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International Breastfeeding Journal Nov 2023Low birthweight (LBW) infants are at increased risk of morbidity and mortality. Exclusive breastfeeding up to six months is recommended to help them thrive through...
BACKGROUND
Low birthweight (LBW) infants are at increased risk of morbidity and mortality. Exclusive breastfeeding up to six months is recommended to help them thrive through infection prevention, growth improvements, and enhancements in neurodevelopment. However, limited data exist on the feeding experiences of LBW infants, their caregivers and key community influencers. The qualitative component of the Low Birthweight Infant Feeding Exploration (LIFE) study aimed to understand practices, facilitators, and barriers to optimal feeding options in the first six months for LBW infants in low-resource settings.
METHODS
This study was conducted in four sites in India, Malawi, and Tanzania from July 2019 to August 2020. We conducted 37 focus group discussions with mothers and family members of LBW infants and community leaders and 142 in-depth interviews with healthcare providers, government officials, and supply chain and donor human milk (DHM) experts. Data were analyzed using a framework approach.
RESULTS
All participants believed that mother's own milk was best for LBW infants. Direct breastfeeding was predominant and feeding expressed breast milk and infant formula were rare. DHM was a new concept for most. Adequate maternal nutrition, lactation support, and privacy in the facility aided breastfeeding and expression, but perceived insufficient milk, limited feeding counseling, and infant immaturity were common barriers. Most believed that DHM uptake could be enabled through community awareness by overcoming misconceptions, safety concerns, and perceived family resistance.
CONCLUSION
This study fills an evidence gap in LBW infant feeding practices and their facilitators and barriers in resource-limited settings. LBW infants face unique feeding challenges such as poor latching and tiring at the breast. Similarly, their mothers are faced with numerous difficulties, including attainment of adequate milk supply, breast pain and emotional stress. Lactation support and feeding counseling could address obstacles faced by mothers and infants by providing psychosocial, verbal and physical support to empower mothers with skills, knowledge and confidence and facilitate earlier, more and better breast milk feeding. Findings on DHM are critical to the future development of human milk banks and highlight the need to solicit partnership from stakeholders in the community and health system.
Topics: Female; Infant; Humans; Breast Feeding; Birth Weight; Tanzania; Malawi; Mothers
PubMed: 37940987
DOI: 10.1186/s13006-023-00597-7 -
Infant Behavior & Development Jun 2024The quality of mother-infant interactions is crucial for child development. Studies show that breastfeeding contributes to maternal sensitivity and the development of a...
INTRODUCTION
The quality of mother-infant interactions is crucial for child development. Studies show that breastfeeding contributes to maternal sensitivity and the development of a positive mother-infant bond. Maternal mental health difficulties negatively impact both maternal sensitivity and breastfeeding. Thus, it is unclear whether breastfeeding contributes to the quality of mother-infant interactions independent from mental health. The purpose of this study is to examine the contribution of exclusive breastfeeding at 3 months postpartum to the quality of the mother-infant relationship at 6 months postpartum, controlling for maternal mental health in a community sample of mothers in Chile.
MATERIALS AND METHOD
Eighty women completed self-report measures of mental health and breastfeeding during the third trimester of pregnancy and 3 and 6 months postpartum. At 6 months after childbirth, the mother-infant interaction was assessed by coding a free-play session between mothers and infants. Logistic regression analysis was used to examine the contribution of breastfeeding practices and mental health to the quality of mother-infant interactions.
RESULTS
Exclusive breastfeeding at 3 months postpartum increased the likelihood of displaying positive mother-infant interactions controlling for maternal mental health. Mothers who continued to breastfeed at 6 months postpartum reported less symptoms of antenatal depression and anxiety and higher levels of sensitivity and cooperation towards their infants.
CONCLUSION
Breastfeeding contributes to maternal sensitivity and cooperation even when controlling for maternal mental health. Implications for health practitioners and limitations due to the sample characteristics are discussed.
Topics: Humans; Breast Feeding; Female; Mother-Child Relations; Adult; Infant; Mental Health; Pregnancy; Mothers; Young Adult; Postpartum Period; Male; Chile; Maternal Behavior; Infant, Newborn
PubMed: 38552559
DOI: 10.1016/j.infbeh.2024.101946 -
BMC Pregnancy and Childbirth Aug 2023To examine the incidence of adverse perinatal outcomes and the risk of adverse perinatal outcomes for Indian-born mothers compared to other mothers living and giving...
OBJECTIVE
To examine the incidence of adverse perinatal outcomes and the risk of adverse perinatal outcomes for Indian-born mothers compared to other mothers living and giving birth in Australia.
DESIGN, SETTING AND PARTICIPANTS
This retrospective cohort study was designed to investigate all births in Australia in 2012 and those in the Monash Health Birthing Outcomes System (BOS) 2014 to Indian-born mothers in Australia. Data sets were analysed involving descriptive statistics using Statistical Package for Social Sciences (SPSS vs. 23).
RESULTS
Indian-born mothers in Australia are at increased risk of induced labour, emergency caesarean section, very preterm birth (20-27 weeks), babies with low to very low birth weight, and low Apgar score (0-2) at 5 min, gestational diabetes, hypothyroidism, iron deficiency anaemia and vitamin B12 deficiencies compared to other mothers giving birth in Australia. This is despite a range of protective factors (25-34 years, married, nonsmokers, and a BMI < 30) that would normally be expected to reduce the risk of adverse perinatal outcomes for mothers giving birth in a developed country.
CONCLUSION
In the absence of many of the recognized maternal risk factors, Indian-born mothers continue to face increased risk of adverse perinatal outcomes, despite access to high quality maternity care in Australia. Recommendations arising from this study include the need for an intervention study to identify maternal risk factors for Indian-born mothers in mid to late pregnancy that contribute to the risk for very preterm birth and low birth weight.
Topics: Infant, Newborn; Infant; Pregnancy; Female; Humans; Cesarean Section; Mothers; Premature Birth; Retrospective Studies; Maternal Health Services; Australia
PubMed: 37605130
DOI: 10.1186/s12884-023-05897-8 -
Scandinavian Journal of Psychology Oct 2023Theory and research have linked pretend play in early childhood with the development of language and theory of mind. In 102 mother-child dyads at 4.5 years, we...
Theory and research have linked pretend play in early childhood with the development of language and theory of mind. In 102 mother-child dyads at 4.5 years, we examined whether (1) introducing a story stem (a play narrative with socioemotional dilemmas) in a mother-child play context increases pretend play complexity compared with mother-child free play; and (2) maternal sensitivity is associated with pretend play complexity. Further, we explored whether the story stem increased child pretend play complexity more in dyads with mothers with low sensitivity compared with highly sensitive mothers. Sensitivity was coded using Coding Interactive Behavior and pretend play complexity with a global, integrated measure of the developmental level and quantity of play. Using generalized estimating equations, we found that pretend play complexity was positively associated with introducing a story stem and maternal sensitivity. Mixed methods ancova showed no significant interaction between play situation and maternal sensitivity. The findings stress the importance of maternal sensitivity and participation for play and how introducing a story stem may help promote child pretend play complexity.
Topics: Female; Humans; Child, Preschool; Mothers; Language; Play and Playthings; Mother-Child Relations
PubMed: 37035921
DOI: 10.1111/sjop.12920 -
Journal of Clinical Child and... Sep 2023Advancing understanding of how early adversity arises, manifests, and contributes to health difficulties depends on accurate measurement of children's experiences. In...
OBJECTIVE
Advancing understanding of how early adversity arises, manifests, and contributes to health difficulties depends on accurate measurement of children's experiences. In early life, exposure to adversity is often intertwined with that of one's caregivers. We present preliminary psychometric properties of a novel measure of adversity, the Assessment of Parent and Child Adversity (APCA), which simultaneously characterizes parents' and children's adversity.
METHODS
During pregnancy, women reported their past adverse experiences. When their children were ages 3-5 years (47% female), 97 mothers (71% White, 17% Hispanic/Latinx) completed the APCA, the Childhood Trauma Questionnaire, and the Benevolent Childhood Experiences scale. They reported their current symptoms of depression and anxiety and their child's emotional and behavioral problems. Using the APCA, we distinguished between maternal adversity during different life periods and obtained metrics of child witnessing of and direct exposure to adversity.
RESULTS
The APCA demonstrated validity with other measures of maternal adverse experiences, maternal positive childhood experiences, and maternal symptoms of psychopathology. Children whose mothers experienced greater adversity, particularly in the prenatal period, had more emotional and behavioral problems, as did children who were directly exposed to greater adversity.
CONCLUSIONS
The APCA has good usability and validity. Leveraging the ability of the APCA to distinguish between adversity during different life stages and originating from different sources, our findings highlight potentially distinct effects of different aspects of maternal and child adversity on difficulties in maternal and child mental health.
Topics: Pregnancy; Child; Humans; Female; Child, Preschool; Male; Mothers; Emotions; Anxiety; Problem Behavior; Adverse Childhood Experiences
PubMed: 35500216
DOI: 10.1080/15374416.2022.2042696 -
International Breastfeeding Journal Aug 2023Many women have low confidence in breastfeeding and have concerns regarding low milk volume or discomfort with breastfeeding. Antenatal hand expression may be an...
BACKGROUND
Many women have low confidence in breastfeeding and have concerns regarding low milk volume or discomfort with breastfeeding. Antenatal hand expression may be an opportunity to help women feel more comfortable with breastfeeding and help promote exclusive breastfeeding. A study at a hospital in Philadelphia, Pennsylvania, U.S. assessed the feasibility of teaching antenatal hand expression at 39 weeks among socioeconomically disadvantaged populations, overall participant satisfaction and adoption of hand expression and breastfeeding.
METHODS
From March 2020 to June 2021, women recruited at 34-39 weeks were taught to hand express, collect, and store colostrum. Starting from 39 weeks, participants were asked to practice hand expression 1-3 times / day until delivery, log their experiences, and store colostrum expressed. Women were contacted to encourage continued hand expression and answer any questions. Postpartum, a survey assessed satisfaction with hand expression and issues encountered. The survey also inquired about breastfeeding plans and barriers, and whether women were exclusively breastfeeding (defined as infants who received only breastmilk from the time of birth). Chart review of postpartum or well-baby visit notes determined whether women continued breastfeeding.
RESULTS
Of the 29 participants, 72% (21/29) reported hand expressing at home, and no women reported contractions when hand expressing. Participants rated mean satisfaction of 8.1/10 (SD = 1.62) with antenatal hand expression, mean satisfaction of 9.4/10 (SD = 0.90) toward hand expression education, mean likelihood of 9.4/10 (SD = 1.24) recommending hand expression to others, and a mean score of 8.1/10 (SD = 1.69) on how helpful hand expression was in breastfeeding initiation. 90% (26/29) of women initiated breastfeeding after birth and 72% (21/29) exclusively breastfed on discharge, but only 11/29 (38%) continued exclusively breastfeeding when re-assessed 4-6 weeks postpartum. Barriers included maternal discomfort, low milk supply, and maternal or infant illness.
CONCLUSIONS
This study suggests that women in an urban setting would be willing to practice antenatal hand expression. A larger and adequately powered study could be feasible to determine associations between antenatal hand expression and breastfeeding rates and confidence.
Topics: Infant; Female; Humans; Pregnancy; Breast Feeding; Mothers; Feasibility Studies; Postpartum Period; Hospitals
PubMed: 37563682
DOI: 10.1186/s13006-023-00578-w -
Journal of Sleep Research Feb 2024Maternal psychological control has been linked consistently to poorer adjustment for adolescents, however, studies of variability in the association between...
Maternal psychological control has been linked consistently to poorer adjustment for adolescents, however, studies of variability in the association between psychological control and adjustment are rare. Sleep serves crucial bioregulatory functions that promote well-being and protect youths against poor adjustment associated with negative family environments. We hypothesised that the link between maternal psychological control and adolescent maladjustment would be strongest for youths with poorer actigraphy-based sleep. The current study included 245 adolescents (M = 15.79 years, 52.2% girls, 33.1% Black/African American and 66.9% White/European American; 43% at or below the poverty line). Adolescents reported on their mothers' psychological control toward them, as well as their internalising and externalising symptoms (aggressive and rule breaking behaviours). Several sleep variables were derived: minutes, onset time, and variability in each parameter over 1 week. For youths with shorter, less consistent sleep (both mean levels and variability in minutes and onset), maternal psychological control was associated with adjustment difficulties, especially externalising symptoms. This association was not significant for youth obtaining longer, more consistent sleep. The results were most evident for variability in sleep minutes and onset as moderators of effects. The findings suggest that longer and more consistent sleep is an important protective factor in the context of more controlling parenting.
Topics: Female; Humans; Adolescent; Male; Sleep; Mothers; Sleep Initiation and Maintenance Disorders; Aggression
PubMed: 37434367
DOI: 10.1111/jsr.13986 -
Journal of Reproductive and Infant... Sep 2023Mental disorders, such as postnatal depression, are common in mothers. Repetitive negative thinking has been identified as a cognitive factor underlying the resulting...
INTRODUCTION
Mental disorders, such as postnatal depression, are common in mothers. Repetitive negative thinking has been identified as a cognitive factor underlying the resulting difficulties in mother-infant interactions.
METHOD
The present online survey investigated associations between infant carrying (baby-wearing) and maternal repetitive negative thinking and positive mental health.
RESULTS
Repetitive negative thinking was significantly lower, and positive mental health was significantly higher while carrying compared to overall levels. There were no relations between maternal mental health and frequency of carrying. Maternal activities during carrying are portrayed.
CONCLUSION
These results are the first indication that carrying could be a low threshold, easily administered intervention method for maternal mental health problems.
Topics: Female; Infant; Humans; Mental Health; Pessimism; Mother-Child Relations; Depression, Postpartum; Mothers
PubMed: 34882494
DOI: 10.1080/02646838.2021.2012647 -
PloS One 2023Close body contact interventions such as Kangaroo Mother Care have been shown to improve maternal mental health following birth. Infant carriers ('slings') facilitate... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Close body contact interventions such as Kangaroo Mother Care have been shown to improve maternal mental health following birth. Infant carriers ('slings') facilitate hands-free close body contact. No studies have specifically examined whether sling use improves maternal mental health. A full-scale efficacy study is needed to examine whether sling use is beneficial to maternal mental health. The current study is a feasibility study designed to gather information to support the design of a future RCT, such as acceptability and study parameters, including recruitment rates, consent rate and attrition.
METHOD
Mothers of infants aged 0-6 weeks were randomised to one of two conditions: intervention (n = 35) vs. waitlist control (n = 32). Intervention participants received sling training, support, and free sling hire for 12 weeks. Participants completed self-report measures of mood, wellbeing and parenting at baseline (Time 1), and 6- (Time 2) and 12- (Time 3) weeks post-baseline.
RESULTS
Eligibility and consent rates met feasibility objectives, though there were some difficulties with retention of participants in the study. Preliminary effectiveness analyses showed a non-significant improvement with a small effect size in postnatal depression from T1 to T3, and a significant improvement with a medium effect size in maternal self-efficacy from T1 to T3. Qualitative feedback indicated acceptability of the intervention and study participation. Intervention participants attributed greater autonomy, bonding with their baby, and parental self-confidence, to the intervention.
CONCLUSIONS
These findings indicate a randomised study of the impact of a sling and related support intervention upon maternal mental health is feasible. These findings should be interpreted within the context of sampling bias (due to the use of volunteer sampling methods), an absence of feedback from those who discontinued participation in the study, and the study not being adequately powered.
TRIAL REGISTRATION
Registration number ISRCTN88575352.
Topics: Female; Humans; Infant; Feasibility Studies; Kangaroo-Mother Care Method; Mental Health; Mothers; Parenting; Infant, Newborn
PubMed: 37948400
DOI: 10.1371/journal.pone.0293501 -
Development and Psychopathology May 2024It remains unclear how the COVID-19 pandemic has affected the mother-infant relationship and associations between maternal postpartum depression (PPD) and offspring... (Randomized Controlled Trial)
Randomized Controlled Trial
It remains unclear how the COVID-19 pandemic has affected the mother-infant relationship and associations between maternal postpartum depression (PPD) and offspring temperament. This study examined the impact of the pandemic on these links and how maternal ratings of the mother-infant relationship mediated associations between PPD and infant temperament in a sample of treatment-seeking mothers in Ontario, Canada before and during the COVID-19 pandemic. Mothers with infants <12 months of age and Edinburgh Postnatal Depression Scale scores ≥10 enrolled in two separate randomized controlled trials of 1-day cognitive behavioral therapy-based workshops for PPD conducted before COVID-19 ( = 392) and during the pandemic ( = 403). Mothers reported on depressive symptomatology, infant temperament, and the mother-infant relationship. Maternal PPD was associated with more infant negative affectivity and mother-infant relationship difficulties. While associations between PPD and infant-focused anxiety were stronger during COVID-19, the pandemic did not otherwise affect associations between PPD and infant temperament. Mediation analyses suggested that aspects of the mother-infant relationship mediated associations between PPD and infant negative affectivity. Findings highlight the importance of detecting PPD and intervening to potentially improve outcomes for mothers and their children.
Topics: Humans; Female; Temperament; COVID-19; Depression, Postpartum; Mother-Child Relations; Adult; Infant; Mothers; Male; Ontario
PubMed: 36700350
DOI: 10.1017/S0954579422001353