Dialogic reading in the rehabilitation of Children with Hearing Loss and the "Born to Read" Project: A pilot study.

The "born to read" initiative entails a dialogic reading to children in poor socio-economical conditions aimed at fostering cognitive and relational skills. Reading is professionally delivered by experts to promote psycho-social development of children and their parents. In this study the project was extended to include children positive at early screening for hearing impairment. A total of 26 children were included and 14 parents were taught to read aloud and emphatically. Reading session were delivered for at least 10 minutes at least 3 times/week, usually at bedtime, for one year. The Griffiths scale were applied to explore the expressive and receptive language skills (Scale C) and eye and hand coordination (Scale D), as measures of linguistic and neurocognitive skills. Program sustainability and reactions by the parents were also investigated. All 14 families successfully received the training, becoming capable of reading aloud and emphatically and provided reading sessions for the entire duration of the study. Children receiving the intervention performed slightly better than controls and those who were exposed to increased number of sessions, performed even better although the differences with controls were not significant. Parents enjoyed reading to their children. They expressed satisfaction and gratitude for being able to play an active and productive role in children rehabilitation. The results of this pilot study suggest that the born to read initiative may be considered in adjunct to medical and psychological interventions to enhance the benefits of early screening of hearing function.

Use of baby carriers to increase breastfeeding duration among term infants: the effects of an educational intervention in Italy.

AIM: To investigate whether the use of baby carriers by term infants during the first month of life is associated with increased rates of breastfeeding. METHODS: Prospective cohort study. Two hundred mothers with healthy term infants were assigned to receive either a baby carrier and some accurate information and training about the use thereof or only information about breastfeeding. Study groups were followed by phone interviews. RESULTS: Of the 100 mothers to whom baby carriers were provided, 69 utilized it for at least 1 h per day during the first month of life, while 31 did not use it at all. While breastfeeding rates were similar in both intervention and control groups at discharge from the maternity ward, mothers in the intervention group scored significantly higher with their infants at two (72% vs 51%) and at 5 months of age (48% vs 24%), respectively. The intervention group infants were breastfed significantly more frequently than those of the control group. CONCLUSIONS: Our finding seems to suggest that the use of baby carriers in healthy term infants during their first month is associated with increased breastfeeding duration.

Feasibility and effectiveness of a population-based newborn hearing screening in an economically deprived region of Italy.

AIM: To describe the effectiveness of a population-based newborn hearing screening program in an economically deprived region of southern Italy. METHODS: A screening protocol was proposed for all newborns of the Campania region, starting on January, 2007. For infants identified with hearing loss, information on degree and type of hearing loss and presence of risk factors was collected. RESULTS: The infants born in the 3-year study period were 182,188. Among them, 146,026 (80%) were tested with OAE. Sensorineural hearing loss ≥40dBnHL was established for 159 infants (1.1×1000). Among the NICU and WIN infants, the rate of hearing loss was respectively 9×1000 and 0.67×1000. Follow-up information was available for 111 children (70%), as 48 (30%) got care in other regions or health facilities. Most infants were fitted hearing aids by 1 month after diagnosis and 15 children (13.5%) received a cochlear implant at a mean age of 25 months (SD 10). CONCLUSIONS: Even in a setting of population poverty, a universal newborn screening program can deliver satisfactory outcomes. The coverage and the tracking system of the program need to be improved, as well as the cooperation between public and private health services.

Breastfeeding and risk for fever after immunization.

OBJECTIVE: The objective of this study was to evaluate the effects of breastfeeding on the risk for fever after routine immunizations. METHODS: A prospective cohort study was conducted at a pediatric vaccination center in Naples, Italy. The mothers of the infants scheduled to receive routine immunizations were instructed on how to measure and record infant temperature on the evening of the vaccination and for the subsequent 3 days. The information about the incidence of fever was obtained by telephone on the third day after vaccination. The relative risk for fever in relation to the type of breastfeeding was estimated in multivariate analyses that adjusted for vaccine dose, maternal education and smoking, and number of other children in the household. RESULTS: A total of 460 infants were recruited, and information on the outcome was obtained for 450 (98%). Fever was reported for 30 (25%), 48 (31%), and 94 (53%) of the infants who were being exclusively breastfed, partially breastfed, or not breastfed at all, respectively (P < .01). The relative risk for fever among infants who were exclusively and partially breastfed was 0.46 (95% confidence interval: 0.33-0.66) and 0.58 (95% confidence interval: 0.44-0.77), respectively. The protection conferred by breastfeeding persisted even when considering the role of several potential confounders. CONCLUSIONS: In this study, breastfeeding was associated with a decreased incidence of fever after immunizations.

A controlled trial of the father's role in breastfeeding promotion.

OBJECTIVE: To investigate whether supporting fathers to recognize the relevance of their role in the success of breastfeeding and teaching them how to prevent and to manage the most common lactation problems would result in more women breastfeeding. METHODS: A controlled trial, in which the participating fathers were allocated in 2-month blocks to a child care training session, was conducted of 280 mothers considering breastfeeding and their 280 partners at a university obstetric department in Naples, Italy. Support and advice about breastfeeding was provided to all of the mothers. Among the fathers of the intervention group, the training session included the management of breastfeeding; among those of the control group, it did not. Primary outcome was the prevalence of full breastfeeding at 6 months. Secondary outcomes were the proportion of women who perceived their milk to be insufficient, who stopped breastfeeding because of problems, and who reported to have received help in breastfeeding management by their partners. RESULTS: The prevalence of full breastfeeding at 6 months was 25% (35 of 140) in the intervention group and 15% (21 of 140) in the control group and that of any breastfeeding at 12 months was 19% (27) and 11% (16), respectively. Perceived milk insufficiency was significantly more frequent among the mothers of the control group (38 [27%] of 140 vs 12 [8.6%] of 140), as well as breastfeeding interruption because of problems with lactation (25 [18%] of 140 vs 6 [4%] of 140). Moreover, significantly more women in the intervention group reported receiving support and relevant help with infant feeding management from their partners (128 [91%] of 140 vs 48 [34%] of 140). Among the women who had reported difficulties with lactation in the intervention and control groups (96 [69%] and 89 [64%], respectively), the prevalence of full breastfeeding at 6 months was 24% and 4.5%, respectively. CONCLUSIONS: Teaching fathers how to prevent and to manage the most common lactation difficulties is associated with higher rates of full breastfeeding at 6 months.