The Impact of Preterm Infants' Continuous Exposure to Breast Milk Odor on Stress Parameters: A Pilot Study.

OBJECTIVE: This pilot study aimed to assess the effect of continuous exposure to the odor of own mothers' breast milk (BM) on the stress parameters of preterm infants. MATERIALS AND METHODS: Fifteen healthy preterm infants were included. Mean heart rate and salivary cortisol were measured over three consecutive time periods, each lasting 2 days: (1) preintervention (odor free); (2) intervention, during which a cotton pad soaked with 1.5 mL of BM was placed near the infant's head with the aim of providing continuous exposure to its odor; (3) postintervention period (odor free). RESULTS: Saliva cortisol levels differed significantly between the three exposure periods (pre-, during, and post-BM odor exposure): 11.38 ± 5.03, 9.51 ± 4.38, and 4.99 ± 3.42 nmol/L, respectively. A repeated univariate analysis of the cortisol measure showed a significant difference (F = 9.34; df = 2.28, p < 0.001). There was no difference in mean heart rate over the three study periods. CONCLUSIONS: Preterm infants exposed to BM odor from their own mothers demonstrate a persistent decrease in saliva cortisol levels, which continues after termination of the intervention. This finding may suggest that exposure to own mothers' BM odor has a soothing effect on preterm infants. Further randomized controlled studies are needed to evaluate this simple, safe, and inexpensive intervention.

Motivations of mothers to enroll their newborn infants in general clinical research on well-infant care and development.

OBJECTIVE: The purpose of this work was to identify possible motivations for mothers to consent to having their newborn infants participate in medical research on well-infant care and to compare between mothers of term infants and mothers of stable preterm infants. METHODS: Two-hundred mothers answered a questionnaire regarding their consent to have their newborns participate in 5 simulated studies at different risk levels and their willingness to provide a telephone number for future contact. Demographic data, attitudes about medicine, medical research, and evaluation of research conditions served as predictors of the degree of consent. RESULTS: Degree of consent was affected mainly by perceived risk, because the research did not offer a direct personal benefit; that is, 80% consented to a psychological study as opposed to 25% who consented to a vaccine study. The strength of the predicting variables differentiated according to the suggested study. No significant difference was found between the mothers of term infants (n = 127) and the mothers of preterm infants (n = 73), either in the degree of consent to the 5 suggested studies or in the predicting variables, except for the measure of actual behavior (ie, revealing a telephone number). Only 23% of the mothers of term infants in comparison with 48% of the mothers of preterm infants were willing to reveal their telephone numbers. CONCLUSIONS: There is some willingness to consent when the infant is healthy and the research is not directed at solving a specific problem of the infant. The degree of consent decreases in accordance with the increase in risk. The altruistic motive is the main predictor for research that is perceived as very risky. The benefit of learning about their infant's development served as a motivating force for less risky studies. We deduce that pointing out personal benefits to balance the usual conveyed information on risks or burdens of the research can increase the willingness to consent.

To vaccinate or not to vaccinate--that is the question: why are some mothers opposed to giving their infants hepatitis B vaccine?

OBJECTIVE: To identify the characteristics of mothers who prevent their newborn babies from receiving the hepatitis B vaccine. METHODS: Women who gave birth and prevented the administration of routine hepatitis B vaccine to their newborn infants (study group) were compared to women who complied with vaccination (control group). During their hospital stay, both groups were asked to answer a questionnaire constructed to evaluate relevant demographic data, knowledge and attitudes liable to differ between the two groups. RESULTS: The 51 women in the Prevent (study) group were more educated and had a higher income level. They expressed more knowledge about the vaccine, and held more naturalistic and less conventional medical attitudes than did the women in the Comply (control) group (153 women). Some of the reasons given by the Prevent group for vaccine rejection included the following: "The child is too young"; "vaccines are dangerous"; "Doctors vaccinate without consideration"; "Vaccines causes trauma to the baby". The Comply group's reasons for giving the vaccine were mainly "to protect the baby" and "trust in the doctors". Differences between the groups were also found with respect to their future intended behavior. The study group planned to breastfeed for a longer period than the control group. Only 16% of the study group compared to 98% of the control group stated they intended to comply with the full vaccination program offered to developing children. On the basis of the answers to the questionnaire, the Comply group was further subdivided into two groups: those with knowledge and those lacking knowledge (determined by subjective evaluation). This subdivision showed that the differences between the Prevent Group and the Comply group exist, even though knowledge was controlled for. CONCLUSIONS: Mothers prevent administration of the hepatitis B vaccine to their newly born children based upon their overall approach, and not due to ignorance. In order to overcome this harmful trend, the medical community must supply counter information that encourages vaccinations.