February 25, 2014

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Finding herself awake in the middle of the night, Jenni Stearman, a NICU nurse at Texas Children’s Newborn Center, began scrolling through posts on Facebook before stopping at one that struck a chord in her heart.

It was a touching update from a NICU parent expressing appreciation for everything the NICU nurses do, and it inspired Stearman to return the compliment by conveying her appreciation and empathy for NICU parents.

“I guess I was just a little bit emotional and I read the post and it was just really inspiring. It was too late to call anyone and talk about my feelings, so I typed,” said Stearman.

Although she was home, off-duty, and had a lot going on in her personal life with an upcoming move, wedding and honeymoon, Stearman took some time to reflect on the rewarding experience of getting to know so many loving families in the NICU at Texas Children’s. In her late-night Facebook post, Stearman recounted the journey and struggle of a NICU parent.

“You are in a situation that you didn’t plan on being in and everything that you did plan is now unobtainable. You feel completely out of control of the situation around you. You are dependent on others to do what you so dearly long to be able to do for your own child. Everything that you would normally do to comfort and care for your baby has been taken away from you. I’m here to tell you, I understand your pain and I appreciate you,” she wrote.

She continued by sympathizing with them and expressing gratitude for all that they do to make her job and life even better.

“You trust me with your most valued possession. You learn to trust my instincts and I yours. We become a team with one common goal in mind and that is to get your child home with you as quickly as possible and as healthy as possible. Thank you for that trust. You become my “friends” while we spend 36hrs/week together. After months of this, we have shared more conversation than I have with some of closest friends. We have shared times of pain and times of joy. We have cried together and we have shared laughter. In some cases we share bonds that will extend far beyond the NICU. Thank you for being my friend.”

And finally, she thanked them for staying in touch and giving her hope during tough times.

“The NICU can be a depressing place (as you know). Your updates help us keep faith that all we do is for a very good reason,” she wrote.

Stearman tagged some of the NICU parents she knew in the post, and by morning, many people had forwarded it on and reached out to tell her how much it meant. The post gained so much momentum that the Huffington Post decided to publish it as an op-ed health piece on their national site, highlighting how much our NICU nurses care about the patients and families at Texas Children’s. The post has generated thousands of social media “likes” and shares.

“I wrote it for the NICU moms so I was happy to hear they were sharing it,” said Stearman. I’m really, really happy that people loved it and felt inspired by it.”

For 30 years, patients and their families have found a welcoming place to escape in a book, play a board game, do a puzzle while in the midst of treatments and hospital stays. What started as a little closet with a few donated books has grown to a comprehensive library with “a little something for everyone” including resource and foreign language books, computers, printers, Fax/copy machine, DVDs, board games and puzzles.

The library’s vast array of books provides a chance to travel to another world but the greatest stories in this library come from the moments patients and families share as they explore new ideas, take a moment away from their hospital room to enjoy a nice story or visit the library to meet a special author who’s here for a visit.

The Pi Beta Phi Patient/Family Library opened in 1984 in a linen closet in the Abercrombie building, 1992 it moved to a larger space and finally settled in 2011 on the 16th floor of West Tower in 2001. The library has been made possible by the generous donations of Houston Pi Beta Phi foundation where it gets its name. From being just an idea by board member Virginia McFarland three decades ago, the Pi Beta Phi Patient/Family Library is now an important part of the Texas Children’s Hospital experience.

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Texas Children’s child life specialists are finding creative ways to ease a child’s anxiety before their procedures, and the specialists’ efforts recently received national attention on NBC’s Today.com.

Texas Children’s has one of the largest child life programs in the country with more than 30 professionals on staff. Child life specialists focus on the psychosocial needs of children, doing everything they can to ensure our young patients feel as comfortable and relaxed as possible during their hospital stays. For patients who come to the hospital for surgery, child life specialists help diminish fears before entering the operating room.

This starts with providing age-appropriate information to alleviate misconceptions, minimize fears and provide each child with a sense of control before they enter the unfamiliar world of the operating room (OR).

“Every child is different, and they cope best if we individualize treatment based on their developmental and psychological needs,” said Child Life Specialist Diane Kaulen.

For example, child life specialists may take young children in a red wagon on their way to an OR or give an older child the chance to see a mock-up of the OR so they can touch and play with medical supplies in a calm setting and even choose their anesthesia “flavor.”

“We use a variety of techniques, including distraction and relaxation methods and engaging in play activities to create a sense of normalcy and control,” Kaulen said. “I think the most important element in preparing a child for surgery is meeting the child where they are. Some children like to know a lot of information and some do not.”

Child Life helps children effectively manage stress, which reduces the need for potentially dangerous sedatives and pain medications and helps children heal faster with fewer long-term psychological effects.

“Most children have a set of coping skills they already draw on to help them cope effectively in difficult situations,” Kaulen said. “We’re able to evaluate potential situations that would create anxiety for that child and then develop a plan to help that child cope with those potential stressors. Parents can be a great resource for us when we individualize the plan of care.”

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TBT: We admitted our first patient to Texas Children’s Hospital on February 1, 1954. Sixty years later, we have over 3.2 million patient encounters a year. Stop by Texas Children’s Facebook for a walk down memory lane. Do you have a great photo or story about a Texas Children’s nurse or doctor? Share them with us in the comments!

22614emphealth640Texas Children’s is dedicated to helping you achieve optimal health and well-being by providing convenient access to excellent health care services at the Main Campus. Here are some reasons why the next time you need to see a primary care provider, you should take the yellow elevators to the 5th floor and visit your Employee Medical Clinic.

1. Location, location, location: The convenience of having an on-site medical clinic means you won’t have to waste time navigating the medical center while you take time out of your day to visit a health care provider. Plus, who wants to pay for parking somewhere else when you’re already parked in your employee parking spot?
2. We’re here for you: In addition to lunch time appointments, you asked for early morning appointments and we listened. Starting March 4, every Tuesday, the clinic will open from 6:30 a.m. to 3:30 p.m. Same-day appointments are available almost every day. Just call ahead and schedule a time that’s convenient for you.
3. Friendly faces: If you haven’t met them yet, our medical providers, Dr. Perkison and Joycelyn Gordon, PA are friendly and approachable and you’ll want to get to know them. Plus, you’ll love working with Noelle Hirst, RN; Valeria Martinez, clinic representative and our wellness team who are dedicated to helping you achieve optimal health and well-being.
4. Save money: All Texas Children’s Hospital medical plan participants pay a reduced $10 co-pay which is also payroll deductible.
5. We respect your privacy: Externally hosted, confidential electronic medical record keeps your information private.

You can get your well checkup and many other primary care services right here at work including, but not limited to:

  • well-woman and well-man exams
  • urgent care for minor personal illness and injuries
  • routine physicals
  • seasonal allergy and cold symptoms
  • on-site physical therapy
  • chronic condition management
  • specialty care coordination

Employee Medical Clinic Information
Location: Employee Health and Wellness Center, Main Campus, 5 Tower by yellow elevators
Hours: Mondays and Wednesday to Friday: 7:30 a.m. to 4:30 p.m.
and Tuesdays: 10 a.m. to 7 p.m. (New Tuesday hours begin March 4: 6:30 a.m. to 3:30 p.m.)
Phone: 832-824-2150

By Dr. Steven Abrams, Neonatologist and Medical Director of Neonatology Nutrition Program

When I first started as a pediatric trainee in 1982, if an infant was going to receive a formula, which, unfortunately was most of them back then, there were only a few choices. Basically three companies marketed cow milk-based or soy-based formulas. Families asked their pediatrician which company they preferred and discussed whether a soy formula might be helpful. Life was simple even if those choices didn’t usually matter very much.

Now, it’s a virtual maze wandering through the formula aisle. There are more companies, more choices, and a complex set of information on the packages that make it very hard for anyone to know what to choose. Do I want my baby to get a “gentle” formula? Is she “sensitive?” Hmmm “organic” must be a good idea? Wait, am I supplementing breast-feeding? Do I need a formula that will “comfort” my baby? What about “spitting” up?

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My children like to laugh and even write that sometimes I go to the store and wander through the infant formula aisle just so I can see what parents must face. It’s not infrequently that I spot a poor mom or dad combing the aisle desperately trying to guess what will make their baby happy (and sleepy!). I consider myself fairly knowledgeable about infant nutrition including formula choices but even I can’t guess sometimes what’s actually in a formula from its name and must read the list of ingredients, or search on the internet, to find the answer.

The basic principles:
So, let’s go through some principles to at least try to help with the formula aisle maze. Unquestionably, breast milk is the best choice for virtually every infant, but it is also true that the majority of infants in the United States will receive some formula during the first year of life. Helping their parents make good choices between formulas and understanding the options for infant formulas is not in conflict with supporting breastfeeding as long as it remains understood that “closest to breastmilk” is a long way away.

First, the good news is that all of the formulas you see that say “infant formula” on the label are safe except for the very few infants with special medical problems which should be identified by your pediatrician.

Second, there is no evidence at all that parents must or should buy the most expensive formula on the shelf or be concerned about the health benefits of lower cost formulas. I would, however, caution against frequent switching of brands based on one coupon or sale as some infants do seem to develop preferences over time and it can be very difficult for parents to determine the differences between an advertised brand of formula and the one their child has been receiving.

Third, parents can usually purchase powder as it is less expensive than pre-mixed liquid formula. A special exception to this is babies who are born prematurely who should only get ready-to-feed liquid for at least a month after their due date. Concentrated liquid formula is another option although parents must be cautious to properly dilute the concentrate with water based on the label instructions.

Fourth, from a nutritional perspective, there is no reason to choose any particular formula brand or type specifically for breast-fed infants who are receiving some supplemental formula. Marketing in this way should not be confused for evidence of a need for a unique formula choice in babies who are partially or primarily breastfed.

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Special conditions:
Now, beyond that, it gets tougher. For the most part, babies will often have colic, spitting (reflux), upset stomachs, or mild allergic symptoms that do not necessarily require violating rule #2 above. Formulas marketed as improving one or more of these symptoms may or may not be successful in an individual baby. In general, I recommend that for most concerns such as spitting, parents try other behavioral and feeding techniques before switching to formulas marketed using vague terms such as “gentle,” “comfort,” or “sensitive.” It is not uncommon for a baby to have been tried on three or more formulas without any real difference in these symptoms. Often a baby grows out of the problem at the same time as yet another formula switch is made leading to uncertainty related to long-term formula selection.

Having said that, there are some babies who improve on specialized formulas, especially the often more expensive formulas designed to deal with severe allergic symptoms or severe reflux that might uncommonly be affecting growth. Formulas with probiotics (beneficial bacteria) may be helpful in some infants with colic although recent studies are not conclusive regarding this issue. I believe that in every such case, a family should carefully consult with their pediatrician before purchasing or using one of these formulas.

The right pediatrician:
Finally, a key message to parents is that just as it is important to find a breast-feeding friendly and knowledgeable pediatrician, it is also important to make sure that your pediatrician can properly guide you through the formula aisle should you choose to provide an infant formula. Ask questions about why a formula choice is being recommended and whether a lower cost one, or a more readily available one, can be tried. If a specialized formula is started for your infant, remind your pediatrician regularly about this and ask if it would be possible to switch to a more routine one after a month or two. Go through the symptoms your baby is having with your pediatrician and see if the formula descriptions I mentioned earlier (e.g. for spit up, for comfort, being gentle, or organic certified) are ones that truly match what is best for your baby.

In summary, I wish you the best of luck traversing the formula aisle. Don’t forget to send occasional notes to the companies that make these formulas if you’re confused by what is being sold. I sure do!

Dr. Steven Abrams is a Texas Children’s Hospital neonatologist and Medical Director of the Neonatology Nutrition Program at Baylor College of Medicine. Like what you read? Check out our expert posts section to hear more from the vast knowledge of our doctors and other experts right here at Texas Children’s.

Ask an expert! Have a question and want to hear expert advice? Just comment below and we may even feature your question in an upcoming blog post.

The March of Dimes Texas Chapter has awarded a grant to Texas Children’s Health Plan to support “Becoming a Mom,” a program that delivers prenatal education in a group setting.

Texas Children’s Health Plan is currently offering the “Becoming a Mom – Comenzando bien Program” in Houston and Huntsville locations. The program’s goal is to provide supportive environments that promote healthy behaviors and positive birth outcomes. The “Becoming a Mom” program helps women overcome barriers to care and become informed of prenatal services.

As a managed care organization serving more than 360,000 members, Texas Children’s Health Plan provides Medicaid and CHIP insurance coverage for individuals in 21 counties, including Harris and the surrounding seven counties. Texas Children’s Health Plan supports pregnant women through the provision of “Becoming a Mom” classes, childbirth classes, home visitation programs and community events, spreading awareness of early prenatal visits and the benefits of waiting until after the 39th week of gestation before delivery.

March of Dimes is the leading nonprofit organization for pregnancy and baby health. With chapters nationwide and its premier event, March for Babies, the March of Dimes works to improve the health of babies by preventing birth defects, premature birth and infant mortality. For the latest resources and information, visit marchofdimes.com or nacersano.org.