Breastfeeding and infant feeding الرضاعة

۞وَٱلۡوَٰلِدَٰتُ يُرۡضِعۡنَ أَوۡلَٰدَهُنَّ حَوۡلَيۡنِ كَامِلَيۡنِۖ لِمَنۡ أَرَادَ أَن يُتِمَّ ٱلرَّضَاعَةَۚ وَعَلَى ٱلۡمَوۡلُودِ لَهُۥ رِزۡقُهُنَّ وَكِسۡوَتُهُنَّ بِٱلۡمَعۡرُوفِۚ لَا تُكَلَّفُ نَفۡسٌ إِلَّا وُسۡعَهَاۚ لَا تُضَآرَّ وَٰلِدَةُۢ بِوَلَدِهَا وَلَا مَوۡلُودࣱ لَّهُۥ بِوَلَدِهِۦۚ وَعَلَى ٱلۡوَارِثِ مِثۡلُ ذَٰلِكَۗ فَإِنۡ أَرَادَا فِصَالًا عَن تَرَاضࣲ مِّنۡهُمَا وَتَشَاوُرࣲ فَلَا جُنَاحَ عَلَيۡهِمَاۗ وَإِنۡ أَرَدتُّمۡ أَن تَسۡتَرۡضِعُوٓاْ أَوۡلَٰدَكُمۡ فَلَا جُنَاحَ عَلَيۡكُمۡ إِذَا سَلَّمۡتُم مَّآ ءَاتَيۡتُم بِٱلۡمَعۡرُوفِۗ وَٱتَّقُواْ ٱللَّهَ وَٱعۡلَمُوٓاْ أَنَّ ٱللَّهَ بِمَا تَعۡمَلُونَ بَصِيرࣱ‏

Mothers suckle their children for two whole years, if they wish to complete the term, and clothing and maintenance must be borne by the father in a fair manner. No one should be burdened with more than they can bear: no mother shall be made to suffer harm on account of her child, nor any father on account of his. The same duty is incumbent on the father’s heir. If, by mutual consent and consultation, the couple wish to wean [the child], they will not be blamed, nor will there be any blame if you wish to engage a wet nurse, provided you pay as agreed in a fair manner. Be mindful of God, knowing that He sees everything you do

وَأَوۡحَيۡنَآ إِلَىٰٓ أُمِّ مُوسَىٰٓ أَنۡ أَرۡضِعِيهِۖ فَإِذَا خِفۡتِ عَلَيۡهِ فَأَلۡقِيهِ فِي ٱلۡيَمِّ وَلَا تَخَافِي وَلَا تَحۡزَنِيٓۖ إِنَّا رَآدُّوهُ إِلَيۡكِ وَجَاعِلُوهُ مِنَ ٱلۡمُرۡسَلِينَ

We inspired Moses’ mother, saying, ‘Suckle him, and then, when you fear for his safety, put him in the river: do not be afraid, and do not grieve, for We shall return him to you and make him a messenger.’

وَوَصَّيۡنَا ٱلۡإِنسَٰنَ بِوَٰلِدَيۡهِ حَمَلَتۡهُ أُمُّهُۥ وَهۡنًا عَلَىٰ وَهۡنࣲ وَفِصَٰلُهُۥ فِي عَامَيۡنِ أَنِ ٱشۡكُرۡ لِي وَلِوَٰلِدَيۡكَ إِلَيَّ ٱلۡمَصِيرُ

We have commanded people to be good to their parents: their mothers carried them, with strain upon strain, and it takes two years to wean them. Give thanks to Me and to your parents- all will return to Me

وَوَصَّيۡنَا ٱلۡإِنسَٰنَ بِوَٰلِدَيۡهِ إِحۡسَٰنًاۖ حَمَلَتۡهُ أُمُّهُۥ كُرۡهࣰ ا وَوَضَعَتۡهُ كُرۡهࣰ اۖ وَحَمۡلُهُۥ وَفِصَٰلُهُۥ ثَلَٰثُونَ شَهۡرًاۚ حَتَّىٰٓ إِذَا بَلَغَ أَشُدَّهُۥ وَبَلَغَ أَرۡبَعِينَ سَنَةࣰ قَالَ رَبِّ أَوۡزِعۡنِيٓ أَنۡ أَشۡكُرَ نِعۡمَتَكَ ٱلَّتِيٓ أَنۡعَمۡتَ عَلَيَّ وَعَلَىٰ وَٰلِدَيَّ وَأَنۡ أَعۡمَلَ صَٰلِحࣰ ا تَرۡضَىٰهُ وَأَصۡلِحۡ لِي فِي ذُرِّيَّتِيٓۖ إِنِّي تُبۡتُ إِلَيۡكَ وَإِنِّي مِنَ ٱلۡمُسۡلِمِينَ

We have commanded man to be good to his parents: his mother struggled to carry him and struggled to give birth to him- his bearing and weaning took a full thirty months. When he has grown to manhood and reached the age of forty he [may] say, ‘Lord, help me to be truly grateful for Your favours to me and to my parents; help me to do good work that pleases You; make my offspring good. I turn to You; I am one of those who devote themselves to You.’

أَسۡكِنُوهُنَّ مِنۡ حَيۡثُ سَكَنتُم مِّن وُجۡدِكُمۡ وَلَا تُضَآرُّوهُنَّ لِتُضَيِّقُواْ عَلَيۡهِنَّۚ وَإِن كُنَّ أُوْلَٰتِ حَمۡلࣲ فَأَنفِقُواْ عَلَيۡهِنَّ حَتَّىٰ يَضَعۡنَ حَمۡلَهُنَّۚ فَإِنۡ أَرۡضَعۡنَ لَكُمۡ فَـَٔاتُوهُنَّ أُجُورَهُنَّ وَأۡتَمِرُواْ بَيۡنَكُم بِمَعۡرُوفࣲۖ وَإِن تَعَاسَرۡتُمۡ فَسَتُرۡضِعُ لَهُۥٓ أُخۡرَىٰ

House the wives you are divorcing according to your means, wherever you house yourselves, and do not harass them so as to make their lives difficult. If they are pregnant, maintain them until they are delivered of their burdens; if they suckle your infants, pay them for it. Consult together in a good way- if you make difficulties for one another, another woman may suckle the child for the father––

Mothers shall suckle their children two whole years-for those who desire to complete the suckling. Great is that Lord who is unique in loving kindness and without peer in caressing servants. He be- stows in testing, He is loyal to assurances. If we call Him, He hears, and if we do not, He knows. He is generous, loving, love-showing, and love-increasing; gentle, defect-hiding, excuse-hearing, a good God. His bounty is beyond all bounty, His generosity beyond all generosity, His mercy greater than all mercies, His love not like other loves. The example given of utmost mercy is the mercy of mothers, but God's mercy toward His servants is more than that, and His love is not like their love. Do you not see that He commands mothers to give milk to their children for two complete years, He urges them to nurture them, and He counsels them to take care of them? He does not confine Himself to the

Mothers shall suckle their children for two full years kāmilayn ‘two full ones’ is an adjective for emphasis; this is for such as desire to fulfil the suckling and this is the maximum length of time. It is for the father to provide food for them the mothers and clothe them during the suckling if they be divorced honourably to the best of his ability. No soul is charged save to its capacity its ability; a mother shall not be harmed by her child that is on account of the child by being forced to suckle it if she does not want to; neither should a father be harmed by his child that is on account of it by being charged with more than he is able to bear. The mention of both parents here in relation to the child is intended to show sympathy for both. The heir the one inheriting from his father that is the young man who is the trustee of his father’s property has a similar duty to that of the f

(�till, when he attaineth full strength and reacheth forty years�) [46:15]. 'Ata' reported that Ibn 'Abbas said: �This verse was revealed about Abu Bakr al-Siddiq, may Allah be well pleased with him. He had travelled with the Messenger of Allah, Allah bless him and give him peace - when he was eighteen years old and the Messenger of Allah, Allah bless him and give him peace, was twenty - to Syria for trade. When they reached a place where there was a lotus tree, the Messenger of Allah, Allah bless him and give him peace, sat under the shade of this tree while Abu Bakr went to a monk nearby to ask him about religion. The monk then asked Abu Bakr: 'Who is that man under the shade of the lotus?' Abu Bakr said: 'He is Muhammad ibn 'Abd Allah ibn 'Abd al-Muttalib'. The monk said: 'By Allah, he is a Prophet. No one sat under the shade of this tree after Jesus, son of Mary, except Muhammad the

And We revealed by inspiration or in a dream to the mother of Moses — who was the said new-born; his sister was the only other person aware of his birth — ‘Suckle him then when you fear for him cast him into the waters namely the Nile and do not fear that he should drown or grieve for being separated from him for We will restore him to you and make him one of the messengers’. She suckled him for three months during which he never cried. She then began to fear for him and so she placed him in a basket coated with pitch and made as a cradle for him on the inside. She then closed it and cast it into the waters of the Nile at night.

And We have enjoined man concerning his parents We commanded him to be dutiful towards them — his mother bears him and weakens in weakness after weakness that is to say she is weakened by the pregnancy the pains of labour and the delivery; and his weaning is in two years and We said to him to man ‘Give thanks to Me and to your parents. To Me is the journey’s end the return.

And We inspired the mother of Musa: "Suckle him (Musa), but when you fear for him, then cast him into the river and fear not, nor grieve. Verily, We shall bring him back to you, and shall make him one of the Messengers. (7)Then the household of Fir'awn picked him up, that he might become for them an enemy and a (cause of) grief. Verily, Fir'awn, Haman and their armies were sinners (8)And the wife of Fir'awn said: "A comfort of the eye for me and for you. Kill him not, perhaps he may be of benefit to us, or we may adopt him as a son." And they perceived not (9) How Musa's Mother was inspired and shown what to do It was mentioned that when Fir'awn killed so many of the males of the Children of Israel, the Copts were scared that the Children of Israel would die out, and they themselves would have to do the heavy labor that the Children of Israel used to do. So they said to Fir'awn, "If th

حَدَّثَنَا أَحْمَدُ بْنُ مَنِيعٍ، حَدَّثَنَا إِسْمَاعِيلُ بْنُ إِبْرَاهِيمَ، حَدَّثَنَا عَلِيُّ بْنُ زَيْدٍ، عَنْ سَعِيدِ بْنِ الْمُسَيَّبِ، عَنْ عَلِيِّ بْنِ أَبِي طَالِبٍ، قَالَ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم ‏ "‏ إِنَّ اللَّهَ حَرَّمَ مِنَ الرَّضَاعِ مَا حَرَّمَ مِنَ النَّسَبِ ‏"‏ ‏.‏ قَالَ وَفِي الْبَابِ عَنْ عَائِشَةَ وَابْنِ عَبَّاسٍ وَأُمِّ حَبِيبَةَ ‏.‏ قَالَ أَبُو عِيسَى حَدِيثُ عَلِيٍّ حَسَنٌ صَحِيحٌ ‏.‏

Ali (bin Abi Talib) narrated that The Messenger of Allah said:“Indeed Allah has made unlawful through suckling whatever He made unlawful through lineage.”

حَدَّثَنَا بُنْدَارٌ، حَدَّثَنَا يَحْيَى بْنُ سَعِيدٍ الْقَطَّانُ، حَدَّثَنَا مَالِكٌ، ح وَحَدَّثَنَا إِسْحَاقُ بْنُ مُوسَى الأَنْصَارِيُّ، قَالَ حَدَّثَنَا مَعْنٌ، قَالَ حَدَّثَنَا مَالِكٌ، عَنْ عَبْدِ اللَّهِ بْنِ دِينَارٍ، عَنْ سُلَيْمَانَ بْنِ يَسَارٍ، عَنْ عُرْوَةَ بْنِ الزُّبَيْرِ، عَنْ عَائِشَةَ، قَالَتْ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم ‏ "‏ إِنَّ اللَّهَ حَرَّمَ مِنَ الرَّضَاعَةِ مَا حَرَّمَ مِنَ الْوِلاَدَةِ ‏"‏ ‏.‏ قَالَ أَبُو عِيسَى هَذَا حَدِيثٌ حَسَنٌ صَحِيحٌ ‏.‏ وَالْعَمَلُ عَلَى هَذَا عِنْدَ أَهْلِ الْعِلْمِ مِنْ أَصْحَابِ النَّبِيِّ صلى الله عليه وسلم وَغَيْرِهِمْ لاَ نَعْلَمُ بَيْنَهُمْ فِي ذَلِكَ اخْتِلاَفًا ‏.‏

Aishah narrated that the Messenger of Allah said:“Indeed Allah has made unlawful through suckling whatever He made unlawful through birth.”

حَدَّثَنَا يَحْيَى بْنُ يَحْيَى، قَالَ قَرَأْتُ عَلَى مَالِكٍ عَنْ عَبْدِ اللَّهِ بْنِ أَبِي بَكْرٍ، عَنْ عَمْرَةَ، أَنَّ عَائِشَةَ، أَخْبَرَتْهَا أَنَّ رَسُولَ اللَّهِ صلى الله عليه وسلم كَانَ عِنْدَهَا وَإِنَّهَا سَمِعَتْ صَوْتَ رَجُلٍ يَسْتَأْذِنُ فِي بَيْتِ حَفْصَةَ ‏.‏ قَالَتْ عَائِشَةُ فَقُلْتُ يَا رَسُولَ اللَّهِ هَذَا رَجُلٌ يَسْتَأْذِنُ فِي بَيْتِكَ ‏.‏ فَقَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم ‏"‏ أُرَاهُ فُلاَنًا ‏"‏ ‏.‏ لِعَمِّ حَفْصَةَ مِنَ الرَّضَاعَةِ ‏.‏ فَقَالَتْ عَائِشَةُ يَا رَسُولَ اللَّهِ لَوْ كَانَ فُلاَنٌ حَيًّا - لِعَمِّهَا مِنَ الرَّضَاعَةِ - دَخَلَ عَلَىَّ قَالَ رَسُولُ اللَّهِ صلى الله عليه وسلم ‏"‏ نَعَمْ إِنَّ الرَّضَاعَةَ تُحَرِّمُ مَا تُحَرِّمُ الْوِلاَدَةُ ‏"‏ ‏.‏

A'isha (Allah be pleased with her) reported tha Allah's Messenger (ﷺ) was with her and she heard the voice of a person seeking permission to enter the house of Hafsa. 'A'isha (Allah he pleased with her) said:Allah's Messenger, he is the person who seeks permission to enter your house, whereupon Allah's Messenger (ﷺ) said: I think he is so and so (uncle of Hafsa by reason of fosterage). 'A'isha said: Messenger of Allah, if so and so (her uncle by reason of fosterage) were alive, could he enter my house? Allah's Messenger (ﷺ) said: Yes. Fosterage makes unlawful what consanguinity makes unlawful

حَدَّثَنَا يَحْيَى بْنُ يَحْيَى، قَالَ قَرَأْتُ عَلَى مَالِكٍ عَنِ ابْنِ شِهَابٍ، عَنْ عُرْوَةَ بْنِ الزُّبَيْرِ، عَنْ عَائِشَةَ، أَنَّهَا أَخْبَرَتْهُ أَنَّ أَفْلَحَ - أَخَا أَبِي الْقُعَيْسِ - جَاءَ يَسْتَأْذِنُ عَلَيْهَا وَهُوَ عَمُّهَا مِنَ الرَّضَاعَةِ بَعْدَ أَنْ أُنْزِلَ الْحِجَابُ قَالَتْ فَأَبَيْتُ أَنْ آذَنَ لَهُ فَلَمَّا جَاءَ رَسُولُ اللَّهِ صلى الله عليه وسلم أَخْبَرْتُهُ بِالَّذِي صَنَعْتُ فَأَمَرَنِي أَنْ آذَنَ لَهُ عَلَىَّ ‏.‏

A'isha (Allah be pleased with her) reported that Aflah, the brother of Abu'l-Qu'ais, who was her uncle by reason of fosterage, came, and asked her permission (to enter the house) after seclusion (Hijab) was instituted. I refused to admit him. When Allah's Messenger (ﷺ) came, I informed him what I had done. He commanded me to grant him permission (as the brother of her foster-father was also her uncle)

العاشر أن تكون محرمة بالرضاع ويحرم من الرضاع ما يحرم من النسب من الأصول والفصول كما سبق ولكن المحرم خمس رضعات وما دون ذلك لا يحرم

وهذا غلط لأن بيع الخمور باطل إذ لم يبق للخمر منفعه في الشرع وثمن البيع الباطل حرام وليس هذا من ذلك بل مثال هذا أن يملك الرجل جارية هي أخته من الرضاع فتباع بجارية أجنبية فليس لأحد أن يتورع منه وتشبيه ذلك ببيع الخمر غاية السرف في هذا الطرف

1143 عن زيد بن أرقم رضي الله عنه أنه رأى قوما يصلون من الضحى فقال أما لقد علموا أن الصلاة في غير هذه الساعة أفضل إن رسول الله صلى الله عليه وسلم قال صلاة الأوابين حين ترمض الفصال رواه مسلم ترمض بفتح التاء والميم وبالضاد المعجمة يعني شدة الحر والفصال جمع فصيل وهو الصغير من الإبل

325 وعن أسماء بنت أبي بكر الصديق رضي الله عنهما قالت قدمت علي أمي وهي مشركة في عهد رسول الله صلى الله عليه وسلم فاستفتيت رسول الله صلى الله عليه وسلم قلت قدمت علي أمى وهى راغبة أفأصل أمي قال نعم صلي أمك متفق عليه وقولها راغبة أي طامعة عندي تسألني شيئا قيل كانت أمها من النسب وقيل من الرضاعة والصحيح

الخامسة أن تمتنع المرأة لتعززها ومبالغتها في النظافة والتحرز من الطلق والنفاس والرضاع وكان ذلك عادة نساء الخوارج لمبالغتهن في استعمال المياه حتى كن يقضين صلوات أيام الحيض ولا يدخلن الخلاء إلا عراة فهذه بدعة تخالف السنة فهي نية فاسدة واستأذنت واحدة منهن على عائشة رضي الله عنها لما قدمت البصرة فلم تأذن لها فيكون القصد هو الفاسد دون منع الولادة

وطء المرأة إذا كانت ترضع وإنه يشبه قتل الولد سرا وأنه يدرك الفارس قيد عثره وقوله في حديث آخر لقد هممت أن أنهى عنه ثم رأيت فارس والروم يفعلونه ولا يضر ذلك أولادهم شيئا وقد قيل أن أحد الحديثين منسوخ بالآخر وإن لم تعلم عين الناسخ منها من المنسوخ لعدم علمنا بالتاريخ وقيل وهو أحسن أن النفي والإثبات لم يتواردا على محل واحد فإنه صلى الله عليه وسلم أخبر في أحد الجانبين أنه يفعل في الوليد مثل ما يفعل من يصرع الفارس عن فرسه كأنه يدعثره ويصرعه وذلك يوجب نوع أذى ولكنه ليس بقتل للولد وإهلاك له وإن كان قد يترتب عليه نوع أذى للطفل فأرشدهم إلى تركه ولم ينه عنه بل قال علام يفعل أحدكم ذلك ولم يقل لا تفعلوه فلم يجيء عنه لفظ واحد بالنهى عنه ثم عزم على النهى سدا لذريعة الأذى الذي ينال الرضيع فرأى أن سد هذه الذريعة لا يقاوم المفسدة التي تترتب على الإمساك عن وطء النساء مدة الرضاع ولا سيما

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Educational interventions for improving primary caregiver complementary feeding practices for children aged 24 months and under.: Background: Although complementary feeding is a universal practice, the methods and manner in which it is practiced vary between cultures, individuals and socioeconomic classes. The period of complementary feeding is a critical time of transition in the life of an infant, and inappropriate complementary feeding practices, with their associated adverse health consequences, remain a significant global public health problem. Educational interventions are widely acknowledged as effective in promotin

Timing of breastfeeding initiation and exclusivity of breastfeeding during the first month of life: effects on neonatal mortality and morbidity--a systematic review and meta-analysis.: The purpose of this study was to review the evidence on the effect of initiation of breastfeeding early after birth and of exclusive breastfeeding during the first month in reducing neonatal mortality and morbidity. We searched Cochrane and PubMed databases for all available papers addressing our review questions and identified eleven papers. Data were extracted using a standard abstraction form. Evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation sy

Cluster-randomized trial on complementary and responsive feeding education to caregivers found improved dietary intake, growth and development among rural Indian toddlers.: Inadequate feeding and care may contribute to high rates of stunting and underweight among children in rural families in India. This cluster-randomized trial tested the hypothesis that teaching caregivers appropriate complementary feeding and strategies for how to feed and play responsively through home-visits would increase children's dietary intake, growth and development compared with home-visit-complementary feeding education alone or routine care. Sixty villages in Andhra Pradesh were rando

Breastfeeding or breast milk for procedural pain in neonates.: Background: Physiological changes brought about by pain may contribute to the development of morbidity in neonates. Clinical studies have shown reduction in changes in physiological parameters and pain score measurements following pre-emptive analgesic administration in situations where the neonate is experiencing pain or stress. Non-pharmacological measures (such as holding, swaddling and breastfeeding) and pharmacological measures (such as acetaminophen, sucrose and opioids) have been used for

PediTools Electronic Growth Chart Calculators: Applications in Clinical Care, Research, and Quality Improvement.

Background: Parameterization of pediatric growth charts allows precise quantitation of growth metrics that would be difficult or impossible with traditional paper charts. However, limited availability of growth chart calculators for use by clinicians and clinical researchers currently restricts broader application. Objective: The aim of this study was to assess the deployment of electronic calculators for growth charts using the lambda-mu-sigma (LMS) parameterization method, with examples of their utilization for patient care delivery, clinical research, and quality improvement projects. Methods: The publicly accessible PediTools website of clinical calculators was developed to allow LMS-based calculations on anthropometric measurements of individual patients. Similar calculations were applied in a retrospective study of a population of patients from 7 Massachusetts neonatal intensive ca…

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The Muslim Ban and preterm birth: Analysis of U.S. vital statistics data from 2009 to 2018.

Anti-immigrant stigma or xenophobia is increasingly pervasive globally. Racism is a determinant of adverse health outcomes, but the epidemiological implications of the recent wave of xenophobic policies have not been well studied. The 2017 travel ban on individuals from Muslim majority countries is an example of such policy efforts in the United States. Using the 2009-2018 National Center for Health Statistics period linked infant birth-death data, we used time series methods to compare the monthly odds of preterm births to women from travel ban countries (Iran, Iraq, Libya, Somalia, Sudan, Syria, and Yemen) after the January 2017 travel ban to the number expected had the ban not been implemented. We estimated our counterfactual from the history of preterm birth among women born in countries included in the ban as well as trends in preterm birth among native-born non-Hispanic (NH) White …

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The unique social sense of puerperium: Increased empathy and Schadenfreude in parents of newborns.

Pregnancy and puerperium are typified by marked biobehavioral changes. These changes, which are traceable in both mothers and fathers, play an important role in parenthood and may modulate social cognition abilities. However, the latter effects remain notably unexplored in parents of newborns (PNs). To bridge this gap, we assessed empathy and social emotions (envy and Schadenfreude) in 55 PNs and 60 controls (childless healthy participants without a romantic relationship or sexual intercourse in the previous 48 hours). We used facial electromyography to detect physiological signatures of social emotion processing. Results revealed higher levels of affective empathy and Schadenfreude in PNs, the latter pattern being accompanied by increased activity of the corrugator suppercilii region. These effects were not explained by potential confounding variables (educational level, executive funct…

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Maternal adverse childhood experiences, mental health, and child behaviour at age 3: The all our families community cohort study.

Links between adverse childhood experiences (ACEs) and threats to health and well-being later in life are well established. The current study extends those findings into younger populations of pregnant women and their children; investigating how ACEs relates to maternal postpartum well-being, coping, and parenting, as well as child outcomes. Participants included 1994 mothers and children from the All Our Families community-based cohort in Alberta, Canada, followed from pregnancy (from 2008 to 2011) until child age 3 years. The sample is representative of the pregnant population in an urban Canadian centre. Mothers completed questionnaires on ACEs, postpartum mental health, as well as parenting morale, efficacy, coping, and personality. Child outcomes included internalizing and externalizing behavior, as well as temperament. Approximately 62% of participants experienced at least one ACE;…

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Paid Maternity Leave in the United States: Associations with Maternal and Infant Health.

Objectives The United States is one of only three countries worldwide with no national policy guaranteeing paid leave to employed women who give birth. While maternity leave has been linked to improved maternal and child outcomes in international contexts, up-to-date research evidence in the U.S. context is needed to inform current policy debates on paid family leave. Methods Using data from Listening to Mothers III, a national survey of women ages 18-45 who gave birth in 2011-2012, we conducted multivariate logistic regression to predict the likelihood of outcomes related to infant health, maternal physical and mental health, and maternal health behaviors by the use and duration of paid maternity leave. Results Use of paid and unpaid leave varied significantly by race/ethnicity and household income. Women who took paid maternity leave experienced a 47% decrease in the odds of re-hospita…

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Motor trajectories from birth to 5 years of children born at less than 30 weeks' gestation: early predictors and functional implications. Protocol for a prospective cohort study.

Introduction: Motor impairments are one of the most frequently reported adverse neurodevelopmental consequences in children born < 30 weeks' gestation. Up to 15% of children born at < 30 weeks have cerebral palsy and an additional 50% have mild to severe motor impairment at school age. The first 5 years of life are critical for the development of fundamental motor skills. These skills form the basis for more complex skills that are required to competently and confidently participate in schooling, sporting and recreational activities. In children born at < 30 weeks' gestation, the trajectory of motor development from birth to 5 years is not fully understood. The neural alterations that underpin motor impairments in these children are also unclear. It is essential to determine if early clinical evaluations and neuroimaging biomarkers can predict later motor impairment and associated functi…

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Healthy Immigrant Effect: Preterm Births Among Immigrants and Refugees in Syracuse, NY.

Objectives: The healthy immigrant effect is the phenomenon by which immigrants experience more positive health outcomes than the native-born population in developed countries. The strength of this effect appears to be related to country of origin, health outcome, healthcare and integration policies of receiving countries, as well as immigration class. This secondary analysis of birth records examines whether immigrants and mothers from refugee countries have lower adjusted risk of preterm births than US-born mothers in Syracuse, NY, a preferred refugee resettlement area. Methods: This secondary analysis included 6354 electronic birth records for residents in the city of Syracuse, NY who gave birth to singleton infants between 2009 and 2011. Multivariate log-binomial regression was used to calculate the adjusted relative risk for preterm birth among foreign-born mothers and mothers from r…

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Novel heart rate parameters for the assessment of autonomic nervous system function in premature infants.

Autonomic nervous system (ANS) balance is a key factor in homeostatic control of cardiac activity, breathing and certain reflex reactions such as coughing, sneezing and swallowing and thus plays a crucial role for survival. ANS impairment has been related to many neonatal pathologies, including sudden infant death syndrome (SIDS). Moreover, some conditions have been identified as risk factors for SIDS, such as prone sleep position. There is an urgent need for timely and non-invasive assessment of ANS function in at-risk infants. Systematic measurement of heart rate variability (HRV) offers an optimal approach to access indirectly both sympathetic and parasympathetic influences on ANS functioning. In this paper, data from premature infants collected in a sleep physiology laboratory in the NICU are presented: traditional and novel approaches to HRV analyses are applied and compared in orde…

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Risk and resilience in preterm children at age 6.

Children born preterm are at risk for experiencing significant deleterious developmental outcomes throughout their childhood and adolescence. However, individual variation and resilience are hallmarks of the preterm population. The present study examined pathways to resilience across multiple domains (e.g., social activities, peer relations, attention-deficit/hyperactivity disorder symptomology, externalizing and internalizing behavior, and sleep quality) as children born preterm reached school age. The study also examined early child and family predictors of resilience. Using a prospective longitudinal design, 173 infants born preterm and without significant neurological complications were assessed at five time points: neonatal intensive care unit discharge, 9 months, 16 months, 24 months, and 6 years. Three pathways of adaptation emerged at 6 years: children who were resilient, those w…

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Perceptions of primiparas on a postnatal psychoeducation programme: the process evaluation.

Objective: to explore the perceptions of primiparas on the contents, delivery and personal impact of postnatal psychoeducation programme. Design and settings: a descriptive qualitative study was conducted in a public tertiary hospital in Singapore in 2013. Participants: 18 primiparas who were able to read and speak English were recruited from the intervention group of a randomised controlled trial. Measurements: a semi-structured interview guide was used to interview participants' perceptions on a postnatal psychoeducation programme at participants' home, which was developed based on the principles of self-efficacy and social exchange theories, between six and nine weeks post partum. The programme comprised of a 90-minute home visit, three weekly telephone follow-up and an educational booklet. Findings: the qualitative interviews revealed that the participants faced many challenges such …

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Cortisol levels in former preterm children at school age are predicted by neonatal procedural pain-related stress.

Early life stress can alter hypothalamic pituitary adrenal (HPA) axis function. Differences in cortisol levels have been found in preterm infants exposed to substantial procedural stress during neonatal intensive care, compared to infants born full-term, but only a few studies investigated whether altered programming of the HPA axis persists past toddler age. Further, there is a dearth of knowledge of what may contribute to these changes in cortisol. This prospective cohort study examined the cortisol profiles in response to the stress of cognitive assessment, as well as the diurnal rhythm of cortisol, in children (n=129) born at varying levels of prematurity (24-32 weeks gestation) and at full-term (38-41 weeks gestation), at age 7 years. Further, we investigated the relationships among cortisol levels and neonatal procedural pain-related stress (controlling for multiple medical confoun…

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Very preterm birth influences parental mental health and family outcomes seven years after birth.

Objective: To evaluate the long-term influence of very preterm birth on parental mental health, family functioning, and parenting stress at age 2 and 7 years. Study design: Participants were 183 children born very preterm (<30 weeks gestation; n = 148 families) and 69 term-born children (n = 66 families). When children were age 7 years, parents were assessed based on the Hospital Anxiety and Depression Scale, the Family Assessment Device, the Parenting Stress Index, and the Social Support Questionnaire. Similar measures were evaluated at age 2 years. Results: When the children were age 7 years, parents of the very preterm-born children were more likely to report moderate to severe anxiety symptoms (P = .03), higher levels of depression symptoms (P = .03), poorer family functioning (P < .05), and higher levels of parenting stress (P < .001) compared with parents of the children born at te…

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Longitudinal study of perinatal maternal stress, depressive symptoms and anxiety.

Objectives: to understand the trends in, and relationships between, maternal stress, depressive symptoms and anxiety in pregnancy and post partum. Design: a prospective longitudinal survey study was undertaken to explore maternal psychological distress throughout the perinatal period. The participants were recruited after 24 completed weeks of gestation, and were followed-up monthly until one month post partum (four surveys in total). Setting: participants were recruited from a single hospital in southern Taiwan, and asked to complete questionnaires in the hospital waiting area. Participants: inclusion criteria were: age ≥18 years, able to read and write Chinese, ≥24 weeks of gestation, singleton pregnancy and no pregnancy complications (including a diagnosis of antenatal depression or anxiety disorder). In total, 197 women completed all four surveys (response rate 74.62%). Measurements …

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Factors associated with the use and quality of antenatal care in Nepal: a population-based study using the demographic and health survey data.

Background: Good quality antenatal care (ANC) reduces maternal and neonatal mortality and improves health outcomes, particularly in low-income countries. Quality of ANC is measured by three dimensions: number of visits, timing of initiation of care and inclusion of all recommended components of care. Although some studies report on predictors of the first two indicators, no studies on the third indicator, which measures quality of ANC received, have been conducted in Nepal. Nepal follows the World Health Organization's recommendations of initiation of ANC within the first four months of pregnancy and at least four ANC visits during the course of an uncomplicated pregnancy. This study aimed to identify factors associated with 1) attendance at four or more ANC visits and 2) receipt of good quality ANC. Methods: Data from Nepal Demographic and Health Survey 2011 were analysed for 4,079 moth…

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Exploration of preterm birth rates using the public health exposome database and computational analysis methods.

Recent advances in informatics technology has made it possible to integrate, manipulate, and analyze variables from a wide range of scientific disciplines allowing for the examination of complex social problems such as health disparities. This study used 589 county-level variables to identify and compare geographical variation of high and low preterm birth rates. Data were collected from a number of publically available sources, bringing together natality outcomes with attributes of the natural, built, social, and policy environments. Singleton early premature county birth rate, in counties with population size over 100,000 persons provided the dependent variable. Graph theoretical techniques were used to identify a wide range of predictor variables from various domains, including black proportion, obesity and diabetes, sexually transmitted infection rates, mother's age, income, marriage…

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Common mental disorders in women and men in the first six months after the birth of their first infant: a community study in Victoria, Australia.

Introduction: Studies of postpartum mental health have focused predominantly on women and on depression. There is limited evidence regarding men's postpartum mental health and about other common mental disorders, such as anxiety and adjustment disorders, which may also be relevant at this life phase. The main aim of this study was to establish the period prevalence of depression, anxiety, and adjustment disorders in primiparous women and their male partners in the first six months postpartum Methods: English-speaking couples were recruited in five local government areas in Victoria, Australia. Women and men completed separate telephone interviews which included the Edinburgh Postnatal Depression Scale (EPDS) and selected Depression and Anxiety modules of the Composite International Diagnostic Interview. DSM-IV criteria were used to classify adjustment disorders, based on subclinical symp…

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Infant cardiac surgery and the father-infant relationship: feelings of strength, strain, and caution.

Objective: The purpose of this study was to examine the father-infant relationship in infants with congenital heart disease (CHD). Method: Sixty-three fathers whose infants had cardiac surgery before 3 months of age reported on their attachment relationship with their infant within two months of hospital discharge using both qualitative and quantitative methods. Results: Mean scores on the Paternal Postnatal Attachment Scale and scores for patience and tolerance were not different from previously published community norms, ps>.05. Scores for pleasure and interaction (t[50]=-2.383, p=.021, CI: -2.93, -.25) and affection and pride subscale (t[56]=-2.935, p=.005, CI: -1.20, -.23) were significantly lower than community norms. Additionally, 37% of fathers described feeling a strong relationship with their infant whereas 17% reported initial apprehension or condition-specific worry. Fathers w…

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Parenting stress in mothers of preterm infants during early infancy.

Objective: Mothers of preterm infants during the first year of life may experience stresses greater that those found in mothers of term infants. The aim of the study was to determine the levels of parenting stress and psychological well-being in mothers of very preterm babies in comparison to a control group of term mothers. Methods: One hundred and five mothers who delivered 124 babies at ≤30weeks gestation were recruited together with 105 mothers who delivered 120 babies at term. At 4months of age (corrected for prematurity for the preterm babies), the mothers completed the Parenting Stress Index Short Form, the Edinburgh Postnatal Depression Scale (EPDS), the Dyadic Adjustment Scale (DAS) and the Short Temperament Scale for Infants (STSI). The preterm and term groups were compared. Results: Questionnaires were returned from 86 of the preterm mothers and 97 of the term mothers. The mea…

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Socioeconomic inequalities and infant mortality of 46,470 preterm infants born in Sweden between 1992 and 2006.

Studies on possible sociodemographic inequities in the survival of preterm infants are scarce. Individual and neighbourhood sociodemographic factors are related to preterm birth and to infant mortality in full-term infants. The aim here was to examine whether infant mortality in Swedish preterm infants is related to individual and neighbourhood sociodemographic factors, and to study whether the hypothesised association between neighbourhood deprivation and infant mortality persists after accounting for individual sociodemographic factors. The study included 46,470 infants with a gestational length of <37 weeks, born in Sweden between 1992 and 2006. Neighbourhood deprivation was assessed by an index (education, income, unemployment, welfare assistance) in small geographical units, and categorised into low, moderate and high deprivation. Adjusted odds ratios for infant mortality were exami…

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Prematurity, maternal posttraumatic stress and consequences on the mother-infant relationship.

Objective: Premature birth is a stressful experience for parents. This study explores the links between maternal posttraumatic stress, maternal attachment representations of the infant and mother-infant dyadic interactions. Methods: The study enrols 47 preterm (GA<34 weeks) and 25 full-term infants. The Perinatal Posttraumatic Stress Disorder Questionnaire was administered to evaluate maternal posttraumatic stress symptoms. At 6 months of corrected age, maternal attachment representations of the infant were explored and coded with the Working Model of the Child Interview. Interactive characteristics were explored in a videotaped play session and coded with the Care Index. Results: Full-term mothers were more likely to follow a "Cooperative" dyadic pattern of interaction with the infant and demonstrate Balanced representations of the infant. Preterm mothers with high posttraumatic stress …

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Neighbourhood socio-economic characteristics and the risk of preterm birth for migrant and non-migrant women: a study in a French district.

Neighbourhood-level deprivation is associated with preterm birth; preterm birth rates are also higher for some, but not all migrant groups. We studied the impact of neighbourhood characteristics (a deprivation score and the proportion of foreign-born residents) on singleton preterm birth in the French district of Seine-Saint-Denis for women born in France, North Africa, sub-Saharan Africa and other countries. Multilevel logistic regression models were adjusted for maternal demographic and health care characteristics. For women born in France, the preterm birth rate rose with neighbourhood deprivation quintile (3.8% in the first to 5.7% in the fifth, adjusted odds ratio: 1.40 [95% confidence interval 1.14, 1.72]) and with increasing proportions of foreign-born residents. Preterm birth rates were not higher in more deprived neighbourhoods for women born outside of France and were lower in …

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Effectiveness of a combined prenatal and postpartum smoking cessation program.

Women frequently quit smoking during pregnancy but then relapse postpartum. The BABY & ME-Tobacco Free program combines prenatal and postpartum smoking cessation counseling and biomarker feedback with monthly postpartum incentives. The settings included 22 sites (WIC offices and prenatal clinics) in upstate New York. A quasi-experimental design was used to evaluate this intervention, that included four face-to-face prenatal sessions with a counselor who did smoking cessation counseling, carbon monoxide testing and random saliva cotinine testing. For 1 year postpartum, mothers were biochemically tested every 3-4 weeks and, if negative, were issued a voucher for diapers. Three implementation models were studied: multi-tasking counselors at fixed sites (Models 1 and 2) versus itinerant smoking cessation specialists (Model 3). Outcomes included biochemically validated abstinence rates during…

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The development of regulatory functions from birth to 5 years: insights from premature infants.

This study examined physiological, emotional, and attentional regulatory functions as predictors of self-regulation in 125 infants followed 7 times from birth to 5 years. Physiological regulation was assessed by neonatal vagal tone and sleep-wake cyclicity; emotion regulation by response to stress at 3, 6, and 12 months; and attention regulation by focused attention and delayed response in the 2nd year. Executive functions, behavior adaptation, and self-restraint were measured at 5 years. Regulatory functions showed stability across time, measures, and levels. Structural modeling demonstrated both mediated paths from physiological to self-regulation through emotional and attentional processes and direct continuity between vagal tone and each level of regulation. Results support the coherence of the regulation construct and are consistent with neurobiological models on self and consciousn…

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Neonatologist training to guide family decision making for critically ill infants.

Objectives: To assess neonatology fellow training in guiding family decision making for high-risk newborns and in several critical communication skills for physicians in these scenarios. Design: A Web-based national survey. Setting: Neonatal-perinatal training programs in the United States. Participants: Graduating fellows in their final month of fellowship. Main outcome measures: Fellows' perceived training and preparedness to communicate with families about decision making. Results: The response rate was 72%, representing 83% of accredited training programs. Fellows had a great deal of training in the medical management of extremely premature and dying infants. However, they reported much less training to communicate and make collaborative decisions with the families of these infants. More than 40% of fellows reported no communication training in the form of didactic sessions, role pla…

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Parenting behavior is associated with the early neurobehavioral development of very preterm children.

Objective: There is an increasing focus on social and environmental factors that promote and support the early development of highly vulnerable children such as those born very preterm. The aim of this study was to assess the relationship between parenting behavior, parent-child synchrony, and neurobehavioral development in very preterm children at 24 months of age. Methods: Participants were 152 very preterm children (<30 weeks' gestation or <1250 g birth weight) and their parents/guardians. At 2 years' corrected age, parents/guardians and children completed a semistructured parent-child interaction task assessing dyad synchrony and parenting behavior (positive affect, negative affect, sensitivity, facilitation, and intrusiveness). Cognitive and motor development was assessed by using the Bayley Scales of Infant Development II, and the Infant Toddler Social and Emotional Assessment was …

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