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Pados BF, Camp L. Physiology of Human Lactation and Strategies to Support Milk Supply for Breastfeeding. Nurs Womens Health 2024; 28:303-314. [PMID: 38972331 DOI: 10.1016/j.nwh.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 05/21/2024] [Indexed: 07/09/2024]
Abstract
Despite advances across the globe in breastfeeding initiation rates, many families continue to report they are not meeting their breastfeeding goals. Concerns about milk supply, infant nutritional intake, and infant weight gain are among the most commonly cited reasons for early breastfeeding cessation. Nurses working with individuals during the perinatal period are uniquely positioned to educate families and offer evidence-based interventions to promote optimal milk supply, infant growth, and maternal mental and physical health. Such interventions include early and frequent skin-to-skin care, emptying of the breast, and professional lactation support. By implementing such evidence-based practices in the first hours after birth and connecting families to lactation support in the first 14 days, nurses can begin to help families achieve their breastfeeding goals.
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Kaynak S, Yilmaz HB. The Impact of Video Calling Between Preterm Infants and Their Mothers on the Physiological Parameters of Infants and Mother-Infant Bonding. J Perinat Neonatal Nurs 2024; 38:E26-E37. [PMID: 39074330 DOI: 10.1097/jpn.0000000000000787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/31/2024]
Abstract
PURPOSE This study aimed to determine the effect of video calling between preterm infants treated in the neonatal intensive care unit (NICU) and their mothers on the physiological parameters of infants and mother-infant bonding. BACKGROUND Preterm infants need prolonged treatment in the NICU, and their families may have difficulty seeing their babies during this treatment process. METHODS This is a prospective, randomized-controlled, experimental study. The study sample consisted of 75 preterm infants and their mothers. The data were collected using a maternal introductory information form, a preterm infant introductory information form, a preterm infant physiological parameters follow-up form, and the Mother-Infant Bonding Scale (MIBS). The study included 3 study groups: the video call group, the video call with lullaby group, and the control group. Video calls between preterm infants and their mothers were made through Zoom for 5 to 10 minutes daily for 7 days. The mothers filled out the MIBS online before and on the 7th and 30th days of the study. RESULTS Preterm infants in the video call and the video call with lullaby groups had higher MIBS mean scores on the 7th and 30th days of the study than their pretest MIBS scores. Preterm infants in the video call and the video call with lullaby groups had statistically significantly higher MIBS mean scores on the seventh day of the study than those in the control group. At the end of the 7-day study period, there was an improvement in the physiological parameters of preterm infants in the video call group and the video call with lullaby group compared with those in the control group, and this relationship was statistically significant. CONCLUSIONS In conclusion, the implementation of video calls between mothers and preterm infants in NICUs had a healing effect on the physiological parameters of preterm infants and increased mother-infant bonding.
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Affiliation(s)
- Serap Kaynak
- Author Affiliations: Departments of Nursing and Pediatric Nursing, Faculty of Health Sciences, Balıkesir University, Balıkesir, Turkey (Dr Kaynak); and Department of Pediatric Nursing, Faculty of Nursing, Ege University, İzmir, Turkey (Dr Yılmaz)
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Boedker I, Ball HL, Richter M, South TL, Roberts SGB. Construction of the Views oN Infant Sleep (VNIS) Questionnaire. Early Hum Dev 2024; 191:105989. [PMID: 38513547 DOI: 10.1016/j.earlhumdev.2024.105989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 03/14/2024] [Accepted: 03/14/2024] [Indexed: 03/23/2024]
Abstract
Parents' beliefs about infant sleep behaviour vary over time and across cultures. No validated instrument exists to understand parents' pre- and postnatal views on infant sleep behaviours, which may influence their caregiving decisions. The Views oN Infant Sleep Questionnaire (VNIS) will be a tool to assess parents' beliefs in order to facilitate tailored perinatal care, increase the reliability of postnatal self-report measures, allow for cross-cultural comparisons, and provide a baseline for researchers to use in longitudinal studies. We recruited an online sample of 971 female participants who were resident in the United Kingdom, at least 28 weeks pregnant, and at least 18 years of age. The initial questionnaire consisted of 31 questions about infant independence, night-waking, infant feeding, touch, and safety, and items were rated on a 5-point Likert scale. The item pool was reduced to 12 using principal component analysis and a structure was found for the three components "Closeness", "Independence", and "Night-waking". Overall, these results suggest that the VNIS can provide a brief scale to measure different aspects of individuals' beliefs about infant sleep. In further research the VNIS needs to be validated with a confirmatory factor analysis in another sample, and to be tested as a cross-cultural instrument.
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Affiliation(s)
- Ingrid Boedker
- School of Psychology, Liverpool John Moores University, Liverpool, United Kingdom.
| | - Helen L Ball
- Department of Anthropology, Durham University, Durham, United Kingdom
| | - Michael Richter
- School of Psychology, Liverpool John Moores University, Liverpool, United Kingdom
| | - Tina L South
- School of Nursing and Allied Health, Liverpool John Moores University, Liverpool, United Kingdom
| | - Sam G B Roberts
- School of Psychology, Liverpool John Moores University, Liverpool, United Kingdom
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Little EE, Bain L, Hahn-Holbrook J. Randomized controlled trial to prevent postpartum depressive symptomatology: An infant carrier intervention. J Affect Disord 2023; 340:871-876. [PMID: 37586649 DOI: 10.1016/j.jad.2023.08.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 08/06/2023] [Accepted: 08/07/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND There is a need for effective interventions to reduce symptomatology of postpartum depression. The objective of this study was to test whether providing an ergonomic infant carrier would reduce postpartum depression symptomatology. METHODS A randomized two-arm, parallel-group trial with 100 participants was conducted between February 2018 and June 2019 in a low-income community. At 30-weeks' gestation, 50 participants were randomly assigned to receive an ergonomic infant carrier and instructions on proper use (intervention group), and 50 participants were assigned to a waitlist (control group). Participants tracked the extent of their infant carrier use and completed the Edinburgh Postpartum Depression Scale (EPDS) to assess postpartum depression symptomatology at 6-weeks postpartum. RESULTS Participants in the intervention group reported using an infant carrier significantly more often than the control group (β = 2.69, SE = 0.347, p < .001, 95 % CI = 2.08-3.41). The intervention group reported fewer depressive symptoms at 6-weeks postpartum than the control group (β = -0.541, p = .042). LIMITATIONS The sample size was relatively small and thus our results may not be generalizable to the general population. CONCLUSION Infant carrying may be a cost-effective intervention to reduce postpartum depression symptomatology. Large-scale studies are warranted to further examine the efficacy and cost-effectiveness of providing carriers as an intervention to reduce postpartum depression symptomatology. CLINICAL TRIAL REGISTRATION Clinicaltrials.gov id: NCT04376021. Data Sharing Statement: Deidentified individual participant data will not be made available because we did not obtain permission to share individual data. CLINICAL TRIAL REGISTRATION NUMBER NCT0437602; https://beta. CLINICALTRIALS gov/study/NCT04376021.
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Dixley A, Ball HL. The impact of swaddling upon breastfeeding: A critical review. Am J Hum Biol 2023; 35:e23878. [PMID: 36787374 PMCID: PMC10909524 DOI: 10.1002/ajhb.23878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 01/24/2023] [Accepted: 01/25/2023] [Indexed: 02/16/2023] Open
Abstract
INTRODUCTION Many parents swaddle their infants to promote sleep and reduce night-waking, however lack of definitive evidence about the pros and cons of swaddling when breastfeeding hinders postnatal recommendations regarding this infant care practice. This review critically examines research conducted on the impact of swaddling upon breastfeeding. METHODS Only two recent studies on swaddling outcomes have reported infant feed-type, therefore the purpose of this paper is to consider the known effects of swaddling on breastfeeding babies and their mothers. We interpret the existing literature on swaddling in terms of impact on breastfeeding physiology and behaviour during the immediate post-natal period, and as infancy progresses. RESULTS Infants swaddled immediately after birth show a delay in initial breastfeeding, less successful suckling at the breast, reduced intake of breastmilk and greater weight loss compared to un-swaddled babies. Swaddling visually obscures feeding cues and reduces crying, thereby eliminating two key feeding prompts typically used by parents/carers. CONCLUSIONS As swaddled babies cry less, and are fed less frequently than un-swaddled babies some clinical trials position swaddling as a 'novel weight regulation tool' to combat obesity. However, in the case of breastfed babies, by reducing feed frequency swaddling may impede maternal milk production and thereby infant growth.
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Affiliation(s)
- Allison Dixley
- Durham Infancy & Sleep Centre, Department of AnthropologyDurham UniversityDurhamUK
| | - Helen L. Ball
- Durham Infancy & Sleep Centre, Department of AnthropologyDurham UniversityDurhamUK
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Abargil M, Irani M, klein Selle N, Atzil S. Breastfeeding at Any Cost? Adverse Effects of Breastfeeding Pain on Mother-Infant Behavior. BIOLOGY 2023; 12:636. [PMID: 37237450 PMCID: PMC10215422 DOI: 10.3390/biology12050636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 04/11/2023] [Accepted: 04/19/2023] [Indexed: 05/28/2023]
Abstract
Breast milk is considered the ideal infant nutrition, and medical organizations encourage breastfeeding worldwide. Moreover, breastfeeding is often perceived as a natural and spontaneous socio-biological process and one of the fundamental roles of new mothers. While breastfeeding is beneficial, little scientific consideration has been given to its potential psychological challenges. Here, we investigate the phenomenon of breastfeeding pain in mothers and its association with maternal and infant behavioral regulation. During the postpartum weeks, the mother-infant dyad can be considered one allostatic unit directed at infant regulation and development. We hypothesize that pain comprises an allostatic challenge for mothers and will thus impair the capacity for dyadic regulation. To test this, we recruited 71 mothers with varying levels of breastfeeding pain and videotaped them with their infants (2-35 weeks old) during spontaneous face-to-face interactions. We quantified the individual differences in dyadic regulation by behaviorally coding the second-by-second affective expressions for each mother and infant throughout their interactions. We tested the extent to which breastfeeding pain alters affect regulation during mother-infant interactions. We discovered that mothers with severe breastfeeding pain express less affective expressions and less infant-directed gaze during interactive moments of engagement and play than mothers with no or moderate pain. Moreover, infants of mothers experiencing pain during breastfeeding express less affective expressions and more mother-directed gaze while interacting with their mothers than infants of mothers who are not in pain. This demonstrates that the allostatic challenge of maternal pain interferes with the behavioral regulation of both mothers and infants. Since the mother-infant dyad is a codependent allostatic unit, the allostatic challenges of one partner can impact the dyad and thus potentially impact child development, bonding, and mother and infant well-being. The challenges of breastfeeding should be considered in addition to the nutritional advances.
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Affiliation(s)
- Maayan Abargil
- The Department of Psychology, The Hebrew University of Jerusalem, Jerusalem 9190501, Israel
| | - Merav Irani
- The Department of Psychology, The Hebrew University of Jerusalem, Jerusalem 9190501, Israel
| | | | - Shir Atzil
- The Department of Psychology, The Hebrew University of Jerusalem, Jerusalem 9190501, Israel
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Liu YW, Liu H, Huang K, Zhu BB, Yan SQ, Hao JH, Zhu P, Tao FB, Shao SS. The association between pregnancy-related anxiety and behavioral development in 18-month-old children: The mediating effects of parenting styles and breastfeeding methods. J Affect Disord 2023; 333:392-402. [PMID: 37086809 DOI: 10.1016/j.jad.2023.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/07/2023] [Accepted: 04/10/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND Pregnancy-related anxiety (PRA) is a distinct type of anxiety from general anxiety, affects many pregnant women, and is correlated with poor behavioral development in children. However, the mediation paths were unclear. METHODS A total of 2032 mother-infant pairs from the Ma'anshan Birth Cohort were included in the current study. Maternal PRA was assessed in the second and third trimesters. Children's behavioral development was evaluated at the age of 18 months. In addition, information on parenting styles and breastfeeding methods was obtained at postpartum. Multivariate regression and structural equation modeling were used to examine the associations between maternal PRA and children's behavioral development. RESULTS Significant intercorrelations were found between maternal PRA, the potential mediators (parenting styles and breastfeeding methods), and 18-month-old children's ASQ scores. Parenting styles played an intermediary role in the relationship between maternal PRA and children's behavioral development (β = 0.030, 95 % confidence interval: 0.017-0.051), and the mediating effect accounted for 29.1 % of the total effect. However, breastfeeding methods did not mediate the link between PRA and children's behavior. LIMITATIONS Depression and postpartum anxiety were not controlled for in our analysis, which left us unable to estimate the independent impact of PRA on children's behavior. CONCLUSIONS Parenting rather than breastfeeding is the mediating factor of behavioral problems in children caused by PRA.
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Affiliation(s)
- Yu-Wei Liu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University; No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Hui Liu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University; No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Kun Huang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University; No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Bei-Bei Zhu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University; No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Shuang-Qin Yan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China; Maternal and Child Health Care Center of Ma'anshan, No 24 Jiashan Road, Ma'anshan 243011, Anhui, China
| | - Jia-Hu Hao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University; No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Peng Zhu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University; No 81 Meishan Road, Hefei 230032, Anhui, China
| | - Fang-Biao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University; No 81 Meishan Road, Hefei 230032, Anhui, China.
| | - Shan-Shan Shao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei 230032, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei 230032, Anhui, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University; No 81 Meishan Road, Hefei 230032, Anhui, China.
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Hookway L, Brown A, Grant A. Breastfeeding sick children in hospital: Exploring the experiences of mothers in UK paediatric wards. MATERNAL & CHILD NUTRITION 2023; 19:e13489. [PMID: 36808886 PMCID: PMC10019061 DOI: 10.1111/mcn.13489] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 01/16/2023] [Accepted: 01/24/2023] [Indexed: 02/23/2023]
Abstract
There is a paucity of literature exploring the challenges of breastfeeding sick children in hospital. Previous research has focused on single conditions and hospitals which limits understanding of the challenges in this population. Although evidence suggests that current lactation training in paediatrics is often inadequate, it is unclear where the specific training gaps are. This qualitative interview study of UK mothers aimed to explore the challenges of breastfeeding sick infants and children on a paediatric ward or paediatric intensive care unit. From 504 eligible respondents, a sample of 30 mothers of children aged 2-36 months with various conditions and demographic backgrounds was purposively chosen, and a reflexive thematic analysis undertaken. The study identified previously unreported impacts such as complex fluid needs, iatrogenic withdrawal, neurological irritability and changes to breastfeeding behaviour. Mothers described breastfeeding as emotionally and immunologically meaningful. There were many complex psychological challenges such as guilt, disempowerment, and trauma. Wider struggles such as staff resistance to bedsharing, inaccurate breastfeeding information, lack of food and inadequate breast pump provision made breastfeeding more challenging. There are numerous challenges related to breastfeeding and responsively parenting sick children in paediatrics, and these also impacted maternal mental health. Staff skill and knowledge gaps were widespread, and the clinical environment was not always conducive to supporting breastfeeding. This study highlights strengths in clinical care and provides insight into what measures are perceived as supportive by mothers. It also highlights areas for improvement, which may inform more nuanced paediatric breastfeeding standards and training.
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Affiliation(s)
- Lyndsey Hookway
- Centre for Lactation, Infant Feeding and Translation (LIFT), School of Health and Social CareSwansea UniversitySwanseaUK
| | - Amy Brown
- Centre for Lactation, Infant Feeding and Translation (LIFT), School of Health and Social CareSwansea UniversitySwanseaUK
| | - Aimee Grant
- Centre for Lactation, Infant Feeding and Translation (LIFT), School of Health and Social CareSwansea UniversitySwanseaUK
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Zimmerman D, Bartick M, Feldman-Winter L, Ball HL. ABM Clinical Protocol #37: Physiological Infant Care-Managing Nighttime Breastfeeding in Young Infants. Breastfeed Med 2023; 18:159-168. [PMID: 36927076 PMCID: PMC10083892 DOI: 10.1089/bfm.2023.29236.abm] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
A central goal of the Academy of Breastfeeding Medicine (ABM) is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient. The ABM empowers health professionals to provide safe, inclusive, patient-centered, and evidence-based care. Pregnant and lactating people identify with a broad spectrum of genders, pronouns, and terms for feeding and parenting. There are two reasons ABM's use of gender-inclusive language may be transitional or inconsistent across protocols. First, gender-inclusive language is nuanced and evolving across languages, cultures, and countries. Second, foundational research has not adequately described the experiences of gender-diverse individuals. Therefore, ABM advocates for, and will strive to use language that is as inclusive and accurate as possible within this framework. For more explanation, please read ABM Position Statements on Infant Feeding and Lactation-Related Language and Gender (https://doi.org/10.1089/bfm.2021.29188.abm) and Breastfeeding As a Basic Human Right (https://doi.org/10.1089/bfm.2022.29216.abm).
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Affiliation(s)
- Deena Zimmerman
- Maternal-Child and Adolescent Division, Public Health Service, Israel Ministry of Health, Jerusalem, Israel
| | - Melissa Bartick
- Department of Medicine, Mount Auburn Hospital, Cambridge, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Lori Feldman-Winter
- Department of Pediatrics, Cooper Medical School of Rowan University, Camden, New Jersey, USA
| | - Helen L Ball
- Durham Infancy and Sleep Centre, Department of Anthropology, Durham University, Durham, United Kingdom
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Grisham LM, Rankin L, Maurer JA, Gephart SM, Bell AF. Scoping Review of Biological and Behavioral Effects of Babywearing on Mothers and Infants. J Obstet Gynecol Neonatal Nurs 2023; 52:191-201. [PMID: 36738764 DOI: 10.1016/j.jogn.2022.12.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE To synthesize the evidence on the biological and behavioral effects of babywearing on mothers and infants. DATA SOURCES We searched PubMed, CINAHL, Embase, PsycINFO, Sociological Abstracts, SCOPUS, and Google Scholar for peer-reviewed, full-text research articles published in English in which researchers reported on the biological or behavioral effects of babywearing on mothers or infants. STUDY SELECTION We reviewed the titles and abstracts of 200 records and abstracted 80 for full-text review. Of these, 29 studies met the eligibility criteria and were included in the review. DATA EXTRACTION We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and extracted the following data from the included articles: author(s), year of publication, setting, aim/purpose, design, description, sample, results/outcomes, and implications to practice. DATA SYNTHESIS We synthesized data from the included studies into the following eight themes: Increased Contact, Responsiveness, and Secure Attachment; Physiologic Effects; Biomechanics and Positioning; Facilitating and Empowering; Comfort; Maternal Benefits; Speech, Vocalizations, and Tempo; and Beliefs and Perceptions About Babywearing. CONCLUSION Babywearing may have a range of beneficial biological and behavioral effects on mothers and infants. The evidence, however, is insufficient to inform practice recommendations, and additional research is warranted.
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Wood NK, Odom-Maryon T, Smart DA. Factors Associated With Exclusive Direct Breastfeeding in the First 3 Months. Nurs Womens Health 2022; 26:299-307. [PMID: 35714762 DOI: 10.1016/j.nwh.2022.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 03/01/2022] [Accepted: 05/19/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To identify factors associated with exclusive direct breastfeeding in the first 3 months among mother and infant dyads living in the United States. DESIGN A secondary analysis of data collected using a cross-sectional online survey completed over a 4-month period in late 2019. PARTICIPANTS We recruited a convenience sample of 370 mothers with healthy full-term singleton infants between 1 and 12 weeks of age whose feeding methods consisted of direct breastfeeding at least once a day. Mothers had not returned to work/school at the time of the survey completion. MEASUREMENTS The questionnaire consisted of 34 questions about maternal and infant factors that influence decisions about infant feeding, professional support, and parental preferences. RESULTS Mothers who practiced feeding on demand (adjusted OR [aOR] = 35.76, 95% confidence interval [CI] [2.04, 500.00]) and mothers of infants 1 to 4 weeks of age (aOR = 2.74, 95% CI [1.54, 4.85]) were more likely to use exclusive direct breastfeeding. The odds of exclusive direct breastfeeding decreased with mothers who breastfed with a nipple shield while in the hospital/birth center/home (aOR = 0.13, 95% CI [0.05, 0.35]), used pacifiers (aOR = 0.31, 95% CI [0.21, 0.65]), or had perceptions of insufficient milk (aOR = 0.11, 95% CI [0.04, 0.26]). CONCLUSION Demand feeding and an infant's age of 1 to 4 weeks contributed to exclusive direct breastfeeding. Lower rates of exclusive direct breastfeeding were associated with the use of nipple shields immediately after birth, pacifier use, and perceptions of insufficient milk. Further investigation is warranted to fully differentiate exclusive direct breastfeeding from exclusive breastfeeding.
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Tanaka M, Sei J, Minai J. [Factors Associated with Breastfeeding at One Month Postpartum: Focus on Nursing Guidance and Mothers' Breastfeeding Behavior]. Nihon Eiseigaku Zasshi 2022; 77. [PMID: 35342143 DOI: 10.1265/jjh.21010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES In this study, we aimed to clarify the factors associated with breastfeeding at one month postpartum, with focusing on midwives' nursing guidance and mothers' breastfeeding behavior. METHODS A total of 158 mothers who participated in a medical examination two weeks after delivery were followed up with a questionnaire at two weeks and one month postpartum. Furthermore, we conducted multiple logistic regression analyses with breastfeeding at the one-month health checkup as the dependent variable and breastfeeding guidance and mothers' breastfeeding behavior as independent variables adjusted for birth history and delivery method, which were the confounding factors. RESULTS For nursing guidance, we examined 149 individuals without missing data. In total, 71 (47.7%) mothers were found to be breastfeeding at one month postpartum. Breastfeeding probabilities were significantly higher in mothers who received guidance regarding the meaning of their infants' crying, changes in breast tension, breast care, and mothers' milk production, which were measured, with odds ratios ranging from 2.47 to 3.68. Breastfeeding odds ratios were significantly higher in mothers who inserted the nipple deeply into the baby's mouth such that the baby's lips spread outward, as well as in those who breastfed until the breast felt light and those who breastfed eight times a day than in mothers who did not, with odds ratios ranging from 2.27 to 5.86. CONCLUSION This study indicated that early postpartum support, including guidance regarding the meaning of infants' crying, changes in breast tension, breast care, lactation measurement, and proper breastfeeding methods, is crucial in establishing breastfeeding.
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Affiliation(s)
- Mai Tanaka
- Course of Midwifery, Gifu University of Medical Science
| | - Jungetsu Sei
- Department of Nursing, Faculty of Nursing, Gifu University of Medical Science
| | - Junko Minai
- Department of Nursing, Faculty of Nursing, Gifu University of Medical Science
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Walker K, Green J, Petty J, Whiting L, Staff L, Bromley P, Fowler C, Jones LK. Breastfeeding in the context of the COVID-19 pandemic: A discussion paper. JOURNAL OF NEONATAL NURSING : JNN 2022; 28:9-15. [PMID: 34366687 PMCID: PMC8332735 DOI: 10.1016/j.jnn.2021.08.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/24/2021] [Accepted: 08/02/2021] [Indexed: 01/03/2023]
Abstract
Breastfeeding offers one of the most fundamental global health benefits for babies. Breastmilk is lifesaving, providing not only nutrition but immunologic benefits and as such is strongly supported by the World Health Organization and leading healthcare associations worldwide. When the COVID-19 pandemic started in 2020, the impact of the restrictions to prevent the spread of the disease created challenges and questions about provision of safe, quality care, including breastfeeding practices, in a new 'normal' environment. Mothers were temporarily separated from their babies where infection was present or suspected, parents were prevented from being present on neonatal units and vital breastfeeding support was prevented. This discussion paper provides an overview of essential areas of knowledge related to practice for neonatal nurses and midwives who care for breastfeeding mothers and babies, in the context of the COVID-19 pandemic and the latest global guidance. Three areas will be discussed; the protective benefits of breastfeeding, keeping breastfeeding mothers and babies together and supporting mothers to breastfeed their babies. Finally, care recommendations are presented to serve as a summary of key points for application to practice for neonatal nurses and midwives.
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Affiliation(s)
| | - Janet Green
- School of Nursing, College of Health and Medicine, University of Tasmania, Australia
| | - Julia Petty
- School of Health and Social Work, The University of Hertfordshire, Hatfield, UK
| | - Lisa Whiting
- School of Health and Social Work, The University of Hertfordshire, Hatfield, UK
| | - Lynette Staff
- School of Nursing, College of Health and Medicine, University of Tasmania, Australia
| | - Patricia Bromley
- School of Nursing, College of Health and Medicine, University of Tasmania, Australia
| | - Cathrine Fowler
- Faculty of Health University of Technology, Sydney, Australia
| | - Linda K Jones
- School of Nursing, College of Health and Medicine, University of Tasmania, Australia
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14
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de Barbaro K, Fausey CM. Ten lessons about infants' everyday experiences. CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE 2022; 31:28-33. [PMID: 36159505 PMCID: PMC9499013 DOI: 10.1177/09637214211059536] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
Audio recorders, accelerometers, and cameras that infants wear throughout their everyday lives capture the experiences that are available to shape development. Everyday sensing in infancy reveals patterns within the everyday hubbub that are unknowable using methods that capture shorter, more isolated, or more planned slices of behavior. Here, we review ten lessons learned from recent endeavors that removed researchers from designing or participating in infants' experiences and instead quantified patterns that arose within infants' own spontaneously arising everyday experiences. The striking heterogeneity of experiences - there is no meaningfully "representative" hour of a day, instance of a category, interaction context, or infant - inspires next steps in theory and practice that embrace the complex, dynamic, and multiple pathways of human development.
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Affiliation(s)
- Kaya de Barbaro
- Department of Psychology, The University of Texas at Austin, SEA 4.208, 108 E. Dean Keaton Stop A8000, Austin, TX 78712-1043
| | - Caitlin M. Fausey
- Department of Psychology, University of Oregon, 1227 University of Oregon, Eugene, OR, 97403
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15
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Barry ES, McKenna JJ. Reasons mothers bedshare: A review of its effects on infant behavior and development. Infant Behav Dev 2021; 66:101684. [PMID: 34929477 DOI: 10.1016/j.infbeh.2021.101684] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 11/05/2021] [Accepted: 12/09/2021] [Indexed: 11/05/2022]
Abstract
Bedsharing is controversial for nighttime caregiving in the U.S. today, as in most of the West. However, from the standpoint of evolutionary pediatrics, anthropology, and cultural psychology, bedsharing is not controversial at all, representing the context for human infant evolution and conferring a host of physiological benefits to the infant as well as the mother. In an effort to understand the rise in Western bedsharing in recent decades (and following Ball, 2002; McKenna & Volpe, 2007), Salm Ward (2015) systematically reviewed the literature on mother-infant bedsharing and identified ten reasons why mothers choose to bedshare: (1) breastfeeding, (2) comforting for mother or infant, (3) better/more sleep for infant or parent, (4) monitoring, (5) bonding/ attachment, (6) environmental reasons, (7) crying, (8) cultural or familial traditions, (9) disagree with danger, and (10) maternal instinct. The current paper offers the "review behind the review," highlighting the scientific evidence behind the reasons mothers give for their decision to bedshare, focusing on how mothers' decisions about infant sleep location influence infant behavior and development.
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Affiliation(s)
- Elaine S Barry
- Human Development & Family Studies, The Pennsylvania State University, Fayette, The Eberly Campus, USA.
| | - James J McKenna
- Mother-Baby Sleep Lab, Department of Anthropology, University of Notre Dame, South Bend, IN, USA; Department of Anthropology, Santa Clara University, Santa Clara, CA, USA
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16
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Ergang BC, da Silva CH, Goldani MZ, Hagen MEK, Bernardi JR. Is the duration of breastfeeding associated with eating behavior in early childhood? Physiol Behav 2021; 242:113607. [PMID: 34582883 DOI: 10.1016/j.physbeh.2021.113607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/14/2021] [Accepted: 09/23/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Eating behavior can be defined as the relationship between human and food and involves a multifaceted network of genetic and environmental influences. The eating behavior acquired in childhood, when dysfunctional, can affect children's health and seems to influence adult eating behavior. This study aimed to analyze the breastfeeding influence on eating behavior in early childhood. METHODS In this longitudinal observational study, data about sociodemographic and breastfeeding practices were collected through questionnaire developed by the researchers and eating behavior was assessed with the Children's Eating Behavior Questionnaire when the children have 3-5 years of age. This instrument was divided into 'food approach' and 'food avoidant' scales, with 'food approach' being linked to overweight/obesity and 'food avoidant' to selectivity. RESULTS Data on 107 mother-child pairs were analyzed, of whom 98.1% (n= 105) were breastfed and 46.7% (n= 50) received infant formula. There was a significant association between lower scores in the 'food approach' scale, eating behavior, and total breastfeeding duration > 6 months (p= 0.033), as well, as with exclusive breastfeeding duration > 3 months (p= 0.001). This relationship was confirmed in a linear regression model, after adjusting for sociodemographic variables and infant nutritional status. It was observed that a one-day increase in total breastfeeding and exclusive breastfeeding was associated with a -0.044 decrease in total score on the 'food approach' scale ([95% CI: -0.08; -0.01]; p= 0.027 and [95% CI: -0.08; -0.01]; p= 0.010, respectively). CONCLUSION The total and exclusive breastfeeding duration are related to child feeding behavior, while a longer period of breastfeeding can be an influencing factor against 'food approach' scale.
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Affiliation(s)
- Bárbara Cristina Ergang
- Graduate Program of Food, Nutrition and Health, Faculty of Medicine, Universidade Federal do Rio Grande do Sul. Ramiro Barcelos Street, 2400. Zip Code 90035-903, Porto Alegre, RS, Brazil.
| | - Clécio Homrich da Silva
- Department of Pediatrics, Graduate Program of Child and Adolescent Health, Faculty of Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Ramiro Barcelos Street, 2400. Zip Code 90035-903, Porto Alegre, RS, Brazil
| | - Marcelo Zubaran Goldani
- Department of Pediatrics, Graduate Program of Child and Adolescent Health, Faculty of Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Ramiro Barcelos Street, 2400. Zip Code 90035-903, Porto Alegre, RS, Brazil
| | - Martine Elisabeth Kienzle Hagen
- Department of Nutrition, Graduate Program of Food, Nutrition and Health, Faculty of Medicine, Universidade Federal do Rio Grande do Sul. Ramiro Barcelos Street, 2400. Zip Code 90035-903, Porto Alegre, RS, Brazil
| | - Juliana Rombaldi Bernardi
- Department of Nutrition, Graduate Program of Food, Nutrition and Health, Graduate Program of Child and Adolescent Health, Faculty of Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Ramiro Barcelos Street, 2400. Zip Code 90035-903, Porto Alegre, RS, Brazil
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17
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Asiodu IV, Beal L, Sufrin C. Breastfeeding in Incarcerated Settings in the United States: A National Survey of Frequency and Policies. Breastfeed Med 2021; 16:710-716. [PMID: 33835854 PMCID: PMC8563451 DOI: 10.1089/bfm.2020.0410] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Objectives: To assess the existence of prison and jail policies and practices that allow incarcerated women to breastfeed while in custody, and prevalence of women in custody who pumped human milk for their infants. Methods: We surveyed 22 state prison systems and 6 county jails from 2016 to 2017 about policies related to breastfeeding and other programs for pregnant and parenting women in custody. In addition, 11 prisons and 5 jails reported 6 months of monthly, prospective data on the number of women pumping human milk, as well as information on placement of infants born to women in custody. Results: Eleven prisons and five jails had policies that supported the practice of expressed milk, either through pumping or breastfeeding. Over 6 months at these sites that allowed lactation, there were 207 women who gave birth in the prisons and an average of 8 women/month who pumped human milk; at the jails, there were 67 women who gave birth and an average of 6 women/month who pumped human milk. Most infants born to women in custody were placed in the care of a family member. Conclusions: Breastfeeding and the provision of human milk are critical public health issues. Our data show inconsistent implementation of policies and practices supportive of breastfeeding in prisons and jails. However, there are institutions in the United States that are supportive of incarcerated women's breastfeeding and lactation needs. Further research is needed to identify the barriers and facilitators associated with implementing supportive breastfeeding policies and practices in the carceral system.
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Affiliation(s)
- Ifeyinwa V. Asiodu
- Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco, San Francisco, California, USA
| | - Lauren Beal
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Carolyn Sufrin
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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18
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Huang Y, Liu Y, Yu XY, Zeng TY. The rates and factors of perceived insufficient milk supply: A systematic review. MATERNAL AND CHILD NUTRITION 2021; 18:e13255. [PMID: 34382733 PMCID: PMC8710095 DOI: 10.1111/mcn.13255] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 11/27/2022]
Abstract
Perceived insufficient milk supply (PIMS) is one of the major reasons for discontinued breastfeeding. We aimed to estimate the rates and evaluate related factors of PIMS. We searched four databases for relevant articles published from January 2000 to March 2021. We then performed a meta‐analysis of the pooled data to estimate the rates and related factors of PIMS using Stata 15.0. Descriptive analyses of textual data were performed to summarise the related factors of PIMS if data could not be synthesised quantitatively. The quality of included studies was assessed using Newcastle–Ottawa scale (NOS), AHRQ checklist or Consolidated Criteria for Reporting Qualitative Research (COREQ). Overall, 27 studies were included in this review. At different periods after delivery, approximately 50% of mothers reported PIMS as the reason for stopping breastfeeding, while for breastfeeding mothers, the incidence of PIMS ranged from 10% to 25%. Breastfeeding initiation (OR 4.22, 95%CI 1.57–11.34) and breastfeeding knowledge (OR 7.10, 95%CI 2.00–25.26) were two factors influencing PIMS. Besides, PIMS had a strong negative relationship with breastfeeding self‐efficacy (r = −0.57); moderate negative association with infant suck ability (r = −0.46) and planned breastfeeding duration (r = −0.45); and a moderate positive correlation with formula supplementation (r = 0.42). Descriptive analyses revealed that infant crying was reported to be a sign of PIMS, and inadequate intake of energy/liquids was a reported cause of it. This review identified a high proportion of women reporting PIMS, particularly among those who stopped breastfeeding. Deliberate interventions were needed to improve breastfeeding for mothers at risk.
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Affiliation(s)
- Yi Huang
- Nursing Department, Tongji Hospital, Tongji Medical College, HuaZhong University of Science and Technology, Wuhan, China
| | - Yu Liu
- Nursing Department, Tongji Hospital, Tongji Medical College, HuaZhong University of Science and Technology, Wuhan, China
| | - Xiao-Yan Yu
- Nursing Department, Tongji Hospital, Tongji Medical College, HuaZhong University of Science and Technology, Wuhan, China
| | - Tie-Ying Zeng
- Nursing Department, Tongji Hospital, Tongji Medical College, HuaZhong University of Science and Technology, Wuhan, China
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19
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Little EE, Cioffi CC, Bain L, Legare CH, Hahn-Holbrook J. An Infant Carrier Intervention and Breastfeeding Duration: A Randomized Controlled Trial. Pediatrics 2021; 148:peds.2020-049717. [PMID: 34193622 DOI: 10.1542/peds.2020-049717] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/21/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Parent-infant skin-to-skin contact immediately after birth increases initiation and duration of bodyfeeding. We hypothesized that providing ergonomic carriers to parents during pregnancy would increase the likelihood of breastfeeding and expressed human milk feeding through the first 6 months of life. METHODS A randomized two-arm, parallel-group trial was conducted between February 2018 and June 2019 in collaboration with a home-visiting program in a low-income community. At 30 weeks' gestation, 50 parents were randomly assigned to receive an ergonomic infant carrier and instruction on proper use to facilitate increased physical contact with infants (intervention group), and 50 parents were assigned to a waitlist control group. Feeding outcomes were assessed with online surveys at 6 weeks, 3 months, and 6 months postpartum. RESULTS Parents in the intervention group were more likely to be breastfeeding or feeding expressed human milk at 6 months (68%) than control group parents (40%; P = .02). No significant differences were detected in feeding outcomes at 6 weeks (intervention: 78% versus control: 81%, P = .76) or 3 months (intervention: 66% versus control: 57%, P = .34). Exclusive human milk feeding did not differ between groups (intervention versus control at 6 weeks: 66% vs 49%, P = .20; 3 months: 45% vs 40%, P = .59; 6 months: 49% vs 26%, P = .06). CONCLUSIONS Infant carriers increased rates of breastfeeding and expressed human milk feeding at 6 months postpartum. Large-scale studies are warranted to further examine the efficacy and cost-effectiveness of providing carriers as an intervention to increase access to human milk.
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Affiliation(s)
| | - Camille C Cioffi
- Prevention Science Institute, University of Oregon, Eugene, Oregon
| | - Lisa Bain
- Project Concern International (PCI), San Diego, California
| | - Cristine H Legare
- Department of Psychology, The University of Texas at Austin, Austin, Texas
| | - Jennifer Hahn-Holbrook
- Department of Psychological Sciences, University of California, Merced, Merced, California
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20
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Redsell SA, Slater V, Rose J, Olander EK, Matvienko-Sikar K. Barriers and enablers to caregivers' responsive feeding behaviour: A systematic review to inform childhood obesity prevention. Obes Rev 2021; 22:e13228. [PMID: 33779040 DOI: 10.1111/obr.13228] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 01/18/2021] [Accepted: 02/06/2021] [Indexed: 12/12/2022]
Abstract
Responsive infant feeding is a critical component of childhood obesity prevention. However, there is little guidance for caregivers on how to do this successfully. The first step to developing an intervention to promote responsive feeding is to systematically identify its barriers and enablers. Searches were conducted in CINAHL, Cochrane Library, Medline, Embase, PubMed, PsycINFO, Maternity, and Infant Care from inception to November 2020. All study designs were included if they reported a barrier or enabler to responsive feeding during the first 2 years of life. We used a "best fit" framework synthesis, with the Capacity, Opportunity, Motivation, and Behaviour (COM-B) model. The Mixed Method Appraisal Tool (MMAT) was used to assess study quality. Forty-three studies were included in the review. Barriers (n = 36) and enablers (n = 21) were identified across five COM-B domains: psychological capacity, physical and social opportunity, and reflective and automatic motivation. Enablers were recognition of infant feeding cues, feeding knowledge and family and friends. Caregiver attitude toward control of feeding was a barrier, together with health care professional advice about formula feeding and breastfeeding expectation. These barriers and enablers provide a comprehensive evidence base to guide intervention development to improve responsive feeding and prevent obesity across individual and population levels.
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Affiliation(s)
- Sarah A Redsell
- School of Health Sciences, University of Nottingham, B302, Medical School Building, Queens Medical Centre, Nottingham, NG7 2UH, UK
| | - Vicki Slater
- Faculty of Health Social Care, Education and Medicine, Anglia Ruskin University, East Road, Cambridge, CB1 1PT, UK
| | - Jennie Rose
- Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, East Road, Cambridge, CB1 1PT, UK.,Ely Primary Care Networks, Staploe Medical Centre, Brewhouse Lane, Soham, UK
| | - Ellinor K Olander
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, London, EC1V 0HB, UK
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21
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Bahorski JS, Mumbower R, Pocchio KE. Describing Maternal Knowledge of Infant Feeding Practices. J Pediatr Health Care 2021; 35:278-284. [PMID: 33358252 DOI: 10.1016/j.pedhc.2020.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/03/2020] [Accepted: 11/06/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION This qualitative study aimed to describe first-time mothers' knowledge of infant feeding practices, including the responsive feeding approach. METHOD This descriptive, qualitative study enrolled first-time mothers in the third trimester of pregnancy. Participants were asked plans for infant feeding and knowledge of infant feeding cues and responsive feeding. NVivo version 11 was used to analyze data using thematic analysis. RESULTS All mothers (n = 30) intended to breastfeed. Hunger cues such as rooting were described; cessation of eating was consistently mentioned as a fullness cue. Mothers were unfamiliar with responsive feeding yet deduced the meaning of feeding in response to infant cues. Readiness for complementary foods was described by infant age and/or health care provider recommendation; developmental readiness was not described. DISCUSSION Findings suggest future education and research should focus on responsive feeding and readiness for complementary foods. Finding ways to assist mothers to adhere to recommendations may promote healthy infant growth and prevent childhood obesity.
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22
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Siddicky SF, Wang J, Rabenhorst B, Buchele L, Mannen EM. Exploring infant hip position and muscle activity in common baby gear and orthopedic devices. J Orthop Res 2021; 39:941-949. [PMID: 34566253 PMCID: PMC8462515 DOI: 10.1002/jor.24818] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 07/13/2020] [Indexed: 02/04/2023]
Abstract
Infant positioning in daily life may affect hip development. While neonatal animal studies indicate detrimental relationships between inactive lower extremities and hip development and dysplasia, no research has explored infant hip biomechanics experimentally. This study evaluated hip joint position and lower extremity muscle activity of healthy infants in common body positions, baby gear, and orthopedic devices used to treat hip dysplasia (the Pavlik harness and the Rhino cruiserabduction brace). Surface electromyography(EMG) and marker-based motion capture recorded lower extremity muscle activity and kinematics of 22 healthy full-term infants (4.2±1.6 months, 13M/9F) during five conditions: Pavlik harness, Rhino brace, inward-facing soft-structured baby carrier, held in arms facing inwards, and a standard car seat. Mean filtered EMG signal, time when muscles were active, and hip position (angles) were calculated. Compared to the Pavlik harness, infants exhibited similar adductor activity (but lower hamstring and gluteus maximus activity) in the Rhino abduction brace, similar adductor and gluteus maximus activity (but lower quadriceps and hamstring activity) in the baby carrier, similar but highly variable muscle activity in-arms, and significantly lower muscle activity in the car seat. Hip position was similar between the baby carrier and the Pavlik harness. This novel infant biomechanics study illustrates the potential benefits of using inward-facing soft-structured baby carriers for healthy hip development and highlights the potential negative impact of using supine-lying container-type devices such as car seats for prolonged periods of time. Further study is needed to understand the full picture of how body position impacts infant musculoskeletal development.
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Affiliation(s)
- Safeer F. Siddicky
- Department of Orthopaedic Surgery, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR
- Mechanical and Biomedical Engineering Department, College of Engineering, Boise State University, Boise, ID
| | - Junsig Wang
- Department of Orthopaedic Surgery, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Brien Rabenhorst
- Department of Orthopaedic Surgery, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Lauren Buchele
- Department of Orthopaedic Surgery, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Erin M. Mannen
- Department of Orthopaedic Surgery, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR
- Mechanical and Biomedical Engineering Department, College of Engineering, Boise State University, Boise, ID
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23
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Barry ES. Sleep Consolidation, Sleep Problems, and Co-Sleeping: Rethinking Normal Infant Sleep as Species-Typical. The Journal of Genetic Psychology 2021; 182:183-204. [PMID: 33783334 DOI: 10.1080/00221325.2021.1905599] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Infants evolved in the context of close contact (including co-sleeping). Evolutionary context is rarely considered in psychological infant sleep research, and Western sleep researchers make assumptions about what optimal "normal" infant sleep is and how to achieve early, deep, infant sleep consolidation and avoid infant sleep problems. However, an evolutionary and anthropological view of infant sleep as species-typical recognizes that human evolution likely prepared the infant brain for optimal development within its evolutionary context - co-sleeping. Thus, "normal" infant sleep, sleep consolidation, and sleep problems should all be understood within the framework of co-sleeping infants, not the historically new-phenomenon of solitary-sleeping infants. Much work needs to be done in order to understand "normal" infant sleep as species-typical and how adaptive infants are to environments that stray from their evolutionary norm.
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Affiliation(s)
- Elaine S Barry
- Human Development & Family Studies, Penn State Fayette, The Eberly Campus, Lemont Furnace, PA, USA
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24
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Mohebati LM, Hilpert P, Bath S, Rayman MP, Raats MM, Martinez H, Caulfield LE. Perceived insufficient milk among primiparous, fully breastfeeding women: Is infant crying important? MATERNAL AND CHILD NUTRITION 2021; 17:e13133. [PMID: 33399268 PMCID: PMC8189230 DOI: 10.1111/mcn.13133] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/03/2020] [Accepted: 12/08/2020] [Indexed: 12/17/2022]
Abstract
Breastfeeding mothers often report perceived insufficient milk (PIM) believing their infant is crying too much, which leads to introducing formula and the early abandonment of breastfeeding. We sought to determine if infant crying was associated with reported PIM (yes/no) and number of problems associated with lactation (lactation problem score [LPS] 6-point Likert scale) before formula introduction. Primiparous breastfeeding mothers were recruited at birth and visited at 1, 2 and 4 weeks. Among those fully breastfeeding at 1 week (N = 230), infant crying variables based on maternal reports were not associated with PIM at 1 week, but LPS was. However, a mother's expectation that her infant would cry more than other infants was associated with increased odds of reporting PIM at 2 and 4 weeks, as were delayed onset of lactation and previous LPS. At 1 week, crying variables (frequency, difficulty in soothing) were associated with LPS along with percent weight change. Delayed onset of lactation, infant care style, number of breastfeeds and previous LPS were longitudinally associated with change in LPS from 1 to 2 weeks and 2 to 4 weeks. Our data suggest that reported infant crying is associated with PIM and LPS in the first 4 weeks of life. Guidance on what to expect in crying behaviour and the impact of infant care style may be beneficial in reducing PIM and LPS in the first month.
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Affiliation(s)
- Lisa M Mohebati
- Center for Human Nutrition, Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.,Nutrition, Food and Exercise Sciences Department, School of Biosciences and Medicine, University of Surrey, Guildford, Surrey, UK.,Food, Consumer Behaviour and Health Research Centre, University of Surrey, Guildford, Surrey, UK
| | - Peter Hilpert
- School of Psychology, University of Surrey, Guildford, Surrey, UK
| | - Sarah Bath
- Nutrition, Food and Exercise Sciences Department, School of Biosciences and Medicine, University of Surrey, Guildford, Surrey, UK
| | - Margaret P Rayman
- Nutrition, Food and Exercise Sciences Department, School of Biosciences and Medicine, University of Surrey, Guildford, Surrey, UK
| | - Monique M Raats
- Food, Consumer Behaviour and Health Research Centre, University of Surrey, Guildford, Surrey, UK
| | - Homero Martinez
- NTEAM, Nutrition International, Ottawa, Ontario, Canada.,Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Laura E Caulfield
- Center for Human Nutrition, Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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25
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Aiga H, Nomura M, Langa JPM, Mahomed M, Marlene R, Alage A, Trindade N, Buene D, Hiraoka H, Nakada S, Arinde E, Varimelo J, Chivale AJ. Spectrum of nutrition-specific and nutrition-sensitive determinants of child undernutrition: a multisectoral cross-sectional study in rural Mozambique. BMJ Nutr Prev Health 2020; 3:320-338. [PMID: 33521543 PMCID: PMC7841811 DOI: 10.1136/bmjnph-2020-000182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 11/07/2020] [Accepted: 11/15/2020] [Indexed: 11/04/2022] Open
Abstract
BackgroundDespite an increasing need for multisectoral interventions and coordinations for addressing malnutrition, evidence-based multisectoral nutrition interventions have been rarely developed and implemented in low-income and middle-income countries. To identify key determinants of undernutrition for effectively designing a multisectoral intervention package, a nutrition survey was conducted, by comprehensively covering a variety of variables across sectors, in Niassa province, Mozambique.MethodsA cross-sectional household survey was conducted in Niassa province, August–October 2019. Anthropometric measurements, anaemia tests of children under 5 years of age and structured interviews with their mothers were conducted. A total of 1498 children under 5 years of age participated in the survey. We employed 107 background variables related to possible underlying and immediate causes of undernutrition, to examine their associations with being malnourished. Both bivariate (χ2 test and Mann-Whitney’s U test) and multivariate analyses (logistic regression) were undertaken, to identify the determinants of being malnourished.ResultsPrevalence rates of stunting, underweight and wasting were estimated at 46.2%, 20.0% and 7.1%, respectively. Timely introduction of solid, semi-solid or soft foods to children of 6–8 months of age was detected as a determinant of being not stunted. Mother–child cosleeping and ownership of birth certificate were a protective factor from and a promoting factor for being underweight, respectively. Similarly, availability and consumption of eggs at the household level and cough during the last 2 weeks among children were likely to be a protective factor from and a promoting factor for being wasted, respectively.ConclusionTimely introduction of solid, semi-solid or soft foods could serve as an entry point for the three sectors to start making joint efforts, as it requires the interventions from all health, agriculture and water sectors. To enable us to make meaningful interprovincial, international and inter-seasonal comparisons, it is crucially important to develop a standard set of variables related to being malnourished.
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Affiliation(s)
- Hirotsugu Aiga
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Human Development, Japan International Cooperation Agency, Tokyo, Japan
| | - Marika Nomura
- Department of Human Development, Japan International Cooperation Agency, Tokyo, Japan
- Center for International Collaboration and Partnership, The National Institute of Health and Nutrition, Tokyo, Japan
| | - José Paulo M Langa
- Endemic and Epidemic Disease Program, National Institute of Health, Maputo, Mozambique
| | - Mussagy Mahomed
- Health System Program, National Institute of Health, Maputo, Mozambique
| | - Rosa Marlene
- Public Health Directorate, Ministry of Health, Maputo, Mozambique
| | - Albertina Alage
- Training Documentation and Technology Transfer Directorate, Ministry of Agriculture and Food Security, Maputo, Mozambique
| | - Nilton Trindade
- Water Resource Directorate, Ministry of Public Works, Housing and Water Resources, Maputo, Mozambique
| | - Dino Buene
- Technical Secretariat for Food Security and Nutrition, Maputo, Mozambique
| | - Hiroshi Hiraoka
- Department of Rural Development, Japan International Cooperation Agency, Tokyo, Japan
| | - Shunichi Nakada
- Department of Rural Development, Japan International Cooperation Agency, Tokyo, Japan
| | - Edgar Arinde
- Niassa Provincial Health Department, Lichinga, Mozambique
| | - José Varimelo
- Niassa Provincial Agriculture and Food Security Department, Lichinga, Mozambique
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Kronborg H, Foverskov E. Multifactorial influence on duration of exclusive breastfeeding; a Danish cohort study. PLoS One 2020; 15:e0238363. [PMID: 32870906 PMCID: PMC7462295 DOI: 10.1371/journal.pone.0238363] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 08/15/2020] [Indexed: 11/19/2022] Open
Abstract
The multifactorial aspects of breastfeeding require measures at many levels to identify mothers in need of breastfeeding support from healthcare professionals. Our objective was to examine the relative importance of sociodemographic, pre/perinatal-, infant-, psychosocial-, and interaction-related factors affecting duration of exclusive breastfeeding. We used self-reported data from a community-based trial including 1265 women (response rate 49%) giving birth from January 2017 to February 2018. Data on outcome, duration of exclusive breastfeeding, were collected three and nine months postpartum; data on the study variables concerning known risk factors for breastfeeding cessation were collected two weeks postpartum. Crude and multiple Cox proportional hazards models were used for statistical analyses with additional analyses for time varying effects. Factors with an independent prognostic influence on duration of exclusive breastfeeding in fully adjusted models included early skin-to-skin contact (HR = 1.18 CI:1.04–1.33), intention to breastfeed (HR = 0.77 CI: 0.73–0.80), positive outcome evaluation, meaning the value mothers attributed to breastfeeding (HR = 1.33 CI: 1.08–1.63), higher level of self-efficacy (HR = 1.46 CI: 1.24–1.72), and maternal sense of security in relation to breastfeeding (HR = 1.31 CI: 1.14–1.50). Higher maternal BMI, lower self-efficacy, shorter breastfeeding duration of previous child, and hospitalization during birth were time dependent by affecting the exclusive breastfeeding duration primarily in the first months following birth. The results suggest that target groups in special need of early breastfeeding support are defined by being hospitalized, obese, having low self-efficacy or short previous breastfeeding experience. The extensive influence of psychosocial factors emphasizes the importance of including both practical facilitating guidance and positive verbal encouragement to ensure effective breastfeeding support.
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Affiliation(s)
- Hanne Kronborg
- Department of Public Health, Aarhus University, Aarhus, Denmark
- * E-mail:
| | - Else Foverskov
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
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Havens KL, Severin AC, Bumpass D, Mannen EM. Infant carrying method impacts caregiver posture and loading during gait and item retrieval. Gait Posture 2020; 80:117-123. [PMID: 32502794 PMCID: PMC9423689 DOI: 10.1016/j.gaitpost.2020.05.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 03/24/2020] [Accepted: 05/11/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Human babies are carried by their caregivers during infancy, and the use of ergonomic aids to wear the baby on the body has recently grown in popularity. However, the effects of wearing or holding a baby in-arms on an individual's mechanics during gait and a common object retrieval task are not fully understood. RESEARCH QUESTION What are the differences in: 1) spatiotemporal, lower extremity kinematics, and ground reaction force variables during gait, and 2) technique, center of mass motion, and kinematics during an object retrieval task between holding and wearing an infant mannequin? METHODS In this prospective biomechanics study, 10 healthy females performed over-ground walking and an object retrieval task in three conditions, holding: (1) nothing (unloaded), (2) an infant mannequin in-arms, and (3) an infant mannequin in a baby carrier. Mechanics were compared using repeated measures ANOVA. RESULTS During gait, greater vertical ground reaction force and impulse and braking force was found during the in-arms and carrier conditions compared to unloaded. Significant but small (<5°) differences were found between conditions in lower extremity kinematics. Increased back extension was found during carrier and in-arms compared to unloaded. Step length was the only spatiotemporal parameter that differed between conditions. During object retrieval, most participants used a squatting technique to retrieve the object from the floor. They maintained a more upright posture, with less trunk flexion and anteroposterior movement of their center of mass, and also did not try to fold forward over their hips during the two loaded conditions. Lower extremity kinematics did not differ between unloaded and carrier, suggesting that babywearing may promote more similar lower extremity mechanics to not carrying anything. SIGNIFICANCE Holding or wearing an infant provides a mechanical constraint that impacts the forces and kinematics, which has implications for caregivers' pain and dysfunction.
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Affiliation(s)
- Kathryn L. Havens
- Division of Biokinesiology and Physical Therapy, University of Southern California, 1540 East Alcazar Street, CHP-155, Los Angeles, California, United States of America 90033, 323-442-2940
| | - Anna C. Severin
- Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot 531, Little Rock, Arkansas, United States of America 72205
| | - David Bumpass
- Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot 531, Little Rock, Arkansas, United States of America 72205
| | - Erin M. Mannen
- Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot 531, Little Rock, Arkansas, United States of America 72205,Center for Orthopaedic Biomechanics, Department of Mechanical and Materials Engineering, University of Denver, 2115 East Wesley Avenue, Denver, Colorado, United States of America 80208,Corresponding Author: Erin M. Mannen, Ph.D., Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, 4301 West Markham Street, Slot 531, Little Rock, Arkansas, United States of America 72205, (501) 686-5416,
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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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Berecz B, Cyrille M, Casselbrant U, Oleksak S, Norholt H. Carrying human infants - An evolutionary heritage. Infant Behav Dev 2020; 60:101460. [PMID: 32569907 DOI: 10.1016/j.infbeh.2020.101460] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 05/21/2020] [Accepted: 06/03/2020] [Indexed: 02/08/2023]
Abstract
We propose that infant carrying is a biological norm for human caregiving, given that human infants have evolved a capacity to cling onto an upright caregiver whose body co-evolved to enable offspring carrying. The origins of this mutual adaptation may date back 4 million years, with the emergence of bipedalism, which precluded the infant horizontal and gravity-supported position on the back of a quadrupedal caregiver. We describe infant cooperative reflexes and behaviors, including the carrying-induced calming response and discuss hypotheses for the invention of infant carrier tools. Carrying involves several physiological and behavioral parent-infant co-adaptations that imply it is an evolutionarily conserved strategy. Epigenetic transmission of reproductive behavior through generations affects the development of the offspring, as well as the mental health of the parent. Carrying might have contributed to the evolution of Hominidae, potentially aiding dexterity, handedness, language acquisition, and social interactions. We review the evolutionary milestones and time points where the infant-caregiver interactions might have changed, exploring infant carrying as it intersects with biological and cultural evolution. We briefly summarize the effects of infant carrying on physiological, epigenetic, and socio-emotional outcomes.
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Affiliation(s)
- Bernadett Berecz
- Eotvos Lorand University, Institute of Biology, Pazmany Peter stny. 1/C. H-1117, Budapest, Hungary.
| | | | | | - Sarah Oleksak
- University of Maryland Eastern Shore, Lift Me Up, Inc., United States
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Miller RR, Bedwell S, Laubach LL, Tow J. What Is the Experience of Babywearing a NICU Graduate? Nurs Womens Health 2020; 24:175-184. [PMID: 32389582 DOI: 10.1016/j.nwh.2020.04.003] [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: 06/21/2019] [Revised: 12/20/2019] [Accepted: 03/01/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To understand the experiences of caregivers using baby carriers to hold their infant after discharge from the NICU. DESIGN The qualitative research design was transcendental phenomenology. SETTING/LOCAL PROBLEM Caregiving of NICU graduates is associated with greater incidence of depression, anxiety, and posttraumatic stress disorder, which can impair caregivers' abilities to form secure attachments with their infants. In addition, lack of paid parental leave, especially among those of low socioeconomic status, can result in prolonged separations between infants and caregivers in the NICU, producing toxic stressors. PARTICIPANTS Eight caregivers ages 21 to 41 years whose infants were discharged from the NICU of a regional referral academic medical center in Oklahoma City, Oklahoma. Homogenous convenience sampling was used by posting recruitment flyers in common areas of the NICU frequented by family members. INTERVENTION/MEASUREMENTS Participants were educated before discharge on using baby carriers that held their infants in kangaroo position. They were asked to carry their infant in the carrier for 3 hours a day for the 2-month study period. RESULTS Six total themes were identified; four were previously identified in kangaroo care and skin-to-skin care research: Decreased Stress and Anxiety, Calmness and Sleep, Attachment, and Parental Empowerment; two were independent to this study: Ease of Work and Self-Care. CONCLUSION The themes identified indicate that babywearing has the potential to address harms-such as stress, fear, depression, anxiety, and posttraumatic stress disorder-that may be experienced by caregivers of infants discharged from the NICU. Babywearing can be used as an intervention to support caregivers and promote positive health outcomes after a NICU discharge.
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Siddicky SF, Bumpass DB, Krishnan A, Tackett SA, McCarthy RE, Mannen EM. Positioning and baby devices impact infant spinal muscle activity. J Biomech 2020; 104:109741. [PMID: 32178849 PMCID: PMC7188598 DOI: 10.1016/j.jbiomech.2020.109741] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 03/02/2020] [Accepted: 03/07/2020] [Indexed: 12/26/2022]
Abstract
Infant positioning in daily life, particularly in relation to active neck and back muscles, may affect spinal development, psychosocial progression, and motor milestone achievement. Yet the impact of infant body position on muscle activity is unknown. The objective of this study was to evaluate neck and back muscle activity of healthy infants in common positions and baby devices. Healthy full-term infants (n = 22, 2-6 months) participated in this experimental study. Daily sleep and positioning were reported by caregivers. Cervical paraspinal and erector spinae muscle activity was measured using surface electromyography (EMG) in five positions: lying prone, lying supine, held in-arms, held in a baby carrier, and buckled into a car seat. Mean filtered EMG signal and time that muscles were active were calculated. Paired t-tests were used to compare positions to the prone condition. Caregivers reported that infants spent 12% of daily awake time prone, 43% in supine-lying baby gear, and 44% held in-arms or upright in a baby carrier. Infants exhibited highest erector spinae activity when prone, and lowest cervical paraspinal muscle activity in the car seat. No differences were found between in-arms carrying and babywearing. This first evaluation of the muscle activity of healthy infants supports the importance of prone time in infants' early spinal development because it promotes neck and back muscle activity. Carrying babies in-arms or in baby carriers may also be beneficial to neck muscle development, while prolonged time spent in car seats or containment devices may be detrimental to spinal development.
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Affiliation(s)
- Safeer F Siddicky
- Department of Orthopaedic Surgery, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - David B Bumpass
- Department of Orthopaedic Surgery, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Akshay Krishnan
- Department of Orthopaedic Surgery, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Stewart A Tackett
- Department of Orthopaedic Surgery, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Richard E McCarthy
- Department of Orthopaedic Surgery, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Erin M Mannen
- Department of Orthopaedic Surgery, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States.
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Almanza-Sepulveda ML, Fleming AS, Jonas W. Mothering revisited: A role for cortisol? Horm Behav 2020; 121:104679. [PMID: 31927022 DOI: 10.1016/j.yhbeh.2020.104679] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 12/31/2019] [Accepted: 01/03/2020] [Indexed: 12/26/2022]
Abstract
This selective review first describes the involvement of the maternal hypothalamic-pituitary-adrenal (HPA) axis during pregnancy and the postpartum period, and the relation between peripartum HPA axis function and maternal behavior, stress reactivity and emotional dysregulation in human mothers. To provide experimental background to this correlational work, where helpful, animal studies are also described. It then explores the association between HPA axis function in mothers and their infants, under ongoing non-stressful conditions and during stressful challenges, the moderating role of mothers' sensitivity and behavior in the mother-child co-regulation and the effects of more traumatic risk factors on these relations. The overarching theme being explored is that the HPA axis - albeit a system designed to function during periods of high stress and challenge - also functions to promote adaptation to more normative processes, shown in the new mother who experiences both high cortisol and enhanced attraction and attention to and recognition of, their infants and their cues. Hence the same HPA system shows positive relations with behavior at some time points and inverse ones at others. However, the literature is not uniform and results vary widely depending on the number, timing, place, and type of samplings and assessments, and, of course, the population being studied and, in the present context, the state, the stage, and the stress levels of mother and infant.
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Affiliation(s)
- Mayra L Almanza-Sepulveda
- Department of Psychology, University of Toronto at Mississauga, 3359 Mississauga Road, Mississauga, ON L5L 1C6, Canada
| | - Alison S Fleming
- Department of Psychology, University of Toronto at Mississauga, 3359 Mississauga Road, Mississauga, ON L5L 1C6, Canada.
| | - Wibke Jonas
- Department of Women's and Children's Health, Karolinska Institutet, Widerströmska Huset, Tomtebodavägen 18a, 171 77 Stockholm, Sweden.
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Feldman-Winter L, Kellams A, Peter-Wohl S, Taylor JS, Lee KG, Terrell MJ, Noble L, Maynor AR, Meek JY, Stuebe AM. Evidence-Based Updates on the First Week of Exclusive Breastfeeding Among Infants ≥35 Weeks. Pediatrics 2020; 145:peds.2018-3696. [PMID: 32161111 DOI: 10.1542/peds.2018-3696] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/06/2019] [Indexed: 11/24/2022] Open
Abstract
The nutritional and immunologic properties of human milk, along with clear evidence of dose-dependent optimal health outcomes for both mothers and infants, provide a compelling rationale to support exclusive breastfeeding. US women increasingly intend to breastfeed exclusively for 6 months. Because establishing lactation can be challenging, exclusivity is often compromised in hopes of preventing feeding-related neonatal complications, potentially affecting the continuation and duration of breastfeeding. Risk factors for impaired lactogenesis are identifiable and common. Clinicians must be able to recognize normative patterns of exclusive breastfeeding in the first week while proactively identifying potential challenges. In this review, we provide new evidence from the past 10 years on the following topics relevant to exclusive breastfeeding: milk production and transfer, neonatal weight and output assessment, management of glucose and bilirubin, immune development and the microbiome, supplementation, and health system factors. We focus on the early days of exclusive breastfeeding in healthy newborns ≥35 weeks' gestation managed in the routine postpartum unit. With this evidence-based clinical review, we provide detailed guidance in identifying medical indications for early supplementation and can inform best practices for both birthing facilities and providers.
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Affiliation(s)
- Lori Feldman-Winter
- Department of Pediatrics, Cooper Medical School, Rowan University and Children's Regional Hospital at Cooper, Cooper University Health Care, Camden, New Jersey;
| | - Ann Kellams
- Department of Pediatrics, School of Medicine, University of Virginia, Charlottesville, Virginia
| | | | - Julie Scott Taylor
- American University of the Caribbean School of Medicine, Sint Maarten, Netherlands Antilles.,Department of Family Medicine, Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Kimberly G Lee
- Division of Neonatology, Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina
| | - Mary J Terrell
- Division of Neonatology, Department of Pediatrics, University of North Carolina Hospitals, Chapel Hill, North Carolina
| | - Lawrence Noble
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Angela R Maynor
- Department of Food and Nutrition, University of North Carolina Health Care, Chapel Hill, North Carolina; and
| | - Joan Younger Meek
- Department of Clinical Sciences, College of Medicine, Florida State University, Tallahassee, Florida
| | - Alison M Stuebe
- Obstetrics and Gynecology, School of Medicine and.,Department of Maternal and Child Health and Carolina Global Breastfeeding Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Abstract
The human need for sleep is universal and unquestioned; however, humans vary in their sleep needs according to age, individual differences, as well as cultural and social norms and practices. Therefore, what is “normal” in infant sleep and the development of sleep architecture in humans is highly dependent on biological and sociocultural variables as well as socially constructed assumptions about what infant sleep “should” look like. This paper uses a multidisciplinary approach to review papers from fields including pediatrics, anthropology, psychology, medicine, and sociology to understand “normal” infant sleep. Because human culture and behavioral practice changes much more quickly than evolved human biology, and because human evolutionary history occurred in the context of breastfeeding and cosleeping, new work in the field of infant sleep architecture development would benefit from a multidisciplinary approach. To come to a consensus about what is “normal” infant sleep, researchers must agree on underlying basic assumptions of infant sleep from which to ask question and interpret findings.
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Affiliation(s)
- Elaine S. Barry
- Human Development and Family Studies, Penn State Fayette, The Eberly Campus, Lemont Furnace, PA, USA
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Williams LR. The impact of infant carrying on adolescent mother–infant interactions during the still‐face task. INFANT AND CHILD DEVELOPMENT 2020. [DOI: 10.1002/icd.2169] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Williams LR, Turner PR. Infant carrying as a tool to promote secure attachments in young mothers: Comparing intervention and control infants during the still-face paradigm. Infant Behav Dev 2020; 58:101413. [DOI: 10.1016/j.infbeh.2019.101413] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 10/16/2019] [Accepted: 12/16/2019] [Indexed: 01/24/2023]
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Kronborg H, Væth M. Validation of the Breastfeeding Score-A Simple Screening Tool to Predict Breastfeeding Duration. Nutrients 2019; 11:nu11122852. [PMID: 31766388 PMCID: PMC6950692 DOI: 10.3390/nu11122852] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 11/02/2019] [Accepted: 11/18/2019] [Indexed: 01/14/2023] Open
Abstract
Easy to use screening tools to identify mothers in risk of early breastfeeding cessation are needed. The purpose was to validate a revised version of the breastfeeding score, consisting of four questions addressing completed education, earlier breastfeeding duration, self-efficacy, and sense of security not knowing the exact amount of milk the baby ingests. We used two cohorts from 2004 (n = 633) and 2017 (n = 579) to explore the predictive validity of the breastfeeding score to identify mothers at risk of breastfeeding cessation within the first 17 weeks postpartum. The analyses included sensitivity and specificity, clinically relevant cut-points, and calibrations plots. A cut-point ≥5 points identified 61% of first-time and 42% of multiparous mothers in the validation cohort 2017 to be at risk of early breastfeeding cessation with a sensitivity and specificity of 80% and 60% for first-time, and 69% and 82% for multiparous, respectively. The corresponding numbers in the 2004 cohort were almost identical. The area under the receiver operating characteristic (ROC) curves were 0.77 and 0.78 and the calibration plots showed good agreement for the two cohorts. The breastfeeding score indicated good ability to discriminate between mothers at risk of early exclusive breastfeeding cessation. The simple form of the tool makes it easy to use in daily practice.
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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: 14] [Impact Index Per Article: 2.8] [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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Barry ES. Co-sleeping as a proximal context for infant development: The importance of physical touch. Infant Behav Dev 2019; 57:101385. [DOI: 10.1016/j.infbeh.2019.101385] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 09/23/2019] [Accepted: 09/23/2019] [Indexed: 12/25/2022]
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Yao X, Plötz T, Johnson M, Barbaro KDE. Automated Detection of Infant Holding Using Wearable Sensing: Implications for Developmental Science And Intervention. ACTA ACUST UNITED AC 2019; 3. [PMID: 31346570 DOI: 10.1145/3328935] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Physical contact is critical for children's physical and emotional growth and well-being. Previous studies of physical contact are limited to relatively short periods of direct observation and self-report methods. These methods limit researchers' understanding of the natural variation in physical contact across families, and its specific impacts on child development. In this study we develop a mobile sensing platform that can provide objective, unobtrusive, and continuous measurements of physical contact in naturalistic home interactions. Using commercially available motion detectors, our model reaches an accuracy of 0.870 (std: 0.059) for a second-by-second binary classification of holding. In addition, we detail five assessment scenarios applicable to the development of activity recognition models for social science research, where required accuracy may vary as a function of the intended use. Finally, we propose a grand vision for leveraging mobile sensors to access high-density markers of multiple determinants of early parent-child interactions, with implications for basic science and intervention.
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Geddes D, Perrella S. Breastfeeding and Human Lactation. Nutrients 2019; 11:nu11040802. [PMID: 30970568 PMCID: PMC6520880 DOI: 10.3390/nu11040802] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 04/02/2019] [Indexed: 01/02/2023] Open
Affiliation(s)
- Donna Geddes
- School of Molecular Sciences, M310, The University of Western Australia, Crawley, Perth, WA 6009, Australia.
| | - Sharon Perrella
- School of Molecular Sciences, M310, The University of Western Australia, Crawley, Perth, WA 6009, Australia.
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