Young teens learn ways to reduce infant mortality rates

Jeff Karoub

PONTIAC, Mich. — Shantaya McDaniel and Victor Reyes learned in school about things that contribute to the high death rate of infants in their city and steps they can take to help keep babies alive.

For the Lincoln Middle School students who just completed a six-week class called Crib Notes, it was more than an academic exercise. Each is applying lessons on healthy and proper eating, sleeping and living. Shantaya is helping her cousin and stepsister with their babies. Victor is using his newfound knowledge to help raise his three-month-old son, Giovanni.

“I was nervous at first, very nervous,” said Victor, a 15-year-old eighth grader at the school in Pontiac, about 20 miles north of Detroit. “I thought it was going to be a little bit complicated until they showed us a video and brought a demonstration baby in. … Now that I’m good at it, it’s not even a problem.”

Crib Notes is designed to reduce infant mortality in Pontiac, which has the highest rate in Oakland County. If the program delivers on that promise, it could serve as the catalyst for a larger effort in a state with one of the highest infant mortality rates in the nation.

Crib Notes’ creators and those who know of efforts to reduce infant mortality say the hands-on program is uncommon in the way it reaches and teaches middle school students. Developers of the joint project between the county’s health division and Pontiac schools say it made sense to tailor the curriculum for that age group based on their interaction with babies and the opportunity to instill healthy behaviors in themselves.

“When you look at middle school-age children … these are kids that are crossing the bridge from childhood into adolescence,” said Lois Winer, a nursing supervisor for the division who oversees the program created and taught by public nurses. “We thought this was a perfect population to begin to educate on … prevention.”

Winer said the program, taught in three schools to sixth- and eighth-graders, is not a sex education class or one that teaches about reproductive health or pregnancy. Instead, it focuses on areas that research has linked to prematurity or infant mortality, such as smoking, obesity and sleeping in unsafe positions and places.

The message appears to be getting through. Victor told his girlfriend and their respective parents, who will help raise Giovanni, about removing bumper pads from the crib because he could get smothered. He and Shantaya also have counseled family members about sleeping with babies.

“We learned not to sleep on the couch,” she said. “That’s what my mom did. She’s still doing that. I had to tell her, ‘No, that’s not good.’”

Teachers, counselors and administrators pick the students for Crib Notes. They could be those likely to share the information with peers, help care for younger family members, baby-sit for others or have a child of their own.

“[The county] came to me with this one and I just jumped right at it,” said Jerry Lane, assistant principal of Lincoln Middle School. “This particular age group, they can soak up whatever you teach them. They’re just at that age to learn.
“It’s a real need, and it will pay off for the city, for the school district in the future.”

Winer said the program, which started as a pilot project in spring 2005, doesn’t yet have data to show its progress. However, health officials are developing a plan to follow up with participants through high school.

The program is funded by the county, but the health division in 2004 received a three-year grant from the Michigan Department of Community Health for the Nurse Family Partnership.

The money provides for home visits by public health nurses to first-time, low-income pregnant women in Pontiac, with a focus on black mothers. A main goal is to reduce infant mortality and the discrepancies between black and white infant mortality rates.

In Pontiac, the infant mortality rate for all races has decreased from 16.6 per 1,000 live births in 1998-2000 to 13.2 per 1,000 live births in 2003-05 — still higher than the county’s average rate of 6.7 for the most recent three-year period. The rate for blacks has decreased from 27 per 1,000 in 1998-2000 to the current rate of 19.7 — still two times the rate of white infants.

Neighboring Genesee County has brought its rate down from a one-time high of 14.5 deaths per 1,000 births in the 1990s, to an all-time low of 8.9 in 2005. Health officials cite a combination of programs, including an after-school program designed to boost self-esteem and resist peer pressure among middle school girls.

Michigan’s overall average infant mortality rate was 8.09 per 1,000, compared with the national average rate of 6.86, according to 2002-04 figures from the U.S. Centers for Disease Control and Prevention, the most recent available.

Doug Paterson, state policy director of the Michigan Primary Care Association, said he isn’t familiar with Crib Notes or aware of courses like it targeting middle schoolers. He said it would do well to model itself after the Nurse Family Partnership, which has been shown to reduce unintended pregnancies and lower infant mortality.

“I want to know how they’re measuring success,” he said. “How well is it truly being tested? … It’s really tough to try and prove [because] there are so many factors that impact infant mortality.”

State Sen. Deb Cherry, D-Burton, who serves on the health appropriations subcommittee, said she would support expanding the program if it can be linked to lowering infant mortality.

“You hate to throw money into a program just because it sounds good, but … if this program can be shown to be effective, I don’t know why we wouldn’t want to invest,” she said.

While Crib Notes’ creators build a case for the future, they can take some comfort that current attitudes appear to be shifting.

Victor said the class has taught him that he has to take greater responsibility now that he’s a father, and will get a job this summer to help support his son. Shantaya, 14, has learned ways to help raise others’ babies — and realizes she’s not ready to take on that kind of responsibility herself.

“It made me think a lot about some of the choices my friends are making, and a lot of teen mothers I knew,” she said. “It taught me really to look back and tell myself I’m glad … I’m not a mother.”

(Associated Press)