Bringing up baby

Sydia Alexander sits on her living room floor, surrounded by a bassinet, stroller and infant carrier -- equipment to help her raise the baby girl she hadn't planned.

Perhaps the most important tool is sitting on a Winnie the Pooh blanket beside her.

Tammy Richardson is a nurse who regularly visits Alexander and baby Siyana in their home. She's been coming since Alexander was 15 weeks pregnant and will continue until the infant is 2 years old.

Richardson has taught Alexander everything from proper nutrition during pregnancy to the importance of interacting with her baby. She has answered the 19-year-old's phone calls and text messages about major concerns such as contractions, and smaller ones such as the dander in her baby's hair.

"Honestly in my situation, Tammy is a very big support," Alexander says. "I have my family, don't get me wrong, but the way I feel and with what's going on now, I only really feel like I have my baby, her daddy and Ms. Tammy."

The women are part of the Nurse-Family Partnership, a nationwide program run locally by the S.C. Department of Health and Environmental Control. The partnership pairs registered nurses with low-income, first-time mothers for home visits from pregnancy until the child turns 2. Mothers voluntarily enroll in the free program, which became available in the Lowcountry in August.

Looking to expand

Currently serving 70 families, the program could expand if it receives a chunk of the $1.5 billion appropriated for such programs by the Patient Protection and Affordable Care Act.

In addition to allowing more families to be served, the funding could create new jobs for nurses and benefit the community economically.

The act's home-visitation grant provision appropriates $1.5 billion over five years to states to provide such programs. States must meet certain benchmarks over time with families enrolled in the programs, such as improving school readiness and economic sufficiency and reducing child abuse and juvenile delinquency.

David Olds is certain the program can deliver those results.

He created the Nurse-Family Partnership in 1977 after working as a day-care teacher in inner-city Baltimore.

"I realized after working in this center for a while that a lot of the children had been abused or been exposed to substances during pregnancy, and I felt that we needed to start earlier and do a better job of helping parents care competently for themselves and their young children."

Olds, now a professor of pediatrics at the University of Colorado-Denver, has led the research on the partnership over the past 30 years.

Studies of participants across the nation have shown that the program improved prenatal health, including cutting down on the use of tobacco, reducing hypertension disorders in pregnancy and improving diets. The partnership has improved children's school readiness, specifically in language functioning and early academic achievement, Olds says.

It also reduces injuries to children, the leading cause of their deaths in the U.S. Recently, The Lancet medical journal identified the Nurse-Family Partnership as having the strongest evidence of preventing child abuse and neglect of any program in the world.

Families that are visited become more economically self-sufficient with increases in employment and reduction in the use of welfare, Olds says. He thinks this is the result of the nurses helping young mothers and fathers start to imagine the kind of life they want for themselves and their babies.

Research by the Washington State Institute for Public Policy and the RAND Corp. have estimated that every dollar invested in Nurse-Family Partnership can yield more than $5 in return.

The results

In South Carolina, the program is offered in nine counties.

Victoria Manigault, nurse supervisor for the Charleston, Berkeley, Dorchester Nurse Family Partnership, is pleased that the program is available here.

"It's an evidence-based program that's been in existence for 30-plus years, and we know that it works," she said.

Alexander learned about the program from a flier, which suggested the opportunity to have a healthy baby.

"I just thought I would give it a try because me being a first (time) mom, I just wanted all the help I could get."

The new mother said she was inclined to put Siyana to sleep on her stomach, but then she learned from Richardson about sudden infant death syndrome and the importance of putting babies on their backs.

She learned about "tummy time," and now lays Siyana on her stomach when she's awake to strengthen her neck muscles and develop her motor skills.

She also received support with breast-feeding, which she had several questions and concerns about after coming home from the hospital. She hopes to breast-feed until Siyana is a year old.

Alexander also hopes to start school in May to become a medical assistant.

The program aims to help clients reach the goals they made before getting pregnant, Manigault said.

Mentor, cheerleader

Before joining the Nurse-Family Partnership, Richardson was the nurse manager at an OB-GYN office and prior to that, a labor-and-delivery nurse.

She said those jobs made her realize that the time and education offered to mothers, especially first-time mothers, is insufficient. Pregnancies and babies don't come with instruction manuals, and doctor's offices aren't open 24 hours a day, she said.

"I like the thought of having that person that could kind of be the liaison, that could be your mentor, that could be your cheerleader, that could answer all the questions you have," Richardson said regarding her interest in the partnership. "I've seen many not-so-great things happen in the hospital setting and the office setting because of that lack of communication between a client and a medical professional."

Richardson said she thinks all 23 of her clients want their children to be educated, healthy and happy.

"They all want better for their children than maybe what they were exposed to or their families were exposed to," Richardson said. "I think it's just a matter of learning how to do it."

Reach Kristen Hankla at 937-5548 or khankla@postandcourier.com.