Supporting expectant mothers

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Expectant mothers in First Nation communities across the country can get the support and information they need to help them have healthy babies, thanks to a federally funded prenatal nutrition program.

The Canada Prenatal Nutrition Program (CPNP), operating since 1994, is aimed at pregnant women in groups considered high risks for having a "poor birth outcome." One of the program's target groups is Aboriginal women. While the main focus of the program is improving prenatal nutrition, it also provides resources to support families after the birth of the child.

Pamela Winquist, a registered dietitian and nutritionalist with the CPNP in B.C., has been involved with the program since its launch.

"Every band gets money to do the program, and it's been universally funded since 1996. Before that it was on a proposal basis, because we just didn't have the numbers to fund all bands."

Although prenatal support programs were available in B.C. prior to the launch of CPNP- the Healthy Baby component of the Brighter Futures program, as well as the provincially run Pregnancy Outreach Program (POP)- CPNP helped fill some of the gaps, Winquist said. One of those gaps was access to prenatal programs on reserve.

Although the federal program was launched in part to help reduce the number of children with low birth rates being born across the country, increasing birth weights is only one focus in Aboriginal communities.

"In Aboriginal communities, we're not so much concerned about low birth weight as we are concerned about other issues related to prenatal health. The birth weight rates in Aboriginal communities nationally are less than the national average, but we have pockets of need, certainly, and we have other needs that may not be identified just by looking at birth weights. Things like isolation and poverty, very young mothers, and alcohol and drug abuse issues, addictions issues, those kind of things," Winquist said.

Winquist is enthusiastic about the work being done through the CPNP.

"I think there have been some wonderfully creative things going on," she said. "They've been doing community kitchens, they've done community gardens, clothing and toy exchanges at their prenatal programs to get women to attend. They've made arrangements to use traditional foods as food supplements. In a program not offering services on reserve, they might give milk for calcium and eggs for protein and orange juice for Vitamin C, and on the on-reserve programs, we're seeing some projects using canned salmon to provide the protein need and the calcium need. And it's a traditional food as well. So it restores some of that identity, and acceptability of the food," she said.

"I think that the program is doing some very positive things in communities. I think it's teaching women . . . it's helping them, supporting them to have healthier birth outcomes. It's teaching them a variety of parenting skills. And I think the program is drawing people from the community together," Winquist said.

"In some communities they have feasts, and they celebrate the birth of the baby. So everyone that had a baby in the year is celebrated at a feast. And what a wonderful way to introduce a child into a community and to make the mother-the parents-feel really special and important. Sometimes we don't do enough of that."

Elaine Prince, former CPNP co-ordinator at Nak'Azdli First Nation near Fort St. James, B.C., was involved in the prenatal nutrition program for five years.

She first got involved as a new mother, then as an outreach worker, and finally as co-ordinator. She was interviewed prior to her leaving the co-ordinator position at the end of August.

One of the initiatives offered through the Fort St. James CPNP has been giving mothers gift certificates so they can buy healthy food for themselves and their children. When the new co-ordinator takes over, the gift certificates will be replaced with home visits and delivery of healthy food, Prince said. The ew approach will let program staff stay in regular contact with the moms, as well ensure they're getting nutritional food.

An initiative to encourage breastfeeding has also been part of the Fort St. James program.

"We offer certificates to moms that breastfeed for six months or more, to a really nice local shop in town, so they can actually go and buy something nice for themselves," Prince said.

CPNP funds have also been used to offer in-home cooking demonstrations and health awareness session, to buy resources such as videos on nutrition, to hold budgeting workshops, to organize shop smart tours, and to offer nutrition sessions.

Last year, a local mom was also hired through the program to work as an outreach worker, to connect with other mothers in the community and keep them up to date on what was going on.

The CPNP has become a valuable resource for the community health nurse, Prince explained.

"It's one thing to say to a mom, 'Well, you need to eat better.' It's another thing to say to a mom, 'Hey, you need to look at eating better, and why don't you go over and see Elaine in the CPNP program and she can help you out,'" Prince said.

Prince, too, was enthusiastic in her support of the CPNP.

"The money that you get, even though it's not like a huge amount, it's such a wonderful resource, because you can be really creative with it, and it's certainly, I think, allowed for some things to happen in our community that wouldn't normally happen. Even just the gift certificates, that's a wonderful way for moms to come in, and you can connect with them and find out how things are going," Prince said. "I just think it makes a huge difference if communities choose to use it."