Neuro NICU is a specialized program that brings together multidisciplinary pediatric specialists to deliver advanced, coordinated care for newborns with complex neurological conditions. Housed within the Neonatal Intensive Care Unit at Cedars-Sinai, the program is designed to provide timely intervention during the crucial period of early brain development.

The Neuro NICU’s comprehensive, multidisciplinary model of care includes leading experts in neonatology, neurology, neurosurgery, neuroradiology and genomics. The staff also includes specially trained NICU nurses and social workers adept at deploying around-the-clock care tailored to the unique needs of newborns and their families.

“The newborn brain is fundamentally different from that of a child or an adult, which is why neurological care at this stage requires highly specialized expertise,” said David Rowitch, MD, PhD, deputy director for Research at Guerin Children’s. “Understanding how the developing brain responds to injury and how to interpret imaging in this context is critical. The Neuro NICU allows us to bring that expertise together in a coordinated way for each patient.”

The Neuro NICU team, led by co-directors Yolanda Brown-Madan, MD, and Xin Ye, MD, is equipped to treat patients with a wide range of neurological conditions, including neonatal seizures, stroke, severe congenital neurological disorders, brain malformations, as well as birth complications and traumatic injuries to the brain or the nervous system.

A defining feature of the Neuro NICU is the early integration of genomics, which allows the team to deliver precision gene therapies and genetic diagnoses to infants sooner. Guerin Children’s is among the first programs to offer rapid whole‑genome sequencing for babies in a NICU setting, with genetic results delivered in a matter of days.

Research at Guerin Children’s has shown that more than 40% of children seen by pediatric neurologists have an underlying genetic condition. Having genetic information readily available can directly influence clinical decisions and improve the ability to personalize care for vulnerable newborns.

“Our comprehensive approach in the Neuro NICU enables Guerin Children’s to deliver a seamless continuum of care as patients improve and grow beyond their stay,” said Shervin Rabizadeh, MD, MBA, chair of the Department of Pediatrics and deputy director of Guerin Children’s.

The Neuro NICU also employs state-of-the-art, infant‑specific technologies, including continuous video electroencephalography (EEG) monitoring, which provides real‑time data to help clinicians intervene quickly during critical moments.

That same level of technological capability extends beyond the unit. Designed to function as a regional center for neonatal neurological care, the Neuro NICU extends its reach to affiliated partners and hospitals in the greater Los Angeles area and beyond. Specialized neonatal transport services allow teams to initiate critical therapies before a baby arrives at Guerin Children’s.

“Our goal is to ensure that newborns receive the right care at the right time, regardless of where they begin their medical journey,” said Rangasamy Ramanathan, MD, director of the Division of Neonatology at Guerin Children’s. “Through advanced transport capabilities and virtual collaboration, the Neuro NICU allows us to support community hospitals and families across the region.”

Additionally, the program offers virtual consultations, enabling neurologists to guide care remotely and support physicians at referring hospitals.

“The launch of the Neuro NICU reflects Guerin Children’s’ commitment to advancing research‑driven, specialized, world-class pediatric care for the most vulnerable patients in greater Los Angeles and beyond,” said Ophir Klein, MD, PhD, executive vice dean of Children’s Health and executive director of Guerin Children’s.

Read more from Cedars-Sinai Stories and Insights: Making Strides in Treating the Smallest Heart Patients

Cedars-Sinai experts recommend getting the flu shot starting in September before flu season begins as early as November. They say vaccination is the most powerful tool to avoid influenza-related hospitalizations or worse. As many as 130,000 people in the U.S. died from the flu last year, according to estimates from the Centers for Disease Control and Prevention.

“By getting the flu shot, you’re not only protecting yourself, you’re protecting your family and vulnerable members of the community who would suffer a more serious illness,” said Jonathan Grein, MD, director of Hospital Epidemiology at Cedars-Sinai and associate professor in the Department of Medicine.

Although vaccination is the best way to prevent the flu, Grein also recommends washing hands thoroughly and often, avoiding others who are sick, and wearing a mask when not feeling well to avoid spreading an illness to others.

The Cedars-Sinai Newsroom spoke with Grein and other Cedars-Sinai specialists about this year’s flu shot recommendations, how to manage flu symptoms and where to seek care during a flu illness.

Who Should Get the Flu Shot?

There are no significant changes to flu shot recommendations this year, Grein said. The vaccine is still advised for eligible adults, teens and children more than 6 months old, according to the Centers for Disease Control and Prevention. Those 65 and older are still encouraged to get a high-dose flu vaccine if available because it elicits a stronger immune response, and older adults’ immune systems weaken with age.

“If a high-dose flu shot is not available, older individuals should receive a standard dose, rather than skipping the shot,” Grein said. “It’s critical for older adults to protect themselves.”

Children 6 months to 8 years old who have never received a flu vaccine should receive two doses, spaced four weeks apart, said Priya Soni, MD, a pediatric infectious disease specialist at Cedars-Sinai Guerin Children’s.

“Ideally, parents should vaccinate their children before the end of October to ensure protection before peak flu season,” Soni said.

Cedars-Sinai primary care physicians and pediatricians are now offering flu shots to patients during scheduled visits. Patients who have been treated by a Cedars-Sinai primary care provider in the past 16 months can schedule a vaccination appointment through My CS-Link at locations in Beverly Hills, Marina del Rey, Santa Monica, Los Feliz, Playa Vista and Tarzana.

How to Treat Flu Symptoms

Like other upper respiratory infections, flu symptoms include nasal congestion, fever, body aches, cough, sore throat and fatigue. Most people with mild symptoms will improve at home with fluids, a pain reliever such as Tylenol and rest, Grein said. Those at high risk of more serious infection—older adults, immune-compromised individuals and others with chronic health conditions—should speak with their physician soon after symptoms appear to find out whether an antiviral medication like Tamiflu would be right for them.

Those with more severe symptoms—a very high fever, loss of appetite or inability to keep fluids down—should see their physician or visit urgent care, said Jonathan Weiner, MD, chair of the Cedars-Sinai Medical Group’s Department of Primary Care and Acute Care Medicine.

Life-threatening symptoms like difficulty breathing should immediately be addressed in the nearest emergency department.

Flu Treatment for Children

Mild flu symptoms in children look similar to those of an adult and will likewise improve with fluids, rest, and Tylenol or ibuprofen, Soni said. She cautioned against giving children aspirin because of the risk of contracting Reye’s syndrome, a rare but serious illness linked to aspirin. Higher-risk children might need an antiviral treatment prescribed by a physician.

Soni explained that children 2 and younger run a high risk of dehydration, so their parents should make sure they drink and eat enough. She also advised parents to watch for signs that their child’s symptoms might be escalating.

“If a child is struggling to breathe, or showing signs of severe fatigue, vomiting or dehydration, they should be seen promptly by their physician or in the emergency department,” Soni said.

Where to Get Care for the Flu

For children and adults with milder symptoms, a virtual visit through a mobile app like Cedars-Sinai Connect is a great first step to get reassurance or guidance on the best treatment options, Weiner said.

“A physician or other provider can see you, assess how sick you appear and determine if you need to be seen in person or if you can manage your illness at home,” said Weiner, who treats patients in person and via Cedars-Sinai Connect. “If we determine that you need to see your Cedars-Sinai primary care physician or you need to go to urgent care for your symptoms, your provider will see the notes from your virtual visit in your chart because we all share the same Cedars-Sinai medical record.”

If a flu test is needed to rule out other illnesses or for a Tamiflu prescription, Cedars-Sinai Connect providers can order one through a streamlined visit at one of Cedars-Sinai’s urgent care locations. Patients also can get an over-the-counter test at their local pharmacy. Weiner said it’s good to know if you have the flu so you can avoid spreading the illness to others. People are contagious a day before symptoms start and up until their fever has resolved and symptoms are improving—as long as five to seven days after getting sick.

If symptoms do not improve, other causes of upper respiratory tract infections need to be ruled out, which could require in-person treatment, Weiner said. He emphasized that an in-person appointment also is recommended for patients with underlying conditions, high fever, trouble keeping food and liquids down, and for anyone who is having trouble breathing.

Read more on the Cedars-Sinai Blog: Flu and RSV: How to Protect Yourself Now

“For very young children, use simple explanations when answering their questions,” Hedrick said. “With older children, you want to be honest and open, directly answering questions and using as simple language as possible.”

Playtime can help children express themselves and feel a sense of control. One example, Hedrick said, is focusing on the positive aspects of knowing fire safety.

“For children who haven’t lost their homes but are affected by the fires, involve them in age-appropriate fire drills,” she said. “Or allow other types of play to be related to the fire, because a lot of times it’s easier for kids to express their feelings through play than by outwardly saying, ‘I'm feeling scared.’”

Building simple forts with pillows, blankets and sheets can be a beneficial play activity for children of all ages—even some middle schoolers, Hedrick said.

“The parent can get inside the fort with them and talk about feelings, as the child may feel safer there,” she said.

It also can be helpful for parents to model how to express feelings.

“A parent could say something like, ‘I noticed I was feeling a little scared today; are you feeling scared?’ This gives their child a chance to talk about feelings of fear, anger, sadness,” she said.

Alternatively, when the child says they’re angry, sad or scared, parents should acknowledge those emotions.

“It’s important not to say, ‘You don't have to feel sad or scared or angry,’” Hedrick said. “It's better to say, ‘Of course, that’s how you’re feeling and it’s perfectly normal. At the same time, there are things we can be grateful for—let’s talk about some of those.’”

Tweens and teens especially may find journaling helpful, as well as art, physical activities and supportive connections with their peers.

“Reminders that there is hope, and that the family will get through this together, are important,” Hedrick said.

Read more on the Cedars-Sinai Blog: Art Therapy Helps Children Cope With Trauma

What type of flu activity are we seeing in California this year and what are the symptoms?

As of early January, flu activity in California has been increasing and is comparable to levels observed at this time last year. Influenza (flu) typically presents with sudden onset of high-grade fever, accompanied by body aches, chills, headache, nasal congestion, runny nose and occasionally sore throat or fatigue.

When should you see a doctor?

The course of the flu can vary from person to person, but if you're experiencing prolonged fevers lasting three to five days, worsening cough or shortness of breath, signs of dehydration, or if you have exacerbation of underlying respiratory conditions such as asthma, it may be a good idea to check in with your primary care provider. Additionally, if you develop a new fever after initially recovering from the flu, be aware of the possibility of a secondary bacterial infection, such as a pneumonia, which would require medical attention.

Is it too late to get the flu vaccine?

While getting the flu shot earlier in the season is ideal, vaccination at any point during the flu season can still provide significant protection. The flu vaccine reduces the severity of illness and lowers the risk of complications, especially for high-risk individuals such as young children, pregnant women, the elderly and those with chronic medical conditions.

Each year, the flu vaccine is designed to target the most likely circulating strains. Although the vaccine may not be a perfect match for all strains, it provides partial immunity, which is highly beneficial in preventing severe illness.

What is norovirus and how is it affecting Californians?

Norovirus, often referred to as the “stomach flu,” is a highly contagious virus that causes gastroenteritis. We see symptoms including nausea, vomiting, diarrhea, abdominal cramping and occasionally low-grade fever. Norovirus is one of the leading causes of foodborne illness.

What can people do to stay healthy during virus season?

The advice is always the same. We need to be really mindful of our hand washing and being careful among high-risk individuals. Wearing a mask is of utmost importance because of the fires but also to prevent the spread of respiratory infections in this critical time period during the winter. Additionally, remember to listen to your body and stay home if you’re unwell.

Read more on the Cedars-Sinai Blog: Ask a Doc | What’s Walking Pneumonia?

The Cedars-Sinai Newsroom sat down with Sabrina Renteria, MD, a child and adolescent psychiatrist in the Cedars-Sinai Department of Psychiatry and Behavioral Neurosciences, and Romina Kim, MD, a pediatric hospitalist with Cedars-Sinai Guerin Children’s, to discuss stress and burnout symptoms and what parents can do to help.  

What are some of the main causes of stress and burnout in children and teens?

Renteria: Some of the top causes of stress and burnout for this age group stem from academic pressures with high expectations and heavy workloads. High achievers, in particular, tend to overwhelm themselves with extracurricular activities in addition to their schoolwork, leaving insufficient time for rest and relaxation, which can be exhausting both physically and mentally. Additionally, social stress is often a contributing factor, especially in the age of social media where kids are constantly online. Bullying, peer pressure and difficulties navigating social relationships can all lead to severe emotional distress.  

What do stress and burnout look like in this age group?

Renteria: Burnout and stress in children and teens can manifest in various ways. This can look like snappiness or irritability, lack of energy or tearfulness. Depression and withdrawing from friends and family can be common as well. Children might even express frustration or that they feel like giving up.

Kim: Physically, stress can show up as things like headaches, gastrointestinal issues, unintended weight loss due to loss of appetite, tics and other generalized pain. In severe cases, some patients can experience what’s known as functional neurologic disorder, which is characterized by physical symptoms that cause distress and impair function without a structural or neurologic abnormality. In these cases, while nothing seems to be physically wrong with the child, they may experience various physical manifestations, including the inability to walk, muscle weakness or even seizures. With proper treatment, along with time and patience, most of these ailments are reversible.

How do doctors determine if a child’s physical ailment is stress-related, versus physiological?

Kim: It’s our role as doctors to do our due diligence. We always start by obtaining a detailed history from the patient and their family. This subjective information is our first step to piece together the puzzle. We also obtain objective data, such as physical exams, lab work, imaging studies and more to help support a possible diagnosis. Once we narrow things down, we often bring in additional experts, such as our neurology or psychiatry teams to help us confirm the diagnosis and address the problem to get the patient firmly on a path to recovery.

What signs of stress or burnout should parents or guardians look for in their children?

Renteria: Parents know their children best and should look out for significant changes in their behavior and mood. If your child starts to have a drop in grades, is increasingly irritable or constantly in a bad mood, those could all be signs they are under too much stress. Kids may also lose interest in their previously cherished pastimes or hobbies. Another red flag may be sleep issues, like trouble falling or staying asleep, or even sleeping too much.

Kim: When kids are burned out or feeling too much stress, they tend not to be able to cope with their emotions. Often, even the smallest inconvenience can trigger a big reaction. It’s important that parents don’t automatically dismiss what may be an unusual behavior for their child as them just being a “moody teenager,” when there may be much more to it than that.

How can parents or guardians help their kids manage significant stress or burnout?

Renteria: It’s OK for kids to be active and busy, but it’s all about striking a balance. It is important to find the right amount of organized activity and free time to help promote social and emotional growth and development in your child. Parents can help children combat burnout by encouraging them to engage in physical activity, maintain a healthy diet, get enough sleep, establish a daily routine, set realistic goals, practice relaxation techniques, limit screen time and seek professional help if needed.

Kim: By building an open, communicative relationship with their children early on, parents can create a foundation in which a child feels comfortable being able to talk openly about any stress or anxiety they’re experiencing. Another important thing for parents to remember: If they are not modeling good self-care and coping skills themselves, it is that much more difficult for their children to learn these habits. By setting an example of healthy balance for yourself, you can help set your kids up for success as well.

Read more from the Cedars-Sinai Blog: Five Deep Breathing Exercises for Kids and Teens

“Donor milk plays a crucial role in improving the outcomes for our most vulnerable premature infants,” said Bevin Merideth, MSN, RN, associate director of the Neonatal Intensive Care Unit at Cedars-Sinai Guerin Children’s. “A diet comprised of human milk—whether maternal, donor, or a combination of both—has been shown to significantly decrease the incidence of necrotizing enterocolitis [NEC], an inflammation of the intestinal tract, which is the leading cause of death in premature infants,” Merideth said.

To participate in the breast milk drive, donors first register with the milk bank, share their health history and undergo a blood test.  

Wendy De Leon, Cedars-Sinai’s lead lactation consultant, said donors are helping the smallest patients.

“Babies digest human milk better than bovine protein and the antibodies from breast milk are greater than what babies would receive from formula,” De Leon said. “The availability of donor breast milk in our Neonatal Intensive Care Unit [NICU] is made possible through these generous donations of surplus breast milk to milk banks.”

Those who wish to participate in the upcoming milk drive should preregister and bring their frozen milk in a cooler to the drop-off. Frozen breast milk is good for approximately six months.

Mothers Milk Drive
When:       Sunday, Aug. 4, 11 a.m.-2 p.m.
Where:      Cedars-Sinai
Thalians Health Center 
8730 Alden Drive
Los Angeles, California 90048

Read more on the Cedars-Sinai Blog: Support for Nursing Parents 

Parents of children 3 to 17 years old can now access Cedars-Sinai healthcare providers for urgent issues, including cough, cold, flu or rash.

• Parents can choose on-demand visits 24/7 or a scheduled visit 7 a.m.-9 p.m. on weekdays and 8 a.m.-4 p.m. on weekends for their sick child.
• A child’s existing pediatrician is kept in the loop through the Cedars-Sinai electronic health record.

Spanish-speaking adults and parents of children 3 and older can now choose a Spanish-language app experience.

• Spanish-speaking healthcare providers are available for scheduled visits 7 a.m.-9 p.m. on weekdays and 8 a.m.-4 p.m. on weekends.
• Translators can support patients seeking on-demand care 24/7 if a Spanish-speaking provider is not available.
• Spanish-speaking adults can access primary care in their preferred language to manage chronic conditions, such as high blood pressure, anxiety, depression and obesity.

“Cedars-Sinai Connect has already helped thousands of new and existing patients easily access the high-quality care for which Cedars-Sinai is known, from home,” said Jill Martin, executive vice president of Cedars-Sinai Medical Network. “The platform is helping us extend that opportunity to even more people throughout California who are coming to Cedars-Sinai for convenient acute or chronic care. These patients also gain access to our broad network of specialists through referrals when appropriate.”

The new care options for children and Spanish speakers build on Cedars-Sinai Connect’s initial success. Since the platform launched in fall 2023, it has helped more than 8,000 patients from San Diego to Sacramento access Cedars-Sinai care through more than 10,500 virtual visits.

“Patients have come to rely on Cedars-Sinai Connect as a convenient way to access Cedars-Sinai expert care and a comprehensive primary care experience,” said Caroline Goldzweig, MD, chief medical officer of Cedars-Sinai Medical Network. “Our unique hybrid model not only offers high-quality virtual care, but it is fully integrated into a top-tier academic health system, making it easier to coordinate care and share a patient’s health records with all of their providers.” 

Cedars-Sinai Connect harnesses AI technology developed by K Health to reduce administrative burdens such as data entry, freeing doctors to focus more time on patient care. K Health helps patients manage their acute, chronic and preventive care needs through its platform that harnesses medical knowledge and real patient experiences.

“Cedars-Sinai Connect is one of the first integrated clinical care apps of its kind that is successfully using technology and care model innovation to address significant pain points—particularly access and quality—in healthcare in the U.S.,” said Ran Shaul, co-founder and chief product officer of K Health. “By combining K Health’s virtual care model with Cedars-Sinai’s high-quality clinical care, our partnership gives Cedars-Sinai greater digital capability while expanding access to expert care across California.”

Martin added that with pediatric care and Spanish-speaking doctors now available, “Cedars-Sinai Connect is furthering our collective goals of tying together in-person and virtual care, reducing wait times and addressing primary care needs for as many Californians as possible, helping Cedars-Sinai advance health equity.” 

Read more on the Cedars-Sinai Blog: Women’s Heart Health | The Virtues of a Virtual Second Opinion