Point of View

A program with a small cost, big effect for healthy NC babies

April 23, 2013 

There’s a reason that a baby can make otherwise staid adults talk in gibberish and make goofy faces. Every baby is a wonder. As a dad, I see all the potential in a baby, and I know that the future prosperity of our state depends on this new generation.

As director of Maternal Fetal Medicine at Eastern Carolina University’s Brody School of Medicine, I know far too well the wonder of how many things have to go just right for a baby to make it to her first birthday.

It starts with the health of the parents before the baby is even born and continues with strong communities to assure that young families have the knowledge and resources they need to navigate new parenthood with good medical care.

North Carolina has an array of services in place that address these many different factors. However, the funding to keep many of these essential programs going will soon expire. The total cost for this bundle of seven programs is $1.63 million – about the medical costs of two babies born with spina bifida or the first-year hospital costs of six babies born very prematurely.

The Child Fatality Task Force, a legislative study commission, recommends maintaining this array of services through a Healthy Babies Bundle designed to address every aspect of infant mortality reduction, including preconception, pregnancy, birth and first-year-of-life with a focus on geographic areas of high need.

Health before pregnancy: Healthy women tend to have healthier babies. That’s why the Healthy Babies Bundle includes two complementary approaches to promoting preconception health. The NC Preconception Health Campaign works with women and health care providers to ensure women are healthy prior to conception using folic acid distribution and other evidence-based strategies. The N.C. Healthy Start Foundation works closely with community-based organizations to assure that local programs use evidence-based practices that improve women’s health.

Health during pregnancy: While it is widely known that tobacco use before, during and after pregnancy is harmful to the mother and her child, not all doctors are specifically trained in how to best help pregnant women stop smoking. That’s why the bundle includes You Quit Two Quit, which provides training and technical assistance to physicians, nurse practitioners and others to help assure that pregnant women are screened for tobacco use and then offered evidence-based assistance to reduce or stop.

Access to specialized prenatal care: The Healthy Babies Bundle arms providers with 17-Progestrone – a proven effective medication that can help women who have had a previous preterm birth carry a baby longer – often to full term – the next time around. The Healthy Babies Bundle also includes funding for the ECU High Risk Maternity Clinic, which provides clinical care to women with high-risk pregnancies and technical support to their doctors in 27 Eastern counties – an area with some of the highest rates of infant mortality in the country.

Best hospital practices: Sometimes people think that experts in hospitals “just know” what to do, but they need information, training and support as well. That’s why the bundle includes services to further strengthen hospital practices. The Perinatal Quality Collaborative of NC promotes time-limited quality-improvement projects. The most recent initiatives have successfully reduced infections, decreased early elective c-sections and increased exclusive use of maternal milk.

First year of life: Even after the baby is born, communities need to support families in safe sleep practices and breastfeeding. The Infant Safe Sleep Campaign works with parents, grandparents, child care providers, hospital staff and community agencies to reduce infant sleep-related deaths.

Just as it takes many factors to go right for a baby to be born healthy and grow up strong, it takes a bundle of services to assure a sound community infrastructure to get there. In North Carolina, both the Senate and House have shown their commitment to reducing infant mortality by directly funding these programs in the past. It is working. We need to continue this investment for healthy babies today and a stronger North Carolina tomorrow.

Jeff Livingston, M.D., lives in Winterville.

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