Today’s blog will highlight a topic that comes up in GGK Seminars quite frequently --- How to support 3-Generation Families. It’s not unusual for a home visitor to have several 3-Generation Families they visit who are looking for effective strategies for creating a healthier balance with care-giving tasks and relationships.  We will enhance today’s discussion with the latest, relevant research pertaining to this topic and conclude with exploring the associated Growing Great Families resources and tools.

For the purpose of this discussion, let’s get started with some definitions. The term 3-Generation Family refers to multigenerational family households where two or more adult generations live together under the same roof; this generally includes a grandparent, parent, and child. Our definition also embraces multigenerational families where grandparents have major influences in caretaking and raising small children, even though all generations are not living together.  According to the American Association of Retired Persons (AARP), there are strong indications that US and Canadian multigenerational living is on the rise. Approximately 51 million Americans, or 16.7 percent of the population, live in a house with at least two adult generations, or a grandparent and at least one other generation, under one roof. This trend is linked to cultures, such as Hispanic, Asian, and African American, who embrace multigenerational housing (, April 2013).

It’s interesting to note that the 2010 US Census indicated that 7.5 million children lived with a grandparent in 2010; that’s about 10 percent of all children in the United States.  Of these children, 4.9 million lived in the grandparent’s home.  Additionally, among children younger than 5 whose mothers were employed, 30% were cared for, on a regular basis, by a grandparent during their mother’s working hours in 2005 (US, 2010). Research indicates that the multigeneration housing phenomenon is increasing due to a variety of factors including economics, child care benefits, preventing elder isolation, family dysfunction connected to teen pregnancy, substance abuse, etc.  PEW Charitable Trust research found that in 2015 the number of grandparents solely responsible for the care of grandchildren had risen to 2.9 million (Wiltz, 2016).

All this data resonates with the composition of today’s home visitor caseloads, doesn’t it?  Most home visiting models are designed to integrate services focusing on addressing the needs of the whole family. This multigeneration approach supports inclusiveness of all family members from a programmatic and cultural perspective. However, it can sometimes be challenging for home visitors when it comes to addressing sensitive topics such as parenting, role clarification, making decisions about childcare practices--- in other words, “who does what” when it comes to the baby and child care decisions, in addition to providing financial support and responsibility for  other household tasks.

Your Growing Great Families manual includes two modules specific to 3-Generation Families.  The modules are intentionally designed to approach sensitive intergenerational topics, while exploring strategies families might consider for promoting more harmony in their home. The conversation guides provided encourage families to reflect on how healthier relationships between parents and grandparents, and a better balance with caregiving might benefit the child and all of his/her caregivers. Let’s take a moment now to spotlight these modules:

  • Becoming a 3-Generation Family- This module is the first in the series designed to explore initial feelings and concerns young parents and grandparents experience upon learning of an unexpected pregnancy; increase understanding and build a more positive relationship by pointing out common feelings and goals parents and grandparents have for the new baby; and to increase positive connections between parents and grandparents by sharing meaningful affirmations with each other.  This Conversation Guide also incorporates a couple of handouts to support parents to give each other more affirmations and appreciation messages.


  • Role Clarification in 3-Generation Families- This module is meant to be used as a follow up to the Becoming a 3-Generation Family and Protecting Your Children from Toxic Stress modules.  This Conversation Guide explores several important topics including changing the “emotional tone” of relationships; old and new ways: making decisions about infant care; grandparenting styles; and role clarification. This module also includes great handouts to explore grandparenting styles and a plan for creating a healthier balance with caregiving.

Check-out this GGF 2 -Modules Series along with their corresponding handouts! Share with your families and remind them of the following:

“Children learn the most about life and how to live it from the day-to-day interactions they experience and observe as they grow up.  Brain research has shown that an infant’s brain stores memories of all these experiences.  We know positive memories will contribute to the child’s long-term happiness and success.”

Works Cited: (April 2013). Home and Family: Three Generations Under One Roof Bulletin by Sally Abrahms. Retrieved from

US (2010). Profile America Facts: Grandchildren. Retrieved from

Wiltz, T. (2016, November 2). Why More Grandparents are Raising Children. Retrieved from PEW Charitable Trusts:

Partnering with families is at the heart of the Growing Great Kids Curriculum. Today’s Great Vine blog is devoted to one of the most important and useful modules for Partnering with families---Successes and Next Steps. We will review this module’s design and structure, content, and how to use with families to enhance our partnering relationship with them.  We will also discuss literature around partnering with families, the power of acknowledgment, and the reflective component of our conversations with parents.  Finally, we’ll conclude with a brief discussion on how to grow home visiting partnership skills during supervision.

Each quarter, parents annext steps cropd home visitors complete the Successes and Next Steps module along with the GGK Tool.   This quarterly review offers families the opportunity to reflect on their parenting skill building process, the knowledge they have gained around child development, family functioning, and protective factors. It also gives them a chance to think about how they are practicing their new skills to support their family and grow their personal successes.  The Successes and Next Steps
conversation guide and The GGK Tool provide a structured format for home visitors to acknowledge family members for their accomplishments and to explore new interests and skills they would like to grow over the next three months.

The Successes and Next Steps conversation guide and The GGK Tool are intentionally crafted to support in-depth conversations around growing skills related to each Daily Do. This also provides the opportunity to reflect on child development screening findings, parents’ management of family sufficiency, expanded life skills, while reviewing progress on family goals. Through this reflective process, home visitors and families determine how they wish to use the Growing Great Kids Curriculum Components during the next quarter.

Now let’s spend a few minutes reviewing the research behind this essential GGK curricula component.  Partnering with families has different names; in health care, it is referred to as family centered; in mental health, family driven; and in social work, relationship based. Regardless of the name, these concepts share the following core principle as professionals intentionally partner with families: (1) seeking family input, (2) viewing the family as the primary expert on the child, and (3) responding to family concerns and needs in a strength-based manner that incorporates the philosophical, cultural, values, and unique needs of the family and individual (Goldfarb, 2010).

This approach is about understanding that each family may need information presented in a different way, and with a different frequency. It is only through a team effort that you and the family can evaluate options and decide together what will work best in each situation, with a genuine willingness to listen and learn about the family’s motivation(s) for growth. The Successes and Next Steps conversation guide, to be used every 3 months with families, encourages parents to be active participants and decision makers in determining “how” and “what” pieces of the GGK Curriculum would be most beneficial to them. This is also a great time to talk about the pacing that would be right for them during the next three months.

Another important component of connecting with families is incorporating acknowledgment and recognition in our conversations with them. Taking the time to acknowledge others is about making a meaningful impact on a human being.  A few genuine words of acknowledgment and recognition brightens anyone’s day, but most importantly it can translate into increased motivation, higher self-esteem, and more confidence in taking on new challenges ( 2013). The Successes and Next Steps module is about acknowledging parents’ successes by pointing out specific accomplishments through the 3-step Accentuating the Positive (ATP) Action Tool during the conversation. This practice reinforces the home visitor-parent relationship. As parents see that their efforts are being noticed and appreciated they not only feel proud of themselves as individuals and parents BUT ALSO, strengthen their commitment to the partnership with their home visitor.

Partnering with families, as well as offering ATPs, requires reflection on the part of the home visitor. It is important to reflect on what personal and professional experiences, values, and feelings are supporting you, as a home visitor, in building a healthier professional relationship with family members and/or what is getting in the way of having positive interactions with them.   This practice will only be true and relevant when you can be fully present and connected during your interactions with families.  The Successes and Next Steps module also provides insights for the home visitor’s areas of growth as new GGK topics are explored with each family.

We will wrap up our discussion with encouraging the use of the supervision process to continue growing your partnership skills with families.  Supervision is the ideal place to discuss how you feel about your relationships with families, specific concerns, and how to support families through active partnership as they find solutions to their problems.  Remember… your role as a home visitor is to partner with families as they make informed decisions. It is their journey!

Works Cited:

Goldfarb, F. D., Devine, Kl, Yingling, J.T., Hill, A., Moss, J., Ogburn, E.S., & Pariseau, C. (2010). Partnering with Professionals: Family-Centered Care from the Parent Perspective. Journal of Family Social Work, 13(2), 91-99. DOI: 10.1080/10522150903487081. (2013). Leadership: Feeling Appreciated? Why It Can Make All the Difference by Margie Warrell. Published online on 5/16/2013. Retrieved from

mother and baby

Pregnancy is a natural state that is usually experienced as a happy, healthy, and exciting time for expecting parents.  Undoubtedly, it is also a period of significant changes in parents’ physical, emotional, mental, and even financial lifestyles as they adapt to meet the needs of a new baby. These adjustments, along with the typical hormonal changes that a mother-to-be experiences may trigger both major and minor depressive symptoms, beginning during prenatally and lasting up to twelve months post-birth.  Research has informed us that fathers-to-be may also experience depression prenatally and postnatally. However, distinguishing between symptoms of depression and normal responses to stressful experiences of pregnancy can be challenging for parents and their home visitors. Additionally, parents often find themselves feeling embarrassed  or shy about openly expressing their feelings of sadness or anxiety during pregnancy or right after birth due to fear of being judged. Let’s spend some time exploring the benefits of supporting your program families to enhance their understanding of pre-natal and post-partum depression. We’ll also review some strategies for encouraging them to seek treatment as needed.

According to Tiffany Field, the interaction disturbances of depressed parents and their infants appear to be universal. Regardless of culture or socioeconomic status groups, depressed mothers exhibit less sensitivity and responsivity in their relationships with their babies. In her study, Field indicated that the caregiving activities that get compromised by postpartum depression across all cultures include feeding practices, most especially breastfeeding, sleep routines, well-child visits, vaccinations, and safety practices (Field, 2010). This tells us that there is a great risk to child development when a parent experiences prenatal and/or postnatal depression.

There is extensive research on the effects of maternal depression on both parents and children.  Some of the effects on parents include failure to respond to infant cues and signals, emotional and physical disconnection from the infant. Parents engage less in vocalization, smiling, imitation, eye contact, and in general, there appears to be lack of feelings of joy toward the infant.  Their interactions tend to be overly intrusive or under-stimulating, and in extreme situations there is fear of harming or actually harming the infant.  The effects of maternal depression on the developing baby include a higher risk of low-term births, lower birth weight babies, higher risks for developmental delays especially in language and motor domains, excessive crying, challenges in adapting to sleep routines, failure to thrive and general feeding problems, among many other risks (Field, 2010)

When parents are depressed, they are unable to be emotionally available to their infant’s physical, emotional, and intellectual stimulation needs. When parents do not receive professional support to treat prenatal and/or postnatal depression, the long-term effects of detached parent-child interactions can give rise to insecure attachments. When young children experience insecure attachments, they display fear, distrust, anxiety, distress, and long-term adverse effects on their brain development, behavioral problems, and relationship challenges (Center for the Study of Social Policy, 2015).

Unfortunately, many expecting parents who recognize they might be experiencing symptoms of prenatal/postnatal depression may be unwilling to express openly their feelings due to fear of being judged as not being good parents.  Some parents go through this phase hoping that the symptoms will soon pass.  As home visitors, our role is to create opportunities for parents to feel safe sharing their feelings in a nonjudgmental environment.
Growing Great Kids Prenatal (GGK) and the Growing Great Families (GGF) curriculum manuals provide a variety of conversation guides to support parents’ increased understanding of depression and its effects, contributors and also indicators of depression. The introduction of modules and tools, aimed at assisting parents in reducing their stress are also valuable resources.  These modules are designed to help parents create awareness of their personal strengths and how they can use them to find solutions to the challenging circumstances they are facing.  Check out the following modules…

Growing Great Kids Prenatal Modules:

Unit 2:

  • Module 3: Prenatal Depression in Moms and Dads is Not Uncommon
  • Module 9: Dads’ Module 3: Driver’s Course for Dads

Unit 4:

  • Module 2: Power Down Stress…Power Up HappinessaH

Growing Great Families Modules:

Unit 2:

  • Module 1: Protecting  Your Children From Toxic Stress
  • Module 2:  Sizing Up Your Strengths… Reducing  Stress
  • Module 3:  Becoming Your Own Personal Coach
  • Module 6: Communicating Effectively…It’s More Than Texting/Talking
  • Module 7: The Power of Appreciation
  • Module 8: Problem Talk…A Problem Solving Skill
  • Module 9: Growing Your Support Network: Strengthening Protective Buffers

GGK is unique in that it provides conversation guides for home visitors and parents to engage in meaningful discussions and activities aimed at growing secure attachments both prenatally and post-birth. These discussions often result in parents feeling less stressed, more positive and hopeful, and more empowered to be open about sharing their feelings and potential risks for depression. When this occurs, home visitors have the opportunity to assess their needs and connect parents with professional support. Supporting families in this way allows them to create the life they want for themselves and their children.  Let’s capture this critical window of opportunity!


Works Cited:

Field, T. (2010). Postpartum Depression Effects on Early Interactions, Parenting, and Safety Practices: A Review. Infant Behavior & Development, 33(1), 1.

Field, T. (2010). Prenatal Depression Effects on Early Development: A Review. Infant Behavior & Development, 34(2011), 1-14.

Center for the Study of Social Policy (2015). Strengthening Families: A Protective Factors Framework. 1575 Eye Street N.W., Suite 500, Washington, DC 20005.

mindful parenting

As we all work to recover from one of the busiest times of the year, we will devote our first blog of 2017 to the concept of “mindfulness.” Specifically, let’s think about mindfulness from the perspective of parenting and its association with parent-child relationships.  We will explore research-based information about the topic, the value of creating and/or raising awareness about mindful parenting in parent-child interactions, and review practical tips for integrating mindfulness into home visiting. We will conclude with a discussion around the various GGK resources and strategies that are effective tools for supporting parents to “be present in the moment” with their child, while paying attention to how they are cultivating emotional awareness and self-regulation.

Dr. Jon Kabat-Zinn provides us with a definition of mindfulness; “the awareness that arises through “paying attention in a particular way, on purpose, in the present moment, nonjudgmentally (Kabat-Zinn, 2003). Dr. Kabat-Zinn has helped us understand that even though mindfulness is rooted in Buddhist practice, mindfulness is considered to be a capacity inherent to humans independent of any affiliation with religion. He pioneered research into mindfulness-based stress reduction as an intervention to support hospital patients with managing pain associated with physical problems, such as, hypertension and heart disease, among many other health and psychological problems.

There are presently countless other applications for mindfulness with documented evidence-based benefits. So, how might mindfulness relate to parenting practices? In 2009, Dr. Duncan and a group of colleagues expanded on Dr. Kabat-Zinn’s definition of mindfulness by introducing a model of mindful parenting (Duncan, et. al., 2009).  Their model represents a framework whereby parents intentionally bring moment-to-moment awareness to their parent-child interactions. This practice focuses on the parent’s ability to observe and listen with full attention when interacting with their child. This cultivates emotional awareness and self-regulation in parents, as well as bringing compassion and nonjudgmental acceptance to their parenting interactions (Duncan, et. al., 2009). Their research suggests that integrating mindful awareness into parent-child interactions, allows parents to view the “here and now” experience of parenting within the context of the long-term outcomes for their child. By being aware of and accepting their child’s needs, feelings, and emotions, parents can gain satisfaction and enjoyment in the parent-child relationship. It was concluded that mindfulness practices promote open, trusting, higher quality family relationships that lead to healthy social child development.

Mindful parenting involves truly “being present” frequently throughout each day as parent-child interactions unfold. When parenting mindfully, the parent brings awareness to his/her own actions ( e. g. touch, eye contact, movements, breathing), physical state and emotions as he/she is observing and reflecting on the child’s cues, physical appearance, emotional state and every interaction with the parent. When parenting mindfully, the parent is not thinking about: where she is going next; who has just sent a text and what that text says; why he needs to hurry; or how many more points her team needs to score to win the game. Being mindful enables parents to slow down, observe, reflect, think and  then decide how best to respond, rather than being driven by emotions that too often result in getting out of sync with a child’s needs.

Now, let’s take a few moments to discuss how we, as home visitors, can support more intentional, mindful parenting in our families by incorporating Growing Great Kids-Families parenting practices and reflections into daily family routines and parenting interactions.

  • Practice E-Parenting during Every Visit: This Parenting Daily Do is foundational to mindful parenting because it requires parents to be present for seeing the world through their child’s eyes, as they ask themselves, “What is my child experiencing right now”? An E-Parenter uses all of his/her senses to figure out the answer to this question…She looks, listens, smells and will sometimes touch or taste too.  It takes a parent feeling with his/her heart to step into a child’s experience. E-Parenting entails slowing down, being present in the moment and reflecting    on what to do right now to share in the child’s experience or to help the child regulate her emotions. This process naturally increases mindful parenting awareness.
  • Encourage Parents To Establish Routines: Routines, such as feeding/family meals, bath time, bedtime songs/reading/prayers, and outdoor play   are opportunities for mindful parent-child interactions. Be sure to introduce parents to GGK subsections that explain the importance and value of incorporating consistent routines into their family life. As you observe families establishing predictable routines, point out how they are helping their children feel secure and protected. Then ask them for examples of what else they could do during these routines to be more present with their child and to have even more fun together as a family.
  •  Frequently Touch Back To What I’d Like For My Child and Our Family Values: Reflecting on the characteristics parents have identified as wanting their child to have and the values that will give strength to their family can support parents to be more mindful in their parenting interactions. To encourage more intentional, mindful parenting, accompany these touch backs with the question, “What is one parenting interaction you can really focus on for a few minutes every day this week to bring just one of these characteristics or values to life?”
  • Increase Awareness Of How Electronic Devices Can Disrupt Positive Parenting Interactions: As you observe a parent’s use of an electronic device drawing his/her attention away from a meaningful parent-child interaction, point out your observation and ask the parent    to reflect on their child’s responsive cues and signals. Then say something such as, I wonder what message (child’s name) will be receiving if this happens again and again, day-after-day and month-after-month…What do you think…What are your concerns? What ideas do you have for keeping these “my device is more important” messages at a minimum? Likewise, be sure to notice when a parent is choosing to be present with his/her child when his/her device is beckoning by offering a Strategic Accentuating The Positives.

So many of the components of the Growing Great Kids and Growing Great Families Curricula are designed to support mindful parenting awareness.  They are intentionally crafted to allow parents to reflect on what each topic means to them within the context of their parent-child relationship, family dynamics, culture, traditions, and values. When parents incorporate intentional, mindful parenting practices they are helping their children to feel loved and valued, safe and secure, and capable and curious. We know that by strengthening the parent-child relationship, we’re optimizing the child’s chances for a happy, healthy life…When this happens, everyone wins!


Works Cited:


Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: Past Present, and future. Clinical Psychology: Science and Practice, 10, 144-156. http://doi:10.1093/clipsy/bpg016

Duncan, L. G., Coatsworth, J. D., & Greenberg, M. T. (2009). A model of mindful parenting: Implications for parent-child relationships and prevention research. Clinical Child and Family Psychology Review, 12(3), 255-70. doi:


The holidays are exciting times of the year for parents and children, but it can also be very stressful if safety is not included on the top of the list of a family’s holiday priorities.  Today’s blog is devoted to tips and recommendations for keeping infants and young children safe while enjoying celebrations, gatherings, traveling, shopping trips and more. Did you know that the Growing Great Kids Curriculum includes conversation guides to explore preventive safety practices? Today we will review them and discuss how to use them, so parents get the most out of those conversations.  We will conclude with a few national/hotline resources that could be shared with parents during your December home visits in preparation for the holidays.

There are many safety dangers for infants and young children during the holidays including: unsupervised exposure to Christmas trees, lights, decorations, food, fireplaces and kitchen appliances. Toys, travel, unfamiliar pets and shopping pose increased risks for young children during the holiday season. To help ensure a safe holiday season, Great Kids, Inc. and the American Academy of Pediatrics provides the following recommendations (, 2015):

Christmas Tree

  • When purchasing an artificial tree, make sure it’s fire resistant, and if it is used be sure the lights are in proper working order.  When buying a live tree, check for freshness.  When setting up the tree, place it away from fireplaces, radiators, or portable heaters.  Place the tree out of the way of traffic and do not block doorways. Hang ornaments above your child’s reach to prevent trees falling over and/or fragile ornaments from breaking in the child’s hands. If your baby is crawling or walking, consider putting a protective fence around the tree.

Holiday Lights

  • Check all lights for safety before hanging them. Position cords to be out of the reach of infants and young children. Never use electric lights on a metallic tree. The tree can become charged with electricity from faulty lights, and a person touching a branch could be electrocuted. Make sure lights themselves are out of the reach of your children. And, turn off all lights when you go to bed or leave the house.

Decorations and Gift Wrapping

  • Use only decorations that are child-friendly, non-breakable that are made from non-combustible or flame-resistant materials. Avoid decorations that have sharp edges anddecorations that resemble candy or food as children may be tempted to eat them.
  • Remove any wrapping papers, bags, ribbons, and bows after gifts are opened. These items may cause suffocation and/or choking hazards.
  • Keep holiday plants that may be potentially poisonous away from children.


  • Purchase “flameless”, battery operated candles.  It is best not to use lighted candles anywhere, and especially not on or near a tree or wreath. If you are visiting a home in which candles are burning, be certain they are out of the reach of your child.


  • Young children frequently swallow and/or choke on small, toxic batteries and little game/toy pieces. Check all toys and their packaging, removing small parts and loose batteries before allowing your child to play with the toy.
  • Balloons are not safe for young children to play with because they can choke or suffocate on uninflated or broken balloons.
  • Remove tags, strings, and ribbons from toys before giving to young children. Toys with strings that are more than 12 inches in length are not safe for infants because they pose a strangulation hazard for babies.

Foods and beverages

  • Be sure to keep alcoholic beverages, foods unsafe for infants/toddlers to consume and hot liquids and foods away from the edges of counters and tables, where they can be consumed or easily knocked over by a young child’s exploring hands.
  • Fully cook meats and poultry, and wash raw vegetables and fruits to remove bacteria.
  • Never allow young children to be close to kitchen appliances when they are in use.


  • Always make sure your infant/young children are secured in an weight-appropriate child safety seat, booster seat, or seat belt, insuring that the safety seat has been correctly positioned and secured.
  •  Never drive under the influence of alcohol or drugs.
  • Be careful when driving at night especially during the holidays, there is a higher incidence of impaired driving.


  • Never leave your child unattended.  While shopping, pay attention to where your child is, what is happening at the moment and be mindful of how you and your infant/young children are feeling about the experience. If your child is sending ‘I’ve had enough or I’m hungry or tired signals, “it’s time to take a break or go home.

Holiday Gatherings

  • Try to stick to your child’s usual routines, including sleep and eating schedules.
  • Decrease stranger anxiety by keeping your infant at a safe distance from people. Infants and young children often get overwhelmed when exposed to many people, lights, sounds, and activities without a break and quiet times in between.
  • Wash your hands frequently. Make sure your children, and anyone who wants to hold your baby, does the same.
  • During cold and flu season, to prevent your baby from catching a cold or the flu, do not encourage others to touch, breathe on or hold your baby. Instead encourage them to interact with the baby from a safe distance.

For general infant-child safety tips and conversation guides included in the Growing Great Kids curriculum, Home Visitors can check out the following references:

  • 0-3-month Infant Safety. This module subsection provides safety references and handouts around sleeping, clothing, toys, baby equipment, feeding, health, and safety in general.
  • 7-9-month Home Safety Checklist for Families with babies 6 months and older.
  • 10-12-month Preventing Toddler Injuries.  This subsection explores common injuries toddlers experience and how to prevent them.
  • 13-15-month Safe and Healthy Environments for Toddlers
  • 25-30-month Car Safety

Home visits during the holiday season are an ideal time for planning to incorporate discussions around preventive safety practices.  The Growing Great Kids conversation guides are presented using a strength-based, solution-focused approach to support parents as they enhance their child safety critical thinking and problem-solving abilities.

And, you might want to remind financially stressed parents that a child’s best gift is feeling safe & secure, love & valued and curious & capable…The only costs associated with this gift  are the parent’s time, effort and love.

The following sources include additional, useful holiday tips for child safety. Check them out and pass them on to families:

Works Cited: (November 17, 2015). Healthy Children: Holiday Safety and Mental Health Tips. Retrieved from



We’ll start today’s post with a story that was recently shared with us. It’s the story of a family who, as a result of having interacted with GGK Modules and Child Development Activities during their home visiting support services, reported the joy they are experiencing as they care for and interact with their baby.

When these parents were then asked about their favorite part of the day with their child, mom described in great detail how she loves to hold her child. “He puts his left arm around my neck and uses his finger to slowly trace my neck, as he falls asleep in my arms.” Dad’s eyes teared up as he listened attentively to mom’s story. He then said, My favorite part of the day is when I come home from work and baby welcomes me with a smile.”

At first these parents were fearful of participating in the home visiting program and had difficulty trusting their home visitor. The family had many challenges in their life.  Both parents struggled with developmental delays and were afraid that their baby was going to be removed from their care. Through routine home visits and support they have learned about child development, bonding, attachment, how to play with their baby, and the importance of self-care.  At this time, Dad has maintained employment for over a year at a local grocery store, and Mom is attending GED classes during the evenings. By finding many opportunities to create joyful experiences with their baby, both parents have blossomed into confident, caring, loving parents. It appears that their new found confidence in their parenting has also contributed to their ability to work toward personal goals for themselves.

Now let’s spend some time talking about how such joyful experiences impact our brains even during our adult life. As in all of our blogs, we will support our discussion with the latest research on this topic, in addition to referencing 7 GGK key ingredients of home visits, as we aim to support you in making your interactions with families fun, engaging, and informative. As demonstrated by our opening story, it’s magical when you can support parents in finding the real joy of parenting!

During the past decade, research has revealed that contrary to assumptions that changes in brain networks are possible only during crucial periods of development, the brain is permanently plastic (Arne, 2011).  In other words, experiences, changes to our environment or learning new skills can actually reorganize the structure of our brain (Arne, 2011). Scientists use the term neuroplasticity to refer to the brain’s ability to reorganize itself.  Neuroplasticity is not a new concept, but with the development of modern technology that allows us to actually see into the brain, science has confirmed the ability of our brains to “re-wire.”  It’s this impressive ability of our brains that allows us to continue to learn new things, and bounce back from damage caused by stroke or injury, even conditions such as autism, ADHD, learning disabilities, depression, and addictions (Hampton, 2015).

How does this neuroplasticity impact our work with families? Every home visit is an opportunity to help parents re-wire their brains as they learn new parenting and life skills.  For these brain changes to occur, parents will need to experience lots of positive interactions and practice new skills over and over again. Scientists call this “experience-dependent neural plasticity” (Arne, 2011), we just call it excellent Home Visiting! Parents will benefit in many ways from your smiles, support, shared laughter as they play with their baby, encouragement, and reassurance – Every home visit provides amazing opportunities to connect families’ interests and motivations with what they want to accomplish, through fun activities and joyful experiences in their relationship with each other, their child, and you.

According to Dr. Bruce Perry in his Cycle of Learning and Mastery, when we experience pleasure during an activity, we want to repeat that experience. With repetition, comes mastery and mastery provides a sense of accomplishment, pleasure, and confidence to act once again on curiosity (Perry,, 2000). What does this mean for you as a Home Visitor? Visits should be FUN…for everyone involved! In order to achieve the desired program outcome, families must be engaged. It’s the pleasure of the visits and their relationship with you that will keep them around and involved in your services.

Keep in mind these 7 Key Ingredients for meaningful, informative, and pleasurable home visits:

1)      Intention: Have a plan for your visit – know what you are aiming for; plan ahead for 2-3 things you want to accomplish during your home visit; AND be prepared to engage parent-child in a fun activity.

2)      Interactions with the parent that communicate “I care about you, and I enjoy being with you” - Listen to hear…not just to respond. Really hear parents’ feelings and opinions; communicate “I’ve been looking forward to being with you today”; create opportunities for parents to experience joy.

3)      Check in on the family’s accomplishments since your last visit – What information and skills have they put into practice; check in on their goal-related progress, communicating interest; look for the positives in all the things they do and accentuate them!

4)      Link their values and dreams to how they are interacting with their child now – Connect the family’s culture and traditions with strengthening their parenting and guiding their lifestyle choices; explore GGK curriculum topics of interests to parents.

5)      Provide opportunities for parents to learn how to support their child’s development – Be prepared to do GGK activities to teach parents how to stimulate their child’s growth across developmental domains; take advantage of teachable moments.

6)      Cultivate a parenting skill aimed at strengthening the attachment relationship – Acknowledge parents for understanding and responding sensitively to their child’s cues and needs; point out to the parents the joy they are experiencing as they are caring and playing with their child

7)      Connect your visit with “real-time” parenting that will take place between now and your next visit – Before your visit ends, ask parents how they will put into practice 2 to 3 bits of information or skills you have been focusing on, between now and your next visit.  Remember repetition leads to mastery!

The Growing Great Kids/Growing Great Families Curriculum materials are your tools for building the joy-filled parent-child interactions that motivate empathic parenting and give parents hope for the future. Busy Home Visitors have a tendency to get stuck using the same Modules and Child Development Activities, overlooking other rich opportunities for bringing curiosity, fun and new perspectives into their visits-Would you be open to, right now, finding 2 new modules and 2 new activities to try out later this week? We hope so!

Works Cited:

Arne, M. (2011). Experience-dependent Structural Plasticity in the Adult Human Brain. Department of Systems Neuroscience, University of Clinic Hamburg-Eppendorf, Germany. Published in Trends in Cognitive Sciences, Vol. 15, No. 10. Retrieved from

Hampton, D. (2015). Neuroplasticity: The 10 Fundamentals of Rewiring the Brain. Published Online on October 25, 2015 by Retrieved from

Perry, B.D., Hogan, L., Marlin, S., (2000). Curiosity, Pleasure and Play: A Neurodevelopment Perspective. HAAEYC Advocate Pages 9-11, August 2000.


In today’s blog, we will explore a topic of interest to all new parents – crying babies and how to console them. We know babies cry for different reasons, and most parents recognize that babies’ crying sounds different in different situations.  Certainly, as parents, we experience many different feelings when we hear our babies cry. How normal is baby’s crying? Is there a difference between “normal” and “excessive” crying? What does the Period of PURPLE Crying mean? We will start our discussion with what experts have to say about these questions. Then, we will explore why comforting a baby might be more important than getting the crying to stop. Crying is the only way infants communicate their needs. When a baby feels that her/his needs are attended to in nurturing and loving ways, they start building secure attachment relationships. Lastly, we will discuss some of the relevant GGK tools to help parents support the development of secure attachment relationships during routine care and daily parent-child interactions.

Infants’ crying is viewed as a normal part of neurodevelopment. Fussing, crying, and inconsolable crying follows a typical curve that increases weekly, peaks during the sixth week postpartum at a stable duration of approximately 2 hours per day, and declines to below 1 hour per day by the 3rd or 4th month.  Although crying may happen at any time of the day or night, it seems to have the propensity to occur in late afternoon or evening. Excessive or problematic crying is defined as crying behavior that occurs more than 3 hours a day, more than 3 days in any week, for at least 3 weeks, without any obvious cause. The unexplained reason of excessive baby crying is what concerns and stresses parents out. Unfortunately, excessive crying has been connected with Shaking Baby Syndrome, child abuse, parental distress, and depression, among many other negative health consequences for infants and parents (Akhnikh, et al. 2014).

In 2007, Dr. Ronald G. Barr in collaboration with Marilyn Barr developed the Period of PURPLE Crying. Dr. Barr is Professor of Pediatrics at the University of British Columbia. The Period of PURPLE Crying does not mean that the baby turns purple while crying but rather is the acronym to describe colic and excessive crying. The program is intended to help parents understand normal crying behavior, and what parents and babies go through when babies experience excessive crying and seem to resist soothing – which is a normal phase of every infant’s development (, 2016).

According to Dr. Barr (2016), all babies go through the Period of PURPLE Crying; some babies cry a lot and some far less, but they all go through it (, 2016). PURPLE stands for:

P: Peak of crying – Your baby may cry more each week; the most at two months, then               less at 3 to 5 months.

U: Unexpected – Crying can come and go, and you don’t know why.

R: Resists soothing – Your baby may not stop crying no matter what you try to do.

P: Pain-like face – A crying baby may look like they are in pain, even when they are not.

L: Long-lasting – Crying can last as much as five hours a day, or more.

E: Evening – Your baby may cry more in the late afternoon and/or evening.

When babies come into this world, their only means of communicating their feelings and distresses is through crying. Thus, crying is a way of securing an empathic response from the parent/caregiver. When babies receive what they need, they feel loved and secure, and they learn that they can depend on their parent/caregiver. Parents’ capacity to respond in nurturing ways depends on their ability to feel empathy for what the baby is experiencing.

GGK has several tools to support parents to grow empathic parenting skills. Today, we will spotlight the Getting in Sync and E-Parenting Daily Do. Getting in Sync is an attachment tool designed to support parents to read their baby’s cues and signals. When parents are able to read cues and sync up emotionally with their babies, they respond in loving and supporting ways. The E-Parenting Daily Do is a strategy intended for parents to grow empathic parenting skills and self-regulation in children. Remember that the “E” in E-Parenting stands for Empathy – this Daily Do describes 3 steps for parents that are easy to put in practice every day within routine care and parent-child interactions. Basically, the Getting in Sync and E-Parenting Daily Do tools are inter-connected; they are both intended to enhance empathic parenting skills.

Managing infants’ excessive crying is not easy! Sometimes infant crying has no medical reason, and new parents are often tired and stressed. What babies need most during this phase is for parents to meet their pressing needs and if nothing seems to help… remaining calm and relaxed would probably be one of the best approaches. As a Home Visitor, helping parents identify their support systems (family, friends, neighbors, parent hotline, etc.) so they can reach out to them when needed, will be extremely important.

Parents will also greatly benefit from reassurance and support from you in growing empathic parenting skills. Remember when parents put Getting in Sync and E-Parenting into practice many times each day, they are helping their baby build secure attachment relationships- and this is much more important than getting the crying to stop.


Works Cited:

Akhnikh, S., M.D., Engelberts, Adèle C,M.D., PhD., van Sleuwen, Bregje E, PhD, L'Hoir, M. P., PhD, & Benninga, Marc A,M.D., PhD. (2014). The excessively crying infant: Etiology and treatment. Pediatric Annals, 43(4), e69-75.

The Period of PURPLE Crying 2016). What is the Period of Purple Crying? Retrieved from





Have you noticed all the GGK resources related to preventing exposure to second and third hand smoke?  GGK is designed to provide program families plenty of opportunities to learn about many health care related topics, including the health effects of second and third hand smoke. It is important for parents to be able to make informed decisions about their family’s health. Today, we will discuss some research-based information about secondhand smoke and  the effects on developing pre-birth babies, infants and young children. We will also spotlight some of the GGK tools and resources along with practical tips and recommendations from the experts.

Let’s start our discussion by reviewing the definitions of second and third hand smoke. According to the Centers for Disease Control, secondhand smoke is defined as the smoke exhaled or breathed out, by a person smoking tobacco products, such as cigarettes, pipes, or cigars.  The tobacco smoke contains more than 7,000 chemicals, hundreds of them considered toxic, and about 70 that are known to cause cancer (Centers for Disease Control, 2016).

Dr. Lowell Dale from the Mayo Clinic and Professor of Medicine in Rochester, MN states that third hand smoke is generally considered to be residual nicotine and other chemicals left on a variety of indoor surfaces by tobacco smoke including that which clings to hair, skin, clothes, furniture, drapes, walls, bedding, carpets, dusts, and many other surfaces. He indicates that the mix of third hand smoke contains cancer-causing substances, posing a potential hazard to nonsmokers who are exposed to it, especially children. He also points out that third hand smoke is a relatively new concept, and researchers are still studying its possible dangers (Mayo Clinic, 2014)

In part because second hand smoke is more obvious, there is greater buy in about the adverse impacts of exposure. Many families seem to be aware that smoking inside when children are present is harmful.  The effects of Third hand smoke exposure, however, has not yet gained the same degree of awareness.

Research indicates that, statistically, low-income populations have are less likely to have total home smoking bans when compared to their wealthier counterparts (Acuff, Fristoe, Hamblen, Smith, & Chen, 2016). When it comes to smoke-free policies, one of the biggest problems seems to be in perception. One study found that most of the participants were not familiar with the information about the effects of third hand smoke, but after it was discussed with them most agreed that the message would motivate them to make their homes smoke-free (Escoffery, et al., 2013)

Let’s do a bit more exploration around how exposure to tobacco smoke, either second or third hand, can harm developing babies, infants and children.

The Developing Baby and Smoke

Exposure to smoke during pregnancy can negatively impact the growth and development of the fetus as well as the child’s future health and behavior. Poor developmental and psychological outcomes can include miscarriage, premature birth, reduced birth weight, and increased risk for diseases and behavioral disorders later in life such as learning problems and attention-deficit/hyperactivity disorder (Grigorenko et al., 2012).

Infants/Children and Smoke

Infants and children exposed to secondhand smoke are at higher risk of serious health problems both short and long term.  Secondhand exposure is connected to respiratory diseases and asthma, low birth weight, sudden infant death syndrome (SIDS), cognitive impairments such as reading and math deficits, behavioral problems such as hyperactivity, aggression, depression, and other conduct disorders, bronchitis, pneumonia, middle ear infections, and other diseases (American for Nonsmoker’s Rights, 2009).

The Growing Great Kids Curriculum is specifically designed to present research-based information in simple, easy, and understandable ways. Here are some examples of the topics and handouts related to preventing second and third hand smoke exposure. Check them out today and share them you’re your program families!

GGK Prenatal: Smoking and Fetal Development

GGK 4-6 Months: Smoking: Facts About Exposing Children

GGK 10-12 Months: Smoking Revisited. Is Your Baby a Second or Third Hand Smoker?

Let’s wrap up with reviewing a few tips for parents from The American Academy of Pediatrics (, 2015)

  • Do not smoke near your children, or your pets
  • Make your home and car smoke free
  • Remove your children from places where smoking is allowed
  • Choose a babysitter who does not smoke
  • Encourage tobacco-free child care and schools
  • And last but not least… talk to your child’s pediatrician about ways to keep your child healthy in regard to tobacco exposure.

We are all at risk of being exposed to secondhand smoke when we go to restaurants, sports events, parks, concerts, and even family or friends’ gatherings.  While eliminating 100% of children’s exposure to second and third hand smoke might be impossible, parents appreciate receiving information that will support them in making “best choices” for their children. You have some great GGK tools and resources for guiding these conversations around this topic!


Works Cited:

Acuff, L., Fristoe, K., Hamblen, J., Smith, M., & Chen, J. (2016). Third hand smoke: Old smoke, new concerns. Journal of Community Health, 680-687.

The Centers for Disease Control and Prevention (2016). Smoking and Tobacco Use. Secondhand Smoke Facts. Retrieved from

Escoffery, C., Bundy, L., Carvalho, M., Yembra, D., Haardorfer, R., Berg, C., & Kegler, M. (2013). Third hand smoke as a potential intervention message for promoting smoke free homes in low income communities. Health Education Research, 923-930.

The Mayo Clinic (July 10, 2014). Healthy Lifestyle Adult Health: What Is Third Hand Smoke? And Why Is It a Concern? Answers from Dr. Lowell Dale. Retrieved from

Grigorenko, E. L., Cicchetti, D., Knopik, V. S., Maccani, M. A., Francazio, S., & McGeary, J. E. (2012). The epigenetics of maternal cigarette smoking during pregnancy and effects on child development. Development and Psychopathology, 24(4), 1377-90. Retrieved from

Americans for Nonsmoker’s Rights (2009). Health Effects of Secondhand Smoke on Children. Retrieved from (October 20, 2015). Health Issues: The Dangers of Secondhand Smoke. Retrieved from

Breastfeeding is a very broad topic that has been rigorously researched in the United States as well as throughout the world. In today’s post we will anchor our discussion around the current US statistical information and the benefits of breastfeeding for the baby, mom, and the family as a whole.  Given that breastfeeding is a personal and family choice, this topic tends to create a level of uncertainty regarding when and how to start these conversations with program families.  For this reason, we will also explore the ways that the GGK curriculum supports your approach to breastfeeding-related topics during home visits.

Let’s start by reviewing the recommendations provided by the American Academy of Pediatrics (AAP). Their most recent breastfeeding policy statement, published in 2012, reaffirmed the recommendation of exclusive breastfeeding for about 6 months, followed by continued breastfeeding as complementary foods are introduced, with continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant (American Academy of Pediatrics, 2012).

The Centers for Disease Control and Prevention (CDC) statistics indicate that while breastfeeding rates in the United States have gone up to 77%, they are still below the desired targets of 81.9% established by the Healthy People 2020 guidelines. The CDC states that there has been progress nationwide in keeping mother and baby together right after birth to support immediate and continued contact between them, which helps the mother establish breastfeeding practices early and learn infant feeding cues. (Centers for Disease Control and Prevention, 2013).

Now let’s talk more specifically about why breastfeeding is a good choice.  According to the AAP policy statement (2012), breastfeeding results in improved infant and maternal health outcomes:

Benefits for the Infant:

  • Reduced rates of Otitis Media,
  • Reduced rates of Gastrointestinal Tract Infections,
  • Reduced rates of Sudden Infant Death Syndrome and Infant Mortality,
  • Reduced rates of Allergic Disease,
  • Reduced rates of Celiac Disease,
  • Reduced rates of Inflammatory Bowel Disease,
  • Reduced rates of Obesity,
  • Reduced rates of Diabetes,
  • Reduced rates of Childhood Leukemia and Lymphoma,
  • Higher intelligence scores.

Families may wonder about why this variety of health outcomes is so closely linked to breastfeeding. The latest research indicates that there may be many mechanisms that come into play, but most of the findings come back to the idea of the human microbiome. Let’s take a few minutes to explore this topic a bit further.

The microbes that live in the human gastro-intestinal system are critical for our well-being. “Imbalances in the normal gut microbiota have been shown to correlate with a range of diseases.” (Pop, 2012) The first few years of life critically shape the composition of bacteria that will inhabit that individual’s body for years to come and much of that composition is based on diet.  “Breast milk has high nutritional content and is important in passing immunological factors from mother to child, as well as nutrients that are essential for gut colonization by bacteria.” (The American Microbiome Institute, Inc., 2015)

This demonstrates yet another way that those early parenting choices are critical, in so many ways, for optimizing the child’s development. There are also great benefits to be gained from breastfeeding in regard to the mother’s health.

Benefits for the Mother:

  • Decrease in Post-Partum Blood loss,
  • More Rapid Involution of the Uterus,
  • Decrease in rates of Post-Partum Depression,
  • Decrease in rates of Diabetes Type 2,
  • Decrease in rates of Hypertension,
  • Decrease in rates of Cardiovascular Disease,
  • Decrease in rates of Breast Cancer,
  • Decrease in rates of and Ovarian Cancer.

When and how do you approach these conversations with program families?  As you know, the Growing Great Kids curriculum provides a variety of breastfeeding conversation guides to share with families at different intervals starting during the prenatal phase. GGK is intentionally designed first to explore what the family knows about the topic, what their views, values, and practices are around that area, and then moves into sharing research information, and finally exploring their thoughts about what they would like to consider and/or put into practice. Here are a few places you’ll find these modules:

  • GGK Prenatal: Breastfeeding…A Lifetime of Benefits
  • GGK: 0-3 Months: Breastfeeding Families
  • GGK: 4-6 Months: Feeding Your Growing Baby
  • GGK 7-9 Months: Feeding and Nutrition 7-12 Months
  • GGK 10-12 Months: Weaning and Self-Feeding Skills

While the topic of breastfeeding might seem challenging for some Home Visitors, it is important always to keep in mind that our role, as home visitors, is to support families by exploring information that will inform their decisions. Following the sequencing of the curriculum is a great starting point!

In addition, prenatal clinics and birthing hospitals can provide contact information on local lactation programs, and there are also many reliable lactation information Internet sources including:

American Academy of Pediatrics

Centers for Disease Control and Prevention

Kelly Mom Parenting Breastfeeding

La Leche League


Be sure to also discuss the many social-emotional BENEFITS FOR THE FAMILY that breastfeeding provides. For example, the many opportunities for mom and baby to connect, skin-to-skin and face-to-face, creates feelings of mutual contentment and contributes to the formation of secure attachment relationships this benefits the whole family!


Works Cited:

Pop, M. (2012). We are what we eat: How the diet of infants effects their gut microbiome. Genome Biology, 152.

The American Academy of Pediatrics (2011). Policy Statement: Breastfeeding and the Use of Human Milk. Pediatrics Volume 129, Number 3, March 2012. Retrieved from

The American Microbiome Institute, Inc. (2015, February 12). Breastfeeding plays an important role in microbiome development. Retrieved from

The Centers for Disease Control (2013). Breastfeeding Report Card United States 2013. Division of Nutrition, Physical Activity, and Obesity. Retrieved from

In our last blog, we discussed the negative impact of technology and use of electronic devices in promoting bonding and attachment, learning, and school readiness. Today, we will expand on this topic by exploring the specific developmental and health consequences related to exposing infants and young children to television, whether used as foreground or background media. As in all blogs, we will reference the Growing Great Kids resources available around this topic and conclude with a few tips and recommendations from the experts.

According to Dr. Dimitri Christakis, a Pediatrician and also the Director of the Child Health Institute at the University of Washington, it is not just the age at which children start to watch TV, but it is also the amount that they watch that is concerning.  Since the time TV came into our homes, some 60 or 70 years ago, the media landscape has evolved considerably.  In the early days, it was estimated that a typical child began watching TV at 4 years of age and consumed approximately 3-4 hours per day.  Today, the typical child begins watching TV at 4 months old and is engaged in media for up to 8 hours per day (Christakis, 2010).  The American Academy of Pediatrics has also revealed some alarming findings around this issue.  They said that 90% of parents report that their children younger than 2 years watch some form of electronic media (TV programs, DVD, videos).  By the age of 3 years, approximately one-third of children have a television in their bedroom (American Academy of Pediatrics, 2011). Parents report they use television as a peacekeeper, a safe activity, and even as part of their children’s sleep routine. All of this is connected to the industry’s efforts that target young children and their parents as key consumers of electronic media including educational videos, television programs, and cable networks.

Researchers point out that infant TV viewing might adversely affect critical milestones of early childhood related to language and cognitive development, attention capacity, and social skills. Screen time has also been associated with health issues including obesity, sleep issues, aggressive behaviors, and attention issues for school age children.  Experts say that the flashing lights, scene changes, quick edits, and auditory cuts may be overstimulating to developing brains and children’s abilities to regulate mood, behavior, and learning.  Additionally, TV viewing limits the infant’s opportunities for quality time with human caregivers (Christakis, 2010).  Babies need face-to-face interactions with their parents/caregivers!

The Growing Great Kids Curriculum incorporates several conversation guides with topics specifically designed to share research findings on TV and Child Development and to explore ways with parents to decrease the amount of TV time. Here are just a few of the many topics:

  • 0-3 Months: Cues and Communication:  No Benefits from Infant DVD’s and TV Programs
  • 0-3 Months: Cues and Communication: Infants Need Face-to-Face Interaction
  • 4-6 Months: Cues and Communication: Foundations for Language Learning
  • 7-9 Months: Physical and Brain Development: Brain Cells: Use Them or Lose Them
  • 10-12 Months: Play and Stimulation: Learning Problem Solving Through Play
  • 16-18 Months: Physical and Brain Development: TV and Early Brain Development
  • 22-24 Months: Play and Stimulation: Arranging Your Toddler’s Day
  • 31-36 Months: Physical and Brain Development: Increasing Attention Span
  • 31-36 Months: Physical and Brain Development: Encouraging Receptive and Expressive Language Development
  • 31-36 Months: Basic Care: I Want to Sleep Handout

Some recommendations by the American Academy of Pediatrics (American Academy of Pediatrics, 2011) around infant/children TV watching include:

  • No media use for children under the age of 2
  • Set media limits for children and have a strategy for managing background media
  • Avoid placing a television in the child’s bedroom
  • If children are engaged in TV watching, turn the TV off at least 45 minutes before the child’s bedtime ritual begins
  • Substitute TV time with  parent-child and  independent play
  • Provide activities and toys to increase the child’s attention span

While eliminating media might not be realistic for many parents, knowing the adverse effects on their children’s development and health would hopefully motivate them to set limits for TV time and look for creative ways to interact with their children. Also, remember that GGK provides hundreds of Child Development Activities for parents and children to experience face-to-face interactions!



Christakis, Dimitri A, M.D., M.P.H. (2010). Infant media viewing: First, do no harm. Pediatric Annals, 39(9), 578-82.

The American Academy of Pediatrics (2011). Media Use by Children Younger Than 2 Years. Pediatrics Volume 128, Number 5. Retrieved from

The American Academy of Pediatrics (2011). Babies and Toddlers Should Learn form Play Not Screens. Retrieved from