Purpose This paper describes the effect that the COVID-19 pandemic, and subsequent shift from in-person to virtual (video-based) home visiting, had on the Los Angeles County Welcome Baby Home Visiting Program. Description The Welcome Baby (WB) Program is a voluntary, universal home visiting program for expectant women and women with infants in Los Angeles County implemented in 14 hospitals in Los Angeles County. Oversight of the program is managed by LA Best Babies Network (LABBN) and funded by First 5 LA. The COVID-19 pandemic forced Welcome Baby Home visitors to shift from in-person home visits to virtual visits, which had an impact on programmatic outcomes. Assessment LABBN manages a database utilized by WB sites. In assessing data trends before and during the pandemic, shifting to virtual visits resulted in an increase in both missed visits and completed visits, and a decrease in overall visit length. Completion of required assessments and overall client program completion were not affected by the COVID-19 pandemic. Conclusion The Welcome Baby sites across Los Angeles County were able to successfully migrate in-person visits to a virtual platform, proving that virtual visits are possible and do provide some programmatic benefits. However, the long-term efficacy of virtual visits remains to be seen, and further research is warranted.

COVID‐19 has disrupted many of the preventive service sectors designed to promote infant mental health. The purpose of this study is to examine provider and supervisor transition strategies as well as maternal‐child outcomes during the transition from in‐person to virtual early childhood home visitation services in Los Angeles County. Los Angeles County is one of the largest home visitation sectors in the U.S. and disproportionately impacted by the COVID‐19 pandemic. Transitioning from in‐person to virtual home visitation was an important step in ensuring the continuity of infant mental health services. Home visitors reported relative ease in transitioning to virtual services themselves but noted that families encountered greater difficulty. The most helpful strategies to support this transition included training, ongoing reflective supervision, and provision of technology. Family level analysis revealed that positive screening rates for anxiety and depression decreased during the pandemic as did referrals for most support services. These findings likely highlight challenges in delivering virtual home visitation. Understanding how transitions in a key infant serving sector were managed serves an important role in forecasting for the future and preparing for future public heath emergencies.

Background: Exclusive breastfeeding is the healthiest and most economical form of infant nutrition. Although research has indicated that professional support increases the length of time women breastfeed, the optimal timing of provider encouragement to sustain mothers' breastfeeding is unknown. We evaluated the impact of the timing of provider encouragement on breastfeeding initiation and three-month duration, especially among racial/ethnic minority mothers who have been underrepresented in breastfeeding outcomes research. Methods:We used data from the 2010 Los Angeles Mommy and Baby (LAMB) Survey. LAMB is a population-based mail survey, distributed to women in Los Angeles County who recently gave birth to a live infant. Participants were asked about their perceptions of provider encouragement of breastfeeding at three specific time points: during prenatal care visits, during the birth hospital stay after the baby was born, and during early well-baby checkups. Mothers were asked whether they breastfed or pumped breast milk to feed their baby after delivery and if they were still breastfeeding at the time of the survey.Results: Overall, 87.6% of LA County mothers initiated breastfeeding after delivery. At 3 months, 60% were still breastfeeding. Adjusted logistic regression analysis showed a positive association between provider encouragement at the delivery hospital and breastfeeding initiation (aOR = 2.7, 95% CI = 1.60-3.96) that was significant across all races/ethnicity. Encouragement during well-baby checkups was positively associated with breastfeeding at 3 months (aOR = 1.5, 95% CI = 1.22-1.93). This latter association was found among all races and ethnicities, except for Black mothers. There was no association between encouragement provided during prenatal care and breastfeeding practices. Conclusions:The optimal timing of provider encouragement on breastfeeding initiation is likely during the birth hospitalization, while sustained breastfeeding likely requires professional support after discharge. Culturally appropriate interventions to maintain positive breastfeeding practices must be identified, especially for black mothers.