👋Welcome to Starting Early. Every other week, we spotlight new reports, useful news, and engaging interviews with people doing important work in the field, and interesting takes on issues that matter.
At the Burke Foundation, we are deeply concerned about America’s maternal mortality crisis. Women of color are two to three times more likely to die from pregnancy-related complications than white women. To address these racial disparities, we are exploring expanding the community-birthing workforce — doulas, peer breastfeeding counselors, and community health workers, for example — to deliver enhanced perinatal care to women and families and create new employment opportunities. We recently began research into several new areas, including breastfeeding and midwifery, with a focus on actionable strategies to improve quality of care, trust, communication, and overall patient outcomes. We will share these findings throughout the fall.
Excitingly, we also opened our new space in Trenton, New Jersey, where we celebrated Trenton’s Athing Mu’s two gold medals at the recent Olympics! 🏅🏅
With our first seven issues, we vowed to keep Starting Early lively and short — with plenty of links so you explore what you want, when you want. This is still our promise to you.
Read on and click the links to go deeper.
1 big thing: New Jersey enacts landmark universal home-visiting program 👏
New Jersey Governor Phil Murphy signed the nation’s most comprehensive law to bring care directly to the homes of all new moms and babies during the first few weeks of postpartum.
Nationally, 40% of new mothers don’t see an OB-GYN after their discharge. In New Jersey, a state with the fourth-highest maternal mortality in the country, the situation is even more alarming.
A life-saving intervention for all:Â For new moms and babies, nurse home visits provide families crucial guidance and offer a window of opportunity to check on the health of both the mom and the baby when they are at highest risk of physical and mental health complications. New mothers, regardless of socioeconomic status, would benefit from additional support on lactation, mental health, and other services, such as finding childcare arrangements or community resources.
With the voluntary program, a registered nurse will visit families’ homes for a free wellness check of the mother and newborn.
- Families will be allowed up to three free home visits within three months
- The law includes eligibility for adoptive parents and those who experience stillbirths
A preventive approach: The legislation was inspired by Family Connects, a nurse home-visiting program that started in Durham, NC and links families to such critical services as lactation, safe sleeping practices, and community resources.
- Two controlled trials of Family Connects showed a 50% reduction in emergency room visits in the first year of life, a 30% decrease in mothers’ postpartum depression or anxiety, and a 44% lower rate of investigations for suspected child abuse or neglect.
At the bill signing, Assemblywoman Shanique Speight of Newark spoke about her own birthing experiences and postpartum. She shared that her husband’s mother died days after giving birth to him and reflected that her mother-in-law may have been saved if home visiting had been available 47 years ago.
“I can’t fathom that a mother could die due to maternity-related complications or the baby won’t live past its first birthday and that’s because of the color of somebody’s skin. We signed up to try and move the needle here in New Jersey, and make New Jersey a safer, more equitable, and a fairer state for everyone.” – New Jersey First Lady Tammy Murphy in One State’s Approach to Maternal Deaths: Free Nurse Visits After Birth.
2. The American Academy of Pediatrics releases important guidance on safe, stable, and nurturing relationships against toxic stress
Pediatric clinicians, who are trusted by families and engage with youth throughout their lives, have an opportunity to improve outcomes. But, how?
Why it matters:Â While the science underlying toxic stress has been evolving for decades, guidance for policy and practical clinical application in pediatrics has lagged.
Finally, a new AAP policy statement and clinical report on trauma-informed care provide guidance for pediatricians, community partners, and other child-serving clinicians to move this science out of the lab and into people’s lives. The new report highlights the importance of strengths-based response to mitigate toxic stress.
The AAP offers recommendations for families, caregivers, teachers, coaches, and others, including:Â
- Learn about positive parenting techniques and developmentally appropriate forms of play, such as shared reading, that promote early literacy and mental skills to get things done
- Learn how to handle your strong emotions, model this skill, and be emotionally available when your children are distressed (“put your own oxygen mask on before helping others”).
- Consider therapy to address unresolved trauma in your own history. Children watch as caregivers strive to become slightly better versions of themselves each day; development of a “growth mind-set” powerful predicts future success
- Help children understand how to channel strong emotions via activities that bring them joy
The bottom line: These compassionate approaches shift the fundamental questions in medical care from, “What’s wrong with you?” to, “What happened to you?,” and, finally, to “What’s strong with you?”
Listen to Dr. Lee Beers, AAP President, in Willis and Friends.
One smile to go: Are you and your baby camera ready? 👶📸
The Mount Sinai Parenting Center is developing an engaging series of educational videos on health, development, and behavior. Each video will be coupled with every primary care visit for a child’s first 5 years.
A multidisciplinary team of filmmakers, comedy writers, producers, doctors, psychologists, pediatricians, and researchers – in partnership with parents – is creating 14 short videos to give parents from all walks of life critical knowledge and information and help create better partnerships with health care providers.
Storytelling as medicine: Scott Peterman, an award-winning filmmaker at the center of creating the Sparks video series, said: “The idea that we are getting to use our powers as filmmakers to actually affect outcomes for kids across the country – not to talk about or record outcomes, but to truly be a part of them – is one of the greatest blessings our team has had in our long careers.” 🎥
In interviews with parents during the production process, Scott learned some surprising things:
- The fragmented and contradictory nature of parenting advice causes confusion, frustration, and guilt
- Parents need good, easy-to-follow, human, authentic, and straightforward, eye-level information
- Though the experience of parenting is different for everyone, there is strong interest in receiving universal messaging
Scott further reflected:Â
“Early childhood is one of the most amazing periods of life – and one of the areas where intervention can have the most outsized benefits, as the experiences we have in those first five years affect every aspect of our lives — from health to relationships to self-confidence to success in school and career. Getting the opportunity to create pieces of storytelling that occur actually within the context of a primary care, well child visit is amazing. This is, in many ways, our legacy – no matter how many dream projects we might go on to or awards we might someday win.”
The videos will cover:
- Medical advice on safety, feeding, nutrition, sleep, and more
- Positive-parenting advice from parents to other parents
- Tools for building strong and nurturing caregiver-child connections
The video series will be available for free to hospitals, clinics, and childcare centers across the country.
We would love your family videos – please share them here. ❤️