Extending our program to the first few months in accordance with research demonstrating the importance of the first few months to a child’s foundation for success.
A guest blog from Teandra Ramos-Hardy, MSW, Director of Medical Engagement for Reach Out and Read Carolinas
We know from research that brains are built over time through a process that begins prenatally. The Center on the Developing Child at Harvard University has an abundance of research confirming that the foundation for all future learning is shaped by early experiences, beginning at birth. A brain’s architecture does not grow in isolation; it is developed by interactions with both genes and experiences. The early years are the most active period for establishing neural connections in the brain. The environment where one lives and grows, and the exchanges that take place with people in the environment shape the capacities that emerge in the early years.
In the very first few weeks and months of life, milestones can be seen that reinforce the construct of brain architecture. A newborn does not immediately have neck control, but a newborn’s head gradually wobbles less in the weeks after birth. One of the best times to observe this is during tummy time. A newborn will also become responsive to sounds, especially their mother’s or caregiver’s voice. They will become drawn to the voice and respond by focusing in the direction of the sound. A newborn can also communicate by being quiet, cooing or babbling, and reaching.
The postnatal period is a critical time for newborn babies and mothers and many changes occur during this period. Although manuals are helpful, they are not provided at discharge from the hospital, and the web is overloaded with information that can easily overwhelm new parents. The pediatric provider is the filter and support system a family needs to navigate through information they’ll receive to care for their newborn. Lack of appropriate care during this time can result in significant issues lasting into adulthood. Newborns and mothers should be assessed at regular intervals following delivery. Further evaluation can be achieved through referrals from the healthcare provider as needed. The American Academy of Pediatrics has developed a periodicity schedule that providers can follow to assess the health of the newborn, and the health and emotional well-being of the mother.
The newborn checkup is an important medical visit for the provider to assess the health and development of the newborn following discharge from the hospital. This initial visit with the healthcare provider allows the family to begin building a relationship with the provider and the medical home as important resources for them and their child – a partnership that lasts throughout the life of the child. Although the newborn checkup is for the new patient, it is equally important to focus on how the entire family is adjusting to the new addition to the family. This visit sets the expectation for the two-generational relationship that is created, and includes asking questions, addressing concerns, and providing parent education and anticipatory guidance.
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Providers spend time educating and giving anticipatory guidance to parents. It has been found that books effectively increase maternal knowledge of anticipatory guidance material and encourage social and emotional bonding between parents and babies. During well-child visits, parents are educated on many topics, and are likely to recall less of the information as more topics are covered. Given the brevity of pediatric visits, providers can target behaviors like reading, talking, singing, cuddling, and bonding that are important. Embedding Reach Out and Read in the standard of medical care offers additional opportunities to encourage parent-infant reading, which influences parent-child interactions, children’s language development, and future reading ability. The value of the intervention has been shown in lower maternal depression scores, and reports of maternal enjoyment of reading, and time spent reading with their children. This is significant because the AAP supports maternal depression screenings per “Incorporating Recognition and Management of Perinatal and Postpartum Depression Into Pediatric Practice,”beginning at the one-month well-child visit.
The research supports the value of starting Reach Out and Read in infancy. Through this early literacy intervention, providers can support parents and impact children’s lives from the beginning. Here in Reach Out and Read Carolinas, we are joining with a National Reach Out and Read initiative to align with science and incorporate a zero to 6-month component of the Reach Out and Read program, encouraging our providers to talk with the pediatric patient and family about the importance of engaging with infants and sharing books in the first few months. Research on the impact of this early intervention will continue to inform and guide our rollout across the country.