Babies & Families Summer 2019

PAGE 17 — Baby

& Families •

Addison Independent, Monday, August 5, 2019

Woody and Marlowe play in the field.

Baby & Families Inside:

Porter specialists asses & treat new mothers’ mood disorders. See Page 19 Dads: Embrace your role as baby’s reader. See Page 21

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& Families •

Addison Independent, Monday, August 5, 2019

(802) 388-0909 132 SOUTH VILLAGE GREEN, COURT STREET MIDDLEBURY, VT 05753

Baby & Families • Addison Independent, Monday, August 5, 2019 — PAGE 19

Safe for the Whole Family PORTER HOSPITAL CERTIFIED Nurse-Midwife Emily Zolten, left, and Alison Underwood, licensed social worker, help identify and treat depression and anxiety experienced by expectant and new mothers.

Independent photo/Abagael Giles

Giving birth can lead to mood changes, depression

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By ABAGAEL GILES these maternal health disorders cost over MIDDLEBURY — A local study shows $14 billion per year in America. that in the weeks just before and just after “Moms are often the stewards of family giving birth, mothers may experience care, including for their partners. (An mood disorders such as depression untreated perinatal mood disorder) can and anxiety related to have multi-generational pregnancy, childbirth and implications,” Benvenuto postpartum recovery more “Ninety-five percent told the Addison often than caregivers had of what (new Independent.

Further, thought. “untreated maternal parents) need to Along with the depression in pregnancy substantial life changes hear is that this is leads to higher rates of that come with having a hard, that it’s hard pre-term birth in infants baby, a person who has for everyone.” and can have long-term given birth experiences — Alison Underwood implications for growth and dramatic hormonal changes development of children.” within their body during But for many women, pregnancy and immediately following those symptoms go untreated due to a host childbirth. During that period, which can of factors. last as long as a year after birth, young “We know that nationally, these health parents are often sleep-deprived from issues are underreported,” says Emily spending long nights up with a newborn.

Zolten, nurse-midwife at Porter Hospital Additionally, new mothers may not be in Middlebury. “Nationally, the data says able to exercise, have as much mobility that they occur in about 7 percent of or be as social as they were before the pregnant and post-partum women. What baby arrived. All these factors can lead to we found in our study was that the rate an extended period of what is commonly was closer to 25 percent.” referred to as “the baby blues,” according Between December 2018 and April to a quality improvement project 2019, Zolten oversaw a qualitative completed at Porter Women’s Health this improvement project (QI), where women spring were surveyed using the Edinburgh Collectively, says Porter Chief Medical Postpartum Depression Scale at the (See Postpartum, Page 20) Officer and physician Anna Benvenuto,

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PAGE 20 — Baby

& Families •

Addison Independent, Monday, August 5, 2019

Postpartum Trusted, Comfortable, & Caring Dentistry for over 41Years

Middlebury Dental Group Cares for Smiles of All Ages Dr. Hopper & Dr. Fasoli Treat Kids & Adults in Middlebury MIDDLEBURY, VT—The best way to guarantee a lifetime of healthy smiles is to provide kids with a “dental home” where they can develop good habits.

This is one of the guiding philosophies at Middlebury Dental Group. By treating children from their first tooth onward, the practice provides a foundation of great dental health for the youngest patients in Addison County.

“We love kids and we know how to care for them,” says Dr. Adam Fasoli.

“Visits to the dentist are a learning experience for kids, so it’s important that we make them feel comfortable and respected.”

Both Dr. Fasoli and Dr. Peter J. Hopper have been caring for children in the local community for years, as well as their parents and grandparents.

The concepts of long-term preventive care and patient education guide their treatment of patients of all ages. While children may be learning to brush, floss, or avoid sugary foods for the first time, the team at Middlebury Dental Group knows that their grown-up patients sometimes need tips to keep their smile healthy, too.

The dentists at Middlebury Dental Group are concerned that lack of convenience is one of the things that keeps busy families from staying up to date with their preventive dental care appointments. They have taken a novel approach to this problem by offering extended hours, with dental appointments after school as late as 4:30pm, so parents don’t have to pull their kids out of class for teeth cleaning appointments.

(Continued from Page 19) beginning of their pregnancy, at about 24 weeks, two weeks after giving birth and six weeks after giving birth. Prior to the QI, mothers were formally screened only after birth. Additionally, the entire Women’s Health office in Middlebury participated in regular luncheons to discuss ways to detect perinatal mood disorders in patients and how to direct them to care. All of this was designed using a protocol and toolkit for hospitals developed by the Alliance for Maternal Health.

For the last two years, the hospital has been able to set up those appointments inhouse, saving new moms time and energy in getting a referral for a mental healthcare provider elsewhere — something Dr. Benvenuto says is in short supply in Addison County. Further, many women are afraid to seek help for mental health during or after pregnancy because they are afraid it will reflect poorly on them as mothers or result in their children being taken away from them.

Porter Women’s Health has had a Licensed Independent Clinical Social Worker on staff, who provides mental health counseling to clinic patients, typically around women’s health issues, since 2017. Those services are free to patients thanks to funding from the state of Vermont’s Blueprint for Health program.

Alison Underwood fulfills that role and says that there is no reason to suspect that rates of perinatal anxiety and depression are higher in Addison County than elsewhere — it’s just that in Addison County, moms are now being asked and offered what Underwood calls “a menu of potential treatment options.” Further, they are working with healthcare providers that they have already built a relationship with.

“We are a small enough office that often times I can come right into an exam room to see someone in a space where they are used to bringing their children and feeling a level of trust with a provider,” she says.

“That’s huge.”

Zolten’s research found that, given this new protocol, more than 84.6 percent of patients who reported a perinatal mood disorder during the study period were referred in-house for treatment and accepted it — a figure above their initial goal of 80 percent. Prior to the QI, that

figure was closer to 58 percent. “We’ve kept the system we’ve implemented in place and are planning to evaluate our numbers again six months out to see how much progress we’ve made,” Zolten says.

The reason for presenting new mothers in their care with a list of standard treatments that they can choose from is simple: pregnant and breastfeeding patients report to medical staff at Porter that they have strong ethical and other concerns about taking medication and other treatment during or immediately after pregnancy. “Treatment of mental health disorders and use of medication is both safe and effective,” Benvenuto says.

“Many medications are safe and effective throughout pregnancy.”

For community members, Underwood suggests taking a proactive approach to helping new moms. “There is so much you gain during that period, but what society doesn’t let new parents talk about is the fact that something is lost: your independence. Ninety-five percent of what people need to hear is that this is hard, that it’s hard for everyone, and that you will get that part of yourself back, and it’s OK to grieve for it,” she says.

Instead of leaving it at saying, “You must be so happy!” to new mothers, Underwood suggests keeping the compliments and adding in phrases like, “How are you holding up?” or making concrete offers to show up and help out with friends and family in small ways.

If a woman is thinking about harming herself or her children, she should seek immediate assistance from her medical provider and/or dial 911. However, for others, services are just a phone call away.

“Asking for help is not going to land you in a place where you could lose your children. And talking through these feelings with another human being may help you find strategies to cope so that you can be a better parent in the end,” Underwood says.

Zolten seconded that: “We need to reframe this as a really common healthcare concern that happens around pregnancy and the postpartum period. I’d like to see us normalize this culturally, bring it out of the shadows, so that people feel they can share their stories, help each other and get care.”

Whenever possible, the practice offers what they call “family style” appointments, where kids and parents have their cleanings scheduled at the same time, so the whole family can be in-and-out quickly and easily.

Middlebury Dental Group is located in Suite 170 at 1330 Exchange Street, located off Route 7, across from the Bridge School & next to Champlain Valley Orthopedics. For more information about the dental care they offer, please call 802-388-3553.

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Baby & Families • Addison Independent, Monday, August 5, 2019 — PAGE 21

Dad’s Night helps new fathers find their groove VERMONT — “Dads’ Night is about helping dads be comfortable as a parent,” says Josh Miller, executive director of the Janet S. Munt Family Room in Burlington’s Old North End. “Dads may do things differently from how a mother does them, but fathers can provide nurturing and support and affection.”

The drop-in evening program has been offered for over 25 years and is open to any father with children under eight years old. Every Dads’ Night includes a free dinner and activities, such as story time with Peter Burns.

“Guys really look forward to when Peter comes,” Miller says. “He increases their capacity to have fun with their kids during reading time, like doing a ‘big voice’ and a ‘little voice’ and a ‘silly voice.’”

Peter’s visits to Dads’ Night are supported by Vermont Humanities via the organization’s Read with Me program, in which facilitators share the importance and the joy of reading picture books with young children.

“It’s always casual, and Peter asks really good questions,” Miller says. “He

PETER BURNS SHARES picture books with young children and models techniques for reading stories aloud during Dads’ Night at a Burlington nonprofit called “The Family Room.”

Photo courtesy of Vermont Humanities Council

notices the small pieces of the story and points them out to the dads, to show them how to connect with their kids on those aspects.”

But Peter’s approach emphasizes that

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it’s not crucial to tell a story exactly the way it’s written in a book. “I’ve really appreciated that, because of the different reading levels that guys have,” Miller says. “It’s really important that fathers

can feel confident to change things up with the story.”

In addition, staff at the Family Room have appreciated how the books chosen (See Dads, Page 23)

PAGE 22 — Baby

& Families •

Addison Independent, Monday, August 5, 2019

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Baby & Families • Addison Independent, Monday, August 5, 2019 — PAGE 23

Today The Baby Crawled on Me

By Toby Baker-Rouse

Today the baby crawled on me, with kisses and with drool.

My mother brought him up the stairs to get me up for school.

Today, the dog, she jumped on me – she sat upon my head.

My mother brought her up the stairs to get me out of bed.

Today my sister woke me up, with stomping and a yell.

She thumped her way down all the stairs, louder than alarm bells.

Today my brother jumped on me, and my blankets he did take.

My mother sent him up the stairs to see I was awake.

Today my mother sang to me, as she is apt to do.

It was very loud and all off-key, but got me up for school.

Today nobody woke me up; I slept till almost noon.

I wore pajamas, read, and played – but Monday comes too soon.

Editor’s note: Toby Baker-Rouse was a 9-year-old fourth-grader in Middlebury when he submitted this poem to the Young Writers Project this past school year.

Dads (Continued from Page 21)

by Vermont Humanities help teach emotional intelligence to both young children and their caregivers.

“The book ‘How do Dinosaurs Say I’m Mad’ led us into a conversation of how you respond to your kids when you’re angry and frustrated,” Miller says. “It can be a very delicate topic. And what’s cool in a group is that you get to hear other dads talk about their experience, which gives fathers the permission to say, ‘Oh, I’ve never thought about it that way, I’ll try that.’”

Read with Me has offered titles focusing

on emotional intelligence since 2018.

“Learning good social and emotional skills is tied into both emotional stability and good cognitive development,” says Ali Palmer, director of Literacy Programs at Vermont Humanities. “Books can help children understand and manage their emotions — especially difficult ones.”

As part of the Read with Me program, caregivers receive free books to take home to read with their children. “Guys who haven’t done a lot of reading before have said that they read a book over and over again to their kids,” Miller says. “I think that’s pretty huge.”

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Helping Young Families Get the Right Start

Learning to cope with sibling rivalies Many parents dream that their children will grow up to be lifelong friends. That happens quite often, but typically not without a few bumps along the way.

Siblings disagree from time to time, and sibling rivalry is a part of growing up and charting one’s course in the family unit.

However, parents can take steps to avoid sibling rivalries developing between their children.

Children routinely test their boundaries and their places within their families, vying for attention from parents or other caregivers, especially when they become a brother or sister for the first time. A firstborn child who went from being the sole focus of his parents’ attention may struggle to adjust when another child is welcomed into the family.

Sibling rivalry also occurs because young children may not be able to fully process their emotions as soundly as adults. Kids may not recognize that a sibling is not a threat; as a result, they may act out reactively instead of thinking and choosing a more productive way of behaving. According to Dr. Gail Gross, a researcher and educator with a Ph.D. in Psychology, competitive or aggressive behavior could set the course for a lifetime of negative patterns, influencing a child’s relationships with their siblings or other significant friends or even future romantic interests when they come of age.

Parents can take proactive approaches to prevent sibling rivalries from developing between their children.

• Encourage friendship before birth. Older children should become acquainted with the new baby before he or she arrives and be included in the process of welcoming him or

her. Parents also can relive the older child’s babyhood, offers childcare expert Dr. Sears.

Show older brothers or sisters what they looked like as infants and how life changed for the better. Assign older children key roles in the family, such as a mother or father’s assistant. This way he or she is taking an active part in helping the family run smoothly.

• Consider spacing children three to four years apart. By spacing siblings apart by three or four years, parents may find that one child is ready for more independence while the new baby will require more constant care. This also may alleviate some stress in the household because the older child can be an important helper.

• Make sure kids have their own unique belongings. Each child can have their own personal toys and possessions that they hold dear. They can choose to share these with one another in play areas, but they should not be forced to compete over particular items.

• Don’t compare children in front of them. Children may interpret comparison as criticism.

Children will not reach milestones at the same time, and parents should not compare their kids’ progress, or lack thereof, in front of the youngsters.

• Let kids work disagreements out. Children will have arguments, and parents should try not to take sides. Let kids work disagreements out on their own when possible.

Sibling rivalries can develop, but parents can take steps to ensure such rivalries do not affect their kids’ longterm relationships with one another.

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Addison Independent, Monday, August 5, 2019