Anemia and Insufficient Milk in First-Time Mothers

ABSTRACT: Insufficient milk is a poorly understood problem that is often identified as a major reason for early discontinuation of breastfeeding. This study explored the relationship between anemia and insuficient milk in 630 first-time mothers. The frequency of anemia (postpartum hemoglobin > 10 g/dL) was 22 percent. Anemic mothers reported a higher level of symptomatology associated with insufficient milk and were more frequently classified as having insuficient milk syndrome. Mothers with the syndrome reported a shorter period of full breastfeeding, and weaned at an earlier age. They identified not having enough milk, baby nursing too often, and baby not gaining enough weight as the main reasons for discontinuing breastfeeding, compared with baby's disinterest and conflicts with school or work as main reasons among mothers not reporting symptoms related to insuficient milk syndrome. The study results suggest that anemia is associated with the development of insuficient milk, which in turn, is related to duration of full breastfeeding and to age at weaning.     

Concerns of Multiparas During the Second Postpartum Week

A study was conducted to identify concerns of multiparas during the early postpartum period. Twenty multiparas were interviewed at home 10 to 14 days postpartum. Family, mother, and baby items were sorted into three categories; worry, interest, and no concern. Meeting the needs of everyone at home and other family items were most frequently sorted as a concern. Feeding method, mother's educational level, yearly household income, sex of the newborn, and childbirth preparation were related to the number of concerns.     

Change in 21 Sexual Concerns of New Parents From Three to Twelve Months Postpartum: Similarities and Differences between Mothers and Partners

BackgroundPostpartum sexual concerns are associated with depressive symptoms, distress, and lower relationship satisfaction, and are commonly reported by both mothers and their partners. Previous studies have examined changes in postpartum sexual concern using aggregate scores and have not examined patterns of change for unique concerns, thus ignoring that the initial levels and trajectories of a variety of distinct, postpartum sexual concerns may differ from one another and may differ between mothers and partners.AimsThe aims of the current study were to (i) examine how a variety of postpartum sexual concerns change from 3 to 12 months postpartum for mothers and their partners using a sample of first-time parents, and (ii) examine how mothers and their partners may differ in their initial levels and subsequent changes in postpartum sexual concerns.MethodsFirst-time mothers and their partners (N = 203 couples) independently completed a measure of 21 postpartum sexual concerns at 3, 6, 9, and 12 months postpartum.OutcomesPostpartum Sexual Concerns QuestionnaireResultsGrowth modeling indicated that twelve of mothers’ and 6 of partners’ postpartum sexual concerns declined over time from 3 to 12 months postpartum, only one concern of mothers’ and none of partners’ concerns increased over time, and the remaining 8 and 15 concerns were stable for mothers and partners, respectively. At 3 months postpartum, mothers had higher levels of 11 postpartum sexual concerns than partners, while partners had higher levels than mothers on 4 concerns. Compared to partners, from 3 to 12 months postpartum, mothers showed both steeper decreases in concern about body image changes and steeper increases in concern about returning to work.Clinical ImplicationsVarious postpartum sexual concerns do not all follow the same pattern of change over time, and mothers and their partners share similarities and differences in these patterns. Clinicians should use a checklist to discuss a range of postpartum sexual concerns with both new mothers and their partners.Strengths and LimitationsThis is the first study, to our knowledge, to examine how a variety of postpartum sexual concerns change over time and how mothers and partners both differ and are similar in their experiences. Most couples were in mixed-sex relationships, identified as White, and were relatively affluent; results may not generalize.ConclusionA variety of postpartum sexual concerns follow different patterns of change from 3 to 12 months postpartum, and mothers and partners share similarities and differences in these patterns.Allsop DB, Impett EA, Vannier SA, et al. Change in 21 Sexual Concerns of New Parents From Three to Twelve Months Postpartum: Similarities and Differences between Mothers and Partners. J Sex Med 2022;19:1366–1377.     

High Risk Infant: Concerns of the Mother After Discharge

ABSTRACT: This study was undertaken to determine the concerns of mothers of high risk infants and whether they differed from those of mothers of normal newborn infants. Thirty mothers of high risk infants and those of normal newborns, were interviewed in their homes on two separate occasions, at two weeks and again at six weeks after their infants’ hospital discharge. Following a semi-structured questionnaire format, the mothers were asked to rate their concerns in several areas and to specify concerns they may have had which were not identified on the questionnaire. Areas in which mothers expressed concerns were: feeding, gastrointestinal problems, sleeping, crying, attachment, rashes, appearance, and concerns about the mother herself, her husband, and other children. Mothers of normal newborn infants expressed worries in those areas already identified by the high risk group but they had fewer concerns and a lower degree of concern. However, no mother of a normal newborn infant was concerned about her infant's appearance and there was a tendency for mothers of normal newborn infants to have a more positive perception of their infants.     

Gestational Weight Gain and Interpregnancy Weight Change in Adolescent Mothers

Study Objective

To examine the association between gestational weight gain (GWG) and interpregnancy weight change (IPWC) in adolescent mothers (younger than 20 years), and to determine if this association differs from adult women (aged 20-35 years).

Risk Estimation of Metabolic Syndrome at One and Three Years After a Pregnancy Complicated by Preeclampsia

BackgroundOur goal was to determine the prevalence of metabolic syndrome in women following a pregnancy complicated by preeclampsia and to determine whether this changes between one- and three-years postpartum.MethodsWe recruited women into a longitudinal prospective cohort following a pregnancy with or without preeclampsia. The prevalence of cardiometabolic factors were assessed at one- and three-years postpartum. A total of 217 women completed a visit at one year postpartum (n = 99 preeclampsia, n = 118 control subjects) and 120 completed a visit at three-years (n = 73 preeclampsia, n = 47 control subjects).ResultsThe prevalence of metabolic syndrome at one- and three-years postpartum was significantly greater in women who had preeclampsia (18.18% at one year, 21.92% at three-years) than in control subjects (6.78%, 6.38%) (P < 0.05), but did not change over time.ConclusionGiven the difficulty in following women long-term,either clinically or as part of study, and because cardiometabolic factors do not change significantly between one- and three-years postpartum, strategies for health preservation and disease prevention should be adopted in the first-year postpartum.     

Group Counseling for Mothers After Emergency Cesarean Section: A Randomized Controlled Trial of Intervention

Abstract: Background : An emergency cesarean section is often a traumatic experience for women, and can be associated with postnatal depression and posttraumatic stress. Various types of interventions have been tested to prevent such consequences. The purpose of this study was to test a model of group counseling for mothers after emergency cesarean section, and to examine its possible effects. Method : After undergoing an emergency cesarean section, 162 Swedish‐speaking women were randomized to group counseling or the control group. The participation rate was 75 percent. The counseling consisted of 2 sessions, conducted at about 2 months postpartum; 72 percent of the women randomized to the counseling group actually attended the sessions. At 6 months postpartum, all study participants completed a postal questionnaire (response rates were 92% in the counseling group and 89% in the control group). Results : No difference between the groups was found in terms of the level of fear after childbirth, symptoms of posttraumatic stress, or postnatal depression at 6 months after the emergency cesarean. The group counseling was much appreciated by the participating women, some of whose experiences are reported in this paper. Conclusion : Group counseling for mothers after emergency cesarean section did not influence their views on the recent delivery or prevent symptoms of posttraumatic stress or postnatal depression. It was, however, appreciated and did no harm. In future studies, other outcomes should be measured.     

Home Care of the Battered Pregnant Woman: One Battered Woman's Pregnancy

Perinatal nurses in the home care setting should screen all women for battering. Pregnant women who are battered need nursing education and intervention to help break the cycle of abuse and promote optimal maternal and fetal outcomes. This case report describes nursing care in the home for a battered pregnant patient at high risk.     

Temporary Resolution of Preeclamptic Symptoms After Intrauterine Death of One Twin

In a 34 year old woman with dichorionic twin pregnancy preeclampsia resolved after the intrauterine death of one of the HLA-identical twins and recurred with the growth of the placenta of the surviving twin later in pregnancy. This case gives indirect evidence that the clinical course of preeclampsia is a dose-dependent phenomenon in conjunction with vital placental tissue.     

One Size Does Not Fit All: Differences in Newborn Weight Among Mothers of Philippine and Other East Asian Origin

ObjectiveTo determine the likelihood that infants born to Filipina, other East Asian, and Canadian-born women may be misclassified as small for gestational age when using conventional Canadian birth weight curves rather than those specific to their world region.MethodsWe conducted a population-based study of 548 418 singleton live births in Ontario between 2002 and 2007. Smoothed birth weight percentile curves were generated for males and females born to women from Canada, the Philippines, and the rest of East Asia/Pacific. We determined the likelihood of misclassifying an infant as small for gestational age (SGA < 10th percentile weight) or large for gestational age (LGA ≥ 90th percentile weight) on a Canadian-born birth weight curve vs. a curve specific to the other two world regions.ResultsFor gestation-specific 10th and 50th percentiles, term infants born to women from the Philippines often had significantly lower birth weights than infants of Canadian-born mothers. Controlling for maternal age and parity, approximately 88 per 1000 male newborns (95% CI 82 to 95) and 72 per 1000 female newborns (95% CI 54 to 60) of mothers from the Philippines were at risk of being misclassified as SGA. LGA would be missed in approximately 54 per 1000 male newborns (95% CI 49 to 59) and 49 per 1000 female newborns (95% CI 44 to 54) of Filipina mothers. Misclassification of both SGA and LGA was more pronounced among infants of Filipina mothers than of mothers from other East Asian origin.ConclusionsInfants of mothers born in the Philippines weigh significantly less than those of Canadian-born women or mothers emigrating from other East Asian countries. Those who use birth weight curves should consider these differences.     

Effect of Maternal and Pregnancy Risk Factors on Early Neonatal Death in Planned Home Births Delivering at Home

Objective

The prevalence of home birth in the United States is increasing, although its safety is undetermined. The objective of this study was to investigate the effects of obstetrical risk factors on early neonatal death in planned home births delivering at home.

Home monitoring of blood pressure in pregnancy at high risk of pre-eclampsia

The early detection of pre-eclampsia is a major challenge in obstetric care. We report a case where pre-eclampsia was detected by home blood pressure monitoring between routine antenatal visits. This novel management approach allows early diagnosis and optimises antenatal care in fulminating disease.