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Infant Health (infant + health)
Terms modified by Infant Health Selected AbstractsAn Examination of Cross-Racial Comparability of Mother-Child Interaction Among African American and Anglo American FamiliesJOURNAL OF MARRIAGE AND FAMILY, Issue 3 2001Leanne Whiteside-Mansell This study examined the cross-racial comparability of maternal quality of assistance and supportive presence coded from a video protocol using data from the Infant Health and Development Program for low-birth-weight, premature 30-month-olds and their mothers. Evidence of equivalence of measures is necessary before comparisons can be made across groups. Multiple-group mean and covariance structures analysis was used to demonstrate the invariance of the measures and make comparisons for Anglo American and African American treatment and comparison groups of dyads. Comparisons across groups indicated similar variances and correlation between child and maternal behavior. Differences were found between the mean scores, with Anglo American treatment families scoring the highest. [source] Differential effects of high-quality child careJOURNAL OF POLICY ANALYSIS AND MANAGEMENT, Issue 4 2002Jennifer Hill In policy research a frequent aim is to estimate treatment effects separately by subgroups. This endeavor becomes a methodological challenge when the subgroups are defined by post-treatment, rather than pre-treatment, variables because if analyses are performed in the same way as with pre-treatment variables, causal interpretations are no longer valid. The authors illustrate a new approach to this challenge within the context of the Infant Health and Development Program, a multisite randomized study that provided at-risk children with intensive, center-based child care. This strategy is used to examine the differential causal effects of access to high-quality child care for children who would otherwise have participated in one of three child care options: no non-maternal care, home-based non-maternal care, and center-based care. Results of this study indicate that children participating in the first two types of care would have gained the most from high-quality center-based care and, moreover, would have more consistently retained the bulk of these positive benefits over time. These results may have implications for policy, particularly with regard to the debate about the potential implications of providing universal child care. © 2002 by the Association for Public Policy Analysis and Management. [source] Promoting Infant Health Through Home Visiting By a Nurse-Managed Community Worker TeamPUBLIC HEALTH NURSING, Issue 4 2001Cynthia Barnes-Boyd R.N., Ph.D. This article describes the Resources, Education and Care in the Home program (REACH-Futures), an infant mortality reduction initiative in the inner city of Chicago built on the World Health Organization (WHO) primary health care model and over a decade of experience administering programs to reduce infant mortality through home visits. The program uses a nurse-managed team, which includes community residents selected, trained, and integrated as health advocates. Service participants were predominately African American families. All participants were low-income and resided in inner-city neighborhoods with high unemployment, high teen birth rates, violent crime, and deteriorated neighborhoods. Outcomes for the first 666 participants are compared to a previous home-visiting program that used only nurses. Participant retention rates were equivalent overall and significantly higher in the first months of the REACH-Futures program. There were two infant deaths during the course of the study, a lower death rate than the previous program or the city. Infant health problems and developmental levels were equivalent to the prior program and significantly more infants were fully immunized at 12 months. The authors conclude that the use of community workers as a part of the home-visiting team is as effective as the nurse-only team in meeting the needs of families at high risk of poor infant outcomes. This approach is of national interest because of its potential to achieve the desired outcomes in a cost-effective manner. [source] Evaluation of early stimulation programs for enhancing brain developmentACTA PAEDIATRICA, Issue 7 2008Christine Bonnier Abstract The term ,early intervention' designates educational and neuroprotection strategies aimed at enhancing brain development. Early educational strategies seek to take advantage of cerebral plasticity. Neuroprotection, a term initially used to characterize substances capable of preventing cell death, now encompasses all interventions that promote normal development and prevent disabilities, including organisational, therapeutic and environment-modifying measures, such as early stimulation programs. Early stimulation programs were first devised in the United States for vulnerable children in low-income families; positive effects were recorded regarding school failure rates and social problems. Programs have also been implemented in several countries for premature infants and low-birth-weight infants, who are at high risk for neurodevelopmental abnormalities. The programs target the child, the parents or both. The best evaluated programs are the NIDCAP (Newborn Individualized Developmental Care and Assessment Program) in Sweden for babies <1500 g in neonatal intensive care units and the longitudinal multisite program IHDP (Infant Health and Development Program) created in the United States for infants <37 weeks or <2500 g. Conclusion: Although the NIDCAP and the IHDP targeted different populations, they produced similar effects in several regards: efficacy was greatest with programs involving both the parents and the child; long-term stimulation improved cognitive outcomes and child,parent interactions; cognition showed greater improvements than motor skills and larger benefits were obtained in families that combined several risk factors including low education attainment by the mothers. [source] Pragmatic indicators for remote Aboriginal maternal and infant health care: why it matters and where to startAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2010Malinda Steenkamp Abstract Objective: There are challenges in delivering maternal and infant health (MIH) care to remote Northern Territory (NT) communities. These include fragmented care with birthing in regional hospitals resulting in cultural and geographical dislocation for Aboriginal women. Many NT initiatives are aimed at improving care. Indicators for evaluating these for remote Aboriginal mothers and infants need to be clearer. We reviewed existing indicators to inform a set of pragmatic indicators for reporting improvement in remote MIH care. Methods: Scientific databases and grey literature (organisational websites and Google Scholar) were searched using the terms ,Aboriginal/maternal/infant/remote health/monitoring performance'. Key stakeholders identified omitted indicators sets. Relevant sets were reviewed and organised by indicator type, stage of patient journey, topic and theme. Results: Forty-two indicators sets were found. Seven focused on Aboriginal health, 23 on reproductive/maternal health, eight on child/infant health and four on other aspects, e.g. remote health. We identified more than 1,000 individual indicators. Of these, 656 were relevant for our purpose and were subsequently organised into 300 topics and 16 themes for antenatal, birth and postpartum, and infant care by indicator type. Conclusion: There are many measures for monitoring health care delivery to mothers and infants. Few are framed around remote MIH services, despite poorer health outcomes of remote mothers and infants and the specific challenges with providing care in this setting. Establishing relevant indicators is vital to support relevant data collection and the development of appropriate policy for remote Aboriginal maternal and infant care. [source] Infant health production functions: what a difference the data makeHEALTH ECONOMICS, Issue 7 2009Nancy E. Reichman Abstract We examine the extent to which infant health production functions are sensitive to model specification and measurement error. We focus on the importance of typically unobserved but theoretically important variables (typically unobserved variables, TUVs), other non-standard covariates (NSCs), input reporting, and characterization of infant health. The TUVs represent wantedness, taste for risky behavior, and maternal health endowment. The NSCs include father characteristics. We estimate the effects of prenatal drug use, prenatal cigarette smoking, and first trimester prenatal care on birth weight, low birth weight, and a measure of abnormal infant health conditions. We compare estimates using self-reported inputs versus input measures that combine information from medical records and self-reports. We find that TUVs and NSCs are significantly associated with both inputs and outcomes, but that excluding them from infant health production functions does not appreciably affect the input estimates. However, using self-reported inputs leads to overestimated effects of inputs, particularly prenatal care, on outcomes, and using a direct measure of infant health does not always yield input estimates similar to those when using birth weight outcomes. The findings have implications for research, data collection, and public health policy. Copyright © 2008 John Wiley & Sons, Ltd. [source] Prenatal drug use and the production of infant healthHEALTH ECONOMICS, Issue 4 2007Kelly Noonan Abstract We estimate the effect of illicit drug use during pregnancy on two measures of poor infant health: low birth weight and abnormal infant health conditions. We use data from a national longitudinal study of urban parents that includes postpartum interviews with mothers, hospital medical record data on the mothers and their newborns, and information about the neighborhood in which the mother resides. We address the potential endogeneity of prenatal drug use. Depending on how prenatal drug use is measured, we find that it increases low birth weight by 4,6 percentage points and that it increases the likelihood of an abnormal infant health condition by 7,12 percentage points. Copyright © 2006 John Wiley & Sons, Ltd. [source] Young African American mothers' changing perceptions of their infants during the transition to parenthood,INFANT MENTAL HEALTH JOURNAL, Issue 5 2009Cynthia O. Lashley Although theory and empirical research with middle-class, mostly White women have suggested that motherhood is an important developmental transition for women, rarely have investigations of adolescent motherhood systematically examined developmental change. This study examines one aspect of change during the transition to parenthood: the mother's emerging perception of her infant. During pregnancy and at 4 months' postpartum, 220 urban African American mothers between the ages of 13 and 21 years were asked to describe their infants. Content analysis of their responses and ratings of the affective tone of the responses suggest that there are changes from pregnancy to 4 months after the birth that parallel shifts noted in literature on women going through the transition to motherhood as adults. Between pregnancy and 4 months, there was a decreasing focus on infant health and physical appearance and an increasing focus on infant behavioral achievements and personality characteristics. Of particular importance to mothers was that their infants be "good" babies who were easy to care for and were easily accepted by the family. Mothers imagined physical similarities with their infants during pregnancy and describe aspects of their interaction and emotional bond with their infants at 4 months. Overall, mothers' descriptions of their babies were quite positive, increasingly positive over time, and offered little evidence that for these young African American women the transition to parenthood was problematic. [source] The development and pilot evaluation of a nutrition education intervention programme for pregnant teenage women (food for life)JOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 2 2003W. L. Wrieden Abstract Background A healthy diet in pregnancy is important for both maternal and infant health but this may be difficult to achieve particularly for groups such as teenage pregnant women, many of whom are from disadvantaged backgrounds. To our knowledge this is the first report of a practical nutrition education programme for this group in the UK. Method An intervention was designed incorporating seven informal food preparation sessions, which allowed opportunities for discussion of nutritional, and other topics (e.g. food safety and well-being in pregnancy). Midwives in a community centre setting led the sessions. The acceptability of the package to participants and midwives was recorded and pre- and post-intervention data collected on sociodemographic details, dietary intake (using an eating-habits questionnaire and a 24-h dietary recall) and cooking skills. Results The midwives found the package easy to follow and use. The 16 (of the 120 invited) women who attended found the courses helpful but objective evaluation of dietary intake was not possible because of poor compliance. Conclusions The nutrition education programme was favourably received by midwives and the women who participated. However recruitment was problematic and alternative methods of delivering and evaluating such a package should be investigated. [source] Maternal, paternal and environmental tobacco smoking and breast feedingPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 3 2002Gabriel M. Leung Summary The effects of environmental tobacco smoke (ETS) on breast-feeding patterns are poorly understood, while those of parental smoking on breast-feeding initiation vs. duration have not been clearly delineated. We conducted a prospective, population-based birth cohort study to examine the independent effects of maternal, paternal and ETS on breast-feeding initiation and duration. A total of 6747 Hong Kong Chinese infants were recruited and followed up in 1997,8. We obtained detailed household smoking history and recorded breast-feeding patterns in three follow-up interviews over 9 months. We found that both maternal and paternal smoking were associated with not initiating breast feeding (odds ratio [OR] for ever maternal smoking = 2.51, 95% confidence interval [CI] = 1.63, 3.86; OR for ever paternal smoking = 1.22, 95% CI = 1.08, 1.39). Exposure to ETS in utero and post partum were also related to not starting breast feeding (ORETS in utero = 1.10, 95% CI = 0.99,1.24; ORETS post partum = 1.21, 95% CI = 1.08, 1.36). These effects, however, did not persist for breast-feeding duration of , 4 months. Cox proportional hazards modelling confirmed the lack of association between any form of smoking and breast-feeding duration. Our findings suggest that smoking of any kind, during or after pregnancy, is a strong risk indicator for not initiating breast feeding. Smoking as a risk indicator for underlying socio-economic, demographic and psychosocial factors is probably responsible for most of the observed adverse effects, although we cannot rule out direct contributions from pathophysiological mechanisms. Public health strategies directed at these underlying factors should be vigorously pursued to reduce the adverse effects of tobacco on breast feeding and infant health in general. [source] Infant sex predicts breast milk energy contentAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 1 2010Camille E. Powe During human evolutionary history, and for many around the world, breast milk is the primary source of nutritional energy for infants. Variation in breast milk quality might logically have important effects on infant health, growth, and development, yet the sources of this variation remain largely unelucidated. We quantified nutrient and energy content of breast milk from 25 healthy, well-nourished Massachusetts mothers with infants aged 2,5 months. We examined several potential sources of variation in milk quality, particularly feeding patterns, infant sex, and maternal breast growth during pregnancy. After controlling for time since last feeding, a known correlate of milk composition, we found that mothers of male infants produced milk that had 25% greater energy content than mothers of female infants (P < 0.001). Change in maternal bra cup size during pregnancy was associated with 16.17 kcal/100 ml greater energy content of milk (P = 0.009), but was not significant after taking infant sex into account. Greater nutritional investment in sons may account for the greater observed growth rates in male compared to female infants. Am. J. Hum. Biol. 2010. © 2009 Wiley-Liss, Inc. [source] Pragmatic indicators for remote Aboriginal maternal and infant health care: why it matters and where to startAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2010Malinda Steenkamp Abstract Objective: There are challenges in delivering maternal and infant health (MIH) care to remote Northern Territory (NT) communities. These include fragmented care with birthing in regional hospitals resulting in cultural and geographical dislocation for Aboriginal women. Many NT initiatives are aimed at improving care. Indicators for evaluating these for remote Aboriginal mothers and infants need to be clearer. We reviewed existing indicators to inform a set of pragmatic indicators for reporting improvement in remote MIH care. Methods: Scientific databases and grey literature (organisational websites and Google Scholar) were searched using the terms ,Aboriginal/maternal/infant/remote health/monitoring performance'. Key stakeholders identified omitted indicators sets. Relevant sets were reviewed and organised by indicator type, stage of patient journey, topic and theme. Results: Forty-two indicators sets were found. Seven focused on Aboriginal health, 23 on reproductive/maternal health, eight on child/infant health and four on other aspects, e.g. remote health. We identified more than 1,000 individual indicators. Of these, 656 were relevant for our purpose and were subsequently organised into 300 topics and 16 themes for antenatal, birth and postpartum, and infant care by indicator type. Conclusion: There are many measures for monitoring health care delivery to mothers and infants. Few are framed around remote MIH services, despite poorer health outcomes of remote mothers and infants and the specific challenges with providing care in this setting. Establishing relevant indicators is vital to support relevant data collection and the development of appropriate policy for remote Aboriginal maternal and infant care. [source] Prevalence of health behaviours in pregnancy at service entry in a Queensland health service districtAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 3 2009Shelley A. Wilkinson Abstract Objective: Limited prevalence data for unhealthy pregnancy health behaviours make it difficult to prioritise primary prevention efforts for maternal and infant health. This study's objective was to establish the prevalence of cigarette smoking, sufficient fruit and vegetable intake and sufficient physical activity among women accessing antenatal clinics in a Queensland (Australia) health service district. Method: Cross-sectional self-reported smoking status, daily fruit and vegetable intake, weekly physical activity and a range of socio-demographic variables were obtained from women recruited at their initial antenatal clinic visit, over a three-month recruitment phase during 2007. Results: Analyses were based on 262 pregnant women. The study sample was broadly representative of women giving birth in the district and state, with higher representation of women with low levels of education and high income. More than one quarter of women were smoking. Few women met the guidelines for sufficient fruit (9.2%), vegetables (2.7%) or physical activity (32.8%) during pregnancy. Conclusions: There were low levels of adherence to health behaviour recommendations for pregnancy in this sample. Implications: There is a clear need to develop and evaluate effective pregnancy behaviour interventions to improve primary prevention in maternal and infant health. Brief minimal contact interventions that can be delivered through primary care to create a greater primary prevention focus for maternal and infant health would be worth exploring. [source] Mothers without Companionship During Childbirth: An Analysis within the Millennium Cohort StudyBIRTH, Issue 4 2008Holly N. Essex MSc ABSTRACT: Background: Studies have highlighted the benefits of social support during labor but no studies focused on women who choose to be unaccompanied or who have no companion available at birth. Our goals were, first, to identify characteristics of women who are unaccompanied at birth and compare these to those who had support and, second, to establish whether or not being unaccompanied at birth is a risk marker for adverse maternal and infant health outcomes. Methods: The sample comprised 16,610 natural mother-infant pairs, excluding women with planned cesarean sections in the Millennium Cohort Study. Multivariable regression models were used to examine, first, sociodemographic, cultural, socioeconomic, and pregnancy characteristics in relation to being unaccompanied and, second, being unaccompanied at birth in relation to labor and delivery outcomes, maternal health and health-related behaviors, parenting, and infant health and development. Results: Mothers who were single (vs not single), multiparous (vs primiparous), of black or Pakistani ethnicity (vs white), from poor households (vs nonpoor), with low levels of education (vs high levels), and who did not attend antenatal classes (vs attenders) were at significantly higher risk of being unaccompanied at birth. Mothers unaccompanied at birth were more likely to have a preterm birth (vs term), an emergency cesarean section (vs spontaneous vaginal delivery) and spinal pain relief or a general anesthetic (vs no pain relief), a shorter labor, and lower satisfaction with life (vs high satisfaction) at 9 months postpartum. Their infants had significantly lower birthweight and were at higher risk of delayed gross motor development (vs normal development). Conclusions: Being unaccompanied at birth may be a useful marker of high-risk mothers and infants in need of additional support in the postpartum period and beyond. (BIRTH 35:4 December 2008) [source] Premature death among teenage mothersBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 8 2004Petra Otterblad Olausson Objective Some data suggest an association between teenage childbearing and premature death. Whether this possible increase in risk is associated with social circumstances before or after childbirth is not known. We studied premature death in relation to age at first birth, social background and social situation after first birth. Design Population-based cohort study. Setting Women born in Sweden registered in the 1985 Swedish Population Census. Population Swedish women born 1950,1964 who had their first infant before the age of 30 years (N= 460,434). Methods Information on the women's social background and social situation after first birth was obtained from Population Censuses. The women were followed up with regard to cause of death from December 1, 1990 to December 31, 1995. Mortality rate ratios and 95% confidence intervals (CI) were calculated. Main outcome measures Mortality rates by cause of death. Results Independent of socio-economic background, teenage mothers faced an increased risk of premature death later in life compared with older mothers (rate ratio 1.6, 95% CI 1.4,1.9). The increased risk was most evident for deaths from cervical cancer, lung cancer, ischaemic heart disease, suicide, inflicted violence and alcohol-related diseases. Some, but not all, of these increases in risk were associated with the poorer social position of teenagers mothers. Conclusions Teenage mothers, independent of socio-economic background, face an increased risk of premature death. Strategies to reduce teenage childbearing are likely to contribute to improved maternal and infant health. [source] Cholinergic and oxidative stress mechanisms in sudden infant death syndromeACTA PAEDIATRICA, Issue 11 2009Anne Dick Abstract Aim:, To determine whether biochemical parameters of cholinergic and oxidative stress function including red cell acetylcholinesterase (AChE), serum/plasma thyroglobulin, selenium, iron, ferritin, vitamins C, E, and A affect risk in apparent life-threatening event (ALTE), sudden infant death syndrome (SIDS), and sudden unexpected death in infancy (SUDI). To assess these biochemical parameters as a function of age; and for influence of pharmacology and epidemiology, including infant health, care, and feeding practices. Methods:, A multicentre, case,control study with blood samples from 34 ALTE and 67 non-ALTE (control) infants matched for age, and 30 SIDS/SUDI and four non-SIDS/non-SUDI (post-mortem control) infants. Results:, Levels/activity of the biochemical parameters were not significantly different in ALTE vs. control infants, with the exception of higher vitamin C levels in the ALTE group (p = 0.009). In ALTE and control groups, AChE and thyroglobulin levels increased and decreased respectively from birth to attain normal adult levels from 6 months. Levels of iron and ferritin were higher in the first 6 month period for all infant groups studied, intersecting with vitamin C levels peaking around 4 months of age. Conclusion:, Lower AChE levels and higher combined levels of iron and vitamin C in the first 6 months of life may augment cholinergic and oxidative stress effect, particularly at the age when SIDS is most prevalent. This may contribute to risk of ALTE and SIDS/SUDI events during infancy. [source] Early-life nutritional and environmental determinants of thymic size in infants born in rural BangladeshACTA PAEDIATRICA, Issue 7 2009SE Moore Abstract Aim:, The aim was to assess the impact of nutritional status and environmental exposures on infant thymic development in the rural Matlab region of Bangladesh. Methods:, In a cohort of Nmax 2094 infants born during a randomized study of combined interventions to improve maternal and infant health, thymic volume (thymic index, TI) was assessed by ultrasonography at birth and at 8, 24 and 52 weeks of age. Data on birth weight, infant anthropometry and feeding status were also collected. Results:, At all ages, TI was positively associated with infant weight and strongly associated with the month of measurement. Longer duration of exclusive breastfeeding resulted in a larger TI at 52 weeks. TI at birth and at 8 weeks correlated positively with birth weight, but by 24 and 52 weeks and when adjusted for infant weight this effect was no longer present. Thymic size was not affected by pre-natal maternal supplementation or by socioeconomic status but was correlated to arsenic exposure during pregnancy. Conclusion:, In this population of rural Bangladeshi infants, thymic development is influenced by both nutritional and environmental exposures early in life. The long-term functional implications of these findings warrant further investigation. [source] Breastfeeding duration and exclusivity associated with infants' health and growth: data from a prospective cohort study in Bavaria, GermanyACTA PAEDIATRICA, Issue 6 2009Barbara Rebhan Abstract Aim: To investigate the relationship between breastfeeding and infant health and to describe growth in the first 9 months. Methods: Mothers delivering a baby in April 2005 were recruited throughout Bavaria, Germany, for a prospective birth cohort study. These mothers reported breastfeeding data, health and growth data of 1901 infants assessed by a physician in questionnaires on day 2,6, and in months 2, 4, 6 and 9. Subjects were healthy term infants with a birth weight ,2500 g. We compared 475 infants breastfed exclusively for ,6 months (group A), 870 infants breastfed fully/exclusively ,4 months, but not exclusively ,6 months (group B) and 619 infants not breastfed/breastfed <4 months (group C). Results: In multivariate analysis ,6 months of exclusive breastfeeding reduced significantly the risk for ,1 episode of gastrointestinal infection(s) during months 1,9 compared to no/<4 months breastfeeding (adjusted odds ratio [OR]: 0.60; 95% confidence interval [CI]: 0.44,0.82). The application of the World Health Organization (WHO) , child growth standards showed lower weight-for-length z-scores in first days of life in group C versus groups A and B, whereas in months 6/7 group C showed the highest scores. Conclusion: Differences in child growth depending on breastfeeding duration should be investigated further. Concerning health outcomes our findings support the recommendation for ,6 months of exclusive breastfeeding. [source] | ||||||||||||||||