Keishaun Watson was the first to show up. She brought along her week-old daughter, Kaeden, who dozed in a Winnie-the-Pooh stroller. Next came Sierra Watkins with an equally new-to-this-world infant, a boy named Tyree.
The two mothers were soon joined by about a dozen other women, all from East Baltimore and all in various stages of pregnancy or motherhood. Some hoisted chubby-cheeked toddlers over their heads, some cooed over sleeping infants, and some patted bulging bellies.
The women -- and one stoic dad -- gathered yesterday at a city Healthy Start clinic not far from Johns Hopkins Hospital to talk about one thing: nursing, how to do it, why it is important, and how to tell pesky relatives that the bottle is not an option.
The breastfeeding-support lunch is one of many programs offered at Healthy Start to ensure that low-income women deliver healthy babies. Baltimore opened its first Healthy Start clinic in 1991 -- federal officials targeted the city as well as 14 others with high infant mortality rates -- and there are now three clinics, serving the city's east, west and central neighborhoods.
Baltimore's Healthy Start program, which is still partially funded with federal dollars and has an annual budget of about $4 million, has reached an impressive benchmark. Today, staff and clients will celebrate the near eradication of low-birth-weight babies to women enrolled in the program for two consecutive years. Babies born at a healthy weight have a much greater chance of survival.
In 2005, 0.7 percent of the nearly 800 women enrolled in the program delivered babies that weighed 3.3 pounds or less. Babies born at a low birth weight -- 3.3 pounds or less -- have a greater chance of dying within the first year of life, according to city health officials.
Last year, the most recent for which data are available, the low-birth-weight rate among Healthy Start participants was 0.9 percent, a figure that meets the surgeon general's Healthy People 2010 goal -- nearly three years in advance. The slight uptick between 2005 and last year does not represent a significant increase in low birth-weight babies, city officials said.
Healthy People 2010 is a set of national health goals for communities and individuals within the first decade of the new century.
"Healthy Start saves babies' lives and provides hope and opportunity to their families," said Health Commissioner Dr. Joshua M. Sharfstein, who is scheduled to attend an event to announce the program's success at 10 a.m. today at the Healthy Start clinic at 1622 N. Carey St. in Sandtown-Winchester. "We need to expand access to solutions like Healthy Start across the city."
City health officials are working to open four Healthy Start clinics in the near future, said Alma Roberts, who heads Baltimore's program.
Roberts said that the state has committed to funding the expansion if the city can show that there is a need for such services. Roberts said her staff will present a report to west-side residents, where the new clinics could open, at a town hall meeting scheduled for Oct. 9.
"The ultimate goal is that we expand Healthy Start services to those communities," said Roberts.
Program officials also are working with medical experts to learn more about how environmental stresses such as crime, pollution and family strife affect women and their pregnancies.
The Healthy Start program enlists active neighborhood outreach workers to meet and talk with women who are pregnant or who have recently delivered a baby. Those who enroll in the program receive medical care, household supplies and instruction in parental skills, as well as job training, drug addiction treatment and mental health services.
The breastfeeding group, which meets once a month, attracts a regular crowd of new and not-so-new mothers. At the meeting yesterday, participants talked about nursing concerns -- sore nipples, fussy babies and annoyed family members -- and joys such as bonding time between mom and baby and less disturbance during late-night feedings.
"When she first latched on, she went right for it," said Watson, who is 18, of her baby's early breastfeeding experience.
She said she didn't have a difficult time getting Kaeden to start nursing, but that is not true for all mothers.
Monic Smith, 38, said she was having trouble getting her month-old daughter, Jeneah, to breastfeed, in part because the baby was jaundiced when she was born and had to be removed from her mother's hospital room for treatment.
"We've got a small window of opportunity, and so if she gets hungry, you tell me," Julia Hayman-Hamilton, the lactation consultant who runs the Healthy Start breastfeeding-support lunch, told Smith.
About 20 minutes later, Smith indicated that her baby was hungry, and the two women scurried to another room with the baby for some lactation instruction. They returned about 10 minutes later frustrated -- little Jeneah had not been able to nurse -- but not completely dejected.
"She's not going to give up," Hayman-Hamilton said of Smith.
Throughout the lunch, women who had been nursing their babies for a few months shouted out advice to those who were beginning or those who were pregnant.
"I want to breastfeed my baby," said Sharlita Key, who is six weeks pregnant. "But ..."
"There's no but," said Hayman-Hamilton. "I don't want to hear you say it."
Near the end of the class, Hayman-Hamilton reminded the participants that she was always available for advice. She gives her cell phone number to all her class members.
"Don't stop [nursing] until you give me one chance to help you," she said.