Infant-rearing experiences of parents during the COVID-19 pandemic in South Korea: a mixed-methods approach.

PURPOSE: This study aimed to identify the infant-rearing experiences of parents during the coronavirus disease 2019 (COVID-19) pandemic and provide foundational data for the development of infant-rearing support programs during pandemic situations. METHODS: Convergent mixed methods were used to better understand the research outcomes by converging both quantitative and qualitative data. A total of 149 parents with infant-rearing experiences during the pandemic responded to a self-report survey, and 10 parents participated in the interviews. Data were analyzed using Colaizzi's method, descriptive statistics, t-test, one-way analysis of variance, the Scheffé test, Pearson correlation coefficients, and hierarchical regression. RESULTS: Analysis of qualitative data yielded the following three categories: five theme clusters, ten themes, and thirty-nine sub-themes. The factors influencing infant-rearing behavior were nuclear family (ß=.34, p<.001) and rearing stress (ß=-.39, p<.001). The explanatory power of the regression equation was 26.6%. CONCLUSION: Infectious disease disasters, such as the COVID-19 pandemic, can quickly alter infant-rearing conditions, causing heightened parental anxiety. This may affect infant-rearing behaviors and hinder healthy infant development. Future research should develop a comprehensive tool to measure holistic health-related parenting behaviors across the different stages of child development. Additionally, pediatric nurse practitioners can play an active role in educating parents, supporting parenting, and promoting healthy infant development in their communities, making pediatric nurse practitioners a highly relevant and necessary healthcare profession during infectious disease disasters. Thus, there is a need to improve institutions and build infrastructure at the national level to support them.

Too hot to thrive: a qualitative inquiry of community perspectives on the effect of high ambient temperature on postpartum women and neonates in Kilifi, Kenya.

OBJECTIVE: To understand community perspectives on the effects of high ambient temperature on the health and wellbeing of neonates, and impacts on post-partum women and infant care in Kilifi. DESIGN: Qualitative study using key informant interviews, in-depth interviews and focus group discussions with pregnant and postpartum women (n = 22), mothers-in-law (n = 19), male spouses (n = 20), community health volunteers (CHVs) (n = 22) and stakeholders from health and government ministries (n = 16). SETTINGS: We conducted our research in Kilifi County in Kenya's Coast Province. The area is largely rural and during summer, air temperatures can reach 37˚C and rarely go below 23˚C. DATA ANALYSIS: Data were analyzed in NVivo 12, using both inductive and deductive approaches. RESULTS: High ambient temperature is perceived by community members to have direct and indirect health pathways in pregnancy and postpartum periods, including on the neonates. The direct impacts include injuries on the neonate's skin and in the mouth, leading to discomfort and affecting breastfeeding and sleeping. Participants described babies as "having no peace". Heat effects were perceived to be amplified by indoor air pollution and heat from indoor cooking fires. Community members believed that exclusive breastfeeding was not practical in conditions of extreme heat because it lowered breast milk production, which was, in turn, linked to a low scarcity of food and time spend by mothers away from their neonates performing household chores. Kangaroo Mother Care (KMC) was also negatively affected. Participants reported that postpartum women took longer to heal in the heat, were exhausted most of the time and tended not to attend postnatal care. CONCLUSIONS: High ambient temperatures affect postpartum women and their neonates through direct and indirect pathways. Discomfort makes it difficult for the mother to care for the baby. Multi-sectoral policies and programs are required to mitigate the negative impacts of high ambient temperatures on maternal and neonatal health in rural Kilifi and similar settings.

Child health nursing in the Solomon Islands: A qualitative evaluation of the impact of the 'Bachelor of nursing - Child health'.

AIM: To explore graduates' perceptions of the impact on nursing practice of a new postgraduate course in child health, developed and implemented in the Solomon Islands in 2016. BACKGROUND: The Bachelor of Nursing - Child Health was implemented in 2016 to develop nurses' knowledge and skills in child health and paediatric care with the intent to improve national child health outcomes. DESIGN: A qualitative exploratory, descriptive design was used to evaluate the impact of the Bachelor of Nursing - Child Health on graduates' nursing practice. METHODS: Fourteen nurses who graduated from the first cohort of students enrolled in the child health course were purposively selected to participate. Participants engaged in individual semi-structured interviews, conducted between August and December 2018. A thematic analysis was undertaken following Braun and Clarke's six-phase process. RESULTS: Findings from the study demonstrate positive impacts of the course on graduates' nursing practice. These include a perceived enhanced quality of care through their commitment to evidence-based practice, the ability to contribute to capacity building of colleagues, the reinforcement of provincial public health programmes and expanded participation in managerial activities. Following graduation, most alumni took on senior roles and greater responsibilities, felt more confident in managing unwell children, felt there was better access to and quality of child health care at the community and broader country levels and felt recognised by colleagues and communities. Some graduates faced resistance from colleagues to change practice and felt that despite being given greater responsibilities, nursing levels and salaries remained unchanged. This reflected a potential lack of recognition from hospital or provincial managers, the Nursing Council as the regulatory body for the nursing profession, and the Ministry of Health and Medical Services. A lack of human and material resources also impacted quality of care. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Findings from this study underline the need for the Solomon Islands National University, the Nursing Council, the Public Service and the Ministry of Health and Medical Services to concord and delineate formal accreditation standards for child health nurses. Overall, collaborative efforts and commitments at local, regional and global levels are required to support child health nurses in their ability and ambition to improve national child health outcomes. CONCLUSIONS: Findings from this study demonstrate positive impacts of the course on graduates' nursing practice. The impact of increasing nurses' knowledge and skills on national child health outcomes could be significant. Ongoing implementation and recognition of this course in the Solomon Islands, as well as more broadly across the Pacific region, are recommended.

Sociodemographic, behavioral, obstetric, and healthcare factors associated with low weight at birth: a case-control study

ABSTRACT BACKGROUND: Understanding social determinants is crucial for implementing preventive strategies, especially for low birth weight (LBW)—a public health issue that severely increases the risk of morbimortality in children. OBJECTIVE: This study aimed to identify the factors associated with LBW among newborns, assisted by the Brazilian Unified Health System. DESIGN AND SETTING: It analyzed data from newborns and their mothers. The sample was selected by convenience from users of the public health system in Francisco Beltrão (Paraná, Brazil). METHODS: Cases (n = 26) were babies weighing ≤ 2,500 g and controls (n = 52) > 2,500 g. All babies were assessed and paired by sex and date of birth in a 1:2 proportion. Statistical power was computed a posteriori, revealing a power of 87% (α = 0.05). RESULTS: Strong and significant differences were found in the bivariate analysis, in which the number of current smokers or those who quit during pregnancy was higher among mothers of babies with LBW. Moreover, the gestational weeks were lower among these cases. Logistic regression models indicated that the gestational week (odds ratio [OR] = 0.17, 95% confidence interval [CI]:0.05-0.54) and fathers' educational level (high school or above; OR = 0.22, 95% CI:0.06-0.99) were related to lower chances of low birth weight. CONCLUSIONS: Our findings confirm previous investigations on LBW's multi-causality, showing that the gestational week could reduce up to 82% chances of a baby being born with ≤ 2,500 g. Its association with paternal education underlines the importance of comprehensive policies to protect newborns.

Prácticas y creencias con el uso de plantas medicinales en lactantes de San Andrés Isla

Introducción: El uso de plantas medicinales es parte de la cultura tradicional de muchas poblaciones alrededor del mundo, se utilizan para prevenir enfermedades y preservar la salud de los individuos, siendo un conocimiento que conservan las madres y abuelas para el cuidado de la primera infancia. Sin embargo, existen muchos vacíos en la investigación con respecto al uso y propiedades de plantas medicinales en lactantes y población general. Objetivo: Analizar y describir las prácticas y creencias con el uso ancestral de plantas medicinales en lactantes de la comunidad raizal en San Andrés Isla. Materiales y métodos: Estudio cualitativo descriptivo etnográfico aplicado a una muestra por conveniencia de ocho abuelas de la comunidad Raizal de San Andrés Isla. Se realizó la descripción y el análisis de las ideas, prácticas sociales, comportamientos, creencias, significados y conocimientos en torno al uso de plantas medicinales en lactantes. Resultados: Aún se conservan los conocimientos ancestrales con el uso de plantas medicinales liderado por las abuelas. El uso de plantas medicinales en lactantes se rige únicamente por la necesidad de manejo de situaciones de salud. En esta investigación se encontraron 23 ejemplares de plantas medicinales de uso en lactantes, de estas son pocas las que se encuentran registradas en el vademécum colombiano de plantas medicinales. Discusión: Los hallazgos concuerdan con los resultados de otros estudios que evidencian la importancia de la tradición cultural en el cuidado de los lactantes, el protagonismo de la experiencia acumulada de las abuelas en estos saberes y prácticas; además de corroborar que el uso de plantas medicinales en lactantes se rige únicamente por la necesidad de cuidado ante situaciones de salud que lo ameritan. Solo dos ejemplares de las plantas medicinales clasificadas por las mujeres raizales de este estudio se encuentran referenciadas en el vademécum colombiano de plantas medicinales. Conclusiones: Las plantas medicinales abordan un amplio espectro de usos y propiedades que necesitan un extenso estudio para su registro y divulgación.

Introduction: The use of medicinal plants is part of the traditional culture of many populations around the world. Used to prevent diseases and preserve the health of individuals, it is a knowledge that mothers and grandmothers keep for early childhood care. However, there are many gaps in research regarding the use and properties of medicinal plants in infants and the general population. Objective: Analyze and describe the practices and beliefs with the ancestral use of medicinal plants in infants by the Raizal community in San Andrés Island. Materials and methods: It's a qualitative study with a descriptive ethnographic design applied to a convenience sample of 8 grandmothers from the Raizal community of San Andrés Island. We made out a description and analysis of the ideas, social practices, behaviors, beliefs, meanings, and knowledge about the uses of medicinal plants on infants. Results: The ancestral knowledge of medicinal plants use led by the grandmothers still persevered. The use of medicinal plants on infants administers only to the need of health situations. The investigation found 23 specimens of medicinal plants used in infant breastmilk, just a few plants found in this study are registered in the Colombian Vademecum of medicinal plants. Discussion: The findings agree with the results of other studies that show the importance of cultural traditions in the care of infants, the role of the accumulated experience of grandmothers in this knowledge and practices. In addition to corroborating that the use of medicinal plants in infants is governed solely by the need for care in health situations that warrant it. Only two specimens of the medicinal plants classified by the Raizal women in this study are referenced in the Colombian Vademecum of medicinal plants. Conclusion: Medicinal plants address a wide spectrum of uses and properties that need extensive study for their registration and dissemination.

Manejo materno de recién nacidos atendidos en el Centro de Salud Tulcán No. 1. Ecuador, 2021-2022

Fundamento: la correcta atención materna en etapa neonatal es un factor elemental para el estado de salud del niño. Objetivo: describir el manejo materno de recién nacidos atendidos en el Centro de Salud Tulcán No. 1. Métodos: estudio observacional, descriptivo, transversal sobre madres de recién nacidos que asistieron al Centro de Salud Tulcán N°1 en el periodo de septiembre de 2021 a febrero de 2022. La población estudiada fue de 30 madres. Se analizaron las variables: identificación de signos de alarmas, elementos referidos a la alimentación, cuidados y características del cordón umbilical, higiene en el manejo del recién nacido y momento de asistencia al primer control neonatal. Para la recolección de la información se empleó una encuesta. Resultados: el 90 % de las madres identificó la presencia de signos de alarma en su hijo (el 33,33 % no puedo alimentarse y/o respirar); el 50 % de los recién nacidos recibieron lactancia materna exclusiva. El 26,67 % de las madres refirió que el estómago de su bebé se pone duro después de la lactancia, y el 26,67 % que su hijo experimentó vómitos después de la alimentación complementaria. El 46,67 % realizó la cura con alcohol como cuidado al cordón umbilical y el 26,67 % presentó una coloración roja del mismo. El 33,33 % refirió lavarse las manos después de cambiar el pañal y el 36,67 % realizó la higiene de los genitales del neonato con cada cambio de pañal. El 16,67 % asistió a la primera consulta de control neonatal en tiempo. Conclusiones: aún existen insuficiencias en el manejo materno del neonato para poder disminuir los factores de riesgo que generan complicaciones.

Foundation: correct maternal care in the neonatal stage is an elementary factor for the child's health state. Objective: to describe the maternal management of newborns treated at the Tulcán Health Center No. 1. Methods observational, descriptive, cross-sectional study on mothers of newborns who attended the Tulcán Health Center N°1 from September 2021 to February 2022. The population studied was 30 mothers. The analyzed variables were: identification of warning signs, elements related to feeding, care and characteristics of the umbilical cord, hygiene in handling the newborn and time of attendance at the first neonatal check-up. A survey was used to collect the information. Results: 90% of the mothers identified the presence of warning signs in their child (33.33% could not feed and/or breathe); 50% of newborns were exclusively breastfed. 26.67% of mothers reported that their baby´s; stomach becomes hard after breastfeeding, and 26.67% reported that their child experienced vomiting after complementary feeding. 46.67% performed the cure with alcohol as care for the umbilical cord and 26.67% presented a red color to it. 33.33% reported washing their hands after changing the diaper and 36.67% cleaned the newborn's genitals with each diaper change. 16.67% attended the first neonatal check-up consultation on time. Conclusions: there are still inadequacies in the maternal management of the newborn to reduce the risk factors that generate complications.

Parental Knowledge and Perceptions on Prevention of Sudden Unexpected Infant Death and Infant Care.

(1) Background: The study's purpose was to explore the knowledge, perceptions, and confidence of mothers about infant care to reduce the risk of sudden unexpected infant death. (2) Methods: A purposeful sampling method was used to recruit 15 first-time mothers from Georgia with infants under 1 year of age. The researchers utilized the Socio-ecological model to report the results. Participants also provided recommendations on how to improve infant care and reduce the risk of SUID. (3) Results: The confidence level of infant care among most participants was low but increased over time. Mothers' knowledge level about the prevention of SUID was high, but poor emotional health could hurt their parental abilities. Most participants recognized medical providers as the main source of reliable information. However, a lack of emotional and physical support was reported by mothers. (4) Conclusions: Results suggested that a more holistic approach to infant care is needed. The healthcare system and communities should provide more physical, social, and mental support to first-time mothers, a consolidated approach to care before and after birth, and easy access to services at all stages of the process to reduce the risk of SUID.

Respectful Maternity Care Practices During Normal Delivery at the Public Health Facilities in Tamil Nadu, Southern India: A Descriptive Study.

INTRODUCTION: The quality of maternity care in Tamil Nadu has significantly improved in the past few years and various public health initiatives have helped to reduce crucial indicators like Maternal Mortality Ratio and Infant Mortality Rate. The improvement in quality of interface between the mothers and service providers in term of language, behaviour and attitude for ensuring 'Respectful Maternity Care' would support further enhancement of maternal and new born outcomes. Delivery of appropriate and respectful care to each pregnant woman would not only go a long way in reducing mortality and morbidity for the woman and new-born but also help in improved cognitive development of the baby. OBJECTIVE: To assess the quality of delivery care practices provided during normal delivery among women accessing public health facilities in Tamil Nadu. METHODS: A descriptive evaluation study was conducted from May to December 2018 in 16 facilities across 14 districts in Tamil Nadu. The health facilities were stratified according to the level of services, Government Medical College hospitals (MC), District headquarter hospitals (DHQ), Sub-district hospitals (SDH), and PHCs, 4 facilities in each category were selected. Data was collected by direct observation using a facility observation check list in an Android-based tablet application. Informed consent was obtained from all participants. RESULTS: A total of 1006 pregnant women out of 2242 women who had normal delivery were assessed and included in the study. More than 50% of deliveries were conducted by nurses and midwives and the perinatal and maternal outcomes were found to be good. The parameters for the respectful maternity care were recorded. Routine care monitoring parameters helped to reduce mortality rate and improved delivery care. CONCLUSION: The state though has achieved substantial success in promoting institutional delivery practices, still needs certain crucial improvements in the quality of respectful maternal care during the delivery.

The overall pooled prevalence of disrespectful maternity care in India was 71.31% (95% CI 39.84­102.78) where every individual study prevalence ranged from 20.9 to 100%. Institutional delivery is 100 percent in Puducherry and Tamil Nadu (NFHS V) and hence it is important to assess the quality of maternity care provided in public healthcare facilities in the state. The improvement in the quality of the interface between the women and service providers in terms of language, behavior, and attitude for ensuring 'Respectful Maternity Care' would thus contribute to positive outcomes for women and their newborns, and also to ensure the cognitive development of children later in life.

Parental experience is linked with lower vasopressin receptor 1a binding and decreased postpartum androgens in titi monkeys.

Parenting induces many neurological and behavioral changes that enable parents to rear offspring. Vasopressin plays an important role in this process via its effects on cognition, affect, and neuroplasticity, and in some cases, via interactions with decreased parental androgens. Thus far, the role of these hormones has been primarily studied in rodents. To address this gap, we explored vasopressin receptors and androgens in titi monkeys, a pair-bonding and biparental primate species. In Studies 1 and 2, we used receptor autoradiography to correlate arginine vasopressin receptor 1a (AVPR1a) binding in the hippocampus (Study 1, n = 10) and the rest of the forebrain (Study 2, n = 23) with parental status, parental experience, parity, infant carrying, and pair affiliation. We found that parents exhibited lower AVPR1a binding than non-parents throughout most brain regions assessed, with especially strong effects in the hippocampus (ß = -.61), superior colliculus (ß = -.88), lateral septum (ß = -.35), and medial preoptic area (ß = -.29). The other measures of parental experience also tended to be negatively associated with AVPR1a binding across different brain regions. In Study 3 (n = 44), we compared pre- and postpartum urinary androgen levels in parents and non-parents and found that mothers exhibited a sustained androgen decrease across 3-4 months postpartum (relative to 3 months prepartum; ß ranged from -.72 to -.62 for different comparisons). For males, we found that multiparous fathers exhibited decreased androgen levels at 1-2 weeks postpartum (ß = -.25) and at 3-4 months postpartum (ß = -.40) compared to the prepartum, indicating both immediate and long-term reductions with subsequent paternal experience. Together, the results of this study suggest that decreases in AVPR1a binding and circulating androgens are associated with parental behavior and physiology in titi monkeys.

Investigating the Effect of Implementing a Web-Based Educational Program on Fathers' Involvement in Infant Care 0 to 6 Months.

Background: Fathers need education to understand their role in infant care and its implications regarding the child's health. Virtual education has been able to compensate for the shortcomings of traditional training and education, and with respect to this, the present study was conducted to determine the effect of virtual education on fathers about infant care and their involvement in infant care. Materials and Methods: The quasi-experimental study was performed on 83 participants in healthcare centers affiliated with North Khorasan University of Medical Sciences. The involvement of fathers in infant care was assessed with a questionnaire of the father's involvement in the care of the infant (mother-reported) in 4-time points: 3-5 days, and 2, 4, and 6 months after birth. Educational materials based on the child's growth and needs and as well as the latest references and national guidelines were prepared, and as the infant grew, were taught step by step to fathers using Soroush's messenger while their questions were answered. Results: The mean score of total father involvement in infant care at two, four, and six months after childbirth was significantly higher in the intervention group than in the control group (p < 0.001). Conclusions: With regard to the lack of access to fathers during their working hours, virtual education can be used to increase their involvement in infant care.

The influence of video-based training on caregiver arrangement of infant sleeping environments.

Recent behavior analytic studies have examined behavioral skills training to teach adults to arrange safe infant sleeping environments. These studies were conducted in an analogue environment and with all training components delivered by an expert staff trainer. The purpose of the current study was to replicate and extend this literature by substituting video-based training for behavioral skills training. We assessed whether expectant caregivers could arrange safe infant sleeping environments following video-based training. The results suggested that video-based training alone resulted in positive outcomes for a portion of participants, whereas a subset of participants required feedback to reach mastery criteria. The social validity data suggest that the participants found the training procedures favorable.

A Family-Based Collaborative Care Model for Treatment of Depressive and Anxiety Symptoms in Perinatal Women: Results From a Pilot Study.

BACKGROUND: Untreated perinatal depression and anxiety can have detrimental consequences on family function. Logistical barriers prevent many perinatal women from accessing treatment, and these barriers are compounded for women residing in rural areas. This paper describes a Family-Based Collaborative Care Model (FBCCM) that is designed to bypass barriers to increase access to care for depressed and anxious perinatal women in rural regions of the United States. The FBCCM includes the following two components: (1) a 10-session video-delivered family therapy treatment for perinatal depression and anxiety and (2) a video-delivered infant care provider training on addressing the parenting needs of depressed and anxious mothers. OBJECTIVE: This paper describes the feasibility of implementing the FBCCM with families and infant care providers. Findings are presented on the preliminary effectiveness of the video-delivered family therapy treatment in reducing maternal depressive and anxiety symptoms, and family conflict. METHODS: This pilot study was carried out using an implementation-effectiveness hybrid trial design without a comparison group. Changes in maternal depressive symptoms, maternal anxiety symptoms, and family conflict were measured at posttreatment, 3 months, and 6 months later. RESULTS: On average, mothers (n=24) attended 9.79 (SD 1.02) sessions. On average, their family members (n=24) attended 9.42 (SD 1.28) sessions. A total of 31 infant care providers attended the training on addressing the parenting needs of depressed and anxious mothers. Mothers reported a significant reduction in depressive symptoms (P<.001) and anxiety symptoms (P<.001) from baseline to the 6-month follow-up. Mothers reported a significant reduction in conflict (P<.001), and their family members also reported a significant reduction in conflict (P=.007) from baseline to the 6-month follow-up. CONCLUSIONS: The findings from this study provide support for the feasibility and preliminary effectiveness of the FBCCM. The findings will be used to inform a larger study of the FBCCM.

Síntomas de estreñimiento funcional y métodos de alimentación complementaria: ensayo clínico aleatorizado / Functional constipation symptoms and complementary feeding methods: A randomized clinical trial

Introducción: El objetivo del estudio fue investigar el impacto de diferentes métodos de alimentación complementaria en la prevalencia de síntomas de estreñimiento funcional en lactantes a los 12 meses de edad. Materiales y métodos: Ensayo clínico aleatorizado realizado en díadas madre-lactante sometidas a intervención a los 5,5 meses del nacimiento, con asignación aleatoria a uno de los tres métodos de introducción de sólidos: destete dirigido por la madre, o parent-led weaning (PLW), método Baby-Led Introduction to Solids (BLISS) dirigido por el lactante, y mixto. Los síntomas de estreñimiento se evaluaron a los 12 meses mediante un cuestionario en línea basado en los criterios diagnósticos de Roma IV y adaptado a la muestra. Los análisis se realizaron mediante la prueba χ2 y los datos se expresaron como frecuencias absolutas y porcentajes. El proyecto fue aprobado por el comité de ética del Hospital de Clínicas de Porto Alegre con el número 2019-0230. Resultados: Se analizaron los datos de 135 lactantes, 45 asignados al método PLW, 48 al BLISS y 42 al método mixto. La prevalencia de síntomas de estreñimiento fue del 49,6% en la muestra global (n=67), siendo del 60% (n=27) en el método PLW, 47,9% (n=23) en el BLISS y 40,5% (n=17) en el mixto. No hubo asociación entre los síntomas de estreñimiento funcional y el método de introducción de la alimentación complementaria (p=0,183). Conclusiones: La prevalencia de estreñimiento y sus síntomas fue alta en la población estudiada. La prevalencia de los síntomas de estreñimiento funcional no se asoció con el método de alimentación complementaria. (AU)

Introduction: The aim of the study was to investigate the impact of different complementary feeding methods on the prevalence of functional constipation symptoms in infants at 12 months of age. Material and methods: Randomized clinical trial in mother–infant dyads that underwent the intervention at 5.5 months post birth, randomly allocated to one of three complementary food introduction methods: PLW (parent-led weaning), baby-led introduction to solids (BLISS) and a mixed approach. The symptoms of constipation were assessed at 12 months with an online questionnaire based on the Rome IV diagnostic criteria and adapted to our sample. The data were summarised as absolute frequencies and percentages and compared by means of the χ2 test. The project was approved by the ethics committee of the Hospital de Clínicas de Porto Alegre under number 2019-0230. Results: We analysed data corresponding to 135 infants, 45 allocated to PLW, 48 to BLISS and 42 to the mixed approach. The prevalence of constipation symptoms was 49.6% in the overall sample (n=67), 60% (n=27) in the PLW group, 47.9% (n=23) in the BLISS group and 40.5% (n=17) in the mixed approach group. We found no association between functional constipation symptoms and the method used to introduce complementary foods (P=.183). Conclusions: The prevalence of functional constipation symptoms was high in the study population. The presence of constipation symptoms was not associated with the complementary feeding approach. (AU)

ABM Clinical Protocol #37: Physiological Infant Care-Managing Nighttime Breastfeeding in Young Infants.

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).

Functional constipation symptoms and complementary feeding methods: A randomized clinical trial.

INTRODUCTION: The aim of the study was to investigate the impact of different complementary feeding methods on the prevalence of functional constipation symptoms in infants at 12 months of age. MATERIAL AND METHODS: Randomized clinical trial in mother-infant dyads that underwent the intervention at 5.5 months post birth, randomly allocated to one of three complementary food introduction methods: PLW (parent-led weaning), Baby-led Introduction to SolidS (BLISS) and a mixed approach. The symptoms of constipation were assessed at 12 months with an online questionnaire based on the Rome IV diagnostic criteria and adapted to our sample. The data were summarised as absolute frequencies and percentages and compared by means of the χ2 test. The project was approved by the ethics committee of the Hospital de Clínicas de Porto Alegre under number 2019-0230. RESULTS: We analysed data corresponding to 135 infants, 45 allocated to PLW, 48 to BLISS and 42 to the mixed approach. The prevalence of constipation symptoms was 49.6% in the overall sample (n = 67), 60% (n = 27) in the PLW group, 47.9% (n = 23) in the BLISS group and 40.5% (n = 17) in the mixed approach group. We found no association between functional constipation symptoms and the method used to introduce complementary foods (P = .183). CONCLUSIONS: The prevalence of functional constipation symptoms was high in the study population. The presence of constipation symptoms was not associated with the complementary feeding approach.

The relationship between psychological contract and occupational wellbeing of mother-infant care helpers in Zhejiang Province.

BACKGROUND: Mother-infant care (MIC) helpers have become an indispensable part in hospital services. In order to stabilize the MIC workforce, it is essential for administrators to have a solid understanding of what may influence occupational wellbeing. This article aims to explore how demographic characteristics and psychological contract affect occupational wellbeing among MIC helpers in Zhejiang Province, China. METHODS: This is a quantitative, cross-sectional study with MIC helpers in obstetrics from 20 hospitals in Zhejiang Province. A questionnaire including demographic data, a psychological contract scale and an occupational wellbeing scale was used in this study. Multiple linear regression was conducted to investigate the relationships between demographic characteristics, psychological contract and occupational wellbeing. RESULTS: This study surveyed 260 MIC helpers and found out the mean score of the psychological contract was 4.38 and the mean score of the occupational wellbeing was 4.01. Monthly income and psychological contract were significant predictors of occupational wellbeing (F = 142.167, p < 0.001), which explained 62.1% of the total amount of variance in occupational wellbeing. Psychological contract was the most important predictor of occupational wellbeing. CONCLUSIONS: Administrators should pay attention to the effect of psychological contract on occupational wellbeing of the MIC helpers in China. Focusing on the inner needs should be considered as a strategy for stabilizing the team.

Functional relationships between estradiol and paternal care in male red-bellied lemurs, Eulemur rubriventer.

Fathers contribute substantially to infant care, yet the mechanisms facilitating paternal bonding and interactions with infants are not as well understood as they are in mothers. Several hormonal changes occur as males transition into parenthood, first in response to a partner's pregnancy, and next in response to interacting with the newborn. These changes may prepare fathers for parenting and help facilitate and maintain paternal care. Experimental studies with monkeys and rodents suggest that paternal care requires elevated estradiol levels, which increase when a male's partner is pregnant and are higher in fathers than non-fathers, but its role in the expression of paternal behaviors throughout infant development is unknown. To assess estradiol's role in paternal care, we analyzed the relationship between paternal estradiol metabolites and 1) offspring age, and 2) paternal care behavior (holding, carrying, huddling, playing, grooming), in wild, red-bellied lemurs (Eulemur rubriventer). We collected 146 fecal samples and 1597 h of behavioral data on 10 adult males who had newborn infants during the study. Estradiol metabolites increased four-fold in expectant males, and in new fathers they fluctuated and gradually decreased with time. Infant age, not paternal behavior, best predicted hormone levels in new fathers. These results suggest that hormonal changes occur in expectant males with facultative paternal care, but they do not support the hypothesis that estradiol is directly associated with the day-to-day expression of paternal care. Future research should explore estradiol's role in facilitating behaviors, including infant-directed attention and responsiveness, or preparing fathers for infant care generally.

Evaluating caregivers arrangement of infant sleeping environments in the home.

Sleep-related infant deaths are one of the top causes of infant mortality in the United States. A few behavior analytic studies have examined behavioral skills training to teach adults to arrange safe infant sleeping environments. These studies were conducted in an analogue environment, and no data were collected outside the training setting. The purpose of the current study was to replicate and extend the extant literature. We taught caregivers to arrange safe infant sleeping environments in a community-based organization. Thereafter, we assessed the feasibility and effectiveness of a technology-based contingency management procedure to examine caregivers' adherence with arrangement of a safe sleeping environment for their newborns across a 2-week period. As in previous studies, behavioral skills training resulted in positive outcomes, and follow-up data suggested that the technology-based contingency management procedure may be a promising approach to promoting adherence with infant sleeping environment recommendations.

Effects of Early Toilet Training and Elimination Communication With Respect to Diaper Types.

To investigate effects of diaper-free times, elimination communication (EC) and early toilet training, a web-based survey was conducted for caregivers. The more diaper-free times an infant experienced during day, the earlier it was toilet trained (P < .001), which was enhanced by the usage of cloth diapers. The amount of diaper-free times significantly reduced the caregiver's continuous sleep, the occurrence of rashes and balm usage (P < .001) and lead to a more regular defecation frequency. Cloth diaper usage had no effect on rashes or balm usage, but on diaper change rate (P < .001). We could show that, although not as effective as full-time EC, part-time EC is more effective if cloth diapers are used, provided they are changed frequently. Furthermore, EC causes a more regular defecation in infants between 1 and 2 years.