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Background: Parenting a child with Autism Spectrum Disorder (ASD) may lead to emotional distress. However, it has been recognized that it can also be accompanied with positive experiences that may conduce parents to posttraumatic growth (PTG). Few studies have investigated the factors that may be associated with growth. The present study aimed to assess the role of maternal perceptions, coping strategies and depressive symptoms to PTG. Method: In this cross-sectional study, 123 mothers of ASD offspring completed self-reported questionnaires to assess posttraumatic growth (PTGI); coping strategies (Βrief-COPE); perceptions about ASD (B-IPQ) and depressive symptoms (PHQ-9). Hierarchical regression analysis was used to assess their independent associations. Results: A significant proportion of mothers (56.1%) reported moderate to high growth levels (PTGI ≥ 63). Nearly half of the mothers (46.3%) reported clinically significant depressive symptoms. Engagement (b = 0.361), cognitive reframing (b = 0.214), personal control (b = 0.200) and depressive symptoms (b = −0.232) were independently and significantly associated with PTG. Conclusions: Mothers of children with ASD may experience moderate to high PTG. Engagement, cognitive reframing, personal control and depressive symptoms were significant predictors of growth level. Interventions aiming to support mothers to potentiate their personal control over ASD, to use adaptive coping strategies and to reduce distress may facilitate their growth. [ABSTRACT FROM AUTHOR]

Background and Objectives: Mental disorders affect around 20% of children and teenagers worldwide, resulting in a decrease in academic success and progress, ultimately resulting in a decrease in their academic performance. This research aimed to determine the level of mental health literacy for high school students in eastern Iran in 2023. Materials and Methods: This descriptive-analytical cross-sectional study was conducted on 348 high school students in Zirkuh City, Iran, using a cluster sampling method. The data was gathered by a 29-item questionnaire known as the Mental Health Literacy Scale (MHLS). Mann-Whitney U-test and Kruskal-Wallis test were utilized for data analysis at a significant level of 0.05. Results: The study included 348 students with a µ (SD) age of 16.27 (0.89) years. Of these, 176 (50.6%) were female. Most students (53.2%) scored low in MHL with a µ (SD) score of 79.3 (9.2). The most common source of mental health knowledge was "Internet and friends" (65.5%). The mean score of "help-seeking attitudes" was significantly higher in students of natural sciences (P<0.03) and technical sciences (P<0.02) than those in humanities. There was a significant difference in the mean score of MHL, the ability to recognize disorders, and help-seeking attitudes based on the father's occupation. The mean scores for MHL and help-seeking attitudes were higher among self-employed fathers than those involved in farming and animal husbandry occupations (P<0.001). The study found that students whose fathers were teachers had a higher ability to recognize disorders compared to the other groups (P<0.001). Conclusion: Based on the results of the study, the level of MHL of the students participating in the study was not favourable. Therefore, it is necessary to develop educational interventions for students and their parents with their teachers' aim. [ABSTRACT FROM AUTHOR]

Copyright of Revista Mexicana de Enfermería is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In Ghana, some pregnant women may not seek antenatal care due to the unavailability of such services in their communities, although preventive service can help reduce maternal mortality with high-quality care. This study aimed to understand the antenatal care opinions of Ghanaian mothers who sought antenatal care, the barriers they faced, and their suggestions for improvement in antenatal care in Ghana. This study's data were collected in the Central and Ashanti regions in Ghana from June 2023 to January 2024. Four hundred and fifty mothers in Ghana who indicated that they had given birth within the last 10 years of the data collection period took part in the study. Our findings revealed that 93.6% of Ghanaian mothers perceived their antenatal care to be of good quality due to proper examinations, friendly provider–patient interactions, reassurance, fair treatment, and proper education, whereas 6.5% of Ghanaian mothers perceived their care to be of poor quality due to long wait times, impersonal interactions, inadequate facility resources, and barriers to communication. For Ghanaian mothers to receive better outcomes for themselves and their children, it is worth improving healthcare facilities, healthcare provider preparedness, local transportation, and addressing financial constraints to go from suboptimal to optimal health services. [ABSTRACT FROM AUTHOR]

Maternal health is a critical public health issue worldwide, with Sub-Saharan Africa (SSA) facing severe challenges in maternal mortality and morbidity. Despite global efforts, progress in SSA remains slow. The Sustainable Development Goals highlight the need for urgent action in this area. Value-based healthcare presents a promising approach to enhance maternal health in SSA by maximising health outcomes for mothers and newborns, enriching patient experiences and efficient resource use. However, the impact and implementation of value-based healthcare in Sub-Saharan Africa's maternal health sector are not well studied. To evaluate the effectiveness and value of value-based healthcare interventions in improving maternal health outcomes in Sub-Saharan Africa. A systematic review was carried out drawing on articles from six databases published between 2000 and 2024. The results suggest that VBHC can significantly improve maternal health, evidenced by successful implementations like obstetric units in Sierra Leone and integrated care in South Africa, which improved outcomes and cost-effectiveness. The success of value-based healthcare interventions hinges on addressing access to quality care, infrastructure, and socioeconomic barriers. Further research is essential to confirm value-based healthcare efficacy in SSA and guide policy for better maternal health outcomes. [ABSTRACT FROM AUTHOR]

Background/Objectives. Adolescence is a critical developmental stage marked by the exploration of independence and self-identity. In this study, we aimed to examine the association between indulgent parenting (characterized by high responsiveness and low demandingness) and adolescents' maladjustments across emotional, behavioral, and social domains. Methods. Using a cross-cultural sample of high school students from the U.S. (n = 268) and China (n = 189), we tested the hypotheses that indulgent parenting was associated with adolescents' maladjustments, and that such association varied by cultural context (U.S. vs. China) and parental gender. Results. The results from Bayesian structural equation modeling supported the hypotheses, showing significant associations between indulgent parenting and adolescents' maladjustments and differences in the associations across cultures and parental gender. Conclusions. The findings highlighted the need for culturally informed parenting programs to foster healthy adolescent development. [ABSTRACT FROM AUTHOR]

Mothers experiencing homelessness are seldom asked about past trauma that may be causal to housing instability and poor health. There are also few validated trauma-focused interventions in family shelters. To address this gap, we tested the feasibility and acceptability of the trauma-focused clinical ethnographic narrative intervention (CENI-TF) in increasing mothers' trauma disclosure, appraisal of its meaning in their lives, and help-seeking behaviors. We also present the qualitative findings to contextualize the intervention. Findings are organized under three major domains and nine subthemes that capture participants' voices and experiences. The CENI-TF has the potential to promote help-seeking behaviors and interrupt recurring cycles of trauma and housing instability in this at-risk population. [ABSTRACT FROM AUTHOR]

Aim: To investigate predictors of low birth satisfaction in a sample of Iranian postpartum women during the COVID‐19 epidemics' fifth wave. Design: A cross‐sectional study. Methods: This study was conducted on 676 postpartum women admitted to postpartum wards of Mobini maternity hospital using a convenience sampling method between 2 Aug and 18 September 2021 in Iran. We used the general linear model and multiple linear regression analyses to determine predictors of birth satisfaction. Results: The mean and standard deviation values of age and education were 28.7 ± 6.6 and 11.1 ± 4.1 (years), respectively. The mean scores of the three scales were as follows: FVC‐19S (14.7 ± 7.5), WHO‐5 (67.5 ± 13.0) and BSS‐R (28.6 ± 7.3). Sixty‐five point nine percent (65.9%) of the participants were multiparous. Overall predictors of low birth satisfaction were emergency caesarean, instrumental birth, episiotomy, Entonox analgesia, low level of well‐being score < 50, fear of COVID‐19, low satisfaction with pregnancy and low satisfaction with spouse's support. The overall proportion of the variance in birth satisfaction explained by all variables is 17.4%. Labor and birth variables explained 12.2% of the variance in birth satisfaction. Patient or Public Contribution: None. [ABSTRACT FROM AUTHOR]

I investigated subjective well-being (SWB)—happiness, meaningfulness, sadness, stress, and tiredness—of 7,087 mothers, engaged in 11,154 cases of activities in which their children were present, using the Conservation of Resources theory. Results of OLS analysis of data from the American Time Use Study suggested that the presence of her parent(s) during the activities was associated positively with the mother's happiness and negatively with her stress. Total time spent with her parent(s) was positively associated with the mother's tiredness. Co-residence with parents was not significantly related to the mother's SWB. The association between the mother's SWB and her involvement with parents was positively moderated by demographic variables that may have increased her need for core resources in the form of kin support. The focus on sandwiched activities in which a mother engaged with her children and parents permitted direct assessment of how those activities affected the mother's SWB. [ABSTRACT FROM AUTHOR]

The purpose of this article is to determine the predictors of positive and negative parenting practices among mothers of two-to-three-year-old children in Tirana, Albania. Cross-sectional data were obtained from a representative sample of 328 mothers of two-to-three-year-old children recruited through eight randomly selected public nurseries in Tirana. Results from bivariate regressions showed significant associations between the key relevant maternal characteristics and maternal parenting practices, in line with previous studies conducted in Western societies. Results from multiple regressions showed that maternal attitudes towards child maltreatment were a dominant significant predictor of negative parenting practices (punitive parenting, inconsistent parenting, and child maltreatment) and that maternal sense of parental competence was a dominant significant predictor of positive parenting practices. The findings suggest a strong, consistent link between maternal belief systems and parenting practices among mothers of toddlers in Tirana and call for the implementation of parent training programmes that address attitudes towards child maltreatment and sense of parental competence in the Albanian society. [ABSTRACT FROM AUTHOR]

Harmonious family relationships are integral to well-being. Given that family relationships are fundamentally interdependent, parents' well-being may be shaped not only by satisfaction with their own relationships with their family members but also by their perceptions of their family members' relationships with each other. This study examines how parents' mental health is shaped by satisfaction with (their perceptions of) the relationships among their children (i.e., perceived children–sibling relationships) and between their spouses and their children (i.e., perceived spouse–child relationships). Analyses using HILDA survey data (N = 43,913 person-years) suggest that parents' satisfaction with their children's relationships with each other and their spouse's relationship with their children are indeed associated with better mental health, primarily through their roles in shaping satisfaction with parent–child and spousal relationships, respectively. Parent–child and spouse–child relationship satisfaction are especially important to mothers' mental health. Findings contribute to family systems research and offer practical implications for promoting family well-being. [ABSTRACT FROM AUTHOR]

BACKGROUND: Postpartum depression (PPD) is an important and prevalent disorder that can have short-term and long-term adverse effects on the mother, child, and family. This meta-analysis was conducted with the aim of investigating factors related to PPD in Iran. METHODS: This systematic review and meta-analysis reviewed observational studies in Iran. Four Persian language databases (Magiran, IranDoc, ISC, and SID) and four English language databases (ScienceDirect, Scopus, PubMed, and Web of Science) were searched from their inception to September 20, 2023. Google Scholar search engine was used to find relevant sources and complete the search coverage. The process of searching and selecting studies was drawn using the Preferred Reporting Items for Systematic reviews and Meta-Analysis diagram. The strength of the association was summarized using the odds ratio (OR) with 95% confidence intervals (CIs). We used RevMan 5.4 software to analyze the data after extraction. RESULTS: A total of 28 studies involving 11,784 participants were included. The meta-analysis showed that cesarean section (OR = 0.77, 95% CI [0.60, 0.98]), history of abortion (OR = 1.48, 95% CI [1.14, 1.92]), unwanted pregnancy (OR = 0.58, 95% CI [0.45, 0.76]), formula feeding (OR = 0.50, 95% CI [0.39, 0.65]), diploma and less education (OR = 1.27, 95% CI [1.08, 1.48]), neonatal hospitalization (OR = 1.77, 95% CI [1.13, 2.76]), more than two deliveries (OR = 0.76, 95% CI [0.67, 0.86]), and low and moderate socioeconomic status (OR = 1.77, 95% CI [1.34, 2.34]) have a significant effect on PPD. Satisfaction of the newborn gender (OR = 0.88, 95% CI [0.58, 1.33]), employment (OR = 1.16, 95% CI [0.97, 1.40]), age (OR = 0.89, 95% CI [0.58, 1.39]), previous depression (OR = 1.76, 95% CI [0.88, 3.50]), and gender of the newborn (OR = 0.82, 95% CI [0.42, 1.60]) did not have a significant effect on PPD. CONCLUSION: The results of this study showed that many factors influence PPD. Most of these factors can be identified during pregnancy, which shows the importance of screening during pregnancy. Therefore, it is necessary to design and use screening tools to identify predisposing variables for PPD according to the social–cultural characteristics of different populations. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Maternal smoking during pregnancy or postnatally contributes to significant harm, including stillbirth, preterm birth, low birth weight, and sudden infant death. Alternatively, maternal smoking cessation benefits the health of the woman and child. Informational resources may be helpful for maternal smoking cessation. The objective of this study is to examine such resources from the perspectives of pregnant and postnatal women who smoked. METHODS: The study was a cross-sectional survey design with quantitative and qualitative data. There were 164 participants: 120 pregnant and 44 postnatal. RESULTS: About 29%–59% of women accessed various resources for smoking-related information. Of those, some perceived the resources as helpful, while others did not share that view. Mixed perceptions of the helpfulness of resources were also the case for women's preferences for resources for quitting smoking. Women offered suggestions for specific information and support they thought would be helpful for quitting smoking during pregnancy or postnatally. Helpful information consisted of (a) realistic messages about the harmfulness of smoking to the fetus, child, and woman and realistic messages involving shared personal experiences of smoking and quitting smoking during pregnancy and (b) advice about how to quit smoking during pregnancy or postnatally. Helpful support consisted of (a) nonjudgmental understanding, (b) assistance to deal with stress and personal issues, and (c) tangible aid for smoking cessation. CONCLUSION: The findings suggest that a variety of informational and support resources are necessary and should be readily available to meet the individualized needs of pregnant women or postnatal women who smoke. [ABSTRACT FROM AUTHOR]

Copyright of Documentos de Enfermeria is the property of Colegio Oficial de Enfermeria de Huelva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

When a mother is supported to breastfeed, the benefits for her mental health are significant. However, if pressured or unsupported, the opposite is true. This research examines mothers' breastfeeding experiences, exploring how perceived pressure can impact perinatal mental health. A sample of 501 respondents to a research questionnaire was explored using Reflexive Thematic Analysis. Three main themes identified were perceived pressure to breastfeed, perceived pressure not to breastfeed and mental health impact. The main findings were that mothers received conflicting advice from healthcare professionals, and pressures to feed in a certain way came from their support networks, as well as from their internal beliefs. Perceived pressures negatively impacted maternal mental health, while positive breastfeeding experiences benefitted mental health outcomes. [ABSTRACT FROM AUTHOR]

Background: Breastfeeding is the gold standard in infant nutrition. Successful breastfeeding depends on many factors, including the help of medical personnel in teaching breastfeeding, the need for professional work, and breastfeeding-friendly places in public spaces. The main goal was to identify various barriers among mothers to breastfeeding. Methods: This study used a quantitative descriptive research design. We recruited 419 mothers aged at least 18 years old through social media. Results were analysed using Pearson's chi-squared and Fisher's tests of independence for pairs of dependent and independent variables. Results: Most often, women gave birth at the age of 25–30, had one or two children, and attended higher education. Almost half of them lived in a large city and gave birth to a child by caesarean section. A total of 83.1% of mothers planned to breastfeed, but not all of them were able to do so for various reasons. One-third of them felt sorry for themselves that they had to change their feeding method. The majority of mothers did not receive sufficient help in the hospital in terms of learning how to breastfeed (61%), did not use the help of a lactation consultant (67%), and answered that there was no lactation consultant in their place of residence (65%). Only 43.2% of mothers returned to work without ceasing breastfeeding. A total of 42% of mothers experienced feelings of embarrassment when breastfeeding in a public place. The most frequently indicated barrier to breastfeeding in a public place was the lack of a suitable location where a woman would feel comfortable, calm, and intimate. Conclusion: There are various barriers towards breastfeeding: too few lactation consultants, problems with breastfeeding when the mother wants to return to work, and unfriendly places for breastfeeding in public spaces. Efforts must be made to support mothers in breastfeeding. [ABSTRACT FROM AUTHOR]

In 2022, 54% of 1.5 million children (age 0–14) living with HIV had access to anti-retroviral medication (ART). Adherence to ART for pregnant or breastfeeding HIV + women is critical for maintaining their personal health and to prevent mother-to-child-transmission (MTCT). For HIV + infants, adherence is essential to establish early viremic control and is contingent on caregiver administration. We conducted a scoping review to systematically identify and categorize the influences on ART adherence for pregnant or breastfeeding HIV + women and their HIV + infants. We searched databases in June 2023 and employed the Social-Ecological Model (SEM) to organize facilitators and barriers to adherence referenced in published articles. All articles published before 2016 were excluded due to updated guidelines from WHO on MTCT and ART. Our analysis included 52 articles. 50/52 took place in Africa and used cross-sectional and mixed-methods design. Barriers to adherence for pregnant or breastfeeding HIV + women included maternal education, self-efficacy, social support, and social/economic context. Barriers to infant adherence included development, nutrition, age of treatment initiation, disclosure, and ART side effects. Additional facilitators and barriers to adherence are presented at family, extra-familial, and socio-cultural SEM levels. Stigma was the most salient barrier referenced across the entire continuum of HIV care and all SEM levels. This review revealed a dearth of literature focusing on HIV + infants who are dependent on their caregivers for ART adherence and lack of a standard adherence measure. We identified multi-leveled influences on adherence impacting both the mother and infant and are amenable to public health intervention. [ABSTRACT FROM AUTHOR]

Depression is associated with alterations in prosody when speaking (e.g., less variation in pitch, slowed speech rate), but less is known about its impact on emotional prosody. This is particularly important to investigate in parent–child contexts, as parental expression of emotion may contribute to the intergenerational transmission of depression risk. The current study asked mothers of preschool-aged children (with and without a history of major depressive disorder during their child's lifetime) to produce child-relevant sentences in neutral, angry, and happy tones of voice. We examined whether groups' portrayals were acoustically or perceptually different, in speech analyses and listener ratings. Mothers with a history of depression expressed happiness with less range in pitch and a slower speech rate (slower, more monotonous voice) than mothers with no history of depression. Across groups, happy exemplars with less range in pitch were rated as less emotionally intense, recognizable, and authentically happy by listeners; slower speech rate was associated with opposite perceptual ratings. However, listeners' ratings did not differ by depression group as a whole. Results suggest that a history of depression may influence maternal vocal expression of happiness, but that its impact on listeners' perceptions may depend on mothers' idiosyncratic use of acoustic cues. [ABSTRACT FROM AUTHOR]

This article explores the ways in which bereaved mothers framed experiences of continuing bonds with their stillborn child and aims to enrich an understanding of maternal sense-making. Four interviews were carried out with bereaved mothers and approached using Interpretative Phenomenological Analysis, so as to offer deeper insight into their individual experiences. Themes which arose from the analysis include: "Continuing bonds and the female body;" "Conflicted bonding with the shape-shifting baby;" and "Experiencing connection in the life beyond loss." These findings point to a tension between restorative meaning-making and detachment in maternal sense-making following stillbirth and have implications for clinicians working with bereaved mothers. [ABSTRACT FROM AUTHOR]

Background: School engagement is a positive, malleable aspect of youth functioning that may be influenced by familial factors. Both risk and protective factors may affect youth's school engagement. Objective: Utilizing an intergenerational transmission of risk framework, the current study examined how maternal factors (i.e., maternal psychopathology, maternal trauma history, maternal education) and youth factors (i.e., social support) relate to school engagement. Methods: Participants were 117 youth of color aged 8–13 years (Mage = 9.96, SD = 1.40), 51% female, 89% Black or African American and their female primary caregivers; all families had experienced adversity. Using a single-group, cross-sectional design, hierarchical linear regression models examined direct and interactive effects. The first block included maternal psychopathology (i.e., anxiety or depression), maternal trauma history, maternal education, and child social support. The second block added the interaction between maternal psychopathology and child social support. Results: Results revealed a direct, positive relation between child social support and school engagement. Social support also moderated the association between maternal anxiety and school engagement; for individuals with extremely low social support, higher maternal anxiety was related to lower school engagement. Conclusions: Results illustrate the value of an intergenerational approach to exploring how maternal factors have implications for youth functioning. Findings also highlight the importance of social support among families of color exposed to adversity. Limitations include the cross-sectional design; thus, future research would benefit from longitudinal examination of maternal and child factors related to school engagement to assess temporal and directional effects. [ABSTRACT FROM AUTHOR]

Background: Knowledge, attitudes, and practices related to oral health among parents play a crucial role in shaping oral hygiene and preventing early childhood caries. This study was intended to determine the effect of a neuroeducational strategy in improving knowledge, attitudes, and practices related to early childhood caries among mothers or caregivers of children. Methods: A quasi-experimental study was conducted, implementing an educational strategy involving 33 mothers or female caregivers of children who met specific selection criteria. The strategy consisted of three key elements derived from neuroeducation: (1) experiment, (2) surprise and play, and (3) learn. Based on the participants' attendance at the sessions, they were categorized into two groups: those who underwent in-person intervention (G1) and those who received a combined in-person and virtual intervention (G2). The impact of the strategy was evaluated by comparing the participants' knowledge and attitudes, as well as their children's plaque index, before and after the intervention (immediate and 6-month impact). Results: The participants exhibited a favorable and statistically significant effect on the median number of correct answers related to knowledge (G1 immediate effect (IE): p = 0.03, 6-month effect (ME): p = 0.002; G2 IE p = 0.002, ME: p = 0.001), and in the children's plaque index (G1 IE: p = 0.003, ME: p = 0.003; G2 IE: p = 0.033, ME: p = 0.003). Furthermore, there was an increase in the number of participants with a high level of knowledge (G1 IE: 41.5%; ME: 75%; G2 IE: 45.5%, ME: 42.9%), and of children with a good level of oral hygiene (G1 IE: 50%; ME: 73.0%; G2 IE: 27.3%, ME: 84.6%). Finally, qualitative interviews revealed a lasting clarity in concepts and sustained knowledge and attitudes at the six-month mark. However, a slightly diminished understanding of the relationship between bacteria, sugar, and caries was observed in G2 group, and some loss of association in the G1 group, at six months. Conclusion: The implementation of this strategy resulted in significant and lasting impacts on knowledge, attitudes, and practices, especially in the G1 group. Nevertheless, there is a need for further reinforcement of the association between bacteria, sugar, and caries. [ABSTRACT FROM AUTHOR]

Background: Infants requiring neonatal care often face initial breastfeeding challenges, leading them to receive expressed breast milk from their mother or donor milk. While emphasizing the mother's own milk as the gold standard for infant nutrition, the utilization of donor milk stands as the preferred alternative over infant formula due to its numerous benefits. To facilitate the provision of donor milk to preterm and ill infants in neonatal units, the active participation of women willing to contribute their breast milk is crucial. This study aims to enhance the understanding of women's experiences in the donation process, thereby contributing to efforts aiming at alleviating the shortage of donated breast milk by improve the care and support for breast milk donors. Methods: This descriptive qualitative study took an inductive approach based on individual semi-structured interviews conducted during 2021 with 15 breast milk donors in Sweden. The data were analysed with thematic analysis. Results: Two themes were identified in the analysis: motivation to donate and challenges to overcome. Many of the women struggled to overcome the apparent challenges of not only starting the process of donating breast milk but also maintaining it. Despite the strain, they were motivated to donate their breast milk and seeking information by themselves to do something important for someone else. Only a few of the women talked about the financial benefits of donating breast milk; donating seemed to be mostly based on altruistic reasons. Conclusions: Despite the challenges posed by COVID-19 restrictions, time consumption, and the hard work of sterilizing pump utensils, women continued to donate their milk driven by altruism. To enhance donor support and increase milk donation, several improvements are suggested: providing comprehensive information and resources, simplifying the donation process, offering flexible scheduling, and recognizing donors' contributions. [ABSTRACT FROM AUTHOR]

Background: Public health initiatives (e.g., the Baby Friendly Hospital Initiative) have led to an increase in breastfeeding rates worldwide. However, as (exclusive) breastfeeding duration is still below WHO recommendations, it is crucial to understand the factors that influence decisions on breastfeeding practice. Modifiable psychological factors such as intention to breastfeed have therefore become targets of recent interventions. As the intention to breastfeed is among the strongest predictors of breastfeeding duration, reliable tools for measuring the intention to breastfeed are needed. The Iowa Infant Feeding Attitude Scale (IIFAS) measures attitudes towards infant feeding and is used in various languages and across different cultural contexts. However, there has been no German version of the IIFAS (IIFAS-G) so far. The aim of this study was to investigate reliability, validity, and associations of the IIFAS-G with feeding method and breastfeeding duration. Methods: Between August and November 2022, a total of 353 mothers (Mage = 35 years, SDage = 4.2 years) of singleton infants (47.3% female (1 undetermined), Mage = 10.8 months, SDage = 4.7 months, age range: 3-547 days; 90.4% living in Switzerland) participated in an online survey. The IIFAS-G was administered as a part of a larger study on early child development and infant feeding method. Results: The translated IIFAS-G showed unsatisfactory model fit for the two factor 17-item solution. Four items showed low factor loadings. After item reduction, a 13-item two factor solution showed satisfactory model fit (CFI = 0.92, TLI = 0.90, RMSEA = 0.07) and high internal consistency (Cronbach's α = 0.85). The IIFAS-G score was higher for mothers who exclusively breastfed their infants compared to mothers who additionally or exclusively fed infant formula. Moreover, mothers with higher IIFAS-G scores were less likely to stop breastfeeding their child over the course of 1.5years (HR = 0.87). Conclusion: A shorter two-factor IIFAS-G is proposed to investigate attitudes towards breastfeeding and formula feeding in German-speaking mothers. [ABSTRACT FROM AUTHOR]

This study examined whether maternal depression is related to Early Childhood Developmental (ECD) delay among children by quantifying the mediating contribution of responsive caregiving. We used data from 1235 children (Children's mean age = 50.4 months; 582 girls, 653 boys, 93.9% were Han), selected through convenience sampling, in 2021. 4.7% of children had ECD delay, 34.3% of mothers had depression. Children with depressed mothers were less likely to receive responsive caregiving (OR 4.35, 95% CI 2.60–7.27), and those who did not receive responsive caregiving were more likely to experience ECD delay (OR 3.89, 95% CI 1.89–8.02). Responsive caregiving partly mediated the relationship between maternal depression and ECD. Early intervention for children with depressed mothers is worthy of further investigation. [ABSTRACT FROM AUTHOR]

Background: This paper outlines a pilot of a new memory aide for breastfeeding conducted in the Northeast of England and North Cumbria between April and August 2023. The United Kingdom has some of the lowest rates of breastfeeding, particularly in the Northeast of England, and as such more needs to be done to support mothers to breastfeed for as long as they would like to. Good support from health professionals can be effective in influencing decisions to breastfeed as well as helping to ensure initiation and continuation of breastfeeding but there is evidence to suggest that professionals and students do not always feel adequately trained and it is here, where memory aides may have value. Methods: Key breastfeeding practitioners and educators were brought together to select one of two memory aides for principles of attachment for effective breastfeeding. The selected memory aide, LATCHS, was piloted with 57 participants with a key role in promotion and support of breastfeeding in the Northeast of England and North Cumbria. Results: Participants conveyed mixed views about the proposed memory aide with more experienced staff reporting more favourable opinions than student midwives and early years practitioners. Experienced staff felt the new memory aide would complement an early memory aide, CHINS, which focused on principles of positioning. Discussion: Findings of the pilot indicate there is a role for a mnemonic to help practitioners understand, recall, and retain theory around attachment for effective breastfeeding and that memory aides can play an important role in complementing existing approaches to education and practice. The participants felt the proposed memory aide had some limitations and suggested important ways for it to be improved, particularly in adding an E to reflect the expecting wording. This produced the final memory aide: LATCHES. Conclusion: Using data from the pilot, the memory aide was refined, and the final version LATCHES agreed for wider dissemination. Future research is needed to understand the value of LATCHES on the wider breastfeeding workforce and whether any future improvements can be made to enhance its utility. [ABSTRACT FROM AUTHOR]

Suicide accounts for 33% of deaths of women during the postnatal period in many low- and middle-income countries (LMICs). Resilience refers to an ability to adapt and recover from adversity or misfortune. Resilience building against mental health challenges during pregnancy and the postnatal period is critical for women to raise their child efficiently and maintain a healthy life. The exploration of maternal resilience against mental health challenges including its developmental processes and the determinants of its successful or unsuccessful cultivation among mothers during pregnancy and childbirth is of paramount importance. Understanding why a subset of mothers effectively develops resilience while others significantly struggle is critical for devising targeted interventions and support mechanisms aimed at improving maternal well-being. This inquiry not only seeks to delineate the factors that contribute to or hinder the development of resilience but also aims to inform the creation of comprehensive support systems that can bolster maternal health outcomes. This paper endeavors to present a comprehensive analysis of maternal resilience, aiming to cultivate a nuanced and profound understanding of the concept within the framework of previous traumatic events and adverse pregnancy outcomes in LMICs. The eight-step method approach proposed by Walker and Avant was utilized for this concept analysis. Several defining attributes were identified in the analysis including social adaptation, support system, optimistic approach, and mindfulness. This analysis contributes to knowledge advancement regarding maternal resilience and provides nurses and other healthcare professionals with a clear understanding of the concept of maternal resilience to help promote resilience among mothers. [ABSTRACT FROM AUTHOR]

Background: The Islamic State of Iraq and Syria (ISIS) committed genocide of the Yazidis in Sinjar 2014, resulting in dispersion and enslavement. Research shows severe mental health problems, such as posttraumatic stress disorder (PTSD) among survivors, but less is known about their resources and strengths, conceptualized as posttraumatic growth (PTG). Aims: are to examine the balance between symptoms and strengths among Yazidi women caring for their infants by identifying groups differing in PTSD and PTG, and analyze how demographic, obstetric, and infant-related factors associate with the groups. Method: Participants were 283 Yazidi mothers with their 1-18-month-old infants displaced in Kurdish Region of North Iraq. PTSD symptoms were measured by Harvard Trauma Questionnaire and PTG by the Posttraumatic Growth Inventory. Results: identified four groups: "Severe symptoms and low growth" (39%), "Low symptoms and moderate growth" (38%), "Moderate symptoms and very high growth" (13%), and "Moderate symptoms and low growth" (10%). Low education, economic difficulties and obstetric problems related to the "Severe symptoms and low growth" group, whereas newborn and infant health problems did not have an impact. Conclusion: Effective help for genocide survivors should both alleviate suffering and encourage resources through tools of recreating a sense of cultural security and pride. [ABSTRACT FROM AUTHOR]

In Japan, many pregnant women and mothers suffer from anxiety, depression, and other postnatal issues that can be exacerbated by their birth experiences. While benefiting from advanced medical care, these women's mental and psychological health may be disregarded in their maternity care. Midwives have the potential to play a significant role in improving women's birth experiences. Hence, this study aimed to explore the meaning of the woman–midwife relationship, with a specific focus on sensing peace of mind and trust to improve women's birth experiences. Using a hermeneutic phenomenological approach, 14 Japanese women were interviewed. Sensing peace of mind and trust was one of the significant meanings of the woman–midwife relationship and is articulated across five themes: (1) attuning to the world, (2) different kinds of safety and trust, (3) relying on and entrusting midwives, (4) making a mother, and (5) an emotional bridge. The positive relationship with midwives enhanced the women's mental well-being through allowing the women to attune to the peaceful mind which directed their future perspectives and sustained them in motherhood. They became confident mothers by trusting their midwives. The maternity care system in Japan needs to shift to more relationship-based care to ensure continuity of midwifery care that will improve women's birth experiences and their long-term well-being. [ABSTRACT FROM AUTHOR]

Breastfeeding is the optimal form of nutrition for infants and young children. The World Health Organization recommends that babies are breastfed exclusively for the first 6 months of life, and up to the age of 2 years or beyond in combination with complementary food. Breastfeeding initiation and continuation rates are suboptimal globally and very low in the Republic of Ireland where health promotion initiatives and healthcare professional support predominantly focus on the important phase of initiation and early months of the breastfeeding journey. This qualitative descriptive study aimed to explore the experiences of women who chose to breastfeed their children beyond 1 year of age in the Republic of Ireland. Fourteen women participated in semi-structured interviews. Interviews were transcribed verbatim and thematic analysis was conducted. The analysis generated three overarching themes: (1) Influences on breastfeeding beyond 1 year, (2) Sustaining breastfeeding and (3) Benefits of breastfeeding beyond 1 year. Family, friends, peers, culture and commercial milk formula marketing had an influence on breastfeeding journeys. Support, determination, knowledge, bed-sharing and Covid-19 pandemic social restrictions helped to sustain breastfeeding beyond 1 year. Benefits of breastfeeding beyond 1 year such as nutrition, strengthening of emotional bonds, development of a parenting tool, and protection of child and maternal health were identified. Our findings support the need for discussions and further research on the normalization of breastfeeding beyond 1 year in the Republic of Ireland, targeted health promotion initiatives and education programmes for healthcare professionals on supporting the continuation of breastfeeding. [ABSTRACT FROM AUTHOR]

Stressful events are inherently emotional. As a result, the ability to regulate emotions is critical in responding effectively to stressors. Differential abilities in the management of stress appear very early in life, compelling a need to better understand factors that may shape the capacity for emotion regulation (ER). Variations in both biologic and behavioural characteristics are thought to influence individual differences in ER development. We sought to determine the differential contributions of temperament and heart rate variability (HRV; an indicator of autonomic nervous system function) to infant resting state emotionality and emotional reactivity in response to a stressor at 6 months of age. Participants included 108 mother‐infant dyads. Mothers completed a measure of infant temperament at 6 months postnatal. Mother and infant also participated in a standardized stressor (the Repeated Still Face Paradigm) at that time. Electrocardiographic data were acquired from the infant during a baseline resting state and throughout the stressor. Fast Fourier Transformation was used to analyse the high frequency (HF) domain of HRV, a measure of parasympathetic nervous system activity. Infant ER was measured via standardized coding of emotional distress behaviours from video‐records at baseline and throughout the stressor. Severity of mothers' depressive symptoms was included as a covariate in analyses. Results of linear regression indicate that neither temperament nor HRV were associated significantly with an infant's emotional resting state, although a small effect size was found for the relationship between infant negative affectivity and greater emotional distress (β = 0.23, p = 0.08) prior to the stressor. Higher HF‐HRV (suggesting parasympathetic dominance) was related to greater emotional distress in response to the stressor (β = 0.34, p = 0.009). This greater emotional reactivity may reflect a more robust capacity to mount an emotional response to the stressor when infants encounter it from a bedrock of parasympathetic activation. Findings may inform eventual markers for assessment of ER in infancy and areas for intervention to enhance infant management of emotions, especially during stressful events. [ABSTRACT FROM AUTHOR]

Background: Violence against women has numerous devastating effects. Exposure to violence not only impacts women but also affects their children both physically and psychosocially. Aims: The study aimed to evaluate the psychosocial problems of children living with their mothers in women's shelters from the mothers' perspective with a phenomenological approach. Methods: Utilizing the phenomenological research method, semi-structured in-depth interviews were conducted with 14 individuals in a women's shelter in a province in northern Türkiye. The criterion sampling method, a purposive sampling technique, was employed to select participants. Interviews continued until data saturation was achieved. All interviews were audio recorded and then transcribed, and thematic analysis was applied to analyze the data. The study adhered to the COREQ checklist for reporting. Results: The data analysis revealed four main categories (effects of violence on the mother, actions taken to protect children from violence, effects of violence and staying in a shelter on the child, and psychosocial needs for the protection of the child's mental health in the shelter) and 10 sub-themes (psychological effects, physical effects, social effects, domestic actions, organizational actions, psychological effects, physical effects, social effects, support system, and coping). Conclusion: The study concluded that violence significantly impacted the mental, physical, and social well-being of both women and children, posing challenges to their ability to cope with the aftermath. Women exerted considerable effort in protecting their children from violence, and they needed psychosocial support to ensure the well-being of their children's mental health during their stay in shelters. [ABSTRACT FROM AUTHOR]

Based on continuing bonds theory, this research examined the experience and manifestations of continuing bonds of bereaved Muslim mothers with their children who died in home accidents. This qualitative phenomenological study is based on interviews with 15 bereaved mothers (aged 28–46 years) whose children (aged 1–6 years) died 2–7 years before the interviews. Analysis revealed three themes: efforts to continue the physical bonds, challenges in the continuing bonds in cases of traumatic death, and belief in afterlife as the main element of the continuing bonds. The traumatic circumstances of the death challenged the ability to maintain the bond based on positive memories without it being overwhelmed by the traumatic memories of the last moments of the child's life. Religious beliefs played an important role in the characteristics of the bond. Maintaining the bond requires professionals to provide a therapeutic environment where bereaved mothers feel safe talking about it. [ABSTRACT FROM AUTHOR]

Purpose: To examine the association between partner support for women's antidepressant treatment and depressive symptoms in pregnant women, those planning pregnancy, and mothers who ever used antidepressants. Methods: We included 334 women (n=44 planners, n=182 pregnant, n=108 mothers) ever treated with antidepressants within the HEALTHx2 study, a web-based cross-sectional study conducted across Norway in June 2020 to June 2021. The Edinburgh Postnatal Depression Scale and two questions of the Patient Health Questionnaire measured depressive symptoms, by degree of severity and for depressed mood, anxiety, and anhedonia sub-dimensions. Partner support was measured using one item from the Antidepressant Compliance Questionnaire. Association was estimated via unadjusted and adjusted linear and logistic regression models. Results: Being unsupported by the partner was associated with increased odds of reporting moderate-to-very-severe depressive symptoms in mothers (adjusted odds ratio (aOR), 3.57; 95% confidence interval (CI), 1.04–12.19) and pregnant women (aOR, 3.26; 95% CI, 0.95–11.14), relative to being supported. Pregnant women (adjusted mean difference (β), 0.76; 95% CI, 0.14–1.38) and mothers (β, 0.93; 95% CI, 0.23–1.64) with no support for their antidepressant treatment presented greater symptoms of anhedonia; for women planning pregnancy, this association emerged in relation to anxiety symptoms (β among non-users of antidepressant, 2.58; 95% CI, 1.04–4.13). Conclusions: Partner support for women's antidepressant treatment may play a key role in depressive symptoms severity and the subtypes of anhedonia and anxiety, among women planning pregnancy, pregnant women, and mothers. This highlights the importance of partner inclusion in the complex decision-making process for antidepressant treatment around the time of pregnancy. [ABSTRACT FROM AUTHOR]

Purpose: Maternal cortisol levels in pregnancy may support the growth of or adversely affect fetal organs, including the brain. While moderate cortisol levels are essential for fetal development, excessive or prolonged elevations may have negative health consequences for both the mother and the offspring. Little is known about predictors of altered hypothalamic–pituitary–adrenal (HPA) axis activity during pregnancy. This study examined maternal hair cortisol concentration (HCC) in the 3rd trimester of pregnancy in relation to severe psychopathology. Methods: Hair samples were collected from 69 women, 32 with a lifetime diagnosis of severe mental disorders (bipolar I or II disorder, moderate or severe depressive disorder, schizophrenic spectrum disorder), and 37 non-clinical controls. Hair samples were collected during the 3rd trimester, and liquid chromatography tandem mass spectrometry was used for cortisol assessment. Psychiatric diagnosis and current level of symptomatic functioning were assessed using the structured clinical interview from the DSM-5 and the global assessment of functioning scale. Results: Women with a lifetime diagnosis of severe mental illness had significantly elevated HCC compared to controls. Poorer current symptomatic functioning was also significantly associated with elevated HCC in pregnancy. Conclusions: The implications of alterations in HCC on both maternal and infant health need further study. [ABSTRACT FROM AUTHOR]

Purpose: This systematic review aimed to determine if digital screening for mental health in pregnancy and postpartum is acceptable, feasible and more effective than standard care (paper-and pen-based screening or no screening). The second aim was to identify barriers and enablers to implementing digital screening in pregnancy and postpartum. Method: OVID MEDLINE, PsycINFO, SCOPUS, CINAHL, Embase, Web of Science, Joanna Briggs Database and All EMB reviews incorporating Cochrane Database of Systematic Reviews (OVID) were systematically searched for articles that evaluated digital screening for mental health in pregnancy and postpartum between 2000 and 2021. Qualitative articles were deductively mapped to the Theoretical Domains Framework (TDF). Results: A total of 34 articles were included in the analysis, including qualitative, quantitative and mixed-methods studies. Digital screening was deemed acceptable, feasible and effective. TDF domains for common barriers included environmental context and resources, skills, social/professional role and identity and beliefs about consequences. TDF domains for common enablers included knowledge, social influences, emotion and behavioural regulation. Conclusion: When planning to implement digital screening, consideration should be made to have adequate training, education and manageable workload for healthcare professionals (HCP's). Organisational resources and support are important, as well as the choice of the appropriate digital screening assessment and application setting for women. Theory-informed recommendations are provided for both healthcare professionals and women to inform future clinical practice. [ABSTRACT FROM AUTHOR]

This study assesses the prevalence and determinants of inadequate (less than eight contacts) and late antenatal care (ANC) initiation (starting after 12 weeks) among mothers delivered at Gadarif Maternity Hospital in eastern Sudan. A hospital-based cross-sectional study was conducted at Gadarif Maternity Hospital. A questionnaire was used to collect sociodemographic, clinical, and obstetric data through face-to-face interviews. Seven hundred mothers were enrolled with the median (interquartile range) of mothers' age, and parity was 28(24–32) years and 3(2–5), respectively. Of these 700 mothers, 79.3 percent and 10.3 percent had inadequate and late ANC, respectively. In multivariable logistic regression analysis, being a housewife (adjusted odds ratio [AOR] 1.93, 95 percent CI 1.09, 3.43) was associated with inadequate ANC. High parity (AOR 1.27, 95 percent CI 1.07–1.52) was positively associated with late ANC initiation. There was no association between age, residence, education, preexisting medical disorder, and history of miscarriage) with inadequate or late ANC initiation In eastern Sudan, four out of five mothers did not comply with the World Health Organization's recommendation of a minimum of eight ANC contacts for positive pregnancy outcomes. This study is crucial for policy-makers to take further strategic actions to ensure adequate and early ANC initiation for all mothers in Sudan. [ABSTRACT FROM AUTHOR]

Eating disorders are complex mental health conditions exacerbated by high mortality rates. International and national guidelines recommend family involvement in the treatment process, recognising the family as an important source of support to young people. Research suggests fathers engage less in the process compared to mothers. In studies exploring parental perspectives, most samples consisted of mothers, with fathers minimally represented. Few studies explore family involvement from the perspective of fathers. This study aimed to explore the experiences of fathers regarding their involvement in the treatment process. Qualitative descriptive methods were used, involving focus group interviews of seven fathers. Interviews were assisted by a semi‐structured interview guide. A qualitative content analysis approach was used to analyse the data regarding paternal experiences of engagement in the treatment process. Fathers understood the importance of the whole family working together but viewed mothers as taking a more central role in the treatment process, with fathers more at the periphery. Gender emerged as an influencing factor in paternal involvement, with mothers primarily taking on responsibility for the child with the eating disorder and fathers providing secondary support. Healthcare providers need to be aware of the contribution of gendered roles within the family system and consider this when working with families within the treatment process. Consequently, mental health nurses have an important role in encouraging fathers to become actively involved in the treatment process. [ABSTRACT FROM AUTHOR]

Background: Anxiety and depression during the postpartum period can have a significant impact on mothers' perceived sense of responsive caregiving, causing considerable distress. This association may be affected by mothers' perception about social support. In the context of low-and-middle-income countries where prevalence rates of maternal mental illnesses are high and access to health care services is limited, informal supports become more relevant. Aim: The study aims to understand the lived experience of mothers who had postpartum depression or anxiety and their perceived distress related to infant care giving. It also explores the role of social support in the motherhood experience. Methods: Six mothers with postpartum depression or anxiety were interviewed to understand their experience of postpartum depression and/or anxiety and their perceptions about social support. The interviews were analyzed using a reflexive thematic analysis approach. Results: The thematic analysis revealed four themes, namely, (a) uncertainty and helplessness, (b) misattunement with the immediate family, (c) personal strength rooted in the family support system, and (d) other means of coping. Mothers with postpartum anxiety and depression can have emotional, informational, and tangible social support needs in the context of uncertainty and helplessness, which are associated with different challenges and barriers for infant care in the Indian context. Conclusion: Support from family members is viewed as a pillar of comfort and recovery for the mothers. At the same time, if it is not adequately attuned to the needs of the mother, it can become a major source of distress. [ABSTRACT FROM AUTHOR]

The dietary choices a mother makes during pregnancy offer her developing fetus its earliest exposure to the family's culinary preferences. This comprehensive literature review synthesizes five decades of research, which has provided valuable insights into fetal flavor learning. Converging evidence across various species supports the functionality of fetal chemoreceptive systems by the end of gestation, enabling the detection of an extensive array of chemosensory cues derived from the maternal diet and transmitted to the amniotic fluid. The fetus effectively encodes these flavors, resulting in their enhanced acceptance after birth. While existing studies predominantly concentrate on fetal learning about odor volatiles, limited evidence suggests a capacity for learning about gustatory (i.e., taste) properties. Examining whether these prenatal odor, taste, and flavor experiences translate into enduring shifts in dietary behaviors beyond weaning remains a crucial avenue for further investigation. [ABSTRACT FROM AUTHOR]

Adaptive parent–child interaction plays a major role in healthy child development. Caregiver mental health problems can negatively impact parent–child interaction. In turn, interactional quality is often studied as a predictor of child outcome. However, child characteristics supposedly shape parent–child interactions as well. Given associations between child and caregiver mental health and child temperament, this study aimed at differentiating their effects on dyadic interaction quality in adolescence. Child temperament and character at age 5 were investigated as longitudinal predictors of observed mother–adolescent interactional quality at age 14 in a community sample (N = 76). It was examined whether these effects were independent of maternal and child mental health and earlier dysfunctional interaction. Lower novelty seeking, higher reward dependence, and higher cooperativeness separately predicted higher dyadic interactional quality at age 14. Controlling regressions for dysfunctional interaction at age 5, which was a significant negative predictor of later interactional quality, cancelled out the effects of novelty seeking and cooperativeness. Past or concurrent maternal or child psychopathology did not explain variance in mother–adolescent interaction. Applying backward selection, a model including reward dependence and dysfunctional interaction at age 5 and concurrent maternal stress showed the best fit for explaining dyadic interaction quality. Results suggest that enduring rather than transient child features predict interactional quality in a community sample. Effects of temperament are not better explained by those of psychopathology, but a combination of child, maternal, and dyadic features predicted dyadic behaviour best. Selective prevention should target parenting in the context of challenging child characteristics specifically. [ABSTRACT FROM AUTHOR]

Child maltreatment can negatively impact not only survivors but also survivors' children. However, research on the intergenerational effect of maternal childhood maltreatment on child externalizing behaviour has yielded contradictory results and has not yet been systematically synthesised. The current three-level meta-analysis and systematic review aimed to provide a quantitative estimate of the strength of the association between maternal childhood maltreatment and child externalizing behaviour and to summarise research on potential mediating factors of this association. PsycINFO, PubMed, and Embase were searched and 39 studies with 82 effects sizes were included in the meta-analysis. Results revealed a small significant association between maternal childhood maltreatment and child externalizing behaviour (r = 0.16; 95% CI 0.12–0.19; publication bias-adjusted effect size: r = 0.12, 95% CI 0.08–0.16). Maternal mental health, particularly depressive symptoms, maternal parenting and children's maltreatment exposure were the most frequently examined mediators of this association, with relatively robust mediating effects for children's maltreatment exposure and maternal depressive symptoms, but mixed evidence for the mediating role of maternal parenting. This meta-analysis provides evidence for a small but significant association between maternal childhood maltreatment and children's externalizing behaviour, emphasizing the need to develop effective preventive and intervention strategies to minimise the effects of childhood maltreatment on the next generation. [ABSTRACT FROM AUTHOR]

Background: Rates of non-communicable diseases are disproportionately high among Native Hawaiian (NH) people, and the proportion of NH infants being fed human milk (HM) is the lowest among all ethnicities within the state of Hawaiʻi. The aim of this study was to explore biological, socio-economic, and psychosocial determinants of the initiation and duration of human milk feeding (HMF) among a study of NH mothers and infants. Methods: A sample of 85 NH mother-infant dyads who were participating in a larger prospective study were involved in this research. Recruitment for the parent was delayed due to the COVID-19 pandemic. Recruitment started in November 2020 and continued until April 2022. Questionnaires were distributed at birth, two-months, four-months, and six-months postpartum. Questionnaires addressed topics relating to maternal and infant characteristics and infant feeding practices. Descriptive statistics, comparative analysis, and multivariate logistic regression tests were conducted. Results: The majority of participating mothers were aged between 31 and 35 years, had some college education or more, were employed, and multiparous. The majority of infants were receiving HM at each timepoint (94% at birth, 78% at two-months postpartum, and 76% at four and six-months postpartum). Factors found to be significantly associated with HMF initiation and duration were prenatal intention to HMF, maternal educational attainment, Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participation, and Supplemental Nutrition Assistance Program (SNAP) recipiency. A prenatal intention to HMF was found to be a strong predictor of HMF at birth (aOR = 64.18, 95% CI 2.94, 1400.28) and at two-months postpartum (aOR = 231.55, 95% CI 2.18, 2418.3). Participants not involved with WIC were more likely to be HMF at four-months postpartum (aOR = 6.83, 95% CI 1.01, 46.23). Conclusion: This research supports existing evidence that prenatal intention to HMF and higher maternal educational attainment are positive predictors of HMF. WIC participation and being a SNAP recipient were found to be negatively associated with HMF which suggests a need for more culturally tailored support. Further research is required to reduce the gap in knowledge related to the determinants of HMF in NH. [ABSTRACT FROM AUTHOR]

Introduction: Pregnancy and the postpartum period is a difficult time for women living with HIV (WLWH) and postpartum engagement with HIV care is often reduced, with implications for health and well-being. We aimed to explore the postpartum health experiences of WLWH in relation to engagement in HIV care. Methods: The NESTOR (iNvESTigating the pregnancy and pOst-paRtum health experience of women living with HIV) study was a UK based qualitative semi-structured interview study. 61 eligible women were identified. We used a purposive sampling technique to recruit women with differing levels of engagement in HIV care. Interviews were conducted via telephone or video call. Interviews were audio recorded and fully transcribed. We used a thematic approach for data analysis, and two researchers independently coded the data and established the key themes. Results: 11 of 61 (18%) eligible women participated in the interviews, and the three main themes were 'infant feeding decisions', 'managing the risk of mother to child transmission', and 'managing the knowledge of their HIV status'. These themes offer detailed insights into the significant psychological and emotional challenges these women had experienced, and the practical support from healthcare professionals in both HIV and maternity services that had enabled them to navigate those challenges. Discussion: There have been life-changing developments in the treatment and care for people living with HIV. However, even in the U = U (undetectable = untransmittable) era, traditional concerns about breastfeeding, risk of transmission to the infant and stigma continue to shape the postpartum experience of WLWH. As these impact on their emotional and psychological wellbeing, support in these areas needs to be prioritised. Significance: Studies report that postpartum retention in HIV care and viral load suppression are suboptimal for women living with HIV, where an important reason is the financial cost and access to healthcare. However, there is a relative scarcity of evidence describing the problems faced by women accessing HIV and maternity services within socialised healthcare systems, such as those in the UK. Women living with HIV face unanticipated challenges when becoming new mothers relating to disclosure of their HIV status, fears of vertical transmission and perceived perceptions of others deeming them inadequate mothers. Importantly, our analysis illustrates potential opportunities where intervention might mitigate the emotional and physical impact of these issues on their wellbeing throughout pregnancy and postpartum. [ABSTRACT FROM AUTHOR]

Objectives: To assess the association between air pollution exposure and housing context during pregnancy and adverse birth outcomes. Methods: We linked air pollution data from the Environmental Protection Agency and housing data from the American Community Survey with birth records from Wisconsin counties over a 9-year period. We calculated average daily pregnancy exposure to fine particulate matter and ozone and modeled its relationship to preterm birth, low birthweight and NICU admission, adjusting for individual characteristics and housing context. Results: Ozone exposure and housing cost-burden had substantive and statistically significant negative associations with birthweight and gestational age, and positive associations with NICU admission, while a poor-quality housing environment had a significant negative effect on weeks of gestation. Fine particulate matter exposure had a negligible correlation with these outcomes. Conclusions for practice: An additional tenth of one part-per-million daily average exposure to ozone is associated with a 33 g decrease in birthweight. This decrease in birthweight is about the same size as the association of gestational diabetes (32 g), larger than the association of chronic hypertension (22 g), and about 40% the size of the effect of smoking during pregnancy on birthweight (84 g). Given the magnitudes of the associations with atmospheric ozone and adverse birth outcomes, reducing atmospheric ozone should be a public health priority. Inclusion of controls for housing cost-burden and poor-quality housing reduces the magnitude of the association with mothers who identify as Black, suggesting the importance of these structural factors in understanding adverse birth outcomes by race. Significance: What is already known on this subject: It is well documented that poor birth outcomes are linked to experiences of social and economic disadvantage, however, environmental correlates of poor birth outcomes are under-researched. Existing research does not account for the ways in which environmental, sociodemographic, and structural factors could confound each other given the concentration of environmental pollutants in communities of color and low-income communities. What this study adds: In this paper, we account for individual sociodemographic characteristics, access to emergency infant healthcare, and neighborhood housing factors to clarify the independent association of air pollution on birth outcomes in Wisconsin across a nine-year period. [ABSTRACT FROM AUTHOR]

Objectives: This qualitative study explored experiences of 15 women in New York City who suffered physical, emotional, and socioeconomic consequences of severe maternal morbidity (SMM). This study aimed to increase our understanding of additional burdens these mothers faced during the postpartum period. Methods: Qualitative analysis of in-depth interviews (n = 15) with women who had given birth in NYC hospitals and experienced SMM. We focused on how experiences of SMM impacted postpartum recoveries. Grounded theory methodology informed analysis of participants' one-on-one interviews. To understand the comprehensive experience of postpartum recovery after SMM, we drew on theories about social stigma, reproductive equity, and quality of care to shape constant-comparative analysis and data interpretation. Findings: Three themes were generated from data analysis: 'Caring for my body' defined by challenges during physical recuperation, 'caring for my emotions' which highlighted navigation of mental health recovery, and 'caring for others' defined by care work of infants and other children. Most participants identified as Black, Latinx and/or people of color, and reported the immense impacts of SMM across aspects of their lives while receiving limited access to resources and insufficient support from family and/or healthcare providers in addressing postpartum challenges. Conclusions for Practice: Findings confirm the importance of developing a comprehensive trauma-informed approaches to postpartum care as a means of addressing SMM consequences. Significance: What is Already Known on this Subject?: For every maternal death, approximately 100 women suffer from life-threatening complications—referred to as severe maternal morbidity (SMM). SMM affects 2,500 to 3,000 women annually. Health impacts can be acute or chronic, including mental health conditions and physical disabilities. What this Study Adds?: The postpartum recovery period is a time for acute vulnerability for people recovering from an SMM event. Women reported navigating an array of physical, social, and emotional traumas and challenges for which they had limited support. This study confirms the need for directive and strategic investment in the postpartum recovery of survivors of SMM to ensure optimum health outcomes. [ABSTRACT FROM AUTHOR]

Mothers who use substances often experience gender‐based and structural inequities that can jeopardize maternal and family wellness. Instability in the availability of services, particularly during public health crises (e.g., COVID‐19 pandemic), often results in changes in population health needs/funding/services, which may magnify experiences of disadvantage. Limited research has focused on times of change/crisis and its impact on maternal and family wellness. We examined the experiences of structural disadvantage, service access, and well‐being among mothers who use or formerly used substances during the first year of the COVID‐19 pandemic. Semi‐structured interviews were conducted with 26 mothers with current or past engagement in outpatient substance use treatment programs for pregnant and parenting women in Ontario, Canada. Transcripts were analysed using reflexive thematic analysis, revealing that instability of services and decreased access to/quality of informal and formal relationships often magnified the mental and affective toll of stressors, both pre‐existing and new. The impact on well‐being appeared to be greater for families who were actively engaged with child protective services. Findings are discussed in relation to literature examining systemic and societal factors that perpetuate gender‐based and structural inequities experienced by mothers with lived and living histories of substance use. The potential impact of changes in public health service delivery requires thoughtful and proactive attention for and by all stakeholders, including integrated attention across systems (e.g., health, social, education) that provide services to support maternal and family well‐being. [ABSTRACT FROM AUTHOR]

Understanding the factors contributing to sensitive parenting is crucial to optimize infant social and emotional functioning. Research has supported the association between parents' personality and parenting quality, but findings are inconsistent when examining various global personality measures. Further, it is likely that the interaction between parent‐level (e.g., personality) and infant‐level characteristics (e.g., temperament) are more strongly associated with caregiving quality. Most studies examining predictors of parenting quality have only included mothers, compared to fathers. The current study examined the interaction between parental personality and infant temperament and associations with parental sensitivity and intrusiveness with mothers and fathers. The participants included families (n = 102) when the infants were 4, 6, and 8 months old. Using parent report measures and a face‐to‐face play task, significant main effects of maternal behavioral inhibition on parenting behaviors were observed for mothers. A Behavioral Activation X Infant Negative Reactivity interaction predicted both maternal sensitivity and intrusiveness, whereas a Behavioral Inhibition X Infant Surgency predicted paternal intrusiveness. In summary, the results revealed support for the goodness‐of‐fit perspective between parents' personality and infant temperament. [ABSTRACT FROM AUTHOR]

The current meta-analysis examined the mediating role of sensitive-responsive parenting in the relationship between depression in mothers and internalizing and externalizing behavior in children. A systematic review of the path of maternal sensitive responsiveness to child psychopathology identified eligible studies. Meta-analytic structural equation modelling (MASEM) allowed for the systematic examination of the magnitude of the indirect effect across 68 studies (N = 15,579) for internalizing and 92 studies (N = 26,218) for externalizing psychopathology. The synthesized sample included predominantly White, English-speaking children (age range = 1 to 205 months; Mage = 66 months; 47% female) from Western, industrialized countries. The indirect pathway was small in magnitude and similar for externalizing (b =.02) and internalizing psychopathology (b =.01). Moderator analyses found that the indirect pathway for externalizing problems was stronger when mother-child interactions were observed during naturalistic and free-play tasks rather than structured tasks. Other tested moderators were not significant. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic had negative effects on many people's well‐being and quality of life. In the present work, we focused on Norwegian mothers with elementary school children, and investigated whether their well‐being, stress, and worries (and the relationships between them) changed across the early months of the pandemic. We collected data at two time points in 2020. In June 2020, 231 mothers (mean age = 40.09, SD = 6.22) responded to an online questionnaire in which they were asked to indicate their well‐being, stress, and worries before the pandemic, during the lockdown (i.e., March 2020), and currently (i.e., June 2020). Of these 231 mothers, 97 (mean age = 40.58, SD = 5.66) answered the same questionnaire again in November 2020. Mothers' well‐being was lower in November 2020 than before the pandemic (retrospectively reported). The age of the youngest child showed the strongest and most consistent relationship with mothers' well‐being across all time points. In addition, we found that the stress mothers felt during the national lockdown in March 2020 was strongly associated with their well‐being both during the lockdown and in June 2020. Finally, in November 2020, mothers' financial pandemic‐related worries were negatively related to their well‐being. Implications and suggestions for future research and for how societies can cope with future health‐related crises are discussed. [ABSTRACT FROM AUTHOR]