 Aloha, and welcome to Aloha United We Stand at Think Tech Hawaii, raising public awareness for issues here in Hawaii. And I'm joined here, I'm Chris Aguinaldo, joined here by Lisa Kingura of Healthy Mothers, Healthy Babies Coalition of Hawaii. And just a reminder, you can join the conversation at Think Tech, Think Tech H.I., we'll take your questions, and we'll have a conversation about Hawaii's mothers' health, issues related to their health, and things that they're doing to help make sure that we have healthy keiki here in Hawaii. Hello, Lisa, how are you today? Hi, great, how are you? You are with the Healthy Mothers, Healthy Babies Coalition of Hawaii, is it the local affiliate of a national organization? We are, yes. So the National Healthy Mothers, Healthy Babies was actually formed in 1981 out of the Surgeon General's call to health to reduce infant mortality. So local coalitions such as Hawaii were formed later to address local issues on a statewide level. When did that start here in Hawaii? Next year will be 25 years for us. 25 years? Yes, it's been a long time, and we've really evolved through the years to address the issues that are arising and the needs that present themselves at the time. And what are the types of issues that you folks have been dealing with for nearly 25 years? What are the most important, what are the most things, what are the things that seem to be the most important that folks don't really think about that you're working on right now? Yes, some things always remain the same, and then some things sort of have priority focus as times change. So above all, we always want to make sure that we are reducing both maternal and infant mortality. And there's a lot of ways to address that. So starting with making sure that women are entering pregnancy healthy, wanting to get pregnant and ready to get pregnant, and then making sure that throughout the way they have adequate prenatal care, that they are not smoking, using alcohol or other substances during pregnancy, and then also choosing to make healthy choices such as breastfeeding, understanding what infant care and infant health and safety is all about, and getting access to services and support to help them make good decisions. Now here in Hawaii, Lisa, are there any particular challenges or anything in particular with our stage, our home, that you keep your eyes on? Yeah, a big thing that's really unique to Hawaii is the disparity geographically for us. So not only do different islands have very disparate access to services, but just getting, for example, to Oahu for specialized services can be extremely costly or an extreme hardship on the family. For example, if a woman is high risk and she's flown to Oahu to deliver her baby, and the baby needs to stay here for longer in the NICU, a lot of times moms either have, you know, other kids they have to get back home to or jobs they need to return to, so they need to travel back, and it creates a lot of, a lot of hardship for people. And do you have programs that help address those needs, things that you specifically talked to, like the neighbor island communities with? Yeah, we are part of the Hawaii Maternal and Infant Health Collaborative, which is a statewide public-private partnership. So we work with Department of Health, we work with the birthing hospitals, we work with other non-profits like March of Dimes, and we all work together to address these issues. So first of all, at a systemic level, we look at what's going on, where these issues are taking place, little interventions that can be made to help improve outcomes, and then when it comes to moms actually giving birth, we have our Healthy Mother's Healthy Babies offers a Mother's Care telephone line, which is a confidential hotline. People can call and ask questions and get referrals to services. So for example, if they are here and they need extra support during a really difficult time, or need any help getting established breastfeeding or things like that, they can call us and get the support or we can refer them out. Elisa, you had mentioned it's a confidential line. Why is it important that it's specifically up for confidential? You know, a lot of people struggle, everybody struggles when they give birth, and it's a very hard time all the way around. And some people don't realize that it is something that's very, it's not unique to them, that it's a very common issue. And so knowing that we support them, that we're not judging them, and we're not releasing their information makes them feel safe and secure in talking to us about it. That seems very important because the connection with mothers and their children, it's a very intimate, it's a very basic connection. And if someone is going through it the very first time, if it's something that they've not experienced, you want to feel that safety, is that something that you folks are offering? That safety, that compassion, that hearing ear? Definitely. And we do work so closely with so many other organizations that are offering sort of wraparound services that we can get them in touch. So for example, if they're struggling with postpartum depression, which is a significant issue. And a lot of people, I mean, it's a great example of people feel very, very alone, they feel very ashamed to talk about it. But it affects up to 20% of moms. 20%? Yeah. And even higher when it comes to people who are already low socioeconomic levels, significant hardship or strife in their life when it comes to economic or domestic violence or things like that, the rates of postpartum depression are even much, much higher. So we want to make sure that moms know that it is common and that it's not something to be ashamed of and that there is help available. Does it make a difference when there's accessibility? I think over the years, because of the advent of the social channels, these web pages, people can talk about it more. But having you folks around that, you're able to pull up the phone or send a message and have that confidential. What kind of reductions have you seen? Or how are these women who are dealing with postpartum depression? How are they dealing with it now that there's resources with you and you're partnering with organizations? I would say for one thing, just knowing that there's support is very helpful to people because they do feel very alone. And knowing that there's someone that's going to listen and not going to judge them and get them in touch is important. Sometimes it's really as simple as the fact that they may have had, sometimes there's a lot of issues and it's not fully understood as to why some people are triggered more than others. But sometimes it's a matter of hormones being out of balance. So getting your physical symptoms addressed in terms of it could be thyroid issues, it could be a lot of things, or it could be just honestly needing some extra sleep and resting carefully yourself. All of those things can really help diminish the symptoms. And depending on the severity of it, we advise women to right away, go get a color OB, get an appointment, get their blood work done, find out if there's any underlying things going on. If so, we can address those physical things before we even take the next step in terms of counseling or therapy or even for some women. Sometimes pharmaceutical drugs are helpful for them too. What other programs would you like to talk about that are similar or things that our audience might not be aware of? We have a program called Cribs for Kids and it's a statewide program. We're on every single island now. And it's a program that's designed to reduce the rate of infant deaths. And what most people are very surprised to learn is that the most common cause of accidental death of an infant is sleep related. And so a lot of times people worry about their car seat or they worry about lots of other things. But the reality is having your baby in an unsafe position, having your baby in bed with pillows and blankets or other siblings or pets or sleeping on couches with lots of cushy crevices. All of those things are very, very hazardous to baby and we have about a death every other week in Hawaii. The death every other week, how has that been over the last few years? Are we improving? Is it going in the direction we want to go in? Sad to say, well, about 20 years ago the recommendation was made to place babies to sleep on their backs. And so we still maintain that recommendation that babies even for naps should always be put to sleep on their back. Once that recommendation was made, the number of deaths decreased by about half, which is significant. However, that number has stayed pretty static since then. So we'll have some dips and some ebbs and flows, but ultimately we haven't reduced it further. And we know that these deaths are preventable and we know that it's preventable through education and through having the proper setup safely for baby. And so that's what our program aims to do. We work with our health center partners to refer their patients and their clients. They come to us and if they are eligible, income eligible, they take the class, which is about an hour long. They learn kind of everything you need to know to help keep babies safe. And then they get to take home a pack and play crib so that they have a safe designated place for the baby. You could put it right next to the bed so mom can breastfeed, put them back to sleep, and everybody knows what to do safely for baby. Now you had mentioned income eligible. Is this specifically targeted at any socioeconomic group, any particular group here in Hawaii? Because we do have a multicultural environment and various ethnicities here. I'm asking if this particular risk is specific to any culture. Is it widespread? Does it affect one more than the other? So interestingly, it does affect everybody across the board. However, we do see a greater proportion of the deaths that are born to moms that are low income or low education or certain ethnic groups. So we specifically do target those just because we know that the incidence is higher. There's a lot of other factors for why that might be, but we also know that babies that are in homes that are not breastfed and are also exposed to smoking are at a much, much higher risk. Not only of sleep related death, but SIDS, which is sudden infant death syndrome. It's slightly more mysterious disease. There's no clear cause of death exactly. However, after an autopsy is done, if no other cause of death is determined, it's attributed to SIDS. And so we know that babies that are exposed to the smoking and babies that are not getting breast milk have a much higher risk. So we've talked a lot about the mothers. Since we're talking about babies now, you have mentioned that what breastfeeding, better nutrition, and having a smoke free environment. Let's talk about the first one last month, which was August. Was it National Breastfeeding Month? Yep, and then the first week is World Breastfeeding Week. And so it's really a special focus on making sure that women are getting information, hospitals are providing a good start for babies. They're getting moms educated on a successful start to breastfeeding. And that basically from pregnancy beyond that women are getting the support that they need to be successful. We like to say that we are in an enlightened, progressive society. Is there still any things that are culturally related? Or just to have a month to have an awareness month? Or what are the things that we have to address about just talking like you and I are normally about breastfeeding? Yeah, I think it's important for women to know that it is the natural normal choice, that it's something that it's not like the gold star extra. It is normal. And so anything that is not breast milk is not the norm. And that's kind of a shift in thinking for people because we do know how exceptionally important it is to build baby's immune system and build baby's brain power. And even for mom, it reduces her risk of ovarian cancer and breast cancer, helps her uterus contract and recover from childbirth faster. So we're not just talking about making the child's health better. The mom is actually benefiting at the same time. And every single month that she continues to breastfeed reduces her risk, her lifetime risk of breast cancer. So it's really significant. Does it make any difference? Is there, have we seen like evidence that shows that? Yeah, there's plenty of evidence. In fact, this chart right here kind of shows that formula and it is life saving for babies that don't have the option to breastfeed. However, there are so many things that cannot ever possibly be replicated in a laboratory. So it's here, antibodies, hormones, anti-virus, anti-allergy. So mother nature has already programmed us with those things and we don't have to go out and buy them. Right, and what's amazing about breast milk is it's constantly changing. So the composition of your individual milk is specific to your individual baby. And it will continue to change as your baby grows. So when your baby is first born, it is packed full of everything that they need to grow really quickly the first month and basically gives them all the antibody protection that they need to come fresh into this world with a brand new immune system. So are part of your programs to educate more about that? Absolutely. What are the resources available that you provide or your partners provide? So for one thing, our mother's care line, we are staffed to be able to provide lactation assistance to them over the phone. And if they do need anything, a lot of times we can answer the majority of questions or concerns that they have. Women sometimes want to know that they're going back to work and baby won't take a bottle and what do they do and things like that or how to get more support at home. Cuz the truth is if you were not breastfed yourself, your parents don't understand necessarily and they may support it but don't know how to support it. So just getting that, knowing how you can support a mom is an important part of the whole equation. And so we help families to understand how they can support. It's as simple as dads want to be involved but obviously they can't breastfeed. They want to support mom cuz she's tired at night but there's other things you can do like bring her a snack or some water or put some pillows under her arms so she can be comfortable. Can we talk about dads? Yeah. Okay, let's talk about dads and other family members. You're not raising a baby by yourself. We're gonna take a little break right now and you can learn more about what we do here at Think Tech in Hawaii. And remember, you can join the conversation, hit us up on Twitter, at Think Tech HI. And you can also tweet me at Chris Aguinaldo right over here. Thank you. Aloha, my name is Josh Green. I serve as Senator from the Big Island on the Kona side and I'm also an emergency room physician. My program here on Think Tech is called Healthcare in Hawaii. I'll have guests that should be interesting to you twice a month. We'll talk about issues that range from mental health care to drug addiction to our health care system and any challenges that we face here in Hawaii. We hope you'll join us. Again, thanks for supporting Think Tech. For a very healthy summer, watch Viva Hawaii. We're giving you the best tips and with our best health coach here. So Viva health coach. Viva la comida saludable. Aloha, I'm Chantel Seville, host of the Savvy Chick Show on Think Tech Hawaii. This show is for you. It's all about inspiring and empowering girls of the future to do what they love, get out there and be healthy, fit and confident. If you're up for that, 11 AM every Wednesday, I'll see you there. Welcome back. I'm talking to Lisa Kumar, Executive Director of Healthy Mothers, Healthy Babies Coalition of Hawaii. I'm Chris Aguinaldo. And just before the break, we just started talking about dads, but let's also talk about family members too. And what we're talking about is how a healthy baby, you need a healthy mom, but a healthy mom also needs a healthy family, a healthy Ohana, a healthy group around them to help raise this kid and the other kids. And you were mentioning dads can be involved in the process, breastfeeding, I can imagine quitting smoking is a good thing. Dad's like throwing out their cigarettes, other kids, the other members of the Ohana coming together. But what's the role that dads can play? Or in other families, two moms can play, grandma or a life partner can play. So again, you had mentioned earlier, they are not alone. Yeah, yeah. Yeah, everybody plays a part. And when it comes to mom and dad, they've both worked to bring this baby into the world, and so they do both have parts to play, even though they might be a little more unique in their roles. So things that they can do for mom, make sure she's eating nice, healthy, regular meals so that she's especially iron-rich foods. Because after a childbirth, very important to replenish your iron stores. And it also helps mom with energy levels. And making sure a whole baby, some mom can take a nap or get a shower, things like that that just do enormous things for your physical sense of comfort. So dads don't be afraid, or partners don't be afraid to hold the baby. Yeah, exactly. Takeover diaper changes. There are lots of other things that you can do. You know, just doing the laundry so that mom can focus 100% on just recovering her body from childbirth, but also helping this little baby grow, because that is her number one job. Oh yeah, and they don't call it labor for nothing. Exactly, it's very laborious. And how about friends? Other moms, a grandmother and aunt, what role can they play, your friends? Yeah, absolutely. I mean, I always say that finding a support network, when it comes to breastfeeding moms, it's so important for them to have friends that have breastfed and can offer the support and reassurance, and not to turn her off or dissuade her when it's getting hard, because sometimes it is hard, and a lot of people do struggle, but getting through that, it's so worth it afterwards. How about socially too? We had mentioned a little bit earlier, they might feel some sense of either isolation or they just need someone to talk to. How about having a network of friends to hang out with and just be a person? How important is it to be still a woman, the role beyond just being a mom and a woman? Right, and I hear from moms that suffer from post-partum depression, that they feel like they've lost themselves and they'll never be themselves again. And so maintaining that sense of self is really important, and it's not something that's really talked about very much. And giving a mom time to herself, whether it's reading a book or whether it's taking a bath or whether it's going to a movie with friends, having people to talk to and having your life that's still central to you is very, very important. And moms will find too that their circle of friends change after they give birth. If they don't have friends that have babies, you're kind of walking a different life now. And so finding- You need people to feel like you belong with. Absolutely, absolutely. Who understand, who can talk you through, who can hold you up when you're struggling. Now, I understand next month you're gonna have an event where you could get a handful of your girlfriends together and have fun. Can you let us know about it, please? So there's a place called Painting with a Twist on Ward Avenue, and we're gonna be having a mom's night out paint night that night. And it's a fundraiser, they're gonna donate half of the proceeds to us, which is very generous of them. And so we're just inviting moms and their friends to come, enjoy a night where it's, you know, there's a professional who's teaching you how to paint on the canvas. If you have an artist, you don't have to be a super fantastic, you can come and learn and just have fun. Yep, you don't need any of your own artistic skills, per se, but it's just a lot of fun. We'll have snacks and wine available. So it'll be fun and $45, which is the normal price, but again, half of the proceeds are donated. And who's doing this with you again? Painting with a Twist. Painting with a Twist, and this is October 6th. What time is it? Seven o'clock. And you can go to hb-hawaii.org for more information, right? Yeah. I'll also put some information on my Twitter. You can check a little later, but I'll put a link to your page on my account at chrisaginaldo. Again, we're talking about just having friends there, whether or not it's at mom's night out, where you paint on October 6th, or just being able to hang out. And I think what we talked about earlier, if the dad or the partner can hold a baby for maybe 30 minutes more, let the new mom get out and just be a human being again, is that, that's critical, right? It is critical, and it's also important for dads because they need the time to bond too. And the more comfortable they are with baby, the more comfortable a baby is with them. And the more natural it's going to be for them to become, to assume their role as caregiver. It's, dads are just as capable as moms are when it comes to that sort of thing, but a lot of times they may not have had the experience before, and it's a whole new world. New mom, new dad. When you hold your community events, do dads pop in and ask questions? Well, what are their typical questions? It depends a lot. And I love when dads do come because a lot of times they're not shy about asking questions. They don't really have the reservations that sometimes moms do. And I guess, sometimes it's because they've let their guard down and they just say, hey, I have no idea, so just tell me everything. And I'm happy to, I love talking to parents and I love, I have three kids of my own and it's really my passion in life. Well, how old are they? Nine, four and two. Okay, so you've got the whole bunch of elementary all the way down to... Free school, yeah. Is that something that attracted you to being part of this effort? What's your history with the coalition? Yeah, so I, after I had my second child, I mean, I really knew that my focus needed to change because I felt very strongly that the experience that I had been through was not unique in any way and was something that needed, we need more support for moms and we need to make sure that moms are getting all the education that they need and deserve during pregnancy and childbirth, that they have advocates on their side to make sure that the support is there for them. And I wanted to put my heart into that. And so I really kind of switched the career path that I was on to enter into this role and it's been the best decision I ever made. It's great to hear and it's good to hear that not only dads but mothers feel comfortable speaking to your organization, your representatives. What's your staffing like and what kind of worker are they doing right now? So we've actually grown quite a bit. So we have a staff of seven, which includes a couple of part-time people and they're working on a variety of things. So our Text for Baby program is one program that we have. What's that? It is actually a really great program, not only for moms and dads, but also grandparents and anybody who's taking care of baby. It's a free text message program that sends three messages a week every week of pregnancy all the way up until baby turns one. And it tells you what to expect, what the development looks like in the baby, what to ask the doctor about, warning signs. And you get the text messages, you can also download the app, which is a free app and it'll show you, for example, this week of pregnancy, baby's the size of an eggplant or whatever. And it's just a really great way to know what's going on and have very qualified information telling you every step of the way. And this app is available on iOS, Android, the major platforms? Yep, yep, free download. How's the response been for that? Really good. So nationally, Healthy Mothers, Healthy Babies rolled it out about six years ago. And nationally, we've hit a million moms that are enrolled, which is fantastic. And in Hawaii, we've had a few thousand and we're really trying to grow that number a lot more. We really do specifically focus on moms that are low income or low education or have less access to services. Just so, again, we have qualified information coming to her and her family at very regular intervals. In addition to Moms Night Out, what else is your staff attending? I know there are some workshops throughout the year. Anything else coming up besides Moms Night Out again October 6th? Yeah, yeah. Anything else? Yeah, we do have workshops throughout the year. What kind? We'll do stuff like we had a series that was all about preparation for parenthood and it was kind of a holistic, not only what you need to know about infant safety kind of stuff, but also the emotional changes that take place. Because I do believe very strongly that to be the best, in the best place you can be, in the best parent you can be, it is not only your physical needs being met, but also emotional, spiritual kind of needs as well that are being addressed. And so that series that we had was all about addressing those types of things and getting comfortable in yourself to be comfortable with baby. We also have workshops on breastfeeding and then we do our safe sleep classes. The classes themselves, the people want the education, it's open to anybody. However, for the free cribs, those come from referrals from our partners. All right. And you had mentioned there's a presence on all the islands, is that correct? How often are you doing outreach on the neighbor islands? Yeah, we have classes every month throughout the islands and so obviously there's fewer people on some of the neighbor islands so we have fewer people participating. But when we go, we do talk about the safe sleep, we also talk about cribs for kids. And then we talk about a program that's called the period of purple crying. And this came out of Kapilani Hospital and it's about preventing shaken baby syndrome, which is what happens when parents get overly frustrated or just don't know how to handle, they might shake their baby out of frustration and it causes brain damage, it causes bleeding in the brain, it causes lifelong profound disabilities. I remember there used to be a campaign against it. I haven't heard of SIDS in a very long time. Is it making a comeback or has it always been there? It's one of those things that sometimes is misunderstood or misrepresented. So even the way that we classify our infant deaths can be kind of ambiguous. If a baby for example is lying in bed with the parents and suffocates in the pills and blankets, it's truly a suffocation death, but sometimes they may be misclassified as SIDS. So therefore sometimes people have questions about how the data is really recorded. And again, SIDS, it's not an extremely prevalent affliction, but it does happen. And when it does happen, parents really blame themselves because they just wonder what happened and how could I prevent this and it's such a traumatic experience for people. But I have talked to moms that it's happened to and it's heartbreaking. Now is it similar to what we talked earlier about more of those who are underprivileged, those who are more of the lower income or any cultural markers on that? Yeah, again, there is definitely a very clear, the data does show that tends to be moms that are of low income status. However, it does happen to everybody. It doesn't, it's not specific, but it is very specific when it comes to smoking and breastfeeding. Those are things that we know the breastfeeding protects and the smoking is really, really a risk factor. All right, Lisa, it sounds like you folks are doing a lot of work. They can go to your website to find out more and don't forget, there is an October 6, mom's night out, where is it again? Painting with a twist on Ward Avenue. So check it out at hmhb-whi.org and you are watching Think Tech Hawaii. You're watching Aloha United We Stand. I'm Chris Agyanaldo. I was joined here by Lisa Kimura, again the executive director of Healthy Mothers, Healthy Babies Coalition of Hawaii. I wanna thank you so much for talking with us and keep tuning in at Think Tech HI. Don't forget to tweet us and we'll see you later. Thank you, Aloha.