine outside of infants (via pregnant mothers) and elderly adults. Should further evaluation (or a new vaccine) emerge to show minimal risk to getting the vaccine, there may be a role in vaccinating older children to prevent the spread within families to high-risk groups. But, for now, the discussion is likely to stay with pregnant women and older adults.

Why is there a need for the vaccine? How will this impact health care systems?

The Centers for Disease Control and Prevention reports that per year, there are between 58,000 and 80,000 hospitalizations for RSV among children under 5. Because so many children get RSV every year, the actual number of children with severe disease is very high. This leads to a massive use of health care resources each year. That’s why there is so much effort into evaluating the vaccine despite some significant safety questions that need answering.

Go here to view more info about RSV from the CDC.

According to the CDC, those at greatest risk for severe illness from RSV include:

• Premature infants
• Infants, especially those 6 months and younger
• Children younger than 2 years old with chronic lung disease or congenital (present from birth) heart disease
• Children with weakened immune systems
• Children who have neuromuscular disorders, including those who have difficulty swallowing or clearing mucus secretions

About Cook Children’s Health Care System 
Cook Children’s is more than a health care system: we strive to be an extension of your family, growing with your child from their first steps to adulthood. By collaborating to deliver on our Promise—to improve the well-being of every child in our care and our communities, we connect the dots for our patients. Between primary and specialty. Between home and medical home. Between short-term care and long-term health. 

Based in Fort Worth, Texas, we’re 8,000+ dedicated team members strong, passionately caring for over 1.5 million patient encounters each year. Our integrated, not-for-profit organization spans two medical centers (including our new, state-of-the-art location in Prosper), two surgery centers, a physician network, home health services and a health plan. It also includes Child Study Center at Cook Children's, Cook Children's Health Services Inc., and Cook Children's Health Foundation. 

And our impact extends beyond the borders of Texas. We proudly treat children from virtually every state in the nation and 32 countries. By seeing the world through the eyes of children and their families from all backgrounds, we’re able to shape health care suited to them: connected by kindness, imagination and respect—with an extra dose of magical wonder. 

Discover more at cookchildrens.org. 

About JPS Health Network 
The Tarrant County Hospital District, known as JPS Health Network, is a tax-supported organization serving the healthcare needs of families in Tarrant County. JPS provides adult inpatient care at John Peter Smith Hospital in Fort Worth, Texas and offers comprehensive services including primary care, behavioral health, and pharmacy at more than 25 community locations. JPS has served as a Level I Trauma Center in Tarrant County for more than a decade. JPS is governed by an 11-member Board of Managers, whose members are appointed by the Tarrant County Commissioners Court. 

JPS was named the Best Hospital for America by Washington Monthly magazine and the Lown Institute in 2020, and Outstanding Healthcare System by D CEO Magazine. 

About City of Fort Worth 
The City of Fort Worth began as a tiny outpost and today, thrives as the 13th largest city with more than 900,000 people. The City blends its cattle and oil heritage seamlessly with an ever-growing, diverse city of new businesses and industries. Fort Worth is one of the fastest growing large cities in the nation, focused on economic development growth, innovative transportation and mobility solutions, quality education opportunities, and building safer, more prosperous communities. 

About LVTRise 
LVT began as a mobile community center providing social services and access to resources for area residents after a series of Town Hall meetings uncovered significant deficiencies and a lack of resources in this part of the community. In 2018, the Las Vegas Trail Revitalization Project became the registered nonprofit currently known as LVTRise, Inc. 

In October 2020, Rise Community Center opened to the public providing a permanent home for the organization. In January 2021, the city of Fort Worth opened a branch of the public library system in the community center furthering the resources available. 

In May 2022, the Fort Worth City Council approved a land lease agreement that paved the way for a Las Vegas Trail Child Development Campus to become a reality for the high need community. Child Care Associates will build and operate the new facility that will be built adjacent to the existing Rise Community Center. Construction is estimated to start in fall of 2022 and is projected to take 18 months to build and finish out an eight classroom, approximately 8,600 SF child development facility. An estimated 100 children and their families will be served through Head Start and Early Head Start. 

Since its inception, LVTRise has dedicated its work to collaborating with community partners, empowering community members through training and case management and impacting the Las Vegas Trail community addressing education, improved quality housing and reducing neighborhood crime.
 
For more information, visit LVTRise.org.

By Ashley Pagenkopf, MS, CCLS, Child Life Specialist at Cook Children's

It’s amazing to see what one bright-colored toy or fidget can do to change the feeling in an exam room. Recently, I have started grabbing something to take to patients when I get a call to help prepare them for a procedure or support them.

Typically, I grab something small – a pop-it, a Hot Wheels car or something else that I can offer them upon entering the room. You can see kids’ eyes when you walk into the room. They are scanning your hands to see why you came and what you are there for. They are really looking for a SHOT!

When they scan my hands, they often see an iPad and some small toy or fidget of some kind, and their face melts a bit. They soften. Why does this happen? Because play is magical…

Play is the act of engaging in something for fun or enjoyment. We know that play is universal and crosses many cultural and language barriers. In fact, child life specialists would say that play can be a language of its own. Play is a pillar of child life practice, and we could not engage patients and families without it.

We see the expression of a child’s emotions and experiences being worked out in play often more than words. We also know that play is an integral part of cognitive, speech/language, social/emotional, and gross and fine motor development.

This makes play essential in a pediatric health care setting. It is our goal to continue the normal growth and development of children even during stressful experiences like hospitalizations, traumatic experiences and chronic illnesses.

There are several ways that we utilize play in the health care environment. We use play for normalizing the environment, preparing and teaching the patient and family about medical procedures, and for processing their experiences.

Normalizing the Hospital Experience

Developmentally appropriate play is the most natural aspect of childhood that kids know and understand. We use developmentally-appropriate play to help normalize what is otherwise a very stressful place. Just as I referenced in the story above, walking in with a toy or a stuffed animal immediately changes the atmosphere.

Basic things like coloring, Play-Doh and bubbles are the framework of breaking barriers with kids in this seemingly very scary place. You will notice in many exam rooms around the hospital and medical center that there are eye-spy art pictures for children to engage in while they wait.

Each age group plays differently and has different needs. When I would meet kids as an inpatient child life specialist, I would often ask kids what they loved to do if they were stuck in bed at their house. We want to start with their favorite things and what brings the most comfort. Thankfully, we are able to provide play opportunities to every kid that enters our doors in some way.

Through hospital allocations and community donations, play is always possible. I’ve played countless hours of Barbies and Battleship with kids. UNO tournaments were a norm in our inpatient playroom. Nerf guns and over the door basketball hoops can bring incredible laughter and smiles even on the worst of days.

Even in the NICU, our babies experience play. We make sure that babies have stimulation at the bedside with mobiles and textured lovies, and jumpers are provided as they are able.

Developmentally appropriate play is just a standard part of childhood. We want to meet the basic needs of children in the health care environment, too. Play is essential.

Processing - Therapeutic Play

While a large part of the play within the health care environment is just for fun, we also spend a lot of time playing with purpose. This is therapeutic play. Therapeutic play can be led by a patient (non-directive) or led by the child life specialist (directive) with the goal of emotional expression, medical teaching or to be physiologically enhancing (blowing bubbles to encourage deep breaths) (Koller).

Some could argue that all play is therapeutic allowing a child to express themselves and process their experiences. However, therapeutic play within the hospital environment is vital. These type of play experiences allow children to build their resilience while developing and practicing new coping skills. We utilize specific medical play often which is discussed in detail a little later.

We also provide art and music opportunities through our CARPE program and other play modalities for patients to express their feelings and work out their thoughts. Remembering that play is a language, we can learn a lot about our patients and families by watching them play or engaging in play with them. These things allow us to better serve our patients and families and develop care and coping plans during their stay.

Preparing for Procedures or Teaching a New Diagnosis

We also utilize play when preparing children for procedures or teaching them about a new diagnosis. This is a type of therapeutic play with a very specific purpose. We often utilize a stuffed animal or doll to first demonstrate a procedure. We may tie a tourniquet around a stuffed animal’s arm so that a child can see what that looks like. We frequently place IVs in dolls and stuffed animals so that the child feels less alone in their experiences while also seeing the steps and understanding the process.

As child life specialists, we facilitate what is called medical play. This may be as simple as a toy doctor’s kit to more complex play using real medical supplies while teaching with a patient and/or sibling.

One of my favorite activities is using an insulin syringe to inject dye into a medical play doll. This ultimately makes a tie-dyed doll, but it also allows a patient to get comfortable with the needle and syringe (under the supervision of a child life specialist).

At Cook Children’s, we host a Kid’s Clinic for patients to come down for a specific time just to do patient-led medical play. Patients are given a medical play doll and then are invited to use medical equipment on their doll. Patients place IVs, casts, and more.

This play often mimics their own experiences while giving them an opportunity to get more comfortable with medical equipment and process their feelings around their own story. Children not only learn from this type of play, but they leave feeling more empowered in their own medical care.

As child life specialists, play is not only essential but also at the forefront of every interaction with a patient and family. Cook Children’s recently lost a precious child life specialist. Amy Johnson was a child life specialist extraordinaire. As we were attending her funeral, many past patients’ families shared stories of Amy.

I was profoundly impacted that what the patients and parents remembered most fondly about Amy was her ability to PLAY – nerf gun wars, water gun fights and more! She had SO much fun during some of the worst moments, and this is the memory that the patients and families had ingrained in their hearts forever. Play is not only essential, but it also changes the environment and allows children to be the very best versions of themselves!

generation and propagation of epilepsy activity in the context of this disorder as a network disease.  

His findings may help physicians to understand how epilepsy activity initiates in a focal brain area of children with epilepsy propagating later in other areas of the brain. Pinpointing these onset areas, where epilepsy starts, would allow stopping seizures through surgery in children suffering from epilepsy without resecting large brain areas, which may damage physiological brain functions such as the language or movements.

Pediatric epilepsy is a neurological disorder, characterized by recurrent seizures due to abnormal electrical brain activity. It has been estimated that 4-10 out of 100 children suffer from epilepsy. A significant proportion of these children are unable to control their seizures with drugs dealing with recurrent uncontrolled seizures. These seizures may have a severe impact on the quality of child’s life leading to serious cognitive and behavioral problems as well as increased mortality. Therefore, it is critical to develop new strategies for the diagnosis and treatment of uncontrolled seizures in children with epilepsy.

Children with uncontrolled seizures undergoing surgery often require the placement of electrodes inside their brain for identifying the area where seizures are generated. Yet, seizures occur spontaneously and propagate fast from onset areas to areas of spread. Thus, we should have to wait for a seizure to occur and this may take several days. This increases the patient’s time in the hospital and thus the risk of infection from invasive electrodes placed in the patient’s brain. 

In this study, Cook Children’s Neuroscience Research team showed that they can map the onset of this propagating activity without having to wait for a seizure to occur. Such a development can shorten the patient’s stay in the hospital improving the presurgical evaluation procedure.

This study is funded by the National Institute of Neurological Disorders and Stroke and is in collaboration with the University Campus Bio Medico in Rome, Italy, the Boston Children’s Hospital, and Harvard Medical School. Margherita Matarrese, a Ph.D. student of Bioengineering under the supervision of Professor Papadelis serves as first author of this scientific paper.

Coming Soon

The Jane and John Justin Institute for Mind Health at Cook Children’s, opening in October 2023, is bringing together nine specialties under one roof. Pediatric specialists in neurological, developmental and behavioral health are changing the way we deliver health care. Together, we’re healing minds and bodies and sharing smiles that warm the soul and connecting care for kids unlike anyone else.

Cook Children’s has treated nine drownings so far this year, one of which was fatal. As the weather warms up, parents and caregivers should take time to review how to keep their young children safe around water.

With the recent news of a Tampa Bay Buccaneers player’s 2-year-old daughter drowning in their swimming pool, we are reminded of how quickly water can turn into a tragic accident. It only takes a minute for a child to drown, and most of the time it is silent.

According to Safe Kids Worldwide, drowning is the leading cause of injury-related death among children between 1 and 4 years old. Even if a child survives a drowning, it's possible to have lasting neurological effects. Cook Children’s leads a campaign called Lifeguard Your Child for parents and caregivers to learn how to protect children in all kinds of water.

Drownings can occur even with many adults present. One key tip is to designate a “water watcher” – a responsible adult who agrees to watch the children in the water without distractions.

Sharon Evans, trauma injury prevention coordinator at Cook Children’s, said it is vital for parents and homeowners to realize they must be on guard at all times if they have a pool.

“All of the barriers along with swimming lessons can prevent drownings,” Sharon said. “Not only having these barriers in place but ensuring the alarms work and are on and the gates remain closed is important as well.”

Drownings can happen silently and quickly. A submerged person might not attract attention or appear to be in danger. Younger children most often drown in swimming pools by falling in while unsupervised. Parents can put barriers in place to help prevent a child from accessing the water or make it more difficult to access when an adult is not present.

Top Pool Barriers
The more barriers in place, the safer the child will be.

• Four-sided isolation fences with self-latching gates
• Alarms (pool, door, gate)
• Automatic pool covers
• Doorknob covers and high locks on doors leading to the outdoors
• Reroute dog/pet doors that have direct access to the pool area

Lifeguard Your Child

Cook Children’s initiated a drowning prevention campaign called Lifeguard Your Child in 2015 in response to a high number of drowning injuries treated in the Emergency Department and medical center that year. The Lifeguard Your Child campaign is spread through the Safe Kids North Texas Coalition, which is based in Fort Worth and led by Cook Children’s.

The campaign’s strategies include Cook Children’s Loaner Life Jacket Stations at many lake entry points across the region. Families can go to the stations to find U.S. Coast Guard-approved life jackets in a variety of sizes with easy tips for a proper fit.

Safety tips for home swimming pools: 
• Restrict access by installing door locks high out of children’s reach. Door and window alarms can signal if someone leaves the house. 
• Install four-sided fencing around pools with a self-latching gate that only opens out. The fence should be at least 4 feet (preferably 5 feet) high. 
• Remove all toys and floats from the pool area so children are not tempted to get close to the water. 
• For above-ground pools, make sure the ladder is removed and not accessible when it’s not swimming time. 
• Consider a pool surface alarm to alert if anyone/anything falls into the water. 

Safety tips for the bathtub: 
• An adult must stay at the side of the tub in reach of the child. 
• Pay attention. This is not the time for multitasking. 
• Ignore distractions like the doorbell or phone calls. 
• Drain the tub after each use. 
For more information about drowning prevention, go to www.lifeguardyourchild.org.

On Tuesday, Cook Children’s Health Care System celebrated the grand opening of a new space dedicated to the siblings of children with medically complex needs. It’s called the Panda Cares® Center of Hope Sibling Support Center and is located inside the newly expanded Dodson Specialty Clinics building at Cook Children’s Medical Center – Fort Worth.

The Panda Cares Center of Hope Sibling Support Center offers the siblings of Dodson Specialty Clinic patients a place to play, create and connect with other children whose families face similar challenges while their brother or sister attends clinic appointments. It also relieves the stress of parents and caregivers so they can concentrate on their child’s medical appointments knowing their other children have a safe and supportive space dedicated to their well-being, too.

The complex medical needs of a child with a chronic condition or life-changing injury can strain the mental and emotional health of the whole family, including brothers and sisters, according to Audra Trussell, coordinator of the Panda Cares Center of Hope Sibling Support Center.

“We are really focused on the sibling’s emotional and psychosocial care,” Trussell said. “A lot of times, they don’t need as much attention as their chronically ill brother or sister so they may feel a little left out and dragged around from appointment to appointment. At this center, we’re able to focus on those kids, give them the care they deserve as well, help them process their feelings and what they are experiencing, and make them feel like a member of the Cook Children’s family, too.”

The center is staffed by Trussell, who has a background in child development, and Judith Siharath, Panda Cares Center of Hope Sibling Support Center assistant, who has experience in psychology and child development. Cook Children’s volunteers will also be on hand to assist.

Everything for the Child

The Panda Cares Center of Hope Sibling Support Center is a therapeutic activity center full of everything for the child, from developmentally appropriate toys and sensory play items to arts and craft supplies. Each day Trussell and Siharath will offer child visitors a guided activity that sparks their imagination, creativity and conversation.

“Every day we'll have a different activity to do that will open up a new discussion for our sibling guests because, given their family’s situation, they might not get that opportunity outside of here, and we want to make sure they feel like they are the center of attention,” Siharath explained. “For example, we have an activity where kids can make a rainbow with colors based upon their feelings. We would ask them questions like, ‘What colors represent you?’ and ‘Which color represents your inside and outside feelings?’”

The questions are meant to help kids connect with other children who also have a sibling with a medical condition and may be experiencing similar emotions related to their brother or sister’s health.

“When we're all sitting around the table and these open-ended questions are being asked to help draw the child out and give them an opportunity to speak up, they'll get to hear other siblings say some things that they may not have felt like they could say out loud, and feelings that they’ve had regarding their sibling that is a patient,” Trussell said. “So that peer-to-peer support is an important piece that we want to emphasize here, too.”

Connecting the Dots for the Whole Family

Together with other Cook Children’s sibling support programs, The Panda Cares Center of Hope Sibling Support Center connects the dots of family-centered care at the health system. It’s an extension, Trussell says, of the work Child Life Services does to care for the mental and emotional health of the whole family through offerings like the Cook Children’s Sib2Sib Program™. Through weekend workshops, camps and family events, Sib2Sib gives patient siblings the opportunity to express themselves and their feelings, receive undivided adult attention, learn coping skills and connect with peers living in similar circumstances.

Sometimes a child will express fear or misunderstanding about their sibling’s health, treatment, or injury while visiting the Panda Cares Center of Hope Sibling Support Center or any of Cook Children’s sibling support programs. For example, if a child has experienced a pet being “put to sleep” they sometimes correlate that term with death, and may think their brother or sister is going to die because they are having a procedure where they will be put to sleep.

“When we hear those things we’ll be able to share that with their parents and connect all of them with a Child Life specialist that can help explain what the procedure is, what's really going to happen medically, and what all the terminology means in good, child-appropriate language that they understand,” Trussell said.

Together, all of these programs and services connect the dots of family-centered care at Cook Children’s.

The Panda Cares Center of Hope Sibling Support Center at Cook Children’s is made possible through the support of Panda Cares®, the philanthropic arm of the Asian dining concept Panda Express®, and its partnership with Children’s Miracle Network (CMN), of which Cook Children's is a member. Following a multimillion-dollar commitment to Children’s Miracle Network Hospitals to fund Panda Cares Centers of Hope, Panda and CMN Hospitals have debuted Center of Hope locations at several hospitals in the U.S. from California and Texas to Hawaii and Washington D.C.

The Panda Cares Center of Hope Sibling Support Center at Cook Children’s is open from 8 a.m. to 5 p.m. Monday through Friday to siblings, ages 3 to 11, of patients who have a clinic appointment. Children may attend the center for 90 minutes per visit. It is free to families. Reservations are not required but parents will be asked to complete a registration and consent form. 

By Ashley Antle

If there is one thing kids know, it’s how to get dirty. So why not let them play in the dirt with purpose and create a home garden where they can experiment with growing their own food or flowers.

Experts say gardening positively impacts everything from food choices to physical fitness and even mood, and kids can reap these benefits, too.

“Gardening saved my brain,” said Dora Garcia, community health program coordinator at The Center for Children’s Health, led by Cook Children’s. “I had always been curious about growing my own food, but really got into it when I was doing a really stressful job. Being outside and digging in the dirt helped alleviate my stress and helped me relax.”

Garcia believes in the benefits of gardening so much so that she turned her stress-release activity into her day job and heads the gardening program for The Center for Children’s Health.

In partnership with the Johnson County Alliance for Healthy Kids and the Healthy Children Coalition for Parker County, Garcia advises schools in Johnson and Parker Counties on how to incorporate gardening into daily school and learning activities. The oldest coalition school garden is now seven years old, surpassing the average school garden life span of two years. 

Reap What You Sow

“Gardening is a hands-on way for kids to experience growing their own food,” Garcia said. “Research has shown that children who grow their own food are more apt to try different fruits and vegetables. They learn where food comes from and learn responsibility as they water and tend to the garden and watch their food grow.” 

Gardening also teaches patience and perseverance, as not everything planted will produce. Garcia says learning what works and what doesn’t is a part of the process and, like in life, working hard to overcome a challenge reaps reward.

Other benefits of gardening with your child include:

●     Decreased screen time and increased physical activity and exposure to mood-boosting sunshine.

●     Family bonding and team building as you work together to dig, plant, grow and harvest.

●     Interactive opportunities to explore and learn science and math concepts related to gardening.

●     Expands creativity and curiosity as kids design and build a green space where they can relax, read a book and explore. 

Bloom Where You're Planted

Growing your own garden doesn’t have to be hard, expensive, or take up too much space. It doesn’t even have to be in the ground. Gardens can be grown in pots, small outdoor beds or even bags. Garcia says to keep it simple and start small. Grow herbs or microgreens in a pot, or turn a galvanized tub into a small vegetable garden.

If you prefer sowing flowers over food, use the thriller/filler/spiller rule for planting an eye-catching flower pot. Choose one focal plant as your “thriller” to add height and drama. Pair with it “filler” flowers that are round or mounding to fill in the space around the thriller. To finish off the look, add a “spiller,” or trailing plant to soften the edges of the container.

When combining plants in containers, whether food or flowers, be sure to pair them according to their light and watering needs. In other words, don’t put shade-loving flowers like impatiens with full-sun plants like hibiscus, or moisture-loving herbs like basil with drought-tolerant plants like rosemary. To learn more, turn to resources such as Texas A&M Agrilife Extension and local plant nurseries that can point you in the right direction on what to plant and how to care for your garden.

Porch ponds can add tranquility to a small outdoor space. Use a galvanized tub or water-tight container to house water plants and a small filter/fountain combination to circulate water. Adding mosquito fish to your pond is an effective and environmentally friendly way to control mosquitos, and your kids will love the aquatic life.

Above all, let your kids get their hands dirty and have fun with your garden, be it big or small. Together, you’ll harvest far more benefits than just healthy food and beautiful blooms.

 “Surgical resection of the brain area where these functional networks are localized offers higher chances of seizure freedom than conventional methods,” said Dr. Papadelis, director of Neuroscience Research at Cook Children’s. “This novel method has the potential to improve the outcome of children with epilepsy, particularly those who were previously ineligible for neurosurgery due to the absence of abnormal activity in their electrophysiological conventional diagnostic tests.”

 One out of every 100 children in the U.S. suffers from epilepsy, a severe brain disease that causes frequent and unprovoked seizures. Anti-seizure drugs can control seizures in most cases, but they fail in 30% of children suffering from epilepsy. Children with uncontrolled seizures are at increased risk for poor long-term intellectual and psychological outcomes and poor health-related quality of life. For these children, brain surgery is the best available treatment since it offers high chances of seizure freedom.

 This study is funded by the National Institute of Neurological Disorders and Stroke and is in collaboration with the Boston Children’s Hospital, Massachusetts General Hospital and Harvard Medical School. Ludovica Corona, a Ph.D. student of Bioengineering at the University of Texas at Arlington, serves as first author in this scientific paper.

Coming Soon

The Jane and John Justin Institute for Mind Health at Cook Children’s, opening in October 2023, is bringing together nine specialties under one roof. Pediatric specialists in neurological, developmental and behavioral health are changing the way we deliver health care. Together, we’re healing minds and bodies and sharing smiles that warm the soul and connecting care for kids unlike anyone else.

 About Cook Children’s

Cook Children’s is more than a health care system: we strive to be an extension of your family, growing with your child from their first steps to adulthood. By collaborating to deliver on our Promise—to improve the well-being of every child in our care and our communities, we connect the dots for our patients. Between primary and specialty. Between home and medical home. Between short-term care and long-term health.

Based in Fort Worth, Texas, we’re 8,000+ dedicated team members strong, passionately caring for over 1.5 million patient encounters each year. Our integrated, not-for-profit organization spans two medical centers (including our new, state-of-the-art location in Prosper), two surgery centers, a physician network, home health services and a health plan. It also includes Child Study Center at Cook Children's, Cook Children's Health Services Inc., and Cook Children's Health Foundation. 

And our impact extends beyond the borders of Texas. We proudly treat children from virtually every state in the nation and 32 countries. By seeing the world through the eyes of children and their families from all backgrounds, we’re able to shape health care suited to them: connected by kindness, imagination and respect—with an extra dose of magical wonder.

Discover more at cookchildrens.org.

at 8 a.m. on Monday, Jan. 9. Our team members in Prosper have already served patients in the community under Cook Children’s signature blue peaks.

Larger than life-size digital displays, storybook murals, walking paths that invite exploration and play, and spaces bathed in every color of the rainbow — it’s what childhood daydreams and imaginations are made of. These are also a few of the moments of magic kids and their families will feel, see and experience when they walk through the doors of the new Cook Children’s Medical Center – Prosper.

Ten-month-old Faylinn Harris was the first patient at Prosper. Her mother, Tionne Harris, said she was relieved to have the medical center so close to where they live.

“It makes me feel 10 times better about everything, especially considering it's right down the street, so this is just great," Tionne said. “The people who took care of her did a really great job and they were really nice.”

The 23-acre Cook Children’s campus in Prosper is the culmination of a multi-year expansion project into the rapidly growing northern region of the state. Cook Children’s began developing the health care landscape in the area in 2019 with the opening of an urgent care center and several area primary care offices, followed by a medical office building and outpatient surgery center in 2020.

Cook Children’s Medical Center – Prosper is the next step in supporting those services and serving families in Prosper and the surrounding communities. It brings world-class medical care from Fort Worth closer to the homes of children living in the northern sector of the Metroplex. We are honored to be able to offer families the care they’ve come to expect and trust from Cook Children’s but in a location closer to their neighborhoods where they have the support structure of family, friends and community.

We are so excited about the opening of the new medical center and want to thank everyone for their hard work in making today a reality.

Go here to view the open positions we're excited to fill in Prosper.

RELATED STORIES: The Cook Children's Story: A New Chapter Unfolds in Prosper

Cook Children’s Unveils New Medical Center in Prosper, Blending Technology with Moments of Magic 

Buffalo Bills defensive back Damar Hamlin suffered cardiac arrest after a hit during Monday evening’s game. The Bills said in a statement that he was given CPR on the field and his heartbeat was restored. On Tuesday, the Bills said Hamlin was in critical condition.

This incident stunned the sports world and community at large, and reiterates the importance of being prepared for a cardiac emergency, especially in sports and school settings, with CPR and an AED.

More than 530 schools in North Texas have partnered with Project ADAM at Cook Children’s to become a “Heart Safe” school. The program trains school staff members on CPR, how to use an automated external defibrillator (AED), and helps create an emergency plan. It also provides resources and support to become a Heart Safe school, which is renewed every year through training and requirements. Project ADAM is a free resource to schools and the community.

The likelihood of sudden cardiac arrest in children and young athletes is known to be enhanced by athletic participation. On average, a seemingly healthy young person suffers a sudden cardiac arrest every three days in the U.S. and it's the leading cause of death in exercising young athletes.

Athletic personnel need to recognize the threat to young athletes and properly prepare for sudden cardiac arrest. Every school or organization that sponsors athletic activities should have an AED, trained coaches, and written Emergency Action Plan.

Cardiac emergency preparedness training empowers people to use the AED device. Texas requires all schools to have an AED, but often people don’t know where it is located, how to use it in an emergency or rely solely on the school nurse to use the device.

Danielle Moyé, M.D., pediatric cardiologist and physician director for Project ADAM at Cook Children’s, encourages schools, parents and the community to see the large impact an AED and CPR can make on a person’s life if utilized effectively. She shared answers for a few common questions.

What causes cardiac arrest?

Cardiac arrest can be caused by different factors. In an exercise setting, cardiac arrest occurs secondary to an arrhythmia which prevents adequate circulation and perfusion of blood and oxygen to the brain and body.

Why is it important to quickly respond to cardiac arrest? How does it affect the person’s outcome?

Timing is of utmost importance when it comes to cardiac arrest. The rhythm that one is in during cardiac arrest is not a perfusing (pump) rhythm. This means that there is not adequate oxygen and blood flow to the brain and body. Restoring sinus rhythm is critical to prevent irreversible organ damage.

When do you use an AED vs administering CPR?

CPR should be administered as soon as a person is found down without a pulse. While awaiting an AED, appropriate CPR can result in continued blood flow and perfusion that the heart is not doing on its own.

Once an AED is available, pads should be placed on an individual’s chest and once turned on, CPR may be paused briefly while the AED is assessing the underlying rhythm. If the person has a shockable rhythm, the AED will recommend delivery of a shock which can restore sinus rhythm. This is a lifesaving device that the world should know about and everyone should familiarize themselves with.

What should parents and caregivers be aware of if their child participates in sports and other physical extracurricular activities?

As mentioned above, parents and caregivers need to be aware of sudden cardiac arrest. They should encourage the schools and sporting facilities to be aware of the risk, have respect for this risk, and arm themselves with knowledge on good CPR, the locations of AEDs, and have an emergency action plan in place should one need it.

What do you see as a cardiologist that you wish more people knew about?

I unfortunately, have seen many episodes of cardiac arrest associated with exertion and at rest. The patients that have the best outcome are those who had a prompt intervention with an AED. I wish every school and every facility had an AED in place and a team dedicated to responding to these types of emergencies.

Sign and symptoms of pediatric heart disease

Sudden cardiac arrest (SCA) is when the heart suddenly and unexpectedly stops beating. SCA often occurs in active people with no history of heart conditions. In children, common causes are genetic, congenital or related to a sudden blow to the chest. If treated quickly, using an automated external defibrillator (AED), it is possible to restart the heart and increase the chances of survival.

Pediatric heart disease has warning signs and symptoms that can go unnoticed. It is important to recognize the following:

• Fainting or near-fainting during or after exercise, emotion or surprise
• Dizziness or lightheadedness
• Extreme fatigue associated with exercise
• Extreme shortness of breath associated with exercise
• Discomfort, pain or pressure in chest during or after exercise
• Skipping or racing heartbeats
• High blood pressure
• Congenital heart abnormality
• Family history of sudden death prior to age 50 or known heart abnormalities

Not all episodes of sudden cardiac arrest are preventable because many of the kids do not have symptoms until they have the episode. For this reason, secondary prevention strategies are important.

About Project ADAM

Project ADAM, which is nonprofit and nationwide, aims to educate school systems, nurses, coaches, trainers, parents and others about pediatric sudden cardiac death and to establish emergency programs to help provide a timely and lifesaving response as emergency medical services are on their way to an incident.

Project ADAM was started in 1999 after a 17-year-old Wisconsin student named Adam Lemel collapsed and died while playing basketball. His parents helped start the Project ADAM program at the Children’s Hospital of Wisconsin in his memory. Cook Children’s is one of 35 hospitals and program sites providing free cardiac resources, including training and AED devices.

RELATED: How to Become a Heart Safe School

Videos:

• Chapter 1: The Adam in Project ADAM
• Chapter 2: Understanding Sudden Cardiac Arrest
• Chapter 3: Being Prepared in a Cardiac Emergency
• Chapter 4: Implementing Project ADAM in Your School
• AED Drill
• Learn How to Save a Life using an AED and Hands Only CPR!

Larger than life-size digital displays, storybook murals, walking paths that invite exploration and play, and spaces bathed in every color of the rainbow — it’s what childhood daydreams and imaginations are made of. These are also a few of the moments of magic kids and their families will feel, see and experience when they walk through the doors of the new Cook Children’s Medical Center – Prosper.

The medical center opens to the community on Monday, Jan. 9, at 8 a.m., and is ready to serve those from Prosper and beyond seeking care under Cook Children’s signature blue peaks.

The 23-acre Cook Children’s campus in Prosper is the culmination of a multi-year expansion project into the rapidly growing northern region of the state. Cook Children’s began developing the health care landscape in the area in 2019 with the opening of an urgent care center and several area primary care offices, followed by a medical office building and outpatient surgery center in 2020. The medical center will support these existing services with an emergency department; a surgical and procedural floor; an infusion center; an outpatient imaging center; a retail pharmacy; an inpatient unit with medical-surgical and pediatric intensive care beds; and two floors of shell space that allow for growth to meet the future needs of the community.

“Cook Children’s Medical Center – Prosper is the next step in supporting those services and serving families in Prosper and the surrounding communities,” said Rick W. Merrill, president and CEO of Cook Children’s Health Care System. “It brings world-class medical care from Fort Worth closer to the homes of children living in the northern sector of the Metroplex. We’re very excited to be able to offer families the care they’ve come to expect and trust from Cook Children’s but in a location closer to their neighborhoods where they have the support structure of family, friends and community resources.”

A Leading Legacy

Those who know the heritage of Cook Children’s say that while construction of the Prosper campus took several years, it’s actually been generations in the making.

“Multiple generations have built Cook Children’s,” said Kevin Greene, vice president and administrator, Cook Children’s Medical Center – Prosper. “We have a nearly 105-year history of dedicated doctors, nurses and support staff caring for children. We are stewards of that history, and I believe that is one of the key components that differentiates Cook Children’s from other pediatric health care systems. Being able to provide top-tier pediatric care with a world-class experience is a product of our century old legacy and the generations that came before us.”

The patient and visitor experience was paramount when it came to creating the building’s blueprint. Each space of the facility is designed with everything for the child in mind.

In the main entrance, guests are welcomed by a Sistine Chapel-like painting of cartoonish flying cows — a nod to Cook Children’s Cowtown roots — a giant digital wall, and a tile motif of a tree whose color-coded falling leaves create a kid-friendly and interactive wayfinding trail to the emergency department in one direction and outpatient services in the other. At each stop in their journey through the facility, kids and their families are greeted with spaces that invite imagination, discovery, play and rest in a way that connects the dots between their ideal experience at Cook Children’s and the health care they receive along the way.

“If I had to pick one of my favorite aspects of the medical center, it's the initial presentation our families experience when they walk in our front doors,” Greene said. “It’s so focused on that child’s experience, and everything has been designed with the child in mind. You feel like you're in a special place. We were very intentional with that. I can't wait for the community to experience and understand who we are in that first moment when they walk in.”

Critical Additions

The medical center's 10-bed emergency department adds much-needed emergency care beds to the area in a time when many pediatric emergency departments are overflowing from an unprecedented season of viral illnesses. Over the next several months, Cook Children’s anticipates opening an additional 10 emergency department beds to support the emergency care needs of children.

Anticipating future growth, a total of four operating rooms have been built and equipped to keep kids close to home when they need surgery. Two will open with the medical center on Jan. 9. The remaining two will open in the future as the community and its needs grow. Each operating room is equipped with technology that allows for real-time remote viewing and physician collaboration with colleagues at Cook Children’s Medical Center in Fort Worth if needed. This gives Cook Children’s Medical Center – Prosper patients and families the advantage of the health system’s full network of world-class physicians and surgeons.

“I’m really excited about the technology built into this campus, and I like the fact that physicians and providers were involved in the design process from day one,” said Tony Anani, M.D., MPH, MBA, gastroenterologist and Medical Director of Clinical Specialties at Cook Children’s Medical Center – Prosper. “There are some features that we’re really going to enjoy while practicing medicine. One of them is the ability for doctors to beam into our surgery and our endoscopy suites. So all our partners in Fort Worth have the ability to help us with their brain trust for difficult patients up here without us having to move the child downtown, and that would not have been possible without the technology and without it being designed into the building.”

Patients awaiting surgery are prepped in one of 12 private pre-operative exam rooms. A surgery waiting area provides private space for families to wait while a child undergoes a procedure.

Until now, children in Prosper and throughout the northern region needing intravenous infusion therapy would have to travel to Cook Children’s Medical Center in Fort Worth or to Dallas. A dedicated infusion center at Cook Children’s Medical Center – Prosper will now bring this critical service close to home for our families. In addition, a specialty procedure area, also referred to as the SPA, has three procedure rooms for gastroenterologists, pulmonologists and ear, nose and throat specialists. The SPA is designed so that physicians can easily work together on difficult cases.

Supporting each of these services is an imaging center equipped with all of the imaging and diagnostic technology needed to provide advanced care for pediatric patients.

Each inpatient room includes a 65-inch television that can integrate with the patient and family’s personal devices. The television serves as an interactive hub for anything the patient may need, from ordering food to entertainment to connecting and consulting with Cook Children’s specialty physicians at the medical center in Fort Worth if needed.

“We're not just Cook Children's – Prosper. We're part of the integrated health care system,” Greene said. “When a family is cared for on our campus or in one of our clinics, they will have the full weight of the entire Cook Children’s Health Care System behind them. From our home health division, to our health plan and physician network made up of more than 800 physicians and providers, our families can rest easy knowing they now have access to one of the nation’s largest integrated pediatric health care systems focused entirely on their child's care.”

Welcoming New Talent

In addition to its technology, infrastructure and patient experience, Cook Children’s Medical Center – Prosper is attracting trailblazing medical talent and bringing more than 500 jobs to the community. Trailblazers like Kanika Bowen-Jallow, M.D., a pediatric surgeon at Cook Children’s Medical Center – Prosper, and only the ninth Black female pediatric surgeon in the United States. Also, Dr. Anani, who was the first physician hired at Cook Children’s Medical Center – Prosper when all administrators had to show him was an empty parcel of land and a vision. Both Dr. Bowen-Jallow and Dr. Anani shared Cook Children’s vision and have been instrumental in the development of the Prosper campus and its services.

“Cook Children’s is hiring,” Dr. Anani said. “That’s an infusion into the economy of Prosper and the surrounding area. We're hiring people that truly care about providing care for the children in our community. I'm really excited about this because I live in Prosper. My kids go to the schools here in Prosper, and I'm happy that we'll have the care we need nearby. What’s good for kids is good for the community, including the local economy.”

Go here to view the open positions we're excited to fill in Prosper.

You will have a hard time finding someone better suited than Parker Vickers to help children choose and build a cuddly friend at the Build-A-Bear Workshop at Cook Children’s Medical Center. Funny, charismatic, kind and big-hearted are a few of the words people use to describe the 18-year-old.

Vickers is a trailblazer, too. As the first to participate in a Cook Children’s Medical Center pilot internship program designed to employ students from the Child Study Center at Cook Children’s Jane Justin School, he’s paving the way for his current and future classmates to join the ranks of the medical center’s workforce.

Vickers is in his fourth year as a student at the Jane Justin Upper School where children with developmental and intellectual challenges are educated using individualized lessons designed to meet each child’s unique learning needs. Teaching life skills necessary for students to achieve productive and meaningful lives is a big part of the curriculum.

“Our mission is to impart skills so that our students can transition successfully into the next learning environment,” said Kimberly James-Kelly, M.S., M.S. Ed., LBA-TX, assistant principal, Jane Justin Upper School. “So we want to create lifelong learners, and that is the case for students transitioning on to more traditional educational settings or for students transitioning on to the workplace setting or to post-secondary education. Really, we just want to help our students achieve the goals they have for themselves and support them in achieving the goals that their family has for them as well.”

The internship offers students a real-life work setting to practice and hone the skills they’ve learned while attending the Jane Justin School—skills like listening to and following instructions, customer service, adjusting to changes in the work environment, accepting feedback from a manager and working independently. A job coach from the Jane Justin School joins the intern during their hours, usually four hours per week, to guide, advise and offer support while on the job.

Just like their in-school instruction, the internship is aligned with the student’s unique strengths, interests and hobbies. Vickers is particularly fond of stuffed animals and plushies, making him the perfect fit for a post in the Build-A-Bear Workshop.

“We work with the administrators of the Child Study Center and they identify a high-potential student,” explained Tracy Vang, Cook Children’s ID&E director. “Once they identify the student, we look at their strengths and try to match them to the opportunities that we have available. It's very important that we don't pick and choose where the student goes because we have bias that leads us to put people where we think they belong. That's not our goal or our intent here. We want to match students to where they feel they belong.”

Vickers started his three-month internship in September as a front-of-the-store greeter. He progressed to helping guests choose their bear and, as a testament to his initiative, now holds the coveted role of bear stuffer.

“If you know anything about Build-A-Bear, you know that stuffing gets everywhere,” said Kimberly Johnson, Build-A-Bear Workshop manager at Cook Children’s. “Parker was quick to get brooms and sweep up the stuffing. When he noticed that the bear inventory out front was low, he went and grabbed bears from the back to stock in the store. I was so amazed and proud that he took that initiative upon himself. So the next step was to teach Parker how to stuff and, if you've been in here, you know the big machine and loud noises are a little ominous. But he took to it like a champ.”

Vickers has been so successful at his job that, over the Thanksgiving holiday, he worked without the oversight of his job coach. It was a proud moment for James-Kelly and his Jane Justin School family.

“He has worked so hard to learn what it means to be an employee at Build-A-Bear and at Cook Children's,” James-Kelly said. “He attended the onboarding training for all new hires. He pays close and careful attention to instructions in the workplace. He asks questions and acquires the skills pretty quickly. He practices them on his own. He takes pride in his work. So when the opportunity arose for him to work independent of our support, we looked at data and we talked with the staff at Build-A-Bear, and we all thought it was time. We’re incredibly proud of him.”

The program is as much a win for the medical center as it is for Vickers and his peers, Vang says.

“I would say the biggest benefit to the hospital is in the spirit of diversity and bringing everyone with different backgrounds together,” she said. “We have kids that have developmental disabilities and challenges and, when they see someone who looks and learns like them, they are able to connect with that person for a more meaningful experience. That really helps us improve our business goals by creating a patient experience marked by our core values of respect, kindness, collaboration, safety, generosity and imagination.”

Speaking of imagination, Vickers has it in spades.

“I’ve got lots of ideas in my head,” he said.

Those ideas are on full display when he performs the Build-A-Bear Heart Ceremony where children make a wish and promise to care for their bear. The ceremony is led by Bear Builders who tailor the dedication to each child’s interests, hopes, dreams and circumstances.

Once the pilot is complete, program leaders are exploring other opportunities for Jane Justin School students to receive real-world training at Cook Children’s. Potential work experiences include the cafeteria, transportation department, dietary aid and environmental services, to name a few. The hope is that Cook Children’s will be able to offer students employment once they complete their internship and that they become members of Cook Children’s work family. Vickers feels “very good” about blazing that trail for those that come behind him.

“I’m the first one,” he said proudly. “If this turns out to be a success, then everyone else would be able to have a chance to do this.”

Wind chills are expected to be below zero degrees on Thursday, according to the National Weather Service. Be sure to dress warmly, cover up any exposed skin and limit your time outdoors. Hypothermia begins when our body temperature drops two to four degrees. 

By Thursday night, low temperatures will fall into the single digits across most of the Dallas-Fort Worth region. By Friday morning, temps will be in the teens or possibly in the single digits with high wind gusts.

People exposed to extreme cold are susceptible to frostbite in a matter of minutes. Areas most prone to frostbite are uncovered skin and the extremities, such as hands and feet.

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.

Carbon Monoxide

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

During the Texas winter storm in February 2021, 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.

Dr. Selby described how families used 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. 

Coats & Car Seats

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.

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.

Dressing Warmly

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., Cook Children’s Medical Advisor for Digital Health. "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.
• 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." 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 in cold rooms.

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

Media partners may use this content for news stories and broadcasts with credit to Cook Children's.

Football players and cheerleaders surprised patients in multiple departments at the Medical Center to spread some holiday cheer. There were extra smiles from that win over the Houston Texans!

Each child receives a stocking loaded with goodies from the Dallas Cowboys and a special toy provided by the UnitedHealthcare Children’s Foundation.

Under the guidance of Mrs. Gene Jones, the entire Cowboys team has conducted annual holiday visits to local children’s hospitals for the past 33 years – with the last two years being held virtually due to the pandemic.

Media partners may use this content for news stories and broadcasts with credit to Cook Children's.

Finding infant formula on store shelves can still be tricky if you’re shopping for specialized types made for premature infants or babies with digestive complications.

Nutritional experts at Cook Children’s say some patient families are struggling even though formula availability generally has improved in recent months. The 2022 shortages have been blamed on a manufacturing recall and supply chain disruptions.

Brand options tend to be limited for preemies, who require formulas with higher calcium, phosphorous and protein for their bone and brain development. Likewise, infants who undergo surgery on their stomach or intestines might need certain easy-to-digest formulas.  

We spoke with three registered dietitians – from the Cook Children’s Neonatal Intensive Care Unit (NICU), the N.E.S.T. Clinic, and the Gastrointestinal Clinic – about tips and support for parents when the formula their baby takes is out of stock.

Their advice? Consider switching to another appropriate brand. Use the imported formulas that received approval from the U.S. Food and Drug Administration. Ask your pediatrician for samples. Don’t dilute formula or make your own version. And don’t give up.  

“I still see grocery stores with formula shelves that look about half empty or less,” said Hayley Spinks, a clinical dietitian in the NICU. “If you’re looking for a specific formula, it doesn’t really matter if the shortage is getting better overall. If you can’t find the formula that your baby needs, it’s really a big deal.”

One resource the dietitians share is a substitution list they created to help families know which brands fall in categories for particular needs. The substitutions list includes standard formulas, premature formulas, reduced lactose formulas and more. Go here to view the formula substitution chart.

The shortage continues to cause challenges and frustration, but dietitians are working to help parents find solutions. Here are their viewpoints.

In the NICU

Dietitians in the NICU monitor growth of the smallest babies, who sometimes need fortifiers added to their feeding regimen. When a preemie product runs out of stock, Spinks said, they turn to alternatives with the right nutritional components that the infant can tolerate. Signs of formula intolerance may include diarrhea, vomiting and belly bloating.

Before patients are discharged, Spinks and her colleague in the NICU like to ask the parents whether they’ve been able to find the formula they need. “Some moms are telling me that they’ve looked and they can’t find the formula that their baby is on,” she said. Others tell her they’ve enlisted relatives and friends to help search the stores.

Spinks makes a habit of checking the formula aisle when she’s shopping. She also belongs to formula finder groups on social media. “I’m always trying to keep my eye on the situation of what we can expect,” she said.

She encourages parents to have confidence in the safety of formulas that have been imported since May to relieve the shortage in the United States. But she cautioned that the measurements might differ (milliliters versus fluid ounces). Always follow the recipe on the can.

In the N.E.S.T. Clinic

The Cook Children's N.E.S.T. Developmental Follow-up Center (cookchildrens.org) provides support, interventions and care coordination for NICU babies as they transition home.

 “A majority of our patients require specialized formula either to meet their increased nutrient needs from prematurity or to improve their tolerance and absorption,” said registered dietitian Kayla Harrell.

Harrell said the shortage has forced some patients to change formula multiple times, incurring the risk of tummy distress, allergic reactions and other symptoms of intolerance. She has seen some improvement in availability. But parents tell her stories of driving up to two hours to track down formula or shipping it from out of state.    

For children with medically complex dietary situations, Harrell said, the formula hunt can be difficult and heartbreaking.

“You are not alone,” she said. “We are always here to help find the best solution for your precious child.”

In the GI Clinic

Gastrointestinal conditions can include bleeding, inflammatory bowel disease, chronic liver disease, swallowing dysfunction and nutrition absorption disorders. Some patients require formula fed through gastrostomy tubes called G-buttons.

Chelsea Barrow, a registered dietitian, said many children with GI problems have significant allergies, growth failure or reflux that causes them to rely on highly specialized formulas delivered from medical supply companies. Some of these formulas have gone in and out of stock, causing shipments to be delayed or partially fulfilled, Barrow said.

“Families are telling us they are driving around everywhere to find formulas,” she said. “They’re unable to find formula on the shelves or online. There’s limited access to grocery stores and pharmacies in their small rural towns. Families are asking if anyone has formula to spare or looking to social media for options.”

Barrow said it’s important to communicate with your health provider regarding brand substitutions. Not all formulas are interchangeable for individual patients, and mixing instructions can vary between brands. She urges patience as the dietitians navigate the inconsistent formula availability by adjusting orders, communicating with medical supply companies, fielding phone calls and continuing to see a full clinic load.

“There is indeed a light at the end of the tunnel with the return of many specialized formulas,” she said. “We are all working very hard and long hours to ensure families have something safe to feed their child.”

RELATED: Two Cook Children’s pediatricians shared their guidance on the infant formula shortage. Click here to watch videos in English and Spanish. 

From Nov. 27 to Dec. 3, there were 533 flu A cases, a positivity rate of 33.8%. Protect yourself and your family by getting vaccinated against the flu and COVID. The flu vaccine works to prevent you from catching the flu or by reducing the severity if you do come down with the illness.

In addition to causing respiratory symptoms, the flu can also cause myositis, which results in significant muscle pain and requires admission for IV hydration and pain management. The best way to prevent influenza-associated pneumonia and influenza-induced myositis is to get your flu vaccine.

Respiratory syncytial virus (RSV) cases are declining compared to previous weeks, but remain high. We are also seeing positive cases of COVID and rhinovirus in our patients.

“There are not any current treatments for RSV,” said Laura Romano, D.O., Hospitalist at Cook Children’s Medical Center. “There is also currently not a vaccine available. We can use Synagis, a monoclonal antibody, to help prevent severe infections but that is reserved for certain patients such as our premature infants, our infants with congenital heart or lung disease, infants with compromised immune systems, or some infants with certain neurological conditions."

Cook Children’s has expedited our winter staffing plan in preparation for peak flu season. Our census is full, including beds, the Emergency Department and Urgent Care Centers. Wait times are extremely long. We ask parents and caregivers to contact their pediatrician unless their child has a moderate or severe illness or injury.

Patient Census

In the last 24 hours, 560 patients went to the Emergency Department, which is equivalent to one check in every 2 minutes. This is causing long wait times (8-10 hours) to transfer patients to the Pediatric Intensive Care Unit.

Across our seven Urgent Care Centers, we saw 654 patients on Friday, 653 patients on Saturday, 677 patients on Sunday and 528 patients in the last 24 hours.

There are steps families can take to avoid getting sick. Parents and caregivers can remind their children to continue the healthy habits learned in the pandemic, including hand hygiene, coughing into a tissue or your elbow and staying home if you or your child feel sick. Face masks add increased protection, especially in public spaces.

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 among the many children who are getting sick.

Positive Influenza A cases at Cook Children’s Health Care System:

Oct. 9 – Oct. 15: 47 cases

Oct. 16 – Oct. 22: 75 cases

Oct. 23 – Oct. 29: 170 cases (14.6% positivity rate)

Oct. 30- Nov. 5: 333 cases (22.6% positivity rate)

Nov. 6 - Nov. 12: 483 cases (27.5% positivity rate)

Nov. 13 - Nov. 19: 630 cases (35.4% positivity rate)

Nov. 20 - Nov. 26: 812 cases (42.3% positivity rate)

Nov. 27 - Dec. 3: 533 cases (33.8% positivity rate)

RSV cases at Cook Children’s Health Care System:

Oct. 2 – Oct 8: 210 cases (24% positivity rate)

Oct. 9 – Oct. 15: 288 cases (29% positivity rate)

Oct. 16 – Oct. 22: 246 cases (24% positivity rate)

Oct. 23 – Oct. 29: 263 cases (23% positivity rate)

Oct. 30 - Nov. 5: 337 cases (23% positivity rate)

Nov. 6 - Nov. 12: 342 cases (19% positivity rate)

Nov. 13 - Nov. 19: 267 cases (15% positivity rate)

Nov. 20 - Nov. 26: 222 cases (12% positivity rate)

Nov. 27 - Dec. 3: 174 cases(11% positivity rate)

Pediatrician Offices

Call your pediatrician first if children are experiencing mild symptoms or injuries (ear pain, sore throat, diarrhea or vomiting, rash, cough or other non-urgent health concerns). The pediatrician’s office can help you decide what steps to take.

As we prepare for the flu season to worsen, make an appointment with your pediatrician to get updated flu and COVID vaccines. Vaccines help prevent infection and can prevent serious outcomes in people who are vaccinated but still get sick with the flu. The vaccines also reduce the risk of hospitalization.

RELATED: Doctor's Note is Not Required for Excused Absence at Fort Worth ISD

Urgent Care Centers

If your child is ill, please contact your pediatrician's office first if it is not a moderate or severe illness or injury. If you cannot get to your provider’s office or it’s after hours, go to an urgent care center. Urgent care centers manage the same problems as your regular health care provider plus services such as X-rays, stitches and splints.

Understand that kids with more severe issues will be seen first and that means long wait times for those with minor illnesses. Staff are overwhelmed and they’re encountering a lot of frustrated parents. Please be nice to the people working – they need kindness!

Emergency Department

Bring your child to the emergency room if they have trouble breathing, unusual sleepiness or confusion, poison ingestion, head injury with vomiting, serious burn or another life-threatening condition.

Seek immediate medical care if your child is experiencing:

• 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.
• Please understand that kids with more severe issues will be seen first and that means long wait times for those with minor illnesses. 

Preparation/Prevention

As we prepare for the flu season to worsen, make an appointment with your pediatrician to get updated flu and COVID vaccines. Vaccines help prevent infection and can prevent serious outcomes in people who are vaccinated but still get sick with the flu. The vaccines also reduce the risk of hospitalization.

Get updated flu and COVID vaccines – these will help prevent infection and reduce the risk of hospitalization. You can call your pediatrician to schedule an appointment to receive vaccinations.

• 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.

RELATED: 

• Prepare Now for Flu Season with Vaccine Protection
• Get Immunized for a Healthy School Year (checkupnewsroom.com)
• Does My Kid Have Allergies, COVID, a Cold or the Flu? (checkupnewsroom.com)

By Ashley Pagenkopf, MS, CCLS, Child Life Specialist at Cook Children's

As a parent, it can be difficult to advocate for our kids, especially amid larger systems like healthcare or education. However, it is one of our primary roles as parents.

Recently in the emergency department, I helped a family who had a son that was on the autism spectrum. His mom gave us a rundown of what is helpful for him and asked if we could tweak the room to make him more comfortable. I told this mom later how thankful I was that she asked for what her kiddo needed even though it was outside of our “normal” procedures. This is advocacy.

We have talked in the previous articles about how crying is a positive expression of emotions and that validating our children and their emotions encourages emotional safety. Advocacy and our voice as parents help to ensure emotional safety in our children’s experiences, and it models to our children how to speak up for themselves when needed.

With two kids in elementary school and one in middle school, I have had multiple opportunities to advocate for my girls. The pandemic provided many challenging experiences that none of us had ever navigated, and I found myself desperately needing to speak up for my kids.

My oldest was a third grader at the beginning of the pandemic and absolutely adored her teacher. The weeks following Spring Break 2020 became some of the most difficult weeks for our family. I realized quickly that the isolation from teachers and friends was taking a huge toll on my daughter. I reached out to her teacher and let her know that my daughter was desperately needing to connect with her as the school year was wrapping up and there were no promises of ever sitting back in the same classroom with the same teacher. She rose to the occasion and left several things on our doorstep and wrote letters to my daughter. In the midst of her own challenges, it was difficult for her to anticipate how every kid in her class was coping. As the parent, I needed to reach out so that she would have the opportunity to meet her needs.

Recently one of my other daughters went through a major hospital stay and surgery. I found myself needing to advocate early in her hospital stay. I didn’t want my daughter to have more pokes than absolutely necessary. There were some difficult conversations with the nursing staff, a need for me to understand their policies more and an opportunity for them to provide a more emotionally safe environment. I am grateful that after a lot of conversation, my daughter did not have any more pokes than absolutely needed. That would not have been the story if I had not spoken up.

One of the roles of a child life specialist is to advocate for the patient and family and educate families on how they can advocate for themselves.

A good example is that many kids cope better by watching an IV or blood draw instead of looking away. This can create quite a bit of anxiety in parents who are not certain how their child will do with watching the procedure. If a child ends up needing to watch and successfully copes through the procedure by being still and calm, I will look at the parents and say, “Your kiddo is a watcher. If they need any type of blood draw in the future, it will be best for them to watch.” This way parents have the words and can now advocate for their child appropriately moving forward.

You can practice advocating for your own kids in three significant ways. Use your voice. Use your knowledge. Use your resources.

Use Your Voice

 As I’ve mentioned, it can be very hard to speak up in a situation where you are already anxious and uncomfortable. I feel like most medical experiences can accompany situations at school and other activities. However, when you don’t speak up, something may be missed.

Often kids have experienced a significant loss that affects how they are coping with most of life. Letting teachers or healthcare workers know about this helps them to provide a more emotionally safe environment for your child through compassion and acknowledgment.

If your child is repeatedly telling you about another child at school or has consistent negative experiences, reach out to teachers and administration and ask about that interaction. If you are feeling like you need to address something with a healthcare provider or a teacher, most likely you do. Take a moment to form your words and allow your emotions to be in check, but then speak up. Make the phone call. Send the email. Ask the question. On the other side of you speaking up, your kids will have a more emotionally safe experience.

Use Your Knowledge

We often say this, and it’s true. You know your kid the best.  If you know something to be true about your kiddo that could be helpful to teachers or healthcare providers, please let us know. Maybe you know that your child is anxious about riding a bus so before the next field trip, tell the teacher about this so that she can appropriately address it. It may be that you know that your child prefers that no one counts before a poke. Let us know that so that we don’t count.

The information you know as a parent about your child is extremely valuable in helping provide an emotionally safe space and experience for kids. Without your knowledge, we are missing important pieces of how to best serve your child.

Use Your Resources

While advocating within systems can have its own challenges, thankfully you have resources. At school, there are school counselors and teams of people whose job is to advocate for your children and respond to their emotional and physical needs.

At the hospital, while everyone in pediatrics is partnering to create an emotionally safe environment, there are some specific people who exist simply to help you advocate. Child Life Specialists, Social Workers, Patient Advocates, and Chaplains are a few disciplines who can advocate for you or help you find the language you need to advocate for yourself.

Another resource we have within the Cook Children’s system is the Comfort Menu. The Comfort Menu has its own built-in advocacy. Every child deserves an equal opportunity to have their fear and pain assessed and addressed. Communicate, collaborate, and create a comfort plan that works for them. - The Comfort Menu Mission Statement

Whitney Brosey, CCLS, Comfort Menu Program Coordinator says, “Going to the doctor or getting a shot doesn’t have to be so scary. We want to do everything we can to help make it as easy and comfortable as possible. Every child has different needs when it comes to medical experiences. The first step in creating an emotionally safe experience for you and your child is to communicate those needs to your medical team. That’s why we created the Comfort Menu! It is meant to be a tool for us to talk with you and learn what might help or not help during potentially stressful medical experiences. You know your child best, and we want to create a plan with you that is individualized for your child.”

As a parent, you are a vital part of your child’s medical team and there are resources available to help you communicate with the rest of the medical team to provide the best experience for your child!

It is not always easy to have to be a voice for someone else. Parents have a difficult responsibility to speak up for our children. However, every time you use your voice, your knowledge, and your resources to advocate for the best experience for your child, you are helping them to feel emotionally safe and secure. You are also teaching them how to be the best advocates for themselves now and in the future!

Go here to view Cook Children's Comfort Menu.

Cook Children’s has expedited our winter staffing plan in preparation for peak flu season. Our census is full, including beds, the Emergency Department and Urgent Care Centers. Wait times are extremely long. We ask parents and caregivers to contact their pediatrician unless their child has a moderate or severe illness or injury.

Be sure that you and your family are vaccinated against the flu and are updated on the latest COVID vaccines and booster shots. The flu vaccine works to prevent you from catching the flu – or, reduce the severity if you do come down with the illness.

“We are seeing increased cases of flu admissions, particularly influenza infections associated with pneumonias,” said Laura Romano, D.O., Hospitalist at Cook Children’s Medical Center. “In addition to causing respiratory symptoms, the flu can also cause myositis, which results in significant muscle pain and requires admission for IV hydration and pain management. The best way to prevent influenza-associated pneumonia and influenza-induced myositis is to get your flu vaccine.”

Respiratory illnesses, like flu and RSV, are typical for this time of year; RSV is a very common respiratory virus. Some children require hospitalization for RSV, but most do not. We are also seeing positive cases of COVID and rhinovirus in our patients.

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.

“RSV cases continue to decline but we are still seeing children, particularly our most vulnerable patients, becoming significantly ill with symptoms,” Dr. Romano said. “Our most at-risk patients include those less than 12 weeks, any pre-term infant born at less than 34 weeks, or any baby with congenital lung disease or congenital heart disease.”

Patient Census

In the last 24 hours, 533 patients went to the Emergency Department, which is equivalent to one check in every 2 minutes. This is causing long wait times (8-10 hours) to transfer patients to the Pediatric Intensive Care Unit.

Across our seven Urgent Care Centers, there were 814 patients seen on Monday and 722 patients seen in the last 24 hours.

There are steps families can take to avoid getting sick. Parents and caregivers can remind their children to continue the healthy habits learned in the pandemic, including hand hygiene, coughing into a tissue or your elbow and staying home if you or your child feel sick. Face masks add increased protection, especially in public spaces.

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 among the many children who are getting sick.

RSV cases at Cook Children’s Health Care System:

Oct. 2 – Oct 8: 210 cases (24% positivity rate)

Oct. 9 – Oct. 15: 288 cases (29% positivity rate)

Oct. 16 – Oct. 22: 246 cases (24% positivity rate)

Oct. 23 – Oct. 29: 263 cases (23% positivity rate)

Oct. 30 - Nov. 5: 337 cases (23% positivity rate)

Nov. 6 - Nov. 12: 342 cases (19% positivity rate)

Nov. 13 - Nov. 19: 267 cases (15% positivity rate)

Nov. 20 - Nov. 26: 222 cases (12% positivity rate)

Positive Influenza A cases at Cook Children’s Health Care System:

Oct. 9 – Oct. 15: 47 cases

Oct. 16 – Oct. 22: 75 cases

Oct. 23 – Oct. 29: 170 cases (14.6% positivity rate)

Oct. 30- Nov. 5: 333 cases (22.6% positivity rate)

Nov. 6 - Nov. 12: 483 cases (27.5% positivity rate)

Nov. 13 - Nov. 19: 630 cases (35.4% positivity rate)

Nov. 20 - Nov. 26: 812 cases (42.3% positivity rate)

Pediatrician Offices

Call your pediatrician first if children are experiencing mild symptoms or injuries (ear pain, sore throat, diarrhea or vomiting, rash, cough or other non-urgent health concerns). The pediatrician’s office can help you decide what steps to take.

As we prepare for the flu season to worsen, make an appointment with your pediatrician to get updated flu and COVID vaccines. Vaccines help prevent infection and can prevent serious outcomes in people who are vaccinated but still get sick with the flu. The vaccines also reduce the risk of hospitalization.

RELATED: Doctor's Note is Not Required for Excused Absence at Fort Worth ISD

Urgent Care Centers

If your child is ill, please contact your pediatrician's office first if it is not a moderate or severe illness or injury. If you cannot get to your provider’s office or it’s after hours, go to an urgent care center. Urgent care centers manage the same problems as your regular health care provider plus services such as X-rays, stitches and splints.

Understand that kids with more severe issues will be seen first and that means long wait times for those with minor illnesses. Staff are overwhelmed and they’re encountering a lot of frustrated parents. Please be nice to the people working – they need kindness!

Emergency Department

Bring your child to the emergency room if they have trouble breathing, unusual sleepiness or confusion, poison ingestion, head injury with vomiting, serious burn or another life-threatening condition.

Seek immediate medical care if your child is experiencing:

• 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.
• Please understand that kids with more severe issues will be seen first and that means long wait times for those with minor illnesses. 

Preparation/Prevention

As we prepare for the flu season to worsen, make an appointment with your pediatrician to get updated flu and COVID vaccines. Vaccines help prevent infection and can prevent serious outcomes in people who are vaccinated but still get sick with the flu. The vaccines also reduce the risk of hospitalization.

Get updated flu and COVID vaccines – these will help prevent infection and reduce the risk of hospitalization. You can call your pediatrician to schedule an appointment to receive vaccinations.

• 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.

RELATED

• Prepare Now for Flu Season with Vaccine Protection
• Get Immunized for a Healthy School Year (checkupnewsroom.com)
• Does My Kid Have Allergies, COVID, a Cold or the Flu? (checkupnewsroom.com)

To get an excused absence due to illness, please:

1. Contact your school’s attendance office to communicate your child’s absence. 
2. Submit a parent note in writing within five school days of your child’s return to campus. The excuse note should include the following:

• Student Name
• Student ID Number
• A written statement giving the dates and reason for absence
• Parent/guardian signature
• Parent phone number

3. If your child is absent for multiple days, contact your school for the attendance petition process.

From Cook Children’s Medical Center: Symptoms to be aware of and action to take

Like many hospitals and children’s hospitals around the country, Cook Children's is experiencing a surge in patients diagnosed with RSV, flu and other respiratory illnesses. The increase impacts our ability to care for patients in a timely manner.

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

It is NOT necessary for your child to take a strep throat, flu or RSV test before returning to school.

RSV and Other Illness Guidelines for Parents

Parents should NOT go to the Urgent Care or Emergency Department for only a flu or 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.

Call your pediatrician if:

• 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-19.

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.
• You have concerns that your child is dehydrated.
• In dehydrated babies, parents will see fewer wet diapers or a lack of tears. Their flat spot on the head can also appear more sunken.
• Breathing faster than usual or can see the skin between the ribs being sucked in.
• If your child requires 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 and approved boosters.
• Teach your children to cough or sneeze into their elbow.
• Use hand sanitizer.
• If sick, wear a mask in public and stay home.

If your child attends a different district, please call your campus to find out what your absentee policy is.

RELATED

• RSV Decreases While Flu Continues to Increase at Cook Children's (checkupnewsroom.com)
• Prepare Now for Flu Season with Vaccine Protection
• Get Immunized for a Healthy School Year (checkupnewsroom.com)
• Does My Kid Have Allergies, COVID, a Cold or the Flu? (checkupnewsroom.com)

Thanksgiving is only a couple of days away: turkey, casseroles, mashed potatoes and more! It’s also GERD Awareness Week to raise awareness of the complications of gastroesophageal reflex and to know the symptoms to look out for as you gather around the table. LaQuatre Rhodes, D.O, Gastroenterologist at Cook Children's Specialty Clinics in Prosper, breaks down what parents need to know or look out for when it comes to this common disorder.

What is GERD?

Gastroesophageal reflux is the passage of gastric/food contents into the esophagus with or without regurgitation or vomiting. It is defined as gastroesophageal reflux disease when reflux leads to troublesome symptoms or complications. A muscular valve is at the end of the esophagus to help prevent backflow of food/gastric contents, but when it doesn’t close well, it results in irritation of the esophagus and reflux symptoms. Symptoms of reflux vary by age.

What are the symptoms?

Infant/Toddler reflux symptoms:

•  Crying
• Fussiness
• Back arching
• Regurgitation
• Vomiting
• Dry cough
• Feeding difficulties
• Poor weight gain
• Breathing difficulties (wheezing, pneumonia, stridor, apnea)
• Recurrent ear infections

Older children reflux symptoms:

• Heartburn
• Abdominal pain
• Regurgitation
• Vomiting
• Acidic or sour taste
• Sore throat
•  Hoarseness
• Dry cough
• Difficulty swallowing
• Choking

Gastroesophageal reflux may be seen more in children with certain medical conditions including neurologic impairments, prematurity, and pulmonary problems (ex. cystic fibrosis, asthma, laryngomalacia).

What are the “red flag” symptoms?

Other conditions which can mimic reflux require further evaluation especially in the setting of red flag symptoms. Some of those conditions include infections, pyloric stenosis, brain tumor, meningitis, hydrocephalus, increased intracranial pressure, metabolic disorders, inflammatory bowel disease, obstruction, anatomical abnormalities, and decreased gut motility.

Red Flag Symptoms suggesting a disorder other than gastroesophageal reflux:

• Weight loss
• Lethargy
• Fever
• Irritable, severe crying, or inconsolable
• Seizures
• Bulging fontanelles in infants
• Increased head circumference in infants
• Small head circumference in infants
• Recurrent forceful or projectile vomiting
• Vomiting blood
• Vomiting bile
• Vomiting overnight
• Rectal bleeding
• Bloody stools
• Abdominal distention
• Breathing problems (difficulty breathing, stops breathing, turns blue, wheezing, frequent choking, recurrent pneumonia episodes)

How do you treat GERD?

Reflux can be concerning as a parent, but in the absence of “red flag symptoms” and if the child is gaining weight well, there's no need to worry. Symptoms should improve with time, lifestyle modifications, diet modifications, and/or acid suppression. If at any point your child develops worrisome or alarming symptoms please have evaluated by primary care physician, gastroenterologist if established care, or local emergency department.

If there are no red flag symptoms present, initial management of GERD is conservative:

Lifestyle modifications

• Staying upright at least 30 minutes after meals
• Burping infants during feeds
• Avoid tobacco smoke exposure
• Avoid tight diapers or elastic waistbands
• Weight loss if child overweight or obese
• Elevate head of bed 30 degrees

Diet modifications

• Thickening feeds with cereal or thickeners
• Formula change to hydrolyzed or amino acid based formula
• Avoid overfeeding
• More frequent smaller meals
• Avoid eating at least 2-3 hours before bedtime in older children
• Avoid large meals before exercise or increased activity
• Avoid acidic foods (ex. pickles, red sauces, citrus) spicy foods, carbonated drinks (ex. sodas, seltzer beverages), high fat foods, chocolate, and caffeine

Trial acid suppression for 4-8 weeks which may be extended longer based on clinical response and/or physician assessment.

• Proton Pump Inhibitors (ex. omeprazole, pantoprazole, lansoprazole, esomeprazole)
• Anti-histamine (ex. Famotadine, Cimetidine, Ranitidine, Nizatidine)

If alarming or worsening symptoms despite initial management, physician may proceed to gastroenterology referral and/or further evaluation including:

• Esophagogastroduodenoscopy (EGD)
• pH probe
• Abdominal ultrasound
• Barium studies (ex.  Upper GI series, esophagram, swallow study)
• Motility studies
• Severe reflux resulting in complications must consider surgery referral for Nissen fundoplication if not responding to medications and no other disorder cause of severe vomiting.

The Cook Children's Health Care System census is full across the board, including beds, the Emergency Department and Urgent Care Centers. The sheer volume has made finding a bed for our patients a daily logistical puzzle.

In the last 24 hours, 487 patients went to the Emergency Department, which is equivalent to one check in every 2 minutes. This is causing long wait times (8-10 hours) for patients to be transferred to the Pediatric Intensive Care Unit and is putting unnecessary strain on the health care system.

Across our seven Urgent Care Centers, there were 763 patients on Friday, 668 patients on Saturday and 754 patients on Sunday. Cook Children’s has expedited our winter staffing plan in preparation for peak flu season.

We ask parents and caregivers to contact their pediatrician first if it’s not a moderate or severe illness or injury. Other hospitals and children's hospitals around the country are also experiencing high number of RSV and respiratory illnesses.

RSV cases at Cook Children’s Health Care System:

Oct. 2 – Oct 8: 210 cases (24% positivity rate)

Oct. 9 – Oct. 15: 288 cases (29% positivity rate)

Oct. 16 – Oct. 22: 246 cases (24% positivity rate)

Oct. 23 – Oct. 29: 263 cases (23% positivity rate)

Oct. 30 - Nov. 5: 337 cases (23% positivity rate)

Nov. 6 - Nov. 12: 342 cases (19% positivity rate)

Nov. 13 - Nov. 19: 267 cases (15% positivity rate)

Positive Influenza A cases at Cook Children’s Health Care System:

Oct. 9 – Oct. 15: 47 cases

Oct. 16 – Oct. 22: 75 cases

Oct. 23 – Oct. 29: 170 cases (14.6% positivity rate)

Oct. 30- Nov. 5: 333 cases (22.6% positivity rate)

Nov. 6 - Nov. 12: 483 cases (27.5% positivity rate)

Nov. 13 - Nov. 19: 630 cases (35.4% positivity rate)

Urgent Care Centers

If your child is ill, please contact your pediatrician's office first if it’s not a moderate or severe illness or injury. If you can’t get to your provider’s office or it’s after hours, go to an urgent care center. Urgent care centers manage the same problems as your regular health care provider plus services such as X-rays, stitches and splints.

Understand that kids with more severe issues will be seen first and that means long wait times for those with minor illness. Staff are overwhelmed and they’re encountering a lot of frustrated parents. Please be nice to the people working – they need kindness!

Emergency Department

Bring your child to the emergency room if they have trouble breathing, unusual sleepiness or confusion, poison ingestion, head injury with vomiting, serious burn or another life-threatening condition. Please understand that kids with more severe issues will be seen first and that means long wait times for those with minor illnesses. 

Pediatrician Offices

Call your pediatrician first if children are experiencing mild symptoms or injuries (ear pain, sore throat, diarrhea or vomiting, rash, cough or other non-urgent health concerns). The pediatrician’s office can help you decide what steps to take.

As we prepare for the flu season to worsen, make an appointment with your pediatrician to get updated flu and COVID vaccines. Vaccines help prevent infection and can prevent serious outcomes in people who are vaccinated but still get sick with the flu. The vaccines also reduce the risk of hospitalization.

Preparation/Prevention

The increase in RSV and influenza began much earlier than usual this year, but we have yet to reach peak flu season. With Thanksgiving approaching, we want to help parents understand what they can do to prevent the spread of illnesses.

As we prepare for the flu season to worsen, make an appointment with your pediatrician to get updated flu and COVID vaccines. Vaccines help prevent infection and can prevent serious outcomes in people who are vaccinated but still get sick with the flu. The vaccines also reduce the risk of hospitalization. Get updated flu and COVID vaccines – these will help prevent infection and reduce the risk of hospitalization. You can call your pediatrician to schedule an appointment to receive vaccinations.

Remind your children to continue the healthy habits learned in the pandemic, including hand hygiene, coughing into a tissue or your elbow and staying home if you or your child feel sick. 

There is a nationwide shortage of RSV tests. RSV testing doesn’t change the way in which most children are treated/managed.

RELATED: 

• Prepare Now for Flu Season with Vaccine Protection
• Get Immunized for a Healthy School Year (checkupnewsroom.com)
• Does My Kid Have Allergies, COVID, a Cold or the Flu? (checkupnewsroom.com)

The state-of-the-art facility was built with everything for the child in mind, including what they'll see and experience as they make their way through the facility. Spaces are bathed in every color of the rainbow. Storybook murals meant to capture and stoke the imaginations of children define many spaces.

In the main entrance, guests are welcomed by a Sistine Chapel-like painting of flying cows — a nod to Cook Children's Cowtown roots — a massive video wall and a tile motif of a tree whose color-coded falling leaves guide visitors to the emergency department in one direction and outpatient services in the other.

“This is an extraordinary time in our almost 105-year history in North Texas,” said Rick W. Merrill, President and CEO of Cook Children’s Health Care System. “Families in this fast-growing region can take comfort in knowing there’s no need to drive long distances to see board-certified pediatricians, specialists, intensivists, hospitalists, and emergency medical doctors. Their child’s medical needs can be met right here by our outstanding team in Prosper.”

Cook Children’s Medical Center – Prosper includes an emergency department, operating and procedure rooms, pediatric ICU, medical/surgical unit, outpatient infusion center, imaging services, retail pharmacy, laboratory services, and pharmacy services.

With thousands of families moving to this area of North Texas each month, the need for quality pediatric health care is evident. Cook Children’s has already served more than 260,000 children through its 17 primary-care clinics located in this booming region, which includes Prosper, Aubrey, Plano, McKinney, Allen, Denton, Celina, Frisco, Little Elm, Flower Mound, and Carrollton.

“Cook Children’s is more than a health care system. We strive to be an extension of your family, growing with your child from their first steps to adulthood,” said Kevin Greene, Vice President and Administrator at Cook Children’s Medical Center – Prosper. “When your child needs world-class pediatric care, we’re here – whether it’s primary, urgent or emergency care, or treatment for a chronic condition. You can trust our team to take care of you and your child’s every need.”

The ribbon-cutting ceremony for Cook Children’s Medical Center – Prosper coincides with a new look for the health care system. This month, Cook Children’s unveiled a new logo and a culture platform to reinforce its commitment to its patients and community. Patient families in the Prosper area can expect to experience the same culture of kindness, safety, and compassion they’ve come to know from Cook Children’s.

Cook Children’s has long been recognized as a leader in pediatric health. In fact, US News & World Report has ranked Cook Children’s among the best children’s hospitals in the United States every year for the past 15 years. In 2022, Cook Children’s earned recognition for cancer treatment, cardiology and heart surgery, diabetes and endocrinology, neurology and neurosurgery, orthopedics, and pulmonology.

Many of these medical specialties are currently available at Cook Children’s Prosper campus, which opened in 2019 with urgent care and primary care services. A medical office building was added in 2020 providing access to 14 specialties including:

• Cardiology
• Ear, Nose and Throat
• Endocrinology
• Gastroenterology
• Hematology and Oncology
• Nephrology
• Neurosurgery
• Psychology
• Sleep Medicine
• Urology
• Neurology
• Pediatric Surgery
• Pulmonology
• Sports Medicine

An ambulatory surgery center for outpatient procedures, outpatient lab, and retail pharmacy are also located in the medical office building. By the end of the year, 549 medical professionals and ancillary staff will work at the Prosper medical campus. 

“Cook Children’s is known nationally and internationally for its world class patient care, leading clinical research and medical advancements,” said Tony Anani, M.D., MPH, MBA, gastroenterologist and Medical Director of Clinical Specialties at Cook Children’s Medical Center – Prosper. “I’m proud to be part of this incredible organization that truly embodies the motto, “Everything for the child.”

Cook Children’s Medical Center – Prosper also showcases the best available medical technology including features directly related to patient satisfaction. For example, if a patient in the hospital needs to see a specialist at Cook Children’s Fort Worth campus, they can visit virtually through the in-room TV.

In addition, the MyCookChildrens app provides patient families access to wayfinding, information about their care team, and daily schedule, to name a few. Another perk of the Prosper campus is Peaks Tech Zone. Similar to Apple’s Genius Bar, Peaks Tech Zone provides families access to health technology advocates who can assist with setup and support for their child’s medical device and/or MyCookChildren’s account.

Cook Children’s Medical Center – Prosper marks the first hospital Cook Children’s has built outside of the flagship medical campus in Fort Worth.

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