"Unable to Feed My Hungry Child": Experiences of Mothers Caring for Children With Prader-Willi Syndrome.

Mothers' experiences of caring for children with Prader-Willi Syndrome (PWS) is largely unknown. With no treatment for PWS, parents undertake (extra)ordinary care practices to keep children safe from overeating and self harm. Knowledge of these care practices could lead to effective interventions. Narrative inquiry was used to study everyday experience with Canadian mothers. Participants cared for a child 3 to 17 years old who had hyperphagia. Participants were interviewed 8 to 12 times each over the course of a year. Narrative accounts were co-composed through a collaborative process of analysis. Engaging with participants' everyday experiences amplified complex care needs for families and gaps in health and social care systems. Narrative threads focused on engaging in (extra)ordinary care practices, rigid care work to keep children healthy and safe, tension from others while enacting these care practices, and difficulty conforming to social expectations with childrearing and care work. Recommendations for practice and policy include (a) shifting from untenable care practices, (b) reconceptualizing care work, and (c) alternative care models.

Antenatal Care Utilisation among Adolescent Mothers in Ngozi Province, Burundi.

Background: Globally pregnancy and childbirth complications are the leading cause of death among adolescents, with evidence showing that antenatal care (ANC) is a very effective preventive intervention. In Burundi, there is limited information on the extent to which pregnant adolescents utilise such services. Objective: To assess the ANC utilisation and factors associated with its use among adolescent mothers in Ngozi Province, Burundi. Materials and Methods: A cross-sectional, health facility-based study among 216 adolescent mothers who had given birth within two years preceding this study, using structured questionnaires and records from previous ANC booklets. A multistage random sampling technique was used to select respondents while the utilisation of ANC was determined by the frequency of ANC visits and the time when the women enrolled for the first ANC visit. Results: The majority (98.1%) of adolescent mothers in Ngozi Province used ANC services. Most respondents (64.8%) initiated ANC services within the first trimester while 57.8% attained the minimum of four recommended ANC visits. Marital status (P = 0.001), geographical location (P = 0.009), occupation of the partner (P = 0.002) and type of the last pregnancy (P = 0.012) were associated with ANC initiation within the first trimester while marital status (P < 0.001), respondent's employment (P = 0.003) and type of last pregnancy (P < 0.001) were associated with appropriate ANC frequency. Conclusion: This study revealed a high use of ANC services among adolescent mothers, although more than one-third attended ANC late. There is therefore the need to put more effort into improving early booking for ANC.

Emotion work and emotional labour, neglected facets of parental health information work. Analysing mothers of neurodivergent children.

The neoliberal and biomedical 'good caregiver' discourse neglects the many facets of everyday information work that parents of children with special needs are required to do as they seek, receive and share information concerning their children's health and wellbeing. Along with time and skills, one such neglected facet is emotion work, the management of feelings in relation to societal norms. The purpose of this article is to explore emotion work, as a facet in parental health information work in the care and education sector, among mothers of neurodivergent children. Our analysis draws on interviews with 50 Swedish mothers of neurodivergent children. We present three primary insights. 1. Emotion work, on the self as well as on others, is pivotal to the information work that the mothers carry out in the education and care sector as they strive to ameliorate their children's situation. 2. Contested diagnoses, such as diagnoses associated with neurodivergent conditions, result in intense parental information and emotion work. 3. Fragmented and complex education and care systems, alongside traditional gender structures, compel mothers to undertake extensive information and emotion work.

Micronutrient inadequacy among lactating mothers in rural areas of North Mecha District, Amhara Region, Ethiopia.

Background: Lactating mothers are frequently at risk for nutritional deficiencies due to the physiological requirements of lactation. Throughout the world, a significant number of lactating mothers have micronutrient intake inadequacy. Evidence on micronutrient intake during lactation is limited in rural Ethiopia. Therefore, this study aimed to determine micronutrient intake inadequacy and associated factors among lactating mothers. Methods and materials: A community-based cross-sectional study was conducted from February 1 to 18, 2023, among lactating mothers in rural areas of the North Mecha District of Amhara Region, Northwest Ethiopia. A multistage sampling technique was used to select 449 study participants. An interviewer-administered questionnaire was employed to collect dietary intake data by using a single multiphasic interactive 24-h dietary recall. The NutriSurvey 2007 software and Ethiopia, Tanzania and Kenya food composition tables were used to calculate nutrient values for the selected 12 micronutrients. For the remainder of the analysis, SPSS version 25 was employed. The Nutrient Adequacy Ratio (NAR) and Mean Adequacy Ratio (MAR) were calculated by dividing all NAR values by the number of micronutrients computed to evaluate the nutrient intakes. A logistic regression analysis was conducted to determine the factors contributing to the overall micronutrient intake inadequacy, and statistical significance was determined at a p value <0.05. Result: A total of 430 lactating mothers participated in the study, with a 96% response rate and a mean age of 29.46 ± 5.55 years. The overall prevalence of micronutrient intake inadequacy was 72.3% (95% CI: 67.9, 76.5). The odds of micronutrient intake inadequacy were 2.5 times higher among lactating mothers aged 18-25 years old as compared to mothers in the age group ≥36 years old (AOR = 2.52, 95% CI: 1.09, 5.83). Mothers with the educational status of unable to read and write and primary school incomplete were 3.5 (AOR = 3.49, 95% CI: 1.24, 9.83) and 3.6 (AOR = 3.56, 95% CI: 1.06, 11.99) times more likely to have micronutrient intake inadequacy than mothers with secondary school completed or above educational status, respectively. Mothers whose partner's occupation was other than farming were 3.3 times more likely to have micronutrient intake inadequacy as compared to mothers whose partners were engaged in farming (AOR = 3.32, 95% CI: 1.08, 10.27). Lactating mothers who were from food-insecure households were 83% more likely to have high micronutrient intake inadequacy as compared to lactating mothers from food-secure households (AOR = 1.83, 95% CI: 1.04, 3.23). Lactating mothers with nutrition-related unfavorable attitudes were 77% more likely to have inadequate intake of micronutrients compared to lactating mothers with favorable attitudes (AOR = 1.77, 95% CI: 1.07, 2.93). Conclusion: The prevalence of micronutrient intake inadequacy among lactating mothers was high. Age of the mothers, educational status of the mothers, occupation of the partner, household food security, and nutrition-related attitude were significantly associated with micronutrient intake inadequacy. Community driven nutrition education and interventions are needed to address the high micronutrient intake inadequacy among lactating mothers in rural Ethiopia.

Reproductive Justice as an Alternative to the Pregnancy Planning Paradigm for Teens.

In this critical commentary, we describe the many limitations of the pregnancy planning paradigm as applied to pregnant and parenting teens. We describe how this paradigm, in characterizing pregnancies as intended or unintended, has shaped campaigns to prevent teen pregnancy and remains largely embedded in formal sex education and family planning programs in the United States. We argue that a paradigm shift is long overdue and describe how the reproductive justice framework addresses the limitations of the pregnancy planning paradigm. Although reproductive justice is endorsed by a growing number of organizations, recommended policies face formidable obstacles given that comprehensive sex education, contraception, and legal abortion are increasingly at risk in a post-Dobbs world.

Experiences of young mothers with the uptake of Sulfadoxine-Pyrimethamine for intermittent preventive treatment of malaria in pregnancy: a cross-sectional study in the Lake endemic region, Kenya.

Background: A substantial proportion of the world population is affected by malaria with 241 million malaria cases reported globally. Intermittent Preventive Treatment in pregnancy (IPTp) with Sulfadoxine-Pyrimethamine (SP) is an effective chemotherapy but its utilisation has not been optimised. Few studies focus on young mothers and their experiences regarding the optimal uptake of IPTp-SP. Methods: The study design was cross-sectional with data derived from six focus group discussions with mothers aged 15-24 years who had a pregnancy and gave birth to a live baby within the last two years in Kisumu and Migori counties, Kenya. Inductive analysis was used to identify themes and patterns. Results: Young mothers were motivated to take IPTp-SP during pregnancy if they had prior knowledge about SP and its associated benefits and if they were knowledgeable about the consequences of malaria infection during pregnancy. Perceived side effects of SP, lack of awareness of SP as a malaria prevention therapy, lack of knowledge on the benefits of SP, dosage and frequency of uptake, poor communication by health providers towards young mothers, and inconsistent supply of SP at health facilities inhibited young mothers from attaining the recommended 3+ doses of IPTp-SP. Conclusions: There is a need for health literacy programmes that focus on increasing knowledge of IPTp-SP dosage, timing and benefits for both the young pregnant mother and her foetus. Community engagement through dialogue with mentor mothers and male partners will be an important complementary approach in establishing a support system for young women for positive health outcomes including attaining the recommended 3+ doses of IPTp-SP.

Effectiveness of family metacognitive training in mothers with psychosis and their adolescent children: a multicenter study protocol.

Background: More than half of women with psychosis take care of their children despite the difficulties caused by the disease. Additionally, these kids have a higher risk of developing a mental health disorder. However, no interventions have been developed to meet these needs. Metacognitive Training (MCT) is a psychological intervention that has demonstrated its efficacy in improving cognitive insight, symptom management and social cognition in people with first-episode psychosis (FEP). Additionally, MCT has shown better results in women than men with FEP. This study aims to adapt and evaluate the efficacy of MCT-F in mothers and adolescent children in an online group context with the main purpose of improving family relationships, cognitive awareness and symptoms in women with psychosis and increase their children's knowledge of the disease and their functioning. As secondary objectives, it also aims to evaluate improvements in metacognition, social cognition, symptoms, protective factors and self-perception of stigma. Materials and methods: A quasi-experimental design with participants acting as their own control will be carried out. Forty-eight mothers with psychosis and their adolescent children (between 12 and 20 years old) recruited from a total of 11 adult mental health care centers will receive MCT-F. Participants will be evaluated 11 weeks before the intervention (T1), at baseline (T2), and post-intervention (T3) with a cognitive insight scale, as a primary outcome. Measures of metacognitive and social cognition, symptoms, cognitive functioning, family and social functioning, protective factors (self-esteem, resilience, and coping strategies) and self-perceived stigma will be addressed as secondary outcomes. Assessment will also address trauma and attachment in mothers and, lastly, the feasibility and acceptability of MCT-F in both participant groups. Discussion: This will be the first investigation of the efficacy, acceptability, and viability of the implementation of MCT-F. The results of this study may have clinical implications, contributing to improving mothers' with psychosis and adolescents' functioning and better understanding of the disease, in addition to the possible protective and preventive effect in adolescents, who are known to be at higher risk of developing severe mental disorders.Clinical trial registration:https://clinicaltrials.gov/, identifier [NCT05358457].

Maternal satisfaction with delivery service and associated factors among women who gave birth at public hospitals in Guji Zone, Southern Ethiopia.

BACKGROUND: Maternal satisfaction during delivery services is considered an important indicator of the quality of healthcare in a hospital setting and determines the uptake of services during subsequent pregnancies. However, there is limited information on the magnitude of women's satisfaction during delivery services in the study area. Thus, this study aimed to assess factors associated with maternal satisfaction with delivery services among women who gave birth at public hospitals in Guji Zone, Southern Ethiopia. METHOD: A facility-based cross-sectional study was conducted at public hospitals in Guji Zone from December 1, 2020, to January 30, 2021. Two hundred forty-nine women who gave birth at public hospitals were recruited by a systematic random sampling technique. The collected data were entered into the Epi Info 7 software and then exported to SPSS Version 26 for analysis. A logistic regression model was employed to identify the association between independent variables and maternal satisfaction during delivery services. A P-value less than 0.05 and an Adjusted Odds Ratio with 95% CI was computed to determine the strength of the association between these variables. RESULT: In this study, 138(55.4%), 95% CI (49.1-61.7) women were satisfied with delivery. Mothers who delivered through cesarean section (AOR = 2.92, 95% CI: 1.34-6.33), privacy assured (AOR = 3.14, 95% CI: 1.76-5.59), shorter duration of labor (AOR = 2.82, 95% CI: 1.64-4.62), waiting time ≤ 30 min (AOR = 5.15,95% CI:1.99-13.32) and normal fetal outcome (AOR = 2.63, 95% CI:1.42-4.85) were associated with mothers satisfaction with delivery care services. CONCLUSION: The overall magnitude of women's satisfaction with delivery services is low, which is below the national client satisfaction target of ≥ 85%. Factors such as mode of delivery, assured privacy, short duration of labor, waiting time ≤ 30 min, and good fetal outcome were significantly associated with women's satisfaction with delivery services. Therefore, healthcare providers should provide better management during intrapartum childbirth or emergency obstetric care to improve fetal outcomes during delivery services. In addition, health facility managers should avail infrastructure that helps to maintain the privacy of women who give birth in the facility.

Mapping the well-being of Norwegian mothers during the COVID-19 pandemic.

The COVID-19 pandemic had negative effects on many people's well-being and quality of life. In the present work, we focused on Norwegian mothers with elementary school children, and investigated whether their well-being, stress, and worries (and the relationships between them) changed across the early months of the pandemic. We collected data at two time points in 2020. In June 2020, 231 mothers (mean age = 40.09, SD = 6.22) responded to an online questionnaire in which they were asked to indicate their well-being, stress, and worries before the pandemic, during the lockdown (i.e., March 2020), and currently (i.e., June 2020). Of these 231 mothers, 97 (mean age = 40.58, SD = 5.66) answered the same questionnaire again in November 2020. Mothers' well-being was lower in November 2020 than before the pandemic (retrospectively reported). The age of the youngest child showed the strongest and most consistent relationship with mothers' well-being across all time points. In addition, we found that the stress mothers felt during the national lockdown in March 2020 was strongly associated with their well-being both during the lockdown and in June 2020. Finally, in November 2020, mothers' financial pandemic-related worries were negatively related to their well-being. Implications and suggestions for future research and for how societies can cope with future health-related crises are discussed.

Mental Health of Mothers with Malnourished Children in Nepal: A Prospective Observational Study.

BACKGROUND: Maternal mental health may influence the nutritional status of their children. It was intended to assess the mental health status of the mothers of children admitted to a nutrition rehabilitation center. We specifically explored the relationship between maternal mental health and malnutrition of the child; to observe any change of maternal depressive/anxiety symptoms and weight gain in the child following admission. METHODS: In a prospective observational study, malnutrition of children was assessed based on weight for height z scores using the WHO Anthro-Survey-Analyser. We evaluated anxiety using the Generalized Anxiety Disorder Scale (GAD-7) and depression by Patient Health Questionnaire (PHQ-9). Demographic and clinical variables were collected. RESULTS: The degree of malnutrition of the children at admission and discharge was: mild (3.6% v 31.7%), moderate (37.7% v 26.3%), severe (58.7% v 8.4%), and no malnutrition (0.0% v 33.5%) (p<0.001). At admission, 12% of mothers had anxiety, depression, or both, which decreased to 3.0% at the time of discharge. There was no difference in malnutrition scores among children of mothers with or without anxiety/depression at admission or discharge, except that children of depressed mothers continued to have significantly greater levels of malnutrition at discharge compared with the mothers without depression. Maternal anxiety or depression was not associated with the severity of malnutrition. CONCLUSIONS: A proportion of mothers of children with malnutrition had clinical anxiety and depression; and maternal mental health concerns, especially depression may influence the nutrition of children. It is imperative to explore maternal mental health routinely for malnourished children.

" He's not beating me"-Socio-cultural construction of intimate partner violence and traditional birth attendants: implications for maternal & child health in rural communities in Hohoe, Ghana.

Introduction: Most research on Intimate Partner Violence (IPV) focuses on the physical, sexual and psychological abuse, with less focus on the financial abuse. This study explores nursing mothers' experiences and perceptions of financial and material support from their significant others and traditional birth attendants' (TBA) observations of support to nursing mothers in their communities. Methods: Using purposive sampling, focus groups and interviews were conducted primarily in Ewe language among nursing mothers and TBAs in rural communities in Hohoe, Volta region, Ghana. All discussions were audio-recorded and transcribed for analysis. Thematic analysis guided by the social constructivist framework was used in data analysis. Results: Twenty-seven women participated in the study, ranging in ages from 19 to 82 (20 nursing mothers; 7 TBAs). Most participants were married (19) and about 65% reported working outside the home (10 nursing mothers; 7 TBAs). Two themes emerged from the data analysis: Lack of support from partners for housekeeping chores and finances; and TBAs as mediators. Nursing mothers who reported lack of financial support did not perceive it as abuse, rather as hinderance to their efforts to care for their children. TBAs act as mediators interceding on behalf of nursing mothers with their husbands and fathers of their children, while also seeking resources to support them. Discussion: Understanding the perceptions and socio-cultural meanings women attached to IPV experience is essential for effective intervention to reduce IPV. In addition, TBAs can be a resource in intervening to alleviate IPV in their communities, thereby improving maternal and child health.

The emotional and social concerns of mothers of children with cleft palate: A cross-sectional study.

PROBLEM: Among birth defects, a cleft palate is one of the most common defects globally, with a prevalence rate of 1 in 700 live-born children per annum. Caring for a child with cleft palate is considered a challenge for mothers who provide around clock care for these children. Despite this, there is limited knowledge of their experiences and needs particularly in low resource settings. BACKGROUND: Previous literature emphasized that mothers of children with cleft palate face many challenges involving emotional distress, social isolation, and financial burden. QUESTION: To investigate the emotional and social concerns of mothers of children with Cleft Palate compared to mothers of children without cleft palate. METHODS: A comparative study design was conducted at the Jordanian Royal Medical Services using convenience sample of 312 mothers of children with and without cleft palate in Jordan. FINDINGS: There was a significant difference in the presence of anxious feelings between mothers of children with cleft palate and those mothers without cleft palate children. Within group comparison for mothers of children with cleft palate has shown a significant difference in their social concerns with regards to social support and child's future. DISCUSSION: Mothers of children with cleft palate reported significantly higher levels of sadness feelings. These emotions could be attributed to several factors, including the financial burden associated with medical treatment and interventions, the burden of caring for a child with special needs, the social stigma related to the child's appearance, the lack of public awareness, and the insufficient social support services. CONCLUSION: Mothers of children with Cleft Palate experience a considerable amount of emotional and social concerns which require urgent interventions.

Impact of maternal HIV infection on perinatal outcomes: A systematic review.

BACKGROUND: Maternal HIV infection remains a significant global health concern with potential repercussions on perinatal outcomes. Emphasis on early intervention to improve peri- and postnatal outcomes in infected mothers and infants is a valid therapeutic concern. OBJECTIVES: To comprehensively analyze perinatal outcomes associated with maternal HIV infection and evaluate adverse effects associated with the HIV infection in the existing literature. SEARCH STRATEGY: A comprehensive search of PubMed, MEDLINE, and Google Scholar was conducted from 2013 to September 2023, using relevant MeSH terms. SELECTION CRITERIA: The included studies encompassed original studies, cross-sectional, prospective, retrospective studies and observational studies focused on perinatal outcomes in the context of maternal HIV infection. DATA COLLECTION AND ANALYSIS: The selected studies underwent rigorous data collection and comprehensive quality checks and adhered to the PRISMA guidelines. MAIN RESULTS: Nine eligible studies from Brazil, China, India, Malawi, Nigeria, Tanzania, the USA, and Canada were included. These studies have consistently demonstrated that maternal HIV infection is associated with adverse perinatal outcomes. The analysis revealed a higher risk of preterm birth (OR 1.57, 95% CI: 1.39-1.78), low birth weight (OR 1.33, 95% CI: 1.18-1.49), and small for gestational age (OR 1.38, 95% CI: 1.24-1.53) among infants born to mothers living with HIV. Notably, the impact of antiretroviral treatment (ART) on these outcomes varied, but maternal HIV infection remained a significant risk factor regardless of income level and geographic region. CONCLUSION: Maternal HIV infection is consistently associated with adverse perinatal outcomes, emphasizing the need for targeted interventions and improved prenatal care in pregnant women with HIV infection.

Home-schooling and caring for children during the COVID-19 lockdown in the UK: emotional states, systems of support and coping strategies in working mothers.

Introduction: We examined the experience of the intensification of home-schooling and/or childcare in working mothers in the United Kingdom during the first national COVID-19 lockdown. Our focus was on understanding how mothers dealt with this challenging period both emotionally and practically. Methods: Eligible mothers (n = 47; Mage = 39.6) participated in an anonymous online survey of openended questions. Results: Thematic analysis of responses showed that mothers found home-schooling and/or childcare to be challenging. This was particularly notable in situations where support from partners, schools, and workplaces was limited. For single working mothers, the absence of support resources was especially impactful. Mothers often felt overly stressed trying to balance work and family responsibilities, guilty for not meeting their child's needs, and were worried over their child's well-being and academic progress and over increasing work demands. Common strategies mothers used to cope with the challenges of home-schooling and/or childcare included adopting a positive outlook, implementing flexible family structures, increasing family connectedness, and negotiating alternative partnership models. Discussion: The intensification of home-schooling and/or childcare during the lockdown in the United Kingdom negatively affected maternal well-being, particularly due to limited support. These findings underscore the importance of prioritizing maternal wellbeing in post-pandemic recovery efforts. Additionally, they highlight the social dimension of maternal wellbeing and suggest a comprehensive approach to support it that includes both timely access to intervention for mental health but also implementing family-friendly work policies and offering support with childcare and children's learning as essential measures.

Parental reflective functioning in mothers and fathers of preschoolers: Associations with adult attachment and parenting behavior.

Parental reflective functioning (PRF) is considered a key parental competence. Since most research on PRF has focused on infancy or the first years of life, there is a gap in our understanding of PRF among parents of older children. Therefore, we investigated PRF in mothers and fathers with preschool-aged children, examining associations between PRF, parent's romantic attachment, and observed parenting behavior. The sample comprised 50 mothers, 40 fathers, and their 5-year-old children. PRF was assessed using the parental reflective functioning questionnaire (PRFQ), parental romantic attachment was assessed using the experiences in close relationships scale-revised (ECR-R), and parenting behavior was assessed during a parent-child free-play interaction with the coding interactive behavior (CIB) coding system. Results showed that mothers scored higher on the interest and curiosity scale than fathers, indicating that mothers show a more active interest and curiosity in their child's mental states. Further, higher levels of attachment anxiety in fathers were associated with higher levels of pre-mentalizing modes. In mothers, higher levels of attachment avoidance were associated with lower levels of interest and curiosity. Finally, and unexpectedly, higher levels of interest and curiosity in mothers were associated with less sensitivity during free play. In summary, the study found meaningful associations between mothers' and fathers' romantic attachment and their PRF indicating a spill-over of their attachment strategies into their relationship with their child. Further, the study results suggest that very high levels of interest and curiosity in mothers reflect hypermentalizing.

From womb to world: mapping gut microbiota-related health literacy among Italian mothers, a cross-sectional study.

BACKGROUND: The gut microbiota is a key determinant of long-term health. Promoting maternal health literacy may enhance children well-being. Aim of the present study was to assess gut microbiota-related health literacy of Italian women and identify potential gaps in awareness. METHODS: A cross-sectional survey study was conducted using an online questionnaire (17 questions) on determinants and long-term impact of infant gut microbiota. The survey targeted Italian pregnant women and mothers of children under 2 years old, and was distributed through various social media channels between September 28th and November 15th, 2022. A total score was calculated as the sum of positive answers. Data on demographics, pregnancy status, and pre-existing knowledge of the infant gut microbiota were also collected. Descriptive and inferential statistics were applied. RESULTS: The questionnaire was completed by 1076 women. Median total score was 9 [7-11]. The 81.7% of respondents declared prior knowledge of the gut microbiota. The internet was among the most commonly cited primary sources of information. Independent predictors of total score were having a university degree (B = 0.656, p = 0.002) and prior knowledge (B = 2.246, p < 0.001). Conversely, older age was associated with lower total scores (B = -0.092, p < 0.001). The least known determinants of infant gut microbiota were gestational BMI, prematurity, mode of delivery and NICU stay. Pregnant women failed to recognize the role of breastfeeding in the development of infant gut microbiota more frequently than non-pregnant women. The 97.5% of participants reported increased interest in the gut microbiota, with heightened interest associated with prior knowledge. CONCLUSIONS: Our study revealed a moderate level of knowledge about infant gut microbiota among respondents, emphasizing the positive impact of prior knowledge on understanding and interest. Targeted educational interventions are needed to address awareness gaps, especially concerning the influence of breastfeeding on infant gut microbiota. Healthcare providers have the potential to enhance women's knowledge and awareness of this topic.

Lactation support in neonatal intensive care units in Germany from the mothers' perspective - a mixed-method study of the current status and needs.

BACKGROUND: Establishing successful lactation in mothers of very low birth weight (VLBW, <1500g) infants requires structured lactation support. Little is known about mothers' perspectives on lactation support in German neonatal intensive care units (NICUs). METHODS: This paper features a convergent mixed-method approach that includes a retrospective, cross-sectional questionnaire and interview data to showcase mothers' perceptions of lactation support in NICUs. Content analysis of the interviews (n = 12) and a descriptive analysis of quantitative data (n = 533) were performed to illustrate the current status and need for lactation support in German NICUs. RESULTS: The results show that lactation support in German NICUs is often inadequate and does not comply with recommendations based on the existing literature to encourage pumping and breastfeeding in mothers. The data imply that even if lactation is successfully initiated in most cases, it is often not maintained over time, which may be due to a lack of personal support and consistent information. CONCLUSION: The overall structures and institutional guidelines for lactation support should be encouraged to promote nutrition with mother´s own milk in German NICUs.

Fluctuations in adult attachment among experienced mothers during re-transitioning to motherhood.

Transition to motherhood encompasses intensive caring for another and thus may activate adult attachment. The current study aimed to examine the fluctuations in adult attachment among the rarely examined population of experienced mothers during their re-transition to motherhood. A sample of 186 Israeli women was followed at the third trimester of pregnancy (T1), 2 months (T2) and 5 months (T3) after giving birth. Participants completed questionnaires regarding their background variables and adult attachment. The findings showed that while anxious attachment remained stable, avoidant attachment decreased from the end of pregnancy to 8 weeks and 5 months after delivery. Despite its relative stability, adult attachment may fluctuate during significant life transitions in a way that is adjusted to the demands of the changing reality. This fluctuation may occur even when individuals have already experienced a life transition.

Arab mothers' viewpoints: Why their children are removed from home.

BACKGROUND: Many studies have explored the impact of child removal on both children and professionals, but there is limited research on the experiences of mothers whose children social services had removed from their homes, particularly within Arab society. OBJECTIVE: This study focused on Arab mothers from East Jerusalem-an ethnic minority in Israel's society, that faces unique challenges-whose children removed from home. The study examines, from the mothers' perspectives (1) reasons for the removal, and (2) relationships with welfare services. METHODS: 15 Arab mothers from East Jerusalem, aged 25 to 49 who had at least one child removed through a court order participated in the study. Nine of the mothers were divorced, separated, or widowed. RESULTS: The mothers described several reasons for their children's removal, including domestic violence and lack of support from their own families after leaving abusive husbands, poverty leading to what social services interpreted as neglect, the child's challenging behavior, and false accusations. The second theme reveals a lack of cooperation between social workers and the mothers, and social workers' negative perceptions of the mothers hindering reunification. CONCLUSIONS: The study sheds light, for the first time as far as we know, on the perspectives of Arab mothers concerning their children's removal. Early support could avert removal, and social workers should make greater efforts to promote child reunification. It is paramount that professionals build trust with these mothers, through culturally sensitive and empowering engagement.