Here’s a confession: In the middle of the night, all new parents talk to their babies. Not just cooing and singing, but long, discursive conversations that start like this: Hi Baby, who in the world are you?
Partially it’s because we’re all sleep-deprived—and partially it’s because we are so full of hope and wonder.
Whatever the details of the conversation (What kind of movies will you like? Who are you going to date? Are you going to share my taste in footwear?), there is one ever-present topic foremost on our minds: How am I going to keep you, Baby, healthy and happy? Because that’s a parent’s job.
And that’s what Johnson & Johnson sees as its job, too.
The company has a long history of putting the littlest patients first, whether it’s working with obstetricians to produce safe delivery kits in the 1890s, debuting the now iconic Johnson’s® Baby Lotion in 1944 to help prevent diaper rash or, more recently, partnering with countries worldwide to send vital healthcare messages via mobile phone to expectant moms who live in areas without ready access to neonatal services.
And as we head into 2018, the company has challenged itself to be at the forefront of a healthy-baby revolution. Whether it’s studying baby skin and the microbiome, common early infectious diseases or the nuances of infant-mother interaction, Johnson & Johnson is making groundbreaking contributions to what it has dubbed Generation Healthy, or “GenH.”
The company kicked off its efforts last year with the launch of the GenH Challenge, a global social venture competition dedicated to finding solutions for some of the world’s toughest health problems—such as infectious diseases that affect babies and preterm birth—in order to produce the healthiest generations ever.
“Johnson & Johnson has been at the forefront of caring for the health and well-being of babies since the 1890s, and from day one, thoughtful innovation has been the fuel that has helped us deliver on our promise then and today to foster healthy generations each and every day,” says Alex Gorsky, Chairman & CEO, Johnson & Johnson. “We are now challenging ourselves to take it to the next level to help create what I call a global GenH—the healthiest generation in history.”
We’re taking a look at how the company is blending cutting-edge science and extensive baby health prowess to help shape, protect and nurture future generations to come.
Why baby health really begins before birth
“If we’re looking to have this next generation be the healthiest ever, we can come up with all the medications in the world, but we really have to start thinking about health before babies are born,” notes Anna Prilutsky, Vice President, R&D Global Baby, Johnson & Johnson.
To make that vision a reality, Johnson & Johnson needs boots on the ground—or certainly booties. That’s why the company recently partnered with UNICEF to help train more than 3,000 midwives and medical workers in safe baby delivery techniques and infant care skills in underserved regions of Vietnam. It’s just the latest in a 15-year legacy of supporting midwifery programs around the world.
There is the need to be prepared for emergencies during childbirth, of course. But there is also a great need to optimize health overall, particularly when it comes to early births.
Preterm births, which had been declining in the U.S. but have now risen significantly over the past two decades, have long-term medical consequences. Even “late preterm” births of 34 to 36 weeks are concerning: Numerous studies show that late pretermers are more subject to conditions like heart disease, diabetes and even depression later in life.
“It’s really tough work, preterm prevention, but it’s critical,” says Joy Marini, Global Director, Global Community Impact, Johnson & Johnson. This is particularly true in some developing countries where undiagnosed medical conditions, like HIV or urinary tract infections, and certain cultural norms (think: heavy manual labor and lack of education about nutrition) can lead to preventable early births.
As Marini has seen firsthand, trying to change habits that have been passed down through the generations can be hard.
“There are factors contributing to preterm birth in other countries that we don’t think about here,” she says. “For example, 70% of women in Bangladesh and Mali continue to do intensive labor throughout pregnancy, like carrying water or farmwork.” This is based on survey findings that came out of the Born On Time program, a partnership between Johnson & Johnson and the Canadian government.
But the company is committed to change. While the Born On Time program is helping address preterm birth outside the U.S., here in the States, Johnson & Johnson has partnered on a like-minded program with Healthy Babies are Worth the Wait for over a decade now.
The program started in 2007 in Kentucky, and after three years of offering expectant moms a combination of education and increased medical access, the number of preterm births in the state dropped by 12%.
The way I see it, MomConnect is not only a way to talk to women, but a way to listen. It doesn’t just push out information. It gives mothers a voice.
Healthy Babies are Worth the Wait is now being instituted in other cities, particularly areas with a significant African-American population, like Newark, New Jersey. Black women have preterm babies at almost twice the rate of Caucasian women—15% versus 9%. Some of the reasons are genetic, but not all. Stress and lack of access to healthcare or good nutrition play a role, says Marini. “We hear many African-American women who feel they are not respected by their healthcare providers,” she notes.
One of the obstacles to great prenatal and first-year care is getting busy women to pay attention. “Get ‘em where they live” goes the old maxim—and now, increasingly, we live on our phones. So Johnson & Johnson has tackled this challenge of outreach since 2010 with mobile messaging programs designed to target low-income mothers in 10 countries by drawing upon the content expertise of BabyCenter® and the skills and experience of local partners.
Take MomConnect, a flagship program of the South African National Department of Health that has reached 1.8 million mothers in three years.
Here’s how it works: A pregnant mother visiting her health clinic for the first time is encouraged to sign up for the MomConnect service, which works on even the most basic phone. After entering her national identification number, language and due date, she’ll receive weekly healthcare messages that will help her look after her own health and that of her baby, like information about how her baby is developing in utero and feeding tips once she’s born.
If it sounds simple, it is. But sometimes this information can be the difference between life and death, particularly in a country like South Africa, where one out of three pregnant women is HIV-positive.
And the information isn’t purely medical. “BabyCenter’s content is designed to make an emotional connection with the mother,” says Joanne Peter, Health Technology Lead, Global Community Impact. “So a message might include information about when her baby learns to hiccup, or when she should expect to feel the first kicks.”
This emotional component is part of what has made MomConnect so successful: It is now available in 95% of clinics in South Africa, and more than 60% of all newly pregnant women have been enrolled.
Apart from informing new mothers, MomConnect plays another crucial role in women’s lives: They can text back and safely report problems they are having with their clinic—say, if it runs out of supplies or if personnel are being disrespectful—without having to confront the staff themselves.
In a country that struggles with poor-quality health services, says Peter, this program helps provide the government with a new source of information to pinpoint problems.
“The way I see it,” she adds, “MomConnect is not only a way to talk to women, but a way to listen. It doesn’t just push out information. It gives mothers a voice.”
Baby Rx: making the first years safer and stronger
Janssen Pharmaceuticals, part of the Johnson & Johnson family of companies, has a history of finding treatments for serious childhood diseases.
Within the past two years, for example, they have focused on helping toddlers exposed to parasites in areas without clean water and kids at risk of developing the potentially lethal condition known as pulmonary arterial hypertension (PAH).
This year, the company has turned its attention to an illness that is both very common—and potentially very serious.
“You know how sometimes you get a cold that lasts a few days—and then you get one that just goes on for weeks, and you can’t seem to beat it?” says Julian Symons, Vice President, Respiratory Development Leader, Janssen Research & Development. “Well, that’s respiratory syncytial virus, or RSV.”
The awful thing about RSV is that while it’s merely an annoyance in adults with a normal immune system, it can be serious, and even deadly, in the very young or very old.
Moreover, RSV is a germ with a particular talent: It’s good at going stealth. This means it can cleverly suppress the immune response the body mounts against it. Babies’ immune systems are not fully developed yet, so of the two-thirds of kids under 1 year old who get the virus, about 170,000 in the U.S. alone end up in the hospital needing oxygen and supplemental nutrition.
When you’ve seen a 3-week-old hooked up to a ventilator and struggling, well, it’s tremendously motivating in my line of work.
This is a big cost to our medical system, not to mention a huge source of panic to new parents. And in developing countries where oxygen isn’t always available, the virus exacts a far greater toll: Each year, over 60,000 children die from RSV.
Currently, Symons and his team are investigating meds that work by either preventing the RSV virus from replicating, or by preventing the virus from entering cells. Janssen is also working on preventative measures that can be safely administered to the most vulnerable populations, babies and the elderly.
Symons, whose own father was hospitalized with RSV, has visited hospitals himself and has seen children diagnosed with the virus laboring to breathe. “When you’ve seen a 3-week-old hooked up to a ventilator and struggling, well, it’s tremendously motivating in my line of work,” he says.
Helping to forge mother and child bonding
If Symons spends his days contemplating what can go wrong in infancy, Janet Nikolovski, Associate Research Director, Global Baby R&D, Johnson & Johnson, has the arguably more pleasant task of studying all the things that go right—and how a baby-centric company like Johnson & Johnson can improve the mother-child bond.
As a biomedical engineer, Nikolovski has studied infant skin for years, and her work on how it differs from adult skin has informed the safety and efficacy of a myriad of Johnson & Johnson products.
Baby skin is thinner, loses moisture more quickly and has a higher pH level than adult skin. But these facts don’t tell the whole skin story. Products need to be very mild, not only to the skin, but also to the microbiome that lives on the skin. This ecosystem is vital to our health, playing a complex role in barrier function and protecting us from germs.
On babies in particular, the evolving microbiome must be treated with as much respect as the skin itself. “We are constantly looking to redefine the limits of mildness,” Nikolovski says.
As a mother of twins herself, the work that most excites Nikolovski is her study of the relationship of skin and our tactile senses to mother and baby bonding. Can a product make the moments a mother cares for a child more meaningful in some way?
Well, if a product can make a mother a little more relaxed, and a little more confident she’s giving the baby what he needs, recent behavioral research says yes.
To that end, Nikolovski and her team have been studying the most quotidian of parental tasks: bathing. In this research, facial electrodes are placed on mothers to record microshifts in muscle movement that reflect emotional fluctuation. At the same time, their babies’ faces are videotaped and studied.
If you want to make a difference in healthy baby development, we have to think more broadly. What is going to increase touch time, for example, because the amount of touch a baby receives correlates with healthy development. So it’s not just about the baby—it’s also about the moms.
“The idea was to see what moments during the bathing routine brought out positive emotion, and what brought negative emotion,” Nikolovski explains. When a mom is talking or singing to the baby, touching him gently, there is this cascade of positive behaviors.
“If you want to make a difference in healthy baby development, we have to not concentrate on just one part of the baby, like the skin. We have to think more broadly,” explains Nikolovski. “What is going to increase touch time, for example, because the amount of touch a baby receives correlates with healthy development. So it’s not just about the baby—it’s also about the moms.”
Another crucial piece of the bonding puzzle? Fragrance. So powerful is the emotional connection between our nose and our brain, that for many, a specific scent from childhood can still elicit feelings of happiness. And for a mom, the smell of a particular baby wash also says “Mission Accomplished,” because it means you’ve done your due diligence. He’s clean, he’s ready for bed and you can now pour yourself a glass of wine.
Given its role in our emotional landscape, can fragrance also influence behavior? Years ago, Johnson & Johnson found that a scent that’s part of its Bedtime® products could help promote sleep; and today, the company is working on finding a fragrance that has the potential to decrease stress.
“We might test 400 different scents to find one that can have a concrete effect on behavior,” notes Hélène Zunino, Research Manager, Functional Fragrances, Johnson & Johnson. “But there’s one thing we do know: Fragrance can increase our daily quotient of happiness.”
There is one overarching notion in creating a healthier generation that all these researchers agree upon: There must be a multipronged approach. New and better medications and consumer products that combine gentleness with effectiveness, sure. But the commitment to health involves a profound commitment to the parents, as well as the baby.
“A baby product needs to delight the senses, because that leads to more engagement between baby and parent, and transforms routines into personalized rituals,” says Prilutsky. A baby product may just seem like a product, Prilutsky adds, but when Johnson & Johnson gets it right, “a product can foster intimacy, and that’s as important to a child as medicine.”
