FORT MEADE, Md. (Aug. 24, 2015) — Most parents, young or old, new or experienced, recall them with a haze of exhaustion-induced nostalgia: the precious days, weeks and months after they brought home that fragile, squalling, mysterious being known as a newborn.
But in between the snuggles and the tiny fingers and the magic of first smiles, there are countless diaper changes and endless nights, unending crying jags and rivers of body fluids. There’s love and helplessness, euphoria and anxiety (and sometimes crushing depression).
For every parent who bonds effortlessly, there’s one who struggles. For every infant who settles into an easy routine, there’s one who has colic or reflux or something much, much worse. And in those dark, lonely hours of the night, in between frantic Internet searches asking “is this normal?” many mothers and fathers would give anything to have someone to turn to, someone to tell them “Yes, your baby is normal. Your baby is healthy. You can do this.”
That’s especially true for military parents, who are often far from home and family, far from support networks and sometimes a world away from their partners. Sometimes, there isn’t anyone to say, “Go take a nap. I’ll watch the baby.”
But in the Army, you’re never really on your own: There are neighbors and friends and battle buddies. And there’s the New Parent Support Program, or NPSP. Run by Army Community Service since 1995, it provides home visitation services from registered nurses and licensed clinical social workers, as well as support groups and classes to new or expectant parents.
“I didn’t know very much going into being a dad,” said Cpl. Benjamin McCluskey of the 741st Military Intelligence Battalion at Fort Meade, Maryland. “I had never changed a diaper until the day [Connor] was born. The home visitor coming over to the house was just awesome. It’s just like information overload. If I had questions, next time she would address them. It was just so helpful.”
Army Families with children under the age of 3 are eligible for the free, voluntary program, although first-time parents, single parents and dual-military families have priority. According to Richard Lopez, the NPSP program manager at Army Installation Command, a Soldier with an open abuse or neglect investigation can be required to participate.
New moms and dads are referred to NPSP through a variety of sources, from the mother’s obstetrician to the baby’s pediatrician to other parents. McCluskey and his wife, Ariel, learned about the program during their in-processing briefing on Fort Meade when a senior noncommissioned officer noticed Connor, who was four months old at the time, and mentioned the program. The McCluskeys met their home visitor, Rafiah Meekins, a registered nurse and an Army spouse, on the spot.
Additionally, program staffers will often reach out to new parents. For example, the Fort Bragg, North Carolina, office tries to contact every mother who delivers at the post’s Womack Army Medical Center within a day of her discharge. About 300 to 350 babies are born at Womack each month, according to Sue O’Brien, a registered nurse and the Fort Bragg NPSP program manager, and that’s not counting other local hospitals. While all of those Families don’t participate in the New Parent Support Program, with 20 home visitors who handle a caseload of 25 to 30 Families apiece across seven counties, Fort Bragg’s program is one of the largest in the Army.
“I really like the home visitors to get out there within a week, but we call them usually within 24 hours, just to check in with the moms and make sure they’re doing OK,” said O’Brien, whose husband is a retired Soldier. That first home visit starts with a needs screener to develop “a little bit of a road map about how the visits go.” Most visits average an hour, and the frequency depends on the Family’s needs, whether it’s once a week or every other week. With Connor now a toddler, the McCluskeys only see Meekins about once a month.
The parents’ most urgent questions might be related breastfeeding or postpartum depression or even basic infant care. Their needs also can affect which home visitor is assigned to the Family. For example, O’Brien has two lactation consultants on her staff. Another visitor is an expert on postpartum depression, or PPD. A third has twins herself and is a big resource for new parents of multiples.
Subjects can range from introducing an older sibling and the new baby to infant massage, which the McCluskeys enjoyed practicing with Connor. Feeding, whether it’s breastfeeding, formula or solids is a frequent topic, and if there is a financial need, home visitors can help connect mother and baby with the Women, Infants, and Children, better known as WIC, program to receive supplemental nutrition. Infant CPR, childproofing and other safety issues are also paramount.
In fact, while Families love the New Parent Support Program, many don’t realize that it’s actually an abuse and neglect prevention program, Lopez said. Home visitors always discuss the dangers of shaking a baby, which can lead to death or lifelong disabilities. No one plans to do it, Lopez said, but it happens. It happens because caring for a newborn is one of the hardest things many people will ever do, especially when that baby simply will not stop crying, no matter what Mom or Dad tries, no matter how many times they feed him or change her or rock him. It’s called PURPLE crying, it can last for hours and it’s incredibly frustrating.
“It gets on Family members’ nerves,” Lopez said. “Unfortunately, that’s when the babies get shaken. ‘Will you stop that?’ and they shake the baby, thinking that that’s going to help. Sometimes the babies do stop crying … so they do it again, and eventually they do it too much and it will cause a fatality.”
“We need to give moms and dads permission to put that baby down in a very safe place in the crib and walk out of the room [for a few minutes],” O’Brien said. “We need to give them permission to let the baby cry.” Home visitors also have parents list three friends or relatives or neighbors they can call if things start to get out of hand.
Safe sleep – putting the baby to sleep alone in an empty crib – is another crucial topic, as are age-appropriate punishments. For example, Meekins told the McCluskeys that the length of Connor’s timeouts should equal his age, so two minutes for his two years. Some parents may be tempted to spank, said Lopez, but physical punishment doesn’t actually work. It just teaches the child to be afraid.
“We just really want to try to help the parents. We don’t want to label them. … We know they’re trying to do the best they can with what they have. Our home visitors will do the best for them,” said Lopez, although he pointed out that all of the Army’s home visitors are mandated reporters.
Neglect tends to be a more widespread problem than abuse, he continued, particularly during deployments when the parent at home may be overwhelmed and unable to cope. Neglect can range from not locking up cleaning supplies to leaving young children alone to not feeding them. It can even encompass a parent who doesn’t give a baby enough attention or affection, which can affect that child forever, he explained.
Neglect can mean the parent needs help just as much as the child. Mom may be young and have no idea how to parent or Dad may have had a terrible example growing up. She might have PPD. He might have PTSD. Home visitors can help ease some of those burdens and refer parents to professionals who can help them and the entire Family, O’Brien said.
Part of keeping Families healthy includes making time for each other. Date nights and staying connected as a couple are important, she and Meekins stressed, and O’Brien said ACS often offers couples classes and counseling.
Meekins, who has a 17-month-old herself, talks to her Families about how to “keep things fresh,” how to handle stress and how to find a work-life balance. She also talks about self-care, saying “a lot of parents need that.” It’s so easy for parents to put themselves last, but “What are your hobbies?” she asks. “Who were you before you were a parent?” That person is still there and needs attention.
“Having her to talk to – we didn’t know anybody so it was like, I have adult conversation besides my husband’s,” said Ariel, explaining that they’re from Idaho, so family support is 30-plus hours away.
“It helped me just to know that she had someone to talk to about anything. It was very much a relief,” McCluskey said. He could spend more time focusing on his mission because he knew Meekins was only a phone call away.
Home visitors hand out books to encourage reading and parent-child interactions, and they always travel equipped with lots of materials and resources. Meekins actually gave him an instruction manual for Connor, McCluskey said. Put together like an operations manual, it has pictures and even suggestions for troubleshooting. It’s perfect for a Soldier, and he and Ariel still refer to it regularly.
“I bring a lot of literature,” Meekins said. Lately she’s been bringing a lot of resources about potty training. Ariel calls it her “least favorite thing so far,” but Meekins has been there to bring books and answer questions, to talk about the signs of readiness and give tips like using charts and stickers and potty dances, and, most importantly, to tell Ariel, “Try not to stress out about it. … It’s going to work out for you. Eventually it will happen.”
Perhaps the most reassuring part of the NPSP for new parents is they have someone to turn to when something is wrong or when they fear their baby might have a delay. “We had concerns with Connor’s speech for a little while, but [Meekins] would say, ‘Don’t worry about it because his motor skills are way advanced so he’s putting his energy into that. Speech will come. Don’t worry,'” McCluskey remembered. Meekins suggested some resources just in case, but they never needed them. One day, just as she predicted, “his speech just came.”
Meekins could be confident saying Connor would be fine because all home visitors conduct Ages and Stages questionnaires with parents. The questionnaires measure the motor, verbal, social and development stages of children up to the age of three. If there are any red flags, visitors will refer the children to their pediatricians and suggest additional, early intervention resources the parents can access.
“Are they average?” O’Brien asked. “Are they a little bit ahead or need to do a little catch up? … Do they need to get a little help? … We’re trained to be able to spot it, but when the mom answers the question and she sees it, I think it’s a little more black and white. It’s not that they’re not good parents. It happened to me with my oldest. … The question was, ‘How well can she kick a ball?’ I thought, ‘I don’t know if I’ve ever even seen her kick a ball.’ So it made me think, ‘Wow. I really need to get a ball and take her outside and play.’
“Along with this screening are opportunities to enrich the kids. We bring out some ideas about how to do that: ‘Here’s some games to play with a ball. … Here’s some things you can try to increase their ability.'”
Other key parts of the NPSP are playgroups and classes designed to get parents out of the house and help them connect with other parents so they can build their own support networks. The offerings vary slightly from installation to installation, but often include playgroups, walking groups for new mothers, craft groups, baby sign language, baby boot camps for expectant parents and special classes for new fathers.
“A lot [of questions] come up with new, expecting dads in our ‘Babease Boot Camps.’ We actually started having a dad come in and give a dad perspective … so we’re getting their needs addressed as well. Just parenting in general: ‘What kind of a dad am I going to be?’ The financial aspects of having a child. … We have a financial readiness officer come in and talk about budgeting,” said Meekins, adding that fathers-to-be also get to wear an empathy belly.
At the end of the day, she said, she tells parents that she’s their biggest cheerleader.
“Saying, ‘What a good job,’ makes a difference,” O’Brien agreed. “Because there are times when you’re thinking, ‘Am I doing this right? What am I doing?’ And to have someone say to you, ‘Look at him look at you. He really loves you,’ that’s really powerful.”