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PubMed1990

"Abandoned" parents. Loss of traditional family support systems. A challenge for health professionals.

Maternal incompetence in childrearing is described in three widely different cultural settings in the southern Negev area of Israel. It is suggested that this incompetence stems from "abandonment" of the parents by traditional family support systems and is reinforced by the inability or lack of readiness of the health system to supply the missing support mechanisms. This picture of parental "abandonment" in widely different cultural settings in Israel may represent an end result of cultural and social upheaval common to other communities in the world. Techniques for prevention include improving awareness of health workers to this problem, teaching appropriate strategies for improving parental confidence and competence, and ensuring that maternal and infant care focuses appropriately on issues of infant behavior and parental concerns.

Cross-Cultural Comparison↗
PubMed1997

An analysis of group versus individual child health supervision.

This study compares the effectiveness of group health supervision (three or four families counseled simultaneously) with traditional visits in conveying knowledge of child health and development, increasing perceived maternal support, and mitigating maternal depression. Subjects were recruited from a predominantly white, middle-class, suburban/rural pediatric practice. Twenty-five families were allocated to group health supervision and 25 to individual visits. A questionnaire covering knowledge of child health and development (CHDQ), the Maternal Social Support Index (MSSI), and the Center for Epidemiologic Studies Depression Scale (CESD) were administered to both groups before their 2-month and after their 10-month visits. A subset of these charts was reviewed for problem visits between 2 and 6 months. As compared with families having traditional visits, families who received the group intervention did at least as well in acquiring knowledge of child care and development and, although not statistically significant, tended to recover from postpartum depression faster and deal better with minor illnesses. The investigators found group child health supervision to be a pleasant and effective method of health care delivery.

Child Development↗
PubMedDate not supplied

Morae and syllables: rhythmical basis of speech representations in neonates.

Are neonates sensitive to the different rhythmical units that are used in different spoken languages? And do they use these units to represent and discriminate multisyllabic words? In the present study, we used the High-Amplitude Sucking procedure to test whether 3-day-old French infants discriminate lists of Japanese words. The lists of words differed either in the number of syllabic units or in the number of sub-syllabic units such as morae. In Experiment 1, infants heard bisyllabic versus trisyllabic words (e.g.: iga vs. hekiga); in Experiment 2, they were presented with bimoraic versus trimoraic bisyllabic words (e.g.: iga vs. iNga). The results corroborate those obtained by Bijeljac-Babic, Bertoncini, and Mehler (1993), providing further evidence that neonates discriminate bisyllabic from trisyllabic words. In contrast, neonates do not appear to discriminate bisyllabic words that vary in number of sub-syllabic units. It is proposed that syllables are particularly salient units during the initial stage of speech processing, irrespective of which language and rhythmical structure is heard.

Electronic Data Processing↗
PubMed2005

Self-esteem and affect as information.

This research tests whether people with high self-esteem are more informed by their emotions than are people with low self-esteem. In Study 1, participants listened to a series of disturbing baby cries, rated how much distress these cries conveyed, and reported their own emotional reactions to the cries. As predicted, the relation between participants' emotional reactions and their cry ratings was strongest at higher levels of self-esteem. In Study 2, self-esteem again determined how strongly participants' own emotional reactions influenced their baby cry ratings, even though esteem was measured weeks before the experiment and even after controlling for social desirability. Study 3 manipulated self-regard and showed that the correlation between participants' emotional reactions and their cry ratings was strong for high-regard participants, moderate for control participants, and weak for low-regard participants. These results suggest that self-esteem serves to validate the informational value of feelings.

Acoustic Stimulation↗
PubMed1997

Nurses' experience with implementing developmental care in NICUs.

The aim of this study was to gain insight into nurses' (N = 8) experience of working in a neonatal intensive-care unit (NICU) that incorporated the developmental-care approach. Although Als's model is family centered, the basic social process identified by nurses was putting the baby first. The process of putting the baby first was uncovered using grounded-theory methodology. The process included three phases: learning, reacting, and advocating/nonadvocating. In each of the phases, four main concepts--encountering, appraising, supporting, and gaining sensitivity--emerged from the data. Nurses appraised the advantages and disadvantages of this therapeutic approach not only to the infant but also to themselves.

Child Development↗
PubMed2005

Epidural analgesia during labor and delivery: effects on the initiation and continuation of effective breastfeeding.

This prospective cohort study examined the association between epidural analgesia during labor and delivery, infant neurobehavioral status, and the initiation and continuation of effective breastfeeding. Healthy, term infants delivered vaginally by mothers who received epidural analgesia (n = 52) or no analgesia (n = 63) during labor and delivery were assessed at 8 to 12 hours postpartum, followed by a telephone interview with the mothers at 4 weeks postpartum. There was no significant difference between the epidural analgesia and no-analgesia groups in breastfeeding effectiveness or infant neurobehavioral status at 8 to 12 hours or in the proportion of mothers continuing to breastfeed at 4 weeks. Therefore, epidural analgesia did not appear to inhibit effective breastfeeding. There was a positive correlation between infant neurobehavioral status and breastfeeding effectiveness (Spearman rho = 0.48, P = .01), suggesting that neurobehavioral assessment may prove beneficial in identifying infants at greater risk for breastfeeding difficulties.

Adult↗
PubMed2005

Indicators of effective breastfeeding and estimates of breast milk intake.

The authors tested indicators of effective breastfeeding to identify those that provide reliable estimates of human milk intake. Human milk intake of 82 full-term infants was measured by test weights before and after feeding and compared with commonly used breastfeeding indicators: rooting, length of time before latch-on, latch-on, suckle, observable swallowing, and audible swallowing. Two models were tested: model 1, describing indicators at 96 hours postpartum, and model 2, describing indicators at >96 hours postpartum. Median (interquartile) milliliters of mother's milk consumed per feeding was 26 ml (range, 4-47) at 96 hours and 54 ml (range, 26-73) at >96 hours. Significant predictors of human milk intake in model 1 were rooting and observable swallowing (R2=26%, P<.01). In model 2, audible swallowing alone estimated human milk intake (R2=29%, P<.001). Observed swallowing and rooting during the first 4 days (96 hours) following birth and audible swallowing after that time should be included in the breastfeeding assessment of full-term infants.

Adult↗
PubMed2006

The conceptualization of perceived insufficient milk among Mexican mothers.

This study sought to provide a comprehensive picture of maternal conceptualization of Perceived Insufficient Milk (PIM) using qualitative methods (semistructured interviews, free lists, and rankings) in Mexico. Two hundred and seven first-time mothers of infants younger than 6 months and mothers-to-be who were (or intended to be) breastfeeding were interviewed in waiting areas at a hospital and a health clinic in Mexico City, Mexico, from September 2000 to January 2001. Pattern searching and triangulation of the 3 qualitative methods indicated that women viewed crying as the chief symptom of PIM. Maternal diet and liquid intake were cited as both the most salient causes and treatments for PIM. The main coping strategy in the event of PIM was formula feeding. These findings highlight the need for addressing maternal concerns in relation to PIM, especially regarding the role of crying as the initiator of the PIM cycle.

Adult↗
PubMed1997

Breastfeeding the sleepy baby.

Sleepy babies can be a source of frustration to both mothers and health care providers during the early days of breastfeeding. This paper looks at some reasons for excessive sleepiness and offers suggestions for helping sleepy babies to breastfeed using the baby as a guide.

Age Factors↗
PubMed1992

Using relaxation with guided imagery to assist primiparas in achieving maternal role attainment.

A framework has been developed that provides nurses with a theoretical basis for using relaxation with guided imagery with primiparas (first-time mothers) to reduce anxiety and depression and to increase self-esteem, thereby promoting maternal role attainment and expected infant behavior during the postpartum period. Although relaxation with guided imagery (RGI) has been used clinically in many situations, no research studies were found that reported using RGI with new mothers. However, because RGI has been effective in altering the responses of adults and children in diverse settings, it is inferred that RGI could be effectively used in helping primiparas adapt to the pressure of parenthood. An RGI protocol for use with new mothers is presented.

Female↗
PubMed1996

Relationship of cues to assessed infant pain level.

Cues that 46 pediatric nurses with a BS in Nursing reported as key to their pain assessments of 88 videotaped infants, ages 0 to 12 months, are identified. Frequencies with which these cues were used for infants of different ages and the relationships between key cues and assessed levels of pain are described. Greater pain was strongly associated with tears, stiff posture, guarding, and fisting. Greater pain was moderately associated with inadequate type or dosage of analgesia, more recent surgery, inconsolability, difficult to distract, does not focus on surroundings, frown, grimace, wrinkled face, flushed face, pain cry, and increased arousal in response to touch of sore area. Internurse variability in cue use was sizable. Most of the often-used cues had weak or no association with assessed pain level. Only consolability, pain cry, grimace, and stiff posture were frequently used and correlated > .51 with assessed level of pain.

Clinical Nursing Research↗
PubMed1996

Distribution of cues across assessed levels of infant pain.

A convenience sample of 24 more experienced, 20 less experienced, and 20 novice nurses assessed videotaped infants in varying degrees of pain (none, mild, moderate, and severe), as determined by an expert panel. Participants identified all information they used in making an assessment (All cues) and that subset they deemed most important (Key cues). Data were analyzed using a two-level analysis of variance (level of assessed pain and pediatric nursing experience). Forty-five of the 62 cues mentioned by participants did not differ across levels of pain. Eleven All cues and 11 Key cues differed between infants in pain and not in pain, suggesting that these cues may be potentially useful as predictors of the presence/absence of pain. Three All cues differed both between pain and no pain as well as between levels of pain, which suggests that participants' awareness of subtle leveling might be used in the discrimination of a wider range of pain levels. Differences in cue utilization among the more experienced, less experienced, and novice participants are discussed.

Clinical Competence↗
PubMed1999

The influence of background clinical data on infant pain assessments.

The purpose of this study was to determine the importance of knowledge of clinical background data on nursing assessments of infant pain. In a quasi-experimental design, the infant pain assessments of two groups of pediatric nurses were compared. Both groups assessed the levels of pain of the same videotaped infants. One group also read clinical background data about each infant; the other group did not. The group who read clinical background data evidenced higher mean levels of assessed pain per videotaped infant than did the group who only viewed the videotapes. Findings underscore the importance of clinical data and clinical context in the process of assessing infant pain and the risk of underestimating pain when all factors are not considered.

Age Factors↗
PubMed2001

Excessive infantile crying: a review of the literature.

Excessive infantile crying is a widespread problem which exerts a serious impact on families' lives. The prevalence, cause, and treatment of the problem have been addressed in the literature for many years but with varying degrees of success. Variation in definition of excessive crying leads to difficulty when comparing results between studies. Flawed method and inadequate sampling characterise many studies in this field, often seriously limiting the usefulness of the findings. Progress has been made in some aspects of excessive crying, and other approaches hold promise of success, but wide gaps remain with regard to cause and treatment.

Colic↗
PubMed2002

Further development of the Liverpool Infant Distress Scale.

The Liverpool Infant Distress Scale (LIDS) was initially designed to assess behaviours reflecting pain in neonates following surgery. This paper reports a further development of the validity and reliability of LIDS and its use as a measure of neonatal behaviour. In the first stage of validity testing the LIDS scores of infants prior to administration of analgesia were compared to LIDS scores postanalgesia. Significantly lower scores were recorded following analgesia. The second stage of validity testing compared LIDS scores of a control group of neonates with those undergoing surgery, each over 43 hours. A significantly lower score on LIDS was found for the control group of infants compared to the surgical group, providing support for validity. Internal consistency was high, providing support for reliability. By providing detailed description of neonatal behaviours LIDS may assist nurses in the identification and objective quantification of neonatal behaviour, the context of which will govern intervention. The efficacy of such interventions may also be measured using LIDS.

Female↗
PubMed2003

Infant EEG spectral coherence data during quiet sleep: unrestricted principal components analysis--relation of factors to gestational age, medical risk, and neurobehavioral status.

EEG spectral coherence data in quiet sleep of 312 infants were evaluated, at 42 weeks post-menstrual age. All were medically healthy and living at home by time of evaluation. The sample consisted of prematurely bom infants with a wide spectrum of underlying risk factors, as well as healthy full-term infants. Initial 3040 coherence variables were reduced by principal components analysis in an unrestricted manner, which avoided the folding of spectral and spatial information into among-subject variance. One hundred fifty factors explained 90% of the total variance; 40 Varimax rotated factors explained 65% of the variance yielding a 50:1 data reduction. Factor loading patterns ranged from multiple spectral bands for a single electrode pair to multiple electrode pairs for a single spectral band and all intermediate possibilities. Simple left-right and anterior-posterior pairings were not observed within the factor loadings. By multiple regression analysis, the 40 factors significantly predicted gestational age at birth. By canonical correlation, significant relationships were demonstrated between the coherence factors and medical risk factors as well as neurobehavioral factors. Using discriminant analysis, the coherence factors successfully discriminated between infants with high and low medical risk status and between those with the best and worst neurobehavioral status. The two factors accounting for the most variance, and chosen across several analyses, indicated increased left central-temporal coherence from 6-24 Hz, and increased frontal-occipital coherence at 10 Hz, for the infants born closest to term with lowest medical risk factors and best neurobehavioral performance.

Electroencephalography↗