Infant Health Research Articles

Kangaroo Mother Care Induced Serum Oxytocin Facilitates Prolactin and IL-10 Among Emergency Cesarean Mothers.

The rate of cesarean section is increasing from 15% to 40% in recent years. The type of delivery influences the hormonal, emotional and mental health of the mother, which correlates positively or negatively with the health benefits of the newborn. There have been many published studies on kangaroo mother care for mothers undergoing elective cesarean section, but there is still a lack of understanding about emergency cesarean section. This study aimed to evaluate the benefits of KMC practice for mothers undergoing emergency cesarean section in terms of hormone levels such as oxytocin, cortisol, prolactin, interleukin-6 and interleukin-10. This retrospective analysis used remnant serum (KMC group = 16; control group = 9), and clinical data such as KMC practice (15-30 minutes three or four times daily until discharge), breastfeeding initiation time, feeding time, crying time and hospital stay were extracted from the electronic database. All hormone and cytokine expressions were quantitatively determined by ELISA. Comparisons within and between groups were performed using appropriate statistical tests. In the KMC group, increased levels of the hormone oxytocin significantly reduced cortisol and IL-6 and negatively influenced prolactin and IL-10 levels. The elevated prolactin facilitates overall lactation behaviour, of which 64% reported breastfeeding directly at the breast. The cytokine analysis revealed a reduction in pro-inflammatory cytokines and thereby an improved wound healing was seen in the KMC group. These quantitative results strongly encourage the use of KMC for mothers undergoing emergency cesarean section. These simple yet effective breastfeeding strategies promote maternal and infant health, which can reduce medication use.

AIMP2 restricts EV71 replication by recruiting SMURF2 to promote the degradation of 3D polymerase

Hand, foot and mouth disease (HFMD), mainly caused by enterovirus 71 (EV71), has frequently occurred in the Asia-Pacific region, posing a significant threat to the health of infants and young children. Therefore, research on the infection mechanism and pathogenicity of enteroviruses is increasingly becoming important. The 3D polymerase, as the most critical RNA-dependent RNA polymerase (RdRp) for EV71 replication, is widely targeted to inhibit EV71 infection. In this study, we identified a novel host protein, AIMP2, capable of binding to 3D polymerase and inhibiting EV71 infection. Subsequent investigations revealed that AIMP2 recruits the E3 ligase SMURF2, which mediates the polyubiquitination and degradation of 3D polymerase. Furthermore, the antiviral effect of AIMP2 extended to the CVA16 and CVB1 serotypes. Our research has uncovered the dynamic regulatory function of AIMP2 during EV71 infection, revealing a novel antiviral mechanism and providing new insights for the development of antienteroviral therapeutic strategies.

Local environment shapes milk microbiomes while evolutionary history constrains milk macronutrients in captive cercopithecine primates.

Milk is a complex biochemical fluid that includes macronutrients and microbiota, which, together, are known to facilitate infant growth, mediate the colonization of infant microbiomes, and promote immune development. Examining factors that shape milk microbiomes and milk-nutrient interplay across host taxa is critical to resolving the evolution of the milk environment. Using a comparative approach across four cercopithecine primate species housed at three facilities under similar management conditions, we test for the respective influences of the local environment (housing facility) and host species on milk (a) macronutrients (fat, sugar, and protein), (b) microbiomes (16S rRNA), and (c) predicted microbial functions. We found that milk macronutrients were structured according to host species, while milk microbiomes and predicted function were strongly shaped by the local environment and, to a lesser extent, host species. The milk microbiomes of rhesus macaques (Macaca mulatta) at two different facilities more closely resembled those of heterospecific facility-mates compared to conspecifics at a different facility. We found similar, facility-driven patterns of microbial functions linked to physiology and immune modulation, suggesting that milk microbiomes may influence infant health and development. These results provide novel insight into the complexity of milk and its potential impact on infants across species and environments.

Early life and infant mental health: Reshaping assumptions in a southern field

Early life and infant mental health: Reshaping assumptions in a southern field

A Systematic Review of Methods and Practice for Integrating Maternal, Fetal, and Child Health Outcomes, and Family Spillover Effects into Cost-Utility Analyses.

Maternal-perinatal interventions delivered during pregnancy or childbirth have unique characteristics that impact the health-related quality of life (HRQoL) of the mother, fetus, and newborn child. However, maternal-perinatal cost-utility analyses (CUAs) often only consider either maternal or child health outcomes. Challenges include, but are not limited to, measuring fetal, newborn, and infant health outcomes, and assessing their impact on maternal HRQoL. It is also important to recognize the impact of maternal-perinatal health on family members' HRQoL (i.e., family spillover effects) and to incorporate these effects in maternal-perinatal CUAs. The aim was to systematically review the methods used to include health outcomes of pregnant women, fetuses, and children and to incorporate family spillover effects in maternal-perinatal CUAs. A literature search was conducted in Medline, Embase, EconLit, Cochrane Collection, Cumulative Index to Nursing and Allied Health Literature (CINAHL), International Network of Agencies for Health Technology Assessment (INAHTA), and the Pediatric Economic Database Evaluation (PEDE) databases from inception to 2020 to identify maternal-perinatal CUAs that included health outcomes for pregnant women, fetuses, and/or children. The search was updated to December 2022 using PEDE. Data describing how the health outcomes of mothers, fetuses, and children were measured, incorporated, and reported along with the data on family spillover effects were extracted. Out of 174 maternal-perinatal CUAs identified, 62 considered the health outcomes of pregnant women, and children. Among the 54 quality-adjusted life year (QALY)-based CUAs, 12 included fetal health outcomes, the impact of fetal loss on mothers' HRQoL, and the impact of neonatal demise on mothers' HRQoL. Four studies considered fetal health outcomes and the effects of fetal loss on mothers' HRQoL. One study included fetal health outcomes and the impact of neonatal demise on maternal HRQoL. Furthermore, six studies considered the impact of neonatal demise on maternal HRQoL, while four included fetal health outcomes. One study included the impact of fetal loss on maternal HRQoL. The remaining 26 only included the health outcomes of pregnant women and children. Among the eight disability-adjusted life year (DALY)-based CUAs, two measured fetal health outcomes. Out of 174 studies, only one study included family spillover effects. The most common measurement approach was to measure the health outcomes of pregnant women and children separately. Various approaches were used to assess fetal losses in terms of QALYs or DALYs and their impact on HRQoL of mothers. The most common integration approach was to sum the QALYs or DALYs for pregnant women and children. Most studies reported combined QALYs and incremental QALYs, or DALYs and incremental DALYs, at the family level for pregnant women and children. Approximately one-third of maternal-perinatal CUAs included the health outcomes of pregnant women, fetuses, and/or children. Future CUAs of maternal-perinatal interventions, conducted from a societal perspective, should aim to incorporate health outcomes for mothers, fetuses, and children when appropriate. The various approaches used within these CUAs highlight the need for standardized measurement and integration methods, potentially leading to rigorous and standardized inclusion practices, providing higher-quality evidence to better inform decision-makers about the costs and benefits of maternal-perinatal interventions. Health Technology Assessment agencies may consider providing guidance for interventions affecting future lives in future updates.

Building Breastfeeding Research Relations and Beyond: An Interview With Fiona Dykes.

Professor Fiona Dykes is Professor Emerita of Maternal and Infant Health at the University of Central Lancashire in the United Kingdom (UCLAN). Fiona has a particular interest in the global, sociocultural, and political influences upon infant and young child feeding practices; her methodological expertise is in ethnography and other qualitative research methods. She founded the Maternal and Infant Nutrition and Nurture Unit (MAINN) in 2000 which she led until she retired from her full-time professorship in 2020. Fiona established the associated MAINN Conference in 2007. The MAINN conference is a 3 day, international, peer reviewed event held bi-annually in the United Kingdom and, more recently, in alternate years overseas (Sydney, Australia; Falun, Dalarna, Sweden; and Florida, United States). The conference draws together key researchers in the field of infant and young child feeding from around the world. Fiona was a founding member of the journal Maternal and Child Nutrition. She is author of Breastfeeding in Hospital: Mothers, Midwives and the Production Line (Routledge) and co-author, with Dr Tanya Cassidy, of Banking on Milk: An Ethnography of Donor Human Milk Relations (Routledge). She is also joint editor of several books including Infant and Young Child Feeding: Challenges to Implementing a Global Strategy (Wiley-Blackwell) and Ethnographic Research in Maternal and Child Health (Routledge). This interview was conducted on April 20, 2023, by Dr. Tanya Cassidy, and is based on a verbatim transcription and edited for readability.TC = Tanya Cassidy; FD = Fiona Dykes.

Experiences accessing nutritious foods and perceptions of nutritional support needs among pregnant and post-partum mothers with low income in the United States.

Access to nutritious foods, a social determinant of health, contributes to disparities in maternal and infant health outcomes such as mental health, breastfeeding intensityand cardiometabolic risk. This study explored perceived nutrition access and intake among pregnant or post-partum women eligible for Medicaid. Qualitative, semistructured interviews were conducted with 18 women who were either currently pregnant (n = 4) or up to 12 months post-partum (n = 14) in 2021-2022. Mothers spoke English (n = 11) or Spanish (n = 7) and lived in the Texas Panhandle. Interviews were audio-recorded, transcribed, translated (Spanish to English)and verified. Two or more researchers coded each interview until consensus was reached using thematic analysis with ATLAS.ti software. The study revealed five drivers for nutrition access. (1) Social factors influenced nutrition; those with less support expressed limited ability to eat healthfully. (2) The Women, Infantsand Children program was perceived as a helpful resource for some, while others faced challenges obtaining it. (3) Stress was bidirectionally related to unhealthy food choices, with food sometimes used as a coping mechanism. (4) Mothers prioritized their babies and others and had limited ability and time to prepare healthy meals. (5) Most participants felt they received inadequate nutrition guidance from their healthcare providers. Participants provided positive responses to a proposed nutritious home-delivered meal intervention. Low-income women may experience nutritional challenges specific to this life stage. Interventions that reduce stressand burden of household tasks (e.g. cooking)and improve education and access to nutritious foods may improve mothers' ability to consume nutritious foods.

Brain health in preterm infants: importance of early-life pain and analgesia exposure.

"Everyday" exposures in the neonatal period, such as pain, may impact brain health in preterm infants. Specifically, greater exposure to painful procedures in the initial weeks after birth have been related to abnormalities in brain maturation and growth and poorer neurodevelopmental outcomes in preterm infants. Despite an increasing focus on the importance of treating pain in preterm infants, there is a lack of consensus of optimal approaches to managing pain in this population. This may be due to recent findings suggesting that commonly used analgesic and sedative medications in preterm infants may also have adverse effects of brain maturation and neurodevelopmental outcomes. This review provides an overview of potential impacts of pain and analgesia exposure on preterm brain health while highlighting research areas in need of additional investigations for the development of optimal pain management strategies in this population.

Total Nitrite and Nitrate Concentration in Human Milk and Saliva during the First 60 Days Postpartum-A Pilot Study.

Nitric oxide (NO) in human milk may have important functions in lactation and infant health. This longitudinal pilot cohort study investigated the total nitrite and nitrate (NOx) concentration in human milk and maternal saliva during the first 60 days postpartum. Additionally, we explored the association between selected breastfeeding variables and milk and saliva NOx concentration. Human milk and maternal saliva samples were collected on days 2, 5, 14, 30, and 60 postpartum and analyzed for NOx concentration. Breastfeeding data were collected through self-assessed questions. Data analyses were performed using mixed models. The concentration of NOx in milk was significantly higher during the first 30 days compared to day 60, and there was a positive association between milk and saliva NOx concentrations throughout the entire study period. In absolute numbers, partially breastfeeding mothers had a lower concentration of NOx in milk on day 2 compared to exclusively breastfeeding mothers (8 vs. 15.1 μM, respectively). Partially breastfeeding mothers reported a later start of secretory activation and fewer mothers in this group started breastfeeding within the first hour after birth. Due to the small numbers, these differences could not be statistically evaluated. Further research is warranted to elucidate the role of NO in lactation success and breastfeeding outcomes.

Vaccination status among children in an urban area and its association with risk factors and some parent health practices: A cross-sectional study.

The study aims to determine the vaccination status of children and evaluate the relationship between vaccination rates, vaccine attitudes, and some parental health practices. This cross-sectional study was conducted with 674 mothers. Data were collected using a survey evaluating vaccine characteristics, some infant health practices, and The Public Attitude Toward Vaccination Scale-Health Belief Model. Chi-square test, independent samples t-test, and logistic regression analysis were used. 80.2% of children were fully vaccinated. The rate of non or under-vaccination was higher in the group that did not regularly undergo follow-up for 0-2-year-old children, did not fully have health screenings, did not use vitamin D and iron supplements, and used alternative medicine. Moreover, the duration of breast milk feeding, the transition to supplementary food, and the duration of vitamin D use in the non-fully vaccinated group were lower than in the fully vaccinated group (p<.05). The increase in maternal education period and severity and benefit attitude scores of vaccine attitude were the factors that decreased the rate of non-fully vaccination. The increase in barrier scores toward vaccines increased the rate of non or under-vaccination. Mothers who have negative attitudes toward vaccination have negative behaviors in health practices and screenings on infant/child health.

The giving tree: impacts of deforestation on birth outcomes in Mexico

ABSTRACT Deforestation adversely impacts human health through mechanisms such as increased air pollution, shifts in disease vector distributions, and changes in local climate. Although the influence of deforestation on human health is recognized, its effects on infant health outcomes have been insufficiently studied. This paper examines the effects of deforestation on infant health by analysing birth certificate data from 2011 to 2021 across Mexican municipalities, combined with satellite-derived annual deforestation rates. We show that increased deforestation leads to decreased birth weight, higher rates of low birth weight (LBW), and reduced Apgar scores. Specifically, an increase of one standard deviation in deforestation results in a reduction of average birth weight by 19 grams, an increase in the probability of LBW by 0.43% points, and an increase in the probability of a low Apgar score by 4.7% points. These effects are consistently observed even after controlling for different definitions of forest cover, excluding data during the COVID-19 pandemic, and limiting the analysis to municipalities with at least 2% forest coverage. This study provides critical evidence that deforestation directly impairs newborn health in Mexico, highlighting a significant and underappreciated environmental cost with long-term implications for human capital.

Sociocultural Implications of Reproductive Health Programs in the Province of La Union, Philippines

This study determined the sociocultural implications of RH programs in the Province of La Union, Philippines. Descriptive-correlational designs were utilized. Questionnaire, personal and phone interviews were used in the data gathering. Frequency and percentage, mean, Pearson r, Chi- square, t-test, ANOVA, and post hoc analysis were used to manage the data. Majority of the respondents are ages 19 to 40, females, have 2 to 4 children, high school graduate, with &lt;P10, 481 income, Catholics, Ilokano are highly aware along all areas of assessment. Extent of practice revealed moderately practiced services along family planning information and services, prevention and management of STDs, and highly practiced services along maternal, infant and child health and nutrition, adolescent and youth RH education and counseling, and male responsibility and involvement in RH. Significant relationship exists between awareness and religion, ethnicity, and income, also, between practice, education, and ethnicity. No significant relationship exists between awareness and age, gender, number of children, and education, also, in practice and gender, number of children, income, and age. Significant difference exists in the awareness between gender, religion, number of children, ethnicity, and municipality. Also, it exists in the practice between gender, religion, number of children, and municipality. No significant difference awareness between age groups, education, and income, also, along practice between age, education, income, and ethnicity. Geographic accessibility tops the list of the barriers to services used.

"You go in heavy and you come out light": An interpretative phenomenological analysis of reflective practice experiences in an Irish infant mental health setting.

Reflective practice (RP) is a core component of infant mental health (IMH); however, there is limited published empirical research on IMH practitioner experiences of RP. This two-stage, qualitative, multimodal study explored Irish IMH practitioners' experiences of RP spaces. Visual and verbal data from seven individual interviews and a participatory arts-based focus group with seven participants (eight participants in total, all white Irish females) were analyzed using Interpretative Phenomenological Analysis. Five group experiential themes (Just get on with it; What should I be bringing to this space?; Who are my "hands"?; Taking a step back; and You go in heavy and you come out light) were generated by the analysis. These were used to construct a developmental and experiential model of learning in an RP space. The themes portray how a practitioner's RP experience can change over time: influenced by prior experiences and practice development stage, practitioners move from initial uncertainty, anxiety, and perceived pressure in a busy workload to developing the trust and ability to be vulnerable in an RP space. Through relationships (supervisor/facilitator or group members), a shared safe space can be created, which addresses practitioners' needs for containment, allowing for experiential learning through a process of transformational moments.

The Potential of Chicken-Herb Essence to Improve Milk Production and Infant Health in the Sprague Dawley Animal Model.

Breast milk serves as the primary source of nourishment for newborns. In cases of low milk production, one approach to address this challenge involves the consumption of lactagogues. Chicken-herb essence, a beverage rich in protein, amino acids, and minerals, presents itself as a viable option to supplement a lactating mother's diet, particularly in terms of protein intake. This study aimed to evaluate the effects of chicken-herb essence on prolactin and lactoferrin in lactating rats. Furthermore, the study also assessed the lactagogue effect on IgA in offspring. The experimental research method used a completely randomized design. The animal models in this study were female Sprague Dawley rats. The result showed that there was an increase in milk production, as seen from the results of the lactagogue effect. The highest increase in prolactin and lactoferrin was obtained in treatment group II (TG II). The increases in prolactin and lactoferrin of TG II were 214.18 ± 71.99 and 904.02 ± 435.35 pg/mL, respectively. The lactagogue test showed that TG II haspotency as a milk-booster. Testing the blood serum of offspring showed that the highest concentration of IgA was also found in TG II at 398.34 ± 214.85 pg/mL.

Global Impact of Delayed Cord Clamping on Newborn Health

Anemia and neonatal jaundice are major contributors to infant mortality. This study investigates the effects of delayed umbilical cord clamping on neonatal hemoglobin levels and jaundice. Using a quasi-experimental posttest-only control design, 101 newborns were sampled and divided into immediate clamping (&lt;3 minutes) and delayed clamping (&gt;3 minutes) groups. Hemoglobin levels were measured within 24 hours, and jaundice was assessed on days 4-7. Results showed that delayed clamping significantly increased hemoglobin levels (P = 0.000) and reduced jaundice incidence (P = 0.010). The findings suggest that delayed clamping improves early infant health outcomes and should be adopted in health facilities. Highlight: Delayed clamping improves hemoglobin, reduces jaundice in newborns. Quasi-experimental design compares immediate vs. delayed cord clamping effects. Adopting delayed clamping enhances early infant health outcomes. Keyword: Anemia, neonatal jaundice, delayed cord clamping, hemoglobin levels, infant health

Associations between sociodemographic characteristics and neonatal length of the stay.

Infants with past NICU admission have a significantly higher risk of developing neurodevelopmental disorders. Studies have demonstrated an iatrogenic effect of the NICU environment on neurodevelopmental outcomes, even while accounting for physical factors. It is, therefore, critical that an infant's LOS is driven by physical needs versus sociodemographic barriers. We leveraged electronic health records and a backward selection regression model to explore physical and sociodemographic predictors of infant LOS. Our results demonstrated that physical predictors (birthweight and ventilator use) accounted for the majority of variance in our model but that a sociodemographic predictor, mean visits per day, was also significant. Infants who were visited more frequently experienced a shorter LOS, possibly due to increased parental involvement resulting in more individualized care and directly impacting infant stability and morbidity. By supporting visitation, we can reduce the costs of lengthy NICU hospitalizations while improving infant and parent health and well-being.

Family-Centered Care for LGBTQ+ Parents of Infants in the Neonatal Intensive Care Unit: An Integrative Review.

Having an infant in the Neonatal Intensive Care Unit (NICU) can disrupt parent well-being, the transition to parenthood, and the typical trajectories of infant and child health. For lesbian, gay, bisexual, transgender, queer, or other sexual and gender minority identity (LGBTQ+) parents, this stress may be compounded by health disparities and fear of stigma and discrimination; however, research is lacking about LGBTQ+ parents of infants in the NICU. The purpose of this integrative review was to better understand the experiences of LGBTQ+ parents of NICU infants, with a focus on experiences of stigma and discrimination, sources of strength and resilience, and provision of family-centered care. We searched EBSCOHost, ProQuest, Web of Science, and Google Scholar between 30 May 2023 and 18 September 2023 for empirical studies published in English in peer-reviewed scholarly journals in which LGBTQ+ parents shared their experiences with having infants admitted to the NICU. We identified six articles that met inclusion criteria, all of which were qualitative studies that included 12-14 LGBTQ+ parents of NICU infants. LGBTQ+ parents in all studies reported instances of perceived stigma and discrimination while their infants were in the NICU, whereas parents in two studies mentioned strength and resilience, and parents in three studies described elements of family-centered care. There is a need for rigorous research on family-centered NICU care that includes questions about sources of strength and resilience in addition to challenges. We propose that future researchers use community engaged methods to center perspectives of LGBTQ+ parents.

Effective Approaches to Addressing Challenges in Exclusive Breastfeeding

Exclusive breastfeeding (EBF) is crucial for infant health and development, endorsed by organizations like the American Academy of Paediatrics and the World Health Organization. Despite its benefits, global EBF rates fall short of targets. Globally, 48% of infants under six months are exclusively breastfed, with significant regional disparities. In India, rates vary across states. In Telangana only 68% of infants under six months are exclusively breastfed. Barriers include insufficient support, perceived milk insufficiency, lack of knowledge, latch and positioning issues, maternal and infant health concerns, work constraints, societal norms, formula marketing, and institutional practices. Strategies to overcome these barriers involve family, healthcare providers, employers, communities, education, counselling, supportive environments, peer support, addressing health concerns, workplace support, cultural sensitivity, regulation, and policy changes.

A Terahertz Metasurface Sensor Based on Quasi-BIC for Detection of Additives in Infant Formula

Prohibited additives in infant formula severely affect the health of infants. Terahertz (THz) spectroscopy has enormous application potential in analyte detection due to its rich fingerprint information content. However, there is limited research on the mixtures of multiple analytes. In this study, we propose a split ring metasurface that supports magnetic dipole bound states in the continuum (BIC). By breaking the symmetry, quasi-BIC with a high quality (Q) factor can be generated. Utilizing an angle-scanning strategy, the frequency of the resonance dip can be shifted, resulting in the plotting of an envelope curve which can reflect the molecular fingerprint of the analytes. Two prohibited additives found in infant formula, melamine and vanillin, can be identified in different proportions. Furthermore, a metric similar to the resolution in chromatographic analysis is introduced and calculated to be 0.61, indicating that these two additives can be detected simultaneously. Our research provides a new solution for detecting additives in infant formula.

ENABLING BREASTFEEDING AT WORKPLACE: BALANCING WORK AND MOTHERHOOD FOR CHILD-WELLBEING

Breastfeeding during the initial phase of an infants life is crucial for supplying all the necessary nutrients that are specially tailored to meet the needs of a growing baby. It is an ideal meal for an Infant. But in the multi-tasker role of a woman as a mother and a professional, it always be a tough challenge to feed the child during the working hours in her busy schedule. Due to this, the child gets neglected and it also hampers the growth and development of the child. The challenge of balancing breastfeeding with work responsibilities is a significant concern for many working women. Without adequate support, resources, and awareness, it can be extremely challenging for women to continue breastfeeding while maintaining their employment. On the other hand, effective workplace accommodations, facilities, awareness, and support can promote breastfeeding and also help to maintain their employment. By prioritizing breastfeeding we can enhance maternal and infant health outcomes, reduce healthcare costs, and contribute to the well-being of future generations. In addition to these challenges, hence some solutions to tackle this challenge and support breastfeeding in the workplace are mentioned intern it can also lead to enhanced productivity, growth, and efficiency for employers. KEYWORDS – breastfeeding, lactation, maternal health, infant health