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An arbitrary gestational age limit of viability cannot be set, and in clinical practice the focus should be on a periviability interval—the so‐called "gray zone" of prognostic uncertainty. For cases within this interval, the most appropriate decision‐making process remains debatable and periviability has emerged as one of the greatest challenges in bioethics. Universally recognized ethical principles may be interpreted differently due to socioeconomic, cultural, and religious aspects. In the case of periviability, there is considerable uncertainty over whether interventions result in a greater balance of clinical good over harm. Furthermore, the fetus or neonate is unable to exercise autonomy and the physicians and parents will act as patient surrogates. When parents and physicians disagree about the infant's best interest, a dialogue without paternalistic attitudes is essential, whereby physicians should only offer, but not recommend, perinatal interventions. Parental choice, based on thorough information, should be respected within the limits of what is medically feasible and appropriate. When disagreements between parents and physicians occur, how is consensus to be achieved? Professional guidelines can be helpful as a framework and starting point for discussion. In reality, however, guidelines only rarely draw categorical lines and in many cases remain vague and ambiguously worded. Local ethics committees can provide counseling and function as moderators during discussions, but ethics committees do not have decision precedence. Counseling assumes the most significant role in periviability discussions, taking into consideration the particular fetal and maternal characteristics, as well as parental values. Several caveats should be observed relative to counseling: message fragmentation or inconsistence should be minimized, prognosis should preferably be presented in a positive framing, and overreliance on statistics should be avoided. It is recommended that decisions regarding neonatal resuscitation in the periviability interval be made before birth and not conditional on the newborn's appearance at birth. Regardless of decision, it is important to assure pre‐ and postnatal coherence. The present article describes how individual physicians, centers, and countries differ in the approach to the decision to initiate or forgo intensive care in the periviability interval. It is impossible to provide a global consensus view and there can be no unifying ethical, moral, or practical strategy. Nevertheless, ethically justified, quality care comprises early involvement of the obstetric and neonatal team to enable a coherent, comprehensible, nonpaternalistic, and balanced plan of care. Ultimately, physicians will need to adjust the expectations to the local standards, local outcome data, and local neonatal support availability. Synopsis: Ethically justified, quality care comprises early involvement of the obstetric and neonatal team to enable a coherent, comprehensible, nonpaternalistic, and balanced plan of care. [ABSTRACT FROM AUTHOR]

Introduction: Breast pumps represent valuable tools to promote continued breastfeeding. Aim: Describe the characteristics of the global scientific production of breast pumps indexed in Scopus. Materials and methods: Descriptive study based on bibliometric methodology. A search equation was created using keywords and logical operators. We found 362 articles in Scopus and selected 292 that met the selection criteria. Visibility, impact, and collaboration indicators were estimated using the SciVal tool. Results: The University of Western Australia had the most publications, although the University of Toronto (18.6) in Canada had the highest average number of citations per publication. The most productive authors were Geddes Donna Tracy and Lai Ching Tat; however, Meier Paula Primmer had 67% more expected citations than the overall average. National collaboration was present in approximately 50% of the publications. Articles in first-quartile journals are published in higher numbers and with a positive trend from 2013 to 2022. Most of the most productive journals were positioned in the Q1 quartile, of these, the Journal of Human Lactation and Breastfeeding Medicine had the most publications. Conclusion: Research on breast pumps increased, especially in journals positioned in the first and second quartile. National cooperation is the most frequent, with the United States as one of the countries with the most institutions among the most productive. [ABSTRACT FROM AUTHOR]

While pregnancy presents a strong motivation to seek and comply with Opioid Use Disorder (OUD) treatment, the risk for relapse during the postpartum period is high. The purpose of the present study was to examine the impact of babywearing while admitted to the NICU on urges to use substances within 9 months of childbirth. Mothers with a history of OUD (N = 47, Mage = 28.91, SD = 5.14; 48.9% White, 19.1% Latinx) and their newborns were randomly assigned to the intervention (babywearing) or control (infant rocker) condition while admitted to a NICU. Interviews occurred every 3-months. Participants reported their strong desire or urge to use substances since the last interview. Approximately 68.1% had urges within 9 months. At 3 months, participants were categorized as: never babywore (0 h, N = 18), some babywearing (1–44 h, N = 13), consistent babywearing (45+ hours, i.e., minimum of 3.5 h per week, N = 16). Condition X2(2, N = 47)=12.55, p < 0.001, Phi = 0.52 and babywearing category, X2(2, N = 47)=6.75, p = 0.034, Phi = 0.38 significantly predicted urges to use. Mothers in the intervention condition were more likely to report no urges to use: 56.5% had no urges (43.5% had urges) compared to 8.3% of control mothers (91.7% had urges). Mothers who consistently babywore had significantly fewer urges to use (43.8% had urges) compared to mothers who never babywore (83.3% had urges). There is a critical window to capitalize on mothers' desire to abstain from substance use. Babywearing, and specifically babywearing at least 30 min a day, reduced urges to use substances post-partum, a factor associated with relapse. [ABSTRACT FROM AUTHOR]

In the 2022 Global Gender Gap Report by the World Economic Forum, the Philippines ranked 19th out of 146 countries. However, delving into the world of media yields a different look on gender equality. Advertisements on baby and childcare products still place the burden of domestic and care work, especially childrearing, solely on the shoulders of women. To examine this status quo, research was conducted to investigate select television commercial advertisements from 2019 to 2023 and to gauge the dominant themes in the videos using qualitative content analysis. To be more specific, a multi-level analysis was employed that explored the themes on a latent and manifest level. It was greatly apparent that Gender and Development (GAD) initiatives have yet to breach the field of advertising as there were gendered depictions on parenthood in the television commercials on baby and childcare products. Conventional and traditional parenthood was still reflected in the advertisements as these lacked the presence of a father or a paternal figure in an active childrearing role. Moreover, the gendered stereotype on women as the sole caretakers of children were capitalized on as all the advertisements clearly targeted mothers due to the notion that they are the ones involved in using the baby and childcare product being advertised. Given these, there is a great need for organizations that monitor advertising agencies to be tapped by the government in a bid to further GAD advocacy and to reshape the way parenthood is depicted. [ABSTRACT FROM AUTHOR]

Objective. Fathers are of great importance for healthy child development. This randomized controlled study investigated the longer-term effects of an intervention using a soft baby carrier on fathers' observed sensitive caregiving, involvement, and oxytocin and cortisol levels. Design. First-time fathers were randomly assigned to use a baby carrier (n = 41) or baby seat (n = 39) and were asked to use the carrier or seat for at least 6 h per week for 3 weeks. Pretest (Mchild age = 2.67 months), posttest (Mchild age = 3.99 months), and follow-up (Mchild age = 8.25 months) father data were collected. Results. No intervention effects of baby carrier use on fathers' sensitivity, involvement, and oxytocin or cortisol levels at follow-up emerged. Unexpectedly, fathers in the baby seat condition reported an increase in the amount of time spent with the infant. Fathers' sensitivity and oxytocin levels decreased over time, while cortisol levels increased over time, irrespective of condition. Conclusions. This study showed less optimal hormonal levels in fathers over time, suggesting that support during the first months of fatherhood is needed. Furthermore, use of a baby seat may have contributed to fathers enjoying their time with their infant and consequently their involvement in child caregiving. [ABSTRACT FROM AUTHOR]

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This article investigates the role of trust/reputation and parasocial influence in influencing purchase intention among consumers of baby products who frequent Polish parenting blogs. Empirical data was collected by survey (n-1050) of blog readers to construct a model to assess the impact of trust/reputation and parasocial influence. Factor analysis was used to create scores which were then tested using a multiple binary logistic regression model. The research found that while both trust/reputation and parasocial influence were important determinants of consumer purchase intention, trust was significantly more important to baby product consumers than parasocial influence. Additionally, parasocial influence was a more important indicator of purchase intention among younger respondents (under 23 years of age) than those 23 years and older. Additionally, readers who have read blogs for longer are more likely to trust these sources, perceiving them to be reputable. Hence, bloggers should aim to foster long-term relationships with consumers when endorsing products that demand higher trust, such as baby products. [ABSTRACT FROM AUTHOR]

The current study aimed to identity the optimal low-cost stroller cooling strategies for use in hot and moderately humid summer weather. A commercially available stroller was instrumented to assess the key parameters of the thermal environment. The cooling efficacy of eight different stroller configurations was examined in a counterbalanced order across 16 hot summer days (air temperature (Ta) = 33.3 ± 4.1 °C; relative humidity = 36.7 ± 15%; black globe temperature = 43.9 ± 4.6 °C). Compared with a standard-practice stroller configuration, combining a moist muslin draping with a battery-operated clip-on fan provided optimal in-stroller cooling, reducing the end-trial air temperature by 4.7 °C and the wet bulb globe temperature (WBGT) by 1.4 °C. In contrast, in-stroller temperatures were substantially increased by draping a dry muslin (Ta = +2.6 °C; WBGT = +0.9 °C) or flannelette (Ta = +3.7 °C; WBGT = +1.4 °C) cloth over the stroller carriage. These findings provide empirical evidence which may inform guidance aimed at protecting infants during hot weather. Practitioner summary: This study examined the efficacy of traditional and novel stroller cooling strategies for use in hot and moderately humid weather. Covering the carriage with a dry muslin cloth substantially increased stroller temperatures and should be avoided. Evaporative cooling methods reduced in-stroller temperatures. A moist muslin cloth draping combined with a fan provided optimal stroller cooling. [ABSTRACT FROM AUTHOR]

Background: Regular evaluation of caesarean section (CS) is required due to their rising trend and outcomes. Many women recently opt for elective CS, even in resource-constrained settings. Data evaluating the outcomes of CS is however sparse. Hence, this study sought to determine the rate of fetal mortalities and their determinants following CS in the Tatale District Hospital of the Northern Region, Ghana. Methods: A retrospective cross-sectional study was employed to analyze the medical records of 275 women who underwent CS from 2019 to 2021. Data were collected from the hospital's record of CS cases from 2019 to 2021. Descriptive statistics were used to summarize the data and Pearson's chi-square/Fisher's exact test was used to examine the relationship between maternal and obstetric characteristics and fetal mortality. At a 95% confidence interval (95% CI), logistic regression was fitted to assess significant variables and reported the results using odds ratio. Results: Of 1667 deliveries, 16.5% of the mothers gave birth by CS. A fetal mortality rate of 76.4 per 1000 total births was recorded following CS. Babies born with low Appearance, Pulse, Grimace, Activity and Respiration (APGAR) scores (0–3) at fifth-minute had an increased risk of fetal mortality (AOR = 523.19, 95%CI: 49.24–5559.37, p = <0.001). Having a history of previous CS, cephalopelvic disproportion and delayed labour were the major indications for CS. Conclusion: Overall, this study found a high rate of CS based on the World Health Organization's recommended CS rate. Interventions such as reducing the waiting time for surgery and early diagnosis of the need for CS, and ensuring the availability of modern equipment to resuscitate infants with low APGAR scores can significantly improve fetal outcomes following CS. [ABSTRACT FROM AUTHOR]

Background: Our objectives were to compare safe sleep knowledge, attitudes and planned vs. actual infant sleep practices among expectant mothers before and after their infant's birth and to determine whether differences (if present) were associated with any demographic variables. Methods: Study participants were surveyed at their 28-week prenatal and 6-week postpartum obstetric clinic visits from November 2019–February 2021. Due to COVID-19 pandemic cancellation of in-person postpartum visits, many participants received text messaging encouraging them to take the follow-up survey online. Frequency and comparative analyses were performed. Results: 355 women (44%) completed both pre- and postnatal surveys. Many participants increased their safe sleep knowledge during the study. For example, of those who were unsure or thought it safe for a baby to sleep in a baby swing/bouncy seat, two-thirds (67/102, 66%) stated it was unsafe on the postnatal survey. In addition, many who were unsure or planned sleep practices considered unsafe prenatally reported utilizing safe sleep practices on their postnatal survey. For example, of those unsure or planning to use a crib bumper (17% of the total), almost all (88%) were not using one postnatally. Conversely, some participants who reported they would be following safe sleep practices prenatally were not doing so postpartum. For example, 13% of those stating they would place their child on their back reported using another sleep position on the postnatal survey. Certain demographics had higher proportions reporting this reversal for specific safe sleep practices. For example, non-Hispanic Whites (19%) as compared to other races/ethnicities (5%) and those with incomes ≥ $75,000 (21%) as compared with those with less income (9%) had higher proportions stating their infant would sleep in the same room but then reported postnatally they were sleeping in a different room, p = 0.0094 and p = 0.0138, respectively. Conclusions: We observed increases in safe sleep knowledge and that some participants followed safer sleep practices than they had planned. However, there were also participants who planned to use safe sleep practices prenatally who were not doing so after their baby's birth. Our study identified demographics for which targeted safe sleep education and more effective interventions may be needed. [ABSTRACT FROM AUTHOR]