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D M Paige

Publications and source records attributed to D M Paige.

At least 19 recordsLinked to original sources
PubMed1999

Early introduction of solid foods among urban African-American participants in WIC.

OBJECTIVE: To compare infant feeding practices among low-income, urban, African-American women enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) with current recommendations for infant feeding. DESIGN: Longitudinal follow-up of women and their infants who participated in a WIC-based breast-feeding promotion project. Women enrolled prenatally at or before 24 weeks of gestation were followed up until 16 weeks postpartum. SUBJECTS/SETTING: Two hundred seventeen African-American WIC participants in an urban area. METHODS: Data related to infant feeding practices were collected by interviewers who used a structured questionnaire to determine when nonmilk liquids or solids were introduced to the infant. Reported practices were compared with current recommendations. STATISTICAL ANALYSIS PERFORMED: Contingency table analysis, including chi 2 tests, and multivariate analysis using logistic regression. RESULTS: By 7 to 10 days postpartum, approximately a third of infants were receiving some nonmilk liquids or solids; this escalated to 77% by 8 weeks and 93% by 16 weeks postpartum. Women breast-feeding exclusively (i.e., not adding nonmilk liquids or solids) were least likely, and women providing mixed feeding (breast milk and formula) were more likely, than women feeding formula exclusively to introduce nonmilk liquids and solids at each data collection time period. APPLICATIONS/CONCLUSIONS: WIC participants who receive instruction about infant feeding nutrition are no more likely than mothers who do not participate in WIC to follow infant feeding guidelines recommended by the American Academy of Pediatrics in regard to the time when solids should be introduced to infants' diet. Our findings suggest the need for WIC to implement more powerful and innovative educational and motivational strategies to help mothers delay the introduction of nonmilk liquids and solid foods until their infants are 4 to 6 months old, as recommended.

Black or African American↗
PubMed1999

Sources of influence on intention to breastfeed among African-American women at entry to WIC.

To examine how individuals within a woman's life influence her infant feeding intention, we interviewed 441 African-American women on the breastfeeding attitudes and experiences of their friends, relatives, mother, and the baby's father. Women were interviewed at entry into prenatal care at clinics associated with one of four Baltimore WIC clinics chosen for a breastfeeding promotion project. Qualitative data were also collected among 80 women. Friends and "other" relatives were not influential. Grandmothers' opinions and experiences were important, but their influence was reduced after considering the opinion of the baby's father. The opinion of the woman's doctor was an independent predictor of infant feeding intention. Breastfeeding promotion programs should recognize the separate influence of fathers, health providers, and grandmothers in women's infant feeding decisions.

Adolescent↗
PubMed1998

WIC-based interventions to promote breastfeeding among African-American Women in Baltimore: effects on breastfeeding initiation and continuation.

We evaluated the single and combined effects of introducing a motivational video and peer counseling into four matched WIC clinics on breastfeeding initiation and continuation at 7-10 days among African-American WIC participants. Of the 242 women with complete data, 48% initiated breastfeeding, but only 31% were still breastfeeding at 7-10 days. Initiation was associated with cesarean delivery, infant feeding instruction, no artificial milk discharge pack, attending the peer counselor only-intervention site, and intention to breastfeed. Continuation was influenced by infant feeding instruction, no artificial milk discharge pack, and intention to breastfeed. Overall, trends toward a positive impact of the breastfeeding promotion activities were evident but weak, and largely gone by 7-10 days postpartum.

Adolescent↗
PubMed1997

Promoting community-based maternal and child health services: a university-health department partnership.

OBJECTIVES: Funded by the Federal Maternal and Child Health Bureau, a partnership between the Johns Hopkins University School of Public Health, Department of Maternal and Child Health (JHU), and the Baltimore City Health Department (BCHD) identifies maternal and child health problems, and develops appropriate interventions. This paper presents the organization and activities of the JHU/BCHD Maternal and Child Community Health Science Consortium as a result of overcoming traditional barriers to collaborative efforts, and discusses what role the Consortium has had in its own collaborative success. METHOD: A review of the literature uncovered a number of barriers to productive interaction. A number of factors contributing to overcoming the barriers was also revealed. The organization and activities of the work of the JHU/BCHD Maternal and Child Community Health Science Consortium has been applied to these barriers and associated factors, and discussed in context of implications for future collaborative efforts. RESULTS: The Consortium has developed a fully integrated administrative structure bridging both the BCHD and JHU. The mission of the Consortium has been translated into four categories of work, each one designed to complement, extend, and augment the other. The infrastructure established in Baltimore, as a direct result of this partnership, has served to overcome traditional barriers to productive academic/agency collaboration, while promoting organizational productivity. This outcome is a result of overcoming the recognized barriers to collaboration. CONCLUSIONS: Health agencies and university public health programs must link resources and collaborate to address public health issues. Commitment to a collaborative approach to the public's health will determine its future.

Child↗
PubMed1995

The effect of a woman's significant other on her breastfeeding decision.

The infant feeding preferences of significant others have been shown to influence a pregnant woman's breastfeeding decision. Many researchers and policy makers are calling for the inclusion of a woman's significant other in the counseling and education of pregnant women regarding breastfeeding. This study reports on the impact of the significant other's infant feeding preferences and beliefs on a woman's intention to breastfeed, her initiation and successful initiation (longer than seven days) of breastfeeding. "Significant other" was defined as the person whom the pregnant woman reported as the one whose opinion "mattered the most to her" regarding feeding her infant. A randomly selected sub-sample of 133 women and their significant others was chosen from a larger infant feeding study. This sub-sample was heterogeneous with respect to age, education, and marital status. The women were interviewed during their third trimester of pregnancy and again at 7-10 days postpartum. Their significant others (71 percent baby's father and 29 percent baby's maternal grandmother), were interviewed during the woman's third trimester of pregnancy. Results indicate that a woman's intention to breastfeed is strongly and positively affected by the significant other's infant feeding preferences, initiation of breastfeeding is mediated through intention to breastfeed, and successful initiation of breastfeeding is also mediated through intention and is uniquely dependent on the pregnant woman's self-efficacy.

Adolescent↗
PubMed1994

Differences in gestational age-specific birthweight among Chinese, Japanese and white Americans.

This study investigated racial differences in gestational age-specific birthweight in a sample of 21,288 Chinese, 11,882 Japanese and 65,818 White resident singleton livebirths, obtained from the National Center for Health Statistics 1983 and 1984 linked birth/infant death cohort files. The gestational age-specific birthweight distributions of Chinese and Japanese were similar, but differed from those of Whites both in the mean level and in the variance. The mean birth-weights of Chinese and Japanese as compared to that of White infants were 4-5% lower among preterm births, and 5-6% lower among term births, after adjustment was made for gestational age, demographic variables, use of antenatal care and infant gender. The racial differences in gestational age-specific birthweight were even greater at the 90th percentile but smaller at the 10th percentile. These racial differences should be considered in both clinical evaluation of newborns and in epidemiological studies. Significant interactions were found between race and such maternal variables as education, marital status, birthplace, and month during which antenatal care began. It suggests that recognition of racial differences in risk factors and exposure-response relationships may be valuable in specifying interventions for intrauterine growth retardation among different racial groups.

Asian↗
PubMed1992

Determinants of breastfeeding in a rural WIC population.

The purpose of the current research was to identify demographic and psychosocial factors important in the decision to breastfeed among a sample of WIC participants in a rural area. One hundred and ninety-eight women completed both a prenatal interview during their third trimester of pregnancy and a second interview within one to three weeks postpartum. Twenty-seven percent of these WIC participants initiated breastfeeding. Multiple logistic regression analysis revealed that prenatal behavioral beliefs about the consequences of breastfeeding and formula feeding were the strongest predictors of breastfeeding initiation. The results suggest that education to improve the current low rates of breastfeeding among WIC participants should emphasize that formula feeding is neither more convenient nor easier than breastfeeding, and that breastfeeding need not limit mothers in public or social settings.

Adult↗
PubMed1991

Gestational age-specific birthweights of twins versus singletons.

In order to more adequately characterize patterns of intrauterine growth retardation in twins, the mean birthweights of all nonanomalous white or black twins born between 24 and 41 weeks of gestation and surviving until discharge over an 11-year period (547 infants) and all similar singletons (19,072 infants) were compared by completed weeks of gestation. Between 24 and 35 weeks of gestation, the mean birthweights for the 547 twins and the 19,072 singletons were comparable and did not consistently differ statistically. From 36 to 41 weeks gestation, however, the difference became large, consistent, and statistically significant for each week at P less than 0.0001. This difference was present among all subgroups of twins, ie, in all males, females, blacks, and whites; it was still evident when the sample was further stratified by both race and sex (black males, white males, black females, white females). These data suggest a pattern of growth retardation in twins compared to singletons which is large, consistent, and statistically significant beginning at 36 weeks gestation. Clinically, these data also suggest the need for ultrasonic examination early in gestation (24-32 weeks) to document normal growth and to provide baseline data, and show the importance of such monitoring later in gestation, specifically after 36 weeks.

Baltimore↗
PubMed1991

Maternal employment during the early postpartum period: effects on initiation and continuation of breast-feeding.

This study sought to determine whether and to what extent maternal employment in the early post-partum period is associated with the initiation and continuation of breast-feeding in a heterogeneous, urban population. A panel of women were interviewed twice during the first 3 months postpartum. In analyses adjusted for maternal demographic characteristics, there was no association between planning to be employed within the first 6 months postpartum and initiation of breast-feeding. However, actually being employed was significantly associated with cessation of breast-feeding as early as 2 or 3 months postpartum, even after adjustment for maternal demographic variables. Less than one half of mothers who were employed were still breast-feeding at the second postpartum interview, whereas two thirds of those who were not employed were still breast-feeding. Among employed mothers, working no more than 20 hours per week appeared to be protective for continued breast-feeding.

Adult↗
PubMed1986

Obesity in childhood and adolescence. Special problems in diagnosis and treatment.

Obesity is an emotional, physical, and social problem in search of a definition as well as an explanation for its pathogenesis and an efficacious approach to therapy. The complexities of the problem and the limitations of our knowledge are compounded by the anabolic aspects of growth and the sex-specific differences in fat deposition and energy requirements of children and adolescents. The clinician has a delicately balanced responsibility to moderate weight gain while avoiding dietary regimens that will induce catabolism. Further, the clinician must provide empathetic counseling and support, modify behavior, and encourage physical activity. All this must be undertaken with the knowledge that the objective may be unobtainable and, on those occasions when it is achieved, the recidivism rate will be high. Despite these difficulties, it is critical that the child and the family be provided with a realistic and practical regimen that has the potential to help while doing no harm.

Adolescent↗
PubMed1981

Nutritional supplementation of pregnant adolescents.

Disadvantaged pregnant black teenagers have a higher proportion of low-birth-weight infants and their offspring have a lower mean birth weight. One hundred and fifty-seven pregnant adolescents enrolled in a Baltimore public school for pregnant teenagers were studied to determine the impact of a nutritional supplement on pregnancy outcome. Seventy-eight students voluntarily agreed to receive a nutritional supplement; 79 comparably matched students did not receive the supplement. The supplement Sustacal provided a mean intake of 8691 cal with 530 g of protein and additional vitamins and minerals over an average period of 15.1 weeks. This supplement was associated with a significant increase of 157 g in the mean infant birth weight (P less than 0.05). A significant increase in infant birth weight of 269 g was noted in the offspring of supplemented girls below 16 years of age compared with the nonsupplemented girls below this age (P less than 0.05). Significant differences in infant birth weight were also noted in the offspring of nonsmoking supplemented adolescents (P less than 0.05). The proportion of low-birth-weight infants was decreased in the supplemented subjects, but the difference was not significant.

Adolescent↗
PubMed1978

Blood glucose rise after lactose tolerance testing in infants.

Lactose tolerance tests are used clinically to screen children and infants. It is assumed that absorption of a lactose challenge in infants would occur in a predictable pattern prior to weaning. Twenty-one infants from 3 to 12 months of age were studied. The maximum blood glucose rise over fasting levels ranged from 11.0 to 62.0 mg/100 ml; the mean was 32.6 mg/100 ml. Six infants had a maximum rise of less than 20 mg/100 ml. Eleven infants (52%) had a maximum rise of greater than 30 mg/100 ml. Signs of intolerance were not noted in any subject. Weight and length were normally disturbed. Results indicate the variance in glucose rise existing within a population of infants growing normally and consuming milk. Gastric emptying, digestion, and absorption may influence the blood glucose rise after a lactose test. Established glucose levels used as an index to lactose absorption in older children and adults may not accurately reflect lactase activity in infants.

Blood Glucose↗
PubMed1977

Lactose malabsorption in preschool black children.

One hundred sixteen healthy black children ages 13 to 59 months, representing high and low socioeconomic deciles, were studied for lactose malabsorption. A fasting lactose tolerance test using 2 g of lactose/kg of body weight was carried out. Glucose was determined at 0, 15, 30, and 60 min. Of the 116 preschoolers 34 (29%) evidenced lactose malabsorption as determined by a blood glucose rise of less than 26 mg/100 ml. Clinical signs of diarrhea, gas, and cramps were noted singly or in combination in 18% of the 34 lactose-malabsorbing children. Of the 82 lactose absorbers, 12% demonstrated similar signs. The nature and length of the initial infant milk feeding failed to show any relationship to the onset of malabsorption. Current milk drinking patterns were reported as being similar. Eight-seven percent of the malabsorbers and 92% of the absorbers report drinking 240 ml or more of milk/day. Socioeconomic status, education, marital status, and medical assistance of the parent is similarly distributed between lactose absorbers and malabsorbers.

Absorption↗