Healthy Start | Summer 2005

Vo l . 11 N o . 3

C o o k C h i l d r e n ’s H e a l t h C a r e S y s t e m

Fall 2005

Cook Children’s Urgent Care Centers

Urgent Care Centers Offer Busy Families An Additional Health Option

Fort Worth

Cook Children’s pediatric-only urgent care centers include experienced staff, kid-friendly environments

A 712 Seventh Ave. Across the street from Cook Children’s Medical Center 4 p.m.–midnight, Mon.–Fri. 3 p.m.–midnight, Sat.–Sun. 682-885-1024

Hurst

6316 Precinct Line Road Open noon–11 p.m. daily 817-605-2500

lthough your child’s pediatrician may have regular office hours, your child’s illnesses and injuries don’t.

Any parent knows that in a moment, your child can go from being active and healthy to sick or injured. Sometimes your child’s aches and pains may be a concern but may not require a trip to the emergency room.

Many working parents already have busy schedules, so getting your child appropriate medical care that fits into your schedule can pose a problem.

Fortunately, Cook Children’s urgent care centers offer a solution.

Cook Children’s established its first pediatric urgent care clinic in Hurst four years ago. Last year, more than 25,000 patients were seen at the facility. To respond to the needs of busy families, Cook Children’s has added an urgent care center in Fort Worth (at left).

“Urgent care centers have proven to be a convenient health care option that parents can be confident in,” says Gary Floyd, MD, medical director of urgent care centers and public policy for Cook Children’s. “Among those whom the centers have benefited include working parents who have difficulty getting their child in to see their pediatrician, and parents with acutely ill children who don’t want to wait for their child to be seen.”

Cook Children’s pediatric-only urgent care facilities are designed with kids in mind. This includes physicians and nurses experienced

in the special health needs of children, as well as child-friendly environments that help keep your child at ease in an unfamiliar and potentially stressful environment. ❖

Gary Floyd, MD, is medical director of urgent care centers and public policy at Cook Children’s.

One Site Fits All www.cookchildrens.org offers health information for kids of all ages

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hether your child is teething or about to have his or her wisdom teeth removed, finding accurate and reliable answers specific to your child’s age on the Web can be more difficult than getting your children to eat their vegetables.

Fortunately, Cook Children’s website offers one place for parents to find a range of health, safety, parenting tips and more at www.cookchildrens.org. Even if your child has the sniffles or is preparing for a complicated medical procedure, the website has information that can be of use to parents.

To view Cook Children’s online health database, go to: ■ www.cookchildrens.org ■ Select “Health Information.”

■ Select “Conditions and Diseases.”

■ Select the topic of your choice.

Visitors to Cook Children’s website can also find a pediatrician or specialist

for their child, find the next child car seat check, view more information on pediatric specialties, print applications to join Cook Children’s adult and junior volunteer programs, make a donation to Cook Children’s with a credit card through a secure format and much, much more. ❖

Telephone Resources Cook Children’s Parent Information Line gives parents access to hundreds of children’s health and safety questions using a touch-tone phone.

The messages are available any time, 24 hours a day, by dialing 1-800-COOK-177 (1-800-266-5177).

For a free catalog with the four-digit codes for all the available health topics, call 1-800-934-COOK (2665).

Help Girls Stay Active as Teens Adolescent girls often skip exercise, putting their health at risk

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Physician Network. “It can be walking, he teen years often bring a sharp playing basketball, games or any other drop in physical activity — activity that lets kids be kids.” especially for girls. But girls who Building activity into girls’ lives before trade tennis for television or volleyball for video games could face a future adolescence could help stave off disease.

Coupled with too many fries and sodas, of obesity and poor health, experts say. a dearth of exercise can lead to obesity, Research shows physical play plummets after age 9. While 72 percent of adolescent diabetes, heart disease and other ailments.

Exercise also plays a vital role in buildboys played hoops, hockey or some other ing strong bones. Research shows that activity for 60 minutes a week, a recent while calcium and vitamin D are imporsurvey found just 57 percent of girls were tant, exercise is the key to healthier that active. Unfortunately, many inactive bones from ages 12 to 17. After that, the adolescents turn into inactive adults later body no longer adds the bone strength in life.

To steer your daughter toward a health- that later fuels resistance to osteoporosis. ❖ ier course, change her focus to skating, running, softball, skateboarding — anything that gets her away from the remote P. David Lopez, DO, and the keyboard. is a pediatrician with Cook “Your child’s daily exercise doesn’t Children’s Physician Network. have to be intense,” says P. David Lopez, His office is located at 731 DO, a pediatrician with Cook Children’s Martin Road in Hurst.

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[ health bits ] Moms Urged to Breast-feed Breast-feeding can do a lot of good for babies and moms, says the American Academy of Pediatrics (AAP). In a breast-feeding policy that came out in February, the AAP cited studies showing that breast-feeding can lessen or ease diarrhea, ear infections and bacterial meningitis in infants. Some studies suggest breast-feeding may help head off sudden infant death syndrome, diabetes, obesity and asthma, the AAP adds. Research also shows breastfeeding can cut a mother’s risk for some medical problems. Among them: ovarian and breast cancer. The AAP recommends moms nourish babies solely through breast-feeding for about six months. It also backs breast-feeding for the first year and beyond — as long as the mother and child both want it to continue.

Crimes Against Students Drop The rate of violent crime against students ages 12 to 18 in school fell by half in the last decade, says a report from the U.S. Education and Justice departments. There were 24 crimes for each 1,000 students in 2002, compared with 48 in 1992. Other key findings: ■

The number of students in grades 9 to 12 who said they had brought a weapon to

school in the past 30 days fell from 12 percent in 1993 to 6 percent in 2003.

■

Urban students ages 12 to 18 were most likely to report gangs in schools (31 percent).

Eighteen percent of suburban students and 12 percent of rural students reported gangs.

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How to Get Your Daughter Moving ■

Turn off the television.

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Find activities (such as soccer or dancing) that she likes to do.

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If your streets aren’t safe, organize neighbors to watch girls and boys at play or while they walk to school.

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Join with her to set small goals, such as walking for 30 minutes a day, three days a week.

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Give her a role model — you — who’s excited about skiing, yoga, swimming, biking or hiking. That may be the most inspiring step of all.

In 2003, 7 percent of students ages 12 to 18 said they had been bullied at school.

That compares with 5 percent in 1999 and 8 percent in 2001.

Obesity Up Among Preschoolers At least one out of 10 preschoolers weighs too much, says the American Heart Association (AHA). The number of overweight children ages 2 to 5 has risen from 7 percent in 1994 to 10 percent in 2002, the AHA says. More than 15 percent of children ages 6 to 19 are overweight or obese. “Childhood risk factors carry over into adulthood, and may eventually translate into heart disease and other medical problems such as diabetes,” says AHA President-elect Robert H. Eckel, MD. “Obesity is a major risk factor for heart disease that should be controlled early in life.”

Scalding Poses a Risk in the Kitchen What’s the top source of burns to young kids in the kitchen? Scalding from hot liquids or steam, according to a report in Pediatrics. Scalding was twice as common as thermal burns (caused by contact with a hot surface), according to emergency room data from 1997 to 2002. Scald injuries often take place one of two ways, the report found: ■

A child reaches up and pulls a pot of hot water off the stove or some other high surface.

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A child spills a container of hot water on himself.

One-year-olds were at highest risk for scalds and burns. Boys were hurt more often than girls.

Healthy Start, Fall 2005 3

SAFETY

Every Time You Take That Ride, Give Your Brain A Place to Hide Bike helmets can reduce the risk of head injury by 85 percent

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EARNING TO RIDE A BICYCLE is one of the major events in a child’s life. But research shows that many parents don’t think enough about their child’s safety.

The single most effective safety device available to reduce head injury and death from bicycle crashes is a helmet.

4 Healthy Start, Fall 2005

Consider these facts: ■ Bicycles are associated with more childhood injuries than any other consumer product except the automobile.

Overall, head injuries are the leading cause of death in bicycle crashes, and they account for more than twothirds of all bicycle-related hospital admissions. Even a fall as little as 2 feet can result in a skull fracture or other traumatic brain injury.

■ More children ages 5 to 14 are seen in hospital emergency rooms for injuries related to biking than any other sport.

■ Preventing head injuries is easy. The single most effective safety device available to reduce head injury and death from bicycle crashes is a helmet.

■ Unfortunately, national estimates report that many children still don’t wear a helmet while riding.

National estimates report that helmet use among child bicyclists ranges from only 15 to 25 percent.

Whether or not your child wears a bike helmet can make a huge difference in keeping your child safe on the road. Non-helmeted riders are 14 times more likely to be involved in a fatal crash than helmeted riders. It is also estimated that bicycle helmets reduce the risk of both head and brain injuries by 85 percent.

That’s a major difference when you consider that recovery from a brain injury can include a long hospital stay, lengthy rehabilitation to relearn normal tasks and effects that can last throughout one’s lifetime.

Getting the proper fit When selecting a bike helmet for your child, parents should make sure that the helmet meets or exceeds the safety standards developed by

the U.S. Consumer Product Safety Commission (CPSC).

However, even when your child wears a CPSC-approved helmet, it will only provide good protection if it fits properly. To make sure it does, check the following: ■ The helmet should rest in a level position low on your child’s forehead, one or two finger widths above the eyebrows (see drawing).

■ The helmet should fit comfortably and snugly.

It should not rock forward and backward or side to side while your child is wearing it.

■ The helmet’s chin strap should always be buckled, but it should not be too tight. When the strap has the correct fit, the helmet should hug your child’s head when his or her mouth is open.

Getting The Right Fit

Incorrect

Correct

Incorrect

Bike helmets aren’t just for when a child is learning how to ride a bike. Parents should help children learn that bike helmets are always mandatory, regardless of a person’s age.

Make helmets a necessity ... not an accessory Bike helmets aren’t just for when your child is learning how to ride a bike, either.

Parents should help children learn that they are mandatory, regardless of the rider’s age. Studies show that helmet ownership and use actually decrease with the child’s age.

According to a recent survey, the reasons that children give for not using helmets include that the helmet is uncomfortable, they don’t feel cool wearing it and they don’t need one because they only ride near home.

“Parents need to stress to children the importance of properly wearing a helmet.

Being a good role model and

wearing your helmet whenever you ride can also make a big difference,” says Jill Gurtatowski, coordinator for the Tarrant County SAFE KIDS Coalition at Cook Children’s Medical Center.

“When it comes to safety, most parents say the right things, but they don’t always follow through with their actions. Role modeling safe behavior for children is an effective way to teach safe behavior.”

Making safe riding a priority Of course, bike safety involves more than protecting your child’s head. It also involves how he or she thinks and behaves while on sidewalks,

paths and streets. When children are first riding their bikes, they may not be able to perceive accurately how fast they are moving, and the speed of pedestrians and vehicles around them. As a general rule, cycling should be restricted to sidewalks and paths until children are 10 years old and can show a parent that they know the traffic laws and can obey them. These include: ■ Riding on the right side of the road, with traffic, not against it ■ Using the appropriate hand signals to turn and stop ■ Stopping at all stop signs and stoplights ■ Always stopping, looking left, looking right and looking left again before entering a street Parental supervision plays a vital role in protecting your child from injuries and serious accidents. This is true not only for bicycling, but for swimming or playing on the playground as well. Although riding can give your child a sense of freedom and excitement, many children can go too far and attempt tricks,

stunts and other inappropriate behavior. Just as your child should always wear a helmet, he or she should also know that inappropriate behavior is off-limits.

“Parents need to stress to children the importance of properly wearing a helmet.

Being a good role model and wearing your helmet whenever you ride can also make a big difference.”

—Jill Gurtatowski, Tarrant County SAFE KIDS Coalition coordinator Monitoring your children’s fun also involves periodically checking their bikes to make sure they work properly. This includes not only making sure that tires are properly inflated, but checking gears, brakes and reflectors as well. Even though your children should avoid riding around twilight, the reflectors and wearing brightcolored clothing can help them be seen by motorists. ❖ Healthy Start, Fall 2005 5

Construction to Expand Cook Children’s Heart Services New facilities to increase access for children needing heart tests and surgery

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onstruction has begun to expand cardiology and cardiothoracic surgery facilities at Cook Children’s Medical Center. The remodeling, scheduled for completion in fall 2005, will allow the clinical staff to better serve the growing patient base of Cook Children’s Heart Center.

In fiscal year 2004 (October 2003 to September 2004), members of the Cook Children’s Heart Center team performed more than 430 heart catheterization procedures, 325 heart surgeries and more than 11,000 echocardiograms at multiple Cook

Blood Pressure Rising Among Children Problems turn up as young as age 2

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he next time you hear folks talking about their blood pressure, take a look. They may be kids.

Yes, children can have high blood pressure, and experts say the number of kids with the problem is on the rise. Reginald Washington, MD, co-chair of the American Academy of Pediatrics Task Force on Obesity, estimates that 10 percent of children between 2 and 18 have high blood pressure, and a lot of them have not even been diagnosed. “We believe we’ll see heart disease and stroke at earlier ages if we can’t get this under control,” Dr. Washington warns.

The increase in children with high blood pressure is directly tied to lifestyle, though genetics plays a role.

Watch children for these risk factors: ■ Obesity/overweight ■ Poor nutrition (too much fast food and junk food) ■ Lack of physical activity ■ Cigarette smoking 6 Healthy Start, Fall 2005

Family history of high blood pressure According to pediatricians, a majority of children with high blood pressure don’t need to be put on medication; many can do well with lifestyle changes alone.

Their recommendations for healthier lives include making sure children get an hour of exercise and eat at least seven servings of fruits and vegetables daily.

“It’s difficult to make significant lifestyle changes, but it can be important for a child’s long-term health,” says Corey Mandel, MD, a pediatric cardiologist with Cook Children’s Heart Center. “A team approach that involves the whole family is the most effective way to do this. If you’re not sure how, ask your child’s pediatrician for assistance.” ❖ ■

Corey Mandel, MD, is a cardiologist with Cook Children’s Heart Center

Turning to Table Food How (and when) should you start your baby on solids?

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eeding a growing infant can challenge any parent.

Although many parents try to start their infant on solid foods at about 5 to 6 months, the American Academy of Pediatrics (AAP) says breast-feeding still offers the best nutrition in the first year.

Since babies receive most of their nutrients from breast milk or formula, pediatricians recommend that solids should never be offered as a replacement for these sources.

At the time you begin introducing your child to solid foods, mothers may breast-feed a bit less often, as these

Construction is expanding heart facilities at Cook Children’s Medical Center. The work is scheduled for completion this fall.

Children’s facilities in Fort Worth and across North and West Texas.

Cook Children’s is renovating a 14,000-square-foot area that previously was the medical center’s pediatric intensive care unit (PICU). A new PICU opened in October 2003, when the medical center expanded critical care

facilities and other services by adding a new five-story patient pavilion. The expanded heart center will include: ■ Two catheterization labs to help Cook Children’s pediatric cardiologists treat abnormal heart rhythms (called arrhythmias).

■ Four echocardiography suites, which

foods help fill up your baby. In the second half of the first year, though, more than half your baby’s calories should still come from breast milk or formula.

“Years ago, many parents started their child on cereals and baby foods when

they were only several weeks of age,” said Wayne Yee, MD, a pediatrician with Cook Children’s Physician Network.

“Over time, pediatricians have delayed introducing these foods due to allergy concerns and the lack of control most babies have over their tongues and mouth muscles.”

Iron-fortified rice cereal is a good first solid food because it poses little risk for allergic reactions and can be mixed easily with breast milk, formula or water. Mix the cereal to a very thin consistency to begin and adjust it as your baby gets used to swallowing.

Once your baby accepts rice cereal, gradually add other cereals, then strained vegetables, then fruit and finally ground meats. Starting with vegetables early in the process will help your baby accept their taste.

Pediatricians often advise parents to start one food at a time, introducing a new food no sooner than every five to

doubles the number of exam rooms.

Echocardiography is an important procedure that allows doctors to observe or monitor a patient’s heart, its pumping function and blood circulation.

■ Two cardiothoracic surgery operating rooms, to allow more space for children needing surgery to correct defects of the heart and circulatory system.

“In the past five years, the number of cases in our catheterization lab has increased more than 30 percent,” says cardiologist Paul C. Gillette, MD, medical director of Cook Children’s Heart Center. “When these new facilities are complete, it will allow many more children to be scheduled for tests and procedures.” ❖

Paul C. Gillette, MD, is medical director of Cook Children’s Heart Center.

seven days. That will help you pin down a problem if your child reacts to a food with vomiting, diarrhea or a rash. If your child has a skin reaction or trouble breathing, call your pediatrician immediately.

Once your baby is sitting up, offer finger foods in small, soft, easy-toswallow pieces. By about 7 or 8 months, many babies are eating up to three small meals a day. Soon, you can try foods with a thicker texture, but start with very small pieces. Things to be avoided include fried foods, refined sugars and things your child can choke on, such as raw vegetables, raisins, grapes, hot dogs and nuts. ❖

Wayne Yee, MD, is a pediatrician with Cook Children’s Physician Network in Lake Worth.

His office is located at 3900 Boat Club Road.

Healthy Start, Fall 2005 7

801 Seventh Avenue Fort Worth, TX 76104

Cook Children’s Physician Network is the

largest nonprofit pediatric

network in North Texas with more than 200 physicians,

physician

including primary care physicians and

pediatric subspecialists in more than

30 locations

in Tarrant, Denton and Hood counties.

To

find a pediatrician near you

or for a referral,

www.cookchildrens.org

please call our toll-free number.

1-800-934-COOK (2665)

Children’s Hospitals Work to Insure America’s Children

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nsuring America’s children is a top public policy priority for children’s hospitals. Children with a consistent source of health insurance receive routine checkups and stay healthier than children without coverage. That’s why the National Association of Children’s Hospitals, the public policy affiliate of NACHRI, advocates strengthening Medicaid and the State Children’s Health Insurance Program (SCHIP) for children.

Two-thirds of the 8 million uninsured children in the United States are eligible but not yet enrolled in these programs.

Introduced 40 years ago, Medicaid insures roughly one out of every four children — making it the country’s

NACHRI National Association of Children’s Hospitals and Related Institutions www.childrenshospitals.net

largest children’s health coverage program. It provides 22 million low-income and disabled children with essential health care benefits. Children reliant on Medicaid come from working families who do not have access to health insurance through their employers.

In 1997, Congress enacted SCHIP. The program allows states to expand Medicaid to uninsured children of low-income families, create alternative insurance programs for them or both.

All states have now implemented SCHIP. For family friendly information on Medicaid and SCHIP, visit http://coveringkidsandfamilies.org.

Even for privately insured families, Medicaid is important because it plays a critical role in the ability of children’s hospitals to care for all children. Children’s hospitals benefit all children by providing clinical care, training the

nation’s pediatricians, conducting pediatric research and advocating public health protections. On average, 40 to 50 percent of children’s hospitals’ revenues comes from Medicaid. Without Medicaid, children’s hospitals cannot fulfill their mission to serve all children. ❖

To Learn More To learn more about the importance of Medicaid and CHIP to children’s health and children’s hospitals, visit www.childhealthtx.org, the Children’s Hospital Association of Texas, or contact your local children’s hospital.

Articles in this newsletter are written by professional journalists or physicians who strive to present reliable, up-to-date information. But no publication can replace the care and advice of medical professionals, and readers are cautioned to seek such help for personal problems. ©2005 Health Ink Communications, 780 Township Line Road, Yardley, PA 19067, 267-685-2800. Some images in this publication may be provided by ©2005 PhotoDisc, Inc. All models used for illustrative purposes only. Some illustrations in this publication may be provided by ©2005 The Staywell Company; all rights reserved. (305)