Ira Hillman -

Jan 15, 2022

Building Philanthropic Momentum in Early Relational Health

At the end of 2021, more than two dozen funders came together for the first Early Relational Health (ERH) Funders Summit, co-sponsored by Einhorn Collaborative with the ERH Coordinating Center at the Center for the Study of Social Policy (CSSP). These funders are part of a new community – the ERH Funders Community who are seeking opportunities for shared learning and connection to improve how we work together to advance early relational health and emotional connection between parents and their young children.

The ERH Funders Community shares a vision of a world where all parents can hold their children close and build a relationship rooted in deep emotional connection in the first hours, days, and weeks of their babies’ lives. Those same parents would also have time off from work – with pay – in order to continue strengthening their relationships with their children, creating habits of mutual, reciprocal, and responsive connection. Our communities would surround these families with organizations that help parents and babies repair and reconnect after moments of inevitable separation. Importantly, all families would be celebrated for the strengths they bring to their experience of early relational health – without judgment from family-facing organizations and professionals.

There is plenty of evidence that this is not the reality for many parents in our country who face numerous barriers that make it harder for them to maintain and re-establish emotional connection with their children. Only 23 percent of private sector employees – and 26 percent of local and state government employees – have access to paid family leave. One in six children ages 6-17 have a treatable mental disorder, but more than half never receive any treatment. One in seven mothers experience maternal depression and anxiety – and that number is much higher for women from low-income communities or communities of color. It is estimated that half of all children are not ready for school as they approach kindergarten age.

The Science and Practice of Early Relational Health

It doesn’t have to be this way. Change is possible. Emotional connection is a state we move in and out of with each other, not a trait a person either has or lacks. This was a key lesson that our community of ERH funders came to understand through a presentation by Dr. Martha Welch, Director of the Nurture Science Program at Columbia University we each attended as preparation for our day-long summit. In the course of only 15 minutes, funders learned about the four domains of emotional connection, and the two reflexes associated with it: the orienting reflex and the social-emotional reflex. When we left the presentation, it was as if we had put on a pair of new glasses: we found ourselves seeing evidence of emotional connection simply by observing interactions around us.

It doesn’t have to be this way. Change is possible. Emotional connection is a state we move in and out of with each other, not a trait a person either has or lacks.

—Ira Hillman, Einhorn Collaborative

With this knowledge that early relational health is observable and actionable in non-judgmental ways, funders came to the Summit eager to understand the obstacles that get in the way of emotional connection and to plan together how we might start to address those challenges. It was energizing and inspiring to hear presentations from researchers, field leaders, program practitioners, and others who all amplified the power and potential of early relational health, as well as the timely opportunities for investment, given the momentum in the field.

To kick off the summit, Einhorn Collaborative’s Executive Director, Jenn Hoos Rothberg joined Dr. Welch in conversation about the interpersonal physiology of emotional connection(video below). Dr. Kate Rosenblum, a leader in the infant mental health field, then described her research findings demonstrating the power of ERH home-visiting to interrupt the effects of intergenerational stress on child development—including the important marker of language development. Dr. Dani Dumitriu gave us a window into research exploring the heart rate synchrony that happens between mom and baby when they connect—literal heart to heart communication. In the course of these talks, a theme emerged: that relational health is not just psychological in nature or impact, and it’s not just for babies and children—it’s foundational for whole-body, and whole-family, health.

As a group of early childhood funders, these new research findings only made us more eager to expand our reach and engage others in our communities in supporting early relational health. Three inspiring leaders, who joined a panel led by Dr. David Willis from CSSP’s ERH Coordinating Center, urged funders to capitalize on the current moment. American Academy of Pediatrics President Lee Beers, MD reiterated the AAP’s commitment in a recent policy statement to partner with families and communities to promote early relational health. Yet, to achieve this goal, the AAP needs support from philanthropy to create the enabling conditions in health care that can accelerate this change. Erasma Beras-Monticciolo, Co-founder and Executive Director of Power of Two, urged the group to consider how we can position and communicate the foundational importance of early relational health in a “politics-proof” way. StoryCorps Chief Program Officer, Lisa Gale, advocated for philanthropic support to put ERH tools and resources into the hands of family-facing organizations and parents themselves to ignite the cycle of change.

That work is already underway among early champions who shared their experiences with the funder community. MaryEtta Callier-Wells, who leads a parent education program at Self Enhancement Inc. in Oregon, described how her focus on emotional connection creates trust and empowerment for families who may have experienced injustices; she also reminded us how easily messages of ERH resonate with families. We heard from Dr. Alice Gong (UT Health San Antonio) about the extraordinary power of emotional expression to facilitate emotional connection for families affected by the stress and trauma of premature birth – which affects 1 in 10 families in the country.

Moving beyond the NICU population to the universal setting of pediatric well-child visits, Dr. Waleed Abdelhafez of People’s Community Clinic in Texas and Dr. Usha Ramachandran of Rutgers RWJ Medical School in New Jersey each described their transformative experiences of integrating a quick observation of emotional connection into their practice. Dr. Abdelhafez described how well ERH fit into the clinic’s focus on social determinants of health and helped his team to offer tiered supports. Dr. Ramachandran shared her experience as part of an emotional connection training pilot with Reach Out and Read.

Funders Commit to Modeling a Relational and Collaborative Approach

After several hours of learning from the applied experience of such diverse practitioners, we digested what we heard and identified areas for further exploration and collaboration.

Scale ERH supports in pediatrics: National funders have been part of the Pediatrics Supporting Parents (PSP) initiative which has been actively focused on this effort for nearly five years, yet still seeks additional funders at the national and local levels.

Leverage existing programs/platforms at the local level: Planning is underway for prototyping and spreading emotional connection training through Reach Out and Read in a collaborative effort housed at the CSSP ERH Coordinating Center.

Explore opportunities in other settings beyond pediatrics: Several funders are developing, in collaboration with CSSP, a pilot of ERH training for a diverse birthing workforce that includes community health workers and doulas.

Address systems barriers that impede provider uptake and disrupt parent-child connection: With an understanding that funding pilots and individual projects alone won’t be enough, the funders hope to learn from bright spots of innovative funding models that support ERH in several states across the country.

Build a movement: The ERH Funders Community wishes to explore a public messaging campaign for ERH.

Center family authority and experience: Funders are committed to parents and families being engaged in all of these efforts as co-designers throughout the work.

New evidence is growing that supports early relational health and emotional connection for families, and new partnerships are forming among researchers, providers, and funders that have the capacity to advance and scale widespread change. The philanthropy sector has a unique opportunity to help leverage the relational models that offer so many positive benefits to families. Funders can also invest in innovative research and collaborations that will unlock new models and opportunities that have yet to be discovered. To do this work well, funders need channels for ongoing communication, learning, and collaboration. If you are a funder interested in early relational health, I hope to see you on the ERH Funders Community on LinkedIn and at future ERH Summits. Together, we can help more parents and babies experience the deep emotional connection they deserve.

Ira Hillman leads Einhorn Collaborative’s Bonding strategy. Learn more about our work in Bonding and more about Ira. Sign up to receive our monthly newsletter and be the first to read Ira’s blog posts.