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Infantile rumination can be defined as self-induced regurgitation of previously swallowed food. Because it can lead to potential somatic complications and because it implies dysfunctional mother-child bonding, both a pediatric and psychiatric approach is needed. The treatment must be somatic (nutritional) and psychological (intensive nursing, mother-baby psychotherapy). Two case studies illustrate this rare but impressive picture.
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PURPOSE: Many studies concluded that the behavior of babies complicated dental care because of child immaturity or the difficulty of establishing acceptable communication and comprehension. METHODS: The records of 696 babies were randomly selected from the baby clinic of Araçatuba in Brazil. Patient age ranged from 0 to 36 months. They were divided into 6 groups according to age: Group I-0 to 6 months; Group II-7 to 12 months; Group III-13 to 18 months; Group IV-19 to 24 months; Group V-25 to 30 months; Group VI-31 to 36 months. The behavior of the child was evaluated upon entrance in the dental office and during the first 4 clinical appointments with a clinical exam and oral physiotherapy. The baby was classified as collaborator (C) or noncollaborator (NC). Statistical analysis was performed using Pearson's chi-square method (P < .05). RESULTS: The percentage of NC for Groups II, III, IV, and V (66%), was significantly higher than for groups I (30%) and VI (50%). CONCLUSIONS: Babies from 0 to 6 months showed a collaborative behavior; babies from 7 to 30 months showed noncollaborative behavior; and babies from 31 to 36 months showed no statistically significant difference between the percentage of C and NC.
Many explanations for the current findings of limited group differences between premature and term infants at comparable conceptional ages can be imagined that remain buried in the data as currently presented. For example, some prematures may indeed be advanced in many areas of behavioral and neurophysiological development, but this is counterbalanced by prematures who are significantly delayed in these parameters for medical reasons such as hypoxia or metabolic disturbance, while a third portion of the infants has uneven and disorganizing mixtures of delayed and advanced development in selective modalities. Hopefully future research which takes these various possibilities into consideration will give us a better understanding of this complex problem.
A total of 345 newborn infants received a behavioral screening consistent with protocol adopted by the Joint Committee on Infant Hearing. Infants were divided into three groups consisting of 108 at-risk for hearing loss, 80 intensive care nursery graduates, and 157 normal control infants. Of the total, 315 newborns received auditory brain stem response (ABR) assessment. The results suggest that 4% of the high risk population had irreversible hearing loss to such a degree that amplification was warranted. Discussion focuses on the questionable use of behavioral screening in the newborn nursery and the application of ABR in a high risk population.
Intentionality is defined as the cognitive ability to represent goals beyond the here and now of perception. First signs of intentionality appear by the second month after birth. A major mechanism responsible for such development might be the unique reciprocal and intentional ways humans communicate with each other, particularly their young progenies. I argue that starting in the second month, reciprocal exchanges, affective mirroring, and mutual imitations with others provide infants with the unique opportunity to differentiate as well as to compare and conjugate first (self) and third (others') person perspectives. This ability is a prerequisite not only for referential communication but also of intentionality. It corresponds to the emergence of a new contemplative and "meta" stance toward the world. An argument is made that the developmental origins of this stance are primarily social, not to be found in the individual infant interacting solely with physical objects.
Assigned randomly 28 neonates born to HIV-positive mothers to a massage therapy or control group. The treatment infants were given three 15-minute massages daily for 10 days. The massaged group showed superior performance on almost every Brazelton newborn cluster score and had a greater daily weight gain at the end of the treatment period unlike the control group who showed declining performance.
A cancer diagnosis impacts the entire family unit, but children are especially vulnerable. In the past, families and professionals did not share information or allow for children to express their feelings or to be involved. Children have the right to know and the need to know the truth. Interventions should be based on both the developmental stage of the child and the stage of the illness. Approaches by disease phase and developmental stage are discussed. Goals include maintaining family stability, preparing children for what may happen, allowing for flexible communication, and preventing serious psychosocial sequelae.
OBJECTIVE: To identify the indicators nurses employ in deciding to test healthy full-term newborns for total serum bilirubin in the absence of a written protocol. DESIGN: Secondary analysis of data available on 130 mother-newborn pairs and informal interviews of 30 postpartum unit nurses. SETTING: Two university teaching hospitals. PARTICIPANTS: All tested newborns and a 33% random sample of remaining newborns from a control group data set created during a previous study and a convenience sample of postpartum nurses from all shifts. MEASUREMENT: Outcome data were obtained from a review of records. Background data were obtained from a review of records and questionnaires. Nurse data were obtained through a modified form of participant observation. RESULTS: Ninety-one percent of newborns tested for bilirubin were tested unnecessarily. In logistic regression analyses, variables predictive of nurse-driven total serum bilirubin testing were presence of jaundice, odds ratio (OR) = 31.95 (95% confidence interval, 6.71, 152.03), and feeding frequency, OR = 0.28 (0.11, 0.72). Identifying both presence and location of jaundice simultaneously did not significantly predict testing, OR = 1.82 (0.66, 5.04). Fifty-three percent of nurses who were interviewed identified both the presence of jaundice and feeding as indicators to consider for testing. CONCLUSION: Newborns are overtested for bilirubin. Indicators used by nurses in deciding to test a healthy newborn for total serum bilirubin are the presence of jaundice and feeding frequency. Nurses who assess feeding frequency are less likely to order bilirubin testing.
1-18 months old Norwegian-Sami girls from Karasjok/Katokeino were compared with girls from Falköping in Sweden. All Karasjok/Kautokeino children were breastfed, usually until 1 year of age. Only a few developed a dummy- or fingersucking habit. They started eating porridge at 4-5 months of age. At about half a year of age they were fed dark, hard chewing bread to gnaw at. Cut and pulped adult food was introduced during the end of the first year of life. In almost all cases the children had dried reindeer meat to gnaw at. They were mostly fed by spoon and drank from a cup. The Falköping girls, on the other hand, were not so often breastfed and for a shorter time. They usually became dummysuckers. The Falköping girls got almost all their nutrition during the first one or two years by sucking or eating food with little chewing resistance. The differences in sucking and chewing behavior could influence on the transversal development of the jaws.
The responses of preterm neonates to acute tissue-damaging stimuli have been described. However, factors which influence these responses have received little attention. In this study, we observed 124 premature infants before, during and after a routine heel lance and determined how two contextual variables (severity of illness and behavioral state) influenced their behavioral responses. Significant changes in facial actions occurred between baseline and the most invasive phase of the heel lance procedure, stick. The fundamental frequency, harmonic structure and peak spectral energy of the infant's cry were also significantly increased during the stick phase. Behavioral state was found to influence the facial action variables and severity of illness modified the acoustic cry variables. Accurate identification of pain in premature infants requires consideration of factors that influence their response.
BACKGROUND: Zinc deficiency is thought to be common in young children in developing countries and some data suggest that it may detrimentally affect children's development. OBJECTIVE: Our goal was to assess the effect of zinc supplementation on the developmental levels and behavior of Bangladeshi infants. DESIGN: This was a randomized, double-blind, controlled trial conducted in Dhaka, Bangladesh. Three hundred one infants aged 1 mo were randomly assigned to receive either 5 mg elemental Zn or placebo daily for 5 mo, and subsequent growth and morbidity were observed. For the present study, developmental levels were assessed in a subsample of 212 infants at 7 and 13 mo of age with use of the Bayley Scales of Infant Development, and the infants' behavior during the tests was observed. The children's social backgrounds, weights, and lengths were also recorded. RESULTS: The children's nutritional status was generally poor. The zinc-treated group had slightly lower scores on the mental development index of the Bayley Scales than did the placebo group (beta = 3.7, SE = 1.3, P < 0.005). This effect remained significant when nutritional status and social background were controlled for. No other significant differences between groups were noted. CONCLUSIONS: The mental development index scores of the zinc-treated group were slightly but significantly lower than those of the placebo group. This finding may have been due to micronutrient imbalance. Caution should be exercised when supplementing undernourished infants with a single micronutrient.
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Neonates born to depressed (n=44) versus non-depressed (n=43) mothers were compared on individual items of the Brazelton Neonatal Behavioral Assessment Scale (NBAS). The neonates of depressed mothers received lower scores on orienting to the live face/voice stimulus and on the alertness items, suggesting they were less attentive. They also scored less optimally on the cuddliness and hand-to-mouth activity items, suggesting they were more aroused. These data lend support to the model that infants of depressed mothers are more aroused and less attentive.
This study investigated whether rhesus macaque (Macaca mulatta) mothers distinguish between what is dangerous to themselves and what is dangerous to their infants. The behavioral interactions between 11 mother-infant pairs and other females living in their group were analyzed in the 1st 2 months of infant life. Mothers behaved as if they perceived higher ranking females as dangerous to both themselves and their infants, lower ranking females as dangerous to their infants but not to themselves, and their young daughters as relatively harmless to both themselves and their infants. Changes in maternal intolerance of infant handling between the 1st and 2nd months covaried with changes in the probability of infant harassment rather than with the temporal pattern of aggression received by mothers. The possible cognitive mechanisms underlying parental recognition of infant's special needs are discussed in the light of comparative evidence from other mammalian species.
The purpose of this study was to ascertain if any gender differences existed in the behaviors of infants experiencing different levels of acute established pain and different levels of arousal within each level of pain. To do this, the behaviors of 152 two-week- to 12-month-old infants were videotaped and compared. Levels of pain were assessed by a panel of expert pediatric nurses. Results indicated that female 2-week- to 6-month-old infants performed more generally broadcast crying than did males and that the cries of female 7- to 12-month-old infants were of higher pitch than those of males. There was no gender difference in any facial or other bodily behavior. One cannot interpolate from these results that there are any gender differences in pain thresholds, only that there seem to be gender differences in behavioral responses to acute established pain.
The claim that very young infants can imitate rests largely on reports that infants match adult displays of mouth opening (MO) and tongue protrusion (TP). Recent reviews suggest that only tongue protruding is reliably matched by young infants. This study tests the proposal that infants' "imitation" of tongue protruding reflects a coincidental match between a sight that infants find interesting and a behavior by which infants express interest. In Study 1, 4-week-old infants who looked longer at a nonsocial light display also produced TPs at higher rates than infants showing less interest. In Study 2, 4-week-old infants showed more interest (looked longer at) a tongue-protruding adult face than a mouth-opening face. Study 3 tracked 2 infants' responses to interesting objects for several weeks before and after the onset of manual reaching. Both infants produced tongue protrusions in response to objects within reach before but not after reaching developed. Together, the results of the 3 studies suggest that infants' tongue protrusions in response to a tongue-protruding adult reflect very early attempts at oral exploration of interesting objects.