September 16, 2014

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Texas Children’s Newborn Center is ranked No. 2 in the nation, but this impressive ranking is more than just a number. It demonstrates our hospital’s commitment to improving the long-term outcomes of premature and critically-ill infants in our Neonatal Intensive Care Unit (NICU).

Each year, more than 2,000 newborns are treated in all levels of our NICU where they receive the most comprehensive neonatal care available. Our Newborn Center combines research, advanced technology and world-class expertise to treat a myriad of complex medical conditions affecting newborns.

Texas Children’s is one of only two hospitals in the Greater Houston area that provides Level IV NICU care, which is the highest level of neonatal care available for extremely sick infants. Many community hospitals with less advanced NICUs transfer their patients to Texas Children’s where our neonatologists collaborate daily with an expert team of neonatal nurses in the Newborn Center.

91714Neooutcomesinside640“Improving neonatal outcomes is what our Newborn Center is all about,” said Texas Children’s chief of Neonatology Dr. Stephen Welty. “We use a collaborative, interprofessional approach to deliver high-quality care to our NICU patients, which include premature infants as well as full-term babies with complex medical diagnoses.”

Texas Children’s has reached numerous milestones to improve neonatal outcomes.

  • Supported by our dedicated team of neonatal nurses in the Newborn Center, Texas Children’s neonatologists collaborate with physicians and surgeons from diverse pediatric subspecialties to ensure infants receive comprehensive NICU care. For instance, our Newborn Center has organized an interprofessional group of pediatric gastroenterologists and surgeons to treat babies with digestive health issues.
  • Our Newborn Center partners with Texas Children’s Fetal Center to ensure babies in utero have the best possible outcomes after birth. Remarkable advances in fetal medicine have led to innovative therapies to treat congenital diaphragmatic hernias, spina bifida and heart disease. Our hospital recently performed a laparoscopic surgical procedure to correct spina bifida while in the womb.
  • Texas Children’s is one of only two hospitals in the Greater Houston area to offer total body cooling treatments to babies deprived of oxygen at birth. This therapeutic treatment allows oxygen-starved brain cells to heal thereby decreasing the potential risk for severe neurological damage. Texas Children’s is the first and only pediatric hospital in Texas to offer whole body cooling treatments to infants during ambulance transport to our Level IV NICU.
  • Since neonatal nutrition is vital to helping NICU babies grow, our Newborn Center is the first hospital in the world to add human milk fat to the diets of premature infants weighing less than 3.3 pounds. A recent Baylor College of Medicine study led by our own Texas Children’s Neonatologist Dr. Amy Hair, and published in The Journal of Pediatrics, found that adding human milk fat to the diets of premature infants in our NICU improved their growth outcomes.
  • Texas Children’s has implemented an exclusive human milk diet fortified with proteins and carbohydrates derived from human milk to nourish our premature infants to health. The fortifiers add calories and nutrients without changing the volume of milk to help infants grow adequately in the NICU.
  • Texas Children’s has developed a donor breast milk program to ensure babies in the NICU have access to donor breast milk if mother’s milk is not available. The Newborn Center also houses a Milk Bank and lactation support programs for mothers to ensure their babies get off to a healthy start.

“Our NICU has seen a significant reduction in the rate of necrotizing enterocolitis since we implemented the exclusive human milk feeding protocol in 2009,” said Dr. Patricia Bondurant, DNP, RN, and vice president of Nursing at Texas Children’s Newborn Center. “Necrotizing enterocolitis is a potentially deadly intestinal infection common in premature infants.”

These remarkable achievements are just a snapshot of what our Newborn Center is doing every single day to improve the long-term health and developmental outcomes of our NICU patients.

Click here to learn more about Texas Children’s Newborn Center and click here to take a video tour of our impressive Level IV NICU where miracles happen all the time. (there are two links in this sentence – you can get from the Connect story)

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The Center for Children and Women recently celebrated its one-year anniversary of delivering quality health care to Texas Children’s Health Plan members. As part of the August 20 festivities, staff members enjoyed cake and punch and received a one-year anniversary token of appreciation. Patients and their families celebrated along with the team by donning birthday hats and stickers and delivering their happy birthday well wishes.

Since opening in 2013, The Center for Children and Women has provided state-of-the-art health care that incorporates a wide variety of services in one location with extended hours. Services include pediatric and obstetrics/gynecology care, imaging, a laboratory, behavioral health services, and an onsite pharmacy, as well as support from a multidisciplinary team of health care professionals.

91714TheCenterinside640“Texas Children’s Health Plan is proud of the exceptional care offered at The Center for Children and Women,” said Christopher M. Born, Texas Children’s Health Plan president. “The Center is revolutionizing the way CHIP and Medicaid patients receive health care by improving access, coordinating care, and providing the highest quality community-based health care.”

As a patient centered primary medical home, The Center for Children and Women has definitely made an impact on the Greenspoint area by delivering care to more than 7,006 patients in the last 12 months. That number includes more than 6,100 pediatric patients and 887 obstetric and CenteringPregnancy patients. There also have been 268 births since August 2013. The actual number of appointments in the past year may best demonstrate the Center’s true footprint in the community. That number totals more than 27,000, which breaks down to 18,000 pediatric, nearly 6,000 obstetric and more than 3,100 behavioral health visits.

During its first year of operation, the facility expanded its scope of services to include dispensing eyeglasses and speech therapy. Also in March 2014, The Center marked another milestone with the addition of dental services through a partnership with UT School of Dentistry.

In addition to other first year accomplishments, The Center for Children and Women earned the National Committee for Quality Assurance (NCQA) Level 3 recognition as a Patient-Centered Specialty Practice for Obstetrics and Level 3 recognition as Patient-Centered Medical Home for Pediatrics. These recognitions further demonstrate the team’s commitment to patient-centered care and clinical quality.

“On behalf of the entire leadership team and staff of The Center for Children and Women, it has been and continues to be a privilege to serve Texas Children’s Health Plan members in the Greenspoint community by enhancing access to the highest quality primary care,” said Tangula Taylor, director of operations at Texas Children’s Health Plan – The Center for Children and Women. “Our extended hours and breadth of services provided in one central location makes it easy for our patients and families to achieve healthy outcomes for their lives.”

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By Rosanne Moore, Bump Watch Editor​

Putting together a diaper bag for a baby may feel like packing for a weeklong vacation! How many diapers do I need? Is one pacifier enough? What other baby gear essentials should I take with me?

For new mothers, leaving the house takes on a whole new meaning. Preparation is key, even if your out-of-the-house excursion means running a few errands with your infant (or infants, in the case of twins!) in tow.

To help make the process easier for new parents, we asked several Bump Watch mothers to share their tips on what to pack in their newborn’s diaper bag. After all, you need to be prepared for any surprises.

Top 15 list of diaper bag essentials:
1. Diapers (at least two per child) and plenty of wipes
2. Boogie wipes (unscented) for the nose and face
3. Travel changing pad
4. Munchkin diaper disposal bags, like this one. They are scented which is a Godsend when baby has a dirty diaper.
5. Small tube of Triple Paste diaper rash cream
6. Pacifier and pacifier sanitizing wipes
7. A favorite teether/toy for baby (such as a Sophie or a rattle)
8. Extra change of clothes in case baby has a blowout
9. BabyGanics stain stick (in case baby stains clothing, you can pre-treat it right away)
10. Blanket or “hooter hider” cover for nursing
11. Pre-measured formula/water if you are formula feeding so you can prepare a new bottle on the go
12. Lightweight blanket for baby
13. Extra bib
14. Burp cloth for spit ups
15. Ziplock bag (so that if baby soils clothing, you can keep it contained away from the rest of your things)

September 9, 2014

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Physicians at the Fetal Center completed their first fetoscopic procedure to repair spina bifida in-utero – an innovative approach that was developed by Dr. Michael Belfort, obstetrician and gynecologist-in-chief at Texas Children’s Pavilion for Women and Dr. William Whitehead, pediatric neurosurgeon at Texas Children’s.

“Our hope is that these types of innovations will lead us to a new era of fetal medicine and surgery,” Belfort said.

Myelomeningocele, or open neural tube defect (NTD), is a form of spina bifida and occurs in 3.4 out of every 10,000 live births in the U.S. and is the most common permanently disabling birth defect for which there is no known cure. Myelomeningocele is a developmental defect in which the spine is improperly formed and the spinal cord is open to, and fused with, the skin. It is usually associated with hydrocephalus, or the buildup of cerebrospinal fluid in the brain, which requires surgical treatment to drain the fluid via an implanted device called a shunt. Originally, closure of the defect occurred after the birth of the baby, which was associated with an 80-90 percent chance that a shunt would be required for life.

But after a breakthrough NICHD-funded study entitled the Management of Myelomeningocele Study (MOMS) demonstrated a significant decrease in the risk of hydrocephalus for select patients undergoing fetal closure of the spine, as well as possible improvement in lower extremity function, compared to patients who underwent standard closure after birth, the Fetal Center adopted this as a treatment option and began performing open fetal surgery to treat spina bifida. To date, we still have one of only a handful of centers in the country that is able to perform this complex in-utero repair. Texas Children’s Fetal Center has completed 23 of these surgeries since 2011, with excellent results.

This technique, the standard of care in the US, involves a uterine incision and can cause maternal complications. With this in mind, the team at the Fetal Center wanted to focus on reducing the risks to the mother and countering the risks of preterm delivery. Working in conjunction with Dr. Jose Luis Peiro and Dr. Elena Carreras of Vall D’Hebron Hospital in Barcelona, Spain, they developed a fetoscopic approach to the repair.

The surgery was over three years in the making and features an in-utero, single layer, sutured repair through only two, four millimeter incisions in the uterus (rather than the 5-6cm opening that is required for an open procedure). In order to practice and perfect performing the closure using a minimally invasive fetoscopic approach, the team built a simulator using a child’s kickball that replicated the mother’s uterus. Inside the kickball, a doll acted as the fetus including a spina bifida defect on the doll’s back. Drs. Belfort and Whitehead practiced closing the defect using a team approach in which they both carry out specific parts of the surgery in a coordinated fashion. The two surgeons performed more than 30 simulated procedures including two full simulations, gowned and gloved, under actual OR conditions with a full support team.

“We have a magnificent team of specialists from a number of departments working together in the best interests of our fetal and neonatal patients. I am incredibly proud to be a member of this outstanding team and to be able to play a role in this mission,” Belfort said.

With a multi-disciplinary structured program in place, clinical planning and training and full Institutional Review Board approval for this experimental procedure, the team performed the first in-utero spin bifida closure on their first patient on July 30, 2014. The procedure went as planned and so far mom and baby are doing well. Doctors are optimistic and are waiting to access the outcome of the repair once the baby has been delivered.

“It is important to note that this mother has not been exposed to a significant uterine incision and we are much less concerned about her risk of a ruptured uterus during this pregnancy than we are after an open repair,” Belfort said. “We look forward to an uneventful delivery and a healthy baby.”

In addition to an expert operating room team and nursing staff, a multidisciplinary team of specialists led this first surgery at Texas Children’s Fetal Center, including Dr. Michael Belfort, Dr. William Whitehead, Dr. Alireza Shamshirsaz, Dr. Oluyinka O. Olutoye, Dr. Olutoyin Olutoye, Dr. David Mann, and Dr. Rodrigo Ruano.

“With the ever-advancing technology and imaging capabilities and dedicated surgeons, I am excited to see what the future holds when it comes to repairing anomalies fetoscopically,” Belfort said. “I am so impressed by what can be achieved with our exceptional team.”

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Christian Spear puts on her headphones and closes her eyes as she stands next to a purple microphone. The former American Idol contestant is not on the stage performing in front of thousands, and she’s not competing in a television program anymore, but she is performing with all of the same passion. She is singing from the heart inside the Purple Songs Can Fly studio at Texas Children’s Cancer Center. It’s a song she wrote and composed along with Anita Kruse, founder and executive director of Purple Songs Can Fly. The program gives patients in the cancer center the chance to compose their own songs and Spear has signed on to be a songwriter for the year, helping children with their tunes.

“Coming back to Texas Children’s has been nothing short of a full-circle experience for me,” said Spear. “It is always so humbling to be amongst children and families who are enduring the very things I endured years ago.”

Spear is a 15 year cancer survivor. She received her treatment right here at this very hospital, and now she is proud to be here hoping to inspire each child she meets. Today, her personal experience and the kids’ battles have inspired the lyrics to her latest song, No One Fights Alone. The song is about uniting in the fight against cancer and it’s dedicated to children at Texas Children’s Cancer Center and beyond. It is in honor of Childhood Cancer Awareness Month. When she opens her mouth and the song lyrics spill out, the emotions are palpable.

“Cancer can’t steal away your joy or ever dim your light,” Spear sings with raw emotion. “Cancer can’t break your spirit or take away your will to fight.”

Take action! Share the video on social media and use the hashtag #NoOneFightsAlone to share your personal stories.

She said having survived cancer inspires so many areas of her life, especially her songwriting.

“I was able to grow with a completely new outlook on life,” said Spear. “I try to find joy in everything around me and it’s inspired my songs to always have a message of hope.”

“Because Christian is a childhood cancer survivor herself, she embodies the spirit of hope, courage, resilience, creativity, connection and love that we all seek,” said Kruse.

Spear’s time at the hospital is spent with the children, and it’s clear she relates to them on a different level. Being a survivor gives her a special connection with those who are still fighting the disease. Her former physician, Dr. ZoAnn Dryer, is among her many fans.

“Stories like Christian’s are what help all of us get up in the morning with a smile on our faces and literally a song, usually hers, in our hearts,” said Dryer. “Christian is a blessing to all, and I am so very proud to introduce her to my patients undergoing therapy so they can truly begin to believe there is light at the end of the ‘cancer tunnel.’”

Spear recently sang her song at a ribbon-tying ceremony which brought together patients and staff to tie more than 600 gold ribbons, each signifying one patient diagnosed with cancer at the cancer center over the last year. Nationally, more than 15,000 children will be diagnosed in one year. The cancer center also provides supportive care to children with cancer in five African counties: Botswana, Uganda, Malawi, Tanzania and Swaziland.

“Our patients serve as our inspiration to provide the best quality medical and psychosocial care, conduct state-of-the art research and train our future leaders in the field,” said Dr. David Poplack, chief of Texas Children’s Cancer Center.

The ribbons will be on display all month at the children’s playground on the first floor of Abercrombie Building. It’s a small reminder of the universal message that no one fights alone.

View photos from the event

“‘No One Fights Alone’ means whether I’m battling a disease, or just having a bad day, I will never be without the love and support of my friends and family,” said Spear. “That’s what I hope to leave each listener with, love and support to bring them joy.”

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Texas Children’s Cancer Center’s Making a Mark art exhibition is showing on The Auxiliary Bridge until Friday, October 3. Sponsored by the Periwinkle Foundation, this exhibit showcases art created by children ages 3 to 22 who have been affected by cancer and blood disorders. This exhibit will travel to five other Texas locations.

A kick-off party was held in the clinic September 5, prior to the exhibit’s opening September 7.

A panel of judges selected purple ribbon pieces of art they felt most effectively represented Childhood Cancer Awareness Month.

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Premature infants have special nutritional needs. Since their fragile bodies cannot consume as much breast milk as full-term babies, they need extra nutrients, minerals and protein to help them grow.

A recent Baylor College of Medicine study led by Texas Children’s Neonatologist Dr. Amy Hair, and published in The Journal of Pediatrics, found that adding a cream supplement in the diets of premature infants improved their growth outcomes in the Neonatal Intensive Care Unit (NICU).

“When premature babies are born, their lungs and other organs are still developing,” said Hair. “They need extra calories to help them grow adequately while in the NICU, thus improving their long-term health and developmental outcomes.”

Hair’s study examined 78 NICU infants weighing less than three pounds at Texas Children’s Newborn Center and the University Health System at San Antonio. Half of the infants received an exclusive human milk diet consisting of mother’s own milk or pasteurized donor breast milk, and a protein fortifier. The other half received the exclusive human milk diet plus a cream supplement derived from pasteurized human milk fat. Researchers found that premature infants who received the cream supplement had better growth outcomes in terms of weight and length than infants who received just the exclusive human milk diet.

“Premature babies can tolerate only a certain amount of feedings since their stomach and intestines are extremely sensitive,” said Hair. “The cream supplement is a natural way to give them fat and boost their caloric intake without changing the volume of milk.”

Texas Children’s is the first hospital in the world to add human milk-based cream to the diets of infants who weigh less than 3.3 pounds. Since our tiniest NICU patients are fed an exclusive human milk diet, this has significantly reduced the rate of necrotizing enterocolitis, a severe and potentially deadly intestinal infection common in premature infants.

“A mother’s milk is the best nutrition a baby can have, which is why we feed only breast milk to the babies in our NICU,” said Nancy Hurst, director of Women’s Support Services at Texas Children’s. “We depend on the generous mothers who donate their excess breast milk to our Milk Bank to ensure our NICU infants have a better chance of survival during this critical stage in their young lives.”

Additionally, Texas Children’s Pavilion for Women has implemented numerous breastfeeding programs for new mothers to ensure their babies get off to a healthy start. The hospital’s focus on neonatal nutrition underscored by its initiatives to promote successful breastfeeding, has helped Texas Children’s inch closer towards achieving the Baby-Friendly Hospital designation.

Click here to learn more about Texas Children’s Milk Bank Donation Program, and click here to read Dr. Hair’s Journal of Pediatrics study.