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BMJ Supportive & Palliative Care Mar 2021The following self-analysis contains key experiences of maternal grief over the course of the first 2 years following the death of a child, with specific examples and...
The following self-analysis contains key experiences of maternal grief over the course of the first 2 years following the death of a child, with specific examples and observations from bereaved mothers shared with the author. The references provide supporting evidence for commonality of the lived experience and observations. Therapeutic responses for clinicians give concrete direction for providing effective comfort. Self-care suggestions for mothers provide specific guidance for the readers. A 14-year retrospective epilogue puts the charged emotional description into a context of healing.
Topics: Adaptation, Psychological; Adolescent; Adult; Child; Emotions; Female; Grief; Humans; Mothers; Retrospective Studies; Self Care; Young Adult
PubMed: 33239325
DOI: 10.1136/bmjspcare-2020-002673 -
Philosophical Transactions of the Royal... Jun 2021It has long been acknowledged that women with children require social support to promote their health and wellbeing, as well as that of their children. However, the...
It has long been acknowledged that women with children require social support to promote their health and wellbeing, as well as that of their children. However, the dominant conceptualizations of support have been heavily influenced by Western family norms. The consequence, at best, has been to stifle our understanding of the nature and consequences of support for mothers and children. At worst, it has led to systematic discrimination negatively impacting maternal-child health. To fully engage with the complexities of social support, we must take multidisciplinary or interdisciplinary approaches spanning diverse cultural and geographical perspectives. However, multidisciplinary knowledge-processing can be challenging, and it is often unclear how different studies from different disciplines relate. To address this, we outline two epistemological frameworks-the scientific approach and Tinbergen's four questions-that can be useful tools in connecting research across disciplines. In this theme issue on 'Multidisciplinary perspectives on social support and maternal-child health', we attempt to foster multidisciplinary thinking by presenting work from a diverse range of disciplines, populations and cultures. Our hope is that these tools, along with papers in this issue, help to build a holistic understanding of social support and its consequences for mothers and their children. Overall, a multidisciplinary perspective points to how the responsibility of childrearing should not fall solely onto mothers. Indeed, this multidisciplinary issue demonstrates that successful childrearing is consistently an activity shared beyond the mother and the nuclear family: an insight that is crucial to harnessing the potential of social support to improve maternal-child health. This article is part of the theme issue 'Multidisciplinary perspectives on social support and maternal-child health'.
Topics: Child Health; Humans; Maternal Health; Mothers; Social Support
PubMed: 33938274
DOI: 10.1098/rstb.2020.0019 -
Infant Behavior & Development Feb 2022Sleep during infancy contributes to the development and maintenance of infant regulatory functioning and may be an early risk marker for more difficult temperamental...
Sleep during infancy contributes to the development and maintenance of infant regulatory functioning and may be an early risk marker for more difficult temperamental traits like negative reactivity. Further, maternal adverse childhood experiences (ACEs) may predispose individuals to greater sleep disturbances in adulthood and have been linked with sleep disturbances in both mothers and infants. Thus, examining maternal history of ACEs and maternal sleep difficulties during pregnancy and postpartum may provide insight into underlying risk factors affecting infant sleep difficulties and early temperament development. Fifty-nine mothers from a diverse, community sample (44% white) completed questionnaires on ACEs, maternal sleep, infant sleep, and infant temperament at 30-weeks gestation, 6-weeks postpartum, and 16-weeks postpartum. Results indicated that maternal ACES and sleep problems during pregnancy have long term implications for infant negative reactivity at 16-weeks, with significant indirect effects through maternal and infant sleep problems at 6-weeks. Addressing psychosocial functioning and prenatal sleep during pregnancy, particularly among women with high ACEs, may be a target of intervention to improve maternal and infant sleep health during the postpartum, and reduce the risk for difficult infant temperament.
Topics: Adult; Adverse Childhood Experiences; Female; Humans; Infant; Male; Mothers; Postpartum Period; Pregnancy; Sleep; Sleep Wake Disorders
PubMed: 34958975
DOI: 10.1016/j.infbeh.2021.101664 -
Nursing ResearchThe Movement Control Order (MCO), also known as the partial lockdown, was introduced in Malaysia in March 2020 to combat the COVID-19 pandemic, changing many public...
BACKGROUND
The Movement Control Order (MCO), also known as the partial lockdown, was introduced in Malaysia in March 2020 to combat the COVID-19 pandemic, changing many public sector protocols and regulations. This may have implications for neonatal and maternity care and services, especially among new mothers.
OBJECTIVE
The aim of this study was to compare the postnatal experiences and feeding practices between mothers who gave birth before MCO (B-MCO) and during MCO (D-MCO).
METHOD
One thousand fifty-one mothers with an infant under 18 months in Malaysia completed an online survey between July 2020 and October 2020. The survey advertisement was disseminated online via various social media platforms.
RESULTS
More D-MCO mothers faced a significant effect on the ability to pay rent/mortgage, with their spouses facing a higher impact on employment. D-MCO mothers were more likely to have changed their birth plans, perceived insufficient breastfeeding support, and experienced changes in postnatal services since MCO. In contrast, more B-MCO mothers had stopped breastfeeding during the MCO and started complementary feeding earlier than planned. Many mothers reported feeling down and lonely and having trouble sleeping and a poor appetite. D-MCO mothers had more time to focus on their health, whereas B-MCO mothers spent more time outdoors.
DISCUSSION
MCO affected mothers' livelihood and postnatal experiences, potentially causing emotional distress. Hence, improved breastfeeding support, particularly at birth, is recommended, as is routine mental health screening during the postnatal checkup. Furthermore, because online contact was readily accessible during the pandemic, the efficacy of online breastfeeding support should be evaluated.
Topics: Breast Feeding; COVID-19; Communicable Disease Control; Female; Humans; Infant; Infant, Newborn; Maternal Health Services; Mothers; Pandemics; Pregnancy; SARS-CoV-2
PubMed: 34818264
DOI: 10.1097/NNR.0000000000000568 -
Infant Behavior & Development May 2023Touch is an important means through which mothers and infants co-regulate during periods of stress or perturbation. The present study examined the synchrony of maternal...
Touch is an important means through which mothers and infants co-regulate during periods of stress or perturbation. The present study examined the synchrony of maternal and infant touching behaviours among 41 mother-infant dyads, some of whom were deemed at-risk due to maternal depressive symptomatology. Mothers and their 4-month-old infants participated in the Still-Face (maternal emotional unavailability; SF) and Separation (maternal physical unavailability; SP) procedures. Infant crying was examined across procedures and investigated as a brief period of perturbation. Results revealed that mothers and infants displayed a positive pattern of tactile synchrony (coordinated, analogous changes in touch) during infant crying episodes. However, dyads in the high depression group displayed significantly less affectionate touch during instances of infant crying. Furthermore, more depressive symptoms were associated with less maternal and infant touch and lower rates of infant crying. This group of dyads may be less expressive via touch, be less affected by disruptions in their interactions, have impaired regulatory abilities, or simply require minimal amounts of touch to mutually regulate following social stressors and during brief perturbation periods. These findings enrich our limited knowledge about the dynamic interplay of maternal and infant touch and inform preventative intervention programs for at-risk groups.
Topics: Female; Infant; Humans; Mother-Child Relations; Touch; Crying; Mothers; Emotions
PubMed: 36758294
DOI: 10.1016/j.infbeh.2023.101821 -
American Journal of Obstetrics and... May 2023More than a decade ago, the United Nations Human Rights Council passed a resolution recognizing maternal health as a human right. Subsequently, global advocates... (Review)
Review
More than a decade ago, the United Nations Human Rights Council passed a resolution recognizing maternal health as a human right. Subsequently, global advocates mobilized to establish the right to respectful maternity care, which has since been formally recognized by the World Health Organization and endorsed by more than 90 international, civil society, and health professional organizations. Despite widespread acknowledgment of this right, traditional approaches to maternity care do not adequately address aspects of quality care that are highly valued by mothers and birthing people, such as respect, dignity, and shared decision-making, and high numbers of women and birthing people worldwide continue to experience disrespect and mistreatment during childbirth. Efforts to reduce maternal mortality have historically overemphasized clinical approaches while failing to listen to mothers and pregnant people, threatening patient autonomy, and contributing to persistent racial disparities and high levels of preventable maternal mortality. This article shares the birth story and evolution of Every Mother Counts, an organization dedicated to making pregnancy and childbirth safe, respectful, and equitable for every mother, everywhere, and provides tangible examples of how storytelling and listening to women-in film, media, research, advocacy, education, and patient care-can serve as powerful vehicles to create awareness of maternal health issues and transform our maternity care system into one that centers mothers in labor and childbirth and elevates equity and birth justice. There are concrete steps that every participant in the maternity care system can take to help make respectful, equitable care a reality, including implementing patient-reported experience measures as part of standard clinical practice, using individualized care plans and shared decision-making tools in patient care, and developing a grievance process to address instances of disrespectful care and mistreatment. Most importantly, we can listen to mothers, women, and birthing people, hear their concerns, and act promptly to provide the care and support that they deserve.
Topics: Female; Pregnancy; Humans; Mothers; Maternal Health Services; Parturition; Delivery, Obstetric; Health Personnel; Attitude of Health Personnel; Quality of Health Care; Professional-Patient Relations
PubMed: 37164500
DOI: 10.1016/j.ajog.2022.12.306 -
Journal of Family Psychology : JFP :... Jun 2023[Correction Notice: An Erratum for this article was reported online in on Feb 09 2023 (see record 2023-44680-001). In the original article, there were errors in the...
[Correction Notice: An Erratum for this article was reported online in on Feb 09 2023 (see record 2023-44680-001). In the original article, there were errors in the second paragraph of the Method section whereby the text "22.1% did not in Grade 3," should have read "22.1% in Grade 3," and the text "The Ohio State University)." should have read "The Ohio State University." In addition, Figure 1 was incorrect and has been replaced. All versions of this article have been corrected.] This study examined the prospective associations among the trajectories of maternal depressive symptoms, maternal sensitivity, and child executive function (EF) across early and middle childhood, and tested the mediating role of maternal sensitivity in the links between change in maternal depressive symptoms and the growth of child EF. Participants included 1,364 children and mothers from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development (NICHD SECCYD). We found that maternal depressive symptoms (from 6 months to Grade 5) and sensitivity (from 36 months to Grade 5) decreased, whereas child EF (planning skills; from Grade 1 to 5) increased over time. We also found several direct associations: (a) lower maternal depressive symptoms at 36 months predicted higher sensitivity at 54 months; (b) higher sensitivity at 54 months and a faster decrease in sensitivity from 36 months to Grade 5 predicted higher child EF in Grade 1; and (c) higher sensitivity at 54 months predicted greater growth of EF from Grade 1 to 5. In addition, two mediation effects were found as follows: Lower levels of maternal depressive symptoms at 36 months predicted both higher levels of child EF in Grade 1 and greater growth of EF from Grade 1 to 5 through higher levels of maternal sensitivity at 54 months. The results suggest that early maternal depressive symptoms may have long-term effects on the growth of EF, especially planning skills, during middle childhood, and that one important pathway that maternal depressive symptoms affect child EF outcomes through maternal sensitivity. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Topics: Child; Female; Adolescent; Humans; Executive Function; Depression; Mothers; Child Development
PubMed: 33661684
DOI: 10.1037/fam0000832 -
American Journal of Human Biology : the... Sep 2021We examine infant sleep from evolutionary, historico-cultural, and statistical/epidemiological perspectives and explore the distinct conceptions of "normal" produced by...
OBJECTIVES
We examine infant sleep from evolutionary, historico-cultural, and statistical/epidemiological perspectives and explore the distinct conceptions of "normal" produced by each. We use data from the "Sleeping Like a Baby" study to illustrate how these perspectives influence the ideals and practices of new parents.
METHODS
The "Sleeping Like a Baby" study investigated maternal-infant sleep in north-east England. Sleep data for exclusively breastfeeding (EBF) and formula-feeding (EFF) dyads were captured every 2 weeks from 4 to 18 weeks postpartum through actigraphy and maternal report. Mothers also reported their infant sleep ideals and practices. Results explore objective and maternally-reported infant sleep parameters, and concordance of maternal ideals and practices with public health guidance.
RESULTS
Comparison of sleep measures showed that mothers overestimate infant sleep duration compared with actigraphy; EFF mothers' reports were significantly more inaccurate than those of EBF mothers. For infants moved to a separate bedroom, maternally-reported sleep increases were not borne out by actigraphy. Across the study period, concordance of maternal ideal sleep location with public health recommendations occurred on average for 54% of mothers, while concordance in practice fell from 75% at 4-8 weeks to 67% at 14-18 weeks. Discordance for EBF dyads occurred due to bedsharing, and for EFF dyads due to infants sleeping in a room alone.
CONCLUSIONS
Beliefs about "normal" infant sleep influence parents' perceptions and practices. Clinical and scientific infant sleep discourses reinforce dominant societal norms and perpetuate these beliefs, but biological and evolutionary views on infant sleep norms are beginning to gain traction with parents and health practitioners.
Topics: Breast Feeding; England; Female; Health Knowledge, Attitudes, Practice; Humans; Infant; Infant, Newborn; Mother-Child Relations; Mothers; Polysomnography; Sleep
PubMed: 33729618
DOI: 10.1002/ajhb.23589 -
Development and Psychopathology Aug 2023Maladaptive offspring emotion regulation has been identified as one pathway linking maternal and child psychological well-being in school-aged children. Whether such a...
Maladaptive offspring emotion regulation has been identified as one pathway linking maternal and child psychological well-being in school-aged children. Whether such a pathway is present earlier in life still remains unclear. The present study investigated the role of preschoolers' emotion reactivity and regulation in the association between maternal psychological distress and child internalizing and externalizing problems. Children's emotion reactivity and regulation were assessed through both observed behavior and physiology. At 42 months of age, children ( = 251; 128 girls) completed a fear induction task during which their heart-rate variability was assessed and their behavior was monitored, and maternal self-reports on depressive mood and anxiety were collected. At 48 months mothers and fathers reported on their children's internalizing and externalizing problems. Higher maternal depressive mood was associated with lower child fear-related reactivity and regulation, as indexed by heart-rate variability. The latter mediated the association between higher maternal depressive mood and higher preschoolers' externalizing problems. Overall, our findings support the role of preschoolers' emotion reactivity and regulation in the relationship between maternal psychological distress and children's socio-emotional difficulties. This role may also depend on the discrete emotion to which children react or seek to regulate as, here, we only assessed fear-related reactivity and regulation.
Topics: Female; Child; Humans; Child Behavior; Emotions; Problem Behavior; Mothers; Psychological Distress
PubMed: 34779373
DOI: 10.1017/S0954579421000936 -
Academic Pediatrics Aug 2022Examine the 1) prevalence of worries among US mothers of infants; 2) association between worries and American Academy of Pediatrics recommended infant care practices...
OBJECTIVES
Examine the 1) prevalence of worries among US mothers of infants; 2) association between worries and American Academy of Pediatrics recommended infant care practices (breastfeeding, supine sleep, roomsharing without bedsharing); 3) association of maternal and household characteristics with worries.
METHODS
We analyzed a nationally representative sample of 3165 mothers who were surveyed regarding safe sleep and breastfeeding when infants were 2 to 6 months of age in 2011-2014. We examined the prevalence of 8 maternal worries (housing, job, income, neighborhood, family relationships, health, baby's health, family member health). We used multivariable logistic regression to examine associations of A) both overall number of worries and individual worries with each infant care practice; and B) maternal and household characteristics with worries.
RESULTS
Twenty-six percent of mothers reported 0 worries, 26% reported 1-2 worries, 23% reported 3-4 worries, and 25% reported 5-8 worries. Compared to those with 0 worries, mothers with 5-8 worries had increased odds of bedsharing (adjusted odds ratio = 1.60 [1.19-2.14]) and non-supine sleep (aOR = 1.37 [1.07-1.74]). Specific worries associated with increased odds of bedsharing included: housing (aOR = 1.39 [1.09-1.78]), income (aOR = 1.35 [1.09-1.67]), neighborhood (aOR = 1.37 [1.05-1.78]), family relationships (aOR = 1.43 [1.10-1.86]), and health of a family member (aOR = 1.24 [1.06-1.46]). Maternal worries were not associated with infant feeding practices.
CONCLUSIONS
We found a high prevalence of worries regarding basic needs, family relationships, and health among US mothers. Greater total worries and several individual worries were associated with higher odds of bedsharing. The "cognitive load" of maternal worries may impact adherence to safe sleep practices and requires further investigation.
Topics: Breast Feeding; Child; Female; Humans; Infant; Infant Care; Mothers; Sleep; Sudden Infant Death
PubMed: 35307603
DOI: 10.1016/j.acap.2022.02.001