Nursing, its duration and its outcomes for mother and child.
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176 to 200 of 480Institutionalizing postpartum intrauterine device (IUD) services in Sri Lanka, Tanzania, and Nepal: study protocol for a cluster-randomized stepped-wedge trial.
Background: During the year following the birth of a child, 40% of women are estimated to have an unmet need for contraception. The copper IUD provides safe, effective, convenient, and long-term contraceptive protection that does not interfere with breastfeeding during the postpartum period. Postpartum IUD (PPIUD) insertion should be performed by a trained provider in the early postpartum period to reduce expulsion rates and complications, but these services are not widely available. The International Federation of Obstetricians and Gynecologists (FIGO) will implement an intervention that aims to institutionalize PPIUD training as a regular part of the OB/GYN training program and to integrate it as part of the standard practice at the time of delivery in intervention hospitals.
Methods: This trial uses a cluster-randomized stepped wedge design to assess the causal effect of the FIGO inte…
matched on breastfeeding (text), Postnatal Care (mesh)
The Foetal Origins of Allergy and Potential Nutritional Interventions to Prevent Disease.
The first nine months from conception to birth involves greater changes than at any other time in life, affecting organogenesis, endocrine, metabolic and immune programming. It has led to the concept that the "first 1000 days" from conception to the second birthday are critical in establishing long term health or susceptibility to disease. Immune ontogeny is predominantly complete within that time and is influenced by the maternal genome, health, diet and environment pre-conception and during pregnancy and lactation. Components of the immunological protection of the pregnancy is the generation of Th-2 and T-regulatory cytokines with the consequence that neonatal adaptive responses are also biased towards Th-2 (allergy promoting) and T-regulatory (tolerance promoting) responses. Normally after birth Th-1 activity increases while Th-2 down-regulates and the evolving normal human microbiome…
matched on Breast Feeding (mesh), Lactation (mesh)
Why do we respond so differently? Reviewing determinants of human salivary cortisol responses to challenge.
Stress and stress-related health impairments are major problems in human life and elucidating the biological pathways linking stress and disease is of substantial importance. However, the identification of mechanisms underlying a dysregulation of major components of the stress response system is, particularly in humans, a very challenging task. Salivary cortisol responses to diverse acute challenge paradigms show large intra- and interindividual variability. In order to uncover mechanisms mediating stress-related disorders and to potentially develop new therapeutic strategies, an extensive phenotyping of HPA axis stress responses is essential. Such a research agenda depends on substantial knowledge of moderating and intervening variables that affect cortisol responses to different stressors and stimuli. The aim of this report is, therefore, to provide a comprehensive summary of important…
matched on Breast Feeding (mesh), Lactation (mesh)
Effectiveness of a psycho-educational intervention for expecting parents to prevent postpartum parenting stress, depression and anxiety: a randomized controlled trial.
Background: The first months postpartum can be challenging for parents, leading to elevated symptoms of parenting stress, depression and anxiety. In turn, distressed parents are at higher risk for providing suboptimal quality of caregiving. As psychoeducational interventions can be effective in reducing psychological distress, the goal of this randomized controlled trial was to examine the effectiveness of low-intensity universal psychoeducational program to prevent postpartum parenting stress, and to enhance parental well-being and caregiving quality.
Method: Between 26 and 34 weeks of pregnancy, 138 pregnant women and 96 partners were randomized to the intervention or a waitlist control group. The intervention consisted of a booklet, a video, a home visit, and a telephone call. Information was provided on (1) sensitive responsiveness, adapting to the parental role, and attending to own…
matched on Infant, Newborn (mesh), Postpartum Period (mesh)
Prenatal and Pediatric Primary Care-Based Child Obesity Prevention Program: A Randomized Trial.
Objectives: To determine impact of a primary care-based child obesity prevention intervention beginning during pregnancy on early childhood weight outcomes in low-income Hispanic families.
Methods: A randomized controlled trial comparing mother-infant pairs receiving either standard care or the Starting Early Program providing prenatal and postpartum nutrition counseling and nutrition parenting support groups targeting key obesity-related feeding practices in low-income groups. Primary outcomes were reduction in weight-for-age z-scores (WFAzs) from clinical anthropometric measures, obesity prevalence (weight for age ≥95th percentile), and excess weight gain (WFAz trajectory) from birth to age 3 years. Secondary outcomes included dose effects.
Results: Pregnant women (n = 566) were enrolled in the third trimester; 533 randomized to intervention (n = 266) or control (n = 267). Also, 358 ch…
matched on Infant, Newborn (mesh), Postnatal Care (mesh)
Effect of a Community Agency-Administered Nurse Home Visitation Program on Program Use and Maternal and Infant Health Outcomes: A Randomized Clinical Trial.
Importance: Postnatal home visitation to support parenting and infant healthy development is becoming increasingly common based on university efficacy studies, but effectiveness when disseminated by communities is not clear.
Objective: To test implementation and impact of the Family Connects (FC) program when administered by a community agency.
Design, setting, and participants: In this randomized clinical trial, births were randomly assigned to receive FC or treatment as usual. Independent evaluation was conducted through parent interviews and review of health and child protective services records. Interviewers were blind to the experimental condition of participants, and participants were blind about the purpose of the interview as an intervention evaluation. A total of 936 consecutive residential births at Duke University Hospital from January 1, 2014, through June 30, 2014, were incl…
matched on Infant, Newborn (mesh), Postnatal Care (mesh)
Crawley R, Ayers S, Button S, Thornton A, Field AP, Lee S, Eagle A, Bradley R, Moore D, Gyte G, Smith H (2018)randomised controlled trialMEDLINE-indexed journal, not yet read by usBMC pregnancy and childbirth7 citations Feasibility and acceptability of expressive writing with postpartum women: a randomised controlled trial.
Background: Pregnancy, birth and adjusting to a new baby is a potentially stressful time that can negatively affect women's mental and physical health. Expressive writing, where people write about a stressful event for at least 15 min on three consecutive days, has been associated with improved health in some groups but it is not clear whether it is feasible and acceptable for use with postpartum women. This study therefore examined the feasibility and acceptability of expressive writing for postpartum women as part of a randomised controlled trial (RCT).
Methods: The Health After Birth Trial (HABiT) was an RCT evaluating expressive writing for postpartum women which included measures of feasibility and acceptability. At 6 to 12 weeks after birth 854 women were randomised to expressive writing, a control writing task or normal care, and outcome measures of health were measured at baselin…
matched on Postnatal Care (mesh), Postpartum Period (mesh)
Postpartum anxiety and adjustment disorders in parents of infants with very low birth weight: Cross-sectional results from a controlled multicentre cohort study.
Background: Both preterm delivery and survival rates of very low birth weight (VLBW: <1500 g) infants are increasing. To date, the focus on studies about postpartum mental health after preterm birth has been on depression and on women. There is a paucity of research regarding prevalence, risks, and predictors of postpartum anxiety in parents after VLBW birth.
Methods: Parents with VLBW infants and parents with term infants were recruited into the longitudinal HaFEn-study at the three largest centers of perinatal care in Hamburg, Germany. State anxiety was assessed with the State-Trait-Anxiety Inventory and anxiety and adjustment disorders with a clinical interview one month postpartum. Psychiatric lifetime diagnoses, social support, trait anxiety, stress during birth, socioeconomic status, risks during pregnancy, and mode of delivery were also evaluated. To examine predictors of postpart…
matched on Infant, Newborn (mesh), Postpartum Period (mesh)
Family Nurture Intervention in preterm infants alters frontal cortical functional connectivity assessed by EEG coherence.
Aim: To assess the impact of Family Nurture Intervention (FNI) on cortical function in preterm infants at term age.
Methods: Family Nurture Intervention is a NICU-based intervention designed to establish emotional connection between mothers and preterm infants. Infants born at 26-34 weeks postmenstrual age (PMA) were divided into two groups, standard care (SC, N = 49) and FNI (FNI, N = 56). Infants had EEG recordings of ~one hour duration with 124 lead nets between 37 and 44 weeks PMA. Coherence was measured between all pairs of electrodes in ten frequency bands. Data were summarised both within and between 12 regions during two sleep states (active, quiet).
Results: Coherence levels were negatively correlated with PMA age in both groups. As compared to SC infants, FNI infants showed significantly lower levels of EEG coherence (1-18 Hz) largely within and between frontal regions.
Conclus…
matched on Infant, Newborn (mesh), Infant, Premature (mesh)
Early intervention program reduces stress in parents of preterms during childhood, a randomized controlled trial.
Background: It is well documented that heightened levels of parenting stress have a negative influence on children's socio-emotional and behavioral development. Parenting stress may therefore be regarded as an outcome variable in its own right. This study investigated whether a sensitizing intervention influences stress reported by parents of prematurely born children until the children were age nine.
Methods: Preterm infants (N = 146, birth weight <2,000 g) were randomized to intervention (N = 72) with the Mother-Infant Transaction Program (MITP) or a preterm control group (N = 74) that received standard hospital care. A term reference group comprised 75 healthy, full-term neonates. Parents reported on the Parenting Stress Index (PSI) when the children were 6 months, 1, 2, 3, 5, 7 years old and on the PSI-Short Form (PSI-SF) at age 9. Main outcomes were the mother's and father's reports…
matched on Infant, Newborn (mesh), Infant, Premature (mesh)
A diet and physical activity intervention for preventing weight retention among Taiwanese childbearing women: a randomised controlled trial.
Objective: to examine the effect of individual counselling on diet and physical activity from pregnancy to six months post partum, or from birth to six months post partum, on weight retention among Taiwanese women.
Design: a randomised controlled trial assigned participants to two experimental groups [from pregnancy to six months post partum (EP) and from birth to six months post partum (EPP)] and one comparison group.
Setting: a 3900-bed medical centre in northern Taiwan with around 3000 births annually.
Participants: a sample of 189 women who had regular check-ups during pregnancy and gave birth at the medical centre.
Interventions: the comparison group received the routine outpatient department obstetric educational programme. The EP group attended regularly scheduled clinic visits with individualised dietary and physical activity education plans from 16 gestational weeks to six month…
matched on Postnatal Care (mesh), Postpartum Period (mesh)
Preventive care at home for very preterm infants improves infant and caregiver outcomes at 2 years.
Objective: The objective of this study was to determine the effects of preventive care at home on child development and primary caregiver mental health at 2 years of age.
Methods: A total of 120 very preterm infants (<30 weeks) were assigned randomly to intervention (n = 61) or control (n = 59) groups. The intervention group received the preventive care program (9 home visits over the first year from a physiotherapist and a psychologist, focusing on the parent-infant relationship, the parents' mental health, and the infant's development); and the control group received standard care. At corrected age of 2 years, developmental outcomes were assessed, and primary caregivers completed the Infant-Toddler Social and Emotional Assessment. The mental health of the primary caregivers was assessed with the Hospital Anxiety and Depression Scale.
Results: At 2 years of age, 115 children (96%) were …
matched on Infant, Newborn (mesh), Infant, Premature (mesh)
Rougé C, Piloquet H, Butel MJ, Berger B, Rochat F, Ferraris L, Des Robert C, Legrand A, de la Cochetière MF, N'Guyen JM, Vodovar M, Voyer M, Darmaun D, Rozé JC (2009)randomised controlled trialMEDLINE-indexed journal, not yet read by usThe American journal of clinical nutrition140 citations Oral supplementation with probiotics in very-low-birth-weight preterm infants: a randomized, double-blind, placebo-controlled trial.
Background: Although recent reports suggest that supplementation with probiotics may enhance intestinal function in premature infants, the mechanisms are unclear, and questions remain regarding the safety and efficacy of probiotics in extremely low-birth-weight infants.
Objective: The objective was to evaluate the efficacy of probiotics on the digestive tolerance to enteral feeding in preterm infants born with a very low or extremely low birth weight.
Design: In a bicentric, double-blind, randomized controlled clinical trial that was stratified for center and birth weight, 45 infants received enteral probiotics (Bifidobacterium longum BB536 and Lactobacillus rhamnosus GG; BB536-LGG) and 49 received placebo. The primary endpoint was the percentage of infants receiving >50% of their nutritional needs via enteral feeding on the 14th day of life. A triangular test was used to perform sequent…
matched on Infant, Newborn (mesh), Infant, Premature (mesh)
Miller Early Childhood Sustained Home-visiting (MECSH) trial: design, method and sample description.
Background: Home visiting programs comprising intensive and sustained visits by professionals (usually nurses) over the first two years of life show promise in promoting child health and family functioning, and ameliorating disadvantage. Australian evidence of the effectiveness of sustained nurse home visiting in early childhood is limited. This paper describes the method and cohort characteristics of the first Australian study of sustained home visiting commencing antenatally and continuing to child-age two years for at-risk mothers in a disadvantaged community (the Miller Early Childhood Sustained Home-visiting trial).
Methods and design: Mothers reporting risks for poorer parenting outcomes residing in an area of socioeconomic disadvantage were recruited between February 2003 and March 2005. Mothers randomised to the intervention group received a standardised program of nurse home vis…
matched on Infant, Newborn (mesh), Postnatal Care (mesh)
Providing Lactation Care Following Stillbirth, Neonatal and Infant Death: Learning from Bereaved Parents.
Objective: The study aimed to identify how, from the perspective of bereaved parents, hospital-based health professionals can better meet their lactation care needs. Methods: In-depth interviews were conducted with 17 mothers and 7 fathers bereaved by stillbirth, neonatal death, or older infant death. Participants were recruited from three large hospitals in Eastern Australia including two with human milk banks. Qualitative thematic data analysis identified bereaved parents' lactation experiences, needs, and how parents wanted lactation care to be provided. Results: Participants experienced lactation after infant death as hard and challenging, while at the same time they received limited lactation care. The negative impact of lactation, however, could be mediated by anticipatory guidance, assistance to make sense of lactation, support to make decisions from available lactation and breast…
matched on Breast Feeding (mesh), Lactation (mesh), breastfeeding (text), human milk (text), Infant, Newborn (mesh)
Mapping Hospital-Based Lactation Care Provided to Bereaved Mothers: A Basis for Quality Improvement.
Objective: The study aimed to identify and map the factors that shape the delivery of hospital-based lactation care for bereaved mothers to inform quality improvement initiatives targeting hospital-based lactation care. Methods: Focus groups and interviews were conducted at three large hospitals in Australia with 113 health professionals including obstetricians, neonatologists, midwives, neonatal nurses, lactation consultants, social workers or pastoral care workers, Human Milk Bank (HMB) staff, and perinatal bereavement nurses. Thematic and interactional data analysis identified the nature, scope, and pattern of bereavement lactation care. Results: A bereaved lactation care pathway was generated from health professionals' reports. Bereaved lactation care, if provided, was limited to brief encounters aimed at facilitating lactation suppression. The type of lactation care offered, and any…
matched on Breast Feeding (mesh), Lactation (mesh), breastfeeding (text), human milk (text), Infant, Newborn (mesh)
Shankar M, Hazfiarini A, Zahroh RI, Vogel JP, McDougall ARA, Condron P, Goudar SS, Pujar YV, Somannavar MS, Charantimath U, Ammerdorffer A, Rushwan S, Gülmezoglu AM, Bohren MA (2024)systematic reviewMEDLINE-indexed journal, not yet read by usPLoS medicine22 citations Factors influencing the participation of pregnant and lactating women in clinical trials: A mixed-methods systematic review.
Background: Poor representation of pregnant and lactating women and people in clinical trials has marginalised their health concerns and denied the maternal-fetal/infant dyad benefits of innovation in therapeutic research and development. This mixed-methods systematic review synthesised factors affecting the participation of pregnant and lactating women in clinical trials, across all levels of the research ecosystem.
Methods and findings: We searched 8 databases from inception to 14 February 2024 to identify qualitative, quantitative, and mixed-methods studies that described factors affecting participation of pregnant and lactating women in vaccine and therapeutic clinical trials in any setting. We used thematic synthesis to analyse the qualitative literature and assessed confidence in each qualitative review finding using the GRADE-CERQual approach. We compared quantitative data against…
matched on Lactation (mesh)
Dahl C, Stigum H, Valeur J, Iszatt N, Lenters V, Peddada S, Bjørnholt JV, Midtvedt T, Mandal S, Eggesbø M (2018)MEDLINE-indexed journal, not yet read by usInternational journal of epidemiology61 citations Preterm infants have distinct microbiomes not explained by mode of delivery, breastfeeding duration or antibiotic exposure.
Background: Preterm infants have low gut microbial diversity and few anaerobes. It is unclear whether the low diversity pertains to prematurity itself or is due to differences in delivery mode, feeding mode or exposure to antibiotics.
Methods: The Norwegian Microbiota Study (NoMIC) was established to examine the colonization of the infant gut and health outcomes. 16S rRNA gene Illumina amplicon-sequenced samples from 519 children (160 preterms), collected at 10 days, 4 months and 1 year postnatally, were used to calculate alpha diversity. Short-chain fatty acids (SCFA) were analysed with gas chromatography and quantified using flame ionization detection. We regressed alpha diversity on gestational age, taking into account possible confounding and mediating factors, such as breastfeeding and antibiotics. Taxonomic differences were tested using Analysis of Composition of Microbiomes (ANCOM…
matched on Breast Feeding (mesh), Intensive Care Units, Neonatal (mesh), breastfeeding (text), Infant, Newborn (mesh), Infant, Premature (mesh)
Association of Red Blood Cell Transfusion, Anemia, and Necrotizing Enterocolitis in Very Low-Birth-Weight Infants.
Importance: Data regarding the contribution of red blood cell (RBC) transfusion and anemia to necrotizing enterocolitis (NEC) are conflicting. These associations have not been prospectively evaluated, accounting for repeated, time-varying exposures.
Objective: To determine the relationship between RBC transfusion, severe anemia, and NEC.
Design, setting, and participants: In a secondary, prospective, multicenter observational cohort study from January 2010 to February 2014, very low-birth-weight (VLBW, ≤1500 g) infants, within 5 days of birth, were enrolled at 3 level III neonatal intensive care units in Atlanta, Georgia. Two hospitals were academically affiliated and 1 was a community hospital. Infants received follow-up until 90 days, hospital discharge, transfer to a non-study-affiliated hospital, or death (whichever came first). Multivariable competing-risks Cox regression was used, …
matched on Intensive Care Units, Neonatal (mesh), breastfeeding (text), Infant, Newborn (mesh)
Which mothers wean their babies prematurely from full breastfeeding? An Australian cohort study.
Aim: To identify the maternal and infant characteristics associated with an early transition from full breastfeeding to complementary or no breastfeeding during the first 2 months of life in a large, representative cohort of Australian infants.
Method: Multinomial logistic modelling was performed on data for infants with complete breastfeeding and sociodemographic data (N = 4679) including maternal age, education, smoking, employment, pregnancy and birth outcomes.
Results: Ninety-one percent of women initiated breastfeeding. Sixty-nine percent of infants were being fully breastfed at 1 month, and 59% were fully breastfed at 2 months. Maternal characteristics - age less than 25 years, smoking in pregnancy, early full-time postnatal employment and less educational attainment - were associated with early breastfeeding cessation. Infant factors - multiple birth, caesarean birth, infant or fi…
matched on Breast Feeding (mesh), Weaning (mesh), breastfeeding (text), Infant, Newborn (mesh)
Reconsidering childhood undernutrition: can birth spacing make a difference? An analysis of the 2002-2003 El Salvador National Family Health Survey.
It is well understood that undernutrition underpins much of child morbidity and mortality in less developed countries, but the causes of undernutrition are complex and interrelated, requiring a multipronged approach for intervention. This paper uses a subsample of 3853 children under age 5 from the most recent family health survey in El Salvador to examine the relationship between birth spacing and childhood undernutrition (stunting and underweight). While recent research and guidance suggest that birth spacing of three to five years contributes to lower levels of infant and childhood mortality, little attention has been given to the possibility that short birth intervals have longer-term effects on childhood nutrition status. The analysis controls for clustering effects arising from siblings being included in the subsample, as well as variables that are associated with household resourc…
matched on Breast Feeding (mesh), Infant Nutritional Physiological Phenomena (mesh), breastfeeding (text), Infant, Newborn (mesh)
Rogawski ET, Guerrant RL, Havt A, Lima IFN, Medeiros PHQS, Seidman JC, McCormick BJJ, Babji S, Hariraju D, Bodhidatta L, Shrestha J, Anania J, Maro A, Samie A, Yori PP, Qureshi S, Mahfuz M, Bessong PO, Kosek MN, Ahmed T, Bhutta ZA, Lang DR, Gottlieb M, Houpt ER, Lima AAM, MAL-ED Network Investigators (2017)cohort or longitudinalMEDLINE-indexed journal, not yet read by usPLoS neglected tropical diseases68 citations Epidemiology of enteroaggregative Escherichia coli infections and associated outcomes in the MAL-ED birth cohort.
Background: Enteroaggregative E. coli (EAEC) have been associated with mildly inflammatory diarrhea in outbreaks and in travelers and have been increasingly recognized as enteric pathogens in young children with and without overt diarrhea. We examined the risk factors for EAEC infections and their associations with environmental enteropathy biomarkers and growth outcomes over the first two years of life in eight low-resource settings of the MAL-ED study.
Methods: EAEC infections were detected by PCR gene probes for aatA and aaiC virulence traits in 27,094 non-diarrheal surveillance stools and 7,692 diarrheal stools from 2,092 children in the MAL-ED birth cohort. We identified risk factors for EAEC and estimated the associations of EAEC with diarrhea, enteropathy biomarker concentrations, and both short-term (one to three months) and long-term (to two years of age) growth.
Results: Overal…
matched on exclusive breastfeeding (text), breastfeeding (text), Infant, Newborn (mesh)
The role of psychosocial factors in exclusive breastfeeding to six months postpartum.
Objective: to investigate the psychosocial variables associated with the ability to exclusively breastfeed to six months postpartum. Additionally, to evaluate a conceptual model of psychosocial correlates of exclusive breastfeeding duration.
Design: online, retrospective questionnaire.
Setting: the questionnaire was placed online and participants accessed it through social networking sites including groups relating to breastfeeding, motherhood and parenting. Participants were also able to share the link with their own networks. This online setting facilitated recruitment of a wide range of Australian and international participants.
Participants: 174 women aged 18 years and older who had given birth between six months to two years prior. Participants completed an online questionnaire, which asked them to report on three time points: pre-pregnancy, during pregnancy and during the first six…
matched on Breast Feeding (mesh), exclusive breastfeeding (text), breastfeeding (text), Infant, Newborn (mesh), Postpartum Period (mesh)
Breastfeeding duration and postpartum psychological adjustment: role of maternal attachment styles.
Aim: Depressive and anxiety symptoms are common in new mothers. The aim of this study is to explore the link between postpartum psychological adjustment and feeding preferences of the mothers.
Methods: Sixty mothers and newborns were enrolled in this prospective, longitudinal study. Maternal depressive symptoms were screened by the Edinburgh Postpartum Depression Scale (EPDS), and maternal anxiety level was assessed by the State-Trait Anxiety Inventory at 1 month postpartum. The Multidimensional Scale of Perceived Social Support was used for the assessment of maternal social support. The Adult Attachment Scale was used to determine the attachment style of the mother. Infants were examined and evaluated at 1 and 4 months of life.
Results: All mothers started breastfeeding their infants postpartum; 91% and 68.1% continued exclusive breastfeeding at 1 and 4 months, respectively. The first-m…
matched on Breast Feeding (mesh), exclusive breastfeeding (text), breastfeeding (text), Infant, Newborn (mesh), Postpartum Period (mesh)
Implications of the Tongue's Anatomy and Biomechanics for Breastfeeding.
Aim: The human tongue is a major player for breathing, swallowing, sucking, chewing and speech. Breastfeeding is the initial training for its subsequent tasks. Thus, we aimed to explore the tongue's anatomy and biomechanics with conclusions on breastfeeding, essential for healthy development.
Methods: Literature on human and animal tongue anatomy and physiology was searched using relevant keywords in the Internet, literature lists from lectures and papers, anatomy and lactation textbooks. As data on tongue anatomy/physiology during breastfeeding is limited, transfer from other research areas was necessary. Own visual material was analysed. We identified and represented contracting and relaxing muscles for three selected tongue movements relevant for breastfeeding and compared them with literature findings.
Results: The tongue as a muscular hydrostat creates different shapes. Simultaneous…
matched on Breast Feeding (mesh), breastfeeding (text)