Newborn Behavior Research Articles

Pengaruh Pemberian Informasi tentang Asuhan Perkembangan pada BBLR terhadap Tingkat Pengetahuan dan Sikap Perawat di Rumah Sakit Al Islam Bandung

Development care is an effort to modify the environment and respond to changes in the behavior of newborns, especially in infants Low Birth Weight, The purpose of this study was to determine the effect of training on developmental care on nurses' ability to care for babies with low birth weight. The design of this study used "quasi experiment pre and post test control", which involved 19 nurses in the perinatology room of Al Islam Bandung Hospital. The results showed a significant increase in the mean score of nurses' knowledge, attitudes and actions after the intervention (p value = 0,000, α = 0.05). This training is effective in increasing nurses' knowledge and attitudes. The recommendation of this study is the need for socialization to all health workers supported by the hospital policy to implement development care and evaluate the implementation of development care in LBW care.

Factors associated with feeding behavior in the early neonatal period focusing on early skin-to-skin contact and epidural analgesia: A prospective observational study at a single hospital in Japan

BackgroundThe feeding behavior of newborns is influenced by the conditions of both the mother and newborn before and after birth. AimsThis study aimed to investigate the factors associated with newborn feeding behavior, focusing on skin-to-skin contact (SSC) as a promoting factor and epidural analgesia as an inhibiting factor, using the Japanese version of the Infant Breastfeeding Assessment Tool (IBFAT). Study DesignProspective observational study conducted in Japan. ParticipantsA total of 176 pairs of healthy mothers and their healthy full-term newborns. Outcome MeasuresThe primary outcome was newborn feeding behaviors measured using the Japanese version of IBFAT within about one day of birth. Stepwise multiple regression analysis was performed to explore the relationship between IBFAT scores and variables that might influence newborn feeding behavior. ResultsMultiple regression analysis revealed that lower IBFAT scores were associated with a higher dose of epidural fentanyl (β = −0.40), and higher IBFAT scores were associated with a longer duration of SSC (β = 0.26), even after adjusting for gestational weeks and Apgar scores. The dose and duration of synthetic oxytocin administration were not associated with IBFAT scores in the multivariate analysis. ConclusionsOur study showed a dose-dependent relationship between fentanyl and SSC, suggesting that consistently implementing SSC for the maximum duration possible may enhance newborn feeding behaviors, which are reduced by fentanyl administration.

Evidence for neurobehavioral risk phenotypes at birth.

Observations of newborn behavior provide clinicians and researchers with a first description of the neurobehavioral organization of the newborn that is largely independent of the postnatal environment. The Neonatal Network Neurobehavioral Scale (NNNS) was developed in 2004 to evaluate how prenatal exposure to substances such as cocaine is related to neurobehavioral outcomes. There are now 156 empirical articles published using the NNNS, which we review and summarize. Z-scores from published studies using the NNNS were compiled and aggregated supporting the replicability of three newborn neurobehavioral phenotypes: one typical and two that are predictive of later cognitive and behavioral delay; hyper- and hypo-dysregulated newborns. These phenotypes emerged from independent samples and research groups and were identified in a variety of populations, including infants with prenatal substance exposure, preterm infants, and healthy term infants. Our findings show that newborn neurobehavior can be measured in a reliable and valid manner and that certain behavioral phenotypes, identifiable at birth, can predict neurodevelopmental challenges. These findings have important clinical utility. Intervening early with infants exhibiting these risk phenotypes may prevent later neurodevelopmental delay. IMPACT: We reviewed all empirical studies published using the Neonatal Network Neurobehavioral Scale and found evidence for two replicable stress phenotypes that predict later behavioral outcomes. This study highlights the utility of the Neonatal Network Neurobehavioral Scale for early identification of newborn neurodevelopmental risk phenotypes. Early identification of neurodevelopmental risk, when neuroplasticity is high, may ultimately reduce the burden of subsequent neurobehavioral problems through early intervention.

Impact of oil massage on newborn behavioural responses in rural India.

The initial weeks of a newborn's life are marked by rapid physiological and behavioural adjustments as the infant adapts to the external environment. This critical period necessitates attentive care, prompting exploration into traditional practices such as oil massage, which holds cultural significance and is believed to enhance neonatal well-being. Despite its prevalence, empirical evidence supporting the efficacy of oil massage remains limited. This study, conducted in a rural setting, aims to bridge traditional practices with evidence-based care, exploring the impact of oil massage on newborn behavioural responses. A quasi-experimental design involving 60 newborns (30 in each group) assessed behavioural responses through a pre and post-test approach. Results indicate a significant improvement in selected behavioural responses among newborns receiving oil massage, emphasizing its potential integration into routine care. The control group showed a pre-test mean of 14.83 (SD = 2.41) and a post-test mean of 16.23, while the experimental group exhibited a pre-test mean of 15.83 (SD = 1.80) and a post-test mean of 26.07. T-test values of 5.194 for the control group and 26.137 for the experimental group were indicative of statistically significant changes. The study contributes insights into neonatal care practices, urging further exploration of contextual intricacies and demographic influences on newborn behaviour.

Положительные тенденции в перинатальных исходах у матерей с раком молочной железы во время беременности

Aim. To evaluate the impact of changes in the treatment of pregnancy with breast cancer on the condition and characteristics of the newborn. Design. Retrospective prospective cohort study. Materials and methods. Evaluation and comparison of data on pregnancy management and characteristics of the condition and management of newborns in two groups. The first group consisted of 68 newborns born to mothers with breast cancer from 2013 to 2019, data from medical records were collected and analyzed retrospectively. The second (prospective) group included 75 children born to mothers with breast cancer during pregnancy from 2020 to 2023. The study was conducted on the basis of the department of newborn National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. Kulakov. Results. The study groups differed statistically in the dates of pregnancy at the time of delivery, which is due to the changed treatment of patients with breast cancer during pregnancy. In the prospective group significantly more children (61 (81.3%) child) were born pregnant (p < 0.05). The absolute majority of pregnancies in a prospective cohort of patients determined differences in the condition and behavior of newborns. Thus, in the first group of children, the duration of hospital treatment after birth was significantly shorter than in the second (4 and 7 days respectively, p = 0.000). In the prospective group with the diagnosis «Healthy» 41 (54.7%) children were discharged from the maternity hospital, in the retrospective group only 9 (13.2%) children (Yates correction, p < 0.05).

MATERNAL STRESS AND NEWBORN BEHAVIOR, MATERNAL DEPRESSION AND NEWBORN COGNITION

The objective of this study is to determine the relationship between maternal stress, maternal depression, and newborn behavior/cognition. This cross-sectional study included 60 participants and their newborn babies. Maternal depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS), while the Perceived Stress Scale (PSS-10) was used to measure stress levels. The newborn behavior/cognition was measured using the BSID-III Screening Test scores. Data was collected from January 2023 to June 2023. Mothers had an average age of 35.63± 7.22 years, while the newborn infants had an average of 8.61± 3.27 years. Among the newborns, 56.7% were male infants, while 43.3% were female infants. The study determined the characteristics of enrolled patients and their newborn infants. The correlations between BSID-III Screening Test scores and maternal depression, as well as maternal stress, were also presented. The study showed that there was a correlation between cognitive development and maternal depression, with an R-value of 0.19 and an insignificant P-value of 0.14. Similarly, a correlation was found between cognitive development and maternal stress, with an R-value of 0.17 and an insignificant P-value of 0.17. The study concluded that maternal stress during pregnancy can impact newborn behavior, highlighting the importance of addressing maternal stress and depression, not only for the well-being of the mothers but also for fostering healthy newborn behavior and cognitive development.

Will Earmuffs Improve Neonate Behavior in The Neonatal Intensive Care Unit?

Abstract Background Modern advanced technologies in the neonatal intensive care unit (NICU) have created more noise sources of varying frequencies and intensities, increasing the risk of hearing loss in infants. This study aimed to determine the effect of earmuffs on neonatal behavior. Materials and Methods This study was conducted in the 13-bed level III-A NICU of a 1,000-bed tertiary care teaching hospital. Preexperimental, one-group pretest, posttest design was adopted in the study. Twenty-seven neonates were selected using nonprobability and purposive sampling techniques. The noise level was checked using a dosimeter (sound level meter SL-4030), the baseline variables were collected, and earmuffs were applied to the neonates for 2 hours in the morning and 2 hours in the evening for 3 consecutive days. An observational checklist was used to assess neonatal behavior. Results The mean age in days was 2.19 ± 0.96, the mean weight in kilograms was 2.92 ± 0.43, and the mean gestational week was 37.56 ± 1.50. The mean sound level in the NICU was 56.7 + 14, which was higher than the NICU's recommended noise level. The most noise-generating events and equipment found in NICU were human-made noise and ventilator bubbling sounds. There was a significant difference in the mean behavioral score among neonates using earmuffs, as the “p-value was < 0.05.” However, there was no association between pretest neonatal behavior with baseline data (p > 0.05). Conclusions This study revealed that wearing earmuffs had a beneficial impact on enhancing newborn behavior.

Effectiveness of Music on Perinatal Anxiety Among Pregnant Women and Newborn Behaviors: A Systematic Review and Narrative Synthesis.

Perinatal anxiety affects the antenatal woman, the growing fetus, and the newborn. This systematic review evaluated the effect of listening to music on perinatal anxiety among pregnant women and on newborn behaviors. No available reviews focus on interventions that include only classical forms of music or its benefit on perinatal anxiety among low-risk pregnant women or on newborn behaviors. We included peer-reviewed primary research studies on the effect of music on perinatal anxiety, published in English, between January 2010 and August 2022. PubMed, Embase, Scopus, and ProQuest were searched using specific keywords, resulting in 225 studies for screening by title, abstract, and full text. Two independent reviewers screened them and assessed the quality of the included randomized controlled trials (RCTs) using Cochrane's Risk of Bias 2.0 tool (RoB2) and non-randomized controlled trial studies using the Joanna Briggs Institute Critical Appraisal tool. Due to the heterogeneity of outcome measures, the review's findings were summarized qualitatively. Nine studies with 1646 pregnant women and one with 260 pregnant women and their neonates were included. Results of all studies suggest that listening to classical music reduces the anxiety levels among pregnant women, as measured by the State-Trait Anxiety Inventory (STAI). Only one study reported the beneficial effect of antenatal exposure to music on improving newborn behaviors like orientation (ES 1.13, 95% CI: 0.82-1.44, P < 0.0001) and habituation (ES 1.05, 95% CI: 0.53-1.57, P = 0.0001). The risk of bias was unclear in most of the studies. Listening to classical music during the perinatal period may be an effective non-pharmacological intervention for reducing anxiety and pain and improving sleep quality and newborn behaviors. There is a need to conduct further interventional studies on the types of music provided and their effects on perinatal health outcomes. The review was prospectively registered in PROSPERO 2021 CRD42021256806.

The Effect Of Nesting On The Behavior Of Low Birth Weight Babies At Medi Medika Clinic, Tangerang Regency Year 2022

Low birth weight babies (LBW) are babies with a birth weight of less than 2500 grams regardless of gestational age. Birth weight is the weight of a baby who is weighed within 1 (one) hour after birth (Amin &amp; Hardhi, 2016). LBW can occur because the gestational age is less than normal, namely 37 weeks and the baby's weight is lower than babies in general (Ministry of Health, 2018). To determine the effect of nesting on the behavior of low birth weight newborns at the Medi Medika Clinic, Tange rang Regency. Using quai experimental design with one group pretest posttest involving one group of subjects. The research sample was 30 low birth weight newborns who were treated at the Medi Medika Clinic in Tangerang Regency and were selected by purposive sampling technique. Research data were analyzed using paired t-test and Wilcoxon test. The results of the analysis showed that there was a significant effect of the use of nesting on the behavior of low birth weight newborns (p = 0.000). The use of nesting as a form of developmental care can facilitate the achievement of better rest (which is characterized by the regularity of physiological functions and the achievement of quiet sleep behavior), so it needs to be implemented in the care of low birth weight newborns at the Medi Medika Clinic, Tangerang Regency. There is a significant effect of the use of nesting on the behavior of low birth weight newborns. Pregnant women are advised to seek more information regarding pregnancy care through health workers, especially midwives, posyandu officers, the mass media and others, so they can recognize the low risk of newborns.

Manual behavior in newborns and infants from birth to three months old

BackgroundThere is more to manual behavior in newborns and infants up to three months old than eye-hand coordination. AimIn this study, we describe changes in the way infants, from birth to three months old, clutched a rod and propose that this might be related to active hands’ exploratory behavior. Study designObservational study which infants clutching behavior was collected during a two-minute session condition carried out in a lab quiet room. The infants were sitting on an adapted baby chair when a rubber rod, similar in size and shape to an adult's finger, was placed into the infants' palms inducing a palmar grasp followed by clutching behavior. Subjects: Fifty-one typical developed full-term infants took part in the study and they were divided into 4 groups: three-day-old (n = 17), one-month-old (n = 9), two-month-old (n = 11), and three-month-old (n = 14). Outcome measures. The rod into infant's hand had a built-in transducer that allowed the measurement of hand pressure used to calculate the mean and standard variation (SD) for multiple dependent variables. ResultsA Kruskal-Wallis analysis revealed the age effect for frequency of clutches, pressure standard deviation and mean clutch duration. We found that, from birth to 3 months old, there was a clear trend which showed that as infants age they clutch more often, faster, and with increasing variability. ConclusionsWe discussed these results as being indicators that during the first three months infants increase their behavior variability to explore objects, learn about the functions of their body, and to identify regularities between actions and their consequences when is given the opportunity.

Skin-to-skin SDF positioning: The key to intersubjective intimacy between mother and very preterm newborn-A pilot matched-pair case-control study.

BackgroundSkin-to-skin contact (SSC) has been widely studied in NICU and several meta-analyses have looked at its benefits, for both the baby and the parent. However, very few studies have investigated SSC’ benefits for communication, in particular in the very-preterm newborn immediately after birth.AimsTo investigate the immediate benefits of Supported Diagonal Flexion (SDF) positioning during SSC on the quality of mother—very-preterm newborn communication and to examine the coordination of the timing of communicative behaviors, just a few days after birth.Subjects and study designMonocentric prospective matched-pair case-control study. Thirty-four mothers and their very preterm infants (27 to 31 + 6 weeks GA, mean age at birth: 30 weeks GA) were assigned to one of the two SSC positioning, either the Vertical Control positioning (n = 17) or the SDF Intervention positioning (n = 17). Mother and newborn were filmed during the first 5 min of their first SSC.Outcome measuresInfants’ states of consciousness according to the Assessment of Preterm Infants’ Behavior scale (APIB). Onset and duration of newborns’ and mothers’ vocalizations and their temporal proximity within a 1-s time-window.ResultsIn comparison with the Vertical group, very preterm newborns in the SDF Intervention Group spent less time in a drowsy state and more in deep sleep. At 3.5 days of life, newborns’ vocal production in SSC did not differ significantly between the two groups. Mothers offered a denser vocal envelope in the SDF group than in the Vertical group and their vocalizations were on average significantly longer. Moreover, in a one-second time-frame, temporal proximity of mother-very preterm newborn behaviors was greater in the SDF Intervention Group.ConclusionAlthough conducted on a limited number of dyads, our study shows that SDF positioning fosters mother-very preterm newborn intimate encounter during the very first skin to skin contact after delivery. Our pioneer data sheds light on the way a mother and her very preterm vocally meet, and constitutes a pilot step in the exploration of innate intersubjectivity in the context of very preterm birth.

Supporting the diagnosis of infantile colic by a point of care measurement of fecal calprotectin.

BackgroundInfantile colic (IC) is a condition characterized by extensive crying which affects about 20% of all infants during their first months of life. Most pediatricians diagnose IC only based on their clinical experience.AimInvestigating if a measurement of fecal calprotectin can support the diagnosis of IC.MethodsThe crying behavior of newborns was assessed using the Wessel's criteria. Fecal calprotectin levels were measured in non-colicky and colicky babies using a standard test that can be used at the time and place of patient care (point of care (PoC) measurement).ResultsColicky babies were found to have significantly elevated fecal calprotectin levels. Calprotectin levels were not influenced by gender, type of feeding, gestation age or birth weight. However, significantly elevated fecal calprotectin levels were found in cesarean section born babies. Fecal calprotectin ≥100 μg/g correlated with a colicky status of an infant while those <100 μg/g indicated a non-colicky status the error margin was 11.2 and 13.2%, respectively. Combining data of fecal calprotectin with information about the type of delivery made it possible to determine the colicky status in vaginally-born infants with fecal calprotectin ≥100 μg/g with an accuracy of 97.8%. As elevated fecal calprotectin levels in cesarean-born infants can be caused by IC, but also by the disturbed gut microbiota commonly found in these babies, the accuracy of diagnosing the colicky status of a cesarean-born infant with calprotectin levels ≥100 μg/g was less accurate (accuracy rate of 76.5%).ConclusionData from the study suggest that measuring fecal calprotectin should be considered by pediatricians to support the diagnosis of IC.The study was registered at ClinicalTrials.gov under NCT04666324.

Early Postpartum Maternal and Newborn Responses to Auditory, Tactile, Visual, Vestibular, and Olfactory Stimuli

ObjectiveTo compare maternal psychological well-being, newborn behavior, and maternal and newborn salivary oxytocin (OT) and cortisol before and after two maternally administered multisensory behavioral interventions or an attention control group. DesignRandomized prospective clinical trial. SettingU.S. Midwest community hospital. ParticipantsNewborns and their mothers (n = 102 dyads) participated. Mothers gave birth vaginally at term gestation and had no physical or mental health diagnoses. Newborns with low Apgar scores, receipt of oxygen, suspected infection, or congenital anomalies were excluded. MethodsDyads were randomly assigned to the auditory, tactile, visual, and vestibular (ATVV) intervention, the ATVV with odor from a baby lotion (ATVVO), or the attention control (AC) Group. Maternal psychological well-being, newborn behavior, and endocrine responses (salivary cortisol and OT) were measured before and after the intervention. ResultsNewborns in the ATVV and ATVVO groups exhibited increases in potent engagement behaviors (p < .0001 and p = .001, respectively). Newborns in the AC group exhibited a decrease in potent engagement (p = .013) and an increase in potent disengagement (p = .029). Mothers in the ATVVO group exhibited an increase in OT (p = .01) and the largest change in OT (p = .02) compared to mothers in the ATVV and AC groups. We noted no change in maternal psychological well-being or newborn endocrine responses. ConclusionInclusion of an odor via lotion with a behavioral intervention (ATVV) influenced maternal OT more than the behavioral intervention alone. Newborns were behaviorally responsive to the interventions; however, endocrine measures were not associated with intervention changes.

Pediatric hospitalization due to COVID-19: experience in a regional hospital.

SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection is usually mild in children, although it can become severe in some cases. Initially, doubts arose due to vertical perinatal transmission in infected mothers. Therefore, the first recommendations were very restrictive, suggesting mother-newborn separation. This study aimed to describe the clinical behavior of newborns born to mothers with SARS-CoV-2 infection and of children admitted to hospital due to COVID-19 (coronavirus-2 disease). We conducted a retrospective descriptive study of pediatric patients hospitalized between May 1, 2020, and April 30, 2021. We included 19 patients: 47.4% were neonates born to mothers infected with SARS-CoV-2 (1.63% of deliveries), and 52.6% were pediatric patients aged 2 months to 12 years with confirmed COVID-19 infection (3.43% of all pediatric admissions). All patients presented mild symptomatology and remained isolated with a family member in the room. Vertical transmission was not found, although a positivity rate of 88.89% was detected in fathers. Pediatric admissions for COVID-19 did not represent an overload of care. No patient developed complications or required specific treatment. The incidence of COVID-19 deliveries was low, and vertical perinatal transmission was not observed. Admission with a companion facilitated pediatric care, which was favorable for the patient and the healthcare staff.

The role of early adversity and cognitive vulnerability in postnatal stress and depression

The purpose of the present study was to examine vulnerability factors in expecting parents that might lead to mental illness in the perinatal period. Specifically, we studied how parental early adversity, attentional bias to infant faces, repetitive negative thinking, and demographic factors, were associated with pre- and postnatal depressive symptoms and parenting stress. Participants were expecting parents taking part in the Northern Babies Longitudinal Study, where assessments were made both pre- and postnatally. Assessments included both questionnaires and cognitive tasks. About half of the participants received the Newborn Behavior Observation (NBO)-intervention after birth, between pre- and postnatal assessments. Results show that repetitive negative thinking was a significant predictor of both depressive symptoms and parenting stress, while education, social support, and parity came out as protective factors, especially in mothers. Parental early adversity had an indirect effect on postnatal depressive symptoms and parenting stress, mediated by prenatal and postnatal depressive symptoms, respectively. The NBO intervention did not affect the results, signifying the importance of early childhood adverse events and negative thinking on parents' postnatal adjustment and mood, even when an intervention is provided. In conclusion, repetitive negative thinking is a significant vulnerability factor independent of the presence of depressive symptoms, and health professionals must be aware of parents’ thinking style both during pregnancy and after birth.

The effect of foot reflexology applied to neonates before oro/nasopharyngeal suctioning on procedural pain and comfort in the neonatal intensive care unit

Introduction and aim. This study was performed to examine the effect of foot reflexology applied to the neonates on the level of pain and discomfort developed due to suctioning procedure. Material and methods. The study was conducted experimentally by taking pretest and repeated measurements on reflexology and control groups determined by simple randomization. The study was carried out with 66 neonates (reflexology applied: 33 and control group: 33). Neonatal Information Form, Neonatal Infant Pain Scale (NIPS) and Newborn Comfort Behavior Scale (NCBS) were used as the data collection tools. Results. The during (p&lt;0.001) and after suctioning (p&lt;0.001), the NIPS scores of the neonates in the intervention group was statistically lower than the control group. The NCBS scores of the neonates in the intervention group during (p&lt;0.001), and after suctioning (p&lt;0.001), were statistically significantly lower than the control group. Conclusion. It was concluded that foot reflexology applied to neonates was effective both in reducing pain during and after the suctioning and in increasing comfort during and after the suctioning.

Experience of early motherhood during the first wave of the COVID-19 pandemic in Northern Germany: a single-centre before and after comparison

ABSTRACT Purpose To assess maternal mental health during the first weeks after birth including birth experience, postpartum adjustment to early motherhood and the perception of newborn behaviour, and how this may be influenced by the first wave of the COVID-19 pandemic. Methods Ninety women who gave birth after the first enforcement of nation-wide disease control restrictions in Germany between 16 March and 10 May 2020 were surveyed and compared with 101 women who had given birth before the pandemic. Information on maternal mental health and maternal perception of early motherhood and neonatal behaviour were assessed at 3–8 weeks postpartum. Results Mothers who gave birth under the COVID-19-associated disease control restrictions did not show significant differences in depression, anxiety and social support scales compared to mothers before the pandemic. Birth experience was similar, while support during birth was perceived to be higher under the COVID-19 restrictions. Confidence in caretaking of the newborn and perception of neonatal behaviour were comparable between the two groups. Mothers expressed significantly higher dissatisfaction with the maternal role during the pandemic. Conclusions Overall, maternal mental health and the perception of the newborn and early caretaking during the first COVID-19 wave did not substantially differ from the perceptions of mothers before the pandemic. A potential influence of the pandemic on higher dissatisfaction with the maternal role may be associated with the pandemic conditions affecting everyday life and should be addressed in postpartum care and in future qualitative and longitudinal studies.

The Effect of Fetus Stimulation Techniques on Newborn Behavior.

Background:Many factors affect fetal behavior, which can also affect the baby's capacity and change interaction with the caregiver. The aim of this study was to investigate the effect of performing fetal sensory systems stimulation techniques by mother during pregnancy on the neonate's habituation behavior.Materials and Methods:This semi-experimental study was conducted in 2019 in Isfahan, Iran. Mothers who referred to public comprehensive health centers in the 27th week of gestation and met the inclusion criteria were selected by convenience sampling method and randomly assigned to two groups of intervention and control. Fetal learning programs were held twice a day from the 27th week to the end of the pregnancy. The habituation domain of the neonate's behavior was assessed by the Brazelton's Neonatal Behavioral Assessment Scale (BNBAS) 3–5 days after the delivery. The mean score of habituation domain of BNBAS among 72 subjects in the intervention and control groups was compared by the Mann–Whitney test.Results:The habituation domain of all 72 newborns born approximately at the gestational age of 38 weeks was assessed. The Mann–Whitney test results indicated that the two groups were significantly different in terms of the total mean score of habituation domain 3–5 days after birth (z = –4.37, p < 0.001) and the score of the intervention group was higher than that of the control group.Conclusions:Generally, it can be concluded that the fetal stimulation techniques can positively affect the neonate's behaviors including the domain of habituation.

Antenatal and perinatal factors associated with newborn behavior: A prospective cohort study

The idea that the newborn is an uncharted and therefore pliable organism, which can be formed according to the will of its parents, has long been rejected, especially after the existence of rules of behavior not only in full-term but also in marginally premature newborns, which are affected by various both prenatal and perinatal factors. The ability of newborns to determine the rules of their behavior according to the stimuli they receive from internal and external factors, has been the subject of many years of research and has led pediatricians and other health professionals to develop a model for grading these newborn abilities. Thus, the Neonatal Behavioral Assessment Scale (NBAS) was created, and it has been used by researchers for more than 40 years. It is a research tool with wide application, as many of the points it addresses, can be integrated into other means of assessing the newborn’s abilities. This scale also has an ever-evolving application as a clinical tool in parental assessment.

Changes in attitudes and behaviors supportive of maternal and newborn health in Ethiopia: an evaluative case study

BackgroundEthiopia’s high neonatal mortality rate led to the government’s 2013 introduction of Community-Based Newborn Care (CBNC) to bring critical prevention and treatment interventions closer to communities in need. However, complex behaviors that are deeply embedded in social and cultural norms continue to prevent women and newborns from getting the care they need. A demand creation strategy was designed to create an enabling environment to support appropriate maternal, newborn, and child health (MNCH) behaviors and CBNC. We explored the extent to which attitudes and behaviors during the prenatal and perinatal periods varied by the implementation strength of the Demand Creation Strategy for MNCH-CBNC.MethodsUsing an embedded, multiple case study design, we purposively selected four kebeles (villages) from two districts with different levels of implementation strength of demand creation activities. We collected information from a total of 150 key stakeholders across kebeles using multiple qualitative methods including in-depth interviews, focus group discussions, and illness narratives; sessions were transcribed into English and coded using NVivo 10.0. We developed case reports for each kebele and a final cross-case report to compare results from high and low implementation strength kebeles.ResultsWe found that five MNCH attitudes and behaviors varied by implementation strength. In high implementation strength kebeles women felt more comfortable disclosing their pregnancy early, women sought antenatal care (ANC) in the first trimester, families did not have fatalistic ideas about newborn survival, mothers sought care for sick newborns in a timely manner, and newborns received care at the health facility in less than an hour. We also found changes across all kebeles that did not vary by implementation strength, including male engagement during pregnancy and a preference for giving birth at a health facility.ConclusionsFindings suggest that a demand creation approach—combining participatory approaches with community empowering strategies—can promote shifts in behaviors and attitudes to support the health of mothers and newborns, including use of MNCH services. Future studies need to consider the most efficient level of intervention intensity to make the greatest impact on MNCH attitudes and behaviors.