Iron supplementation given to nonanemic infants: neurocognitive functioning at 16 years.

OBJECTIVE: There is concern that high iron uptake during the critical period of early brain development carries potential risks, especially for nonanemic infants. This study examined the neurocognitive functioning of 16-year-olds who were nonanemic as infants and received iron supplementation. METHODS: We studied 562 Chilean adolescents (M 16.2 years; 52.7% female) who participated in a randomized controlled iron supplementation trial in infancy. Between 6 and 12 months, 346 consumed an iron-fortified formula (12.7 Fe mg/L) or, if primarily breastfed, liquid vitamins with 15 mg elemental iron as ferrous sulfate, and 216 consumed unmodified cow milk without iron or liquid vitamins without iron if primarily breastfed. RESULTS: Compared to adolescents in the no-added iron condition in infancy, those in the iron-supplemented condition had poorer visual-motor integration, quantitative reasoning skills, and incurred more errors on neurocognitive tasks. Consuming larger amounts of iron-fortified formula in infancy was associated with lower arithmetic achievement. Of adolescents who had high hemoglobin at 6 months (Hb ≥ 125 g/L), those in the iron supplemented condition had poorer performance on arithmetic, quantitative reasoning, and response inhibition tests than those in the no-added iron condition. Of adolescents who had marginally low 6-month hemoglobin (Hb > 100 and < 110 g/L), those who received no-added iron incurred more errors on a visual searching task than those in the iron-supplemented condition. CONCLUSION: The physiologic need for iron during the period of rapid and critical brain development in young infants should be considered vis-à-vis the risks associated with supplementing nonanemic infants with high levels of iron.Clinical Trials number: NCT01166451.

Iron Deficiency in Infancy and Sluggish Cognitive Tempo and ADHD Symptoms in Childhood and Adolescence.

OBJECTIVE: To determine whether iron deficiency in infancy is associated with sluggish cognitive tempo (SCT) or attention-deficit/hyperactive-impulsive (AD-HI) symptoms in childhood and adolescence, and whether such behaviors contribute concurrently and predictively to lower verbal and mathematical abilities. METHOD: Chilean children (N = 959; 50% male, of Spanish or indigenous descent from working-class backgrounds) were rated by mothers for SCT or AD-HI symptoms at ages 5, 10, and 16 years. Children completed standardized tests assessing verbal and mathematical abilities at ages 5, 10, and 16. At ages 12 and 18 months, children were assessed for iron deficiency. RESULTS: Adjusting for a comprehensive panel of covariates, greater severity of iron deficiency in infancy was associated with more frequent SCT and AD-HI symptoms at all ages studied. Most effects of iron deficiency on children's verbal and math skills were indirect, mediated through AD-HI behaviors. Children's AD-HI symptoms related to lower verbal and math test scores within age and across age. CONCLUSIONS: The long-term associations found between infant iron deficiency and SCT and AD-HI behaviors suggest that the neurodevelopmental alterations that stem from postnatal iron deficiency might play an etiological role in the development of ADHD. Screening for early-life nutritional deficiencies among children with SCT or ADHD symptoms might prove useful, and behavioral screening of children with a history of iron deficiency seems warranted. Interventions that support brain development after early nutritional deprivation also would be beneficial.

Adolescent Internalizing, Externalizing, and Social Problems Following Iron Deficiency at 12-18 Months: The Role of Maternal Responsiveness.

This study tested whether maternal responsiveness moderated or mediated pathways from iron deficiency (ID) at 12-18 months to adolescent behavior problems. Participants were part of a large Chilean cohort (N = 933). Iron status was assessed at 12 and 18 months. Maternal responsiveness was assessed at 9 months and 5 years. Parents reported their child's symptomology at 5 years, 10 years, and adolescence (11-17 years; M = 14.4). Structural equation modeling identified a previously unrecognized pathway by which child externalizing problems and negative maternal responsiveness at 5 years mediated associations between ID at 12-18 months and adolescent internalizing, externalizing, and social problems. Positive maternal responsiveness in infancy did not buffer those with ID anemia from developing 5-year internalizing problems.

Sensitive periods for psychosocial risk in childhood and adolescence and cardiometabolic outcomes in young adulthood.

Greater psychosocial risk in childhood and adolescence predicts poorer cardiometabolic outcomes in adulthood. We assessed whether the timing of psychosocial risk from infancy through adolescence predicts cardiometabolic outcomes in young adulthood. Young adults and their mothers participated in a longitudinal study beginning in infancy in Santiago, Chile (N = 1040). At infancy, 5 years, 10 years, and adolescence, mothers reported on depressive symptoms, stressful experiences, support for child development in the home, father absence, parental education, and socioeconomic status (SES) to create a psychosocial risk composite at each time point. Young adults (52.1% female; 21-27 years) provided fasting serum samples and participated in anthropometric and blood pressure (BP) assessments, including a dual-energy X-ray absorptiometry (DXA) scan for measuring body fat. Greater infant psychosocial risk was associated with a greater young adult metabolic syndrome score (ß = 0.07, 95% confidence intervals (CI): 0.01 to 0.13, p = 0.02), a higher body mass index and waist circumference composite (ß = 0.08, 95% CI: 0.03 to 0.13, p = 0.002), and a higher body fat (DXA) composite (ß = 0.07, 95% CI: 0.01 to 0.12, p = 0.02). No psychosocial risk measure from any time point was associated with BP. Infant psychosocial risk predicted cardiometabolic outcomes in young adulthood better than psychosocial risk at 5 years, 10 years, or adolescence, mean of psychosocial risk from infancy through adolescence, and maximum of psychosocial risk at any one time. Consistent with the Developmental Origins of Health and Disease model, findings suggest that infancy is a sensitive period for psychosocial risk leading to poorer cardiometabolic outcomes in young adulthood.

Risk and protective factors for sexual and dating violence victimization: a longitudinal, prospective study of Latino and African American adolescents.

Teen dating violence and sexual victimization are serious public health concerns. Although research has highlighted the correlates and consequences of such abuse, little is known about early antecedents. The current study sought to identify the risk and protective factors evident in early adolescence that are associated with sexual and dating violence victimization in late adolescence. The sample involved 236 (52% female) low-income Latino (69%) and African American (31%) youth, their older sisters, and their mothers who were studied when youth were, on average, ages 13 and 18 years. The results indicated that early indicators of a risky lifestyle (e.g., getting drunk, having sex) and having deviant friends and siblings were associated with a higher likelihood of subsequent victimization. Mothers' early strictness, monitoring, and conservative sexual attitudes predicted a lower likelihood of subsequent assault and served as significant buffers given specific risks, particularly for girls and Latinos. The findings suggest that behavior and social network patterns established relatively early in life increase one's vulnerability to victimization later in life, as well as point to aspects of parenting that serve a protective function against such outcomes.

Associations between Adolescent Alcohol Use and Neurocognitive Functioning in Young Adulthood.

This study examined the associations between excessive alcohol intake during adolescence and neurocognitive functioning in young adulthood and whether these relations varied by sex. Participants were working-class Chilean adolescents (N = 692; Mage 16.0 years; 54.5% female) who provided frequency of past 30-day bingeing and past-year intoxication. Neurocognitive measures were completed in young adulthood (Mage 21.2 years). Illicit substance users were excluded a priori and other substance use was controlled. When males and females were considered simultaneously, no main effects of intoxication or bingeing were found. However, several sex-specific effects emerged for intoxication, such that more frequent intoxication was associated with poorer visual memory, attention, processing speed, response inhibition, and cognitive flexibility in females, while frequent intoxication related to better attention and processing speed in males. In general, effect sizes were small. No relations emerged for verbal memory, working memory, or spatial learning. Possible factors that contribute to divergent sex effects are discussed.

Sibling Caretaking Among Mexican American Youth: Conditions That Promote and Hinder Personal and School Success.

This study examined how Mexican American youths' extent of sibling caretaking is related to their personal and school adjustment, and whether mothers' gender-role attitudes and youths' familistic beliefs moderate these associations. One hundred and ninety-five Mexican American youth (M age 14.8 years; 64% girls) and their mothers participated in the study. Youth completed questionnaires about their extent of sibling caretaking, their educational aspirations, school involvement, school absences, grades, and their prosocial tendencies. Results indicated that, when examined singly, frequent sibling caretaking was related to youths' higher educational aspirations, greater prosocial tendencies, and more school engagement for older youth, but also to more school absences. When extensive sibling care was coupled with mothers' sex-stereotyped attitudes, youth experienced poorer outcomes. Youth who held strong familistic beliefs and were highly involved in sibling care reported lower educational aspirations, particularly girls. Findings underscore the importance of considering socialization influences when evaluating associations between sibling caretaking and youths' development.

The younger siblings of childbearing adolescents: parenting influences on their academic and social-emotional adjustment.

The younger siblings of childbearing adolescents have poorer school outcomes and exhibit more internalizing and externalizing problems compared to their peers without a childbearing sister. We test a model where living with an adolescent childbearing sister constitutes a major family stressor that disrupts mothers' parenting and well-being, and through which, adversely affect youths' adjustment. Data came from 243 Latino younger siblings (62% female, M age 13.7 years) and their mothers, 121 of whom lived with a childbearing adolescent sister and 122 of whom did not. Individual fixed-effects models controlled for earlier measures of each respective model construct, thereby reducing omitted variable bias from pre-existing group differences. Results show that, for boys, the relationship between living with a childbearing adolescent sister and youth outcomes was sequentially mediated through mothers' stress and parenting (i.e., monitoring and nurturance). For girls, however, the relationship was mediated through mothers' monitoring only. Findings elucidate the within-family processes that contribute to the problematic outcomes of youth living with childbearing adolescent older sisters.

Effects of Adolescent Childbearing on Latino Siblings: Changes in Family Dynamics and Feelings Toward the Teen Mother.

Latinos have had the highest teenage birthrate of any racial or ethnic group in the United States for the past 15 years, yet little is known about how Latino families are affected by a teenage daughter's childbearing. In-depth interviews were conducted with 32 Mexican American younger siblings of parenting teens to discern how their sister's childbearing had affected them and their families. The most commonly reported negative effects were increased family stress and conflict, more arguments with the parenting older sister, and less time spent with family members. Regarding benefits, all youth described a loving bond with their sister's baby, two thirds described their family becoming closer, and 81% felt closer to their older sister. The implications of these effects for Mexican American families are discussed.

Home and parenting resources available to siblings depending on their birth intention status.

This study examines the differential availability of family and parenting resources to children depending on their birth planning status. The National Longitudinal Survey of Youth data were analyzed, 3,134 mothers and their 5,890 children (M = 7.1 years, range = 1 month-14.8 years), of whom 63% were intended at conception, 27% were mistimed, and 10% were unwanted. Fixed-effects models show that unwanted and mistimed children had fewer resources than intended siblings. Parents' emotional resources to older children decreased after the birth of a mistimed sibling. Findings suggest that cognitive and emotional resources are differentially available to children within a family depending on intention status and that unintended births lead to decreased parental resources for older children in the household.

Youths' Caretaking of Their Adolescent Sisters' Children: Results From Two Longitudinal Studies.

The extent and experiences of youths' caretaking of their adolescent sisters' children have been assessed in two longitudinal studies. The first study examines the caretaking patterns of 132 Latino and African American youth during middle and late adolescence. The second study involves 110 Latino youth whose teenage sister has recently given birth. Youth are studied at 6 weeks and 6 months postpartum. In both studies, girls provide more hours of care than boys, and in Study 1, girls' hours of care significantly increase with age whereas boys' hours of caretaking decrease. Girls provide more care when their sisters are older and when their mothers provide many hours of care, whereas boys provide less care when their mothers provide more care and when they have many siblings. Results of both studies reveal age, gender, and across-time differences in the extent of care, type of caretaking activities, and experiences in providing care.

The Impact of Refugee Mothers' Trauma, Posttraumatic Stress, and Depression on Their Children's Adjustment.

The mechanisms linking refugee parents' trauma onto their children's functioning are not well understood. The current study sought to identify how Somali refugee mothers' past trauma and current mental health impact their children's psychosocial adjustment. One hundred and ninety-eight Somali mothers (M age = 39 years) and their children (M age = 10 years; 56% male) were studied. On average, mothers spent 7 years in refugee camps, experienced significant trauma, and some had been tortured. Measures of mothers' posttraumatic stress and depression were analyzed as three symptom clusters: volatility/panic, withdrawn/detached, and depressed mood. Most children were born in the U.S. and their indirect exposure to trauma was statistically controlled. Results from structural equation modeling indicated that there was no direct association between trauma of the mother and their children's well-being, however, mothers' posttraumatic stress and depressive symptoms significantly mediated the effects of mothers' past torture on their children's adjustment-a pattern indicative of intergenerational traumatization. Findings enhance our understanding of how refugees' traumatization lingers and possibly affects their and their children's health and well-being.

Association between adolescent pregnancy and a family history of teenage births.

CONTEXT: The extent to which young women's risk of adolescent pregnancy is associated with having a mother who was a teenage parent, a sister who was a teenage parent or both is not known. METHODS: A sample of 127 Latina and black adolescent females completed in-depth surveys at three time points between 1994 and 2000. Logistic regression analyses were used to examine whether socioeconomic factors, mothers' parenting characteristics and certain sibling relationship qualities explain the association between a family history of teenage births and young women's risk of pregnancy. RESULTS: Compared with young women with no family history of teenage births, young women whose sister had had a teenage birth and those whose sister and mother both had had teenage births were significantly more likely to experience a teenage pregnancy (odds ratios, 4.8 and 5.1, respectively). Young women who had only a sister who had had a teenage birth had greater odds of pregnancy than young women who had only a mother who had had a teenage birth (4.5). Having both a mother and a sister who had had teenage births was independently associated with an elevated risk of pregnancy (3.7), even after controlling for socioeconomic and mothers' parenting characteristics. Frequent companionship with an older sister was associated with increased odds of teenage pregnancy (4.5); frequent conflict with an older sister who had had a teenage birth was marginally associated with decreased odds of the outcome (0.3). CONCLUSION: Pregnancy prevention interventions targeting young women according to maternal and sibling teenage birth histories may be effective.

Longitudinal pathways linking family factors and sibling relationship qualities to adolescent substance use and sexual risk behaviors.

This 3-wave, 5-year longitudinal study tested the contributions of family contextual factors and sibling relationship qualities to younger siblings' substance use, sexual risk behaviors, pregnancy, and sexually transmitted disease. More than 220 non-White families participated (67% Latino and 33% African American), all of which involved a younger sibling (133 girls and 89 boys; mean age = 13.6 years at Time 1) and an older sister (mean age = 17 years at Time 1). Results from structural equation latent growth curve modeling indicated that qualities of the sibling relationship (high older sister power, low warmth/closeness, and low conflict) mediated effects from several family risks (mothers' single parenting, older sisters' teen parenting, and family's receipt of aid) to younger sibling outcomes. Model results were generally stronger for sister-sister pairs than for sister-brother pairs. Findings add to theoretical models that emphasize the role of family and parenting processes in shaping sibling relationships, which, in turn, influence adolescent outcomes.

Mothers' differential treatment of their adolescent childbearing and nonchildbearing children: contrasts between and within families.

This study examined mothers' differential treatment of adolescent sibling pairs in 2 family contexts: families with and without an adolescent childbearing daughter. Results based on mothers' ratings and children's ratings revealed that the mothers of childbearing daughters treated all of their children less affectionately than did the mothers of nonchildbearing adolescents. In families with a childbearing daughter, mothers expected a brighter future for and treated their never-pregnant daughter(s) more favorably than their childbearing daughter, and mothers' harsh treatment toward their children was correlated with high financial stress, excessive time spent caring for their daughter's child, and younger children's sexual behavior and drug and alcohol use. Findings highlight the preferential parenting that occurs within the families of childbearing teens and suggest its ramifications.

High Educational Aspirations Among Pregnant Adolescents Are Related to Pregnancy Unwantedness and Subsequent Parenting Stress and Inadequacy.

On the basis of theories of maternal identity development, role conflict, and childbearing motivation, the authors tested whether high educational aspirations among pregnant adolescents are related to the unwantedness of the pregnancy and whether pregnancy unwantedness leads to subsequent parenting stress and inadequacy. Longitudinal data from 100 first-time-pregnant, unmarried Latina adolescents (M age = 17.3 years) were analyzed. Results from structural equation path modeling confirmed these associations, with strong educational ambitions related to greater unwantedness of the pregnancy, which led to feeling trapped by parenting at 6 months postpartum, which in turn was related to unaffectionate parenting and feeling inadequate in mothering at 1 year postpartum. The potential long-term negative consequences of high educational aspirations for pregnant adolescents' adjustment to parenting are discussed.

Stress in Latino families following an adolescent's childbearing: effects on family relationships and siblings.

This study examined how increased stress in Latino families following an adolescent's childbearing impacts family relationships and the adolescent's siblings. Participants were 243 Mexican American youth (mean age: 13.7 years; 62% girls), or 121 youth who had a pregnant adolescent sister and 122 youth who had an adolescent sister who had never been pregnant. Youth and their mothers were studied at 4 time points across 15 months: The families of pregnant adolescents were studied when the adolescent sister was in her third trimester of pregnancy, and at 2 months, 6 months, and 12 months postpartum; the families of never-pregnant adolescents were studied at like intervals. Individual fixed-effects structural equation models were computed, which control for earlier measures of study constructs and thereby reduce omitted variable bias from preexisting family group differences. Results showed that an adolescent's childbearing was related to increases in family stress, which were related to increases in mothers' harsh parenting and mother-sibling conflict, which, in turn, were related to subsequent increases in siblings' problem behavior. Multiple group analyses revealed that the pathways through which a teenager's childbearing influences siblings operate similarly for girls and boys. Tests of an alternate ordering of model variables indicated a poor fit with the data. Findings provide evidence that the accumulation of stressful family changes following an adolescent's childbearing can negatively impact siblings. Findings also elucidate how family-level stress and disruption experienced across a family transition trickle down to affect family relationships and, in turn, child family members.

Adolescents' Pregnancy Intentions, Wantedness, and Regret: Cross-Lagged Relations With Mental Health and Harsh Parenting.

The authors used cross-lagged analyses to examine the across-time influences on and consequences of adolescents' pregnancy intentions, wantedness, and regret. One hundred pregnant Latina adolescents were studied during pregnancy and at 6 and 12 months postpartum. The results revealed 4 main findings: (a) similar to what has been found in adult women, adolescents' lower prenatal pregnancy intendedness and wantedness predicted initial difficulties in parenting; (b) frequent depression symptoms predicted subsequent lower pregnancy intendedness and wantedness; (c) adolescents' poor mental health and harsh parenting of their child predicted subsequent higher childbearing regret, and (d) high childbearing regret and parenting stress were reciprocally related across time. In addition, adolescents' wantedness of their pregnancy declined prenatally to postbirth, and strong pregnancy intendedness and wantedness were not concurrently related to adolescents' poor prenatal mental health. The findings reveal how adolescents' thoughts and feelings about their pregnancies are influenced by and predictive of their mental health and parenting experiences.

Children's experiences after the unintended birth of a sibling.

This study examines whether children with a younger sibling whose birth was unintended experience larger declines in the quality of their home environment and larger increases in behavioral problems than children whose younger sibling's birth was intended. We use data from the NLSY79 to estimate cross-lag regression models that assess changes in the home environment and children's behavioral problems after the birth of a sibling (intended or unintended). Results are consistent with our hypotheses, finding that, indeed, unintended births have negative spillover effects. Compared with children whose sibling's birth was intended, both boys and girls whose sibling's birth was unintended experienced larger declines in the quality of their home environment, and boys had larger increases in behavioral problems. We also find some unexpected evidence that mistimed births may have larger negative effects than unwanted births. This deserves further research, and we offer some possible explanations that could guide those investigations.

Children's Provision of Family Caregiving: Benefit or Burden?

Despite the high numbers of children who provide care to family members in industrialized countries, relatively little is known about the impact of caregiving on children's development. In this article, issues related to children's caregiving, including a discussion of who provides care, the costs and benefits of caring, and directions for future research are reviewed. This review is intended to stimulate further study of this issue, particularly in clarifying who is most vulnerable to caregiving burden and understanding how caregiving affects children's lives and development.