Eloise Funmaker patiently slipped a tiny needle through the holes of tiny beads — two white, then three blue, then two more white — to add another row in a pattern on what would become tiny moccasins for the tiniest of baby feet.

It was a meticulous labor of love, community and culture.

For nearly a year, Funmaker and others have been gathering periodically to learn the art of beading and sewing moccasins for American Indian infants in the Neonatal Intensive Care Unit and Special Care Nursery at Children's Hospitals and Clinics of Minnesota.

The handmade moccasins mean babies with serious health issues can feel the embrace of their culture and community all the way down to their tiny toes.

The effort, called First Gift, is one of several new programs that Children's is sponsoring to engage with the American Indian community through its honored traditions. It's part of an attempt to break barriers of mistrust of large institutions, one of the factors that can lead to health inequity.

"When people's babies are sick, it's probably the worst time in their lives," said Lisa Skjefte, a Red Lake Nation of Ojibwe member who is working for Children's as an American Indian community liaison. A gift of handmade moccasins for a struggling baby might make wary family members feel more comfortable in a large hospital, she said.

"It's a small gift that can make a family feel connected back to the community."

Every other Monday night, a mix of adults and teens, women and men, sit at long white tables inside the Two Rivers Gallery of the Minneapolis American Indian Center on Franklin Avenue. They share stories, eat a meal together and pour their laughter and positive energy into their work as they cut thin deer hide from handmade patterns, adorn it with beads in elaborate designs and poke delicate stitches to form moccasins.

A wicker basket sits in the middle of a table, cradling the finished products, which take several weeks to complete. The baby moccasins are adorned with beads in lines, geometric shapes and flowers. Some are sewn with gathers around the toe-box — a "pucker toe" design. Others have seams only along the top and the heel. Others have flat tops.

Varying bead patterns and shoe designs represent cultural traditions from different tribes or areas of the country, but inside the center, those sewing the First Gift moccasins sometimes mix the traditions, giving sick American Indian babies a figurative embrace from all tribes.

Some expectant mothers come to make moccasins, then receive a pair when their babies are born. Others are made for babies nobody in the room will know.

It's a tradition in American Indian culture to make moccasins for a baby's first gift — a milestone in their new lives.

"It's their welcome into the world," said Joy Rivera, who came to sew moccasins after working as a community education specialist with the American Indian Cancer Foundation. "It's significant."

Building trust

Children's Hospital in Minneapolis is surrounded by an American Indian community. As health equity has become an issue nationally, leaders at Children's decided in 2013 to try to focus on their backyard.

In Minnesota, infant mortality rate differences are striking among racial and ethnic groups, according to the state Department of Health. From 2009-2013 there were 9.6 deaths per 1,000 infants born to American Indian mothers compared with 4.1 deaths per 1,000 live births to white mothers.

Children's gathered hospital and community leaders to brainstorm about how to engage people and build trust instead of having health officials descend into the community and focus on how to change things.

Before hiring Skjefte as a liaison, American Indian community members reviewed the job description and participated in interviews.

Skjefte said she was a bit skeptical of what Children's was aiming to do until she walked in and saw community leaders in the interview.

"I thought, 'Oh my gosh! Children's is doing something different,' " she recalled. "I was drawn to it and I was eager to participate in it."

Skjefte, 33, has since brought creative energy to the position, said Anna Youngerman, senior director of advocacy and health policy at Children's.

In addition to First Gift, the hospital is now recruiting volunteers from the American Indian community to hold babies who are sick, even though there is a waiting list for such volunteers.

"We all need community," Youngerman said. "When you're in times of trauma and your baby is sick … the community you need is maybe more that's one in touch with your own history."

Skjefte said sometimes mistrust is so ingrained that patients might not realize it. Mistrust may lead to withholding information from health professionals or simply not asking for help, she said.

Skjefte told the story of one new mother from northern Minnesota who was at Children's Hospital with her baby. The woman was tired and hungry, she said. Her baby wanted to be held all night and she didn't know what to do, as she had no relatives nearby.

Though nurses had been in and out of the room, the woman hadn't told them that she was feeling distressed, too.

"She told me within two minutes of walking into the room," Skjefte said. Skjefte put her in touch with hospital staff who gave her food vouchers and provided volunteer baby holders to give her a break.

In times of stress, she said, people might feel more comfortable with "someone who understands without too much explanation."

'Gift and blessing'

The first pair of First Gift baby moccasins were delivered a few weeks ago to a one-and-a-half week old Jacob Bellanger Jr., who was in a Children's Special Care Unit at Mercy Hospital in Coon Rapids.

Baby Jacob's grandmother, Lisa Bellanger, had made moccasins with the group and when Jacob had trouble sustaining oxygen levels and wound up in the hospital, Bellanger remembered the First Gift program.

Skjefte showed up with a pair of tiny tan and black moccasins with yellow trim and flowing beadwork.

For Jacob's mom, Cherise Browneagle, it was a comfort at a stressful time, she said.

The tiny moccasins were "beautiful," she said. "It was just nice to have a gift and blessing from a woman from our community … to know that someone handmade these moccasins and put the time and put the love and care into it, it was awesome."

Besides feeling a cultural embrace, Browneagle said, the moccasins opened up a different line of communication with hospital staff, too.

Nurses and doctors heard about the tiny moccasins and came in to see them, she said, and "it made me feel like they could relate to me on a cultural level."

Jacob is now six weeks old and healthy. Bellanger feels the special gift helped: "I believe it was the ceremony and the moccasins and that whole gift from the community."

Pam Louwagie • 612-673-7102