Spring 2021

Your quarterly maternal and child health newsletter, provided by the Snohomish Health District's Maternal Child Health team. Stay up to date on local programs, topics, and resources for families and the professionals who serve them.

In this issue...

COVID-19 Vaccine Update and Resources
Financial Assistance for Basic Needs
COVID-19 Birth Rights and Education Toolkits
Perinatal Mental Health & COVID-19
Resilience Exercise: Take Inventory
CARE Cohort 4 Trauma Informed Training
Snohomish Health District Program Updates

News Corner

COVID-19 Vaccine Update & Resources

The U.S. Food and Drug Administration (FDA) has issued Emergency Use Authorization for the following vaccines:

Pfizer-BioNTech vaccine for use in individuals 16 years of age or older as a 2-dose regimen given 3 weeks apart
Moderna vaccine for use in individuals 18 years of age or older as a 2-dose regimen given 1 month apart
Johnson & Johnson vaccine for use in individuals 18 years of age or older as 1-dose.

All three vaccines have been shown to be safe and highly effective at preventing severe COVID-19 illness. At this time, individuals eligible for Phases 1a and 1b1 are being vaccinated. For information about who is currently eligible for vaccination and how to get a vaccine, visit the Snohomish County COVID-19 Vaccination webpage.

When Will the Vaccine be Available for Children?

The Pfizer-BioNTech vaccine is currently approved for individuals 16 years of age or older and the Moderna and Johnson & Johnson vaccines are approved for individuals 18 years of age or older. Children and adolescents outside of these authorized age groups should not receive a vaccine at this time. Clinical trials are currently underway to test the safety and effectiveness of the vaccines in children 12 years of age and older. It is expected that vaccines will be authorized for use in this age group by Spring 2021. Additional trials in even younger children are being planned.

What about People who are Pregnant or Breastfeeding?

Due to limited data about the safety of COVID-19 vaccines for pregnant and breastfeeding people, there is not a definitive recommendation for or against getting vaccinated. Given that the vaccines do not contain live virus, and therefore cannot give someone COVID-19, experts believe that the vaccines are unlikely to pose a specific risk to people who are pregnant or breastfeeding. More data is expected to become available in the coming weeks and months. People who participated in the original vaccine clinical trials who became pregnant are being monitored, and studies are planned in people who are pregnant.

The American College of Obstetricians and Gynecologists (ACOG) recommends that COVID-19 vaccines should not be withheld from pregnant people who meet the criteria for vaccination. It is recommended by both ACOG and the CDC that people discuss their options with their healthcare provider, considering both the risks and benefits of vaccination.

See COVID-19 Birth Rights & Education Toolkits from the Maternal Coalition for a printable resource that covers what we know about pregnancy and the vaccine. For more information, see the CDC Vaccination Considerations for People who are Pregnant or Breastfeeding and ACOG Practice Advisory.

Featured Resources for Families

Financial Assistance for Basic Needs

Local Community Resource Centers may be able to help families who are experiencing financial hardship with certain household expenses due to COVID-19, including: utility costs, food, transportation, medical care, and other life sustaining services. Please direct your clients to the Community Resource Center in their area:

North Counties' Family Services - Darrington: 360-436-0334 or alanncfs@gmail.com
ChildStrive - Everett, Lynnwood, Edmonds: 425-530-8907 or Jazmin.lopezIbarra@childstrive.org
YWCA - Everett, Lynwood, Edmonds: 425-626-1480 or vdorway@ywcaworks.org
Take the Next Step - Monroe: 360-794-1022
Cocoon House - Youth/Families with children aged 8-18: 425-551-9661 or Referrals@cocoonhouse.org
Arlington Resource Center: 360-322-6988
CRC of Stanwood - Camano: 360-629-5257 x1009 or relief@crc-sc.org
Sky Valley Resource Center - Sultan: 360-793-2400

COVID-19 Birth Rights and Education Toolkits

The Maternal Coalition is a Seattle-based nonprofit focused on promoting equitable and just care during pregnancy and the postpartum period. During the pandemic, they have developed and maintained a toolkit covering Pregnancy, Birth and Postpartum Rights related to COVID-19, and more recently, Pregnancy and the COVID-19 Vaccine. Both toolkits contain empowering information for expecting parents, and are available in English, Amharic, Spanish, Somali, Mandarin. You can access the toolkits on The Maternal Coalition website.

Maternal & Child Health Notes

Perinatal Mental Health & COVID-19

A recent study from the U.K. found that after the pandemic began, 43% of postnatal women surveyed reported clinically relevant depression and 61% reported clinically relevant anxiety. This is a dramatic increase from pre-pandemic levels, and many participants felt that psychological changes occurred as a result of social distancing measures independent of other factors. These results align with those from other countries, and are perhaps what we would expect given the collective hardship the past year has brought about. Even prior to the pandemic, about 20% of women experienced depression and 15% experienced anxiety related to pregnancy or after birth. Some of the risk factors for perinatal mood and anxiety disorders are social isolation, stressed relationships, and financial struggles, all challenges that have become more widespread during the past year.

It is more important than ever that we break the silence when it comes to maternal mental health disorders. Postpartum depression and anxiety are treatable, and do not signify that someone is a bad parent. We must remember that partners can experience perinatal mood disorders as well. Ask your loved ones and clients how they are holding up, and remind them that help is available. For information about how to access support, visit the Snohomish County NEAR Collaborative's Perinatal Mental Health webpage or the Perinatal Support Washington website.

Featured Resource for Providers

Resilience Exercise: Take Inventory

Resilience and self-care have been big buzz words this past year as our families, workplaces, and communities have begun to acknowledge their importance in the face of the collective trauma of the COVD-19 pandemic. At this point you may even feel bombarded with directives to practice various forms of self-care. But this may leave you wondering – “what does building resilience actually look like in practice? For myself? For my children?”

Let’s examine one component of internal resilience and a small practical exercise you can do this week to build up your own resilience and support the resilience of the children in your life. One component of internal resilience is self-regulation. This means having the ability to experience a variety of emotions and to respond in an appropriate and effective manner. If you find yourself having trouble with this in the middle of a global pandemic, work stress, helping with online school, family responsibilities, illness, or any number of other challenges you may be facing, then you are not alone.

One strategy for practicing self-regulation is identifying your emotions. This means getting curious and getting specific. When you find yourself in a dysregulated state, ask yourself “what is going on for me right now?” Beyond “good, bad, stressed,” try labeling your emotion or feeling more specifically. Are you sad? Angry? Frustrated? Overwhelmed? Identifying your emotion is the first step to identifying what you are needing and then communicating that to your colleagues, partner, family, or friends. Slowing down to identify your emotions can also provide you with enough pause to avoid an outsized or inappropriate reaction.

Exercise: Take inventory. At the end of each day this week, reflect on the day’s experiences and identify two different specific emotions you felt. Consider the following questions:

In what moments or circumstances did these emotions occur?
Were you aware of the emotion you were having in the moment it occurred?
Did you respond appropriately or effectively?
Knowing you felt or may still be feeling a specific challenging emotion, is there something you can identify that you need today? This week? How might you express this need?

If you have children, consider doing this reflection with them and helping them to work on labeling their own emotions. Dinnertime, bedtime, or the drive from school or sports practice might be good opportunities for discussion.

This Photo by Unknown author is licensed under CC BY-SA-NC.

Groups at Work

Coalitions, Collaborations, & Councils

Children's Wellness Coalition

The Snohomish County Children’s Wellness Coalition is a countywide collaborative effort to improve the health and wellness of young people throughout our region. The Coalition is supported by Snohomish County Human Services and many organizations and expert community partners.

The Coalition is thrilled to announce this fall there will be a 2021 Cohort 4 Trauma Informed CARE Designated Train the Trainer Training.

To date, 42 organizations in Snohomish County are a part of the CARE movement. What this means is these organizations are committed to embedding sustainable restorative trauma informed and diversity, equity and inclusion practices. Here are a list of the current organizations committed to this work to date: https://arcg.is/01CSfW

They are seeking 10 new organizations to join the 2021 Cohort and are offering the remaining spots to current CARE organizations who want to strengthen their current training teams. To become a CARE organization two employees from each organization need to complete the CARE TOT training with the intent of going back and training your entire organization within a year.

What the CARE Movement includes:

Supporting you to build a Trauma Informed Leadership Team (TILT)
Monthly Learning Collaboratives
Access to many trainings to support the work
Ongoing technical assistance and support from Snohomish County staff
Diversity and Restorative Practice trainings
Having common language, intention, training and collaboration with other Snohomish County organizations

For more information contact Liza Patchen-Short at Liza.patchen-short@snoco.org

Snohomish Health District Program Updates

Universal Developmental Screening

The Universal Developmental Screening program aims to increase the rate of developmental screening and referrals to appropriate resources. We know that identifying developmental delays as early as possible allows children to get the support they need to thrive, and to identify and leverage the child's strengths. Although developmental screening is recommended for all children at ages 9, 18, and 30 months, only 25% of children in Washington are screened at all before the age of 35 months.

Right now, Snohomish County is in the early stages of implementing a Help Me Grow model for system-wide collaboration, with the aim of organizing community resources to help families and children develop and thrive. The Health District is participating in both local and statewide organizing around Help Me Grow. If you would like to learn more about how to get involved in this planning effort, contact Kendall Appell at kendall.appell@childstrive.org

Access to Baby & Child Dentistry

Do you or your clients need extra help finding a dentist, or with common barriers such as transportation, language access, or scheduling? There is extra help available through the Access to Baby & Child Dentistry (ABCD) program for children under the age of 6 who are insured by Medicaid. Contact the Snohomish County ABCD Coordinator at dentalinfo@snohd.org or 425-339-5219.

In addition to providing care coordination for patients, the ABCD program trains dentists to provide care to children under the age of 6. ABCD certified dentists receive enhanced fees through Medicaid for certain procedures and oral health education. ABCD certification requires just a few hours of free, CDE eligible training that is delivered by a volunteer dentist in your area. To become an ABCD dentist, contact Laura Nay, at lnay@snohd.org or 425-359-0384.

Thank you for reading! We plan to publish the next newsletter in June 2021

The Dyad+ (plus) highlights the health of the mother-child dyad plus their family and support system. The health and well-being of the mother-child dyad is dependent on each other, and the importance of the pregnancy and postpartum period cannot be overstated. The health status of the dyad during this unique time has a persistent and long lasting effect on an individual's lifelong health, and therefore has a big impact on the overall health of a population. The primary caregiver, who may or may not be the biological mother, fills an essential role in the child's life that can help or hinder the child's potential, especially for children under age 5. Maternal and child health is essential public health.

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