Strong Foundations: Minnesota’s Birth to Three Institute for Healthy Development

The Center for Leadership Education in Maternal and Child Public Health, the Center for Early Education and Development, the Minnesota Department of Health, the Minnesota Department of Human Services and the Minnesota Department of Education are excited to sponsor Strong Foundations: Minnesota’s Birth to Three Institute for Healthy Development.

The purpose of this institute is to strengthen the knowledge, skills, strategies, and alliances of those who work with expectant families, infants, toddlers, parents and communities to build a strong foundation for healthy development.

When: May 30-31, 2012

Where: Earle Brown Heritage Center, 6155 Earle Brown Drive, Minneapolis, MN

Cost: $195; $165/students. Limited scholarships are available.

Register at: http://www.cehd.umn.edu/CEED/conferences/strongfoundations/default.html

Keynote Speakers include:

• Sondra Samuels, Northside Achievement Zone (NAZ) President and Chief Executive Officer

Cradle to College is the cornerstone of the work of the Northside Achievement Zone (NAZ). Focusing on the importance of community leadership and family engagement, as well as starting early (prenatally), Sondra asserts that taking a life course perspective will positively impact the achievement of all children.

• Sasha Silveanu, Washington State Family Policy Council, Policy Analyst and Story Tracker

A Powerful Framework will share examples of how communities in Washington State have applied a science-based framework to fuel practice and policy changes. Sasha and her colleagues’ work include strengthening foundations for positive early childhood development; responding to ACEs with innovation and informed care; making accommodations for people, including parents and their children, with high ACEs; and improving response to ACEs focused on resilience and positive adaptation. She will share examples from–but not limited to–the education, social work, child care, mental health, home-visiting, and public health sectors.

Contact hours and graduate credits are available (graduate students only).

Healthy Babies are Worth the Wait

The March of Dimes has initiated a new project called Healthy Babies are Worth the Wait (HBWW). This public health campaign strives to prevent factors related to preterm birth, including social, medical and biological influences. Children born prematurely are more likely to have vision and hearing problems, lasting physical and mental disabilities, and learning delays later in life. [i] Aiming for pregnancies that are at least 39 weeks in length decreases the likelihood of children developing health problems There has been a rise of in the number of U.S. births before week 39 over the past two decades, with 12.8% of live births in 2006 classified as a preterm birth. [ii]

The Kentucky Department for Public Health in collaboration with the March of Dimes and Johnson & Johnson Pediatric Institute helped create HBWW: a community-based, preterm birth prevention initiative. An innovative key to the campaign is engaging the community among local- and state-level clinical and public health partners. It includes targeted resources for both the public (info sheet: http://www.marchofdimes.com/pregnancy/getready_atleast39weeks.html) and professionals (toolkit: http://www.marchofdimes.com/professionals/medicalresources_39weeks.html).

How can we use these strategies in our work throughout MCH? This collaborative theory and process influences much of our work, but more can be done across sectors, fields and levels of work. Check out a webinar March 29, 2012 11:00pm CST sponsored by Healthy People 2020 Leading Health Indicators: http://goo.gl/iFJbQ. Participants will learn about how collaboration and partnerships, provider initiatives, patient support, public engagement, and progress measures helped inform HBWW’s conceptualization.

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[i] March of Dimes. (2010, April). Your premature baby. Retrieved from March of Dimes: http://www.marchofdimes.com/baby/premature_indepth.html

[ii] March of Dimes (2011). Medical Resources. Retrieved from March of Dimes: http://www.marchofdimes.com/professionals/medicalresources_hbww.html.

Healthy Homes: Lead Poisoning

Keeping the home healthy: an environmental health issue. But should it also be a concern for MCH? Where children spend time eating, drinking, playing, doing homework and sleeping, should the MCH field focus on how living spaces may influence health? Many of the hazards that affect a child’s life course may originate in the home setting. However, should the government regulate private residencies; are they overstepping their boundaries into this sphere, or is this a case to protect a special vulnerable population?

Despite these concerns, public health officials are working to ensure children live fulfilling lives. A MCH campaign in St. Louis is working to prevent lead exposure in children. Researchers there began the Heavy Metal Project, offering low-income pregnant women free home inspections and screening. Moreover, if researchers found lead, they cleaned and covered old paint and replaced windows. Here, the project aimed to prevent newborns from being exposed to lead in the first place.

Was the program effective?

Compared to babies whose homes were not cleaned, babies who lived in homes researchers intervened in had lower blood lead levels. Visit the study’s methodologies and results at: http://www.ajog.org/article/S0002-9378%2812%2900002-6/fulltext.

Why is this significant?

Lead exposure has been shown to be related to brain damage, leading to lower IQ, behavioral problems and learning disabilities, as well as cardiovascular and immune system troubles later in life. Despite the fact that campaigns have been working for decades to remove lead pain from housing, about 250,000 children each year are diagnosed with lead levels higher than the recommended 10 micrograms. According to the Centers for Disease Control and Prevention (CDC), 24 million homes in the U.S. are still thought to have paint with lead.

In January 2012, the Advisory Committee on Childhood Lead Poisoning Prevention released recommendations to decrease the limit of how much lead exposure is considered dangerous. This was cut in half for children ages 5 and younger, from 10 micrograms to 5, doubling the number of children considered in danger of high levels.

Despite this, Congress has slashed funding for the CDC’s lead prevention grant program from $30 million to $2 million (that’s 94 %!). More and more children are now screened after age 5 for lead positioning; this is in contrast to families receiving home inspections before exposure occurs.

What factors influence this environmental MCH problem?

• Social determinants related to substandard housing
  • Socioeconomic status
  • Education
  • Race/ethnicity

• Children can also be exposed to lead via:
  • Tap water
  • Older toys
  • Jewelry
  • Soil around houses

For more information

Visit the CDC’s Healthy Homes and lead information website at http://www.cdc.gov/HealthyHomes/index.html and http://www.cdc.gov/nceh/lead/ respectively.

NCS Speakers’ Series Feeding Young Children: The Good, the Bad and the Picky

The National Children’s Study Speaker Series is sponsored by the Center for Leadership Education in Maternal and Child Public Health and the National Children’s Study – Ramsey County Location. On January 11, 2012, the series offered a talk on “Feeding Young Children: The Good, the Bad and the Picky” by Jamie Stang, PhD, MPH, RD, LN, from the UMN School of Public Health. She describes behaviors of young children that are common concerns of parents, discusses the role of parent feeding styles in early childhood obesity risk, as well as identifies behavioral strategies that parents can utilize to cope with challenging food behaviors. Dr. Stang also discusses the role of food allergies and intolerances in challenging food behaviors of young children.

The archived presentation is now available online: https://umconnect.umn.edu/p51351258/.

For more information on the National Children’s Study, visit their webpage at: http://www.nationalchildrensstudy.gov/Pages/default.aspx

New Research on Birth Spacing and Child Maltreatment

In connection to yesterday’s blog for increased visibility of child abuse in the U.S., newly published research in the Maternal and Child Health Journal assessing the relationship between birth spacing and child maltreatment may broaden our understanding of how to combat the problem.

Rationale: An objective of Health People 2020 states that births should be spaced greater than 18 months (Objective FP-5), based on evidence of improved maternal social and infant health outcomes in increased lengths between births.

Methodology: Using a home visiting Healthy Start program, eligible participants were recruited via a family stress checklist to see if they were at-risk for child maltreatment. Researchers focused on the index child of a rapid repeat birth (RRB)—“the child born immediately prior to a subsequent child in a birth interval.” A baseline interview was conducted within a month of delivery and follow-up collected at age 2 and 7.  RRB was defined as a child born within 24 months of an index child for mothers age 20 and older, and as subsequent birth before age 20 for females age 19 and under.

Variables:

• Parental stress tactics—adjustment problems, child abuse (physical), neglect
• Child Protective Service (CPS) reports
• Child behavior—adaptive behavior and social skills
• Child development—memory, verbal, abstract and quantitative reasoning

Results: RRB did not influence parenting behaviors, including stress and child physical abuse. However, there was an association between RRB and parental neglect. In addition, women with a RRB were more likely to have a substantiated CPS report in their name (after controlling, there was a relative risk of 1.8 compared to women without a RRB).

In addition, index children who had mothers with a RRB had poorer behavioral outcomes and poorer developmental outcomes compared to families without a RRB.

Implications for MCH professionals: These associations can be used to help educate health departments for interventions on increasing birth spacing. Findings are consistent with other research that has reported birth spacing associated with neglectful rather than abusive parenting. Targeting subgroups of children, including index or subsequent children, and mothers who are at risk or show neglectful behavior, may be necessary.

Shea Crowne, S., Gonsalves, K., Burrell, L., McFarlane, E., & Duggan, A. (2011). Relationship Between Birth Spacing, Child Maltreatment,and Child Behavior and Development Outcomes Among At-Risk Families. Maternal and Child Health Journal.