Little Rylee Munns got two bouncy seats for Christmas.
But her mom wasn't sure exactly how they should be set up.
So Mom -- Heather Bell -- got some expert advice from visiting nurse Lindsey Cassler, who knows about babies' developmental issues and bouncy seats.
Initially, Bell set up the seats so the baby's feet wouldn't touch the floor, because little Rylee's legs weren't strong enough to be putting pressure on them.
But now that Rylee is almost 6 months old, the seats have been lowered and she's pushing off the floor like a big girl.
Cassler visits Bell and Rylee once a week, providing education, checking the baby's weight and development, and offering advice when appropriate under the local health department's Parenting Support Project.
"It's like having a little doctor visit between doctor visits," said Bell, who is part of a special pilot program operated by the Lincoln-Lancaster County Health Department and Cedar's Youth Services, which worked with 81 families last year.
The staff are trained in the Healthy Families America program, an evidence-based model that has proved to be effective in preventing abuse and neglect, said Shirley Terry, public health nursing supervisor.
The program has been so successful that all of the department's public health nurses have received the Healthy Families America training and will use the model with all maternal health clients, eventually serving about 500 families a year.
The Lincoln program targets first-time moms who have potential stressors in their lives, like low income, a missing dad, no family support, no high school diploma.
These are red flags that can put a woman at higher risk, according to Terry.
"We are there to support, to cheer them (moms and dads) on. We are going to teach them to take care of their babies," she said.
For some, the visits are their only support, Terry said.
No one has taught them what to do when the baby cries, she said. No one has said it is normal to want a break from baby tending.
The home visits are a relaxing time, and the home visitors model good parenting behavior.
They also help parents work on larger family goals, which can be as simple as learning what is going to happen during a given trimester of pregnancy or as daunting as mom returning to school or getting a job.
Families stay in the program for several years, although the weekly visits -- the "intense home visitation" -- generally tapers off after the baby is 6 to 9 months old, Terry said.
"We talk. And she plays with Rylee and makes sure everything is OK," Bell said of her weekly visits with Cassler.
She also gives Bell the latest advice on nutrition.
Take baby food.
Bell started Rylee with a single vegetable, not a fruit, after talking with Cassler. Babies like sweet fruit too much, and then they can be reluctant to move on to vegetables.
Bell passes on what she learns to Rylee's dad, Jeff Munns, who takes care of his daughter at night while Bell works.
The new model is more intensive with pregnant moms and during infancy and works with parents longer than traditional visitation programs, Terry said.
The department will serve fewer families using the Healthy Families America program with everyone, but Terry believe the extra attention and education pays off.
Last year, all the participating children had their well-baby checks and immunizations on time and 90 percent were meeting or exceeding developmental milestones. And, Terry said, none of the participating families had any substantiated reports of abuse or neglect.
The $149,000 state grant for the Parenting Support Program is part of the $1.67 million maternal child health budget.
Home visits are a big part of the Health Department's maternal child health program, including following up when a doctor thinks a family needs a little extra attention. But nurses and outreach workers also give immunization shots to the homeless and near homeless, and do health screenings for several special programs.