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Miller EB, Whipps MDM, Bogen DL, Morris PA, Mendelsohn AL, Shaw DS, Gross RS. Collateral benefits from a school-readiness intervention on breastfeeding: A cross-domain impact evaluation. MATERNAL & CHILD NUTRITION 2022; 19:e13446. [PMID: 36218286 PMCID: PMC9749611 DOI: 10.1111/mcn.13446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 09/19/2022] [Accepted: 09/22/2022] [Indexed: 11/05/2022]
Abstract
This study evaluated the collateral, or unanticipated, impacts of Smart Beginnings (SB), a two-site, tiered intervention designed to promote responsive parenting and school readiness, on breastfeeding intensity in a low-income sample. Impact analyses for the SB intervention were conducted using an intent-to-treat design leveraging a two-arm random assignment structure. Mothers assigned to the SB intervention group were more than three times more likely to give breastmilk as the only milk source at infant age 6 months than mothers assigned to the control group at one site, an effect not evident at the other study site. As development and growth are the two most salient domains of child health, understanding how interventions impact subsequent parenting practices across both domains is critical to address long-term economic and racial/ethnic disparities. Implications of the findings are discussed for improving the efficacy of interventions based on paediatric primary care.
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Affiliation(s)
- Elizabeth B. Miller
- Department of Population HealthNYU Grossman School of MedicineNew YorkNew YorkUSA
| | | | - Debra L. Bogen
- Department of PediatricsUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Pamela A. Morris
- Department of Applied PsychologyNew York UniversityNew YorkNew YorkUSA
| | - Alan L. Mendelsohn
- Department of PediatricsNYU Grossman School of MedicineNew YorkNew YorkUSA
| | - Daniel S. Shaw
- Department of PsychologyUniversity of Pittsburgh, PittsburghPennsylvaniaUSA
| | - Rachel S. Gross
- Department of PediatricsNYU Grossman School of MedicineNew YorkNew YorkUSA
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Pezley L, Cares K, Duffecy J, Koenig MD, Maki P, Odoms-Young A, Clark Withington MH, Lima Oliveira M, Loiacono B, Prough J, Tussing-Humphreys L, Buscemi J. Efficacy of behavioral interventions to improve maternal mental health and breastfeeding outcomes: a systematic review. Int Breastfeed J 2022; 17:67. [PMID: 36064573 PMCID: PMC9446548 DOI: 10.1186/s13006-022-00501-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 08/08/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Despite extensive benefits and high intentions, few mothers breastfeed exclusively for the recommended duration. Maternal mental health is an important underlying factor associated with barriers and reduced rates of breastfeeding intent, initiation, and continuation. Given evidence of a bidirectional association between maternal mental health and breastfeeding, it is important to consider both factors when examining the efficacy of interventions to improve these outcomes. The purpose of this manuscript is to review the literature on the efficacy of behavioral interventions focused on both maternal mental health and breastfeeding outcomes, examining the intersection of the two. METHODS This systematic review was completed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. Studies were selected if they were available in English, used primary experimental design, and used a behavioral intervention type to examine maternal mental health and breastfeeding outcomes. Articles were identified from PubMed, CINAHL, Embase, and PsycINFO from database inception to 3 March 2022. Study quality was assessed using the Cochrane Risk of Bias tool. Results were synthesized by intervention success for 1. Mental health and breastfeeding, 2. Breastfeeding only, 3. Mental health only, and 4. No intervention effect. PROSPERO CRD42021224228. RESULTS Thirty interventions reported in 33 articles were identified, representing 15 countries. Twelve studies reported statistically significant positive effect of the intervention on both maternal mental health and breastfeeding; most showing a decrease in self-report depressive and/or anxiety symptoms in parallel to an increase in breastfeeding duration and/or exclusivity. Common characteristics of successful interventions were a) occurring across pregnancy and postpartum, b) delivered by hospital staff or multidisciplinary teams, c) offered individually, and d) designed to focus on breastfeeding and maternal mental health or on breastfeeding only. Our results are not representative of all countries, persons, experiences, circumstances, or physiological characteristics. CONCLUSIONS Interventions that extend the perinatal period and offer individualized support from both professionals and peers who collaborate through a continuum of settings (e.g., health system, home, and community) are most successful in improving both mental health and breastfeeding outcomes. The benefits of improving these outcomes warrant continued development and implementation of such interventions. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021224228.
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Affiliation(s)
- Lacey Pezley
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W. Taylor St, Chicago, IL, 60612, USA.
| | - Kate Cares
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W. Taylor St, Chicago, IL, 60612, USA
| | - Jennifer Duffecy
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Mary Dawn Koenig
- Department of Human Development Nursing Science, University of Illinois at Chicago, Chicago, IL, USA
| | - Pauline Maki
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | | | | | - Manoela Lima Oliveira
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W. Taylor St, Chicago, IL, 60612, USA
| | | | - Jilian Prough
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W. Taylor St, Chicago, IL, 60612, USA
| | - Lisa Tussing-Humphreys
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, 1919 W. Taylor St, Chicago, IL, 60612, USA
| | - Joanna Buscemi
- Department of Psychology, DePaul University, Chicago, IL, USA
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Aboagye RG, Okyere J, Dowou RK, Adzigbli LA, Tackie V, Ahinkorah BO, Seidu AA. Prevalence and predictors of mother and newborn skin-to-skin contact at birth in Papua New Guinea. BMJ Open 2022; 12:e062422. [PMID: 36691147 PMCID: PMC9445788 DOI: 10.1136/bmjopen-2022-062422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 06/10/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE This study examined the prevalence and predictors of maternal and newborn skin-to-skin contact at birth in Papua New Guinea. DESIGN Data for the study was extracted from the 2016-18 Papua New Guinea Demographic and Health Survey. We included 6,044 women with birth history before the survey in the analysis. Percentages were used to summarise the prevalence of maternal and newborn skin-to-skin contact. A multivariable multilevel binary logistic regression was adopted to examine the predictors of maternal and newborn skin-to-skin contact. The results were presented using adjusted ORs (aORs), with their respective 95% confidence intervals (CIs). Statistical significance was set at p<0.05. SETTING The study was conducted in Papua New Guinea. PARTICIPANT Mothers with children under 5 years. OUTCOME MEASURES Mother and newborn skin-to-skin contact. RESULTS The prevalence of mother and newborn skin-to-skin contact was 45.2% (95% CI=42.4 to 48.0). The odds of mother and newborn skin-to-skin contact was higher among women with primary education (aOR=1.38; 95% CI=1.03 to 1.83), women with four or more antenatal care attendance (aOR=1.27; 95% CI=1.01 to 1.61), those who delivered at the health facility (aOR=1.27; 95% CI=1.01 to 1.61), and women from communities with high socioeconomic status (aOR=1.45; 95% CI=1.11 to 1.90). CONCLUSION The study has demonstrated that the prevalence of mother and newborn skin-to-skin contact in Papua New Guinea is low. Factors shown to be associated with mother and newborn skin-to-skin contact were maternal level of education, antenatal care attendance, health facility delivery, and community socioeconomic status. A concerted effort should be placed in improving maternal health service utilisation such as antenatal care attendance and skilled birth delivery, which subsequently lead to the practice of skin-to-skin contact. Also, women should be empowered through education as it has positive impact on their socioeconomic status and health service utilisation.
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Affiliation(s)
- Richard Gyan Aboagye
- Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Joshua Okyere
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Robert Kokou Dowou
- Department of Epidemiology and Biostatistics, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Leticia Akua Adzigbli
- Department of Epidemiology and Biostatistics, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Vivian Tackie
- School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | | | - Abdul-Aziz Seidu
- Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
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Still-face redux: Infant responses to a classic and modified still-face paradigm in proximal and distal care cultures. Infant Behav Dev 2022; 68:101732. [PMID: 35760032 DOI: 10.1016/j.infbeh.2022.101732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 05/31/2022] [Accepted: 06/06/2022] [Indexed: 11/23/2022]
Abstract
Literature on infant emotion is dominated by research conducted in Western, industrialized societies where early socialization is characterized by face-to-face, vocal communication with caregivers. There is a dearth of knowledge of infant emotion in the context of social interaction outside of the visual and vocal modalities. In a three-population cross-cultural comparison, we used the still-face task to measure variation in behavior among infants from proximal care (practicing high levels of physical contact) communities in Bolivia and distal care (emphasizing vocal and visual interaction) communities in the U.S. and Fiji. In a modified version of the face-to-face still-face (FFSF), Study 1, infants in the U.S. and Fiji displayed the typical behavioral response to the still-face episode: increased negative affect and decreased social engagement, whereas infants in Bolivia showed no change. For tactile behavior, infants in Bolivia showed an increase in tactile self-stimulation from the interaction episode to the still-face episode, whereas U.S. infants showed no change. In Study 2, we created a novel body-to-body version of the still-face paradigm ("still-body") with infants in US and Bolivia, to mimic the near-constant physical contact Bolivian infants experience. The U.S. and Bolivian infant response was similar to Study 1: US infants showed decreased positive affect and increased negative affect and decreased social engagement from the interaction to the still-body episode and Bolivian infants showed no change. Notably, there were overall differences in infant behaviors between the two paradigms (FFSF and Still-Body). Infants in Bolivia and the U.S. showed increased positive facial affect during the FFSF paradigm in comparison with the Still-Body paradigm. Our results demonstrate the need for more globally representative developmental research and a broader approach to infant emotion and communication.
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Sponseller L, Silverman F, Roberts P. Exploring the Role of Occupational Therapy With Mothers Who Breastfeed. Am J Occup Ther 2021; 75:14129. [PMID: 34780643 DOI: 10.5014/ajot.2021.041269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Occupational therapy practitioners can play a pivotal role in supporting breastfeeding mothers as they transition to and form new routines for this occupation. OBJECTIVE To explore whether occupational therapy programming can assist breastfeeding mothers in reaching their personal occupation-based wellness goals. DESIGN Mixed-methods design that involved development of an occupational profile and a goal attainment scale (GAS). After the intervention, participants rescored their GAS goals and completed a semistructured exit interview. SETTING Nonprofit lactation center located in the suburbs of a large mid-Atlantic U.S. city. PARTICIPANTS Women recruited through convenience sampling who had been breastfeeding an infant for <6 mo, who were not currently weaning, and who had met with a lactation consultant at least once since giving birth were eligible (N = 17). INTERVENTION Group occupational therapy that consisted of 10 weekly 1-hr sessions. Topics were based on occupational profiles, GAS scores, and lactation consultant input. Outcomes and Measures: Each participant created and scored three goals using the GAS before and after the intervention. RESULTS Data from 14 of the 17 participants were analyzed. The average postintervention GAS score was 56.50 (M = 50), indicating that most personal wellness goals were reached. Thematic analysis revealed that occupational therapy programming helped mothers persevere with breastfeeding, feel more confident as new parents, and value both themselves and their baby. CONCLUSIONS AND RELEVANCE There is an increasing role for occupational therapy practitioners in helping new mothers reach their personal wellness goals in ways that support their ability to continue breastfeeding. What This Article Adds: Maternal wellness and breastfeeding represent an emerging area of practice in which occupational therapy practitioners can provide new mothers with physical, social, and psychological supports that help them maintain self-efficacy related to breastfeeding and other meaningful occupations. This study provides foundational evidence in support of this collaboration.
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Affiliation(s)
- Lauren Sponseller
- Lauren Sponseller, PhD, OTD, MSOTR/L, MEd, is Chair and Associate Professor, Department of Occupational Therapy, Salus University, Elkins Park, PA;
| | - Fern Silverman
- Fern Silverman, EdD, OTR/L, is Associate Professor, Department of Occupational Therapy, Salus University, Elkins Park, PA
| | - Pamela Roberts
- Pamela Roberts, PhD, OTR/L, SCFES, FAOTA, CPHQ, is Executive Director and Professor, Department of Physical Medicine and Rehabilitation, and Executive Director to the Chief Medical Officer, Cedars-Sinai Medical Center, Los Angeles, CA
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6
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Taylor CL, Brown HK, Saunders NR, Barker LC, Chen S, Cohen E, Dennis CL, Ray JG, Vigod SN. Maternal Schizophrenia, Skin-to-Skin Contact, and Infant Feeding Initiation. Schizophr Bull 2021; 48:145-153. [PMID: 34308961 PMCID: PMC8781380 DOI: 10.1093/schbul/sbab085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND The World Health Organization recommends mothers and infants be in direct skin-to-skin contact immediately after birth and initiate breastfeeding as soon as possible. Little is known in women with schizophrenia. METHODS We conducted a population-based cohort study using administrative health data from Ontario, Canada (2012-2014), comparing women with (n = 471) and without schizophrenia (n = 218 435), and their infants, on the primary outcomes of any skin-to-skin contact and opportunity to initiate breastfeeding within the first 2 h after birth. For dyads with available data, secondary outcomes of intention to breastfeed, breastfeeding support, any breastmilk, and exclusive breastmilk at discharge were assessed. Modified Poisson regression was used to generate relative risks (aRR) and 95% confidence intervals (CI), adjusted for maternal age, parity, neighbourhood income, region of residence, smoking in pregnancy, and maternal medical and non-psychotic psychiatric comorbidity for all outcomes. RESULTS Maternal schizophrenia was associated with lower likelihood of skin-to-skin contact (65.2% vs 78.1%; aRR 0.88, 95% CI: 0.82-0.94), and breastfeeding initiation post-delivery (38.9% vs 52.6% aRR 0.80, CI: 0.71-0.90) compared to dyads unexposed to maternal schizophrenia. Secondary outcomes followed a similar pattern. The magnitude of the effect was slightly less when restricting the cohort to full-term, vaginal deliveries, not admitted to NICU, and infant not discharged to social services. CONCLUSIONS Reduced maternal-infant skin-to-skin contact and breastfeeding initiation immediately after birth may significantly impact maternal-child bonding and the establishment breastfeeding in this population. Mothers with schizophrenia may require individualized support to promote these WHO recommended hospital practices in the early post-natal period.
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Affiliation(s)
- Clare L Taylor
- Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada,ICES, Toronto, ON, Canada
| | - Hilary K Brown
- Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada,ICES, Toronto, ON, Canada,Department of Health & Society, University of Toronto, Scarborough, Toronto, ON, Canada,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Natasha R Saunders
- The Hospital for Sick Children, Toronto, ON, Canada,ICES, Toronto, ON, Canada,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada,Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Lucy C Barker
- Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada,ICES, Toronto, ON, Canada,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | | | - Eyal Cohen
- The Hospital for Sick Children, Toronto, ON, Canada,ICES, Toronto, ON, Canada,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada,Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Cindy-Lee Dennis
- St Michael’s Hospital, Toronto, ON, Canada,Department of Psychiatry, University of Toronto, Toronto, ON, Canada,Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Joel G Ray
- St Michael’s Hospital, Toronto, ON, Canada,The Hospital for Sick Children, Toronto, ON, Canada,ICES, Toronto, ON, Canada,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada,Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Simone N Vigod
- Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada,ICES, Toronto, ON, Canada,Department of Psychiatry, University of Toronto, Toronto, ON, Canada,To whom correspondence should be addressed; Women’s College Hospital, 76 Grenville Street, Toronto, ON M5S 1B2, Canada; tel: +416-323-6400, fax: +416-323-6356, e-mail:
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7
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Cooijmans KHM, Beijers R, Brett BE, de Weerth C. Daily skin-to-skin contact in full-term infants and breastfeeding: Secondary outcomes from a randomized controlled trial. MATERNAL AND CHILD NUTRITION 2021; 18:e13241. [PMID: 34236131 PMCID: PMC8710110 DOI: 10.1111/mcn.13241] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 06/12/2021] [Accepted: 06/17/2021] [Indexed: 11/27/2022]
Abstract
This randomized controlled trial evaluated the effect of a 5-week daily skin-to-skin contact (SSC) intervention between mothers and their full-term infants, compared with care-as-usual, on exclusive and continued breastfeeding duration during the first post-natal year. Healthy pregnant women (n = 116) from a community sample were enrolled and randomly allocated to the SSC or care-as-usual condition. SSC mothers were requested to provide one daily hour of SSC for the first five post-natal weeks. Twelve months post-partum, mothers indicated the number of exclusive and continued breastfeeding months. Multiple regression analyses were conducted using intention-to-treat, per-protocol and exploratory dose-response frameworks. In intention-to-treat analyses, exclusive and continued breastfeeding duration was not different between groups (exclusive: 3.61 ± 1.99 vs. 3.16 ± 1.77 months; adjusted mean difference 0.28, 95% confidence interval [CI] -0.33 to 0.89; p = 0.36; continued: 7.98 ± 4.20 vs. 6.75 ± 4.06 months; adjusted mean difference 0.81, 95% CI -0.46 to 2.08; p = 0.21). In per-protocol analyses, exclusive and continued breastfeeding duration was longer for SSC than care-as-usual dyads (exclusive: 4.89 ± 1.26 vs. 3.25 ± 1.80 months; adjusted mean difference 1.28, 95% CI 0.31-2.24; p = 0.01; continued: 10.81 ± 1.97 vs. 6.98 ± 4.08 months; adjusted mean difference 2.33, 95% CI 0.13-4.54; p = 0.04). Exploratory dose-response effects indicated that more SSC hours predicted longer exclusive and continued breastfeeding duration. This study demonstrates that for the total group, the 5-week daily SSC intervention did not extend exclusive and continued breastfeeding duration. However, for mothers performing a regular daily hour of SSC, this simple and accessible intervention may extend exclusive and continued breastfeeding duration by months. Future studies are required to confirm these promising findings. Trial registration: Netherlands Trial Register (NTR5697).
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Affiliation(s)
- Kelly H M Cooijmans
- Department of Developmental Psychology, Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.,Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Roseriet Beijers
- Department of Developmental Psychology, Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.,Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bonnie E Brett
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Carolina de Weerth
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
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Exploring the Perspectives of South African Parents and Primary Caregivers Living in Low-Income Communities on What Children Need to Thrive within the First 1000 Days of Life. CHILDREN-BASEL 2021; 8:children8060483. [PMID: 34200273 PMCID: PMC8229791 DOI: 10.3390/children8060483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 05/24/2021] [Accepted: 06/03/2021] [Indexed: 11/25/2022]
Abstract
The first 1000 days is recognised as a critical period for the development of children. What children need to thrive in this particular phase of development may be different from any other phase. In South Africa, parents’ perception of children’s needs within the first 1000 days of life could be considered as emerging. Therefore, this study aims to explore the perspectives of South African parents and primary caregivers on what children need to thrive within the first 1000 days. An exploratory qualitative study design was used to explore the parents’ understanding of what children need to thrive in the first 1000 days. A purposive sampling approach was employed to select parents and primary caregivers in low-income communities. In all, thirty respondents participated in the study. The data were analysed using thematic analysis. During the analysis, four themes emerged. The themes included (1) the importance of parenting, care and support; (2) children’s need for holistic development; (3) parental roles; and (4) sharing responsibilities. Parents and primary caregivers living in low-income communities understand what children need to thrive within the first thousand days of life. The study could assist policymakers and service providers to design appropriate interventions for parents within these communities.
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Norholt H. Delivering Clinically on Our Knowledge of Oxytocin and Sensory Stimulation: The Potential of Infant Carrying in Primary Prevention. Front Psychol 2021; 11:590051. [PMID: 33995157 PMCID: PMC8116555 DOI: 10.3389/fpsyg.2020.590051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 11/16/2020] [Indexed: 11/18/2022] Open
Abstract
Oxytocin (OT) is one of the most intensively researched neuropeptides during the three past decades. In benign social contexts, OT exerts a range of desirable socioemotional, stress-reducing, and immunoregulatory effects in mammals and humans and influences mammalian parenting. Consequentially, research in potential pharmacological applications of OT toward human social deficits/disorders and physical illness has increased substantially. Regrettably, the results from the administration of exogenous OT are still relatively inconclusive. Research in rodent maternal developmental programming has demonstrated the susceptibility of offspring endogenous OT systems to maternal somatosensory stimulation, with consequences for behavioral, epigenetic, cognitive, and neurological outcomes. A translation of this animal research into practically feasible human parenting recommendations has yet to happen, despite the significant prevention potential implied by the maternal developmental programming research. Extended physical contact with full-term healthy infants in the months following birth (infant carrying) might constitute the human equivalent of those specific rodent maternal behaviors, found to positively influence emerging OT systems. Findings from both OT and maternal programming research parallel those found for infants exposed to such extended parental physical contact, whether through skin-to-skin contact or infant carrying. Clinical support of parents to engage in extended physical contact represents a feasible intervention to create optimum conditions for the development of infant OT systems, with potential beneficial long-term health effects.
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Affiliation(s)
- Henrik Norholt
- SomAffect - The Somatosensory & Affective Neuroscience Group, Liverpool, United Kingdom
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10
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Cena L, Biban P, Janos J, Lavelli M, Langfus J, Tsai A, Youngstrom EA, Stefana A. The Collateral Impact of COVID-19 Emergency on Neonatal Intensive Care Units and Family-Centered Care: Challenges and Opportunities. Front Psychol 2021; 12:630594. [PMID: 33716895 PMCID: PMC7943863 DOI: 10.3389/fpsyg.2021.630594] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 01/25/2021] [Indexed: 12/28/2022] Open
Abstract
The ongoing Coronavirus disease 2019 (COVID-19) pandemic is disrupting most specialized healthcare services worldwide, including those for high-risk newborns and their families. Due to the risk of contagion, critically ill infants, relatives and professionals attending neonatal intensive care units (NICUs) are undergoing a profound remodeling of the organization and quality of care. In particular, mitigation strategies adopted to combat the COVID-19 pandemic may hinder the implementation of family-centered care within the NICU. This may put newborns at risk for several adverse effects, e.g., less weight gain, more nosocomial infections, increased length of NICU stay as well as long-term worse cognitive, emotional, and social development. This article aims to contribute to deepening the knowledge on the psychological impact of COVID-19 on parents and NICU staff members based on empirical data from the literature. We also provided evidence-based indications on how to safely empower families and support NICU staff facing such a threatening emergency, while preserving the crucial role of family-centered developmental care practices.
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Affiliation(s)
- Loredana Cena
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Paolo Biban
- Department of Neonatal and Pediatric Critical Care, Verona University Hospital, Verona, Italy
| | - Jessica Janos
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Manuela Lavelli
- Department of Human Sciences, University of Verona, Verona, Italy
| | - Joshua Langfus
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Angelina Tsai
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Eric A. Youngstrom
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Alberto Stefana
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
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11
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Moberg KU, Handlin L, Petersson M. Neuroendocrine mechanisms involved in the physiological effects caused by skin-to-skin contact – With a particular focus on the oxytocinergic system. Infant Behav Dev 2020; 61:101482. [DOI: 10.1016/j.infbeh.2020.101482] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 07/30/2020] [Accepted: 08/04/2020] [Indexed: 10/23/2022]
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12
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Bigelow AE, Power M. Mother-Infant Skin-to-Skin Contact: Short- and Long-Term Effects for Mothers and Their Children Born Full-Term. Front Psychol 2020; 11:1921. [PMID: 32982827 PMCID: PMC7485314 DOI: 10.3389/fpsyg.2020.01921] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 07/13/2020] [Indexed: 12/02/2022] Open
Abstract
This brief report reviews findings from a longitudinal study of skin-to-skin contact (SSC) with mothers and full-term infants and a follow-up study of these dyads when the children were 9 years. Findings infer the positive influence of SSC on mother-child interactions in infancy and into children's middle childhood. Mothers and infants in SSC and control groups were seen when infants were 1 week, 1 month, 2 months, and 3 months. SSC group mothers reported fewer depressive symptoms in infants' early weeks and had a greater reduction in salivary cortisol, a physiological stress indicator, in infants' first month (Bigelow et al., 2012). SSC group mothers who initially chose to breastfeed continued to breastfeed their infants throughout the 3 months, whereas breastfeeding mothers in the control group declined over the visits (Bigelow et al., 2014). When engaged in the Still Face Task with their mothers, SSC group infants showed the still face effect with their affect at 1 month, a month before the control group infants did so (Bigelow and Power, 2012). At 3 months, SSC group infants were social bidding to their mothers during the still face phase. When the children were 9 years, the mother-child dyads engaged in conversations about the children's remembered emotional events (Bigelow et al., 2018). Mother-child dyads who had been in the SSC group showed more engagement and reciprocity in the conversations than mother-child dyads who had been in the control group. Oxytocin, which is induced by SSC, is hypothesized to be an underlying factor that helped the mother-infant relationship have a positive trajectory with long-term benefits.
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Affiliation(s)
- Ann E. Bigelow
- Department of Psychology, St. Francis Xavier University, Antigonish, NS, Canada
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Revisiting the roots of attachment: A review of the biological and psychological effects of maternal skin-to-skin contact and carrying of full-term infants. Infant Behav Dev 2020; 60:101441. [PMID: 32603951 DOI: 10.1016/j.infbeh.2020.101441] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 03/19/2020] [Accepted: 03/19/2020] [Indexed: 12/18/2022]
Abstract
During the early period of hypothesis building and empirical testing of attachment theory, a major emphasis was placed on mother-infant physical contact. In spite of this, mother-infant contact has received scant attention amongst attachment and child development researchers in the past decades. Here, a brief theoretical framework for mother-infant contact is presented, drawing on animal studies as well as human studies of preterm infants and neonates. Salient mechanisms may include an extended sensitive period during early infancy, requiring specific somatosensory stimuli for bio-behavioral homeorhesis; oxytocinergic and epigenetic pathways; kinesthetic stimuli and face-to-face proximity allowing for increased social interaction. Studies of extended human mother-full-term infant physical contact have demonstrated positive effects in multiple domains. For infants, these include sleep organization, temperature and heart rate regulation, behavioral response, crying/colic, socio-emotional development, attachment quality, speech development opportunities and mother-child interactions. For mothers, studies demonstrate improved depressive symptomatology, physiological stress regulation, contingent responsivity, breastfeeding and mother-child interactions. Parent-infant attachment quality has gained prominence as a trauma-resilience factor as well as a predictor of adult physical health. The potential role of mother-infant contact as an attachment promoting intervention as well as future research subjects are discussed. Current evidence supports the original attachment research that early maternal touch provision may influence infant socio-emotional development and attachment quality, with positive implications for mother-child relationship functioning.
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Nakano M, Sourander A, Luntamo T, Chudal R, Skokauskas N, Kaneko H. Early risk factors for postpartum depression: A longitudinal Japanese population-based study. J Affect Disord 2020; 269:148-153. [PMID: 32339130 DOI: 10.1016/j.jad.2020.03.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 03/06/2020] [Accepted: 03/09/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Postpartum depression (PPD) negatively impacts maternal health, parenting and development of children. Most previous studies on PPD risk factors are based on Western populations. Additionally, little is known about the association between psychosocial factors during early pregnancy period and PPD. We aimed to identify early risk factors for PPD until three months after delivery using a longitudinal population-based sample from Japan. METHODS The data was collected from 1050 mothers at four time points: first trimester, after the birth, and one and three months post-delivery. Mothers who had a Japanese Edinburgh Postnatal Depression Scale (EPDS) cutoff score above 9 at one or 3 months after delivery were recognized as having PPD (n = 91/8.7%). RESULTS Negative feelings about pregnancy, combined breast and bottle feeding, first-time motherhood, motherhood 24 or less years old, perceived maternal mental illness before pregnancy, and lack of social support were all significantly associated with PPD at three months after delivery. LIMITATIONS The data was collected from one city in Japan, which limits the generalization of the findings. Additionally, PPD was assessed by an EPDS questionnaire, and not by a clinical interview. CONCLUSIONS Even after controlling for the perceived mental illness before pregnancy, several risk factors as early as in the first trimester were associated with PPD. These risk factors should be identified and the mothers should be offered a suitable intervention, in order to prevent the development of PPD.
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Affiliation(s)
- Mami Nakano
- Graduate School of Education and Human Development, Nagoya University, Furo-cho, Chikusa-ku, Nagoya 464-8601, Japan.
| | - Andre Sourander
- Research Center for Child Psychiatry, University of Turku, Lemminkäisenkatu 3/Teutori 3rd Floor, Turku 20014, Finland.
| | - Terhi Luntamo
- Research Center for Child Psychiatry, University of Turku, Lemminkäisenkatu 3/Teutori 3rd Floor, Turku 20014, Finland.
| | - Roshan Chudal
- Research Center for Child Psychiatry, University of Turku, Lemminkäisenkatu 3/Teutori 3rd Floor, Turku 20014, Finland.
| | - Norbert Skokauskas
- Centre for Child and Adolescent Mental Health and Child Protection, Faculty of Medicine, NTNU, NO-7491, Trondheim, Norway.
| | - Hitoshi Kaneko
- Psychological Support and Research Center for Human Development, Nagoya University, Furo-cho, Chikusa-ku, Nagoya 464-8601, Japan.
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Agudelo S, Díaz D, Maldonado MJ, Acuña E, Mainero D, Pérez O, Pérez L, Molina C. Effect of skin-to-skin contact at birth on early neonatal hospitalization. Early Hum Dev 2020; 144:105020. [PMID: 32220769 DOI: 10.1016/j.earlhumdev.2020.105020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 03/05/2020] [Accepted: 03/07/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND Skin-to-skin contact (SCC) at birth has a positive impact on breastfeeding indicators and physiological stabilization at birth. On the other hand, globally and in Colombia, morbidity and mortality have increased in intermediate- and low-risk infants. The aim of the study was to assess the effect of immediate skin-to-skin contact, compared to separation at birth, on the risk of hospitalization of intermediate- and low-risk infants prior to discharge from the maternity ward. METHODOLOGY A retrospective cohort study of newborn who underwent a SCC compared to habitual management was conducted. Intermediate- and low-risk neonates with spontaneous neonatal adaptation and cardiorespiratory stability at birth were included. Main outcome measure was hospital admission prior to the discharge from the maternity ward. RESULT A total of 816 infants were included, 672 (82.3%) in the skin-to-skin contact group and 144 (17.6%) in the habitual management group. The main causes of hospital admission were jaundice and feeding/sucking related issues. Significantly lower admission to the neonatal unit was found for infants in the contact group compared to infants who did not receive skin-to-skin contact (13.8% vs. 26.4%; OR 0.46, 95% CI 0.29-0.71, p = 0.001). CONCLUSION Skin-to-skin contact in newborns of intermediate and low risk has protective effects on the risk of hospital admission within the first few hours of life. SSC is proposed as a prevention strategy in second-level care scenarios.
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Affiliation(s)
- Sergio Agudelo
- Graduate School, Universidad CES, Universidad de La Sabana, Medellín, Colombia; Paediatrics Department, School of Medicine, Universidad de La Sabana - Clínica Universidad de La Sabana, graduate school CES University, Chía, Colombia.
| | - Diana Díaz
- Research Department, Universidad de La Sabana, Chía, Colombia.
| | - María José Maldonado
- Paediatrics Department, Universidad de La Sabana y Clínica Universidad de La Sabana, Chía, Colombia.
| | - Eduardo Acuña
- Paediatrics Department, Hospital Universitario de La Samaritana - Unidad Funcional Zipaquirá, Zipaquirá, Colombia.
| | - Daniel Mainero
- School of Medicine, Universidad de La Sabana, Chía, Colombia.
| | - Oman Pérez
- Paediatrics Department, Hospital Universitario de La Samaritana - Unidad Funcional Zipaquirá, Zipaquirá, Colombia
| | - Laura Pérez
- Paediatrics Department, Hospital Universitario de La Samaritana - Unidad Funcional Zipaquirá, Zipaquirá, Colombia
| | - Carlos Molina
- Graduate School, Universidad CES, Universidad de La Sabana, Medellín, Colombia.
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Mothers’ and fathers’ early tactile contact behaviors during triadic and dyadic parent-infant interactions immediately after birth and at 3-months postpartum: Implications for early care behaviors and intervention. Infant Behav Dev 2019; 57:101347. [DOI: 10.1016/j.infbeh.2019.101347] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 08/01/2019] [Accepted: 08/01/2019] [Indexed: 02/02/2023]
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Little EE, Legare CH, Carver LJ. Culture, carrying, and communication: Beliefs and behavior associated with babywearing. Infant Behav Dev 2019; 57:101320. [PMID: 31103747 PMCID: PMC10676003 DOI: 10.1016/j.infbeh.2019.04.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 01/12/2019] [Accepted: 04/10/2019] [Indexed: 11/30/2022]
Abstract
Ethnographic research suggests mother-infant physical contact predicts high levels of maternal responsiveness to infant cues, yet it is unclear whether this responsiveness is driven by the act of physical contact or by underlying beliefs about responsiveness. We examine beliefs and behavior associated with infant carrying (i.e., babywearing) among U.S. mothers and experimentally test the effect of mother-infant physical contact on maternal responsiveness. In Study 1 (N = 23 dyads), babywearing mothers were more likely to interact contingently in response to infant cues than non-babywearing mothers during an in-lab play session. In Study 2 (N = 492 mothers), babywearing predicted maternal beliefs emphasizing responsiveness to infant cues. In Study 3 (N = 20 dyads), we experimentally manipulated mother-infant physical contact in the lab using a within-subjects design and found that babywearing increased maternal tactile interaction, decreased maternal and infant object contact, and increased maternal responsiveness to infant vocalizations. Our results motivate further research examining how culturally-mediated infant carrying practices shape the infant's early social environment and subsequent development.
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Affiliation(s)
- Emily E Little
- Department of Psychology, University of California, San Diego, La Jolla, CA, 92093, USA.
| | - Cristine H Legare
- Department of Psychology, University of Texas at Austin, Austin, TX, 78712, USA
| | - Leslie J Carver
- Department of Psychology, University of California, San Diego, La Jolla, CA, 92093, USA
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Webber E, Benedict J. Postpartum depression: A multi-disciplinary approach to screening, management and breastfeeding support. Arch Psychiatr Nurs 2019; 33:284-289. [PMID: 31227081 DOI: 10.1016/j.apnu.2019.01.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 10/13/2018] [Accepted: 01/24/2019] [Indexed: 01/16/2023]
Abstract
Postpartum depression (PPD) is a common condition affecting 11%-20% of all postpartum women. Depression can have significant consequences for both mother and infant. There are many risk factors associated with PPD, all of which contribute to an inflammatory response in the mother. An inverse relationship exists between PPD and breastfeeding; women with PPD are less likely to have a positive breastfeeding experience which can lead to early weaning, while long-term exclusive breastfeeding is associated with decreased rates of PPD. A multi-disciplinary approach to managing PPD, including strong breastfeeding support, will lead to improved mental health outcomes for women and their children.
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Affiliation(s)
- Elaine Webber
- University of Detroit Mercy, 4001 W McNichols Rd, Detroit, MI 48221, United States.
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19
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Crenshaw JT. Healthy Birth Practice #6: Keep Mother and Newborn Together-It's Best for Mother, Newborn, and Breastfeeding. J Perinat Educ 2019; 28:108-115. [PMID: 31118548 DOI: 10.1891/1058-1243.28.2.108] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Mothers and newborns have an emotional and physiological need to be together at the moment of birth and during the hours and days that follow. Keeping mothers and newborns together is a safe and healthy birth practice. Evidence supports immediate, undisturbed skin-to-skin care after vaginal birth and during and after cesarean surgery for all medically stable mothers and newborns, regardless of feeding preference; and, no routine separation during the days after birth. Childbirth educators and other health-care professionals have an ethical responsibility to support this essential healthy birth practice through education, advocacy, and implementation of evidence-based maternity practices.
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20
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Bigelow AE, Power M, MacLean K, Gillis D, Ward M, Taylor C, Berrigan L, Wang X. Mother-infant skin-to-skin contact and mother-child interaction 9 years later. SOCIAL DEVELOPMENT 2018. [DOI: 10.1111/sode.12307] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | | | | | | | - Michelle Ward
- Kids First Family Resource Program for Pictou; Antigonish, and; Guysborough Counties of Nova Scotia
| | - Carolyn Taylor
- St. Francis Xavier University
- University of British Columbia
| | | | - Xu Wang
- St. Francis Xavier University
- Wilfrid Laurier University
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21
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Hakala M, Kaakinen P, Kääriäinen M, Bloigu R, Hannula L, Elo S. Implementation of Step 7 of the Baby-Friendly Hospital Initiative (BFHI) in Finland: Rooming-in according to mothers and maternity-ward staff. Eur J Midwifery 2018; 2:9. [PMID: 33537570 PMCID: PMC7839134 DOI: 10.18332/ejm/93771] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 07/14/2018] [Accepted: 07/26/2018] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Rooming-in is an evidence-based practice during which postpartum mothers and infants stay together. Rooming-in benefits both the mother and infant, and is especially important for breastfeeding. This study aims to describe rooming-in (Step 7 of the BFHI), according to mothers and maternity-ward staff in Finnish maternity hospitals, as well as the factors associated with its implementation. METHODS The presented research adopted a cross-sectional study approach. Questionnaires were used to collect data from mothers (n=111) who had given birth and the attending maternity-ward staff (f=1554 reported events) at 8 Finnish maternity hospitals. The data were analysed using descriptive statistics, as well as chi-squared, t-test, and Fisher, Mann-Whitney, Kruskal-Wallis tests. Answers to the open-ended questions were analysed using content specifications. RESULTS Rooming-in was utilised to a satisfactory extent, especially after vaginal birth. Most of the mothers regarded it as a very positive experience. Rooming-in was delayed mainly because of a mother's tiredness and the infant's condition. Factors such as a staff member's age, work experience, and completion of breastfeeding counselling training (WHO 20-h), a mother's parity, need for supplementation, and mode of childbirth, were found to be associated with the decision to implement rooming-in. CONCLUSIONS Rooming-in should be used more with infants born by caesarean section and primiparous mothers. The need for supplementation clearly increased when roomingin was not employed. The presented information could be crucial for effectively allocating maternity ward resources and demonstrating the importance of rooming-in to a diverse audience of health care professionals.
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Affiliation(s)
- Mervi Hakala
- Northern Ostrobothnia Hospital District, Oulaskangas Hospital, Oulainen, Finland.,Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
| | - Pirjo Kaakinen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
| | - Maria Kääriäinen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.,Medical Research Center (MRC), Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Risto Bloigu
- Medical Informatics and Statistics Research Group, University of Oulu, Oulu, Finland
| | - Leena Hannula
- Metropolia University of Applied Sciences, Helsinki, Finland
| | - Satu Elo
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland.,Medical Research Center (MRC), Oulu University Hospital and University of Oulu, Oulu, Finland
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22
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Letourneau NL, Tryphonopoulos PD, Novick J, Hart JM, Giesbrecht G, Oxford ML. Nursing Child Assessment Satellite Training Parent-Child Interaction Scales: Comparing American and Canadian Normative and High-Risk Samples. J Pediatr Nurs 2018; 40:47-57. [PMID: 29776479 DOI: 10.1016/j.pedn.2018.02.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 02/06/2018] [Accepted: 02/26/2018] [Indexed: 11/19/2022]
Abstract
PURPOSE Many nurses rely on the American Nursing Child Assessment Satellite Training (NCAST) Parent-Child Interaction (PCI) Teaching and Feeding Scales to identify and target interventions for families affected by severe/chronic stressors (e.g. postpartum depression (PPD), intimate partner violence (IPV), low-income). However, the NCAST Database that provides normative data for comparisons may not apply to Canadian families. The purpose of this study was to compare NCAST PCI scores in Canadian and American samples and to assess the reliability of the NCAST PCI Scales in Canadian samples. METHODS This secondary analysis employed independent samples t-tests (p < 0.005) to compare PCI between the American NCAST Database and Canadian high-risk (families with PPD, exposure to IPV or low-income) and community samples. Cronbach's alphas were calculated for the Canadian and American samples. RESULTS In both American and Canadian samples, belonging to a high-risk population reduced parents' abilities to engage in sensitive and responsive caregiving (i.e. healthy serve and return relationships) as measured by the PCI Scales. NCAST Database mothers were more effective at executing caregiving responsibilities during PCI compared to the Canadian community sample, while infants belonging to the Canadian community sample provided clearer cues to caregivers during PCI compared to those of the NCAST Database. Internal consistency coefficients for the Canadian samples were generally acceptable. CONCLUSIONS The NCAST Database can be reliably used for assessing PCI in normative and high-risk Canadian families. PRACTICAL IMPLICATIONS Canadian nurses can be assured that the PCI Scales adequately identify risks and can help target interventions to promote optimal parent-child relationships and ultimately child development.
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Affiliation(s)
- Nicole L Letourneau
- Faculty of Nursing and Cumming School of Medicine (Pediatrics, Community Health Sciences & Psychiatry), University of Calgary, Alberta , Canada.
| | | | - Jason Novick
- Cumming School of Medicine (Pediatrics), University of Calgary, Calgary, Alberta Canada
| | - J Martha Hart
- Faculty of Nursing and Cumming School of Medicine (Pediatrics, Community Health Sciences & Psychiatry), University of Calgary, Alberta , Canada
| | - Gerald Giesbrecht
- Cumming School of Medicine (Pediatrics and Community Health Sciences), Faculty of Arts (Psychology), University of Calgary, Alberta Canada
| | - Monica L Oxford
- Center on Human Development & Disability, School of Nursing (Family & Child Nursing), Washington University, Seattle, WA United States
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Jameson M, Fehringer K, Neu M. Comparison of two tools to assess dyad feeding interaction in infants with gastroesophageal reflux disease. J SPEC PEDIATR NURS 2018; 23. [PMID: 29205957 DOI: 10.1111/jspn.12203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 10/30/2017] [Accepted: 11/04/2017] [Indexed: 01/08/2023]
Abstract
PURPOSE The aim of this study was to compare the Mother-Infant/Toddler Feeding Scale (MITFS) and the Nursing Child Assessment Feeding Scale (NCAFS). Specific questions were as follows: (1) Are there differences between the results of the MITFS and the NCAFS tools in terms of rating infant feeding interactions? And (2) does one tool provide a more detailed, nuanced overview of the quality of feeding interactions than the other? DESIGN AND METHODS This comparative descriptive study is a secondary analysis of a study evaluating a massage intervention for infants with symptoms of gastroesophageal reflux disease (GERD). A feeding observation for each dyad was scored using both the NCAFS and MITFS. Infants were 6-18 weeks of age. RESULTS There were moderate correlations (r = 0.3-0.8) between 11 of 20 possible NCAFS and MITFS mother-related subscales, and between 3 of 10 possible NCAFS and the MITFS infant-related subscales. A total of 19 dyads (83%) had one or more NCAFS subscale scores that were at least 1 standard deviation (SD) below normative scores, and 21 dyads (91%) had one or more MITFS subscale T-scores that deviated 1 SD from the normative T-scores. Agreement between the two instruments on scores deviating from the norm was 78%. PRACTICE IMPLICATIONS Both instruments discussed in this paper are standardized ways of assessing an infant feeding. Use of a standardized feeding tool is an objective way to evaluate feedings and can potentially identify specific areas of concern to guide an individualized intervention for a mother-infant dyad. Thus, nurses and other health professionals working with mothers and babies, whether in the hospital, pediatrician offices, or clinics would benefit from learning how to use a standardized feeding tool. Use of a feeding tool also provides the opportunity for nurses to understand the basis of important qualities of a feeding interaction, and a way for nurses who regularly feed infants to self-evaluate their feeding methods. This may minimize less than optimal interactions and allow for optimal support for infants during feedings by mothers and nurses.
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Affiliation(s)
| | - Karen Fehringer
- University of Colorado, School of Public Health, Aurora, CO, USA
| | - Madalynn Neu
- University of Colorado, College of Nursing, Aurora, CO, USA
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What promotes and hinders success in breastfeeding in hospital care? – the role of social support and anxiety. HEALTH PSYCHOLOGY REPORT 2018. [DOI: 10.5114/hpr.2018.73051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Weaver JM, Schofield TJ, Papp LM. Breastfeeding duration predicts greater maternal sensitivity over the next decade. Dev Psychol 2017; 54:220-227. [PMID: 29083214 DOI: 10.1037/dev0000425] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The current study represents the first longitudinal investigation of the potential effects of breastfeeding duration on maternal sensitivity over the following decade. This study also examined whether infant attachment security at 24 months would mediate longitudinal relations between breastfeeding duration and changes in maternal sensitivity over time. Using data from 1,272 families from the National Institute of Child Health and Human Development's Study of Early Child Care and Youth Development, we found that longer breastfeeding duration (assessed up to age 3) predicted increases in observed maternal sensitivity up to child age 11, after accounting for maternal neuroticism, parenting attitudes, ethnicity, maternal years of education, and presence of a romantic partner. Additionally, secure attachment at 24 months was predicted by breastfeeding duration, but it did not act as a mediator of the link from breastfeeding duration to maternal sensitivity in this study. Generating a more specific understanding of how breastfeeding impacts the mother-child dyad beyond infancy will inform recommendations for best practices regarding breastfeeding. (PsycINFO Database Record
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Affiliation(s)
| | - Thomas J Schofield
- Department of Human Development and Family Studies, Iowa State University
| | - Lauren M Papp
- Department of Human Development and Family Studies, University of Wisconsin-Madison
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26
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Wood NK, Sanders EA. Mothers With Perceived Insufficient Milk: Preliminary Evidence of Home Interventions to Boost Mother–Infant Interactions. West J Nurs Res 2017; 40:1184-1202. [DOI: 10.1177/0193945916687552] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Perceived insufficient milk (PIM) is the primary reason for breastfeeding discontinuation globally. This study evaluated the short-term impact of mother–infant interactions through home interventions designed to overcome PIM as a result of the infant’s behavior, delivered to 14 dyads of breastfeeding mothers and their full-term singleton infants. A single group, three-occasion prepost design was used. Mother–infant interactions were measured by the Nursing Child Assessment Feeding Scale (NCAFS) at 6, 13, and 27 days postpartum. There were significantly increased mother–infant interactions during intervention. Specifically, significant growth over the intervention occurred for mother’s sensitivity to cues, cognitive growth fostering, infant’s clarity of cues, and responsiveness to caregiver. The NCAFS total score was also significantly improved. Although modifications are required, the three home intervention sessions showed promise in improving mother–infant interactions during breastfeeding. Further investigation using a randomized experimental design is warranted.
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Moore ER, Bergman N, Anderson GC, Medley N. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev 2016; 11:CD003519. [PMID: 27885658 PMCID: PMC6464366 DOI: 10.1002/14651858.cd003519.pub4] [Citation(s) in RCA: 318] [Impact Index Per Article: 39.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Mother-infant separation post birth is common. In standard hospital care, newborn infants are held wrapped or dressed in their mother's arms, placed in open cribs or under radiant warmers. Skin-to-skin contact (SSC) begins ideally at birth and should last continually until the end of the first breastfeeding. SSC involves placing the dried, naked baby prone on the mother's bare chest, often covered with a warm blanket. According to mammalian neuroscience, the intimate contact inherent in this place (habitat) evokes neuro-behaviors ensuring fulfillment of basic biological needs. This time frame immediately post birth may represent a 'sensitive period' for programming future physiology and behavior. OBJECTIVES To assess the effects of immediate or early SSC for healthy newborn infants compared to standard contact on establishment and maintenance of breastfeeding and infant physiology. SEARCH METHODS We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (17 December 2015), made personal contact with trialists, consulted the bibliography on kangaroo mother care (KMC) maintained by Dr Susan Ludington, and reviewed reference lists of retrieved studies. SELECTION CRITERIA Randomized controlled trials that compared immediate or early SSC with usual hospital care. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. Quality of the evidence was assessed using the GRADE approach. MAIN RESULTS We included 46 trials with 3850 women and their infants; 38 trials with 3472 women and infants contributed data to our analyses. Trials took place in 21 countries, and most recruited small samples (just 12 trials randomized more than 100 women). Eight trials included women who had SSC after cesarean birth. All infants recruited to trials were healthy, and the majority were full term. Six trials studied late preterm infants (greater than 35 weeks' gestation). No included trial met all criteria for good quality with respect to methodology and reporting; no trial was successfully blinded, and all analyses were imprecise due to small sample size. Many analyses had statistical heterogeneity due to considerable differences between SSC and standard care control groups. Results for womenSSC women were more likely than women with standard contact to be breastfeeding at one to four months post birth, though there was some uncertainty in this estimate due to risks of bias in included trials (average risk ratio (RR) 1.24, 95% confidence interval (CI) 1.07 to 1.43; participants = 887; studies = 14; I² = 41%; GRADE: moderate quality). SSC women also breast fed their infants longer, though data were limited (mean difference (MD) 64 days, 95% CI 37.96 to 89.50; participants = 264; studies = six; GRADE:low quality); this result was from a sensitivity analysis excluding one trial contributing all of the heterogeneity in the primary analysis. SSC women were probably more likely to exclusively breast feed from hospital discharge to one month post birth and from six weeks to six months post birth, though both analyses had substantial heterogeneity (from discharge average RR 1.30, 95% CI 1.12 to 1.49; participants = 711; studies = six; I² = 44%; GRADE: moderate quality; from six weeks average RR 1.50, 95% CI 1.18 to 1.90; participants = 640; studies = seven; I² = 62%; GRADE: moderate quality).Women in the SCC group had higher mean scores for breastfeeding effectiveness, with moderate heterogeneity (IBFAT (Infant Breastfeeding Assessment Tool) score MD 2.28, 95% CI 1.41 to 3.15; participants = 384; studies = four; I² = 41%). SSC infants were more likely to breast feed successfully during their first feed, with high heterogeneity (average RR 1.32, 95% CI 1.04 to 1.67; participants = 575; studies = five; I² = 85%). Results for infantsSSC infants had higher SCRIP (stability of the cardio-respiratory system) scores overall, suggesting better stabilization on three physiological parameters. However, there were few infants, and the clinical significance of the test was unclear because trialists reported averages of multiple time points (standardized mean difference (SMD) 1.24, 95% CI 0.76 to 1.72; participants = 81; studies = two; GRADE low quality). SSC infants had higher blood glucose levels (MD 10.49, 95% CI 8.39 to 12.59; participants = 144; studies = three; GRADE: low quality), but similar temperature to infants in standard care (MD 0.30 degree Celcius (°C) 95% CI 0.13 °C to 0.47 °C; participants = 558; studies = six; I² = 88%; GRADE: low quality). Women and infants after cesarean birthWomen practicing SSC after cesarean birth were probably more likely to breast feed one to four months post birth and to breast feed successfully (IBFAT score), but analyses were based on just two trials and few women. Evidence was insufficient to determine whether SSC could improve breastfeeding at other times after cesarean. Single trials contributed to infant respiratory rate, maternal pain and maternal state anxiety with no power to detect group differences. SubgroupsWe found no differences for any outcome when we compared times of initiation (immediate less than 10 minutes post birth versus early 10 minutes or more post birth) or lengths of contact time (60 minutes or less contact versus more than 60 minutes contact). AUTHORS' CONCLUSIONS Evidence supports the use of SSC to promote breastfeeding. Studies with larger sample sizes are necessary to confirm physiological benefit for infants during transition to extra-uterine life and to establish possible dose-response effects and optimal initiation time. Methodological quality of trials remains problematic, and small trials reporting different outcomes with different scales and limited data limit our confidence in the benefits of SSC for infants. Our review included only healthy infants, which limits the range of physiological parameters observed and makes their interpretation difficult.
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Affiliation(s)
- Elizabeth R Moore
- Vanderbilt UniversitySchool of Nursing314 Godchaux Hall21st Avenue SouthNashvilleTennesseeUSA37240‐0008
| | - Nils Bergman
- University of Cape TownSchool of Child and Adolescent Health, and Department of Human BiologyCape TownSouth Africa
| | - Gene C Anderson
- Professor Emerita, University of FloridaCase Western Reserve UniversityOak Hammock at the University of Florida5000 SW 25th Boulevard #2108GainesvilleFLUSA32608‐8901
| | - Nancy Medley
- The University of LiverpoolCochrane Pregnancy and Childbirth Group, Department of Women's and Children's HealthFirst Floor, Liverpool Women's NHS Foundation TrustCrown StreetLiverpoolUKL8 7SS
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Jaafar SH, Ho JJ, Lee KS. Rooming-in for new mother and infant versus separate care for increasing the duration of breastfeeding. Cochrane Database Syst Rev 2016; 2016:CD006641. [PMID: 27562563 PMCID: PMC9168801 DOI: 10.1002/14651858.cd006641.pub3] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Mother-infant proximity and interactions after birth and during the early postpartum period are important for breast-milk production and breastfeeding success. Rooming-in and separate care are both traditional practices. Rooming-in involves keeping the mother and the baby together in the same room after birth for the duration of hospitalisation, whereas separate care is keeping the baby in the hospital nursery and the baby is either brought to the mother for breastfeeding or she walks to the nursery. OBJECTIVES To assess the effect of mother-infant rooming-in versus separation on the duration of breastfeeding (exclusive and total duration of breastfeeding). SEARCH METHODS We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 May 2016) and reference lists of retrieved studies. SELECTION CRITERIA Randomised or quasi-randomised controlled trials (RCTs) investigating the effect of mother-infant rooming-in versus separate care after hospital birth or at home on the duration of breastfeeding, proportion of breastfeeding at six months and adverse neonatal and maternal outcomes. DATA COLLECTION AND ANALYSIS Two review authors independently assessed the studies for inclusion and assessed trial quality. Two review authors extracted data. Data were checked for accuracy. We assessed the quality of the evidence using the GRADE approach. MAIN RESULTS We included one trial (involving 176 women) in this review. This trial included four groups with a factorial design. The factorial design took into account two factors, i.e. infant location in relation to the mother and the type of infant apparel. We combined three of the groups as the intervention (rooming-in) group and the fourth group acted as the control (separate care) and we analysed the results as a single pair-wise comparison. Primary outcomesThe primary outcome, duration of any breastfeeding, was reported by authors as median values because the distribution was found to be skewed. They reported the overall median duration of any breastfeeding to be four months, with no difference found between groups. Duration of exclusive breastfeeding and the proportion of infants being exclusively breastfed at six months of age was not reported in the trial. There was no difference found between the two groups in the proportion of infants receiving any breastfeeding at six months of age (risk ratio (RR) 0.84, 95% confidence interval (CI) 0.51 to 1.39; one trial; 137 women; low-quality evidence). Secondary outcomesThe mean frequency of breastfeeds per day on day four postpartum for the rooming-in group was 8.3 (standard deviation (SD) 2.2), slightly higher than the separate care group, i.e. seven times per day. However, between-group comparison of this outcome was not appropriate since every infant in the separate care group was breastfed at a fixed schedule of seven times per day (SD = 0) resulting in no estimable comparison. The rate of exclusive breastfeeding on day four postpartum before discharge from hospital was significantly higher in the rooming-in group 86% (99 of 115) compared with separate care group, 45% (17 of 38), (RR 1.92; 95% CI 1.34 to 2.76; one trial, 153 women; low-quality evidence). None of our other pre-specified secondary outcomes were reported. AUTHORS' CONCLUSIONS We found little evidence to support or refute the practice of rooming-in versus mother-infant separation. Further well-designed RCTs to investigate full mother-infant rooming-in versus partial rooming-in or separate care including all important outcomes are needed.
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Affiliation(s)
- Sharifah Halimah Jaafar
- Regency Specialist HospitalDepartment of Obstetrics and GynaecologyNo 1 Jalan Suria,Bandar Seri AlamJohor BahruJohorMalaysia81750
| | - Jacqueline J Ho
- Penang Medical CollegeDepartment of Paediatrics4 Sepoy LinesPenangMalaysia10450
| | - Kim Seng Lee
- Fatimah HospitalDepartment of PediatricsOff Lebuh Chew Peng Loon, Ipoh GardenIpohPerakMalaysia31400
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Kielbratowska B, Kazmierczak M, Michalek J, Preis K. Temperament and the mother-infant dyad: associations with breastfeeding and formula feeding with a bottle. Infant Ment Health J 2015; 36:243-50. [PMID: 25973840 DOI: 10.1002/imhj.21508] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Breastfeeding supports the formation of an emotional bond between mothers and their children. The feeding method is associated with both the child's temperament and the mother's perception of herself and the child. Therefore, the present study focuses on the feeding method, mothers' reaction during feeding, and infants' temperament traits. Ninety-eight mothers with children aged 3 to 5 months participated in the study. Children were assessed with the Children Development Scale (A. Matczak et al., 2007) to measure their temperament. Mothers completed the Mother and Baby Scale (D. Wolke & I. St James-Roberts, 1987, as cited in T.B. Brazelton & K. Nugent, 1995), which measures mothers' evaluation of their children's behaviors during feeding and their overall experiences with their children's care. The results show that breastfed newborns, as compared to bottle-fed newborns, demonstrate higher vigor, which includes activity and the intensity of reaction. Bottle-fed children demonstrate higher regularity than do breastfed children. Mothers who bottle-feed their children perceive themselves to be less confident in the feeding domain than do mothers who breastfeed. Our results indicate that children's temperament might be an important factor in the decision regarding the feeding method. The study supports the idea of promoting knowledge of children's behaviors during feeding among mothers even before their children are born, such as during antenatal classes.
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Crenshaw JT. Healthy Birth Practice #6: Keep Mother and Baby Together- It's Best for Mother, Baby, and Breastfeeding. J Perinat Educ 2014; 23:211-7. [PMID: 25411542 DOI: 10.1891/1058-1243.23.4.211] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Mothers and babies have a physiologic need to be together at the moment of birth and during the hours and days that follow. Keeping mothers and babies together is a safe and healthy birth practice. Evidence supports immediate, uninterrupted skin-to-skin care after vaginal birth and during and after cesarean surgery for all stable mothers and babies, regardless of feeding preference. Unlimited opportunities for skin-to-skin care and breastfeeding promote optimal maternal and child outcomes. This article is an updated evidence-based review of the "Lamaze International Care Practices That Promote Normal Birth, Care Practice #6: No Separation of Mother and Baby, With Unlimited Opportunities for Breastfeeding," published in The Journal of Perinatal Education, 16(3), 2007.
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