My Sister in the Struggle to Reduce Infant Mortality

There are sisters. And there are sisters. I consider Phyllis Rabinowitz to be my sister in the struggle to save infants who never make it to their first birthday--a cause I am passionately committed to. Phyllis joined the fight after enduring a mother's worst nightmare.

On July 21, 2006, her daughter Rebecca Ava died at 8-day-old after being misdiagnosed in the emergency room. The trauma began with their ER experience.

"The doctor was so dismissive. He was like, 'This is just a common cold. I've seen children for 20 years. I've got to get to a real emergency down the hall.' . . . No matter what my husband and I asked for, the whole experience was very condescending. We knew she was sick," Phyllis recalls.

They refused to readmit her. By the next morning baby Rebecca was septic and bleeding from the nose. Phyllis will never forget the sight of her husband desperately performing CPR and the seemingly endless ride in the ambulance, but baby Rebecca didn't make it. The Rabinowitz's ordered a state autopsy, independent of the hospital, which revealed that baby Rebecca had a common enteroviral infection, not a common cold. Had baby Rebecca's symptoms been properly diagnosed and treated she would still be here today.

Instead Phyllis and her husband, Andrew, learned in the most horrible way that most emergency room physicians are not properly trained in pediatric emergency care. In fact, very few hospitals have all the necessary equipment to properly treat babies.

"Like any parent, we were profoundly sad and angry. I was in a deep depression. We started researching for answers. We knew something was not right. We learned how all ERs are not created equal when it comes to being ready to treat infants," Phyllis says.

And then, sitting in their den, with supportive friends and family, Phyllis and her husband decided to do something. The R Baby Foundation http://www.rbabyfoundation.org/index.php was born with the distinct purpose of saving as many babies lives as possible, particularly those have some sort of viral infection in their first month of life, by improving pediatric care in emergency rooms across the country.

Today their work includes, raising awareness around infant mortality and emergency room care, providing training opportunities for anyone who touches a baby, providing life-saving equipment to hospitals and parent education (check the website for a soon-to-be-released 10-page guide for parents).

I'm a proud supporter of the R Baby Foundation and I am always inspired by Phyllis' commitment to teach parents how to advocate for their children. This for me is especially important in the African American community, where the quality of the healthcare we receive is often tainted by bias, stereotypes and living in underserved communities.

This year, the MochaManual team and I will be once again participating in the R Baby Foundation's Mother's Day Run/Walk http://www.rbabyrunwalk.org/Markslist/ext/rba/home.do?masterCampaignId=3130 on Sunday, May 9th in Central Park, New York City, to raise awareness and funds to improve emergency pediatric care for babies. There are plenty of activities for the whole family. Visit www.mochamanual.com for details for our team. What a great way to start my Mother's Day!

As for life after loss, Phyllis said it best: "My baby only lived 8 days, but she's in my heart everyday. And she inspired us to help save other babies so they could live their lives."

Text 4 Baby! : New Service Delivers Info to Moms to Be

I'm all for getting information out to expecting moms by any means necessary--especially when it's new ways to reach African American women with the information they need to have healthy pregnancies. That's why I was really excited to hear about the new Text4Baby http://text4baby.org/ service.

At first, I thought, why didn't they have this when I was pregnant? But enough of my envy. It's great to have timely information, practical tips and friendly reminders on your mobile phone. We're always attached to them anyway. Heck, we've invented a whole new texting language that leaves many of us pausing and stumped when we have to fully type out an actual word for a work-related email.

What's even more remarkable about this project is that it represents an unprecedented coming together of the government and the private sector (pause for shocking gasps!) using new technology (double gasps!) to actually help improve maternal health among underserved women (you know what to do now).

But it's true. Text4Baby is the first ever free mobile health service in the United States, and it sends free text messages to pregnant women and new moms through their first year. It also really shows the power of mobile phones and other technology to get powerful information to people who need it most. Not everyone has a home computer, but nearly everyone these days has a mobile phone.

All you have to do is text BABY to 511411 (or BEBE for Spanish) to get three free text messages each week just right for your due date or your baby's age. These messages focus on a variety of topics related to maternal and child health, including birth defects prevention, immunization, nutrition, seasonal flu, mental health, oral health and safe sleep. Text4baby messages also connect women to prenatal and infant care services and other resources, if you need them.

Please tell everyone you know. Underserved, overserved, supersized or emphasized. This service is great for all moms!

And holds great promise of things to come. " Text4Baby demonstrates the ability of mobile phones to inform and engage people to help them live healthier lives. These same tools can be applied to many of America's big health care challenges, " said Paul Meyer, chairman and president of Voxiva, the mobile health platform provider for the service.

Here's hoping.

To make this amazing resource happen The National Healthy Mothers, Healthy Babies Coalition http://www.hmhb.org/ (I'm a big fan of their work) collaborated with White House Office of Science and Technology Policy, the Department of Health and Human Services and Department of Defense Military Health System. Johnson and Johnson is a major sponsor as is Johnson Baby. Then the wireless carriers joined the party and voluntarily agreed to distribute the text messages for free. (Participating carriers include: Alltel, Assurance Wireless, ATandT, Boost Mobile, Cellular South, Cellcom, Centennial Cellular, Cincinnati Bell, Metro PCS, N-Telos, Sprint Nextel, T-Mobile, U.S. Cellular, Verizon Wireless and Virgin Mobile USA--if you're carrier isn't on this list, switch now. It's a bad message (not text) to moms, if they didn't jump on this boat! )

There's a critical mission to be taken on to improve maternal health in this country. Infant mortality rates in the U.S. are embarrassing at best and abysmal in the African American community. And if a mobile phone, fax, wooden spoon or pot and pan can help. Then I'm all in.

ConTEXTually yours,

Kimberly

Vanity Fair's Cover Sends a Dangerous Message to Young Black Girls

I often find it stressful to see how the media stereotypes black women or how it sends subliminal yet painful messages to our children. I had this unsettling feeling recently when looking at the latest issue of Vanity Fair heralding the next generation of Hollywood starlets.

It was bad enough that they couldn't (or didn't try) to find at least one person of color to include in their annual "New Hollywood" spread in the March issue. They've been taking a little heat for this ridiculous oversight. What about Gabourey Sidibe from "Precious" and Zoe Saldana? Even as an Avatar, she was still in one of the highest grossing movies of the year. Or even Penelope Cruz.

I could have stomached the photo spread, I'm pretty much used to African Americans being excluded from mainstream Hollywood. But they really went too far with the descriptive language in the accompanying story with each waiflike actress getting her respective props for "downy-soft cheeks," a "button nose," "patrician looks and celebrated pedigree," "dewy, wide-eyed loveliness," or "Ivory-soap-girl features." Ivory soap-girl features???

But is this Vanity Fair's journalistic failure and bad PR problem (hitting the stands during Black History Month no less. The horror!!) or just an accurate depiction of hot Hollywood these days?

Either way, as a mom raising a daughter, it sends dangerous messaging to all girls in general and African American girls, in particular. We've often criticized the beauty industry for their unrealistic images of Barbie-like girls and women. We've told young girls they are beautiful as they are in all shapes, sizes, skin tones and features (ivory soap or not), but then stories like these show the reality of the world all of our girls are growing up in. And what a challenge we have as moms to counteract these influences to raise confident, self-assured black girls who love their bodies, their skin, their hair and everything in between.

Quite frankly, I'm no fan of Hollywood lately, anyway. And if Sandra Bullock wins an Oscar for The Blind Side, I will be on a very long personal boycott of the award show. I mean, yet another movie about a (albeit well intentioned) white woman saving a large, menacing in appearance, from the hood with nobody else, black person. This blog isn't long enough for me to list the stereotypes in that Hollywood gem (Or in movies like Dangerous minds, Freedom Writers, The Soloist. etc.). And this is Oscar-worthy movie making??

Puh-leeze.

Attention Hollywood: there a thousands of equally inspirational stories of African Americans saving themselves (gasp!) or white people too (double gasp!), but those don't get told because they don't fit into your stereotype of who we are.

But I digress. Slightly.

My point is Vanity Fair has a problem and Hollywood has an even bigger problem. When a major media outlet ignores its responsibility to represent all its readers and its messaging to the young girls who aspire to be in Vanity Fair (or Hollywood), that's just irresponsible journalism. Read: only "button noses" and ivory-soap girls need apply.

Hollywood on the other hand has a more deeply rooted issue that concerns me as mom. For years extremely talented black female actresses like Halle Berry, Regina King, Jada Pinkett Smith, Kerry Washington, Sanaa Lathan, Kimberly Elise, Nicole Ari Parker, Lynn Whitfield, Lela Rochon (I could do this for three more pages . . . ) have lamented the dearth of quality movie roles (no crackheads

please) available to black actresses. Meanwhile, Jennifer Aniston (no disrespect, I'm a huge fan Rachel)has played the same exact character 50 million times with no end in sight.

Thankfully, my own little black girl has not mentioned any dreams of a Hollywood career because, even in this "Yes We Can" era, I'd feel some parenting compulsion to say, "probably not, sweetie." I wish I didn't feel that way. But this very "fair" article only confirms my fears.

Unfortunately for us all, Vanity Fair did a great job of highlighting the inconvenient truth of exactly how Hollywood is. New or old. And I find that reality very, very stressful.

 

Black Motherhood: Celebrating Our History, Redefining Our Experience

February is all about reflecting on black history. As a mother, our black history is a tale of troubling beginnings followed by triumphant gains. Of course, I'll never forget the moment Michelle Obama became First Lady of the United States. She epitomizes everything modern black motherhood is about, career success, loving partnership, and commitment to being the mom-in-chief of your own family command center.

But getting to Michelle Obama has been a long and sometimes troubling journey. The black motherhood experience in this country had a painful start with lingering effects that still hover overhead today. First, let's go back. As enslaved black mothers we were viewed as breeders not humans and we had no control over our experience in motherhood or our children. As slaves, our children were ripped from our bosoms and sold as we stood helpless in despair.

"Labor of Love, Labor of Sorrow: Black Women, Work and the Family from Slavery to Present" by Jacqueline Jones http://www.amazon.com/Labor-Love-Sorrow-Slavery-Present/dp/0465037569 details how pregnant slaves were forced to lie face down in a specially dug impression in the ground when they were whipped. Perhaps in the demented mind of the slave owner, he was simultaneously protecting his economic investment in the fetus while still punishing the mother.

Our experience as black mothers was always laced with pain.

But we always wanted more for our children. And even as freed-men and -women, it was also clear that we saw the role of mother as tantamount to preserving our families, our communities and to the progression of the black race. Contrary to popular belief, we have a history of being thoughtful and resourceful about our duty and power as mothers.

Witness this excerpt from a speech by Frances Ellen Watkins Harper, a 19th century African American abolitionist, teacher, women's rights advocate, writer and poet. She spoke these words on November 15, 1892 in a speech called Enlightened Motherhood, an address to the Brooklyn Literary Society.

"The work of the mothers of our race is grandly constructive. It is for us to build above the wreck and ruin of the past more stately temples of thought and action. Some races have been overthrown, dashed in pieces, and destroyed; but today the world is needing, fainting, for something better than the results of arrogance, aggressiveness, and indomitable power. We need mothers who are capable of being character builders, patient, loving, strong, and true, whose homes will be uplifting power in the race. This is one of the greatest needs of the hour."

In 1902, the book Twentieth Century Negro Literature, included an essay on the responsibilities of educated black women on the black race written by Sarah Dudley Petty, a writer, teacher and preacher's wife. What were her thoughts on black motherhood?

"A faithful, virtuous and intelligent motherhood will elevate any people . . . True patriotism, obedience and respect for law, both divine and civil, the love and yearning for the pure, the sublime and the good, all emanate from mother's personality . . . I would urge then, as the first prerequisite for our work, a pure, pious and devoted motherhood."

Years later, our quest to define motherhood moved to the television screen. When I was growing up in the late 1970s and 1980s we looked to successful working women like Claire Huxtable on the Cosby Show and Vivian Banks on the Fresh Prince of Bel Air for a glimpse into what black motherhood looked like. Every Thursday night on television, Claire Huxtable, Esq, showed a generation of future lawyers, doctors and accountants that upwardly mobile black women could indeed have it all. We could raise five kids without a nanny, take care of a house, maintain a high-powered career, be adored by our husband and still look glamorous and sexy. Whether having it all is truly possible for any woman (white, black or green) is still debatable, but this was new territory for black women. For decades, this was something that only seemed possible for white women.

This black history month, I'm asking all black mothers to remember our history as women who carried our families and communities. Mothers who didn't listen when the world said we were thoughtless breeders and our children were mere commodities to be bought or sold. In more recent history black mothers have been publicly shamed as crack mothers, welfare queens, and the face of "baby mama drama." Black single motherhood is blamed for all sorts of social ills from crime to drugs to "wilding" teens. And black mothers are often represented in popular culture as neck-rolling domineering household managers who run circles around our men. Even the critically acclaimed movie, "Precious" has raised eyebrows for perpetuating ideas of black women as abusive mothers.

But I'm asking you to stay true to what you know: These stereotypes are very far from the truth. In truth, black women today have redefined black history and created a new conversation about our roles as mothers. For example, when I watched the Brady Bunch and Happy Days and reruns of Leave It To Beaver, the subtle messaging was that being a stay at home mom and catering to your child's every need was a white woman's pleasure. Black women have always worked--as slaves, as cleaners, as teachers, as doctors, as lawyers. Even our TV mamas (Claire Huxtable included) always worked.

Today more and more black women are stay at home moms (myself included), we have robust national organizations like Mocha Moms http://mochamoms.org/ to support women who are making motherhood their career (even if just for a few years or so).

This shift in our motherhood experience may seem subtle, but in the framework of our history, it is groundbreaking. And thrilling. It not only speaks to how far we have come as a people, but how far we have come as black mothers, who went from having no control over our children to taking control of our children, our lives, and our families' financial future. We now have varied and different motherhood experiences yet we still know we are doing important work that goes well beyond our home.

As we celebrate our history as black Americans, take a moment to reflect and celebrate your history as a black mother. Take a moment to celebrate you!

A Plus-Sized Problem: Black Women and Obesity

She enters the stage in a revolving pyramid and haze of smoke. Dressed in shiny gold wide-legged pants and a matching gold jacket, she confidently walks to center stage.

In a boisterous voice she calls for all the "fat girls" to stand up and take a bow. It's the beginning of a popular and very funny stand-up routine of Mo'Nique, Golden Globe winner and comedy star, a routine where she spends a lot of time making fun of skinny girls--I won't use her exact words in this family friendly blog.

Suffice to say, Mo'Nique made a name for herself in the stand up circles as the poster child of "big girls" and quickly became one of America's best-loved plus sized personalities. She even penned the New York Times bestselling book, "Skinny Women Are Evil: Notes of a Big Girl in a Small-Minded World," published by Simon and Schuster.

I gotta admit, watching her comedy clips on YouTube--the act is very funny. But really obesity is no laughing matter.

Now I know we've never entertained the same body image perspectives as white women. Our families are full of Big Mamas, robust Aunties and other big women who doled out good food and good love, both in earnest portions. And let's face it: Black men tend to like us with ample thighs and a little "junk in the trunk," as they say. Or as my Granny would say, "Don't nobody want a bone, but a dog."

But things are getting beyond a little healthy meat on the bones. Overweight and obesity has increased for all Americans across the board. It's no wonder, President Obama recently announced a new obesity reduction initiative to be spearheaded by First Lady Michelle Obama.

The problem is particularly pronounced in our community. Nearly 70 percent of African Americans are overweight compared to 62 percent of white Americans. Among black women the statistics are reveal a greater difference. About 78 percent of black women age 20-74 are overweight, compared to 57 percent of white women in that same age group. Fifteen percent of black women are classified as severely obese, compared to 5 percent of white women.

The culprits in our community are typical: poor dietary choices, lack of healthy or organic food options in many urban areas, lack of physical activity or exercise and our greater acceptance of larger body types.

The ramifications can't be ignored. In pregnancy, being overweight or obese can lead to pregnancy complications and a difficult labor and delivery. The risk of a pregnant woman of being hospitalized goes up four times if she's overweight.

The March of Dimes Task Force on Nutrition and Optimal Human Development presented a report indicating that women who are overweight or obese are 30 to 40 percent more likely to have a baby who has major birth defects such as those that affect the brain, heart, and digestive system. Among the most common obesity-related birth defects are neural tube defects, heart defects, and abdominal wall defects. Folic acid supplements, usually effective in preventing these conditions, may not be as protective in overweight women, according to some studies.

Beyond our babies, obesity often leads to heart disease and many other problems in black women. This is not about a number on the scale; it's about being healthy. It's time for big girls and skinny girls and everyone in between to come together for all girls.

Michelle Obama's Plan: Mothers Need Apply

Soy milk invaded my childhood at age 6 and not because I particularly preferred it. Rather my mom bought it, packed it in the fridge, and drank it. And because I adored and mimicked my mom, I drank soy milk with enthusiasm.

This past Tuesday, thoughts of soy milk and my mother came to mind as I attended Michelle Obama's White House kick-off of "Let's Move," her multi-year, multi-agency, and era-changing plan to fight childhood obesity in America.

It was my first time inside the White House and as soon as Michelle Obama walked out confident and beautiful, I realized that she could tell America to eat turnips and flax seed every morning and night and a good portion of people would follow suit.

Michelle Obama has that stunning package of qualities that my mother has. Fearless, authoritative, and caring, the mother-of-two and Harvard-trained lawyer can command many children and adults to follow her quest just by suggesting them. And like my mother, Michelle appears to walk on water.

Now, I believe it is that power for women and mothers to be role models that I think will amplify the goals of Obama's movement aimed to reverse the fact that young people, due to obesity-related disorders, might have a shorter life-span than their parents. A focus on women and mothers could turn Obama's national fitness movement into a penetrating cultural, psychological mandate.

Right now, Michelle Obama's plan combines major thrusts: moves to provide front-of-package nutrition labeling on food products and the elimination of food deserts in neighborhoods with no grocery stories; a policy to increase healthy meals in public schools; marketing and tools to spur athleticism in children and wellness decisions in families; and billions towards these goals over the next 10 years. Her vision, fortified by private and public support, is both necessary and impressive.

In addition, child's health foundations will come together to fund the Partnership for a Healthier America, which is a non-partisan convener of sectors and agencies supporting solving childhood obesity in 30 years. And President Barack Obama signed a Presidential Memorandum to launch the first Task Force for Childhood Obesity to review and create countrywide plans to employ federal resources to improve child nutrition and exercise.

Imploring Americans to read about what they eat, talk health with their circles, and see health as a self-esteem issue, Michelle Obama's plan is simply epic, a practical movement that could change everything.

Yet one thing I noticed about Michelle Obama's informative and passionate literature about the plan is that the words families and parents are preferred over women and mothers. It appears state and social forces will usher in this very crucial movement, when in fact, women and children are the exact linchpin. Many people like me, even with two active parents, draw a direct line of my eating and lifestyle experiences to my mother. While my father influenced my eating habits, healthy food practices were often implemented by my mother. Fathers can regulate the diet of children, but can they manage the lifestyle of mothers?

Still now, I don't understand the mechanism of vegetables and I can't explain the chemistry of pure hair oils. But I know that when I cook greens in too much oil, they don't taste as good as my mother's, and when I use olive oil on my hair instead of synthetic creams, my hair becomes shiny, beautiful, and strong as my mother's.

This relationship works in reverse. Four out of five African American women are obese, making us the most obese group of Americans. And the CDC finds that maternal pre-pregnancy obesity is associated with childhood obesity. Some of this explains why African American children between ages 6 and 17 are 1.3 times as likely to be overweight as their white peers and are at greater risk of diabetes, asthma and heart disease. A lot of the problem is, mother see, child do. Michelle Obama's campaign has the chance to embrace and nurture mothers in a huge, phenomenal way.

For years my mom was soy-minded, making as many trips to mainstream grocery stores as small health food shops. Her bookshelves were lined with alternative healthy living literature. When she was going to make a big change in her life, she meditated on it. And when she went vegetarian, she invited her children to join along.

Throughout the years, I adopted these habits, and not because I was a health guru like my mother, but because I absorbed them as a result of admiring my mother, my role model since the womb. Now I have a health propensity without thinking about it. And, some things are just wired. No matter where I am in the world, if I have even a cold, I call my mom first. How maternal health emerges in this vast obesity fight will be amazing to watch, and necessary to see.

-- Kimberly Seals Allers is on vacation this week. --

Intensely aware of what health care advocates gently refer to as "health disparities," members of state coalitions meeting over the weekend confessed that they were struggling to find a best strategy to promote breastfeeding among African-American mothers.

Studies to date indicate that African American mothers are least likely to breastfeed--even though they are more at risk for breast cancer, obesity and high blood pressure. In addition, they are more likely to give birth early and breast milk can literally save the lives of preemies in a way formula does not.

As more than 300 breastfeeding activists--physicians, nurses, lactation consultants, and health activists-- gathered in Arlington, Va. to expand the support for breastfeeding in hospitals, families, law and workplaces, the toughest question was how can we be more successful with African American mothers and mothers-to-be?

http://www.usbreastfeeding.org/

Part of my work at the conference was to discuss at a breakfast table how Women's eNews is changing the media narrative about African maternal and infant health. I talked about Women's eNews'Black Maternal Health project and the value of shifting breastfeeding news focused on babies to the lives of the mothers, particularly black mothers.

http://www.womensenews.org/story/090922/black-maternal-health-legacy-and-future

Black moms are three-to six times more likely to die during pregnancy and during the post-partum weeks and thus they are the face of our country's most acute maternal health problems. If the United States can mend poor health outcomes among black women and their infants, certainly the entire health care system will benefit.

But confronting the reality of black maternal health and breastfeeding at the conference is not so easy.

"Nooo," said Lorine Bizzell, a regional nutritionist with the United States Department of Agriculture, in Atlanta. That was her response when I asked for her input on the fact that that college-educated black women breastfeed less than low-income moms, teen moms, and moms with only 12 years of schooling.

http://www.womensenews.org/story/black-maternal-health/090922/breastfeeding-not-you-sisters-listen

"That's hard to believe. Young black career women that I know are all nursing their children under a variety of challenging circumstances."

Laura Sinai is a North Carolina-based pediatrician. She works in a private practice outside Charlotte and a third of her clients are black. Talking to black mothers about breastfeeding has been difficult. "They just say, 'You don't know my life. I will not breastfeed.'"

Melissa Bartick, a physician with the Massachusetts Breastfeeding Coalition, spearheads efforts for hospitals in the state to become Baby Friendly, an award given for prioritizing breastfeeding in maternity wards and backed by the World Health Organization.

After I asked Bartick how she's targeting black mothers, she took a deep breath and said: "Yes, there are disparities. They do exist."

"Where do I find black women who want to be lactation consultants?" said Anna Uttar, the regional director of the International Board of Lactation Consultant Examiners in Falls Church, Virginia. "They are not coming out to get trained."

As the conference was coming to an end, I was starting to worry that the question of how to increase breastfeeding among black mothers was left hanging, like a great news story unpublished.

Right as I gathered my bags and headed out the conference hall, Napiera Loveless approached me.

She is co-founder of MamaTotoMatema, a Cincinnati agency urging breastfeeding among African-American families. We got to talking and laughing and sharing how we wished the conference had a dance party.

http://www.mamatotomatema.com/

Loveless told me about how she reports to black women and activates their interest. Immediately I realized she should have been a keynote speaker; she was a guru of connecting ideas to messages, to challenges.

When talking to low-income black women, Loveless appeals to fashion. Many young black women like the bling, she said. The shiny things. The nice clothes. "I tell some mothers, 'You know how you like your Dereon jeans and Gucci? Well breast milk is the name-brand jeans. Formula is the rip-off!'"

When talking to upper-income black women, Loveless said that family support systems may be lacking. Many families look to a high-earning black woman for financial and emotional support, so a lot is riding on her shoulders.

"I want to find out who their support system is," she said. "It might be her best friend or her co-worker. Can your co-worker help you on the job? Watch your work while you get a chance to pump?"

She said her strategy is gaining effect in Ohio.

As I left the Third National Conference of State/Territory/Tribal Breastfeeding Coalitions, my heart was warmed by Loveless, and the many leaders talking about black maternal health. My mind was racing.

There is always a way to get through.

Malena Amusa is a reporter living in New York City.