The birth of a child—particularly the first baby—is one of the great miracles and surprises a person will experience. The mother, however, maintains a symbiotic link to that miniature human being, a biological connection that has taken place for the better part of nine months and generally continues for a lifetime.
Too often that moment of joy for the new mom is marred by circumstances that could have been remedied early with the proper attention paid by medical professionals and via the many resources available to make the early months of parenthood less stressful and more rewarding.
On May 18, the city of Lancaster will partner with the Antelope Valley Partners for Health to announce the new Antelope Valley Welcome Baby Program. A reception and press conference begins at 10:30 a.m. at Antelope Valley Hospital Community Resource Center, 44151 15th Street West, in Lancaster.
About 4 million babies are delivered in the United States each year, and roughly 110 infants each day in Los Angeles County. Locally, representatives from First 5 Los Angeles, the Fifth Supervisoral district, Antelope Valley Hospital, Black Infant Health, Children’s Bureau of the Antelope Valley, and Kaiser Permanente have joined forces to encourage more pregnant women to get vital prenatal care, as well as to provide support services and resources to families. They will convene to encourage more attachment between the parent and baby, discuss breastfeeding and how to identify and overcome possible post-partum depression.
The Welcome Baby Program offers voluntary home visitation services to local women who give birth at Antelope Valley Hospital. As part of Best Start LA—a multi-year investment created by First 5 LA—the program aims to shape, strengthen and support Los Angeles County neighborhoods by building resources while providing access to activities that improve the well-being, development and care for pregnant women, new parents and children age three and under. The program also provides new parents with information and resources—prenatal through the child’s first nine months—that will support them to help their child reach developmental milestones. Among the goals are to: Promote overall health and wellness from pregnancy through the first year; help parents nurture very young children through greater understanding of physical and emotional development; increase the rate of breastfeeding; ensure that children have health coverage; and to enhance the existing community network of services and to foster community relationships.
“We’re very excited about this program because it is universal. No one will be denied because of lack of insurance,” said Michelle Kiefer, executive director of Antelope Valley Partners for Health. “With the rise of childhood obesity, a healthy start is vital for a newborn. The Welcome Baby Program will promote good health from information about breastfeeding, how to bond with your baby as well as identifying the early signs of postpartum depression.”
Keifer added that a representative from Antelope Valley Hospital will visit each new mother within the first 72 hours after birth to help instill within her good practices for rearing a healthy infant. “We want to identify the issues that may hinder a healthy start for the baby, and extra support is available for the moms. All of this is free. We want new moms to take advantage of this program because when you practice good habits in caring for the baby, the child’s mental and physical growth will benefit tremendously in the years to come,” she said.
Reports among some populations of American women find a wide gulf between healthy pregnancies, births defects and maternal welfare based on socioeconomic factors and ethnicity. According to a 2012 study conducted by the World Bank and reported this week by Al Jazeera, the United States ranks 50th in maternal mortality globally—falling behind every other industrialized nation. In fact, the report found that American and Iranian women fall equal in maternal mortality. America spends more money than any nation on the costs associated with maternal healthcare, but poor women and minorities are the hardest hit in terms of prenatal care, birth defects, maternal mortality and a lack of affordable health care.
New York Women’s Foundation in 2011 studied the rise in maternal mortality and saw that Black women in their mid-20s died during childbirth at a rate of 79 deaths per 100,000 live births, compared to 10 deaths per the same amount of live births for White women. Effectively, Black women in New York City have a worse maternal mortality rate than women of the same age living in Syria or Iraq. Closer to home, the Henry J. Kaiser Foundation found last year that 23 percent of Black women and 36 percent of Latinas had no health insurance in 2013.
Pregnancy-related death is most often caused by medical complications during the gestation period and occurs during the nine-months or within one year after the end of pregnancy. WomensHealth.gov, a health and wellness website under the auspices of the U.S. Department of Health and Human Services (HHS), announced last fall that African American women are more likely to die from ectopic pregnancies (the egg develops outside of the womb, often within a fallopian tube), and preeclampsia (a potentially dangerous condition in late pregnancy that can result in high blood pressure, fluid retention, excessive weight gain and protein in urine). The report also found that Black women are more likely to leak amniotic fluids during pregnancy, which can lead to infection. With African American women, the HHS found, the risk of pregnancy-related death increased with age. Most of the women in the study said they wanted earlier prenatal care, but they could not afford it because of low finances, no insurance, or inability to get an appointment with a obstetrician/ gynecologist.
American infant mortality rates would appear to be falling across racial and ethnic lines (six deaths today per every 1,000 births compared to seven deaths in 2000), but this improvement is often not reflected among poor Black and Latino women. The Centers for Disease Control and Prevention (CDC) in 2010 found that non-Hispanic Black women saw an infant mortality rate of 13.6 for every 1,000 live births, while the rate among White women has decreased to 5.7 out of the same amount of live births. Some of these deaths may be attributed to low birth weight as Black babies are twice as likely to be born far underweight (often weighing eight to nine ounces less than comparable infants of African and/or Caribbean women and White women) and the infants are four times more likely to succumb from resulting complications.
Black women also reported the lowest rate of breastfeeding. In 2010, 65 percent of these respondents said they did not nurse their child, compared with 35 percent of Black women surveyed in 1975. Researchers remarked in the report that it would appear “…[Black] grandmothers have less influence today on young mothers.” Insurance has also been a prohibitive aspect of more healthy Black babies; before the enactment of the Affordable Care Act, Black women age 25 were charged up to 84 percent more for health insurance than White women of the same age.
Latino women also fair poorly in receipt of prenatal care. Some of these findings may be the result of the Catholic religion which, to many immigrant women, suggests that the entire child-bearing timeline—from pregnancy, to labor and delivery—be linked to time-honored practices, beliefs and traditions. There is also a deep, generational respect for elders’ advice and guidance during a pregnancy. Some Latino women will not take pain medication during pregnancy because they believe it may not be good for the embryo, fetus or developed baby. An older generation of Latino women would most often have their baby at home with only a mid-wife present, though hospitalization has always been recommended.
“Despite the rapid increase of the Hispanic population in the U.S., it is estimated that 25 percent of Hispanic women do not receive prenatal care during the first three months of pregnancy,” said Selene Velasco, MD, this week for Discovery Familia. The organization is conducting this month its “Camino al Bienestar” (“road to wellness”) in collaboration with the March of Dimes to inform the Latino community about the importance of prenatal care.
Communicating with newborns
Babies are fascinating little miracles. Though a newborn’s cries may seem like a foreign language, practically all mothers quickly pick up on a certain sound they make that helps them answer his/her needs from hunger, a wet diaper, cold feet, being tired or restless or even the need to be cuddled. Sometimes a baby’s needs can be identified by a specific type of cry. For instance, the “I’m hungry” cry may be short and low-pitched, while “I’m upset” may sound choppy. Because a newborn can differentiate between the sound of a human voice and other sounds, doctors suggest you pay attention to how the baby responds to your voice which he/she already associates with care (i.e. food, warmth and touch). If the baby is crying in the bassinet, see how quickly your approaching voice calms he or she. Observe how closely the baby listens when you talk in soft, loving tones. Though the baby may not yet coordinate looking and listening—most often staring into the distance—the child will pay attention to your voice as you speak and may subtly adjust body position or facial expression and move arms and legs as you speak. This is usually the period when you get a glimpse of a first smile—though the same smile could easily be focused on a toaster or wall clock—because as the days after delivery pass, the baby will begin to focus more on your face.
Bonding with your baby
Bonding is the intense attachment that develops between parents and their baby. Though the baby cannot intently request your hugs and kisses, the bonding aspect is most prevalent when either parent must get up in the early morning hours for feeding and comfort. Scientists have identified the strong ties between parents and the newborn as an early role model for intimate relationships, as well as a way of fostering security and positive self-esteem. A parent’s responsiveness to an infant’s signals can affect the child’s social and cognitive development.
Bonding is essential for a baby and most crave this interpersonal communication almost immediately. Some parents may have mixed feelings about early bonding as one caregiver, usually the mother, may feel an intense attachment within the first minutes of delivery, and for others—especially if the baby is adopted or, for premature babies, has been placed in intensive care—it may take a bit longer. Bonding is not something that has to be limited to happening within a certain time period after birth, but rather is a byproduct of daily caregiving. You may not even know it is happening until you and baby suddenly lock eyes one day. Babies follow moving objects with their eyes and, early on, will try to mimic your facial expressions and gestures.
Tactile touch becomes an early “language” within itself. Babies respond to skin-to-skin contact and this becomes a soothing exercise for both parent and child while promoting healthy growth and mental development. When either parent holds or touches the infant frequently, the child will soon know the difference between the two. Breastfeeding and bottle-feeding are both natural times for bonding. Infants respond to the smell and touch of their mothers, as well as the responsiveness of the parents to their needs.
Early bonding activities that both parents can experience together include: Participating in labor and delivery, singing, bathing, mirroring the baby’s movements and mimicking the baby’s cooing and other vocalizations which are the first efforts at communication.
Hormones can significantly affect bonding. While nursing a baby in the first hours of life can help with bonding, it also causes the outpouring of many different hormones in mothers. Some mothers may have difficulty bonding with their baby if their hormones are raging or if they experience postpartum depression. Bonding can also be delayed if a mother is exhausted and in pain following a prolonged, difficult delivery.
Learning with our baby
The period between eight and 12 months will often find a baby exploring more of his/her surroundings. Play will take on a new dimension as language emerges and “babbling” begins to morph into words like “mama,” “dada” and most frequently the word “no” because children up to 18 months likely hear that word more so than others. Babies will often begin to point or wave for expression; as the child becomes more mobile and demonstrates more interest in exploring, pediatricians say it is important for parents to provide more supervision and to “childproof” the house to prevent accidents.
At one year, most babies become more adept at changing positions, moving readily from lying to sitting, then pulling themselves to stand. By holding on to furniture or other large objects, an infant will take tentative steps and start maneuvering along the furniture. Some babies may learn to walk independently during this stage. As hand-eye coordination improves, babies will begin to explore more objects in detail, and also learn their functions such as watching you brush your hair, speak on the telephone, remove something from the refrigerator, etc. Experts suggest this is an excellent time to encourage learning by introducing simple words for familiar objects and allow the baby to imitate you. Repeat the words and encourage the baby’s expressions by waiting for a response as the two of you engage in your first “conversation.” Games like “peekaboo,” hiding a toy—first partially and then completely—and letting the baby find it, and teaching songs like “Pat-A-Cake” or “Itsy Bitsy Spider” will encourage the baby to anticipate the accompanying hand movements, vocalizations and facial expressions.
The transition from pregnancy to parenthood is a major life adjustment. During the first few days after delivery, experts say the emotional highs and lows for the mother are said to be normal and are commonly referred to as “baby blues.” These mood swings typically last for a few days or weeks and usually resolve on their own without medical treatment. Doctors suggest new mothers eat a healthy diet and, if possible, get as much rest as you can because exhaustion and sleep deprivation often reinforce and fuel feelings of sadness.
There is still no predictor of postpartum depression, but in the last decade it has manifested itself in tragic ways for some women with toddlers or even grade-school children. If “baby blues” lasts longer than a week or two, or if symptoms become worse, talk to your doctor to discuss whether postpartum depression may be the cause of your emotional lows. In the meantime accept help, especially after the first days and weeks after labor and delivery. Let family and friends run errands for you. Allow someone to prepare meals, do the laundry and light housework while you catch a quick nap or even a warm bath. Also, talk to loved ones or other new mothers who can provide a support network.
For more information about the Welcome Baby Program, or to refer a friend or relative, call Antelope Valley Partners for Health at (661) 942-4719.