AMCHP 2006 ANNUAL CONFERENCE
EARLY CHILDHOOD: BUILDING THE FOUNDATION FOR LIFELONG HEALTH
March 4-8, 2006
MELINDA SANDERS: Good afternoon. I don't have one of those formal PowerPoint presentations, or anything like that. We have had a turnover in about 50 percent of our travel team for our infant mortality collaborative. So not long ago I was sitting in a room and they said, oh, here, it's yours now. Okay. So now it's mine.
So I haven't had a chance to put together a big PowerPoint and tell you all the wonderful things that we've done. But one of the things, timing-wise it works out real good to follow Belinda, was to talk about a focus, some of the focus groups that we've also done in Missouri just recently, and we've just kind of gotten clearance to be able to talk about the results and just got all that approved.
We have about a four time -- our infant mortality rate in African American community in Missouri is about four times the rate it is for the Caucasians. So we decided -- you know, we've done the literature search, we've seen all the things that are out there, all those things saying, well, we think this is probably -- you know, all these different factors that play into that. But we thought we really needed to find out exactly what was going on, rather than just say, well, it could be this, it could be that. We need to find out, and hear from the folks in our African American communities in Missouri what exactly is going on.
So I wanted to focus on some infant care practices, especially. And we contracted with University of Missouri in Columbia, and they did 18 focus groups throughout the state for us. And basically, they did ask some just very general questions about infant care and infant practices. And we went to urban sites, several sites in St. Louis, we went to some real little bitty -- we went to Maysville, which is 50 miles from Iowa. We went to Sikeston, which is about 50 miles from Arkansas and about 50 miles from Kentucky, so we got a real different mix from both different sizes of the towns.
Basically the results were -- one of the things that we learned about SIDS, when we talked about the incidence of SIDS and what their knowledge was about SIDS, one of the interesting things for me was that there was a quote in there from several of them that said that they didn't put their babies to sleep in a crib, because it's crib death. And so if you don't put them in a crib, they don't die. But if you put them in the bed with you, and they co-sleep with them, then they thought that was okay because they only died in cribs.
And so we talked a lot about where do they get information about sleeping and sleeping positions, on the back to sleep. And we went through the whole thing of, you know, so many of them said, well, I was told by the nurse at the hospital that I should put my baby on its back to sleep, but when they brought that baby in from the nursery, the baby was laying on its side, had it propped up on its side, or the baby was laying on its stomach. And they would tell me this, but then the nurse would actually this other thing.
And we actually had done a study about five years ago in the state of Missouri, and we found out that -- I mean, I'm a nurse, I'm ashamed to tell you this, but it we found out that the prevalence of the OB nurses or the nursery nurses, what they were doing with those babies is they weren't putting those babies on their back to sleep. They would tell them that, but you know, there was still this thing inside them where we were taught in nursing school those babies are going to choke if you do that. And so the parents were actually telling us the same thing. They tell us that, but they don't actually practice that in their behavior. So that's a big area, another area that we're looking at, as well.
Another thing, of course, is kind of what was said earlier, about the fact of the impact of the grandparents and the parents, and some of those older folks where, you know, you may have a very young mother who comes home and says okay, now, the nurse at the hospital told me I need to put this baby on its back to sleep. And the mother says or the grandmother says, what are you talking about? That's the craziest thing I've ever heard of. Don't you know that baby is going to choke? And I, you know, I had five kids and none of you all died from doing that. So, you know, that's ridiculous, don't you be doing that, they're just telling you some crazy stuff.
When it came to infant care, and infant feeding especially, I thought it was interesting, one of the investigators said, you know, maybe what we need to go is to stop looking at all those roles, and -- those rules that we have out there that have come from, you know, great sources like the American Academy of Pediatrics and those folks, and really look at what the parents are doing, and see how we can work with them.
The majority of the women that were participants in these focus groups were also WIC participants. And they said, you know, like one of them said, you know, she just didn't get it. I kept saying okay, I'm feeding that baby the formula, I'm feeding the formula, I'm feeding the formula. But this baby is still crying. And, you know, this baby is still hungry. And they're saying nope, she's too young, you cannot give that baby any food, that's all there is to it. That's the rules, you know, period.
So one of the investigators said, well, maybe we need to work with them and say okay, because if they're just going to turn around and do it anyway, maybe instead of saying, you know, okay, well, just scrape off some of that Reese's Peanut Butter Cup and, you know, scrape it on that one tooth that they have, and talk about giving them cereal and breaking it up in little pieces. Or if they're going to do something, you know, try to educate them so that they can do something and make maybe some wiser decisions.
They talked a lot about working with the parents. Again, how influential the parents and the grandparents were on those decisions.
Let's see. Grandparents. They talked about how of course the important role the grandparents and how much education that the grandparents provided. And I want to read you, just by close, just by reading a little quote that one mother said, and I think this just pretty well sums it up and tells us where we need to focus our efforts. She said, "A mother in Kansas City explained that while experts may talk about what is best for babies in general, her mother would explain to her," in quotes, "This is our kind of baby. They don't know about our kind of baby. They don't know nothing about our kind of babies."
And I think that's just exactly where -- you know, where we're at. And that's what we need to look at, is how can we -- how can we provide education out there and not look like we're -- you know, so totally different, and that we're up here, these experts, and we're going to tell you what to do, but then we don't turn around and practice that ourselves. Thanks.