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F ever is a warning sign that your child may have an illness that needs atten- tion. But a report from the American Academy of Pediatrics (AAP) stresses that fever itself is usually not a problem. In fact, it can be beneficial. “Fever is the body’s first line of defense against infection,” says Rachel Baker, M.D., a pediatrician affiliated with Children’s Memorial Hermann Hospital. “It slows the growth of bacteria and viruses and boosts production of white blood cells. Generally, you don’t need to bring a fever down unless it’s causing your child discomfort.” A temperature of 100.4 degrees or higher is considered a fever. It’s best to take the temperature rectally or in the ear with a dig- ital thermometer. A child who is eating and sleeping well and playing often doesn’t need fever-lowering treatment. But treatment may be needed if your child isn’t doing those things or has a history of fever-related convulsions. Call your child’s pediatrician in these situations: Ages 2 months and younger: rectal tem- perature of 100.4 degrees and higher Ages 3 to 6 months: 101 degrees and higher Not all fevers need treatment Ages 7 months and older: 103 degrees and higher Fever associated with severe sore throat, severe earache, coughing, unexplained rash, repeated vomiting or diarrhea Fever that lasts more than 24 hours When a fever is making your child uncom- fortable, these steps may help: Dress your child lightly to avoid overheating. Place your child in a lukewarm bath. Avoid putting alcohol in the bath as this can make chills worse. Encourage your child to drink extra fluids to prevent dehydration. Water, diluted fruit juice, popsicles and electro- lyte solutions are good choices. Consider using acetaminophen or ibu- profen to reduce fever. Follow label instructions. Check with a doctor before giving acetaminophen to a baby younger than 2 months or ibuprofen to a baby younger than 6 months. Don’t give ibuprofen to a dehydrated or vom- iting child without a doctor’s supervi- sion. You can alternate acetaminophen and ibuprofen every three hours to keep the fever down. Avoid aspirin. Its use by children with viral illnesses has been linked to Reye’s syndrome, a rare but serious disease that can harm the liver and brain. EXPERT MATERNITY CARE HELPS MOTHER AND BABY THRIVE 2 SURGERY BEFORE BIRTH IMPROVES BABY’S OUTLOOK 3 HAVE A HAZARD-FREE HALLOWEEN 4 INSIDE childrensmemorialhermann.org HEALTH HIGHLIGHTS FOR PARENTS NEWS FROM CHILDREN’S MEMORIAL HERMANN HOSPITAL FALL/WINTER 2011 Affiliated with The University of Texas Medical School at Houston

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Page 1: Children’s Memorial Hermann | Houston Children’s …childrens.memorialhermann.org/uploadedFiles/childrens...Memorial Hermann Hospital. “It slows the growth of bacteria and viruses

 Fever is a warning sign that your child may have an illness that needs atten-

tion. But a report from the American Academy of Pediatrics (AAP) stresses that fever itself is usually not a problem. In fact, it can be beneficial.

“Fever is the body’s first line of defense against infection,” says Rachel Baker, M.D., a pediatrician affiliated with Children’s Memorial Hermann Hospital. “It slows the growth of bacteria and viruses and boosts production of white blood cells. Generally, you don’t need to bring a fever down unless it’s causing your child discomfort.”

A temperature of 100.4 degrees or higher is considered a fever. It’s best to take the temperature rectally or in the ear with a dig-ital thermometer.

A child who is eating and sleeping well and playing often doesn’t need fever-lowering treatment. But treatment may be needed if your child isn’t doing those things or has a history of fever-related convulsions. Call your child’s pediatrician in these situations:

■ Ages 2 months and younger: rectal tem-perature of 100.4 degrees and higher

■ Ages 3 to 6 months: 101 degrees and higher

Not all fevers need treatment ■ Ages 7 months and older: 103 degrees and higher

■ Fever associated with severe sore throat, severe earache, coughing, unexplained rash, repeated vomiting or diarrhea

■ Fever that lasts more than 24 hours

When a fever is making your child uncom-fortable, these steps may help:

■ Dress your child lightly to avoid overheating.

■ Place your child in a lukewarm bath. Avoid putting alcohol in the bath as this can make chills worse.

■ Encourage your child to drink extra fluids to prevent dehydration. Water, diluted fruit juice, popsicles and electro-lyte solutions are good choices.

■ Consider using acetaminophen or ibu-profen to reduce fever. Follow label instructions. Check with a doctor before giving acetaminophen to a baby younger than 2 months or ibuprofen to a baby younger than 6 months. Don’t give ibuprofen to a dehydrated or vom-iting child without a doctor’s supervi-sion. You can alternate acetaminophen and ibuprofen every three hours to keep the fever down.

■ Avoid aspirin. Its use by children with viral illnesses has been linked to Reye’s syndrome, a rare but serious disease that can harm the liver and brain. ■

ExpErt MatErnity CarE HElps MotHEr and BaBy tHrivE 2

surgEry Before BirtH iMprovEs BaBy’s outlook 3

HavE a Hazard-FrEE HallowEEn 4

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HeALTH HiGHLiGHTsFOR PARenTsn e w s F r o m c h i l d r e n ’ s m e m o r i a l h e r m a n n h o s p i ta l Fa l l / W I N T E R 2 011

Affiliated with The University of Texas Medical School at Houston

Page 2: Children’s Memorial Hermann | Houston Children’s …childrens.memorialhermann.org/uploadedFiles/childrens...Memorial Hermann Hospital. “It slows the growth of bacteria and viruses

 Having a baby is exciting. But it can be a different experience for couples

with high-risk pregnancies who need special care to protect the health of the mother and unborn child.

Specialists affiliated with Children’s Memorial Hermann Hospital provide expectant mothers facing high-risk preg-nancies exceptional care and support close to home. The hospital is a center of excel-lence that serves as a resource for families throughout the state who need leading-edge maternity services. Fetal specialists at the hospital recently performed the first in utero repair of spina bifida in Texas. They operated during pregnancy on a baby with this birth defect, which can affect the spine and brain and cause paralysis, learn-ing disabilities and other long-term symp-

High-Risk Pregnancies

All pregnancies carry the risk for complications. But some pregnan-cies have a higher risk for potential problems that can affect the mother, baby or both. High-risk pregnancies can be caused by a variety of factors, including: • Chronic conditions, such as

heart disease or diabetes, present before pregnancy • Medical conditions that develop

during pregnancy, such as pre-eclampsia (high blood pressure) and gestational diabetes • Young or advanced maternal age • Mothers being overweight or

underweight • Problems with previous preg-

nancies • Delivering multiples • Labor that starts before 37

weeks gestation • Genetic abnormalities or other

problems that affect the baby

2 Children’s Memorial Hermann Hospital Health Highlights for Parents

Expert maternity care helps mother and baby thrive

toms (see story on Page 3).“In addition to obstetric and neonatal

expertise, we have specialists available around the clock to treat pregnant women for other complications such as trauma, heart problems and other potential com-plications,” says Joan Mastrobattista, M.D., a maternal-fetal medicine specialist affili-ated with Children’s Memorial Hermann Hospital and codirector of the Texas Center for Maternal and Fetal Treatment. “Our pediatric specialists are also available for babies with congenital birth defects requiring medical or surgical expertise.”

A Broad Array of ServicesChildren’s Memorial Hermann Hospital offers comprehensive services before conception, throughout pregnancy and after delivery in one convenient facility. Some of the services available include:

■ Preconception consultation and evaluation

■ Genetic counseling to assess a baby’s risk for inherited diseases

■ Maternal assessments, diagnosis and treatment

■ Fetal monitoring and antepartum testing ■ Advanced fetal imaging, such as targeted ultrasound and fetal MRI

■ Detailed fetal care plans ■ Neonatal intensive care ■ Counseling, education and support for families

In addition, the pediatric surgery teams are onsite to perform surgery after delivery in babies with surgical condi-tions, such as abdominal wall defects, cleft lip and palate, and heart defects. Sophisti cated surgery during pregnancy for fetal conditions is performed by the fetal team. These procedures can save or enhance the quality of babies’ lives.

A Team You Can TrustWomen with high-risk pregnancies receive care from a multidisciplinary team of maternal, fetal and pediatric specialists assembled to meet the family’s individual needs. Whenever possible, appointments with specialists are scheduled on the same day for patient convenience.

“We try to identify any potential prob-lems as early as possible so the parents and the medical team can prepare for the remainder of the pregnancy, delivery and after delivery,” says KuoJen Tsao, M.D., a pediatric surgeon affiliated with Children’s Memorial Hermann Hospital and codirector of the Texas Center for Maternal and Fetal Treatment. “We provide whatever services families need to have the best outcomes possible.” ■

We offer expert services for high-risk pregnancies. Learn how we can care for you and your baby at www.childrensmemorialhermann.org/highrisk.

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with life-threatening conditions. But a federally funded study found that fetal surgery can diminish symptoms and dramatically improve quality of life for babies with spina bifida, which is gen-erally not life-threatening.

The study, conducted at Children’s Hospital of Philadelphia, Vanderbilt University and the University of California, San Francisco, found that babies with spina bifida who had sur-gery before birth were more likely to walk and less likely to need shunts, spe-cial devices that drain excess fluid from the brain. Fluid buildup in the brain is a common complication of spina bifida.

“Fetal surgery is not a cure for spina bifida,” says KuoJen Tsao, M.D., a fetal surgeon affiliated with Children’s Memorial Hermann Hospital who per-formed the procedure on Mrs. Hagler and Faith. “But it’s an exciting option that may help reverse or slow the neu-rological damage that spina bifida causes.”

Surgery before birth improves baby’s outlook

childrensmemorialhermann.org Fall/Winter 2011 3

 L ike many expectant parents, Ivan and Colette Hagler were excited to

get a glimpse via ultrasound of the baby they would soon have. But the Dallas couple learned some difficult news. Their baby had spina bifida, a common and potentially disabling birth defect that occurs when the spinal cord doesn’t close fully during the first month of pregnancy.

There are several types of spina bifida that may affect the spinal cord, nerves and/or brain. Symptoms vary depending on the type and location of the defect. Those with this condition may have difficulty walking, learning disabilities, urinary and bowel problems, and other lifelong effects.

Fortunately, the Haglers’ daughter Faith has a better chance of living a more normal life thanks to innovative surgery she had before her birth at Children’s Memorial Hermann Hospital in Houston. It was the first time this sophisticated type of fetal surgery was performed in Texas.

Advances in Fetal SurgeryFetal surgery – procedures performed to correct fetal problems during preg-nancy – carries some risk for mothers and babies. Doctors have historically reserved these procedures for babies

A Matter of FaithThe landmark five-hour procedure involved opening Mrs. Hagler’s abdomen and uterus to gain access to Faith and close the open-ing in her back. Faith was operated on at 24 weeks and was delivered at 32½ weeks on July 4. She went home at 38 weeks.

Faith’s full outcome won’t be evident for several years as she grows and develops. Early evaluations, however, are encouraging. She’s able to move her legs, a sign that she should be able to walk.

“We thought a lot about all the benefits and risks and decided to have the surgery,” Mrs. Hagler says. “We’re confident that the surgery made a difference and gave Faith a chance to live the healthiest life possible.” ■

Read more about our fetal surgery ser-vices for spina bifida at www.childrensmemorialhermann.org/fetalsurgery.

New DoctoR oN Staff

Eric Eichenwald, M.D., neonatologist, received his medical degree from Harvard Medical School and has training in pediatrics and neonatal/perinatal medicine. In 2010, he became affiliated with Children’s Memorial Hermann Hospital and joined the faculty of The University of Texas Health Science Center at Houston (UTHealth) Medical School, where he is an associate professor of Pediatrics. He is also the assistant dean of Children’s Health Care Quality and is division director of Neonatal/Perinatal Medicine.

Colette Hagler holds her daughter Faith, who underwent fetal surgery

for spina bifida.

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follow UsFacebook.com/ ChildrensMemorialHermannHospital

Twitter.com/houstonhospital

PoSTMASTer: PleASe deliver BeTween oCToBer 24 And 28.

Have a hazard-free halloween

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pAiDMemorial Hermann Healthcare System

7737 Southwest Freeway Houston, TX 77074-1800

Memorial Hermann Healthcare System

■ Avoid pointed props such as spears, swords or wands that endanger other children’s eyes.

■ For greater visibility during dusk and darkness, decorate or trim costumes with reflective tape. Bags or sacks should also be light colored or decorated with reflective tape.

■ Have children carry a bright flashlight to illuminate sidewalks, steps and paths.

■ Accompany younger children while they travel about the neighborhood. Older children should trick-or-treat in groups.

■ Be sure the path and stairs to your front door are well-illuminated and clear of obstacles.

■ Make sure your kids eat a healthy meal before trick-or-treating, so they’ll be less likely to overindulge on candy.

■ Inspect all candy before allowing children to have it. ■

 When we think of Halloween, we picture children laughing in colorful

costumes, jack-o’-lanterns glowing in house windows and buckets brimming with candy and treats. Experts warn, however, that this fun-filled night can pose safety hazards.

An alternative is to throw a Halloween party and invite kids, rather than have them out on the street. If your kids will be going door-to-door trick-or-treating, however, some precautions can make the evening safe and enjoyable for everyone.

■ Have children wear makeup instead of masks.

■ Avoid costumes with wigs, floppy hats or eye patches that block vision. When purchasing a store-bought costume, look for a label that says “Flame Resistant.”

Try this healthy version of a family favorite.

½ cup raw brown rice⅓ cup medium barley⅓ cup red lentils⅓ cup yellow split peas2 ribs celery, sliced4 carrots, sliced2 garlic cloves, crushed2 tbsp. dried parsley1 tbsp. dried thyme1 tsp. powdered ginger1 tsp. marjoram½ to 1 tsp. salt, depending on taste½ tsp. ground black pepper1 pound boneless, skinless chicken breasts, cut into bite-size pieces12 cups water

Put all ingredients in a large pot. Bring to a boil. Cover the pot and turn the heat down to simmer. Cook for about one hour, until all grains are tender. Check seasonings. Soup will be thick. You can thin, if you like, by adding water or chicken stock.

Serves eight. Each 1½ cup serving contains approximately 236 calories, 22 grams protein, 3 grams fat and 30 grams carbohydrate.

multigrain chicken soup

Find more kid-friendly recipes online. Search for recipes under the Kids Health section at www.childrensmemorialhermann.org/resources.

Children’s Memorial Hermann Hospital6411 Fannin, Houston, TX 77030. Call 713.704.KIDS (5437).