2007 NACHRI Profile Series – The Prevention of Child Abuse & Neglect

NACHRI has made the prevention and treatment of child abuse and neglect a priority. Following Defining the Children’s Hospital Role in Child Maltreatment, which outlines opportunities for children’s hospitals to become leaders in response activities, this profile focuses on the proactive efforts being implemented by children’s hospitals to reduce child abuse and neglect. Twelve children’s hospitals are cited here. Representing their colleagues, each hospital is involved in a number of outreach efforts, and works with families and communities to prevent child abuse and neglect.

THE HAPPIEST BABY ON THE BLOCK

C. S. Mott Children’s Hospital (Ann Arbor, MI)

Harvey Karp, M.D. developed The Happiest Baby on the Block, a method that teaches caretakers how to recreate the environment of the womb. His perspective is rooted in child development and based on the premise that infants in their first few months can have trouble adjusting to external stimuli.

Karp’s method combines swaddling, the side-stomach position, shushing sounds, swinging and sucking, known as the 5 “Ss,” to recreate the coziness and the rhythmic motions of the womb. He offers a parent education curriculum, described as a “calming reflex” and as a positive and empowering message for parents.

To encourage parents to come their hospital, staff at C.S. Mott Children’s trained nurses and other health care professionals in Karp’s baby soothing technique. Hospital staff met Karp in 2004 and began thinking of ways to bring his program to their hospital. Together with Prevent Child Abuse America, they planned a training day with Karp in their state. Through the use of grant funds the hospital sent 30 staff to the training and purchased The Happiest Baby on the Block certification kits. Karp also conducted four three-hour informational sessions (advertised state-wide) at the children’s hospital. More than 100 nurses, residents, doctors and other staff were briefed on strategies for calming crying babies and communicating with toddlers.

After training and certification, participating nurses agreed to lead The Happiest Baby on the Block classes for the hospital free of charge for one year. The hospital currently offers the class once per month for the public and plans to expand its offerings to its birthing education classes and offsite clinics. There is a fee for the class to cover materials, though some are sponsored to participate for free. C.S. Mott Children’s also includes information about SBS and shows the “Portrait of Promise” video during the class.

C.S. Mott Children’s home-visiting nurses have been certified in Karp’s method as well. A nurse will visit each family with a newborn one time after birth. The nurses incorporate Karp’s message and method into the home visit presentation. They also provide and leave information on SBS.

St. Luke’s Children’s Hospital (Boise, ID)

St. Luke’s Children’s Hospital is using The Happiest Baby on the Block to educate new parents about the dangers that exist when frustrating moments arise.

St. Luke’s conducted community-wide awareness programs like Fragile: Handle with Care. Although successful, the hospital decided it needed to do something more – to focus on what is often the trigger of shaking, crying, and give parents a skill set to calm babies.

St. Luke’s paid for two staff to take Dr. Karp’s training class and become certified in The Happiest Baby on the Block. The hospital now offers a pre-andpost natal class for parents and uses the soothing method to begin baby and child safety discussions.

Presently, four to six classes are offered each month with at least 25 participants; one-on-one sessions may also be offered. The 5 Ss, crying as a trigger and having a plan for crying are covered during the pre-and-post natal classes. The hospital charges fifteen dollars for the class, the cost of materials; scholarships are available to assist families in need.

Through its mother/baby unit, the hospital also distributes swaddling blankets to all new families with instructions on the 5 Ss associated with The Happiest Baby on the Block. The blankets are presented as a gift to new mothers. Then, nurses explain and demonstrate the first S, swaddling, and continue to have a discussion about baby safety.

St. Luke’s is expecting to add The Happiest Toddler on the Block to its program in 2007. Except for materials for participants, all expenses of the program are absorbed by the hospital.

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