Infant Care Research Articles

Need for national guidance regarding proactive care of infants born at 22–23 weeks' gestation

Need for national guidance regarding proactive care of infants born at 22–23 weeks' gestation

Abstract 4135745: Prematurity Predicts Neurodevelopmental Outcomes in Congenital Heart Disease

Background: Neurodevelopmental (ND) impairment is common in both prematurity and congenital heart disease (CHD). Preterm infants with CHD may have a “double hit,” with worse ND impairments than seen in prematurity or CHD alone. We analyzed whether gestational age (GA) at delivery predicted ND outcomes in children with CHD. Methods: We performed a single-institution retrospective study of children who underwent infant heart surgery from 2007-2020 and returned for ND evaluation after discharge. Exclusion criteria were 1) trisomy 21 and 2) PDA ligation alone. The Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III) assessed ND between ages 6-40 months. Patients were stratified into 4 GA groups: very/moderately preterm (≤33 weeks), late-preterm (34-36 weeks), early-term (37-38 weeks) or term/post-term (≥39 weeks). Hierarchical linear regression evaluated potential predictors of Bayley-III composite scores including GA category, demographic, medical, and surgical variables. Results: Among 1350 infants, 513 (38%) had a Bayley-III at median age 28 months [IQR 19, 34]. Of these, 448 (87%) were full-term and 65 (13%) preterm. In univariate analyses, children born preterm vs. full term had lower Bayley-III cognitive, language, and motor scores, explaining from 2.4% (language) to 6.2% (motor) of the variance in Bayley composite scores. In the final models, GA remained a strong independent predictor of motor and cognitive scores. Children with GA ≤33 weeks had the worst outcomes, with age-adjusted cognitive and motor composite scores 11 and 15 points lower, respectively, than those of term infants (Figure). Other significant risk factors included lower primary caregiver education, Black race, longer hospital length of stay, and genetic diagnosis. These models ultimately explained 17-26% of the variance in Bayley scores, with the highest explained variance in the motor domain. Conclusions: Adjusting for other patient and medical factors, preterm infants with CHD have worse cognitive and motor outcomes; risk is highest in those born at ≤33 weeks. Further work is needed to identify potentially modifiable factors to tailor prenatal, postnatal and perioperative care of infants with CHD born prematurely.

Motherhood in the Making: Key Determinants of Parenthood Motivation in Young Adult Women

Background: Demographic changes are often prone to purely social perspectives, while individual differences are overlooked. This research examines the role of attachment and emotional intelligence in childbearing motivation. Methods: In total, 234 female students participated in an online survey, including sociodemographic data, adult attachment, emotional competencies, and parenting-related variables. Results: Statistical analyses revealed that the students express positive and negative childbearing motivation almost equally and moderately. They were both linked to religiosity and emotional management. We further explore the differences in relationship status and address the role of religious beliefs. The demographic measures identified as most important include healthcare availability for both mother and child, subsidizing housing loans or rent, and encouraging fathers to become more actively involved in the care of infants. Conclusion: These emerging trends deserve further investigation and social incentives.

HUBUNGAN PEMBERIAN JENIS ASUPAN NUTRISI DAN PEMILIHAN TERAPI DENGAN LAMA PERAWATAN PADA BBLR DENGAN IKTERUS NEONATORUM DI RSUD KANJURUHAN MALANG

Infants born weighing less than 2500 grams can be classified into the Low Birth Weight (LBW) category. This classification is not based on gestational age, which makes LBW infants particularly vulnerable because their bodies are not fully prepared to face the extrauterine environment. There are several impacts associated with LBW, one of which is the incidence of neonatal jaundice. This condition occurs especially in LBW infants, leading to longer hospital stays. During the treatment period, the reduction in serum bilirubin levels must be supported by adequate nutritional intake and appropriate therapy. Nutritional intake may include exclusive breastfeeding, predominant breastfeeding, or a combination of both, while therapies include phototherapy, exchange transfusion, and pharmacological treatments. Providing nutrition as early as possible can help reduce bilirubin levels more quickly. Therefore, the purpose of this study was to determine the relationship between types of nutritional intake, therapy selection, and the length of stay in LBW infants with neonatal jaundice at Kanjuruhan Kepanjen Hospital, Malang Regency. The study used an observational analytic design with a cross-sectional approach and included 56 samples selected through purposive sampling. Data were collected using a form based on secondary data and analyzed using the Eta Test, with a correlation value of η = 0.438. The results indicate a moderate relationship between the type of nutritional intake and the length of stay in LBW infants with neonatal jaundice. This study also reported a significant difference in the average length of stay based on the type of nutritional intake, with an ANOVA test yielding a p-value of 0.004. This suggests a significant difference in the length of stay based on nutritional intake. These findings should be of particular concern to healthcare workers when providing nutritional care for LBW infants with neonatal jaundice. Keywords: LBW, neonatal jaundice, infant nutrition, therapy selection, hospitalization.

Diabetes prevention after gestational diabetes: challenges and opportunities

Abstract Gestational diabetes (GDM) poses significant health concerns for women and their offspring, with implications that extend beyond pregnancy. While GDM often resolves postpartum, a diagnosis of GDM confers a greater risk of future type 2 diabetes (T2D) and other chronic illnesses. Furthermore, the intergenerational impact of GDM predisposes offspring to increased chronic disease risk. Despite the awareness of the short- and long-term consequences of GDM, translating this knowledge into prevention strategies remains challenging. Challenges arise from a lack of clarity among health professionals regarding roles and responsibilities in chronic disease prevention and women’s lack of awareness of the magnitude of associated health risks. These challenges are compounded by changes in the circumstances of new mothers as they adjust to balance the demands of infant and family care with their own needs. Insights into behaviour change strategies, coupled with advances in technology and digital healthcare delivery options, have presented new opportunities for diabetes prevention among women with a history of GDM. Additionally, there is growing recognition of the benefits of adopting an implementation science approach to intervention delivery, which seeks to enhance the effectiveness and scalability of interventions. Effective prevention of T2D following GDM requires a comprehensive person-centred approach that leverages technology, targeted interventions, and implementation science methodologies to address the complex needs of this population. Through a multifaceted approach, it is possible to improve the long-term health outcomes of women with prior GDM.

The influence of maternal long term health conditions including multimorbidity on child oral health: A scoping review and evidence gap map protocol

Objective This scoping review will map the extent and type of evidence in relation to the association between maternal long term health conditions (LTCs), including multimorbidity, and child oral health. Introduction Newer theories are emerging that detail the many factors that can influence child oral health at child, family and community levels. More recently, the association between maternal general health and child oral health has been explored, with preliminary evidence suggesting a link between shared environmental factors and diet/substance use during pregnancy causing childhood caries. Inclusion criteria All published studies that describe the relationship between maternal LTCs (including multimorbidity) and child oral health. There will be no limitation on the date of publication due to the limited number of studies available from the initial search of PubMed. The review will exclude case studies, abstracts, and grey literature. Literature must be in English language. Methods The following databases will be searched; CINAHL, Cochrane Library, Maternity and Infant Care, Medline via PubMed, Scopus, Web of Science. The search will include sources in English only and will be undertaken between April and July 2024. Studies to be included will be of any type of study design that describe a relationship between maternal long term health conditions, including maternal long term oral health conditions, and child oral health. Data extraction will be undertaken using tabulation of results by at least two independent reviewers. Narrative analysis of the evidence will be undertaken, and results will be presented in a narrative and tabular manner due to the heterogenous and limited evidence base found in the test search. This review has been registered prospectively on Open Science Framework, (https://doi.org/10.17605/OSF.IO/ECSWJ). The review will also inform an Evidence Gap Map (EGM) to illustrate the current evidence base regarding maternal health factors that influence child oral health.

Kangaroo Mother Care: A Low-cost Intervention for Improving Cerebral Hemodynamics in Preterm Babies

Background Kangaroo mother care (KMC) has been utilized extensively for the care of infants with low birth weight and babies born prematurely. However, changes in cerebral blood flow (CBF) during KMC interventions are not known clearly. Hence, this study was done, in clinically stable premature babies, to study the changes in cerebral hemodynamics after KMC sessions. Methods It was a prospective study, done without a control group, with a pre-post test design. In our study, an assessment of 104 stable preterm newborns was done, before and after KMC. CBF parameters, which included mean velocity (MV), resistive index (RI) and pulsatility index (PI) were assessed using doppler ultrasonography in middle cerebral artery. Results Both PI and RI were found to be significantly decreased after KMC sessions. Their values, before and after KMC, were 2.06 ± 0.83 versus 1.67± 1.06 ( p value .04) and 0.88 ± 0.27 versus 0.75 ± 0.37 ( p value .04), respectively. On the other hand, MV of blood flow was found to be increased after KMC (33.47 ± 18.16 vs. 40.46 ± 19.49; p value .01). Thus, there is an increase in CBF parameters after KMC. Conclusion There is an increase in CBF after providing KMC, thereby having a positive influence on the structure and development of the premature infant’s brain.

And Baby Makes Three: Postpartum Changes in Male-Female Affiliative Interactions in White-Faced Capuchins.

In group-living primates, male investment in infants is highly variable. Previous research on polygynandrous primates found that male care of infants, whether direct or indirect, may be a means to increase offspring survival, increase social status, invest in future mating opportunities, and/or invest in future social or coalition partners, any of which may increase fitness outcomes. Relationships between male white-faced capuchins (Cebus imitator) and infants are highly variable, ranging from neutral to highly affiliative during periods of group stability to lethal during times of instability. We used genetic paternity analysis and behavioral observations to investigate the impact of paternity status, female dominance rank, male dominance rank, and infant sex on changes in rates of affiliation (contact and proximity) between capuchin males and females following the birth of an infant (n = 92 dyads). We used generalized linear mixed models and an information theory approach to select models for averaging. We found that overall rates of male-female affiliation increased following the birth of an infant (contact change: +1.09 ± 2.55%; proximity change: +1.16 ± 3.08%). Infant sex was the only significant explanatory variable; dyads that included males and females who gave birth to male infants experienced a significant increase in their time in contact and proximity in comparison to dyads with females who gave birth to female infants (contact change: p < 0.05 in 2/3 models; proximity change: p < 0.001 in 3/3 models). These findings add to previous data indicating that male capuchins do not recognize their offspring or have the motivation to preferentially invest in their care. We suggest that the observed sex bias may be a form of sex-specific socialization connected to the importance of forming long-term cooperative male bonds that are maintained via male parallel dispersal in this species.

Development and Usability of the OHiFamily Mobile App to Enhance Accessibility to Maternal and Infant Information for Expectant Families in Ohio: Qualitative Study.

The Infant Mortality Research Partnership in Ohio is working to help pregnant individuals and families on Medicaid who are at risk for infant mortality and preterm birth. As part of this initiative, researchers at The Ohio State University worked to develop a patient-facing mobile app, OHiFamily, targeted toward, and created for, this population. To address the social determinants of health that can affect maternal and infant health, the app provides curated information on community resources, health care services, and educational materials in a format that is easily accessible and intended to facilitate contact between families and resources. The OHiFamily app includes 3 distinct features, that is, infant care logging (eg, feeding and diaper changes), curated educational resources, and a link to the curated Ohio resource database (CORD). This paper describes the development and assessment of the OHiFamily app as well as CORD. This study aimed to describe the development of the OHiFamily mobile app and CORD and the qualitative feedback received by the app's intended audience. The researchers performed a landscape analysis and held focus groups to determine the resources and app features of interest to Ohio families on Medicaid. Participants from several focus groups were interested in an app that could offer community resources with contact information, information about medical providers and information and ways to contact them, health tips, and information about pregnancy and infant development. Feedback was provided by 9 participants through 3 focus group sessions. Using this feedback, the team created a curated resource database and mobile app to help users locate and access resources, as well as access education materials and infant tracking features. OHiFamily offers a unique combination of features and access to local resources for families on Medicaid in Ohio not seen in other smartphone apps.

Investigation of Prognosis and Related Factors of Premature Neonates

The birth of premature infants remains a challenge in many societies. This cross-sectional study investigates prenatal care and influential factors in preterm infants hospitalized in the Neonatal Intensive Care Unit (NICU) of Fatemieh Educational-Medical Center in Hamadan, Iran, from March 2018 to March 2019. We examined premature infants with a gestational age of less than 37 weeks who were admitted to the NICU. Data on demographic and maternal characteristics, length of hospital stay, maternal underlying diseases, probable causes of preterm birth, neonatal complications, treatment types, treatment-related complications, resuscitation needs, ventilation, and mortality rates were extracted from patient records. Among 388 preterm infants studied, 204 (52.6%) were female. The mean gestational age was 31.8±2.8 weeks, birth weight was 1647.4±625.6 grams, and average hospital stay was 10.2±9.3 days. The most common maternal underlying disease was pregnancy-induced hypertension or preeclampsia (22.2%), respiratory distress syndrome, jaundice, and low birth weight were the leading reasons for hospitalization (84%). Neonatal outcomes included 92 (23.7%) deaths, 25 (6.4%) intraventricular hemorrhages, 39 (10.1%) patent ductus arteriosus cases, 20 (5.2%) bronchopulmonary dysplasia cases, and 41 (10.6%) retinopathy of prematurity cases. Regression analysis revealed significant predictors of neonatal mortality, including male gender, maternal underlying diseases, need for cardiopulmonary resuscitation, low Apgar score at one-minute, lower birth weight, shorter gestational age, and NICU stay duration. This study underscores the high neonatal mortality rate among preterm infants. Implementing preventive measures, particularly addressing maternal underlying diseases and low birth weight, can significantly reduce neonatal mortality.

Effect of Combination of Facial Acupuncture Therapy with Lavender Aromatherapy on Reducing Postpartum Maternal Anxiety Levels in Medan Tuntungan District

Following childbirth, moms will undergo emotional fluctuations characterized by mood swings, anxiety, dizziness, and feelings of despair. Impaired maternal understanding of infant care can lead to psychological issues that impact the mother's physical well-being, including disrupted sleep patterns and reduced appetite. Failure to promptly manage anxiety in postpartum mothers can lead to the development of baby blues syndrome and postpartum depression. This study employs a Quasi Experiment design with a pre-posttest not include a control group to quantitatively investigate the impact of combining facial acupressure therapy with lavender aromatherapy on anxiety reduction in postpartum mothers. The investigation was conducted in Medan Tuntungan District, located in Medan City. One hundred postpartum women constituted the sample in this study. The data collection process involved administering treatment (facial acupressure therapy with lavender aromatherapy), followed by observation and interviews conducted using the HARS instrument. The analysis conducted using the Wilcoxon Signed Ranks Test revealed a negative ranks value of 94. This indicates that out of the 100 postpartum women who participated in the study, 94 mothers reported a reduction in anxiety levels. The positive rankings index is 0, indicating that none of the 100 postpartum moms who participated in the study reported a rise in anxiety levels. The tie value of 6 indicates that among the 100 postpartum moms who participated in the study, 6 mothers did not show any significant difference in anxiety levels before and after undergoing a combination of Facial Acupressure Therapy with Lavender Aromatherapy. Moreover, it is established that the significance value at this stage of analysis is 0.000 or greater than ? (0.05). Therefore, it can be inferred that there is a significant impact of the combination of Facial Acupressure Therapy with Lavender Aromatherapy on the reduction of anxiety levels in postpartum mothers.

Design of a hazard prediction system with intelligent multimodal fusion based on artificial intelligence &amp; internet of things technology: taking a crib as an example

Problem How to design an intelligent multimodal fusion hazard prediction system using AIoT (Artificial Intelligence &amp; Internet of Things) technology to predict some potential dangers. This article will provide some ideas and methods. Introduction This article designs an intelligent multimodal fusion hazard prediction system based on AIoT technology. The system mainly consists of an IoT hardware device and an AI multimodal and multi-dimensional Hazard Prediction Algorithm. Method This article will take baby cribs as an example, using this system to empower traditional baby cribs and transform them into intelligent baby cribs. Results In this example, the system can detect the real-time status of the baby and predict upcoming dangers, including kicking the quilt, wetting the bed, fever, crying, climbing over the crib, and turning over. Hypothesis Assuming that intelligent systems can detect the status of infants in real-time and make predictions before potential dangers occur, to promptly alert parents. Perhaps it can prevent some irreversible dangers from occurring. Background This system solves the pain point problem of parents having to take care of their babies after working hard. Purpose In this scenario, the system provides a design scheme for an intelligent multimodal fusion hazard prediction system with a temporary care function. The application of this system to baby cribs not only reduces the burden on parents but also ensures the safety and comfort of the baby. Transferability At the same time, the system has transferability, and its design concept can be transferred to other application scenarios, such as hospital care for infants, young children, or elderly patients, as well as childcare stations for abandoned children in society. Significance This innovative system design scheme has a positive significance for family harmony and social development.

Roma mothers of infant children in the health system - a qualitative study

Abstract Background The Roma in Bulgaria constitute the third largest group - 4% of the population. Data on demographic processes by ethnicity are scarce. A national survey in 2003 found significant differences in infant mortality - 9.9‰ for Bulgarian, 18‰ for Turkish, and 28‰ for Roma infants. Poverty among Roma children, risk of poor education, especially for girls, barriers to accessing health services remain high. We aim to reveal the cultural specificity in prenatal behavior and infant care among Roma mothers in the context of the role of the Bulgarian health service. Methods In-depth interviews with Roma mothers of infants up to 1 year were utilized for data collection. To ensure heterogeneity among the interviewees, several “nests” with varying socio-cultural status in the Varna district were identified in advance for participants recruitment. A list of interview themes concerning respondents’ relationships with the public health system with an emphasis on the experiences of mothers was drawn up. Results Ten interviews with mothers having between 1 and 7 children were conducted in 2023. The mothers recounted discriminatory experiences during their interactions with certain health facilities (maternity wards), which act as barriers to accessing and utilizing health services. Maternity and infant counselling services are highly esteemed with favorable influence on child health outcomes. There has been a positive shift away from early marriage and childbirth towards prioritizing education for Roma girls. Mothers prioritize their children, and there is no neglect in their care. Family relations and support are being upgraded, with Roma fathers becoming involved in child care. Respondents express their educational needs and hopes for community-based support to better cope with their roles as mothers. Conclusions Ethno-cultural factors shaping the mother’s role maintain traditional family support, while also reflecting significant modernization that needs societal support. Key messages • A glimpse into people’s experiences of the healthcare system - a clue to its effectiveness. • Тhe ethno-cultural factors in Roma are subject to modernization.

Male involvement in infant care and associated factors among infants less than one year in Bibugn district of Ethiopia

Male involvement in infant care is an effective intervention to improve infant health outcomes. However, evidence regarding male involvement in infant care and its associated factors is limited in Ethiopia. To assess the male involvement in infant care and associated factors among infants less than one year in Bibugn district of Ethiopia. A community-based cross-sectional study was conducted among 606 participants from April 1–30/2023. A systematic sampling technique was used to select each study participant. Data was collected using interviewer-administered questionnaires. Data were entered into Epi data 4.6 and analyzed using statistical Product Service and Solution (SPSS) version 2 5. Both descriptives, mean, frequency and analytical statistics were employed. Variables with a p-value of less than 0.25 in bivariate logistic regression were entered into a multivariate logistic regression to identify associated factors. Statistical significance was declared at p < 0.05. The prevalence of male involvement in infant care was 42.2% with a 95% CI (38.26–46.12). Male who did not attend formal education (AOR = 0.24, 95% CI = 0.14–0.43), having one child (AOR = 5.66, 95%CI = 2.94–10.88), having male infants (AOR = 2.51, 95% CI = 1.60–3.95), first infant order (AOR = 2.70, 95% CI = 1.36–5.39), having adequate knowledge towards infant care (AOR = 5.56,95% CI = 0.12–0.28), and having favorable attitude towards infant care (AOR = 1.70,95% CI = 0.34–0.99) were factors associated with male involvement in infant care. Less than 50% ( 50%) of males are involved in their infant care. Educational status of males, number of infants, male infants, male knowledge, and attitude towards infant care were significantly associated with involvement in infant care. Therefore, efforts should be directed at improving males’ educational status, knowledge, and attitude to improve their engagement in caring for their infants.

Attitudes and Experiences Among Swedish NICU Nurses Regarding Skin-to-Skin Care of Infants Born at 22-23 Weeks of Gestation.

Skin-to-skin care (SSC) is an evidence-based care method for preterm-born infants. Staff may hesitate to initiate early SSC, the first or second week of life, for the most extremely preterm infants; 1 reason could be nurses' attitudes. The aim was to investigate the attitudes and experiences of neonatal nurses regarding early SSC for the most extremely preterm infants, born at gestational week (GW) 22-23, using an exploratory and descriptive approach. A web-based survey was sent to all nurses across the 6 Swedish units routinely caring for the most extremely preterm infants. Descriptive statistics and qualitative content analysis were used to analyze the data. The response rate was 258 out of 547 (47%). This study reveals a spectrum of attitudes and experiences among nurses, ranging from viewing early SSC as an integral aspect of infant care to deeming it very challenging or simply not feasible. The outcomes are presented in 2 categories, describing both facilitators and challenges associated with early SSC. Noteworthy, facilitators include well-implemented guidelines that support early SSC. Conversely, challenges encompass knowledge gaps and the scarcity of scientific evidence demonstrating the safety of all SSC, including early, for the most extremely preterm infants. This study underscores the importance of spreading knowledge, and has clinical adapted guidelines about the practical aspects of SSC for infants born at 22-23 GW. Future research is required to clarify safety aspects pertaining to SSC for the most extremely preterm infants.

Fatherhood in the context of preterm birth: A narrative review of contemporary research evidence

AbstractLong focused on maternal roles in infancy, research is now exploring fathers' contributions to child development. Current public policy emphasizes early prevention and intervention for child and parent well‐being, especially for at‐risk infants such as those born prematurely. A literature review was conducted following the approach of a narrative review, to examine fatherhood in the context of preterm birth, highlighting the stress and emotional vulnerability experienced by fathers of preterm infants. Promoting early paternal presence and involvement in infant care helps fathers cope with this emotionally challenging experience. Despite limited data on premature fatherhood, fathers are active partners in dyadic interactions and play a significant role in their infant's neonatal intensive care unit journey and family dynamics. The discussion underscores the importance of father‐focused interventions and the paternal contribution to child development, framed within the authors' proposed integrative and developmental model of the family triad.

Kangaroo mother care improves cardiorespiratory physiology in preterm infants: an observational study

ObjectivesTo evaluate whether kangaroo mother care (KMC) in preterm infants on non-invasive respiratory support improves indices of cardiorespiratory wellbeing.Study designProspective quasi-experimental observational study.SettingTertiary perinatal neonatal unit.Patients50 very preterm infants being...

Highlights From the 2023 Revision of Pediatric Tactical Emergency Casualty Care Guidelines.

In 2023 the Committee for Tactical Emergency Casualty Care (C-TECC) issued updated Pediatric Tactical Emergency Casualty Care (TECC) Guidelines (Guidelines) that focus on the delivery of stabilizing care of children who are the victims of high-threat incidents such as an active shooter event. The Guidelines provide evidence-based and best practice recommendations to those individuals and departments that specifically provide operational medical support to law enforcement agencies caring for children in this uniquely dangerous environment where traditional resources may not be available. This article highlights key takeaway points from the Guidelines, including several updates since the first version was released in 2013.The evidence base for the care of children in this environment is lacking, and medical care delivered in the high-threat environment is inconsistent and often not optimized for the care of infants and children. The Guidelines are supported from the existing literature base where possible, and where it is not, by consensus as to the current best practices as determined by iterative deliberations among the diverse and experienced group of stakeholders who are members of C-TECC. The Guidelines provide patient assessment and management information specific to the care of children in the following 3 dynamic phases of the high-threat environment: Direct Threat, Indirect Threat, and Evacuation. The phases represent a continuum of risk to the patient and the responder ranging from extreme (such as ongoing gunfire) to minimal (during movement toward definitive medical care).The high-threat environment is dynamic and there is competing safety, tactical/operational, and patient care priorities for responders when infants and children are injured. The Guidelines provide recommendations on the type of medical and psychological care that should be considered under each phase of threat and establishes the context for how and why to deliver (or potentially defer) certain interventions under some circumstances in order the maximize the opportunity for a good outcome for an injured pediatric patient. The Guidelines also emphasize the importance of synergizing hospital-based pediatric trauma care with those law enforcement and fire/emergency medical services that may provide field care to children under high-threat circumstances.

Impact of visitation restrictions in neonatal intensive care units during the COVID-19 pandemic on parents in northern Hokkaido, Japan.

Medical institutions restricted visitation to neonatal intensive care units (NICUs) during the coronavirus disease (COVID-19) pandemic. Therefore, this study aimed to investigate the impact of COVID-19 NICU visitor restrictions on parents. We conducted a questionnaire of 378 parents of infants who were hospitalised for more than 1 week at two NICUs in our area and discharged between 1 April 2020 and 31 March 2022. While the visiting rules for NICUs during this period varied depending on the phase of the COVID-19 epidemic, generally, only parents were allowed to visit the NICUs for a few hours daily. A total of 157 parents (A University Hospital (AMUH), n = 79; AK General Hospital (AKGH), n = 78) responded to the survey (41.3% response rate), with 40% stating that their emotions towards their infants were affected by restrictions due to the COVID-19 pandemic. Parents' feelings towards their infants were influenced by mode of delivery, parity, duration of hospitalisation and opportunities to visit the NICU. More than 70% of respondents felt stressed due to COVID-19 restrictions, and anxiety and emotional stress related to visitor restrictions were significantly affected by the number and duration of visits and allowability of family member visits. Parents felt that the restrictions had a negative impact on breastfeeding, overall infant care and infant-family bonding. As parents felt an impact on the bond with their infant during visitation restrictions, it is essential for facilities to implement measures to protect infant-family bonding during potential future pandemics.

Successful adoption of non-orphaned infant by a parous, nursing female in yaki (Sulawesi crested macaque)

Abstract Adoption is an unusual behaviour across taxa, and for adoption to be successful, with the infant surviving to independence, the adoptive parent must be able to provide appropriate nutrition and care. Successful adoption has now been reported in several nonhuman primate species and here we add a case in wild yaki (Sulawesi crested macaque, Macaca nigra). We observed the adoption of an approx. 2-week-old infant by a female with her own approx. 3-week-old infant who went on to carry, nurse, and care for both infants until they both became independent. The adoptive and biological mother had each previously raised the same number of offspring (5). There was no evidence of aggressive transfer and we did not observe any attempts by the adopted infant’s biological mother to retrieve her. The biological mother went on to have another infant 8 months later while the adoptive mother was still caring for her other infant. This case may reflect some of the health costs and reproductive benefits of adoption for nonhuman primates.