Maternal Child Health Center Research Articles

The Influence of Infants’ Characteristics on Breastfeeding Attitudes among Jordanian Mothers

Background: Breastfeeding is the desired nutritional method for infants. Some infants’ characteristics were found influential to mothers’ point of views toward breastfeeding. However, the relationship between infants’ characteristics and mothers’ attitudes toward breastfeeding is still uncertain. The aim of this study was to assess infants’ characteristics and their impact on Jordanian mothers’ attitudes toward breastfeeding. Methods: A descriptive cross-sectional design was used. A sample of 130 mothers was selected conveniently from mothers attending four major governmental maternal-child health centers at Zarqa city in Jordan. The Iowa Infant Feeding Attitude Scale along with infants’ characteristics data sheet were used for data collection. Results: A more positive attitude toward breastfeeding was manifest (mean 63.5, SD: 4.67). Positive attitudes toward breastfeeding were higher among women who delivered normally than women who delivered by cesarean section (p = 0.040). In addition, women who had healthy infants were more likely to have positive attitudes toward breastfeeding compared to women with ill infants (p = 0.021). However, women with preterm deliveries were less likely to have positive attitudes compared to women with full-term deliveries (p = 0.013). Likewise, women whose infants admitted to neonatal intensive care unit recorded less positive attitudes toward breastfeeding than women with healthy neonates (p = 0.043). Gestational age, admission to neonatal intensive care unit, infant’s health status, and type of delivery, were factors influencing mothers’ attitudes towards breastfeeding. Conclusions: Jordanian mothers have positive attitudes toward breastfeeding. However, positive attitudes are subject to different infants’ characteristics that should be considered while undertaking heath education programs for promoting breastfeeding. More focusing is recommended for women who delivered preterm infants, women who have ill infants, and women who delivered by cesarean section.

Empirical study for women and children institutions of infant mental health

The samples of experimental and control groups were obtained by 1:1 matching method and divided into development (242 pairs) and sign (156 pairs) groups. Through a 10-month group and case type intervention, Gesell test was performed for 5 zone development quotients of large motor, fine motor, adaptability, speech and personal-social to determinate the effectiveness of interventions. Before intervention, t values of the development group were 1.07, 1.42, 0.78, 0.62 and 1.67 while those of sign group -1.48, -1.96, 1.82, 1.78 and -1.73 respectively. The inter-group comparison of various developmental quotient differences had no statistical significance (P>0.05). After intervention, t values of the development group were 9.85, 8.92, 3.57, 11.21 and 9.30 for inter-group comparison and -31.65, -36.94, -46.26, -37.56 and -49.85 for intra-group comparison. The results of sign group were 10.91, 9.61, 10.75, 12.01 and 14.36 for inter-group comparison and -23.20, -31.75, -44.94, -33.58 and -54.58 for intra-group comparison. Between intra-group and inter-group, the comparison of the developmental quotient differences had statistical significance (P<0.01). In two experimental groups, the post-intervention developmental quotients in 5 zones are better than those pre-intervention levels. It shows that preventive intervention of infant mental health is effective. Key words: Child psychology; Maternal-child health center

Editorial introductions

Current Opinion in Obstetrics and Gynecology was launched in 1989. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The field of obstetrics and gynecology is divided into nine sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Journal's Section Editors for this issue. SECTION EDITORS David L. OliveDavid L. OliveDr David Olive is certified by the American Board of Obstetrics and Gynecology in both Obstetrics and Gynecology as well as Reproductive Endocrinology and Infertility. He is also certified in advanced gynecologic laparoscopy and hysteroscopy by the Accreditation Council of Gynecologic Endoscopy. Dr Olive received his medical degree from Baylor College of Medicine, Houston, TX, USA in 1979. He completed a residency in obstetrics and gynecology at Northwestern University, Chicago, IL, USA, and a fellowship in reproductive endocrinology at Duke University, Durham, NC, USA. Dr Olive was previously a faculty member at the University of Arkansas, USA, the University of Texas, USA, professor and chief of Reproductive Endocrinology at Yale University, USA, and more recently professor, chief of reproductive Endocrinology, and vice chairman of Academic Development at the University of Wisconsin-Madison, USA. Dr Olive has authored more than 300 publications in scientific journals and the popular press. He has acted as an editor or reviewer for over 20 professional journals and has been an investigator on numerous scientific grants. He has lectured extensively around the world on topics such as infertility, endometriosis, fibroids, and clinical epidemiology. He is a past president of the American Association of Gynecologic Laparoscopists and the Board of Trustees of the AAGL/SRS Fellowship in Gynecologic Endoscopy. Dr Olive is currently President of Wisconsin Fertility and Reproductive Surgery Associates and co-founder of the Wisconsin Fertility Institute. Recently he was named to the steering committee to develop a maternal-child health center in Leogane, Haiti, to which he devotes considerable time and effort. Colin J. DavisColin J. DavisMr Colin Davis is a Consultant Obstetrician and Gynaecologist and Honorary Senior Lecturer for Gynaecology at St Bartholomew's and the Royal London Hospitals, UK. He is a Fellow of the Royal College of Obstetricians and Gynaecologists and obtained his Doctorate of Medicine from Imperial College London, UK. He is one of the few surgeons in the UK leading the way in new endoscopic techniques including; laparoscopic tubal microsurgery, laparoscopic surgery for severe endometriosis, laparoscopic myomectomy and hysterectomy. He has established a nationally recognised minimal access training centre at St Bartholomew's Hospital. Mr Colin Davis is the Training Programme Director for the London Deanery for Obstetrics and Gynaecology as well as an Inspector for the Royal College of Obstetricians and Gynaecologists subspecialty training programme in Reproductive Medicine and Surgery. He has a PhD research programme examining genetic expression in endometriosis and has written a number of papers and books on the topics of tubal surgery and endometriosis. He co-authored the 3rd Atlas of Endometriosis. He practices at St Bartholomew's Hospital London as well as the Princess Grace Hospital, The Portland Hospital and the London Clinic, UK.

Knowledge, Attitude and Practice of Oral and Dental Healthcare in Pregnant Women

Pregnant women are more susceptible to periodontal disease like gingivitis. Periodontal disease may be associated with adverse pregnancy outcomes. There is no published literature on dental health in pregnant women in Brunei, Darussalam. The objective of this study was to assess women's knowledge and attitude towards oral and dental health during pregnancy and to examine their self-care practices in relation to oral and dental health. This study was carried out at the maternal child health clinic, Jubli Perak Sengkurong Health Centre, Brunei, Darussalam. This was a cross-sectional descriptive and analytical study conducted at the maternal child health center in Brunei, Darussalam. The study group was comprised of 95 pregnant women attending the MCH clinic, Jubli Perak Sengkurong Health Centre, September 2010, using convenience sampling method. A self-administered questionnaire was used, after it was pre-tested and validated. Statistical analysis was done using SPSS version16. Of the total study group, 97.9% responded to the questionnaire and participated in the study. All the women brushed at least twice daily. However, only 40.9% flossed daily, 31.2% brushed after meals and 26.9% had a dental check-up at least twice a year. The knowledge related to dental care was also poor among the pregnant women. Though the majority of them (96.8%) agreed that women should have a dental check-up during pregnancy, only 55.9% actually practiced this. This raises serious concern since pregnant women may need extra oral and dental care due to susceptibility to gum diseases during pregnancy, which may contribute to low birth weight babies and premature births. This study highlights important gaps in dental knowledge and practices related to oral and dental healthcare among pregnant women in Brunei, Darussalam. More intense dental health education, including oral health promotion in maternal child health centers can lead to improved oral and dental health, and ultimately pregnancy outcomes.

The Free Lunch Is Always an Effective Marketing Tool: Why WIC Must Change

Congratulations to Jensen and Labbok 1 and indeed to Breastfeeding Medicine for their article on the impact of the Special Supplemental Nutritional Program for Women, Infants and Children (WIC) on breastfeeding rates in the United States. It provides excellent evidence for the insidious impact of what is in effect a clever and effective formula company profit-making scheme. Who can resist a free lunch?! As Kent put it, ‘‘WIC’s breastfeeding promotion efforts are good, but not likely to be of the scale needed. It would take a much larger effort to counteract the strong incentive effect of offering free name-brand infant formula that appears to be endorsed by government.’’ Jensen and Labbok also suggest that allowing formula companies to use WIC’s name in their marketing serves as a form of endorsement, if unintentional. I saw the remarkable power of this phenomenon in a study in St. Vincent when I discovered that a group of mothers who passed a Catholic malnutrition rehabilitation facility on their way to work all used the same (unusual) brand that the nuns did. Spying it by looking into the windows, they actually told me they believed the nuns were using it to teach them what they should feed their babies. As an intern to a public health nutritionist in Silver Spring, MD, I helped design Montgomery County’s first WIC application in the summer of 1974. We heard that the program was saved from oblivion by infant formula company lobbying to Congress. Apparently the companies’ market research led them to despair of ever convincing the low-income groups, especially African Americans, to switch from evaporated milk to infant formula. This gave them the ingenious ‘‘health’’ argument that offering free formula was the only way to get low-income U.S. populations weaned off of such a relatively less appropriate means of feeding infants (with, for example, accompanying high levels of infant anemia). Thus warned of the risks involved, we tried reducing them by budgeting so that the value of the food a breastfeeding mother would receive was about double the value of infant formula at that time. Now, of course, the inflation-adjusted price of infant formula is much higher, no doubt linked to the WIC rebates, as Jensen and Labbok suggest. But neither we in 1974 nor Jensen and Labbok came upon the simplest and most powerful way of reducing WIC’s antibreastfeeding impact. Stop offering free formula. The only excuse for offering formula at all is that it is shifting lowincome mothers who may in any case not want to breastfeed from more harmful infant feeding regimens. But, formula does not need to be free to prevent women from raising babies on something inferior. It just needs to be the cheapest alternative available. In 1978–1981, I designed and evaluated a Rockefeller Foundation–funded breastfeeding promotion program in Yemen for my Ph.D. research. I spent one entire year obtaining baseline data and working with anthropologists and health workers to try understanding why breastfeeding had declined so rapidly during the previous few years. A wise Swedish midwife working in a Maternal Child Health center there helped me with one strand of the causal web. She said that Yemeni women had nothing against breastfeeding. They just saw the decision to switch to the bottle as unimportant—each feeding method had its advantages and disadvantages. Thus one goal of the later campaign (which set in motion processes that led gradually to a doubling of the duration of breastfeeding in both rural and urban areas of the country) was not so much to say that women ought to breastfeed as to help them realize that deciding to supplement in the early months or to stop it in the first couple years was a serious one—especially in a country where only 2% of couples practiced any form of modern contraception. (The qualitative ‘‘illuminative evaluation’’ found that most women who did practice exclusive breastfeeding were doing it because they were tired of having a baby every year.) As it stands now, many WIC mothers probably think similarly, if they think much about breastfeeding at all—or they abandon it at the first sign of difficulty—because accepting free formula is such an easy alternative into which to slide. If the WIC formula has a cost, even if low, then it is more likely that low-income women will go through some kind of weighing of the alternatives before making decisions so crucial to their own and their infants’ health.

Editorial introductions

Current Opinion in Obstetrics and Gynecology was launched in 1989. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The field of obstetrics and gynecology is divided into nine sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Journal's Section Editors for this issue. Section EditorsDavid L. OliveDr David Olive is certified by the American Board of Obstetrics and Gynecology in both Obstetrics and Gynecology as well as Reproductive Endocrinology and Infertility. He is also certified in advanced gynecologic laparoscopy and hysteroscopy by the Accreditation Council of Gynecologic Endoscopy. Dr Olive received his medical degree from Baylor College of Medicine, Houston, TX in 1979. He completed a residency in obstetrics and gynecology at Northwestern University, Chicago, IL and a fellowship in reproductive endocrinology at Duke University, Durham, NC. Dr Olive was previously a faculty member at the University of Arkansas, the University of Texas, professor and chief of Reproductive Endocrinology at Yale University, and more recently professor, chief of reproductive Endocrinology, and vice chairman of Academic Development at the University of Wisconsin-Madison. Dr Olive has authored more than 300 publications in scientific journals and the popular press. He has acted as an editor of reviewer for over 20 professional journals and has been an investigator on numerous scientific grants. He has lectured extensively around the world on topics such as infertility, endometriosis, fibroids, and clinical epidemiology. He is a past president of the American Association of Gynecologic Laparoscopists and the Board of Trustees of the AAGL/SRS Fellowship in Gynecologic Endoscopy. Dr Olive is currently President of Wisconsin Fertility and Reproductive Surgery Associates and co-founder of the Wisconsin Fertility Institute. Recently he was named to the steering committee to develop a maternal-child health center in Leogane, Haiti, to which he devotes considerable time and effort.Colin DavisMr. Colin Davis is a Consultant Obstetrician and Gynaecologist and Honorary Senior Lecturer for Gynaecology at St Bartholomews and the Royal London Hospitals. He is one of the few surgeons in the UK leading the way in new endoscopic techniques and has pioneered laparoscopic tubal microsurgery and laparoscopic surgery for endometriosis. He has established a nationally recognised minimal access training centre at St Bartholomews Hospital. Mr. Colin Davis is an Inspector for the Royal College of Obstetricians and Gynaecologists subspecialty training programme in Reproductive Medicine and is a member of the American Association of Gynaecological Laparoscopists. He has written a number of papers and books on the topics of tubal surgery and endometriosis and has co-authored the 3rd Atlas of Endometriosis. He currently has major research projects examining the effects of endometriosis on fertility and the management of uterine fibroids.

Clinical distribution analysis of pathogenic bacterium in women and children' s hospital and health institute

Objective To investigate the clinical distribution and change of pathogenic bacterium in women and children' s hospital and health institute. Methods Pathogens isolation, and identification were conducted for samples, which were gathered from patients in our hospital between Nov. 2001 and Oct. 2007. Results The total posi-tive rate was 12.7%. Conclusion Clinical distribution of pathogenic bacterium in women and children' s hospital and health institute was different from other hospitals. It is important for reasonable antibacterials application, also for nosocomial infection prevention and reduction. Key words: Cross infection; Noxae; Maternal-child health centers

Preventing and Terminating Unwanted Pregnancies in Turkey

To determine the methods used to prevent pregnancy by women seeking abortion of unwanted pregnancy, their knowledge and use of emergency contraception, and reasons for wanting the abortion. The sample was 144 randomly selected women, who requested abortion for termination of their pregnancies at two hospitals in Izmir, Turkey, during the study period. A questionnaire was completed by the researcher in face-to-face interviews. In this sample 43.8% had had previous abortions; 77.1% used some method of family planning; 7.0% used emergency contraceptives. The methods selected after unprotected sexual intercourse by these women included vaginal douche (37.5%), waiting to see whether the menstrual cycle would begin (27.0%), going to a hospital or maternal-child health center (24.3%), and two other alternatives (4.2%). One-fifth of the women said that, if they get pregnant again, they will have another abortion. The number of unwanted pregnancies is high and many women seek abortions as a birth control method. Women in this sample needed information about effective methods for preventing pregnancy.

A Study on the Development of an Education Curriculum for Maternal-Child Health Center Managers

Purpose: The purpose of this study was to develop a specialized education curriculum aimed at helping nurses prepare for running and managing a Maternal-Child Health Center (Postpartum Care Center). Method: This study was conducted by an academy and industry joint research group consisting of professors of Nursing, and nurses actually running a Postpartum Care Center. The group compiled job descriptions of nursing through document research, interviews and observation during site visits, surveys, and seminars. They then performed a feasibility study and developed the final curriculum. Result: The education curriculum is a 32-week(2semester) program compromised of a theory part (12 credits, 180 hours) covering maternal and infant care and business start-up and field practice (3 credits, 45 hours). Courses in the theory part include an antenatal care, overview and details of maternal care, starting a business and its management. Of these courses, the overview of a maternal care course was developed with web-based contents. Field practice is designed to give students opportunities to visit Postpartum Care Centers, observe the care provided, and get hands-on experience. Conclusion: The specialized education curriculum is a 32-week course comprised of 12 credits on theory of antenatal care, overview and details of maternal care, infant care, starting and operating a business and 3 credits of field practice.

Women's efficiency in decision making and their perception of their status in the family.

This study is descriptive in nature. Three hundred ten women who applied to the Maternal-Child Health and Family Planning Center in Erzurum, Turkey, between June 1 and August 30, 2001 were included in this study. Data were collected through the inquiry form, which was prepared to determine women's efficiency in decision making, their perception of their status within the family, and their demographic characteristics. Women's decision-making rate was lower than that of men, except for selecting clothes. Couples' joint decision-making rate was high on personal matters but low on official matters. The women's educational level affected their decision making in the family. The majority of the women perceived themselves as wives sharing everything within the family. Women's perception of their positions in the family was related to their status and decision making. The results can be used in primary care practice for women's health promotion. The sample in this study reflects only one area of Turkey.

The effect of low-dose combined oral contraceptive pills versus injectable contraceptive (Depot Provera) on liver function tests of women with compensated bilharzial liver fibrosis

This was an open comparative trial of two types of hormonal contraceptives, a low-dose combined oral contraceptive and the injectable depot-medroxyprogerone acetate, with a control group using an intrauterine device (copper T-380). Clients were recruited from bilharzial patients attending the maternal-child health and family centers affiliated with the National Liver Institute. Clients with compensated bilharzial liver disease were chosen and were divided into three subgroups according to their own preference for the method of contraception. Baseline, 2-, and 4-months liver function tests were compared, and abdominal ultrasound scanning of the liver was done. There was a nonsignificant change in liver function tests, and the portal vein diameter measured by ultrasound scanning was not changed with steroidal contraceptives. The use of combined oral contraceptive containing low-dose estrogen or using depot medroxyprogertone acetate injectables are safe and can be prescribed in cases with compensated bilharzial hepatic fibrosis with normal function.

Anxiety and functional status after childbirth

This prospective longitudinal study explored the relationship between anxiety and functional status after childbirth. Two hundred new mothers aged 20 to 35 years who experienced a normal pregnancy and delivered a healthy term infant were surveyed using the Inventory of Functional Status After Childbirth and Spielberger's State Anxiety Inventory. All participants attended maternal child health centres in regional New South Wales, Australia. Results revealed a significant increase in functional status during the first six months postpartum and significant correlations were found between functional status and maternal anxiety at six weeks, three months and six months postpartum. The more anxious mothers were also significantly more likely than less anxious mothers to have an unsettled baby, a baby that slept fewer hours at night and were significantly less satisfied with motherhood. Assessing maternal anxiety levels may assist midwives identify women at risk of parenting difficulties and psychological distress postpartum.

INVESTIGATING THE RELATIONSHIP BETWEEN Satisfaction With Social Support and Functional Status After Childbirth

To explore the relationship between satisfaction with support and functional status after childbirth. Prospective longitudinal survey design. Two hundred new mothers who had experienced a healthy pregnancy, normal delivery and puerperium, and delivered a healthy infant between 37 and 42 weeks gestation were approached while attending primary healthcare maternal-child health centers and immunization clinics in New South Wales, Australia. Measurement tools included the Inventory of Functional Status After Childbirth and the Support Behavior Inventory, and were administered at 6 weeks, 3 months and 6 months. Significant increases in total mean functional scores, scores for household responsibilities, social activities, and self-care were noted. Although no significant correlation was found between satisfaction with social support and functional status after childbirth, satisfaction with support from one's partner decreased significantly during the 6-month survey period, as did satisfaction with support from others. It could be that providers need to assess the social support needs of their clients. A postnatal support plan could be used by mothers to negotiate the long-term involvement of others in household tasks and selected aspects of infant care.

Functional Status After Childbirth in an Australian Sample

To investigate changes in functional status after childbirth from 6 weeks to 6 months post-delivery. Prospective, longitudinal survey. Maternal-child health centers and immunization clinics in regional New South Wales, Australia. Two hundred Australian mothers from culturally diverse backgrounds, ages 20-35 years, who had experienced normal pregnancies, labors, and deliveries and delivered healthy singleton infants between 37 and 42 weeks gestation. The Inventory of Functional Status After Childbirth. Significant increases in functional status were noted in household (t = -6.871, df = 311, p = .0001), social (t = -5.856, df = 311, p = .0001), and self-care activities (t = -3.469, df = 313, p = .0006). However, none of the mothers had achieved full functional status by 6 months postdelivery. A gradual resumption of past role-related activities may reflect the normal adjustments required when a woman becomes a mother. Mothers not only resume most aspects of previous roles, but also add to their multiple role demands by assuming primary responsibility for infant care. Further investigations are required to identify why aspects of certain roles are resumed and others are discarded either temporarily or permanently.

An Australian study of functional status after childbirth

To identify key predictive variables of functional status after childbirth. An investigative survey design. Primary health care maternal child health centres in one large city in Victoria, Australia. 200 mothers selected from a culturally diverse population. All were aged 20 to 35 years, had experienced normal pregnancies, labours, deliveries and delivered a healthy baby between 37 and 42 weeks' gestation. MEASURES AND FINDINGS: The Inventory of Functional Status After Childbirth (IFSAC) (Fawcett Tulman & Myers 1988) was used as the main outcome measure. Three variables predictive of functional status after childbirth were identified, namely, satisfaction with level of stamina and well-being, sleep pattern at night and perceived lack of support following childbirth. Return to full functional status as measured by IFSAC takes longer than physiological recovery after childbirth. Women who experience diminished well-being, interrupted sleep patterns and lacked support, appeared to be at greater risk of role congestion, overload and dysfunction. To help women avoid the additive nature of assuming the motherhood role while also resuming past role responsibilities, practitioners could encourage pregnant women to develop a postnatal support plan. Women need to be proactive in negotiating specific and ongoing support from others with household responsibilities and some aspects of baby care.

Functional status after childbirth: A comparison of australian women from english and non-english speaking backgrounds

A survey was used to explore the relationship between English speaking versus non-English speaking backgrounds (NESB) and functional status after childbirth. Women were recruited (n=132) from a culturally diverse population and allocated to sub-groups based on their dominant language background. All had experienced an uncomplicated pregnancy, delivery and delivered a healthy infants between 37 and 42 weeks gestation. Mothers were contacted while attending maternal child health centres and surveyed at 6 weeks post delivery using the Inventory Of Functional Status After Childbirth ( Fawcett, Tulman, & Myers, 1988). Functional status scores were not significantly different based on dominant language background, however significantly fewer women of NESB (X 2=7.03, df 1, p=0.02) breast fed their infant.

Prise en charge de l'enfant contaminé par le virus de l'immunodéficience humaine et de sa famille dans le cadre d'une mission humanitaire en Tanzanie

The activities are described of an aid mission of Medecins du Monde (MDM) in the impoverished northern Tanzanian region of Kagera. The spread of AIDS in the region has been assisted by population upheaval the war with Uganda poor agricultural development and socioeconomic deterioration. HIV seroprevalence is estimated at 10% of the rural and 17-24% of the urban population. There were 4135 reported cases of AIDS in late 1992. A major objective of MDM is to enable the regional hospital in Bukoba and the rural dispensaries to provide better management of HIV symptoms and a better quality of life for patients and to reduce transmission. The pediatric service treats an average of 260 children monthly in 70 beds. 60% of child deaths are due to malaria and 16% to acute infantile diarrhea. MDM assistance to the pediatric service has included provision of drugs and treatment rooms development of a system of hygiene and sterilization and a unified record system and provision of treatment protocols and follow-up care for children with AIDS. The maternal-child health center diagnoses sexually transmitted diseases in pregnant women but is constrained from HIV testing by cultural and economic obstacles. Four rural dispensaries have been renovated and provided with drugs. A mobile MDM nurse-midwife provides health education and vaccination in distant localities. HIV testing is available at the regional hospital. Indications for blood transfusion have been limited and a pool of low-risk donors created in order to minimize the danger of transmission. Home-based care is provided to the HIV seropositive in order to reduce pressure on the hospital services. AIDS prevention efforts stress peer counseling and education. AIDS education is provided in bars by hostesses working with the hospital AIDS counselor and the MDM physician and free condoms are distributed. MDM has sought to cooperate closely with local health services so that activities will continue after the mission departs.

A Phenomenological Study on Mother - Infant Interacting Behavior Patterns related to Newborn Infant Feeding in Korea

The purpose of this study was to describe mother-infant interacting behavior patterns related to newborn infant feeding and to explore the mother's cultural belief about their infant. The data collection was conducted by observation and interview. Twenty-five mothers and their newborn infants who were normally delivered and were also planned to breastfeed were comprised as the subjects of this study. All subjects were interviewed and observed individually at 1 to 5 days after the delivery at the hospital, mid-wife's clinic, Maternal Child Health Center and their home throughout the country from remote area to big city. The observation data were recorded with symbolic letter on a recording sheet newly developed as a result of preliminary study. The interview data were tape recorded and then recorded in narrative form. Mother-infant interaction behaviors in early-feeding period were analyzed based on 19 analytic sub-categories and their composing elements. Unit of analysis were mother, infant and mother-infant dyad. 8 analytic categories draw from the data. Each were preparation, instrument, interaction inducing, evaluation referred to mother's behavior, preparation, instrument, interaction inducing referred to infant's behavior and synchronic behaviors referred to mother-infant dyad. Frequencies of behavior items based on the categories were converted to percent. The result showed that in mother's preparation behavior, the breast condition of Korean mother can be an affecting factor for mother-infant interaction during feeding, and vocalization behavior was observed most frequently in interaction inducing behavior while the least frequent behavior observed was contacting. Subcultural characteristics of mother-infant interaction behaviors were analyzed for their relationships between groups of mothers who have lived in remote area vs urban area, and who were multipara vs primipara. Using a chi-square test, there were statistically significant relationships in the activity of psychological readiness in preparation behavior and the movement of extremities for the position of instrumental behavior in both groups. However, interaction inducing behaviors were not related with statistical significance in any set of groups. Accomplishment of marriage, bonding and emotional mediation of family members were the categories related to mother's cultural belief about the infant in aspect of functional values. Infant at birth is considered little more than a biological organism without social capabilities. Although the newborn infant is still be attached to his mother, he makes his mother extend her territoriality. The mother's interacting behavior toward her infant based on those beliefs appeared task oriented, separative behavioral series.(ABSTRACT TRUNCATED AT 400 WORDS)

Assessing Health Care Delivery in Saudi Arabia

This paper deals with the some of the important variable factors relating to health care in Saudi Arabia, with special emphasis on primary health. Other aspects considered are the financial influen...

Infant feeding pattern in three districts of Istanbul.

In 1982 infant feeding pattern among 269 mothers living in 3 different socioeconomic districts of Istanbul Turkey was determined. % of infants who were breastfed at birth 1 month 36 and 12 months was 94 83 74 67 and 63% respectively. The duration of exclusive breastfeeding was short: 51% of infants began receiving complementary foods or were weaned during the 1 month. Breastfeeding prevalence was shortest among mothers living in the district with high socioeconomic status and with 6 years of education. Commercial breast milk substitutes were expensive and used during the 1st weeks of complementary feeding whereafter home-made milk mixtures were utilized. The main reason expressed by mothers for discontinuation of breastfeeding was milk insufficiency. Respondents selected from records of private physicians and Maternal-Child Health Centers were interviewed by trained interviewers on infant feeding social background and living conditions using a pretested questionnaire and a slightly modified version of questionnaire B used in the WHO study. The decrease in time a which 1st complements are introduced to infants diets were a result of hospital practices and messages from the mothers close environment. Considering the high cost of commercial breastmilk substitutes and the possible unsuitability of home-made mixtures promoting exclusive breastfeeding for at least 4-6 months or until the incremental weight increase of the infant indicates a need for complementation seems to be an important message to be included in a promotional effort. (authors modified)