Science
Can a baby struggle with their mental health? How this hospital is helping L.A.’s youngest
A major initiative at Children’s Hospital Los Angeles aims to address a critical but much overlooked need: mental health care for families experiencing the complex flood of joy, fear and upheaval during the first few years of a child’s life.
Myriad issues can emerge or become exacerbated in a family after a baby is born, including maternal postpartum depression, sleep problems, attachment issues between caregivers and children, early signs of behavioral challenges, domestic conflict between parents, and housing insecurity that often worsens as a family grows. If a child also experiences a medical issue, including an extended hospital stay, a serious birth defect or a developmental delay, these problems can be compounded.
A $25-million gift from the Tikun Olam Foundation of the Jewish Community Foundation of Los Angeles will allow the hospital to expand mental health screening and services to as many as 30,000 children ages 3 and under who seek care at Children’s Hospital each year, making it one of the first hospitals in the country to provide universal infant-family mental health services. Currently, the hospital provides these services to about 1,800 children each year.
The idea behind the program is to provide attention and care that can strengthen the bond between parents and children during the baby’s crucial early years — and help prevent problems from spiraling in the longer term.
Engage with our community-funded journalism as we delve into child care, transitional kindergarten, health and other issues affecting children from birth through age 5.
These bonds are essential to a baby’s healthy brain development in a period of rapid neuron formation and great sensitivity, said Melissa Carson, a pediatric psychologist at the hospital and co-director of the Early Connections Program.
Medical issues and family stressors — also called adverse childhood experiences — can disturb this process, but often aren’t identified until preschool or later, when behavioral or other problems have spiraled.
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1. Several of Vicente Giron Sarria’s medications fill up a cabinet at his home. 2. Evy Soto replaces the cap on Vicente Giron Sarria’s feeding tube. 3. Stephanie Blanco shuffles through a cabinet of her son’s medical records. 4. Evy Soto gives Vicente Giron Sarria, 6, formula through a feeding tube before he wakes up for the day. (Juliana Yamada / Los Angeles Times) 5. Stephanie Blanco gets her son Vicente Giron Sarria dressed for the day.
“Just a little support at a critical moment can really prevent the need for much more intensive service later,” said pediatric psychologist Marian Williams, the program’s co-director.
Children’s Hospital Los Angeles has been offering mental health screening and services to the sickest young children who pass through its neonatal intensive care unit for about 10 year. That program was also funded by Mindy and Gene Stein, whose Tikun Olam Foundation focuses on early childhood.
The demand became evident when the hospital found that many families that were offered mental health support in the neonatal intensive care unit stuck with the services after leaving the hospital. Soon, other departments, such as the cardiac unit, were requesting similar services for their patients as well.
“I hope this becomes something that everybody understands and looks at as a crucial part of a child’s development,” Mindy Stein said.
A ‘window’ of opportunity in early childhood
The hospital will also use the funds to train providers in infant and family mental health care and research the effectiveness of the program in the hopes that the model will spread to other hospitals.
Psychologist Marian Williams at Children’s Hospital Los Angeles.
“We have this kind of window when you have a new baby. And there’s also a window when you have a medical need,” Williams said. “There’s probably a lot of parents who will say, ‘I don’t really need you. I’m here because of a cut finger, and we’re fine.’ But I imagine there’s going to be a lot more who say, ‘Oh, wow. Since you asked … .’”
Many families probably could benefit from a handout or video about a common early childhood problem such as sleep issues, picky eating or excessive crying. Some might want to join a parent group with others facing similar challenges, or benefit from a few home visits from a nurse who can help them adjust to life with a new baby.
But other families may need more intensive assistance, such as longer-term therapy. The hospital will also screen them for needed social supports such as housing, food, transportation and internet access, — the lack of which can contribute to a family’s stress and a child’s long-term mental health challenges.
What is infant-family mental health?
The term “infant mental health” can be confusing. After all, it’s difficult to believe that a baby could already be experiencing emotional difficulties. But mental health care in the early years is laser-focused on supporting the developing relationship between the caregiver and child, which can set the trajectory of a child’s life.
For an infant, a therapist might work with the parent to help them notice their baby’s cues, find activities to help the baby explore their environment, and work on their own emotional regulation. As a baby gets older, the therapist also uses play to help develop the bond and begin to treat the child more directly.
Vicente plays with a train set in his bedroom at his home.
For families in the midst of a medical crisis, these early days and months can be particularly fraught, said Patricia Lakatos, a psychologist at the hospital who works with families of children who have been treated in the intensive care unit.
In the neonatal intensive care unit, parents are not only dealing with the day-to-day medical reality, but they’re also “grieving the imagined baby — the baby you thought you were going to have,” Lakatos said. Her work is to visit the family regularly during their stay to help the parent work through their grief and understand how their baby communicates.
Stressful experiences can also affect the baby’s well-being. A baby with traumatic medical needs, for example, may panic every time an adult tries to touch them.
Psychologist Patricia Lakatos.
Lakatos said she can read the signs of a struggling newborn in their eyes. Healthy babies, she said, “have a bright, shiny look that tells you, ‘I’m ready. I’m here. I’m curious and want to engage with the world.’” But babies who experience distress often have a “dull, glazed look in their eye. You might try to engage them, and they’re really not engaging with you.”
Others have eyes that are “wide open, almost like hyperalert,” she said. They’re easily startled and may arch their back and splay their hands, as if to say, “The world is stressful for me.”
But having a nurturing, supportive relationship with a caregiver helps buffer that stress. Supporting this bond includes helping the parent notice the signs that the baby is ready to engage — even momentarily — or whether the baby’s cues are telling them they need to “soften my voice or just hold them and not try to look at them because that’s too much stimulation.” The ultimate goal is to help the caregiver find the joy and delight in the baby they have.
A lifeline of support for mother and baby
Stephanie Blanco of Mission Hills first learned she would be having a baby with major medical complications during an ultrasound early in her pregnancy. “I didn’t think I was going to be able to handle it, going through that,” she said.
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1. A photo of Stephanie Blanco and her son Vicente Giron Sarria as an infant hangs on the fridge at their home. 2. Stephanie Blanco’s ultrasounds of her son, Vicente Giron Sarria.
But right away, she was referred to Children’s Hospital’s Fetal-Maternal Center, which specializes in pregnancies with complex medical conditions, where she met Lakatos. Her son, Vicente Giron Sarria, had been diagnosed with facial deformities, and Lakatos began joining Blanco and her partner at every meeting with the craniofacial team.
“They would explain [the problems] to me, but you would go through so many emotions in that moment. So she would tell me, ‘It’s OK, I’m here,’” and ask her how she was feeling. It was a moment of great tension and stress with her son’s father as they navigated what their new life would look like. She wasn’t sure they would make it as a couple. But Lakatos helped them process their feelings together, she said, and learn to communicate about the their son’s health.
Vinny was born with numerous complications even beyond the predicted facial abnormalities, including the need to eat through a feeding tube, and spent about two months in the intensive care unit, where Lakatos visited the family every other day.
Stephanie Blanco and Vicente dance to one of Vicente’s favorite YouTube videos.
Lakatos taught her breathing exercises, helped her connect with her son and encouraged her to take some time for herself on walks around the hospital campus. Blanco was able to bond with her baby. “You’re thinking, I can deal with this,” she said. “He’s my baby, and we’re going to get through it. The love comes out.”
The challenges didn’t end when Blanco and Vinny finally went home, and neither did Lakatos’s support. Vinny needed several surgeries, and Blanco had to learn how to feed him six times a day — including the middle of the night — through a gastronomy tube.
But Blanco and her partner, Jesse Giron, continued their visits with Lakatos for several more years. Vinny was eventually diagnosed with nonverbal autism and a seizure disorder, and Blanco joined a support group for parents that Lakatos was leading.
Blanco said she is still processing life with a medically complex child who requires constant care at home. “Every day is something new. Every day I learn something. Some days are harder than others.”
But she credits Lakatos and Children’s Hospital Los Angeles with saving her life — and her relationship. “If it wasn’t for them and their kindness, their compassion and their guidance, I would be lost.”
This article is part of The Times’ early childhood education initiative, focusing on the learning and development of California children from birth to age 5. For more information about the initiative and its philanthropic funders, go to latimes.com/earlyed. The Stein Early Childhood Development Fund at the California Community Foundation is among the funders.
Blanco holds Vicente and their dog Benny at their home.
Science
Can fire-resistant homes be sexy? ‘You be the judge,’ says this Palisades architect
At first glance, it looks like nothing more than a charming Spanish-revival, quintessentially Californian home — but this Pacific Palisades rebuild is constructed like a tank.
Every exterior wall of the steel-framed home is a foot-thick, fire-resistant barricade. The home is connected to a satellite fire monitoring service. Should a fire start in town, sturdy metal shutters descend to cover every window. An exterior sprinkler system can pump 40,000 gallons of water from giant tanks hidden behind the shrubs in the property’s yard. If the cameras and heat sensors around the house detect danger, the system can envelop the home in over 1,000 gallons of fire retardant and hundreds of gallons of fire-suppressing foam.
Palisades resident and architect Ardie Tavangarian is so confident in his design that he even asked the fire department if they could start a controlled fire on the property to test it all out. (They said no.)
Tavangarian built a career designing multimillion-dollar luxury homes in Los Angeles, but after the Palisades fire destroyed 13 of his works — including his family’s home — he found another calling: how to design a house that can handle what the Santa Monica Mountains throw at it. And how to do it quickly and affordably.
Water tanks form part of a backup water supply in a newly built fire-resistant home in Pacific Palisades.
“Nature is so powerful,” he said, sitting on a couch in the new house, which he built for his adult twin daughters. “We are guests living in that environment and expecting, ‘Oh, nature is going to be really kind to me.’ No, it’s not. It does what it’s supposed to do.”
Tavangarian watched the Jan. 1 Lachman fire from his property not far from here; a week later that fire rekindled, grew into the Palisades fire, and burned through his house. But the painful details of the fire — the missteps of the fire department, the empty reservoir — didn’t matter when it came to deciding how to rebuild, he said. The reality is, many fires have burned in these mountains. Many more will.
A sprinkler on the roof is part of a house-wide sprinkler system.
For the architect, who has spent much of his 45-year career designing for luxury, hardening a home against wildfire has brought a new kind of luxury to his homes: peace of mind.
It’s a sentiment that resonates with fire survivors: Tavangarian says he’s received considerable interest from other property owners in the Palisades looking to rebuild their houses.
The metal shutters and advanced outdoor sprinkler system are the flashiest parts of Tavangarian’s home hardening project, and the efficacy of these adaptations is still up for debate. Because the measures have not yet been widely adopted, there are few studies exploring how much or little they protect homes in real-world fires.
Architect Ardie Tavangarian inside the house he designed.
Anecdotal evidence has indicated the effectiveness of sprinklers can vary significantly based on the setup and the conditions during the fire. Extreme wind, for example, can make them less effective. Lab studies have generally found shutters can reduce the risk of windows shattering.
These measures aren’t cheap, either. Sprinkler systems can cost north of $100,000, for example. However, Tavangarian said when all was said and done, the home he built for his daughters cost around $700 per square foot — less than what Palisades residents said they expected to pay, but more than what Altadena residents expected for their rebuilds.
Tavangarian also hopes to see insurers increasingly consider the home-hardening measures property owners take when writing policies, which he said could potentially offset the extra cost in a decade or less. As he explored getting insurance for the new home, one insurer quoted him $80,000 a year. After he convinced the company to visit the property, it lowered the quote to just $13,000, he said.
The house includes metal heat shields that can drop down if a fire approaches.
The home also has essentially all of the other less flashy — but much cheaper and well-proven — home hardening measures recommended by fire professionals: The underside of the roof’s overhang is closed off — a common place embers enter a home. The roof, where burning embers can accumulate, is made of fire-resistant material. The windows, vulnerable to shattering in extreme heat, are made of a toughened glass. There is virtually no vegetation within the first five feet of the home.
When asked if he felt he had compromised on design, comfort or aesthetics for the extra protection — one of the many concerns Californians have with the state’s draft “Zone Zero” requirements that may significantly limit vegetation within five feet of a home — Tavangarian simply said, “You be the judge.”
Science
Commentary: My toothache led to a painful discovery: The dental care system is full of cavities as you age
I had a nagging toothache recently, and it led to an even more painful revelation.
If you X-rayed the state of oral health care in the United States, particularly for people 65 and older, the picture would be full of cavities.
“It’s probably worse than you can even imagine,” said Elizabeth Mertz, a UC San Francisco professor and Healthforce Center researcher who studies barriers to dental care for seniors.
Mertz once referred to the snaggletoothed, gap-filled oral health care system — which isn’t really a system at all — as “a mess.”
But let me get back to my toothache, while I reach for some painkiller. It had been bothering me for a couple of weeks, so I went to see my dentist, hoping for the best and preparing for the worst, having had two extractions in less than two years.
Let’s make it a trifecta.
My dentist said a molar needed to be yanked because of a cellular breakdown called resorption, and a periodontist in his office recommended a bone graft and probably an implant. The whole process would take several months and cost roughly the price of a swell vacation.
I’m lucky to have a great dentist and dental coverage through my employer, but as anyone with a private plan knows, dental insurance can barely be called insurance. It’s fine for cleanings and basic preventive routines. But for more complicated and expensive procedures — which multiply as you age — you can be on the hook for half the cost, if you’re covered at all, with annual payout caps in the $1,500 range.
“The No. 1 reason for delayed dental care,” said Mertz, “is out-of-pocket costs.”
So I wondered if cost-wise, it would be better to dump my medical and dental coverage and switch to a Medicare plan that costs extra — Medicare Advantage — but includes dental care options. Almost in unison, my two dentists advised against that because Medicare supplemental plans can be so limited.
Sorting it all out can be confusing and time-consuming, and nobody warns you in advance that aging itself is a job, the benefits are lousy, and the specialty care you’ll need most — dental, vision, hearing and long-term care — are not covered in the basic package. It’s as if Medicare was designed by pranksters, and we’re paying the price now as the percentage of the 65-and-up population explodes.
So what are people supposed to do as they get older and their teeth get looser?
A retired friend told me that she and her husband don’t have dental insurance because it costs too much and covers too little, and it turns out they’re not alone. By some estimates, half of U.S. residents 65 and older have no dental insurance.
That’s actually not a bad option, said Mertz, given the cost of insurance premiums and co-pays, along with the caps. And even if you’ve got insurance, a lot of dentists don’t accept it because the reimbursements have stagnated as their costs have spiked.
But without insurance, a lot of people simply don’t go to the dentist until they have to, and that can be dangerous.
“Dental problems are very clearly associated with diabetes,” as well as heart problems and other health issues, said Paul Glassman, associate dean of the California Northstate University dentistry school.
There is one other option, and Mertz referred to it as dental tourism, saying that Mexico and Costa Rica are popular destinations for U.S. residents.
“You can get a week’s vacation and dental work and still come out ahead of what you’d be paying in the U.S.,” she said.
Tijuana dentist Dr. Oscar Ceballos told me that roughly 80% of his patients are from north of the border, and come from as far away as Florida, Wisconsin and Alaska. He has patients in their 80s and 90s who have been returning for years because in the U.S. their insurance was expensive, the coverage was limited and out-of-pocket expenses were unaffordable.
“For example, a dental implant in California is around $3,000-$5,000,” Ceballos said. At his office, depending on the specifics, the same service “is like $1,500 to $2,500.” The cost is lower because personnel, office rent and other overhead costs are cheaper than in the U.S., Ceballos said.
As we spoke by phone, Ceballos peeked into his waiting room and said three patients were from the U.S. He handed his cellphone to one of them, San Diegan John Lane, who said he’s been going south of the border for nine years.
“The primary reason is the quality of the care,” said Lane, who told me he refers to himself as 39, “with almost 40 years of additional” time on the clock.
Ceballos is “conscientious and he has facilities that are as clean and sterile and as medically up to date as anything you’d find in the U.S.,” said Lane, who had driven his wife down from San Diego for a new crown.
“The cost is 50% less than what it would be in the U.S.,” said Lane, and sometimes the savings is even greater than that.
Come this summer, Lane may be seeing even more Californians in Ceballos’ waiting room.
“Proposed funding cuts to the Medi-Cal Dental program would have devastating impacts on our state’s most vulnerable residents,” said dentist Robert Hanlon, president of the California Dental Assn.
Dental student Somkene Okwuego smiles after completing her work on patient Jimmy Stewart, 83, who receives affordable dental work at the Ostrow School of Dentistry of USC on the USC campus in Los Angeles on February 26, 2026.
(Genaro Molina / Los Angeles Times)
Under Proposition 56’s tobacco tax in 2016, supplemental reimbursements to dentists have been in place, but those increases could be wiped out under a budget-cutting proposal. Only about 40% of the state’s dentists accept Medi-Cal payments as it is, and Hanlon told me a CDA survey indicates that half would stop accepting Medi-Cal patients and many others will accept fewer patients.
“It’s appalling that when the cost of providing healthcare is at an all-time high, the state is considering cutting program funding back to 1990s levels,” Hanlon said. “These cuts … will force patients to forgo or delay basic dental care, driving completely preventable emergencies into already overcrowded emergency departments.”
Somkene Okwuego, who as a child in South L.A. was occasionally a patient at USC’s Herman Ostrow School of Dentistry clinic, will graduate from the school in just a few months.
I first wrote about Okwuego three years ago, after she got an undergrad degree in gerontology, and she told me a few days ago that many of her dental patients are elderly and have Medi-Cal or no insurance at all. She has also worked at a Skid Row dental clinic, and plans after graduation to work at a clinic where dental care is free or discounted.
Okwuego said “fixing the smiles” of her patients is a privilege and boosts their self-image, which can help “when they’re trying to get jobs.” When I dropped by to see her Thursday, she was with 83-year-old patient Jimmy Stewart.
Stewart, an Army veteran, told me he had trouble getting dental care at the VA and had gone years without seeing a dentist before a friend recommended the Ostrow clinic. He said he’s had extractions and top-quality restorative care at USC, with the work covered by his Medi-Cal insurance.
I told Stewart there could be some Medi-Cal cuts in the works this summer.
“I’d be screwed,” he said.
Him and a lot of other people.
steve.lopez@latimes.com
Science
Diablo Canyon clears last California permit hurdle to keep running
Central Coast Water authorities approved waste discharge permits for Diablo Canyon nuclear plant Thursday, making it nearly certain it will remain running through 2030, and potentially through 2045.
The Pacific Gas & Electric-owned plant was originally supposed to shut down in 2025, but lawmakers extended that deadline by five years in 2022, fearing power shortages if a plant that provides about 9 percent the state’s electricity were to shut off.
In December, Diablo Canyon received a key permit from the California Coastal Commission through an agreement that involved PG&E giving up about 12,000 acres of nearby land for conservation in exchange for the loss of marine life caused by the plant’s operations.
Today’s 6-0 vote by the Central Coast Regional Water Board approved PG&E’s plans to limit discharges of pollutants into the water and continue to run its “once-through cooling system.” The cooling technology flushes ocean water through the plant to absorb heat and discharges it, killing what the Coastal Commission estimated to be two billion fish each year.
The board also granted the plant a certification under the Clean Water Act, the last state regulatory hurdle the facility needed to clear before the federal Nuclear Regulatory Commission (NRC) is allowed to renew its permit through 2045.
The new regional water board permit made several changes since the last one was issued in 1990. One was a first-time limit on the chemical tributyltin-10, a toxic, internationally-banned compound added to paint to prevent organisms from growing on ship hulls.
Additional changes stemmed from a 2025 Supreme Court ruling that said if pollutant permits like this one impose specific water quality requirements, they must also specify how to meet them.
The plant’s biggest water quality impact is the heated water it discharges into the ocean, and that part of the permit remains unchanged. Radioactive waste from the plant is regulated not by the state but by the NRC.
California state law only allows the plant to remain open to 2030, but some lawmakers and regulators have already expressed interest in another extension given growing electricity demand and the plant’s role in providing carbon-free power to the grid.
Some board members raised concerns about granting a certification that would allow the NRC to reauthorize the plant’s permits through 2045.
“There’s every reason to think the California entities responsible for making the decision about continuing operation, namely the California [Independent System Operator] and the Energy Commission, all of them are sort of leaning toward continuing to operate this facility,” said boardmember Dominic Roques. “I’d like us to be consistent with state law at least, and imply that we are consistent with ending operation at five years.”
Other board members noted that regulators could revisit the permits in five years or sooner if state and federal laws changes, and the board ultimately approved the permit.
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