Search

Aim Methods Results Conclusion To evaluate the effect of couplet care on parent–infant closeness among preterm infants.A comparison study in a Level III neonatal intensive care unit (NICU) before and after the introduction of couplet care, including stabilising infants in the delivery unit for early skin‐to‐skin contact, providing mothers' postpartum care in the infant's room and providing the father's bed in the infant's room. The study included parents of preterm infants born below 35 weeks.Parents of 40 and 66 infants were included before and after couplet care was introduced, respectively. In the linear regression model, the first skin‐to‐skin contact happened significantly earlier after the introduction than before: mean 4.0 vs. 24.0 h after birth and mean difference −18.5 (95% confidence interval −34.8 to −2.1). A larger proportion of infants received their first skin‐to‐skin contact within 2 h after birth after the introduction than before (45.5% vs. 8.6%; odds ratio 13.8 [3.6–62.8]). At least one parent was present in the infant's NICU room longer after the introduction than before (mean 21.2 vs. 10.8 h per day; mean difference 10.8 [9.1–12.4]).Couplet care significantly increased parent–infant closeness during the first weeks of life. [ABSTRACT FROM AUTHOR]

Introduction: The coronavirus disease 2019 (COVID‐19) pandemic has intensified perinatal anxiety disorders. Psychological flexibility (PF), considered a specific mental toughness, has not been examined with regard to its relationship with anxiety in women after childbirth. We aimed to compare levels of anxiety, PF, and pain in women depending on the mode of birth, parity, and the magnitude of risk of developing an anxiety disorder. We also investigated the association of anxiety with PF and pain. Methods: A total of 187 women after childbirth completed validated questionnaires for anxiety (State‐Trait Anxiety Inventory, Hospital Anxiety and Depression Scale‐Anxiety, Numerical Rating Scale for anxiety [NRS‐A]), PF, and pain (Numerical Rating Scale for pain). Specific postpartum anxieties were assessed with a numerical scale from 0 to 10. The relationship of anxiety with PF and pain was examined. Women at low and high risk of developing anxiety disorder were compared in terms of PF, anxiety, and pain. Results: On the second postpartum day, women after cesarean birth demonstrated significantly greater anxiety on NRS‐A and pain than those after vaginal birth. Primiparous women experienced significantly greater anxieties and pain compared to multiparous women. The higher the PF patients demonstrated, the less anxiety and pain they had. Patients at high risk of developing an anxiety disorder had a lower level of PF (P <.001) and higher levels of anxiety (P <.001) and pain (P <.01) than patients at low risk of developing an anxiety disorder. No difference in the anxiety of getting COVID‐19 was observed between the groups (P >.05). Conclusions: PF is an important psychological construct related to the mental and physical condition of women after childbirth. Increasing PF in women after childbirth may be considered as an important goal of preventive and intervention measures. [ABSTRACT FROM AUTHOR]

Despite decades of research establishing the importance of breastfeeding, skin‐to‐skin contact and mother–infant closeness, the response to the coronavirus disease 2019 (COVID‐19) pandemic has underscored the hidden assumption that these practices can be dispensed with no consequences to mother or child. This article aims to support shared decision‐making process for infant feeding and care with parents and health care providers during the unprecedented times of the pandemic. It proposes a structure and rationale to guide the process that includes (1) discussing with parents evidence‐based information and the different options to feed and care for an infant and young child in the context of the pandemic as well as their potential benefits, risks and scientific uncertainties; (2) helping parents to recognize the sensitive nature of the decisions and to clarify the value they place on the different options to feed and care for their infant or young child; and (3) providing guidance and support needed to make and implement their decisions. A shared decision‐making process will help parents navigate complex feeding and care decisions for their child as we face the different stages of the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Postpartum depression (PPD) is the most common complication of childbearing, and recent studies have attempted to examine risk factors associated with it. The main study hypothesis was that a protective situational factor at a sensitive time period (full rooming‐in postpartum) would moderate the associations between insecure attachment dimensions and PPD. Three hundred twelve women, in either full or partial rooming‐in, participated in a longitudinal study at the maternity ward of a tertiary healthcare center. A Demographic questionnaire and the Experiences in Close Relationships Scale were administered at 1–4 days postpartum, and the Edinburgh Postnatal Depression scale at 2 months postpartum. PPD was significantly associated with both anxious and avoidant attachment dimensions, but not with rooming‐in conditions. In addition, women in partial rooming‐in showed a positive correlation between insecure attachment dimensions and PPD, whereas no such correlation was found for full rooming‐in women. A situational factor such as full rooming‐in, which occurs at a critical time point for the mother–infant relationship, can moderate the association between maternal avoidant or anxious attachment dimensions and the mother's PPD levels. Postpartum practices, such as rooming‐in, can be personalized and thus beneficial in moderating personal risk factors for PPD. [ABSTRACT FROM AUTHOR]

Background: Rooming‐in, or keeping mothers and infants together throughout the birth hospitalization, increases breastfeeding initiation and duration, and is one of the Ten Steps to Successful Breastfeeding. Methods: The Centers for Disease Control and Prevention's (CDC) Maternity Practices in Infant Nutrition and Care (mPINC) survey is a biennial census of all birth facilities in the United States and its territories. Data from the 2007‐2015 mPINC surveys were used to assess trends in the prevalence of hospitals with most (≥90%) infants rooming‐in more than 23 hours per day (ideal practice). Hospital practices among breastfed infants not rooming‐in at night and reasons why hospitals without ideal rooming‐in practices removed healthy, full‐term, breastfed infants from their mothers' rooms were also analyzed. Results: The percentage of hospitals with ideal practice increased from 27.8% in 2007 to 51.4% in 2015. Most breastfed infants who were not rooming‐in were brought to their mothers at night for feedings (91.8% in 2015). Among hospitals without ideal rooming‐in practices, the percentage removing 50% or more of infants from their mothers' rooms at any point during the hospitalization decreased for all reasons surveyed during 2007‐2015; however, in 2015, hospitals still reported regularly removing infants for hearing tests (73.2%), heel sticks (65.5%), infant baths (40.2%), pediatric rounds (35.5%), and infant photos (25.4%). Conclusions: Hospital implementation of rooming‐in increased 23.6 percentage points during 2007‐2015. Continued efforts are needed to ensure that all mothers who choose to breastfeed receive optimal lactation support during the first days after giving birth. [ABSTRACT FROM AUTHOR]

Abstract: Background: Since 1992, breastfeeding promotion in Taiwan considerably raised the breastfeeding rates; however, more recent surveillance showed that breastfeeding indicators stagnated or even decreased. Methods: We analyzed 6 cross‐sectional national surveys of 69 159 postpartum women to examine the breastfeeding trends at 6 months postpartum during 2011‐2016 in Taiwan and the contributing role of maternal and environmental factors. Data were collected through telephone interviews, using structured questionnaires with randomly selected mothers, who gave birth in those years. A multinomial logistic regression was used to analyze the data. Results: Partial breastfeeding rates at 6 months postpartum increased from 2011 to 2016 (25.4%‐45.1%, crude odds ratio [OR] = 1.14 per year of study); however, the rates of exclusive breastfeeding at 6 months postpartum declined (24.5%‐14.8%, crude OR = 0.91 per year of study). During this period, increases in maternal age and educational level, employment outside the house, and prepregnancy obesity were observed. Despite a growing number of births at certified baby‐friendly hospitals, fewer mothers experienced early skin‐to‐skin contact and rooming‐in in 2016 than in 2011. Adjustment for breastfeeding‐related factors did not appreciably change the odds ratio for year of birth. Prenatal intention to breastfeed was most strongly associated with breastfeeding at 6 months postpartum (OR > 5). Conclusions: Maternal and environmental factors in the study could not explain the decline in exclusive breastfeeding. The decline in exclusive breastfeeding, accompanying the increase in partial breastfeeding, suggests that more support is needed for mothers who intend to breastfeed exclusively. [ABSTRACT FROM AUTHOR]

Rates of breastfeeding uptake are lower after a caesarean birth than vaginal birth, despite caesarean rates increasing globally over the past 30 years, and many high-income countries reporting overall caesarean rates of above 25%. A number of factors are likely to be associated with women's infant feeding decisions following a caesarean birth such as limited postoperative mobility, postoperative pain, and ongoing management of medical complications that may have triggered the need for a caesarean birth. The aim of this systematic review was to evaluate evidence of interventions on the initiation and duration of any and exclusive breastfeeding among women who had a planned or unplanned caesarean birth. Seven studies, presenting quantitative and qualitative evidence, published in the English language from January 1994 to February 2016 were included. A limited number of interventions were identified relevant to women who had had a caesarean birth. These included immediate or early skin-to-skin contact, parent education, the provision of sidecar bassinets when rooming-in, and use of breast pumps. Only one study, an intervention that included parent education and targeted breastfeeding support, increased initiation and continuation of breastfeeding, but due to methodological limitations, findings should be considered with caution. There is a need to better understand the impact of caesarean birth on maternal physiological, psychological, and physical recovery, the physiology of lactation and breastfeeding and infant feeding behaviors if effective interventions are to be implemented. [ABSTRACT FROM AUTHOR]

Objectives We examined progress in the practice of early skin-to-skin contact and rooming-in, and their association with breastfeeding, using national samples of postpartum women in the years 2004 and 2011 in Taiwan. Methods This study was a secondary data analysis using 2004 and 2011 national surveys of 12,201 and 12,405 postpartum women, respectively. Results More women had early skin-to-skin contact in 2011 than in 2004 (54.9% vs 20.6%, p < 0.001). Although fewer women practiced rooming-in in 2011 than in 2004 (33.8% vs 45.8%, p < 0.001), the percentage of women rooming-in for 24 hours improved from 6.1 percent to 22.7 percent from 2004 to 2011, and for rooming-in from 12 to less than 24 hours, the percentage improved from 4.3 percent to 10.9 percent ( p < 0.001). The rate of breastfeeding increased by 50 percent during hospitalization (from 57.4% to 85.6%) and by 150 percent at 6 months postpartum (from 20.1% to 50.2%). After adjustment for background characteristics, women who had early skin-to-skin contact were more than twice as likely to breastfeed their infants during hospitalization, and about 1.2 times as likely to breastfeed at 6 months postpartum. The odds ratio for breastfeeding at 6 months generally increased as the duration of rooming-in increased in 2004 ( OR ranged from 1.37 to 2.47). In 2011, only rooming-in for 12 to less than 24 hours ( OR = 1.31) and 24 hours ( OR = 1.98) daily significantly increased the odds ratio for breastfeeding at 6 months postpartum. Conclusions Significant improvements in early skin-to-skin contact, the duration of rooming-in, and breastfeeding were observed in Taiwan. Early skin-to-skin contact and rooming-in for more than 12 hours were associated with increased chances for exclusive breastfeeding and breastfeeding at 6 months postpartum. [ABSTRACT FROM AUTHOR]

The authors present a reply to the article "Maternal and infant characteristics associated with maternal opioid overdose in the year following delivery" by T. Nielsen et al. in the February 2020 issue.

The main objectives of this project, in rural Western Australia, were to collect information, compare and evaluate the functioning of novel types of psychiatric services, including rooming-in facilities, using outcome measurement tools, and to assess the attitude of mental health professionals towards routine outcome measurement. For the first time in rural health services, two outcome measurement tools were used for this purpose: the Health of the Nation Outcome Scales and the World Health Organization Short Disability Assessment Schedule. While staff at 11 rural sites were trained in the use of outcome measurements, only staff from three sites were able to participate in the data collection that spanned for a year and shed information on 39 patients. Two of these sites were rooming-in facilities with different models of care and patient characteristics. Shortage of staff, lack of adequate local information technology support on sites and technical difficulties limited participation. The assessment of staff attitudes towards routine outcome measurement revealed a need to provide staff with reasons and incentives for incorporating outcome measurement into routine practice, in addition to provision of a thorough and on-going training and support in time and resources from management. [ABSTRACT FROM AUTHOR]

Aim: As a result of increased neonatal morbidity, the infants of diabetic mothers have routinely been admitted to a neonatal special care unit (NSCU). We therefore investigated whether the offer of rooming-in diabetic mothers and their newborn infants has an effect on neonatal morbidity. Methods: The records of an old cohort of 103 infants routinely admitted to the NSCU, and a new cohort (N = 102), offered rooming-in were assessed for neonatal morbidity. Results: Eighty-four (82%) of the new cohort infants followed their mothers to the maternity ward; whereas 19 (18%) were transferred to the NSCU chiefly because of prematurity. Ten infants were later transferred to the NSCU for minor problems. Neonatal morbidity and neonatal hypoglycaemia were significantly less common in the new cohort than in the old cohort [27 (26%) vs. 55 (54%), p < 0.001 and 42 (41%) vs. 64 (63%), p = 0.0027 respectively]. Maternal HbA1c in late pregnancy was significantly lower in the new cohort, but the only independent predictors of neonatal morbidity were belonging to the old cohort and preterm delivery. Conclusion: Neonatal care with rooming-in mothers with type 1 diabetes and their newborn infants seems safe and is associated with reduced neonatal morbidity, when compared with routine separation of infants from their mothers. [ABSTRACT FROM AUTHOR]