Baby

Good quality sleep of sufficient duration is vital for optimal physiological function and our health. Sleep deprivation is associated with impaired neurocognitive function and emotional control, and increases the risk for cardiometabolic diseases, obesity and cancer. Sleep develops during fetal life with the emergence of a recognisable pattern of sleep states in the preterm fetus associated with the development, maturation, and connectivity within neural networks in the brain. Despite the physiological importance of sleep, surprisingly little is known about how sleep develops in individuals born preterm...

Pharmacokinetic data on drug administration during lactation are often inconsistent or missing. For legal reasons medicinal drug product information generally advises to interrupt breastfeeding for 24 h after medication intake. However this is not standard of care in clinical practice as the mother should be instructed to initiate breastfeeding as soon as possible after giving birth. At the same time the medication exposure over the breast milk for the newborn should be minimized. Aim of this article is to summarize pharmacokinetic data and to give important clinical information on medications frequently administered during the lactation period...

BACKGROUND: The attitude towards vaccination is a major determinant of vaccination behavior; this also includes parents' attitudes towards the immunization of their child. Negative attitudes have been associated with vaccine hesitancy and outbreaks of infectious diseases throughout the globe. This study aimed to assess how and why attitudes become more pro-vaccine or vaccine-skeptical over time, and which sources are especially influential in this process. METHODS: Prospective cohort study with measurements at time of recruitment during pregnancy and at +3, +6 and +14 months after childbirth with cross-sectional control groups...

BACKGROUND: Current guidelines for the management of obesity in women planning pregnancy suggest lifestyle modification before conception. However, there is little evidence that lifestyle modification alters pregnancy outcomes. Bariatric surgery results in significant weight loss. This appears to reduce the risk of adverse pregnancy outcomes for the mother but may increase the risk of adverse outcomes for the infant. In order to reduce the risks of obesity-related adverse pregnancy outcomes for both mother and offspring, alternative approaches to the management of obesity in women planning pregnancy are needed...

Recently, a range of prescription and over-the-counter drugs have been reportedly used as Novel Psychoactive Substances (NPS), due to their potential for abuse resulting from their high dosage/idiosyncratic methods of self-administration. This paper provides a systematic review of the topic, focusing on a range of medications which have emerged as being used recreationally, either on their own or in combination with NPS. Among gabapentinoids, pregabalin may present with higher addictive liability levels than gabapentin, with pregabalin being mostly identified in the context of opioid, polydrug intake...

BACKGROUND: Universal newborn hearing screening (UNHS) aims to identify hearing loss in the early postnatal period; prompt detection of bilateral or unilateral hearing loss is mandatory for timely intervention. METHODS: This retrospective study reports the results of the first two years of a UNHS program on 4,719 newborns in a large public Italian hospital. Screening was divided into two levels: automated transient otoacoustic emissions were used for first level; automated auditory brainstem response for second level...

A report released by the World Health Organization states that worldwide less than 10% of birth occur in hospitals certified through the Baby-Friendly Hospital Initiative. Furthermore, the Baby-Friendly Hospital Initiative's primary focus is on breastfeeding for healthy, mother-infant dyads. This article provides alternative models for implementing evidence-based care during maternal-infant separation so that mothers can achieve their personal breastfeeding goals. These include the Spatz 10-step model for human milk and breastfeeding in vulnerable infants and the Breastfeeding Resource Nurse model...

In 2012, the state of South Carolina lacked any Baby-Friendly designated hospitals. The Medical University of South Carolina had a strong lactation service since 2002 but continued to struggle with improving breastfeeding rates. The Baby-Friendly Hospital Initiative was the catalyst to increase breastfeeding rates at this academic medical center. In 2012, membership in the Best Fed Beginnings Learning Collaborative heightened awareness of the importance of interdisciplinary collaboration. Participation in the regional collaborative provided evidence-based breastfeeding education and best clinical practices that supported the maternal-infant dyad...

Adolescents and young adults living with HIV (YLHIV) face numerous stresses that affect their care and medication adherence. The clinic social environment may play an important supportive role for YLHIV, influencing health outcomes. The aim of this article is to explore how YLHIV in Baltimore, Maryland understand the various forms of social support provided within the social environment of their HIV clinic. We used qualitative research methods including iterative, semi-structured in-depth interviews with 20 YLHIV interviewed up to three times each to explore HIV stressors, support systems, and medication adherence...

Serum rotavirus IgA responses are an imperfect non-mechanistic correlate of protection, and the lack of an accurate serological marker is a challenge to the development of new rotavirus vaccines. Serological responses to rotavirus NSP2 occur following wild-type infection; however, it is unknown if serological responses to NSP2 occur following administration of rotavirus vaccines. The phase IIa immunogenicity trial of RV3-BB provided an opportunity to investigate the serological responses to NSP2 following vaccination...

OBJECTIVE: To evaluate the impact of a post-Helping Babies Breathe bundle of interventions on the retention of provider-level knowledge and skills. METHOD: The present prospective pre-post study following a 1-day Helping Babies Breathe training of professional midwives, physicians, and nurses was conducted in Cajamarca Province, Peru between January 1 and July 31, 2017. The interventions to improve retention included structured worksite practice before every shift, weekly in-service simulated scenarios, and monthly supervised peer-to-peer abbreviated refresher trainings...

BACKGROUND: Satisfaction is a key component of the care experience and part of the health system "triple aim," along with improving population health and reducing per capita health care costs, the other two parts of the "triple aim." The objectives of the study were to examine birth-experience satisfaction among women in Ontario, Canada, who received care from midwives, family physicians, and obstetricians. METHODS: We used Statistics Canada's 2006 national Maternity Experiences Survey...

Sirenomelia is a rare congenital malformation that results in the fusion of the lower limbs together with multiple visceral anomalies. We report a case of sirenomelia observed in Mauritius and the different findings seen in the baby. The baby had fused lower extremities and bony structures for each leg were present. The umbilical cord consisted of a single artery and one vein. The external genitalia was absent and an imperforate anus was also seen. An x-ray revealed poorly expanded lungs and two distinct sets of femur and tibia were seen on imaging...

Introduction Giving birth in water has increased in popularity over recent years, with potential benefits in terms of maternal comfort and decreased rates of instrumental delivery. Some concerns have been raised about possible adverse neonatal outcomes, including hypothermia and respiratory distress. There is not currently, however, a clear consensus in the literature. This study sought to assess the safety of delivering in water for low-risk vaginal deliveries in a District General Hospital in the United Kingdom...

For hypertensive women in CHIPS (Control of Hypertension in Pregnancy Study), we assessed whether the maternal benefits of tight control could be achieved, while minimizing any potentially negative effect on fetal growth, by delaying initiation of antihypertensive therapy until later in pregnancy. For the 981 women with nonsevere, chronic or gestational hypertension randomized to less-tight (target diastolic blood pressure, 100 mm Hg), or tight (target, 85 mm Hg) control, we used mixed-effects logistic regression to examine whether the effect of less-tight (versus tight) control on major outcomes was dependent on gestational age at randomization, adjusting for baseline factors as in the primary analysis and including an interaction term between gestational age at randomization and treatment allocation...

BACKGROUND: The pain experience associated with labour is complex. Literature indicates psychosocial and environmental determinants of labour pain, and yet methods to support women usually target physiological attributes via pharmacological interventions. AIM: To provide an update of our understanding of labour pain based on modern pain science. The review aims to help explain why women can experience labour pain so differently - why some cope well, whilst others experience great suffering...

BACKGROUND: The increasing rate of caesarean deliveries has become a serious concern for public health experts globally. Various medical and non-medical factors, such as maternal socio-demographics, are found to be responsible for this upsurge. Like in other countries, the rate of caesarean sections has increased in Pakistan as well. Therefore, there is a need to investigate the factors behind this increase. This study aims to assess the determinants associated with caesarean deliveries among child-bearing women aged 15-49 years in Pakistan...

OBJECTIVE: The primary objective is to investigate the related factors of exclusive breastfeeding based on the theory of planned behaviour (TPB) and identify the most influencing factor in first-time mothers at 4 postnatal months. DESIGN AND PARTICIPANTS: A cross-sectional study was conducted and 400 first-time mothers at 4 months postnatal were approached. MEASUREMENTS: Data on mothers' breastfeeding knowledge, attitude, subjective norm and practice control were collected at 4 months postnatal based on the TPB...

OBJECTIVE: To describe and explore 'gut instinct' that something was wrong in women who identified that they experienced gut instinct during pregnancy. METHOD: A case-control study utilising an international web-based questionnaire. Stillborn cases (n = 146) and liveborn controls (n = 234) answered the gut instinct question within 30 days of the pregnancy ending. Of those, 84 cases and 27 controls also provided qualitative comment data. Descriptive statistics were used for the question, with a fixed option and summative content analysis was used to analyse the comment data...

The Developmental Origins of Health and Disease suggest the in utero environment programs offspring obesity and cardiovascular disease. Therefore, there is a need to implement safe therapeutic interventions that do not involve the intake of medications or biological products during pregnancy that can improve maternal and fetal health. Prenatal exercise is established to promote maternal and fetal health. It is generally recommended that women accumulate at least 150 minutes per week of moderate-intensity exercise...