Boots, Birth, Beyond
Studying the Health of Military Children
30 April 2018
They may not come issued with a seabag, but children are an important part of military families. Healthy, resilient children and families contribute to the readiness of individual service members. Each year, approximately 100,000 infants are born to military families. These children will continue to be affected by military life for years to come. Understanding the relationship between military service and the health of military children is crucial to maintaining the well-being and readiness of the entire family, and the Naval Health Research Center (NHRC) uses science and research to support the youngest members of our military community.
MILITARY SERVICE AND REPRODUCTIVE HEALTH
After the first Gulf War, service members whose children were born with birth defects were concerned that their war-time exposures were to blame. At the time, there was no available baseline data for reproductive health outcomes, and the Department of Defense (DOD) was not able to determine if there was an association. In 1998, the assistant secretary of defense for health affairs established the DOD Birth and Infant Health Research (BIHR) program in direct response to these concerns.
From 2003 through 2014, approximately 6.2 percent of infants born to active duty women were born to moms who were deployed for part of their pregnancy. The BIHR team evaluated these infants to see how their health outcomes compare to infants whose mothers did not deploy. The team also observes the health of infants conceived after active duty fathers return from deployment.
The BIHR team monitors health outcomes, such as birth defects and low birth weight, among infants born to military families through their first year of life. In addition, because exposures that occur just before or during pregnancy can affect the overall health of an infant, the BIHR team also focuses their research on potentially concerning exposures that can happen before a baby is born, such as contact with workplace or environmental contaminants, chemicals, toxins or other hazards. To help determine the potential reproductive impact, researchers and clinicians look at several factors, including:
* When the exposure happened (before conception or during pregnancy)
* The type of exposure (chemical, infectious disease, radiation, stress-related)
* Amount of the exposure
* Duration of the exposure
Exposures don't have to be specifically related to military service. For example, military families stationed in Japan at the time of the 2011 earthquake, tsunami and subsequent Fukushima nuclear power plant disaster had a potential exposure to radiation. The BIHR team's research can help determine if infants born after such disasters have an increased risk for poor health outcomes.
The center's research also looks at risks associated with exposures that are an expected part of military service, such as deployments and vaccinations. By identifying these types of risks, procedural and policy changes can be made to prevent or reduce them.
While vaccinations, for example, protect service members, a number are not recommended for use in pregnancy, such as anthrax or smallpox. However, they may be inadvertently given to female service members who are not yet aware they may be pregnant.
In the early 2000's, the BIHR team indicated that revisions to the vaccination pre-screening form, such as targeted questions about the possibility of pregnancy, would reduce the number of servicewomen inadvertently vaccinated while pregnant. The team also developed registries for active duty women vaccinated with smallpox and anthrax while pregnant, with a goal of evaluating pregnancy, infant and early childhood health outcomes.
Because of such work, the BIHR team has found that infants born to women vaccinated against smallpox or anthrax during pregnancy do not have higher rates of birth defects, preterm birth or low birth weight when compared to infants in the overall BIHR program. They are also reaching age appropriate developmental milestones.
MILITARY LIFE AND FAMILIES
While the BIHR team focuses on the physical health of the youngest military children, the Millennium Cohort Family Study looks at the overall well-being of military families.
Launched in 2011, the Millennium Cohort Family Study was designed to determine if, and how, deployment experiences and service member readjustment issues affect family health and well-being. Military family members are selected to take part in the study if their service member participates in the Millennium Cohort Study, a research project examining the long-term effects of military service.
Every three years, families in the study are asked to share their experiences, providing important information about how military families adapt over time as they manage deployments, moves, separations, and other life and career transitions. To date, nearly 10,000 spouses have been surveyed. Their responses provide a better understanding of military life.
Together, the Millennium Cohort Study and the Family Study create a complete picture of the triumphs and challenges faced by military families. Findings from these studies can be used to develop and guide programs, interventions and policies that support service members and their families.
Deployments, experienced by approximately 70 percent of study participants, are a particular concern. They can affect the psychological and behavioral health of children while service members are away and when they're transitioning back home. Increased demands on the parent at home, shifting household responsibilities and worry about the safety of the deployed parent can all have negative effects.
An article published by Family Study researchers, "Mental health of children of deployed and nondeployed US military service members: The Millennium Cohort Family Study," examined how parents' deployments can affect their children's symptoms of depression and behavioral problems. Findings suggest that most military children appear to be doing well, but that some may have a greater likelihood of depression or attention deficit hyperactivity disorder (ADHD).
Researchers have also identified factors that can positively influence how well children handle deployment. Study findings indicate that military spouses who experience deployment and remain involved in normal social activities with friends and family lowered their children's risk of depression and ADHD.