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

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

It begins with trauma-informed care.

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

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

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

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

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

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

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

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

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

"We try and try, but he won't burp."

Oh, the magical burp. It's that often elusive sound that would be offensive for you to let loose at the dinner table, but everyone celebrates when it comes from your newborn.

So, what's the point? Easy, to get some of the air that's trapped in the stomach below the milk … out. Some babies are easy to burp. They can suck down eight ounces of milk in five minutes and you barely get them upright before your hear a big, manly burp. There are other babies who, no matter what you do: pat, bounce, dance or turn them upside down … they are not going to burp.

I actually don't think it matters. I think the biggest benefit of the process of burping is simply that you aren't immediately laying them down flat right after they feed. Keeping them upright helps the milk settle lower in their stomach and provides some protection from spitting up, but actually obtaining the precious belch is probably not all that important.

Do you have more questions about newborns? Check out Dr. Smith’s program, Newborn University, including 20 posts about newborn care and classes or consultation at his office in Lewisville.

About the author

Justin Smith, M.D., is a Cook Children's pediatrician in Lewisville . He attended University of Texas, Southwestern Medical School and did his pediatric training at Baylor College of Medicine. He joins Cook Children's after practicing in his hometown of Abilene for four years. He has a particular interest in development, behavior and care for children struggling with obesity. In his spare time, he enjoys playing with his 3 young children, exercising, reading and writing about parenting and pediatric health issues.