Blogger | Child health

Back to School: Nourishing Brains and Bellies

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By Jake Frydman
Outreach Specialist

As Kansas children head back to school, they return to an environment designed to foster growth in their developing brains. Many kids, however, also look forward to the return of a different kind of nourishment that is far too often absent over the summer months. The kind of nourishment for growing bodies that comes from regular, healthy meals at breakfast and lunch.

Recognizing the vital importance of this secondary function of Kansas schools for thousands of Kansas children and families, Kansas Action for Children has partnered with the Food Research & Action Center and Kansas Appleseed in an effort to increase access to school breakfast and lunch for Kansas kids.

To achieve this goal, we have published and promoted materials to inform Superintendents across Kansas about programs and opportunities available to schools and school districts that help ensure all Kansas children get the healthy meals they need to be successful in the classroom.

Programs like Breakfast in the Classroom encourage schools to offer breakfast during the first class of the day, rather than before school. Serving breakfast before the bell means many students who rely on busses or long walks are often unable to arrive in time for the most important meal of the day.

The Community Eligibility Provision helps address the issue of unfiled paperwork that often stands between a hungry kid and a hot meal at lunch. When adopted, this provision allows schools with a large percentage of children on free and reduced lunch status to offer free lunch to all students.

Programs such as these improve the Kansas school experience for everyone. No hungry kids means fewer distractions in the classroom, better attendance, improved performance, and an enriched learning experience for all.

If you want to learn more about how to get these programs implemented at your school, please contact us at kac@kac.org, because even one hungry kid in Kansas is one too many.

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Longterm consequences of childhood poverty

By Shannon Cotsoradis
October 29, 2015

On Thursday, October 22nd I had the privilege of presenting at the Kansas Economic Policy Conference.  The theme of this year’s conference was Economic Opportunity in Kansas: What Does the Future Hold?  When we think about what the future holds in Kansas, many of us are quick to focus on the state’s current fiscal situation.  And, while that certainly doesn’t bode well for our future, I think there is another indicator that is just as important. Here are a couple of the thoughts I shared with the audience:    

 

Childhood poverty is persistently high in Kansas.  For more than a decade, the percentage of children living in poverty in Kansas has been on the rise.  Nearly 1 in 5 Kansas children are growing up in poverty.  Despite a recent downtick in this trend, childhood poverty continues to be at levels more consistent with a recession than with an economic recovery.  And, we are lagging several of our neighboring Midwestern states in terms of improvement on this indicator.   

 

We know what to do, but we just aren’t doing it.  While the dialogue at the state level might suggest we don’t know what to do to change the trend with respect to childhood poverty, the evidence is clear and compelling.  For our youngest children, changing the trajectory means investing in two things: income supports and access to high-quality early learning.  It is that simple.  In fact, for a family with a young child, a $3,000 annual boost to family income is associated with a 17 percent increase in adult earnings and 135 additional work hours per year after age 25.  And, children who have access to high-quality early education require less remediation and special education, complete more school, are better prepared for a job, have higher lifetime earnings, and incur lower criminal justice and welfare costs.  Together, income supports –  like Temporary Assistance to Needy Families and the Earned Income Tax Credit – and access to high-quality early learning is a powerful combination that can change the course of a child’s life.

 

Childhood poverty has consequences for our economy.  While there are more immediate opportunities for concern when it comes to the Kansas economy, the long-term implications of persistently high levels of childhood poverty are significant and shouldn’t be overlooked.  Children that grow up in poor families – absent significant intervention – are likely to become tomorrow’s poor adults.  The poverty status of children has negative consequences for their health as adults, their educational attainment, and their lifetime earnings.  Poor adult health, low educational attainment, and the inability to transcend low-wage work has obvious human costs.  What may be less apparent is how costly it is for all of us.  If policymakers continue to make choices that fly in the face of what’s good for children growing up in poverty today, tomorrow the same children will be relying on Medicaid, public assistance, and other costly government programs.

 

This conversation will certainly continue as the 2016 legislative session approaches, and we hope you will contribute to the dialogue. If we are committed to an economic future that is bright in Kansas, we can’t continue to ignore the consequences of failing to invest in our poorest children.  Policymakers must set their ideological commitments aside, and instead commit to an approach that recognizes the success of children is inextricably linked to the success of their parents. 

Posted in Child health, Child Poverty, Economic security, Kansas Legislature | Leave a comment

KCK Public Schools take pro-active approach to child hunger

By Shannon Cotsoradis
KAC President & CEO

Kansas City Kansas Public Schools recently announced that their district has begun providing breakfast and lunch to all early childhood and elementary students at no cost to students’ families. This opportunity became possible through the Community Eligibility Provision (CEP), which was part of the Healthy, Hunger-Free Kids Act of 2010. CEP is an innovative tool to improve child nutrition and reduce administrative burdens on schools and parents.

USD 500 is one of the first Kansas school districts to take advantage of this program. It is a smart and strategic move on the part of KCK Superintendent Dr. Cynthia Lane – as well as other district leaders – to help reduce child hunger.

The district’s decision to participate in CEP matters because it is part of a larger, sobering conversation about Kansas kids and their futures. Although the Great Recession is long over, nearly one in three Wyandotte County children continue to live in poverty. Kids in poverty are more likely to be food insecure, and studies prove that hungry children struggle to learn.

The effects of child poverty are especially evident in the classroom. Times are tough for all Kansas schools as they struggle to serve more students with fewer resources. A greater number of poor Kansas children combined with less state funding is an equation for crisis in Kansas schools. Alternate school meal models like CEP will help get nutritious meals to kids who need them – ensuring more kids are healthy and ready to learn.

Kansas kids who started Kindergarten when the Great Recession began in 2008 are now a year away from high school. We can’t afford to let child hunger continue at such significant levels for another year. The longer kids go hungry, the more likely they are to face other challenges later in school and – ultimately – later in life. Dr. Lane and USD 500 are to be applauded for their pro-active focus on this critical issue.

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Time to #ThinkBIG!

By Hilary Gee
KAC Government Relations Specialist

Think Big Start Small

Kids learn habits while they’re small that persist through adulthood – when kids are big!  Child care providers are key leaders in helping Kansas kids build lifelong healthy habits. By making a few key changes related to food, drinks and activity, providers can have a big impact on the health of Kansas kids.

Adults and kids of all sizes can benefit from good nutrition and activity habits, but changes are needed because a growing number of Kansans of all ages are overweight or obese. These serious health problems start early – 20% of children ages 2-5 in the U.S. are already overweight or obese, according to the Institute of Medicine.

Children who are overweight or obese are more likely to suffer health, social and educational challenges than their healthy-weight peers. Additionally, people who are overweight or obese as children are more likely to be obese as adults. Early environments – like child care and early education programs – play a crucial role in shaping behaviors and habits for life.

 

The Think Big! Start Small Pledge Program

The Think Big! Start Small provider pledge is a voluntary program led by Child Care Aware® of Kansas and Kansas Action for Children to connect child care providers with information and resources to promote healthy habits for kids related to food, drink, active play and screen time.

By completing a simple online pledge, child care providers are committing to help make Kansas kids healthier through a few simple changes in their programs. Already, hundreds of providers from child care centers and homes across Kansas have taken the pledge! Join us in building healthier communities so that all Kansas kids can grow up healthy – take the pledge here.

 

Small Changes, Big Impact.

To help maximize the impact of a few changes, we’ve identified four top priorities based on research and collaboration with Kansas experts: Better Beverages, Unplug Under 2, Breastfeeding Benefits and Right Rewards.  These are simple changes that are designed to work in all child care programs – from small family day care homes to big child care centers.

 

Better Beverages

Better BeveragesWhile food choices get a lot of attention, it’s important to remember that beverages also play a big role in children’s nutrition and health. Children and adults get a lot of calories from sugary beverages like soda pop, juice drinks, and sports drinks, but water is the best beverage for keeping kids older than age 1 hydrated.  Calories from sugary drinks don’t satisfy hunger like calories from food.  And while some sweet drinks (like diet soda) don’t have calories, they make you crave sweet foods and ultimately consume more calories. Children should be encouraged to drink water or low-fat milk instead of sugary drinks.

Having too many sugar-sweetened drinks contributes to a variety of health problems for kids – from dental cavities to heart disease and high blood pressure.  If you currently drink or serve sweet drinks a lot, start by replacing one or two sweet drinks each day with a better beverage, or skipping all sweet drinks just one day a week (learn more in “Pass on Pop”). Low-fat milk and water are great for kids.  To make water more fun, add some fruit, fresh or frozen, for flavor.

 

Unplug Under 2

Unplug Under TwoKids and adults spend a lot of time looking at electronic screens, like smart phones, tablets and TVs, but for young children, screen time should be limited or avoided. While parents and other caregivers may allow lots of screen time at home, you have the opportunity to support healthier habits while kids are in your care.

As a general rule, children under age 2 should have no screen time.  For these young children, screen time can interfere with healthy brain development – a child’s brain develops best when interacting with people like parents, caregivers and other kids, not screens.  The stimulation from electronics can also interfere with restful sleep.  Babies and toddlers sleep a lot, so when they are awake, it’s important to maximize the time they spend interacting and exploring the real world.

Older children should have no more than two hours of screen time each day.  For children of all ages, time spent looking at screens is generally sedentary and occupies time when they could be engaged in active play.   Excessive screen-time can lead to serious issues, including attention problems, trouble in school, sleep disorders, and obesity.  When older kids are allowed screen time, make sure it’s a high-quality and interactive experience – ask questions and discuss what is happening on the screen. This helps kids make connections with real world activities.

 

Breastfeeding Benefits

Breastfeeding BenefitsBreast milk is the ideal food for infants. Child care providers have a valuable opportunity to support and promote breastfeeding.  Parents of breastfed children need information and support to continue breastfeeding when children are in a child care program. In addition to supporting parents, it’s also important to support fellow providers who choose to continue breastfeeding while working.

Breastfeeding has benefits for child care providers as well as children and their families.  The American Academy of Pediatrics recommends exclusive breastfeeding for first six months of life for optimal nutrition.   Breastmilk lower infants’ risk for infections, colds, asthma, allergies, SIDS, chronic health problems, as well as diabetes and obesity.  In addition to keeping babies healthy, breastfed babies are happier! Breastmilk is easier to digest than formula, and this makes babies less fussy.

Continuing breastfeeding when babies are in child care is a big commitment for mothers – it takes time and patience to both express adequate milk to send to child care and to continue nursing when with their children.  Providers play an important role in helping mothers succeed who choose to breastfeed succeed.  Work with breastfeeding mothers to establish a feeding schedule that supports their feeding/expressing routine at home.

 

Right Rewards

Right RewardsTo help kids learn to enjoy healthy food and physical activity, we need to rethink some customs around rewards and incentives.  Food and physical activity should not be used as a punishment or as a reward.

If you reward good behavior with unhealthy food (like ice cream or candy), kids develop a stronger preference for sweets.  It also contradicts nutrition values they are learning at home and in child care.  Rewarding kids with unhealthy food is like saying “You need healthy food to grow up strong and feel good, but if you’re good, you will be rewarded with unhealthy food.”  Confusing, right?  Food rewards also give kids calories they may not need, or replace healthier food in their day.  By providing food only when kids are hungry – and not as a treat – children learn to respond to their bodies’ hunger cues.  Instead, reward good behavior with praise, a fun activity or other classroom privilege (like leading an activity or picking a game for the group). Similarly, using physical activity – like running laps – as a punishment for bad behavior reinforces negative associations with exercise.

Regular activity helps children regulate their actions and behavior, so punishing bad behavior by limiting activity (like making a child sit in time-out while other kids get to run around) can be counter-productive.  Activity should not be treated like a privilege.  Instead, correct problematic behavior by restricting screen time or taking away a toy.

 

Now that you know how small changes in your child care program can have a big impact on the lives of young kids, take the pledge at www.kac.org/think-big-start-small. After you pledge, you’ll be connected with information and resources to promote healthy habits for kids related to food, drink, active play and screen time.  You can also connect with other Think Big! Start Small pledge providers on Pinterest to share your ideas and learn from others across the state.  Changes you make when kids are small can have big benefits!

Learn more about Think Big! Start Small.

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GUEST BLOG: Small Steps, Big Impact

Leadell EdigerBy Leadell Ediger
Child Care Aware of Kansas Executive Director

This month, I welcomed my fifth grandchild! In some ways, I feel like an old hat at this grand-parenting job. I know the ropes, I know what’s expected of me, and yet, different, especially since this is my daughter’s first child! He or she will deserve a grandma that can Think Big and Start Small.

As an experienced grandma, here’s my 21-step plan (started out as a 20-step plan but the last one is also very important) that will be evaluated and modified as needed.

1. Read all kinds of books that both baby and I will enjoy (I’m especially looking forward to reading my collection of Gyo Fujikawa books to this little one!)

2. Sing songs that are silly, fun, and have surprises, even though my voice is far less than perfect)!

3. Talk about everything; what I see in his/her room, what I see outside, what the weather is outside, the colors of vegetables, what the dogs are doing that help protect and love him/her.

4. Encourage and support the lack of technology! In this information age (the I want-it-at-my fingertips and I want it now age), that can all wait. Yes, I’ll expect this baby to be unplugged until a much later age!

5. Hold often – when he/she is sleeping, crying, snuggling, discovering, etc.

6. Comfort when needed (see above…hold often).

7. Don’t judge, trust that he/she will make mistakes and grow from those blips.

8. Love with all my heart.

9. Attend the recitals/concerts/games (when they come).

10. Give time, just being there (see lack of technology as a means of being fully engaged).

11. Bake special treats (in moderation).

12. Change a diaper or two, when needed.

13. Rock as often as possible.

14. Support mama in her breastfeeding effort.

15. Take care of myself, so I’m ready to be a great grandma.

16. Share my faith.

17. Tell stories about his/her mama’s childhood.

18. Laugh often, especially when I hear that baby belly laugh!

19. Enjoy the quiet moments and those that are not so quiet.

20. Advocate for a safe and trusting child care environment that supports both mama and baby.

21. And, of course, as all good job descriptions include: other duties as assigned!

Looking at my list, I imagine lots more big and little steps will be needed over the next 18 or so years! It’s good that I’ve started to plan already! But what is most important to remember: this baby needs (beyond the basic needs of course) love, comfort, joy, playfulness, and friends and family that cherish and adore him! I wish that for every child!

By the way, I’m out of the office right now…caring for the new grandbaby. Wish me Luck!

Leadell

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Serving up success in school with Breakfast in the Classroom

By Hilary Gee
KAC Government Relations Specialist

PBIC Infographic

Everyone – from parents and pediatricians to policymakers and teachers – understands that kids have trouble focusing and controlling their behavior when they’re hungry.  That’s why school lunch has been a key piece of public education since 1946.

Then, in 1975, the school lunch program expanded to include school breakfast, which was a highly positive step forward in reducing child hunger and improving child nutrition in America.

Sadly, too many Kansas kids are still distracted from morning lessons by rumbling tummies.

Although breakfast is served in most Kansas schools, it’s not always easy for kids to participate. Most schools serve breakfast in the cafeteria before the start of the school day. Bus schedules, limited time, and classroom distance from the cafeteria are all barriers to participation in school breakfast.

In fact, Kansas actually ranks 33rd in the entire country in providing breakfast to low-income children. This may not seem like a big deal, but studies consistently prove that hungry children are more likely to get sick, less likely to succeed in school, and less likely to finish high school or go on to college. With nearly one in five Kansas kids living in poverty, there’s also a good chance that many kids missing out on breakfast are food insecure.

Fortunately, there is a solution!

With many Kansas kids heading back to school this week, KAC released a brief about the benefits of Breakfast in the Classroom and our work as part of Partners for Breakfast in the Classroom in Kansas. Check out the report, and share resources on Facebook and Twitter.

As they say, breakfast is the most important meal of the day. We have a responsibility to make sure all Kansas kids have access to it.

Learn more about Breakfast in the Classroom and other alternative breakfast models at www.BreakfastInTheClassroom.org.

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It’s time for an honest conversation about child poverty

By Shannon Cotsoradis
Kansas Action for Children President & CEO

Last week Kansas Action for Children partnered with the Annie E. Casey Foundation in the release of its 26th Annual KIDS COUNT Databook, exploring state trends in child well being. They evaluated each state in 16 indicators and four categories: economy, education, health, and family and community.

Kansas made a few modest gains, but a closer look at the data reveals little to celebrate. As the state agency charged with protecting our most vulnerable children and their families, it is troubling that the Kansas Department for Children and Families (DCF) was quick to laud the 2015 KIDS COUNT report as good news.

Here is some context to consider as you evaluate the claims:

  • Children in Poverty: The 2015 report cites 132,000 Kansas kids in poverty, compared to 135,000 kids in 2014. That sounds like good news, right? Not when you evaluate Kansas’ trajectory. Percentages – not raw numbers – are the measure that allows us to compare statistically meaningful progress year-to-year. For Kansas, this means child poverty continues to linger at an alarming 19 percent. If nearly one in five Kansas kids living in poverty is interpreted as positive news, there’s a lack of understanding about what this important indicator means for the future of our state. Growing up in poverty is the single most important social determinant of health and a strong predictor of future economic security. The fact that Kansas again failed to make progress on improving the percentage of children living in poverty, after more than a decade-long climb, is cause for great concern.
  • Concentration of Children in High Poverty Areas: This indicator doesn’t lend itself to easy manipulation. No matter how you look at it – percentages, raw numbers, year-to-year, or the five-year trend – Kansas is moving in the wrong direction. In fact, Kansas had one of the largest increases in the percentage of children living in high-poverty areas in the entire country (Kansas tied for the 7th highest increase in the nation). This matters because kids in concentrated poverty areas are isolated from resources to promote healthy development (things like libraries, health care, transportation, or grocery stores). In turn, it impacts nearly every other indicator of well-being, putting the cycle of poverty into motion.
  • Economic Well-Being: Despite Kansas’ relatively high state rank and the nationally growing economy, well-being of Kansas kids worsened on three of four economic indicators. Additionally, our overall rank in economic well being dropped two spots from 2014. This is not the portrait of a state in recovery – especially when most economic indicators are improving nationally.

It’s important to understand data can be volatile from one year to the next, so a one-year change may not be meaningful.  That’s why we look at trends over time when determining whether something improved or worsened. When you look at the trends reflected on the 2015 National KIDS COUNT data sheet, Kansas saw eight indicators improve, seven indicators (including poverty) worsen, and one indicator stagnate.  In contrast, the nation fared better, with 10 improved indicators, 5 worsened indicators, and one unchanged indicator.

The bottom line: Kansas is not keeping pace with the nation.  If we remain committed to making Kansas the best state in the nation to live, work, and raise a family, it’s time for an honest conversation about what’s really happening in our communities, why it’s happening, and how to reverse these trends.

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Diminishing HOPE for Kansas Families with Children

By Shannon Cotsoradis
Kansas Action for Children President & CEO

For struggling Kansans, state-administered safety net programs are an essential lifeline to help families meet basic needs. When the HOPE Act is fully implemented, fewer families with children will have access to pathways out of poverty in Kansas.

An already minimal benefit will become more limited.

Cash assistance for Kansas families living in deep poverty is already very minimal (a family of three can receive a maximum benefit of just $429 per month). Hundreds of families with children will be cut off from assistance in January when a 36-month lifetime limit goes into effect. This policy change will penalize the most vulnerable families who are unable to climb out of assistance within the time limit, or those who experience a setback after leaving the program once. Kansas policymakers should reconsider the policy, which has prompted the Department of Children and families to create a plan to warn food pantries and homeless shelters that more families will be in need of help once they reach their lifetime limit of assistance.

Already struggling families will face new, unnecessary burdens.

Other new regulations unnecessarily burden families who are already piecing together work, child care, and transportation. Beginning July 1, Kansans will not be able to use cash assistance to make purchases outside of the state, even if the nearest or cheapest grocery store or gas station is just across a state border. A $25 per day limit on ATM withdrawals will expose poor families to additional fees and add yet another hassle to their day-to-day lives – all without any known policy benefit. Supporters of the restrictions say this is about promoting self-reliance, but it’s really about penalizing families for being poor. Most TANF recipients are hard working, they’re not spending TANF funds on things that are unnecessary. This law mischaracterizes the majority of TANF beneficiaries.

More poor children will not have access to economic support.

New legislation codifies existing administrative changes that caused a sharp decline in the number of children in families receiving cash assistance. This decline is particularly troubling because enrollment in other safety net programs, like food assistance, KanCare, and free and reduced price lunch, has increased during this time period. That means that even though more children are growing up in poor families, fewer are able to access vital economic support.

While policymakers may be well intended in their desire to promote self-sufficiency among poor Kansas families, the policy changes included in the legislation are not supported by evidence that demonstrates they will achieve the goal’s the administration’s has stated. What is certain are the enormous consequences the most economically fragile Kansas families with children will face as a result of the HOPE Act. Short-term, the legislation may further reduce the number of families with children that access safety net programs, but long-term policymakers have increased the likelihood that today’s poor children will become tomorrow’s poor adults.

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Honoring outstanding child advocates

On Wednesday, Feb. 25, Kansas Action for Children and the Partnership for Early Success hosted the first-ever Symposium for Early Success. More than 200 child advocates and policymakers were in attendance to hear from our keynote speaker, Dr. Vincent J. Felitti, a world-renowned physician and research on Adverse Childhood Experiences (ACEs).

We also presented four Awards for Early Success, honoring outstanding child advocates in Kansas, including health care providers, educators, business leaders and state officials.

We received many outstanding nominations from across the state. Our honorees stood out for their exemplary commitment to improving the lives of Kansas children.

MoserOur “Child Advocate of the Year” in the government official category is Dr. Robert Moser. Dr. Moser was secretary of the Kansas Department of Health and Environment from January 2011 to December 2014. During that time he undertook important work to improve outcomes for young Kansas children. Under his leadership, KDHE launched its first public awareness campaign to reduce infant mortality. KDHE also made changes to improve the Medicaid enrollment process for new mothers. He also served on the Governor’s Task Force on Childhood Poverty.

Dennis Cooley, MDThe “Child Advocate of the Year” in the health care category is Dr. Dennis Cooley. Dr. Cooley is a pediatrician who has practiced in Topeka for 35 years. He has served three terms as president of the Kansas chapter of the American Academy of Pediatrics and. In 2010, the Academy appointed him to its national Committee on Federal Government Affairs. Dr. Cooley is the chair of the Kansas Blue Ribbon Panel on Infant Mortality, chair of the Kansas Maternal Child Health Council and a long-time champion for childhood immunization.

20131123011225!Westar-logoThe “Child Advocate of the Year” in the business leader category is Westar Energy. Westar is honored for setting an example of business sector leadership in preventing child maltreatment. Westar has become an ambassador for safe, stable, nurturing relationships and environments. Westar also has joined forces with the Kansas Power of the Positive, the collective effort to reduce the number of children exposed to adverse childhood experiences.

We received several outstanding nominations in the early childhood educator category. We cannot name the winner without first recognizing some worthy contenders.

Deanna Berry was nominated for her tireless advocacy efforts on behalf of young children and for her work knitting together programs and partnerships to serve the children of southwest Kansas.

Shanna Russell was nominated for her hard work building a safe, nurturing environment for young children in the Pine Ridge community of Topeka.

Dawn Chandler was nominated for the impact she’s made on early childhood education in North Central Kansas by sharing her expertise and supporting the families of children with social-emotional needs. All of these women should be proud of what they have accomplished this year on behalf of Kansas kids.

Villalba, EmyriaOur “Child Advocate of the Year” in the early childhood educator category is Emyria Villalba. Emyria is a long-time educator at the Family Resource Center in Pittsburg. She moved to the United States from Colombia, where she was a well-respected elementary school principal. Although English was not her first language, her expertise and dedication to young children translated into an exemplary career. She started in the infant room at the Family Resource Center and began a 14 ½ year quest for self-improvement that led her to earn her Child Development Associate credential; become lead teacher in her classroom; study infant development; and volunteer to help start a community health center. In May, Emyria is retiring.

We all have a vested interest in how Kansas children are faring today and what lies ahead tomorrow. As we look into the next decade, the foundation on which early childhood programs in Kansas rests is shaky. The Kansas Endowment for Youth Fund and the Children’s Initiatives Fund support the majority of early childhood programs in our state, however, just last month, lawmakers voted to sweep $12 million from the KEY Fund, leaving it nearly empty. Childhood is a once-in-a-lifetime opportunity, and kids shouldn’t have to shoulder the burden of tax cuts and gaps in the state budget. We’ll continue to stand up for Kansas children, and with supporters like those who attended our Symposium, we can help to protect these important children’s programs.

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Finding answers to tough questions about infant death

By Dr. Jeffrey Colvin

Like nearly all pediatricians, my training in pediatrics after medical school focused on the care of hospitalized children. Much of my time was spent with infants in the Neonatal Intensive Care Unit, nearly all of whom had been admitted directly from the delivery room. The year after completing my pediatrics residency, I had the opportunity to spend much more time caring for healthy infants in a community hospital’s newborn nursery. It was a very different experience, and my efforts transitioned from curing an ill infant to preventing healthy infants from becoming sick and injured. I learned that for these healthy newborns, their primary threats were not genetic conditions, breathing problems or heart defects. Instead, the greatest risks to their lives were injuries and sleep-related deaths, such as Sudden Infant Death Syndrome, known as SIDS or “crib death.” Despite injuries and SIDS being the leading causes of infant death after the first month of life, they were not areas that were discussed much within the pediatric community. Even worse, there were no medications or surgeries that could “fix” them.

To best help parents keep their infants safe, I learned as much as possible about which specific conditions placed infants at highest risk of SIDS. I especially wanted to know about those conditions that could be changed or modified to decrease their risk. The journey to learn more about preventable causes of SIDS has lead me to look for answers in existing research as well as by conducting new research to discover new causes and the relative importance of known causes.

An amazing group of talented and dedicated individuals came together to conduct the research: Christy Schunn from the Kansas Infant Death and SIDS Network, Vicki Collie-Akers from the University of Kansas and Dr. Rachel Moon from the American Academy of Pediatrics. Our research examined the presence of known risk factors in infants who died during sleep so that we could better learn the relative significance of each risk factor. Our projects to date have examined the differences in risk factors for younger infants compared to older infants and for risk factors associated with placing the infant to sleep on non-traditional surfaces, such as on sofas. Our results have been surprising. We found that approximately 75 percent of younger infants were sleeping with an adult at the time of death and half were sleeping in an adult bed. We also found that nearly 1 in 8 infants who died in their sleep were sleeping on a sofa and nearly 90 percent of those infants were sharing the sofa with someone else at the time of death.

Although troubling, these findings gave us hope because the risk factors could be changed with education of new parents. We could teach parents to have the infant sleep in his or her own bassinet or crib; while in the same room as the parents, the crib or bassinet would ensure that the infant was not sleeping in the same bed as the parents. We could also warn parents about the dangers of placing infants on sofas to sleep.

But how do we get this message to parents? And what is the best way to get that message to them? What about causes of infant death other than SIDS? How do factors specific to Kansas (and even to specific cities in Kansas) influence the risk of an infant dying? What Kansas needs now is a community-based process for examining infant deaths, determining their community-specific root causes and developing and implementing interventions best adapted for each community.

Kansas Action for Children is working with Geary, Shawnee, Wyandotte and Sedgwick counties on Fetal and Infant Mortality Review (FIMR) programs that will help us answer these questions. FIMR is a national model adapted by local groups to find ways to prevent infant deaths tailored to their own communities. Find out more about FIMR at www.nfimr.org. If you have questions about FIMR in Kansas, you can email Janelle Brazington at KAC.

Dr. Colvin is a member of Kansas Action for Children’s Board of Directors.

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