To break the cycle of childhood trauma, pediatricians help new parents : Shots - Health News HealthySteps is an intervention where new parents get practical help with their lives, allowing them to create stable, nurturing bonds with their babies. It all starts at the baby's checkups.

How to break the cycle of childhood trauma? Help a baby's parents

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A MART├ŹNEZ, HOST:

From the time a child is born until they're 3 years old is a stage of development that lays the foundation for the child's future. But growing up in a financially stressed household can hurt a child's physical and emotional growth. Now a new intervention is trying to prevent those problems for at-risk kids by better supporting their parents in those early years. For our ongoing series Living Better, NPR's Rhitu Chatterjee reports the work starts in the pediatrician's office.

(CROSSTALK)

RHITU CHATTERJEE, BYLINE: It's a busy morning at this clinic in Brooklyn.

UNIDENTIFIED PERSON: She's waiting for shots, right?

CHATTERJEE: A young couple is here with their 11-month-old baby, Kayla, to see her pediatrician, Dr. Marilyn Arca.

MARILYN ARCA: Good morning. Kayla, good morning to you too, baby. Come. Let's go. Let's face Dr. Grandma now.

CHATTERJEE: But Kayla's appointment isn't just with Dr. Arca. Here at Brookdale Family Care Center, which mostly serves people on Medicaid and CHIP, families can also see a child development specialist. That specialist here is Allison Lieber.

ALLISON LIEBER: Like, a month ago, you guys were here. And you did ASQ. And development looks beautifully on schedule.

CHANTEL SPRINGER DOWELL: Thank you.

CHATTERJEE: Lieber spends nearly 30 minutes with Kayla and her parents, Chantel Springer Dowell and Tishon Dowell, asking them about their baby's development.

LIEBER: Oh, no. What happened?

SPRINGER DOWELL: She don't like to lay down.

(SOUNDBITE OF BABY FUSSING)

LIEBER: Is she starting to cruise? You can pick her up.

SPRINGER DOWELL: She crawls. She climbs out of, like, her bassinet.

CHATTERJEE: Over the course of their conversation, Lieber gets a sense of what the couple is struggling with. She suggests a nighttime routine to help Kayla fall asleep more easily and how to help her try new foods.

LIEBER: What about doing, like, dinner together, where she gets her own little plate to play with while you guys are all eating?

SPRINGER DOWELL: Yeah. We can do that. Like an empty plate, right?

LIEBER: Well, no. Put a little food on her plate.

SPRINGER DOWELL: Oh.

LIEBER: That way it's family dinnertime. Maybe...

CHATTERJEE: Then Lieber asks the parents how they're doing.

LIEBER: So what else is going on with you guys? How's work?

TISHON DOWELL: Work is OK.

SPRINGER DOWELL: Work is good.

CHATTERJEE: Lieber directs a program here called HealthySteps. Her role is both of an educator and one of social and practical support for parents, teaching them about their child's development and how they can best facilitate that.

LIEBER: We want parents to be the hands that let their child go out and explore and welcome them back, but sometimes parents need hands, too, and so how can we be that support for them?

CHATTERJEE: And supporting parents also involves addressing other factors affecting their stress levels.

LIEBER: It's really hard to focus on tummy time or reading to your child if you're living in shelter or you're bouncing from couch to couch or you don't have enough food stamps to be able to put food on the table for your older children.

CHATTERJEE: So Lieber and her colleagues address those challenges. They help families find housing, sign up for food benefits, connect them with job opportunities and mental health care. One of the many mothers the program has helped is Teresa Cox-Bates, who calls Lieber by her first name, Allie.

TERESA COX-BATES: Allie is more like family to me. She's been the absolute best. Anytime I needed something, she was there. Even when I didn't need anything, she would just - she'll just call and check on me.

CHATTERJEE: Cox-Bates and her husband signed up for HealthySteps in 2017 after their second son was born. She says the program has seen her through many ordinary parenting struggles and some crises, like the time she had postpartum depression when her youngest, Ava, was still a baby.

COX-BATES: I was definitely sleep deprived because by then Ava still wasn't sleeping through the night. And I just felt really sad. I was crying uncontrollably at work.

CHATTERJEE: At home, she was irritable and impatient with her kids. One day, she found herself yelling at her two boys for something small.

COX-BATES: And I just started screaming out of nowhere, and then they got really scared. And I was like, oh. I felt really bad afterwards. I went in a room and I cried, and I told John that this is not me.

CHATTERJEE: Then she called Allison Lieber, and thanks to Lieber's prompt help, Cox-Bates was able to get admitted for inpatient care. Across the country, nearly 250 clinics are now using the HealthySteps program, mostly with grant funding. The program now reaches more than 370,000 children. Rahil Briggs is the national director for the program. She says the stress of poverty has serious consequences on children's development.

RAHIL BRIGGS: We see impacts on physical health, on developmental health. You're seeing illness, hospitalizations, developmental delays, increased behavior problems, decreased cognitive functioning.

CHATTERJEE: Factors that affect their lifelong health. Briggs says HealthySteps is trying to prevent these inequities and give children from disadvantaged backgrounds a healthier start. Studies show that the program is already succeeding on many fronts.

BRIGGS: We know that mothers felt significantly more supported to breastfeed, and we know that with HealthySteps, they had higher rates of continued breastfeeding.

CHATTERJEE: Briggs says when mothers have a history of trauma from their own childhood, it can affect how they parent. But she says research shows that HealthySteps prevents moms from passing on their trauma to their kids.

BRIGGS: So a bunch of children whose mothers had experienced trauma, some get HealthySteps; some don't. And when you look at the children who received HealthySteps, looking much better on a social emotional screening than the ones who didn't.

CHATTERJEE: Teresa Cox-Bates is among the healthy steps mothers with a history of childhood trauma. When she was only 11, her father died, and her mother struggled to provide for her five kids.

COX-BATES: Most of the time, my mom, she only fed us once a day. So if we snuck in the kitchen to get something, like, you know, she beat us.

CHATTERJEE: She says her mother struggled with alcoholism and was sometimes violent. So when Cox-Bates became a mother, she wanted to give her kids a better childhood, one filled with stability, love and connection. And she's been able to do that, she says, largely thanks to support from HealthySteps.

COX-BATES: Because I had the resources and I had to help, and I had Allie. And even if she couldn't do it, she would find somebody else that did. And if I didn't have that, I don't think I would have been able to manage my mental health and for me to even press on to be the mother that I am today.

CHATTERJEE: And she sees that reflected in her kids, who are happy and thriving.

Rhitu Chatterjee, NPR News.

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