The Impact of Infant Rooming-In on Maternal Sleep at Night

Two opposing issues in postpartum rooming-in are the benefits of continuous interaction and the threat of maternal sleep disruption. A two-group comparison study was designed to investigate differences in sleep patterns for a group of mothers who roomed-in with their infants at night as compared with a group who was separated from their infants at night. The data collected from the mothers in the study indicated that mothers did not sleep longer or better when their infants were returned to the nursery during the night.     

Sleep Disturbances,Vitality, and Fatigue Among a Select Group of Employed Childbearing Women

Self-reported sleep disturbances and levels of vitality and fatigue were studied in a secondary analysis of 25 pregnant and 29 postpartum employed women. Results indicate that pregnant women have problems initiating and maintaining sleep, and postpartum women have problems maintaining sleep, but not falling asleep. The primary reason for midsleep awakenings was urinary frequency among the pregnant women, and child care responsibilities among the postpartum women. Chronic sleep disturbance was indicated by a greater percentage of postpartum women who fell asleep easily, very few who felt highly energetic at work, and most who perceived a high level of fatigue during the past week. Even with these sleep disruptions, no differences occurred in the mean scores for perception of fatigue und vitality between the two groups. Clinicians can use these findings to educate women about some changes they may anticipate and how they might manage them during pregnancy and postpartum     

Breastfeeding,Bed‐Sharing,and Infant Sleep

Abstract: Background: Expectations for infant sleep development and for the appropriate degree of parental proximity for infant sleep are culturally weighted and historically shifting aspects of parenting behavior, and are known to affect breastfeeding prevalence and duration. This paper examined how new parents managed night‐time feeding in the first 4 months, with a particular focus on the relationship between breastfeeding, infant sleep location, and sleep bout duration. Methods: Sleep logs and semistructured interviews were used with a sample of 253 families in North Tees, United Kingdom, to explore how parents responded to their infant's sleep patterns, how breastfeeding parents managed night‐time feeding, and whether bed‐sharing was a common strategy. Results: A clear relationship between breastfeeding and parent‐infant bed‐sharing was demonstrated. Some evidence indicated that bed‐sharing may promote breastfeeding. Conclusions: An understanding of the role of infant feeding practice on infant sleep and parental caregiving at night is a crucial element in breastfeeding promotion and enhancement of infant health. Health professionals should discuss safe bed‐sharing practices with all parents. (BIRTH 30:3 September 2003)     

The Relationship of Maternal Personality Characteristics to Birth Outcomes and Infant Development

Background: Previous studies reported an association between maternal psychological factors and adverse pregnancy outcomes. The objective of this study was to evaluate the relationships between maternal personality characteristics, as determined by the Minnesota Multiphasic Personality Inventory (MMPI), and infant birth outcomes and development. Method: The inventory was administered during pregnancy to 638 pregnant women enrolled in a staff model health maintenance organization. MMPI validity as well as clinical and research scales were evaluated in relationship to infant birth outcomes (low birthweight, preterm birth) and 15‐month‐old infant development as assessed by the Bayley Scales of Infant Development. Results: Mothers of low birthweight infants scored significantly lower on the hypochondriasis scale, a relationship which was no longer significant after controlling for ethnicity. No other relationships were observed between infant birth outcomes and maternal MMPI scale scores. A higher infant Mental Developmental Index (MDI) was related to higher maternal masculinity‐femininity and ego‐strength scale scores and lower lie and hypochondriasis scale scores. Only the relationship between infant MDI and maternal masculinity‐femininity scale score remained significant after controlling for ethnicity and socioeconomic index (β= 0.104, p =0.036). Conclusions: Maternal personality characteristics, as determined by the MMPI, did not appear to be significantly related to the occurrence of preterm birth or low birthweight in this healthy, general population. Maternal personality characteristics reflected in the MMPI masculinity‐femininity scale appeared to be related to infant mental development, above and beyond the effects of socioeconomic status and ethnicity.     

Racial/Ethnic Differences in Prenatal and Postnatal Counseling About Maternal and Infant Health-Promoting Practices Among Teen Mothers

Study ObjectiveDisparities in perinatal counseling among all pregnant women exist, yet teen data are lacking. We evaluated racial/ethnic differences in (1) prenatal and (2) postnatal counseling of teen mothers.Design, Setting, and ParticipantsThis retrospective cross-sectional study included Pregnancy Risk Assessment Monitoring System data from 2012-2016 and included mothers 19 years of age and younger.Interventions and Main Outcome MeasuresCounseling measures included tobacco, alcohol and illicit drugs, weight gain, HIV testing, influenza vaccination, breastfeeding, infant safe sleep, postpartum depression, and contraception. Bivariate associations of maternal/infant characteristics and counseling were estimated using χ² tests. Multivariable logistic regression was used to assess the independent relationship between race/ethnicity and counseling.ResultsA weighted sample of 544,930 teen mothers was analyzed. Compared with non-Hispanic white (NHW) teens, non-Hispanic black teens were more likely to receive counseling on tobacco (adjusted odds ratio [aOR], 1.4; 95% confidence interval [CI], 1.10-1.77), alcohol (aOR, 1.77; 95% CI, 1.28-2.46), illicit drugs (aOR, 1.79; 95% CI, 1.33-2.41), and HIV testing (aOR, 1.62; 95% CI, 1.26-2.09). Compared with NHW teens, Hispanic teens were less likely to receive tobacco counseling (aOR, 0.78; 95% CI, 0.64-0.97) and more likely to receive influenza vaccine counseling (aOR, 1.44; 95% CI, 1.18-1.76). No difference was found in receipt of postnatal counseling.ConclusionRacial/ethnic differences in receipt of perinatal counseling exist, with non-Hispanic black teens being more likely to receive counseling on substance use and HIV testing and Hispanic teens being more likely to receive influenza vaccine recommendations compared with NHW teens. Ongoing investigation is needed to understand drivers of these differences.     

Breastfeeding Patterns: Comparing the Effects on Infant Behavior and Maternal Satisfaction of Using One or Two Breasts

In the Western world advice given by breastfeeding consultants about the use of one or two breasts at each feed has resulted in apparently arbitrary changes over time. This study compared 1-month-old breastfed infants' reactions to single- and two-breast feeds in terms of restlessness, crying, sleeping, and frequency of feeds, wet diapers, and loose stools. Eighty mothers were randomly assigned at the maternity ward, 44 to the single-breast group and 36 to the two-breast group. At one-month follow-up no differences between the groups were seen regarding any infant behavior variables, or in terms of maternal satisfaction, confidence, and mood throughout the full 24-hour observation period or during a 4-hour period in the evening. Compliance with the assigned feeding method was better in the two-breast than in the one-breast group. This may partly be due to tradition, since the two-breast practice has been recommended by child health nurses in Sweden for over 50 years. It seems reasonable that a baby should be allowed to finish the first breast and, if still hungry, be offered the second breast. The baby's appetite is the deciding factor.     

Relationships Between Maternal Smoking,Placental Pathology,and Fetal Growth

Placental and feto-neonatal characteristics were compared between 199 smokers and 231 non-smokers. Controlling for such maternal confounders as maternal age, gestational age, race, socioeconomic status drug and/or ethanol abuse, and lack of prenatal care, maternal smoking was strongly related to decreased birth weight (mean difference 415 grams), length, head circumference, and elevated cord hematocrit, indicating early and late components of the growth-inhibiting effects of smoking. These relationships persisted when growth measures were adjusted for effects of placental weight, presence of placental infarction, or other specific placental lesions.     

Grassroots Strategies for Promoting Maternal and Infant Health

ABSTRACT: For the past four years, grassroots organizing efforts in Rhode Island have been directed toward improving maternal and infant health. Coalitions of consumer organizations, health care providers, and activists have achieved important legislative initiatives, such as health insurance for uninsured pregnant women and promotion of midwifery services. This article examines the processes involved in organizing for improved maternal and infant health care, the dynamics involved in achieving a particular outcome, and the ways in which grassroots mobilization can affect public policy and contribute toward improved maternal and infant health.     

Functional Assessment of Infant Breastfeeding Patterns

Abstract: As breastfeeding rates have increased in the United States, the need has arisen for coordinated approaches to the assessment of normal and problem situations. Since some difficulties are related to the manner in which baby feeds, guidelines are discussed for the visual assessment of breastfeeding. These include the when, why, and how of assessing seven common situations or problems: initial breastfeeding experiences, inadequate infant weight gain or low milk intake, insufficient milk supply (real or perceived), nipple problems, latch-on and sucking disorganization, high-risk situations, and the good baby syndrome.