CINCINNATI – The nightmare of not having enough food to feed one's baby is a reality for 15 percent of the parents who walk into the pediatric clinic at Cincinnati Children's Hospital. Moms tell doctors that they dilute formula, cut feedings off before their babies are full or take more time between feedings to stretch what they have.
Cincinnati's Freestore Foodbank estimates that 20,000 babies live in homes without enough food in the 20 counties that the food bank serves.
The immediate impact of babies going hungry may be obvious and heart wrenching, but a lack of good nutrition in the first year of life also sets a child on a path to lifelong trouble.
Babies who don't get all the nutrition they need won't mentally develop as well as well-fed children, making it more likely that they won't be ready to learn and socialize in kindergarten, which makes it more likely they won't read by third grade, which makes it more likely they'll drop out of high school, which makes it harder to find a good job.
They're also at higher risk for psychological and behavioral problems down the road, according to studies cited by Cincinnati Children's Hospital.
The beginning of a solution is under way. Children's and the Freestore Foodbank partnered with Procter & Gamble and Kroger to work on the daunting problem with the KIND program, short for Keeping Infants Nourished and Developing.
The program launched at Children's pediatric care center at its main campus in 2011 but has since expanded to five other clinics, all of which primarily serve low-income patients who receive Medicaid.
Doctors ask questions meant to identify families who run out of food by the end of the month and have trouble feeding their babies. Once identified, parents are given a can of formula and diapers. Also key to the program, doctors and staff direct patients to other support services since the formula and diapers last only for a week or less.
"There are a lot of consequences to food insecurity," said Dr. Melissa Klein, a founder of the KIND program.
She said most babies who aren't receiving enough formula appear to be growing normally. But they're more likely to be anemic, prone to infection, hospitalization, stomachaches, headaches and colds, among other problems.
"There's also a big impact on development. They may have lower math achievement, other mental health issues like ADHD and aggression issues," she said
"On a population level, it's not an overstatement to say that if they don't have the proper nutrition, they're not going to be as likely to be kindergarten ready," Klein said.
Children's Hospital supports mothers who nurse their newborns with an array of resources, including lactation consultants and other educational resources. But for the mothers who are unable or choose not to breastfeed, the hospital is focusing on finding ways to reduce the shortage of formula among hungry families.
The P&G Fund contributed $100,000 to pay for formula and diapers, which are purchased from Kroger at a discounted rate, according to Sarah Cook of the Freestore Foodbank.
David Taylor, P&G's Global Health & Grooming group president, said P&G recognized a need in the community for the program.
“The Freestore FoodBank’s program works to provide infants with the proper nutrition they need for physical and mental development at such a critical time in their lives” Taylor said.
Kroger, which has partnered for many years with the Freestore to help the hungry, also saw the program as an effective means to ease the problem.
"The KIND program allows Kroger to help families in need with baby formula and diapers. Kroger is proud to partner with the Freestore Foodbank to help thousands of neighbors every day," said Rachael Betzler, a Kroger spokesperson.
To date, 1,042 families have participated in the KIND program, receiving more than 2,000 cans of formula, Klein said.
"It's a scratch (of the problem's surface). We started in March 2011, the uptake was slow, but now we are in full swing," she said. "I think the innovative thing we did was increase what doctors ask."
Doctors' focus may have been too narrow before, never thinking to ask if children whose growth and other vital signs appeared normal might be going hungry. Now, the participating clinics ask all of their patients questions that research proved struck the right balance of sensitivity and effectiveness at identifying hunger:
• Do you worry that your food will run out before you get money or food stamps to get more?
• Did the food you bought not last and you did you not have money to get more?
The results were disturbing.
"We surveyed over 200 patients. We found that almost 30 percent were food insecure, and about 15 percent were stretching formula," Klein said.
Children's and the Freestore don't have the resources to eliminate the problem, but they don't turn away any participants in the program who ask for formula. They also seek to educate families about other resources for short-term help and for long-term solutions like agencies
that help parents earn their GEDs to get work and income.
Almost two thirds of caregivers surveyed by Children's faced financial hardship and 15 percent did not finish high school.
Kurt Reiber, Freestore Foodbank president and CEO, is bullish about the effectiveness of the program and ambitious about expanding it.
"It's definitely money well spent. A hungry child can't learn and an uneducated adult can't earn," Reiber said. "We have a lot of early learning initiatives in Greater Cincinnati – Success by Six, Every Child Succeeds. But you don't get there if in the first 12 months they're not getting the support they need. Food is really the essence of a healthy lifestyle."
Reiber has already introduced the program to other area food banks, and he hopes to make KIND a model for food banks and children's hospitals throughout the country.
"We're trying to get the food banks in metropolitan areas to partner with their children's hospitals to get the message out," he said.
Klein said the problem of hunger is bigger than Children's Hospital can tackle by itself, but the KIND program is helping.
"If we can start things off right in this one arena, we're setting kids up for a better trajectory through life," she said.