Tarrant County Maternal and Infant Health Update

Kristin McElroy, MPH
Maternal Child Health Epidemiologist, Tarrant County Public Health

Bridging Community Connections through Count the Kicks: Enhancing Prenatal Care with Digital Health Solutions

Megan Aucutt
Program Director, Healthy Birth Day, Inc.

Sarah Hybels
Program and Product Administrator, Healthy Birth Day, Inc.

Fetal movement monitoring is a critical aspect of prenatal care, offering early indications of fetal distress. Count the Kicks, a digital health solution, provides expectant mothers with an accessible and user-friendly tool for tracking fetal movements. This presentation explores how Count the Kicks not only enhances prenatal care but also bridges gaps within the community by fostering connections among healthcare providers, expectant mothers, and community organizations. AWHONN released a 2024 practice brief on decreased fetal movement, highlighting how teaching expectant parents to recognize changes in fetal movement can improve both maternal and fetal outcomes. 

Count the Kicks is more than a digital tool; it is a catalyst for community building and enhanced prenatal care. By empowering expectant mothers to monitor fetal movements and fostering a collaborative environment among stakeholders, Count the Kicks bridges critical gaps in prenatal healthcare. This presentation underscores the importance of integrating digital health solutions into community health practices and highlights the potential for similar initiatives to improve maternal and fetal health outcomes globally.

1. Discuss the importance of fetal movement monitoring.
2. Describe the significance of tracking fetal movements in assessing fetal well-being.
3. Identify the benefits of early detection of potential fetal distress through movement monitoring.
4. Demonstrate the Count the Kicks app.
5. Explain the features and functionalities of the Count the Kicks app.
6. Discuss the advantages of using the app over traditional methods of fetal movement monitoring.
7. Promote consistent monitoring practices.
8. Review the importance of regular and consistent monitoring of fetal movements.

Maternal Mental Health

Mehreen Khan, MD, MHA
Consultation-Liaison Psychiatry and Women's Mental Health, JPS Health Network

Maternal mental health conditions are the most common complications of pregnancy and childbirth. They affect 1 in 5 perinatal women and are the leading underlying cause of pregnancy-related death in the United States. Women who get treatment can and do recover.

1. Review maternal mental health conditions and their prevalence rates.
2. Explain the importance of early detection and intervention in improving outcomes.
3. Identify risk factors associated with mental health conditions.
4. Identify strategies for integrating maternal mental health discussions into routine care.

Lunch   

Nature’s Perfect Match: Human Milk for Human Babies

Shaina Starks, MPH, CPH
Executive Director of Mothers’ Milk Bank of North Texas 

Valencia Moore BSN, IBCLC
Lactation Consultant Team Lead, John Peter Smith Hospital

The American Academy of Pediatrics recommends exclusive breastfeeding for the first six months and continued breastfeeding until two years or beyond, and that premature and low birthweight infants be fed donor human milk in the absence of the mother's own milk, for the best health outcomes. However, only 24% of Texas infants are breastfed exclusively for six months, which falls well short of the Healthy People 2030 42.45% goal. CDC surveillance on breastfeeding also found that 19.8% of breastfed infants in Texas are supplemented with formula before hospital discharge. Supplementation with a human milk substitute has been associated with a more than 2-fold increase in breastfeeding cessation and is negatively associated with achieving breastfeeding goals.

Educating healthcare workers is essential to supporting mothers in establishing breastfeeding and achieving infant recommendations. However, gaps in healthcare worker education programs are prevalent, and many healthcare workers report receiving no formal breastfeeding education. Additionally, if the healthcare worker does not work at a hospital with the Baby-Friendly Designation, where training is required, they are far less likely to use evidence-based practices for breastfeeding support. As a result, healthcare workers often lack the effective communication skills necessary to counsel mothers on breastfeeding initiation, troubleshooting common problems, and providing emotional support; have gaps in their understanding of the latest research and evidence-based practices regarding breastfeeding; are not equipped to address the full range of breastfeeding challenges that mothers face, or may fail to intervene early enough; and can too quickly introduce formula rather than emphasize breastfeeding. Comprehensive training and education that address evidence-based breastfeeding techniques and counseling practices can lead to more consistent, supportive, and effective breastfeeding education and care, ultimately improving breastfeeding outcomes and maternal-infant health.

This session will cover infant feeding recommendations, the composition of human milk, the benefits and infant health outcomes of an exclusive human milk diet, how to identify potential interactions between prescribed medications and breastfeeding, and best practices for supplementation when a mother's own milk is not available.

1. Describe three benefits of breastfeeding for both the mother and the infant.
2. Identify at least three barriers to breastfeeding.
3. Counsel mothers about the benefits of breastfeeding.
4. Recall how to access information on medications and breastfeeding.
5. Identify at least three key roles that healthcare workers play in supporting breastfeeding.

Safe Infant Sleep

Isel Collazo, MSW, CPST
Pregnancy Risk Reduction Program Case Manager/Health Educator, Tarrant County Public Health

Donna Hilderbrand, MD, MSPH, PhD
Medical Director Neonatology, Wellpoint/Elevance Health

Safe infant sleep is a national and state public health priority. "In 2022, about 3,700 infants died from sleep-related death in the United States.” The topic of safe infant sleep is complex and nuanced, underscoring the importance of consistent messaging that goes beyond campaign slogans. Providing information on risk reduction strategies alone will not improve outcomes. Conversations that include real solutions tailored to meet the needs of parents and everyone caring for infants offer a comprehensive approach to saving infant lives. This CME activity will give providers resources to have these conversations with patients.

1. Describe evidence-based recommendations for parents and caregivers that reduce the risk of infant sleep-related deaths.
2. Demonstrate culturally supportive conversations to promote safe sleep screening and caregiver knowledge of safe infant sleep practices.
3. Model the use of Let’s Talk - Safe Infant Sleep toolkit resources.
4. Identify resources available to share with your community.

Congenital Syphilis in Texas

Amy Carter
Congenital Syphilis Coordinator, Texas Department of State Health Services

Nationally, Congenital Syphilis (CS) case rates have risen annually since 2013. Historically, Texas has reported high rates of CS compared to other states. CS increased approximately 148 percent from 2018 to 2022.

1. Define acquired and congenital syphilis.
2. Describe congenital syphilis in terms of surveillance classifications.
3. Describe congenital syphilis symptoms.
4. Define adequate treatment for acquired syphilis and congenital syphilis.
5. Describe common barriers to care and missed opportunities for preventing congenital syphilis.
6. Identify how to get involved in preventing CS births in Tarrant County.