Journal articles on the topic 'Mother and infant Australia'
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1
Sarna, Mohinder, Ross Andrews, Hannah Moore, Michael J. Binks, Lisa McHugh, Gavin F. Pereira, Christopher C. Blyth, et al. "‘Links2HealthierBubs’ cohort study: protocol for a record linkage study on the safety, uptake and effectiveness of influenza and pertussis vaccines among pregnant Australian women." BMJ Open 9, no. 6 (June 2019): e030277. http://dx.doi.org/10.1136/bmjopen-2019-030277.
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IntroductionPregnant women and infants are at risk of severe influenza and pertussis infection. Inactivated influenza vaccine (IIV) and diphtheria-tetanus-acellular pertussis vaccine (dTpa) are recommended during pregnancy to protect both mothers and infants. In Australia, uptake is not routinely monitored but coverage appears sub-optimal. Evidence on the safety of combined antenatal IIV and dTpa is fragmented or deficient, and there remain knowledge gaps of population-level vaccine effectiveness. We aim to establish a large, population-based, multi-jurisdictional cohort of mother-infant pairs to measure the uptake, safety and effectiveness of antenatal IIV and dTpa vaccines in three Australian jurisdictions. This is a first step toward assessing the impact of antenatal vaccination programmes in Australia, which can then inform government policy with respect to future strategies in national vaccination programmes.Methods and analysis‘Links2HealthierBubs’ is an observational, population-based, retrospective cohort study established through probabilistic record linkage of administrative health data. The cohort includes births between 2012 and 2017 (~607 605 mother-infant pairs) in jurisdictions with population-level antenatal vaccination and health outcome data (Western Australia, Queensland and the Northern Territory). Perinatal data will be the reference frame to identify the cohort. Jurisdictional vaccination registers will identify antenatal vaccination status and the gestational timing of vaccination. Information on maternal, fetal and child health outcomes will be obtained from hospitalisation and emergency department records, notifiable diseases databases, developmental anomalies databases, birth and mortality registers.Ethics and disseminationEthical approval was obtained from the Western Australian Department of Health, Curtin University, the Menzies School of Health Research, the Royal Brisbane and Women’s Hospital, and the West Australian Aboriginal Health Ethics Committees. Research findings will be disseminated in peer-reviewed journals, at scientific meetings, and may be incorporated into communication materials for public health agencies and the public.
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Sindi, Azhar S., Ali S. Cheema, Michelle L. Trevenen, Donna T. Geddes, Matthew S. Payne, and Lisa F. Stinson. "Characterisation of human milk bacterial DNA profiles in a small cohort of Australian women in relation to infant and maternal factors." PLOS ONE 18, no. 1 (January 25, 2023): e0280960. http://dx.doi.org/10.1371/journal.pone.0280960.
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Human milk is composed of complex microbial and non-microbial components that shape the infant gut microbiome. Although several maternal and infant factors have been associated with human milk microbiota, no study has investigated this in an Australian population. Therefore, we aimed to investigate associations between human milk bacterial composition of Australian women and maternal factors (body mass index (BMI), mode of delivery, breast pump use, allergy, parity) and infant factors (sex, mode of feeding, pacifier use, and introduction of solids). Full-length 16S rRNA gene sequencing was used to characterise milk bacterial DNA profiles. Milk from mothers with a normal BMI had a higher relative abundance of Streptococcus australis than that of underweight mothers, while milk from overweight mothers had a higher relative abundance of Streptococcus salivarius compared with underweight and obese mothers. Mothers who delivered vaginally had a higher relative abundance of Streptococcus mitis in their milk compared to those who delivered via emergency caesarean section. Milk of mothers who used a breast pump had a higher relative abundance of Staphylococcus epidermidis and Streptococcus parasanguinis. Milk of mothers whose infants used a pacifier had a higher relative abundance of S. australis and Streptococcus gwangjuense. Maternal BMI, mode of delivery, breast pump use, and infant pacifier use are associated with the bacterial composition of human milk in an Australian cohort. The data from this pilot study suggests that both mother and infant can contribute to the human milk microbiome.
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Begley, Andrea, Kyla Ringrose, Roslyn Giglia, and Jane Scott. "Mothers’ Understanding of Infant Feeding Guidelines and Their Associated Practices: A Qualitative Analysis." International Journal of Environmental Research and Public Health 16, no. 7 (March 29, 2019): 1141. http://dx.doi.org/10.3390/ijerph16071141.
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There is limited evidence to describe Australian mothers’ understanding of the Australian Infant Feeding Guidelines (AIFG). A qualitative inductive methodological approach was used in this study to explore experiences with the introduction of solid food. Seven focus groups with 42 mothers of children aged 4–18 months were conducted in disadvantaged areas in Perth, Australia. The mean age of infants was 9.6 months and mean age of introduction of solid food was 4.3 months (range 1.2 to 7.5 months). Almost half of the mothers in this study were aware of the AIFG however, only half again could correctly identify the recommended age for introducing solid food. Four themes and nine subthemes emerged from the analysis. Themes were (1) Every child is different (judging signs of readiness); (2) Everyone gives you advice (juggling conflicting advice); (3) Go with your gut—(being a “good” mother); and (4) It’s not a sin to start them too early or too late (—guidelines are advice and not requirements). The findings indicated that in spite of continued promotion of the AIFG over the past ten years achieving the around six months guideline is challenging. Professionals must address barriers and support enablers to achieving infant feeding recommendations in the design education materials and programs.
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Hume-Nixon, Maeve, Tupou Ratu, Stephanie Clark, Cattram Duong Nguyen, Eleanor F. G. Neal, Casey L. Pell, Kathryn Bright, et al. "Prevention of young infant infections using oral azithromycin in labour in Fiji (Bulabula MaPei): study protocol of a randomised control trial." BMJ Open 12, no. 12 (December 2022): e061157. http://dx.doi.org/10.1136/bmjopen-2022-061157.
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IntroductionInfections are a leading cause of neonatal mortality globally and can be transmitted from mother-to-child vertically or horizontally. Fiji has higher rates of serious neonatal infections and infant skin and soft tissue infections (SSTIs) than high-income countries. Research from the Gambia found that a single dose of oral azithromycin in labour decreased bacterial carriage and infections in mothers and infants, particularly infant skin infections. The Bulabula MaPei clinical trial evaluates the safety and efficacy of a single dose of azithromycin in labour in reducing the incidence of maternal and infant SSTIs and other infections and the impact on bacterial carriage. It will also describe the effect of azithromycin on antimicrobial (AMR) resistance, the maternal and infant microbiome, and infant dysbiosis.Methods and analysisWe are conducting a blinded, placebo-controlled randomised clinical trial administering 2 g of oral azithromycin, or placebo, given to healthy, pregnant women (≥18 years) in labour in Suva, Fiji. The primary outcome is the cumulative incidence of SSTIs in infants by 3 months of age. Secondary outcomes include the incidence of other infant and maternal infections, and safety and tolerability of azithromycin in mother and infant. Following informed consent, 2110 pregnant women will be randomised in a 1:1 ratio, with all study staff and participants masked to group allocation. Mother/infant pairs will be followed up for 12 months over six visits collecting clinical data on infections, antimicrobial use, safety and anthropometrics, in addition to nasopharyngeal, oropharyngeal, rectovaginal and vaginal swabs, maternal breastmilk and infant stool samples, in order to compare bacterial carriage, AMR rates and microbiome. Recruitment for Bulabula MaPei started in June 2019.Ethics and disseminationThis trial was approved and is being conducted according to the protocol approved by The Royal Children’s Hospital Human Research Ethics Committee, Australia, and the Fiji National Health Research and Ethics Review Committee. The findings of this study will be disseminated in peer-reviewed journals and presented at conferences.Trial registration numberNCT03925480.
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Manohar, Narendar, Andrew Hayen, Sameer Bhole, and Amit Arora. "Predictors of Early Introduction of Core and Discretionary Foods in Australian Infants—Results from HSHK Birth Cohort Study." Nutrients 12, no. 1 (January 19, 2020): 258. http://dx.doi.org/10.3390/nu12010258.
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Early introduction of complementary foods can have a detrimental impact on children’s long-term health. This study examined the timing and determinants of early introduction of core and discretionary foods among infants in Sydney, Australia. Mothers (n = 1035) from an ongoing population-based birth cohort study were interviewed at 8, 17, 34 and 52 weeks postpartum. The outcome was ‘age at which particular core and discretionary food items were first introduced’. Multivariable logistic regression models were used to investigate family and infant-related determinants of early introduction of core (<17 weeks of age) and discretionary foods (<52 weeks of age). Of the 934 mother-infant dyads interviewed, 12% (n = 113) of infants were introduced core foods before 17 weeks of age (median: 22). Mothers working part-time (adjusted odds ratio (OR): 3.42, 95% confidence interval (CI): 1.54–7.62) and those exclusively formula-feeding their babies at four-weeks postpartum (adjusted OR 3.26, 95% CI: 1.99–5.33) were most likely to introduce core foods early. Ninety-five percent (n = 858) of infants were introduced discretionary foods before 52 weeks of age (median: 28). Low socio-economic status was significantly associated with early introduction of discretionary foods (adjusted OR: 3.72, 95% CI: 1.17–11.78). Compliance with infant feeding guidelines related to core foods was better; however, discretionary foods were introduced early in most infants.
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Brookman, Ruth, Marina Kalashnikova, Penny Levickis, Janet Conti, Nan Xu Rattanasone, Kerry-Ann Grant, Katherine Demuth, and Denis Burnham. "Effects of maternal depression on maternal responsiveness and infants’ expressive language abilities." PLOS ONE 18, no. 1 (January 11, 2023): e0277762. http://dx.doi.org/10.1371/journal.pone.0277762.
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High levels of maternal responsiveness are associated with healthy cognitive and emotional development in infants. However, depression and anxiety can negatively impact individual mothers’ responsiveness levels and infants’ expressive language abilities. Australian mother-infant dyads (N = 48) participated in a longitudinal study examining the effect of maternal responsiveness (when infants were 9- and 12-months), and maternal depression and anxiety symptoms on infant vocabulary size at 18-months. Global maternal responsiveness ratings were stronger predictors of infants’ vocabulary size than levels of depression and anxiety symptoms. However, depression levels moderated the effect of maternal responsiveness on vocabulary size. These results highlight the importance of screening for maternal responsiveness–in addition to depression–to identify infants who may be at developmental risk. Also, mothers with elevated depression need support to first reduce their symptoms so that improvements in their responsiveness have the potential to be protective for their infant’s language acquisition.
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Bor, William, Patricia A. Brennan, Gail M. Williams, Jake M. Najman, and Michael O'callaghan. "A Mother's Attitude Towards her Infant and Child Behaviour Five Years Later." Australian & New Zealand Journal of Psychiatry 37, no. 6 (December 2003): 748–55. http://dx.doi.org/10.1080/j.1440-1614.2003.01272.x.
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Objective: The relationship between maternal attitude to the infant at 6 months of age and behavioural outcomes at 5 years is explored, controlling for numerous demographic, child and psychosocial family factors. Method: Data was used from the Mater-University Study of Pregnancy, an Australian longitudinal study of over 7000 mothers and children followed from pregnancy to when the children were 5 years. Measures ranging from the key variables of maternal attitude and child behaviour as well as numerous confounders were dichotomised. Logistic regression analyses were performed to examine the relationship between maternal negative attitude toward the infant and clinically significant levels of child behaviour problems and other infant risks, early social risks, and concurrent social risks. Results: The results suggest that maternal negative attitude towards the infant at 6 months is an independent predictor of child behaviour problems at 5 years. This association remained significant for boys’ externalizing behaviours and girls’ internalizing behaviours. Conclusions: The findings lend support to the concept of a sensitive period in early infancy; the need for a broad perspective in the assessment of the mother-infant relationship and the need for early intervention with dysfunctional mother-infant dyads.
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Roberts, Kathryn, Christine Paynter, and Beryl McEwan. "A Comparison of Kangaroo Mother Care and Conventional Cuddling Care." Neonatal Network 19, no. 4 (June 2000): 31–35. http://dx.doi.org/10.1891/0730-0832.19.4.31.
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Purpose: To compare kangaroo mother care (KMC) and conventional cuddling care (CCC) in premature and smallfor-gestational-age infants.Design and Sample: Thirty mother-infant dyads in two Australian neonatal nurseries were randomly assigned to the KMC group or the CCC group. Both groups of mothers cuddled their babies for a minimum of two hours a day, five days a week while in the study, with the KMC group having skin-to-skin contact while the CCC group had contact through normal clothing.Main Outcome Variable: The main outcome variables were infant weight gain, temperature maintenance during KMC and CCC, and length of hospital stay.Results: The results showed no difference between groups on the Parental Stress Scale (NICU) or the Parental Expectations Survey. Infants in both groups experienced equivalent maintenance of or rise in temperature while out of the incubators, equal weight gain, equal length of stay in the hospital, and equal duration of breastfeeding.
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Huynh, Dao, Dominique Condo, Robert Gibson, Beverly Muhlhausler, Philip Ryan, Sheila Skeaff, Maria Makrides, and Shao J. Zhou. "Iodine status of postpartum women and their infants in Australia after the introduction of mandatory iodine fortification." British Journal of Nutrition 117, no. 12 (June 28, 2017): 1656–62. http://dx.doi.org/10.1017/s0007114517001775.
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AbstractMandatory I fortification in bread was introduced in Australia in 2009 in response to the re-emergence of biochemical I deficiency based on median urinary I concentration (UIC)<100 µg/l. Data on the I status of lactating mothers and their infants in Australia are scarce. The primary aim of this study was to assess the I status, determined by UIC and breast milk I concentration (BMIC), of breast-feeding mothers in South Australia and UIC of their infants. The secondary aim was to assess the relationship between the I status of mothers and their infants. The median UIC of the mothers (n 686) was 125 (interquartile range (IQR) 76–200) µg/l and median BMIC (n 538) was 127 (IQR 84–184) µg/l. In all, 38 and 36 % of the mothers had a UIC and BMIC below 100 µg/l, respectively. The median UIC of infants (n 628) was 198 (IQR 121–296) µg/l, and 17 % had UIC<100 µg/l. Infant UIC was positively associated with maternal UIC (β 0·26; 95 % CI 0·14, 0·37, P<0·001) and BMIC (β 0·85; 95 % CI 0·66, 1·04, P<0·001) at 3 months postpartum after adjustment for gestational age, parity, maternal secondary and further education, BMI category and infant feeding mode. The adjusted OR for infant UIC<100 µg/l was 6·49 (95 % CI 3·80, 11·08, P<0·001) in mothers with BMIC<100 µg/l compared with those with BMIC≥100 µg/l. The I status of mothers and breast-fed infants in South Australia, following mandatory I fortification, is indicative of I sufficiency. BMIC<100 µg/l increased the risk of biochemical I deficiency in breast-fed infants.
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Liamputtong, Pranee, and Charin Naksook. "Infant Feeding Practices: The Case of Thai Immigrant Women in Australia." Australian Journal of Primary Health 7, no. 1 (2001): 46. http://dx.doi.org/10.1071/py01007.
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This paper examines the perceptions and experiences of infant feeding among 30 Thai women in Australia. Ethnographic interviews and participant observation were used to elicit information in the study. Most Thai mothers breastfed their infants, but there were some women who chose bottlefeeding or mixfeeding. Their main reasons were the health and wellbeing of their infants as well as their own needs and illnesses. Nearly all mothers offered water after each feed in order to prevent jaundice and dehydration in their infants. Mothers who breastfed also offered early supplementary foods but continued to breastfeed past one year. The introduction of solid food was in accordance with recommendations of health care providers but some mothers commenced it earlier. The paper argues that infant feeding practices must be considered within the context of Thai culture and women's social situations. This will prevent misunderstanding and only then can health services and care be made more meaningful to the many women who want to implement best feeding practices for their children in their new homeland.
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Hewitt, Lyndel, Carolyn Frohmuller, Li Ming Wen, and Anthony D. Okely. "Effect of a multicomponent intervention in postnatal mothers’ groups on meeting the Australian Physical Activity Guidelines for infants: protocol for a randomised controlled trial." BMJ Open 12, no. 4 (April 2022): e054183. http://dx.doi.org/10.1136/bmjopen-2021-054183.
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IntroductionGiven the importance of tummy time and the low levels of tummy time reported globally, there is a need for high-quality intervention strategies to promote tummy time. This study describes the protocol of a randomised controlled trial that aims to determine the effectiveness of a multicomponent intervention delivered in postnatal mothers’ groups in increasing infant tummy time.Methods and analysisA randomised controlled trial will be conducted. Eligible participants will be mothers and their infants attending postnatal mothers’ groups (New South Wales, Australia). Participants will be randomised to participate in either (1) infant tummy time intervention group (practice, education, WhatsApp) plus usual care; or (2) usual care group. Randomisation process and outcome assessors will be blinded. The intervention will comprise an online education and practice session (60 min) and 4 weeks of WhatsApp messaging (standardised, three times per week). Usual care will be attendance at a mothers group once per week for 3 weeks for information and support for ad hoc mother craft activities (standard practice provided by early childhood nurses for this local health district). The primary outcome will be the amount of infant tummy time using the GENEActiv accelerometer and a questionnaire (post intervention). The accelerometer will be worn on the right hip secured by an elastic belt around the waist. Wear and non-wear time will be classified using temperature and z-axis cut points as per previous research. This protocol paper presents the scientific background and proposed methods of the randomised controlled trial. Findings will inform the design of practically based strategies to inform clinicians, educators and parents about infant physical activity.Ethics and disseminationThe University of Wollongong and Illawarra Shoalhaven Local Health District Health and Medical Human Research Ethics Committee approved the study (2020/ETH02970). Dissemination plan is publication, staff training and conference presentations.Trial registration numberAustralian New Zealand Clinical Trials Registry ACTRN12621000575831; Pre-results.
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Borschmann, Rohan, Emma Molyneaux, Elizabeth Spry, Paul Moran, Louise M. Howard, Jacqui A. Macdonald, Stephanie J. Brown, Margarita Moreno-Betancur, Craig A. Olsson, and George C. Patton. "Pre-conception self-harm, maternal mental health and mother–infant bonding problems: a 20-year prospective cohort study." Psychological Medicine 49, no. 16 (December 18, 2018): 2727–35. http://dx.doi.org/10.1017/s0033291718003689.
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AbstractBackgroundSelf-harm in young people is associated with later problems in social and emotional development. However, it is unknown whether self-harm in young women continues to be a marker of vulnerability on becoming a parent. This study prospectively describes the associations between pre-conception self-harm, maternal depressive symptoms and mother–infant bonding problems.MethodsThe Victorian Intergenerational Health Cohort Study (VIHCS) is a follow-up to the Victorian Adolescent Health Cohort Study (VAHCS) in Australia. Socio-demographic and health variables were assessed at 10 time-points (waves) from ages 14 to 35, including self-reported self-harm at waves 3–9. VIHCS enrolment began in 2006 (when participants were aged 28–29 years), by contacting VAHCS women every 6 months to identify pregnancies over a 7-year period. Perinatal depressive symptoms were assessed with the Edinburgh Postnatal Depression Scale during the third trimester, and 2 and 12 months postpartum. Mother–infant bonding problems were assessed with the Postpartum Bonding Questionnaire at 2 and 12 months postpartum.ResultsFive hundred sixty-four pregnancies from 384 women were included. One in 10 women (9.7%) reported pre-conception self-harm. Women who reported self-harming in young adulthood (ages 20–29) reported higher levels of perinatal depressive symptoms and mother–infant bonding problems at all perinatal time points [perinatal depressive symptoms adjusted β = 5.40, 95% confidence interval (CI) 3.42–7.39; mother–infant bonding problems adjusted β = 7.51, 95% CI 3.09–11.92]. There was no evidence that self-harm in adolescence (ages 15–17) was associated with either perinatal outcome.ConclusionsSelf-harm during young adulthood may be an indicator of future vulnerability to perinatal mental health and mother–infant bonding problems.
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Ayton, Jennifer, Ingrid van der Mei, Karen Wills, Emily Hansen, and Mark Nelson. "Cumulative risks and cessation of exclusive breast feeding: Australian cross-sectional survey." Archives of Disease in Childhood 100, no. 9 (June 8, 2015): 863–68. http://dx.doi.org/10.1136/archdischild-2014-307833.
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ObjectivesTo estimate the prevalence of cessation of exclusive breast feeding at each month up to 6 months and document key factors and cumulative risks associated with exclusive breastfeeding cessation for children aged from 0 to 6 months.MethodsSecondary analysis using a national representative sample of 22 202 mother and infant pairs derived from the 2010 Australian Institute of Health and Welfare cross-sectional survey, the Australian Infant Feeding Survey.ResultsAmong breastfed infants, 49% had ceased exclusive breast feeding before they had reached 2 months of age. In the final Cox proportional hazards model, cessation of exclusive breast feeding was most strongly associated with partners preferring bottle feeding (HR 1.86, 95% CI 1.69 to 20.6) or having no preference (HR 1.37, 95% CI 1.33 to 1.42), regular dummy use (HR 1.35, 95% CI 1.31 to 1.39) and maternal obesity (HR 1.29, 95% CI 1.24 to 1.35). Living within the most disadvantaged areas of Australia (quintile 1) was not strongly associated with cessation (HR 1.08, 95% CI 1.02 to 1.14) compared with least disadvantaged areas. Having three risk factors significantly increased the risk of cessation by 31% (HR 1.31, 95% CI 1.07 to 1.6).ConclusionsThe prevalence of early cessation of exclusive breast feeding is alarmingly high with 50% of infants no longer exclusively breast fed by age 2 months. Given that not one factor is associated with cessation of exclusive breast feeding, the greatest public health impact is likely to be achieved when multiple risk factors are modified or prevented.
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Sved Williams, Anne E. "Perinatal and infant mental health in Australia: moving forward towards REAL prevention and early intervention – can we do it?" Australasian Psychiatry 25, no. 3 (April 27, 2017): 274–76. http://dx.doi.org/10.1177/1039856217700761.
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Objectives: Australia has been at the forefront of appropriate early intervention. Prevention of mental illness in infants by early identification and intervention in the mental health of their mothers has stalled since the cessation of funding through the National Perinatal Depression Initiative (NPDI, 2009–2015). Whilst screening for maternal mental illness has been widely implemented throughout Australia during the last two decades, services are now diminishing and great opportunities to ride the crest of a wave for appropriate mental illness intervention are receding. Reviews of history and interventions internationally may help guide future directions. Conclusions: Advocacy through across-agency and across-political-party support has been markedly successful for perinatal and infant mental health in the United Kingdom. A solid foundation exists in Australia. Australian psychiatrists have the ability to continue to change the face of prevention and early intervention.
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Taylor, Lee, Delyse Hutchinson, Ron Rapee, Lucy Burns, Christine Stephens, and Paul S. Haber. "Clinical Features and Correlates of Outcomes for High-Risk, Marginalized Mothers and Newborn Infants Engaged with a Specialist Perinatal and Family Drug Health Service." Obstetrics and Gynecology International 2012 (2012): 1–8. http://dx.doi.org/10.1155/2012/867265.
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Background. There is a paucity of research in Australia on the characteristics of women in treatment for illicit substance use in pregnancy and the health outcomes of their neonates.Aims. To determine the clinical features and outcomes of high-risk, marginalized women seeking treatment for illicit substance use in pregnancy and their neonates.Methods. 139 women with a history of substance abuse/dependence engaged with a perinatal drug health service in Sydney, Australia. Maternal (demographic, drug use, psychological, physical, obstetric, and antenatal care) and neonatal characteristics (delivery, early health outcomes) were examined.Results. Compared to national figures, pregnant women attending a specialist perinatal and family drug health service were more likely to report being Australian born, Aboriginal or Torres Strait Islander, younger, unemployed, and multiparous. Opiates were the primary drug of concern (81.3%). Pregnancy complications were common (61.9%). Neonates were more likely to be preterm, have low birth weight, and be admitted to special care nursery. NAS was the most prevalent birth complication (69.8%) and almost half required pharmacotherapy.Conclusion. Mother-infant dyads affected by substance use in pregnancy are at significant risk. There is a need to review clinical models of care and examine the longer-term impacts on infant development.
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Bailey, Cate, Susan Tawia, and Elizabeth McGuire. "Breastfeeding Duration and Infant Sleep Location in a Cohort of Volunteer Breastfeeding Counselors." Journal of Human Lactation 36, no. 2 (June 25, 2019): 354–64. http://dx.doi.org/10.1177/0890334419851801.
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Background Debate about mother and infant bed sharing has been polarized between supporters of bed sharing and public health policies that attempt to mitigate the risk of Sudden Infant Death Syndrome. Differences in group demographics may be an important aspect in co-sleeping acceptability. Research aims The first aim of this study was to investigate infant sleeping location in a dataset of mothers with strong breastfeeding outcomes. The second aim was to investigate the association between infant sleeping location and breastfeeding (exclusive breastfeeding to 6 months and total breastfeeding duration). Finally, we aimed to investigate predictors of breastfeeding duration. Methods Participants comprised 174 women who had applied to train as counselors with the Australian Breastfeeding Association. Data were compiled from a survey of the participants’ lactation histories, including questions related to the exclusivity and duration of breastfeeding, concerns about and problems encountered during breastfeeding, type of birth, medications during birth, demographics, and infant sleeping location. The study design was a cross-sectional, one-group survey design. Results A high proportion of participants in this study bed shared and room shared: At 0–1 month ( n = 58), 33% of participants bed-shared, which increased to 58% by 6–12 months ( n = 80). Infants who co-slept were more likely to be exclusively breastfed at 6 months (χ2 (2, n = 116) = 4.83, p = .03) and had longer breastfeeding duration ( t (62.61) = 3.81, p < .001). Conclusions Breastfeeding targets have been difficult to achieve globally, and innovative ideas are required to improve breastfeeding outcomes through public health messaging. There was a strong association in the current study between breastfeeding outcomes and degree of closeness of the infant to the mother at night. This finding should be brought into the discourse on breastfeeding and infant sleep arrangements, accompanied by evidence-based advice about safe sleeping and the promotion of breastfeeding.
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Hill, Rebecca, Daphne Law, Chris Yelland, and Anne Sved Williams. "Treatment of postpartum psychosis in a mother-baby unit: do both mother and baby benefit?" Australasian Psychiatry 27, no. 2 (January 21, 2019): 121–24. http://dx.doi.org/10.1177/1039856218822743.
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Objectives: To describe characteristics and treatments of mother-baby dyads affected by postpartum psychosis admitted to a specialist mother-baby inpatient psychiatric unit in Australia. Methods: A retrospective review of medical records for all mothers with postpartum psychosis and their babies admitted to a mother-baby unit over a 5-year period was conducted. Results: A total of 25 dyads met the study criteria. Affected women were found to be severely ill with a high rate of involuntary status (64%). They waited an average 4.7 days for a bed in the mother-baby unit. All received an atypical antipsychotic, with 16% receiving lithium augmentation. Infants were found to have generally normative growth and development, with relationship concerns noted in 5. A total of 36% of the cohort maintained some breastfeeding, and all had their infants in their care at discharge. Conclusions: The mother-baby unit enabled severely ill women to remain with their infants during treatment. While a minority of infants showed developmental concerns, appropriate development was noted in most. Future efforts should focus on determining the most effective treatments and further defining the risks and benefits for infants in mother-baby units.
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Liamputtong, Pranee. "Childrearing Practices and Child Health among the Hmong in Australia: Implications for Health Services." International Journal of Health Services 32, no. 4 (October 2002): 817–36. http://dx.doi.org/10.2190/ttlq-yc48-gtvq-3djh.
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This study of cultural beliefs and practices related to childrearing and child health among the Hmong in Melbourne, Australia, used in-depth interviews and participant observation of 27 Hmong mothers and some Hmong traditional healers between 1993 and 1998. Traditional Hmong beliefs and practices include: taking notice of the birth date and time, placing a silver necklace on the newborn, not praising the newborn, not taking the infant out during the first 30 days, breastfeeding, the infant's sharing a bed with the parents, and a soul-calling ceremony on the third day after birth. All Hmong mothers follow cultural beliefs and practices to prevent the ill-health or death of their newborn infants, but some aspects of these practices have had to be modified to suit the new living environment in Australia. Health care professionals need to acknowledge the different ways of caring for a young child among the Hmong so as to avoid misunderstandings and to provide sensitive care. Hmong beliefs and practices also have implications for health promotion campaigns and can be a valuable source of ideas in the efforts to promote infant health and reduce infant deaths in Australia and elsewhere.
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Rossen, Larissa, Delyse Hutchinson, Judy Wilson, Lucinda Burns, Steve Allsop, Elizabeth Elliott, Sue Jacobs, Jacqui Macdonald, Craig Olsson, and Richard Mattick. "Maternal Bonding through Pregnancy and Postnatal: Findings from an Australian Longitudinal Study." American Journal of Perinatology 34, no. 08 (February 17, 2017): 808–17. http://dx.doi.org/10.1055/s-0037-1599052.
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Background Mother-infant bonding provides the foundation for secure attachment through the lifespan and organizes many facets of infant social-emotional development, including later parenting. Aims To describe maternal bonding to offspring across the pregnancy and postnatal periods, and to examine a broad range of sociodemographic and psychosocial predictors of the maternal-offspring bond. Methods Data were drawn from a sample of 372 pregnant women participating in an Australian population-based longitudinal study of postnatal health and development. Participants completed maternal bonding questionnaires at each trimester and 8 weeks postnatal. Data were collected on a range of sociodemographic and psychosocial factors. Results Bonding increased significantly through pregnancy, in quality and intensity. Regression analyses indicated that stronger antenatal bonding at all time points (trimesters 1 through 3) predicted stronger postnatal bonding. Older maternal age, birth mother being born in a non-English speaking country, mother not working full time, being a first-time mother, breast-feeding problems, and baby's crying behavior all predicted poorer bonding at 8 weeks postpartum. Conclusion These novel findings have important implications for pregnant women and their infant offspring, and for health care professionals working in perinatal services. Importantly, interventions to strengthen maternal-fetal bonding would be beneficial during pregnancy to enhance postnatal bonding and infant health outcomes.
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Oei, Ju Lee, Mohamed E. Abdel-Latif, Fiona Craig, Aivy Kee, Marie-Paule Austin, and Kei Lui. "Short-Term Outcomes of Mothers and Newborn Infants with Comorbid Psychiatric Disorders and Drug Dependency." Australian & New Zealand Journal of Psychiatry 43, no. 4 (January 1, 2009): 323–31. http://dx.doi.org/10.1080/00048670902721087.
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Objectives: The aim of the present study was to determine the characteristics and short-term outcomes of mother–infant pairs with comorbid drug dependency and psychiatric disorders. Methods: A population-based retrospective chart review was carried out of 879 drug-dependent mother and infant pairs in New South Wales (NSW) and the Australian Capital Territory (ACT) who delivered between 1 January and 31 December 2004. Results: Psychiatric comorbidity (dual diagnosis, DD) was identified in 396 (45%) of the 879 drug-dependent women. DSM-IV depression (79%), followed by anxiety (20%), was most prevalent. DD women were more likely to use amphetamines (29% vs 18%, p < 0.05), less likely to use opiates (42% vs 51%, p < 0.05) and to have had no antenatal care (24% vs 8%, p < 0.05). They also had more previous pregnancies (4, range = 2–5 vs 3, range = 2–5, p < 0.05) and domestic violence (29% vs 14%, p < 0.05) was more common. DD infants were less likely to be admitted to a nursery (47% vs 55%, p < 0.05). Withdrawal scores were similar (maximum median Finnegan scores = 4 (interquartile range = 3–8) vs 10 (interquartile range = 7–12, p = 0.30) but fewer needed withdrawal medication (19% vs 27%, p < 0.05). Maternal psychotropic agents did not worsen the severity of neonatal withdrawal. Conclusions: Psychiatric comorbidity, especially depression, is common and affects almost half of drug-using mothers. Antenatal care, drug use and social outcomes are worse for DD mothers and their infants. It is recommended that all drug-using women be assessed antenatally for psychosocial disorders so that timely mental health intervention can be offered, if required.
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Best, Karen P., Tim J. Green, Dian C. Sulistyoningrum, Thomas R. Sullivan, Susanne Aufreiter, Susan L. Prescott, Maria Makrides, Monika Skubisz, Deborah L. O'Connor, and Debra J. Palmer. "Maternal Late-Pregnancy Serum Unmetabolized Folic Acid Concentrations Are Not Associated with Infant Allergic Disease: A Prospective Cohort Study." Journal of Nutrition 151, no. 6 (April 13, 2021): 1553–60. http://dx.doi.org/10.1093/jn/nxab040.
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ABSTRACT Background The increase in childhood allergic disease in recent decades has coincided with increased folic acid intakes during pregnancy. Circulating unmetabolized folic acid (UMFA) has been proposed as a biomarker of excessive folic acid intake. Objective We aimed to determine if late-pregnancy serum UMFA and total folate concentrations were associated with allergic disease risk in the offspring at 1 y of age in a population at high risk of allergy. Methods The cohort consisted of 561 mother–infant pairs from Western Australia. To be eligible the infant had to have a first-degree relative (mother, father, or sibling) with a history of medically diagnosed allergic disease. Maternal venous blood was collected between 36 and 40 wk of gestation. Serum UMFA was measured by LC–tandem MS. Serum total folate was determined using a microbiological method with chloramphenicol-resistant Lactobacillus rhamnosus as the test organism, and was collected between 36 and 40 wk of gestation. UMFA concentrations were measured by tandem MS using stable isotope dilution; folate concentrations were determined using the microbiological method with standardized kits. Infant allergic disease outcomes of medically diagnosed eczema, steroid-treated eczema, atopic eczema, IgE-mediated food allergy, allergen sensitization, and medically diagnosed wheeze were assessed at 1 y of age. Results Median (IQR) concentrations for UMFA and serum folate were 1.6 (0.6–4.7) and 53.2 (32.6–74.5) nmol/L, respectively. Of the infants, 34.6% had medically diagnosed eczema, 26.4% allergen sensitization, and 14.9% had an IgE-mediated food allergy. In both adjusted and unadjusted models there was little evidence of association between UMFA or serum folate and any of the infant allergy outcomes. Conclusions In this cohort of children at high risk of allergic disease there was no association between maternal UMFA or serum folate concentrations measured in late pregnancy and allergic disease outcomes at 1 y of age.
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Gould, Jacqueline F., Lisa N. Yelland, Robert A. Gibson, Andrew J. McPhee, Jojy Varghese, Rosalie Grivell, and Maria Makrides. "Protocol for a multicentre prospective observational study of families with full-term infants on postnatal wards and in the community to capture feeding practices across the first year of life: the Mother Infant Lactation Questionnaire (MILQ) study." BMJ Open 12, no. 10 (October 2022): e066355. http://dx.doi.org/10.1136/bmjopen-2022-066355.
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IntroductionBreastmilk is considered the gold standard for infant nutrition. Breast feeding is recommended as the sole source of nutrition between birth until around 6 months of age and should be continued beyond this age as complementary foods are introduced. While breast feeding initiation is generally high in developed countries, continuation of breast feeding appears to drop rapidly. This is a prospective observational study of life that aims to characterise a current picture of infant feeding practices across the first year, and motivations for feeding practices, and to identify barriers and enablers for breast feeding.Methods and analysisCaregivers with newborn singleton infants of normal birth weight are approached on the postnatal units of three hospitals in South Australia, or through targeted online advertising campaigns promoting the study. Caregivers are asked to complete surveys when their infant reaches 3, 5 and 7 weeks’, and at 3, 4, 5, 6, 9 and 12 months of age. Initially, baseline characteristics, intentions and preferences for infant milk feeds, as well as reasons for preferences are captured. Latter surveys query how infants are being fed, difficulties or barriers to breast feeding, as well as any enablers (if breast feeding). Once infants reach 5 months of age, surveys capture complementary feeding. A large opportunistic sample from the Adelaide community with a minimum of 1000 mother–infant pairs will be enrolled. The data will be analysed descriptively and using regression models.Ethics and disseminationWomen’s and Children’s Health Network Human Research Ethics Committee reviewed and approved the study (approval no HREC/19/WCHN/140, approval date: 22 November 2019). Study results will be disseminated through academic meetings, peer-reviewed journals, in-services for postnatal healthcare services, results letters for participants and social media.Trial registration numberACTRN12620000529943.
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Anusha, Kaneshapillai, Usha Hettiaratchi, Dulani Gunasekera, Shamini Prathapan, and Guwani Liyanage. "Maternal Vitamin D Status and Its Effect on Vitamin D Levels in Early Infancy in a Tertiary Care Centre in Sri Lanka." International Journal of Endocrinology 2019 (July 9, 2019): 1–6. http://dx.doi.org/10.1155/2019/9017951.
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Epidemiologic studies from South Asian countries have reported vitamin D deficiency among all age groups. However, there is very little information on vitamin D levels, especially in the vulnerable populations (pregnant/breast feeding mother and infants) in Sri Lanka. More data on vitamin D status of such populations will be important for policy decisions to be made at a national level. Similarly, it will be valuable for healthcare programs in other countries (e.g., United States, Australia, Europe, and Canada) as Sri Lankans are a fast-growing migrant population to those countries. The purpose of this study was to investigate maternal vitamin D status and its effects on infants in a state sector tertiary care centre in Sri Lanka. This prospective cohort study was conducted on 140 healthy pregnant mothers in the third trimester (mean gestational age 39±1 weeks). Blood was collected for 25(OH)D and parathyroid hormone (PTH). Sun exposure and feeding patterns of the infants were recorded based on maternal reporting. Mean age of the infants at follow-up visit was 36±7 days. Vitamin D (25 (OH)D) deficiency (<25 nmol/L) was observed in 12% pregnant mothers, 5% lactating mothers, and 63% infants. Insufficiency (<50 nmol/L) was found in an additional 51% and 43% in pregnant and lactating mothers and 25% of infants. Mean 25(OH)D was higher in pregnant (46.4±17.5 nmol/L) and lactating (51.9±17.0 nmol/L) mothers than infants (28.1±13.7 nmol/L). Maternal vitamin D level during pregnancy was a significant risk factor (OR: 6.00, 95%CI: 1.522-23.655) for infant deficiency and insufficiency. Sun exposure of infants showed a significant positive correlation with vitamin D level (OR: 3.23, 95%CI: 1.19-8.68). In conclusion, the presence of Vitamin D deficiency/insufficiency is higher in infants compared to pregnant/lactating mothers. Low maternal 25(OH)D during pregnancy was a risk factor for deficiency in infants. Although majority of lactating mothers had sufficient vitamin D, most of their exclusively breastfed offspring were deficient.
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Shannon, Jaylene, Kath Peters, and Stacy Blythe. "The Challenges to Promoting Attachment for Hospitalised Infants with NAS." Children 8, no. 2 (February 22, 2021): 167. http://dx.doi.org/10.3390/children8020167.
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The postnatal period is crucial for infants in establishing a connection with and security in primary caregivers and can have enduring effects on attachment patterns. However, due to the need for symptom management, many infants diagnosed with neonatal abstinence syndrome (NAS) may be separated from primary caregivers and cared for in a neonatal intensive care unit (NICU) or special care nursery (SCN) soon after birth. Research has shown that substance-exposed infants are more likely to experience insecure attachment patterns with their primary caregivers and that mothers with a history of substance abuse are less sensitive to their infants’ cues. Therefore, the aim of this research was to explore nurses’ and midwives’ experiences in promoting the attachment relationship for infants admitted to an NICU/SCN with NAS. A qualitative research design was used to gather data on the experiences of nine nurses/midwives from various NICU and SCN settings in Australia. Individual, semi-structured interviews were conducted, and transcribed interviews were coded using thematic analysis. While nurses/midwives valued the attachment relationship for infants with NAS, facilitation of the attachment relationship was mainly promoted when the mother was present. However, parents were often reported to be absent from the nursery. Difficulties in promoting an attachment relationship were also identified when an infant had child protection involvement. This research identifies areas in need of innovative change regarding the approach taken to promote the attachment relationship for infants with NAS when they are admitted to an NICU/SCN.
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Bunston, Wendy, Dianne J. Haufe, Jillian R. Wallis, Robyn Fletcher, and Adrian J. Mether. "Once upon a Pandemic: ‘Online’ Therapeutic Groupwork for Infants and Mothers Impacted by Family Violence." International Journal of Environmental Research and Public Health 19, no. 23 (December 2, 2022): 16143. http://dx.doi.org/10.3390/ijerph192316143.
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This case study describes the transition to an ‘online’ delivery of an evaluated infant mental health group work intervention for infants/mothers impacted by family violence during the COVID 19 pandemic. The imperative to provide early intervention to infants and their mother is outlined. The model and practice principles integral to this intervention are provided and described are four separate groups run online within two different Australian cities. Facilitators of the groups found that they were able to hold the infants and mothers safely in the online space despite the unexpected presence of others in the families’ homes. The home-based nature of the work caused by lockdown restrictions revealed a transparency not found in office-based work, whilst simultaneously, evoking some discomfort. The ease with which infants and young children embraced technology worked in favor of using the online space. Playful, restorative, and creative ways of engaging with a highly vulnerable cohort of families were achieved; enhancing relational repair following both family violence and the isolation created by restrictions imposed by lockdowns. Despite an initial hesitancy to move online, the authors discovered meaningful ways through which to engage, treat and provide safe relational repair work with infants and their mothers impacted by family violence.
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Chimoriya, Ritesh, Jane Anne Scott, James Rufus John, Sameer Bhole, Andrew Hayen, Gregory S. Kolt, and Amit Arora. "Determinants of Full Breastfeeding at 6 Months and Any Breastfeeding at 12 and 24 Months among Women in Sydney: Findings from the HSHK Birth Cohort Study." International Journal of Environmental Research and Public Health 17, no. 15 (July 27, 2020): 5384. http://dx.doi.org/10.3390/ijerph17155384.
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The aim of this study was to report on breastfeeding duration up to 24 months and determine the predictors of breastfeeding duration among women in South Western Sydney, one of the most culturally diverse and socioeconomically disadvantaged regions of New South Wales (NSW), Australia. Mother–infant dyads (n = 1035) were recruited to the Healthy Smiles Healthy Kids birth cohort study. Study data were collected through telephone interviews at 2, 4, 8, 12, and 24 months postpartum. Cox proportional hazards models were used to determine factors associated with the risk of stopping full breastfeeding at six months and any breastfeeding at 12 and 24 months. The majority of mothers (92.3%) had initiated breastfeeding. At six months, 13.5% of infants were fully breastfed, while 49.9% received some breast milk. Only 25.5% and 2.9% of infants received some breast milk at 12 and 24 months, respectively. Lower maternal education level, lower socioeconomic status, full-time employment, maternal smoking during pregnancy, and caesarean delivery were associated with increased risk of stopping full breastfeeding at six months and any breastfeeding at 12 and 24 months. Older maternal age and partner’s preference for breastfeeding were associated with an increased likelihood of continuing any breastfeeding at 12 and 24 months. These findings present a number of opportunities for prolonging breastfeeding duration in disadvantaged communities in NSW.
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Galbally, M., A. Sved-Williams, D. Kristianopulos, K. Mercuri, P. Brown, and A. Buist. "Comparison of public mother–baby psychiatric units in Australia: similarities, strengths and recommendations." Australasian Psychiatry 27, no. 2 (November 8, 2018): 112–16. http://dx.doi.org/10.1177/1039856218810165.
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Background: Mother–baby units are innovative and important models of care that allow inpatient treatment of postpartum maternal mental disorders whilst preserving and promoting the attachment relationship with their young infants. Objectives: To report data across five public mother–baby units in Australia in order to explore similarities and distinguishing features of each model. Method: Each unit also provided 12 months of data on key characteristics of their unit. Results: Despite the geographic differences, the diagnostic profiling, length of stay, and child protection involvement were similar across the units. Conclusions: Acute care for perinatal mental illness offered in public mother–baby units in Australia shows consistency across units, raising concerns for where such treatment is unavailable.
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Macdonald, Elspeth, Heather Mohay, Debra Sorensen, Neil Alcorn, Brett Mcdermott, and Erica Lee. "Current Delivery of Infantmental Health Services: Are Infant Mental Health Needs Being Met?" Australasian Psychiatry 13, no. 4 (December 2005): 393–98. http://dx.doi.org/10.1080/j.1440-1665.2005.02232.x.
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Objective: To identify services supporting the well-being of infants and their families in an area of South Brisbane, Australia, highlight problems of accessing these services and recommend strategies to make them more readily available. Method: Semistructured interviews were conducted with staff from 18 service providers offering antenatal services, or programmes primarily focused on children under the age of 2 years and/or their families. The interview aimed to identify the precise nature of the services offered, problems encountered in providing those services, perceived gaps in services and potential strategies for improvement. Results: Services were diverse, provided by a range of different professionals, in varying locations (home, community, hospital) and with funding from various sources. The major findings were:(i) the fragmentation of services, lack of communication between them, and lack of continuity in services from one stage of family formation to another; (ii) the shortage of services working with the parents and infant together; and (iii) the difficulty ofproviding services for some at-risk populations. Conclusions: Recommendations included: (i) maintaining a range of different services networked through a centralized resource/referral centre; (ii) expandingjoint mother–infant services and providing training for such services; and (iii) supporting outreach services for difficult to engage populations.
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Goldsmith, Jessie J., Patricia T. Campbell, Juan Pablo Villanueva-Cabezas, Rebecca H. Chisholm, Melita McKinnon, George G. Gurruwiwi, Roslyn G. Dhurrkay, et al. "Capturing Household Structure and Mobility within and between Remote Aboriginal Communities in Northern Australia Using Longitudinal Data: A Pilot Study." International Journal of Environmental Research and Public Health 19, no. 19 (September 22, 2022): 12002. http://dx.doi.org/10.3390/ijerph191912002.
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Cultural practices and development level can influence a population’s household structures and mixing patterns. Within some populations, households can be organized across multiple dwellings. This likely affects the spread of infectious disease through these communities; however, current demographic data collection tools do not record these data. Methods: Between June and October 2018, the Contact And Mobility Patterns in remote Aboriginal Australian communities (CAMP-remote) pilot study recruited Aboriginal mothers with infants in a remote northern Australian community to complete a monthly iPad-based contact survey. Results: Thirteen mother–infant pairs (participants) completed 69 study visits between recruitment and the end of May 2019. Participants reported they and their other children slept in 28 dwellings during the study. The median dwelling occupancy, defined as people sleeping in the same dwelling on the previous night, was ten (range: 3.5–25). Participants who completed at least three responses (n = 8) slept in a median of three dwellings (range: 2–9). Each month, a median of 28% (range: 0–63%) of the participants travelled out of the community. Including these data in disease transmission models amplified estimates of infectious disease spread in the study community, compared to models parameterized using census data. Conclusions: The lack of data on mixing patterns in populations where households can be organized across dwellings may impact the accuracy of infectious disease models for these communities and the efficacy of public health actions they inform.
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Jin, Ying, Jane Coad, Shao J. Zhou, Sheila Skeaff, Cheryl Benn, Nicholas Kim, Rachael L. Pond, and Louise Brough. "Mother and Infant Nutrition Investigation in New Zealand (MINI Project): Protocol for an Observational Longitudinal Cohort Study." JMIR Research Protocols 9, no. 8 (August 27, 2020): e18560. http://dx.doi.org/10.2196/18560.
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Background Thyroid dysfunction is associated with cognitive impairment, mood disturbance, and postnatal depression. Sufficient thyroid hormone synthesis requires adequate intake of iodine, selenium, and iron. Iodine deficiency was historically a problem for New Zealand, and initiatives were introduced to overcome the problem: (1) mandatory fortification of all bread (except organic) with iodized salt (2009) and (2) provision of subsidized iodine supplements for pregnant and breastfeeding women (2010). Subsequent to these initiatives, most adults and children have adequate iodine status; however, status among breastfeeding women and their infants remains unclear. This paper outlines the methodology of the Mother and Infant Nutrition Investigation (MINI) study: an observational longitudinal cohort study of breastfeeding women and their infants. Objective This study will determine (1) women’s iodine intake and status among supplement users and nonusers; (2) women’s intake and status of iodine, selenium, and iron relating to thyroid function; (3) associations between women’s selenium status, thyroid function, and postnatal depression; (4) infants’ iodine and selenium status relating to first year neurodevelopment. Methods Breastfeeding women aged over 16 years with a healthy term singleton infant were recruited from Manawatu, New Zealand. Participants attended study visits 3, 6, and 12 months postpartum. Maternal questionnaires investigated supplement use before and after birth, iodine knowledge, and demographic information. Dietary assessment and urine, blood, and breast milk samples were taken to measure iodine, selenium, and iron intake/status. The Edinburgh Postnatal Depression Scale was used repeatedly to screen for postnatal depression. Thyroid hormones (free triiodothyronine, free thyroxine, thyroid stimulating hormone, thyroglobulin, antithyroglobulin antibodies, and antithyroid peroxidase) were measured in blood samples, and thyroid gland volume was measured by ultrasound at 6 months postpartum. Infant iodine and selenium concentrations were determined in urine. The Ages and Stages Questionnaire was used to assess infant development at 4, 8, and 12 months. Results Data collection was completed. Biological samples analysis, excluding nail clippings, is complete. Data analysis and presentation of the results will be available after 2020. Conclusions This study will provide data on the current iodine status of breastfeeding women. It will also provide a greater understanding of the three essential minerals required for optimal thyroid function among breastfeeding women. The prospective longitudinal design allows opportunities to examine women’s mental health and infant neurodevelopment throughout the first year, a crucial time for both mothers and their infants. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12615001028594; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369324 International Registered Report Identifier (IRRID) DERR1-10.2196/18560
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Bilston-John, Sabrina H., Ardra Narayanan, Ching T. Lai, Alethea Rea, John Joseph, and Donna T. Geddes. "Macro- and Trace-Element Intake from Human Milk in Australian Infants: Inadequacy with Respect to National Recommendations." Nutrients 13, no. 10 (October 9, 2021): 3548. http://dx.doi.org/10.3390/nu13103548.
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Longitudinal variations of macro- and trace elements in human milk (HM) are not well characterised, and therefore, the recommendations for intake for Australian infants require more evidence to ensure accuracy. We aimed to investigate the longitudinal variation of HM macro- and trace-element concentrations (1–12 months) and infant intake (1–6 months) and to investigate the relationships between intake and infant growth parameters at 3 and 6 months, and determine if intake was sufficient when compared to national guidelines. HM samples were collected monthly for the first 6 months and then at 9 and 12 months postpartum from mother–infant dyads (n = 83). Test–weighing was used to determine the volume of HM consumed daily. Element concentrations (Na, Ca, K, Mg, P, I, Se, Zn, Cu, Mn, Mo, and Fe) were measured using ICP-MS, and intake was calculated using the measured concentrations and the volume of HM consumed. The average intake of HM was 776.3 ± 24.0 mL for the infants. Changes in concentration from months 1 to 12 postpartum were observed for all the measured micronutrients (all p < 0.05). The calculated intakes of all the macro- and trace elements showed that 0% to 82% of infants met the current adequate recommendations at varying periods of lactation. The calculated macro- and trace-element intakes were below the adequate intake recommendations, suggesting that they are not reflective of healthy infant requirements. These findings suggest the need for larger studies using sensitive analytical techniques and the revision of current recommendations for breastfed infants.
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Kostenzer, Johanna, Charlotte von Rosenstiel-Pulver, Julia Hoffmann, Aisling Walsh, Silke Mader, and Luc J. I. Zimmermann. "Parents’ experiences regarding neonatal care during the COVID-19 pandemic: country-specific findings of a multinational survey." BMJ Open 12, no. 4 (April 2022): e056856. http://dx.doi.org/10.1136/bmjopen-2021-056856.
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ObjectivesThe COVID-19 pandemic has disrupted healthcare systems, challenging neonatal care provision globally. Curtailed visitation policies are known to negatively affect the medical and emotional care of sick, preterm and low birth weight infants, compromising the achievement of the 2030 Development Agenda. Focusing on infant and family-centred developmental care (IFCDC), we explored parents’ experiences of the disruptions affecting newborns in need of special or intensive care during the first year of the pandemic.DesignCross-sectional study using an electronic, web-based questionnaire.SettingMulticountry online-survey.MethodsData were collected between August and November 2020 using a pretested online, multilingual questionnaire. The target group consisted of parents of preterm, sick or low birth weight infants born during the first year of the COVID-19 pandemic and who received special/intensive care. The analysis followed a descriptive quantitative approach.ResultsIn total, 1148 participants from 12 countries (Australia, Brazil, Canada, China, France, Italy, Mexico, New Zealand, Poland, Sweden, Turkey and Ukraine) were eligible for analysis. We identified significant country-specific differences, showing that the application of IFCDC is less prone to disruptions in some countries than in others. For example, parental presence was affected: 27% of the total respondents indicated that no one was allowed to be present with the infant receiving special/intensive care. In Australia, Canada, France, New Zealand and Sweden, both the mother and the father (in more than 90% of cases) were allowed access to the newborn, whereas participants indicated that no one was allowed to be present in China (52%), Poland (39%), Turkey (49%) and Ukraine (32%).ConclusionsThe application of IFCDC during the COVID-19 pandemic differs between countries. There is an urgent need to reconsider separation policies and to strengthen the IFCDC approach worldwide to ensure that the 2030 Development Agenda is achieved.
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Rehayem, Amanda, Sarah Taki, Nicola Brown, and Elizabeth Denney-Wilson. "Infant feeding beliefs and practices of Arabic mothers in Australia." Women and Birth 33, no. 4 (July 2020): e391-e399. http://dx.doi.org/10.1016/j.wombi.2019.07.004.
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Frank, Michael C., Katherine Jane Alcock, Natalia Arias-Trejo, Gisa Aschersleben, Dare Baldwin, Stéphanie Barbu, Elika Bergelson, et al. "Quantifying Sources of Variability in Infancy Research Using the Infant-Directed-Speech Preference." Advances in Methods and Practices in Psychological Science 3, no. 1 (March 2020): 24–52. http://dx.doi.org/10.1177/2515245919900809.
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Psychological scientists have become increasingly concerned with issues related to methodology and replicability, and infancy researchers in particular face specific challenges related to replicability: For example, high-powered studies are difficult to conduct, testing conditions vary across labs, and different labs have access to different infant populations. Addressing these concerns, we report on a large-scale, multisite study aimed at (a) assessing the overall replicability of a single theoretically important phenomenon and (b) examining methodological, cultural, and developmental moderators. We focus on infants’ preference for infant-directed speech (IDS) over adult-directed speech (ADS). Stimuli of mothers speaking to their infants and to an adult in North American English were created using seminaturalistic laboratory-based audio recordings. Infants’ relative preference for IDS and ADS was assessed across 67 laboratories in North America, Europe, Australia, and Asia using the three common methods for measuring infants’ discrimination (head-turn preference, central fixation, and eye tracking). The overall meta-analytic effect size (Cohen’s d) was 0.35, 95% confidence interval = [0.29, 0.42], which was reliably above zero but smaller than the meta-analytic mean computed from previous literature (0.67). The IDS preference was significantly stronger in older children, in those children for whom the stimuli matched their native language and dialect, and in data from labs using the head-turn preference procedure. Together, these findings replicate the IDS preference but suggest that its magnitude is modulated by development, native-language experience, and testing procedure.
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Drever-Smith, Cassia, Fiona Bogossian, and Karen New. "Co-Sleeping and Bed Sharing in Australian Maternity Units: An Electronic Survey of Midwifery Clinicians’ Knowledge, Practice, and Education." International Journal of Childbirth 5, no. 1 (2015): 33–43. http://dx.doi.org/10.1891/2156-5287.5.1.33.
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BACKGROUND: There is little published research regarding co-sleeping and bed sharing in maternity units. As primary carers of mothers and infants, midwives’ knowledge and practice may influence co-sleeping and bed sharing.AIM: To assess clinical midwives’ knowledge and practice surrounding co-sleeping and bed sharing in maternity units in the initial postpartum period.METHODS: A nationwide electronic survey assessed clinical knowledge and self-reported clinical practice and personal experiences of co-sleeping and bed sharing.FINDINGS: Eighty-six registered midwives from 48 hospitals responded to the survey. The majority responded with best practice to hypothetical scenarios. Mother–infant co-sleeping/bed sharing in maternity units was observed by 64% of midwives. All midwives reported providing some education to parents and most (80%) had received education on co-sleeping/bed sharing.CONCLUSION: Co-sleeping and bed sharing are relatively common in postnatal maternity units. Clinical practice documents should be consistent with the UNICEF guidelines, and midwives should be supported to implement best practice.
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Thorley, Virginia. "Accounts of infant-feeding advice received by mothers: Queensland, Australia, 1945-1965." Nursing Reports 2, no. 1 (October 31, 2012): 12. http://dx.doi.org/10.4081/nursrep.2012.e12.
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In the period 1945-1965 most women in the state of Queensland, Australia, gave birth in hospitals and thereafter they used a variety of services and individuals for advice on infant feeding. The services available were similar throughout the period. As mothers rarely worked outside the home, being <em>good mothers</em> was important to their identity. In this historical study, telephone interviews and written responses involving 44 mothers and former nurses from every region of this geographically vast state were used in order to investigate sources of personal advice on infant feeding used during this period, mothers’ experience relating to this advice, and the extent to which they followed the advice. The free, nurse-run well-baby clinics and related services conducted by the state’s Maternal and Child Welfare service were the most commonly mentioned services. However, the uptake of advice from this source showed considerable variation as women also drew upon family members, their general practitioners, advice columns, radio broadcasts, other mothers and their own judgment. Only rarely was a specialist pediatrician consulted. A minority of mothers was advised by pharmacists, private baby nurses, or entered residential mothercraft facilities. An important finding is that attendance at the baby clinics did not necessarily equate with compliance, especially as mothers became more experienced.
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Mauch, Chelsea Emma, R. A. Perry, A. M. Magarey, and L. A. Daniels. "Dietary intake in Australian children aged 4–24 months: consumption of meat and meat alternatives." British Journal of Nutrition 113, no. 11 (April 23, 2015): 1761–72. http://dx.doi.org/10.1017/s0007114515000719.
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Meat/meat alternatives (M/MA) are key sources of Fe, Zn and protein, but intake tends to be low in young children. Australian recommendations state that Fe-rich foods, including M/MA, should be the first complementary foods offered to infants. The present paper reports M/MA consumption of Australian infants and toddlers, compares intake with guidelines, and suggests strategies to enhance adherence to those guidelines. Mother–infant dyads recruited as part of the NOURISH and South Australian Infants Dietary Intake studies provided 3 d of intake data at three time points: Time 1 (T1) (n482, mean age 5·5 (sd1·1) months), Time 2 (T2) (n600, mean age 14·0 (sd1·2) months) and Time 3 (T3) (n533, mean age 24 (sd0·7) months). Of 170 infants consuming solids and aged greater than 6 months at T1, 50 (29 %) consumed beef, lamb, veal (BLV) or pork on at least one of 3 d. Commercial infant foods containing BLV or poultry were the most common form of M/MA consumed at T1, whilst by T2 BLV mixed dishes (including pasta bolognaise) became more popular and remained so at T3. The processed M/MA increased in popularity over time, led by pork (including ham). The present study shows that M/MA are not being eaten by Australian infants or toddlers regularly enough; or in adequate quantities to meet recommendations; and that the form in which these foods are eaten can lead to smaller M/MA serve sizes and greater Na intake. Parents should be encouraged to offer M/MA in a recognisable form, as one of the first complementary foods, in order to increase acceptance at a later age.
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Mulcahy, Brendan, Daniel L. Rolnik, Alexia Matheson, Yizhen Liu, Kirsten R. Palmer, Ben W. Mol, and Atul Malhotra. "Preterm Infant Outcomes Following COVID-19 Lockdowns in Melbourne, Australia." Children 8, no. 12 (December 10, 2021): 1169. http://dx.doi.org/10.3390/children8121169.
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Background Community lockdowns during the coronavirus disease 2019 (COVID-19) pandemic may influence preterm birth rates, but mechanisms are unclear. Methods We compared neonatal outcomes of preterm infants born to mothers exposed to community lockdowns in 2020 (exposed group) to those born in 2019 (control group). Main outcome studied was composite of significant neonatal morbidity or death. Results Median gestational age was 35 + 4 weeks (295 infants, exposed group) vs. 35 + 0 weeks (347 infants, control group) (p = 0.108). The main outcome occurred in 36/295 (12.2%) infants in exposed group vs. 46/347 (13.3%) in control group (p = 0.69). Continuous positive airway pressure (CPAP) use, jaundice requiring phototherapy, hypoglycaemia requiring treatment, early neonatal white cell and neutrophil counts were significantly reduced in the exposed group. Conclusions COVID-19 community lockdowns did not alter composite neonatal outcomes in preterm infants, but reduced rates of some common outcomes as well as early neonatal inflammatory markers.
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Do, Loc G., Diep H. Ha, Lucinda K. Bell, Gemma Devenish, Rebecca K. Golley, Sam D. Leary, David J. Manton, W. Murray Thomson, Jane A. Scott, and A. John Spencer. "Study of Mothers’ and Infants’ Life Events Affecting Oral Health (SMILE) birth cohort study: cohort profile." BMJ Open 10, no. 10 (October 2020): e041185. http://dx.doi.org/10.1136/bmjopen-2020-041185.
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PurposeThe long-term goal of the Study of Mothers’ and Infants’ Life Events Affecting Oral Health (SMILE) birth cohort study is to identify and evaluate the relative importance and timing of critical factors that shape the oral health of young children. It will then evaluate those factors in their inter-relationship with socioeconomic influences.ParticipantsSMILE is a single-centre study conducted in Adelaide, Australia. All newborns at the main three public hospitals between July 2013 and August 2014 were eligible for inclusion. The final recruited sample at birth was 2181 mother/infant dyads. Participants were followed up with questionnaires when the child was 3 and 6 months of age, and 1, 2 and 5 years of age. Oral epidemiological examinations and anthropometric assessments were conducted at age 2 and 5 years.Findings to dateSMILE has contributed comprehensive data on dietary patterns of young children. Intakes of free sugars, core and discretionary foods and drinks have been detailed. There was a sharp increase in free sugars intake with age. Determinants of dietary patterns, oral health status and body weight during the first 5 years of life have been evaluated. Socioeconomic characteristics such as maternal education and household income and area-level socioeconomic profile influenced dietary patterns and oral health behaviours and status.Future planFunding has been obtained to conduct oral epidemiological examinations and anthropometric assessments at age 7–8 years. Plans are being developed to follow the cohort into adolescent years.
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Edvardsson, Kristina, Elizabeth Hughes, Beverley Copnell, Ingrid Mogren, Don Vicendese, and Richard Gray. "Severe mental illness and pregnancy outcomes in Australia. A population-based study of 595 792 singleton births 2009–2016." PLOS ONE 17, no. 2 (February 28, 2022): e0264512. http://dx.doi.org/10.1371/journal.pone.0264512.
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Background Women with Severe Mental Illness (SMI) may have more complex pregnancies and pregnancy outcomes that require different care and management, but this has not been extensively studied. The aim of this study was to explore associations between SMI and adverse maternal and infant outcomes in the state of Victoria, Australia. Methods Our sample included all reported live singleton births in Victoria 2009–2016 (N = 595 792). Associations between SMI and adverse pregnancy outcomes were explored using Odds Ratios (OR), adjusted for sociodemographic and lifestyle factors, and co-morbidities, including any other mental illness. Results Of all singleton births, 2046 (0.34%) were to a mother diagnosed with a SMI. We found evidence of an association between SMI and a range of adverse maternal and infant outcomes. Compared to women without SMI, women with a SMI had higher adjusted odds of being admitted to a High Dependency Unit or Intensive Care Unit (aOR 1.83, 1.37–2.43), having gestational diabetes mellitus (1.57, 1.34–1.84), undergoing an unplanned caesarean section (1.17, 1.02–1.33), induction of labour (1.17, 1.05–1.30) and postpartum haemorrhage (1.15, 1.03–1.29). Newborns of women with SMI had higher adjusted odds of being admitted to Special Care Nursery (aOR 1.61, 1.43–1.80), a low Apgar score at 5 minutes (1.50, 1.19–1.90), preterm birth (1.40, 1.20–1.63), and low birthweight (1.26, 1.06–1.49). Conclusion Women with SMI are at higher risk for a range of adverse maternal and infant outcomes and are a population that may benefit from targeted early identification and enhanced antenatal care.
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Rossen, Larissa, Richard P. Mattick, Judy Wilson, Lucinda Burns, Jacqui A. Macdonald, Craig Olsson, Steve Allsop, et al. "Mother-Infant and Partner-Infant Emotional Availability at 12 Months of Age: Findings From an Australian Longitudinal Study." Infancy 23, no. 6 (August 6, 2018): 893–916. http://dx.doi.org/10.1111/infa.12247.
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Irvine, Vanessa, James Rufus John, Jane A. Scott, Andrew Hayen, Loc Giang Do, Sameer Bhole, Diep Ha, Gregory S. Kolt, and Amit Arora. "Factors Influencing the Early Introduction of Sugar Sweetened Beverages among Infants: Findings from the HSHK Birth Cohort Study." Nutrients 12, no. 11 (October 30, 2020): 3343. http://dx.doi.org/10.3390/nu12113343.
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Understanding the determinants of early introduction of sugar sweetened beverages (SSBs) may assist in designing effective public health interventions to prevent childhood weight related conditions (obesity). This study explores the relationship between family/infant characteristics and the early introduction of SSBs among infants in Sydney, Australia. Mothers (n = 934) from an ongoing birth cohort study were interviewed at 8, 17, 34, and 52 weeks postpartum. Multivariable logistic regression analysis was used to identify family/infant factors independently associated with the likelihood of early introduction of SSBs (<52 weeks of age). Of the 934 mothers interviewed, 42.7% (n = 399) of infants were introduced to SSBs before 52 weeks. Mothers who were born in Vietnam (adjusted Odds Ratio (AOR) = 2.14; 95% confidence interval (CI) 1.33, 3.47), other Asian countries (AOR = 1.62; 95% CI 1.02, 2.58) as well as single mothers (AOR = 3.72; 95% CI 2.46, 5.62) had higher odds of introducing SSBs early to their infants. Mothers from highly advantaged socioeconomic background (AOR = 0.43; 95% CI 0.28, 0.68), those who breastfed their baby for 17–25 weeks (AOR = 0.60; 95% CI 0.37, 0.99), 26–51 weeks (AOR = 0.65; 95% CI 0.45, 0.94), and 52 weeks or more (AOR = 0.62; 95% CI 0.43, 0.90); and those who introduced solids between 17–25 weeks (AOR = 0.58; 95% CI 0.36, 0.91) and 26 weeks or more (AOR = 0.55; 95% CI 0.34, 0.91) had reduced odds of introducing SSBs early. Tailoring health promotion programs for these vulnerable groups may delay the introduction of SSBs.
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Coxon, Claire, Gemma Devenish, Diep Ha, Loc Do, and Jane A. Scott. "Sources and Determinants of Discretionary Food Intake in a Cohort of Australian Children Aged 12–14 Months." International Journal of Environmental Research and Public Health 17, no. 1 (December 20, 2019): 80. http://dx.doi.org/10.3390/ijerph17010080.
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Despite recommendations to the contrary, consumption of discretionary (energy-dense, nutrient-poor) foods begins for some children early in the weaning period, and the proportion of children consuming discretionary foods increases markedly in the second year of life. The purpose of this study was to determine intake and sources of discretionary foods in a cohort of 828 Australian toddlers (mean age: 13.1mo), and to identify determinants of discretionary food intake. At approximately 12 months of age, 3 non-consecutive days of dietary intake data were collected using a 24-h recall and 2-day food record, and the percentage total energy derived from discretionary foods was estimated. Linear regression was used to identify associations between discretionary food intake and socio-demographic determinants (mother’s age, level of education, country of birth, pre-pregnancy body mass index, socioeconomic position, parity, age of child when mother returned to work, and child’s sex) and age at which complementary foods were introduced. The average energy intake of children in this cohort was 4040 (±954.7 SD) kJ with discretionary foods contributing an average of 11.2% of total energy. Sweet biscuits, and cakes, muffins, scones and cake-type desserts contributed 10.8% and 10.2% of energy intake from discretionary foods, respectively. Other key contributors to energy intake from discretionary foods included sausages, frankfurters and saveloys (8.3%), vegetable products and dishes where frying was the main cooking technique (8.6%), butter (7.3%), and finally manufactured infant sweet or savory snack foods (9.3%). Higher intakes of discretionary food were associated with children having two or more siblings (p = 0.002), and being born to younger mothers (<25 years) (p = 0.008) and mothers born in Australia or the United Kingdom (p < 0.001). Parents, in particular young mothers and those with larger families, need practical guidance on how much of, and how often, these foods should be eaten by their children.
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Li, Lin, Min Zhang, Jane A. Scott, and Colin W. Binns. "Infant feeding practices in home countries and Australia: Perth Chinese mothers survey." Nutrition & Dietetics 62, no. 2-3 (September 26, 2005): 82–88. http://dx.doi.org/10.1111/j.1747-0080.2005.00006.x.
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George, Alexandra D., Melvin C. L. Gay, Mary E. Wlodek, Kevin Murray, and Donna T. Geddes. "The Fatty Acid Species and Quantity Consumed by the Breastfed Infant Are Important for Growth and Development." Nutrients 13, no. 11 (November 22, 2021): 4183. http://dx.doi.org/10.3390/nu13114183.
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The fatty acids (FAs) of human milk (HM) are the building blocks of the HM lipidome, contributing to infant health and development; however, this has not been comprehensively characterised with respect to infant intake. Eighteen Western Australian mother–infant dyads provided monthly longitudinal HM samples during six months of exclusive breastfeeding. Monthly anthropometric measurements, health data and basic maternal food frequency data were also collected. At three months, infant 24 h milk intake and total lipid intake were measured. The FA profile was analysed using gas chromatography–mass spectrometry. Linear regression and Pearson’s correlation were used to identify associations between HM FA composition, HM FA intake, maternal characteristics and infant growth and developmental outcomes. Mean infant intake of total lipids was 29.7 ± 9.4 g/day. HM FA composition exhibited wide variation between dyads and throughout lactation. Infant intake of a number of FAs, including C15:0, C18:1, C18:2 and C20:3, was positively related to infant growth (all p < 0.001). There were no relationships detected between C22:5 and C20:5 and infant head circumference. Infant total lipid intake and the infant intake of many FAs play essential roles in infant growth and development. This study highlights the important relationships of many HM FAs not previously described, including C15:0 and C18:2 species. Infant outcomes should be considered in the context of intake in future HM studies.
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Homer, Caroline S. E., Seong L. Cheah, Chris Rossiter, Hannah G. Dahlen, David Ellwood, Maralyn J. Foureur, Della A. Forster, et al. "Maternal and perinatal outcomes by planned place of birth in Australia 2000 – 2012: a linked population data study." BMJ Open 9, no. 10 (October 2019): e029192. http://dx.doi.org/10.1136/bmjopen-2019-029192.
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ObjectiveTo compare perinatal and maternal outcomes for Australian women with uncomplicated pregnancies according to planned place of birth, that is, in hospital labour wards, birth centres or at home.DesignA population-based retrospective design, linking and analysing routinely collected electronic data. Analysis comprised χ2tests and binary logistic regression for categorical data, yielding adjusted ORs. Continuous data were analysed using analysis of variance.SettingAll eight Australian states and territories.ParticipantsWomen with uncomplicated pregnancies who gave birth between 2000 and 2012 to a singleton baby in cephalic presentation at between 37 and 41 completed weeks’ gestation. Of the 1 251 420 births, 1 171 703 (93.6%) were planned in hospital labour wards, 71 505 (5.7%) in birth centres and 8212 (0.7%) at home.Main outcome measuresMode of birth, normal labour and birth, interventions and procedures during labour and birth, maternal complications, admission to special care/high dependency or intensive care units (mother or infant) and perinatal mortality (intrapartum stillbirth and neonatal death).ResultsCompared with planned hospital births, the odds of normal labour and birth were over twice as high in planned birth centre births (adjusted OR (AOR) 2.72; 99% CI 2.63 to 2.81) and nearly six times as high in planned home births (AOR 5.91; 99% CI 5.15 to 6.78). There were no statistically significant differences in the proportion of intrapartum stillbirths, early or late neonatal deaths between the three planned places of birth.ConclusionsThis is the first Australia-wide study to examine outcomes by planned place of birth. For healthy women in Australia having an uncomplicated pregnancy, planned births in birth centres or at home are associated with positive maternal outcomes although the number of homebirths was small overall. There were no significant differences in the perinatal mortality rate, although the absolute numbers of deaths were very small and therefore firm conclusions cannot be drawn about perinatal mortality outcomes.
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MOHSIN, M., F. WONG, ADRIAN BAUMAN, and JUN BAI. "MATERNAL AND NEONATAL FACTORS INFLUENCING PREMATURE BIRTH AND LOW BIRTH WEIGHT IN AUSTRALIA." Journal of Biosocial Science 35, no. 2 (April 2003): 161–74. http://dx.doi.org/10.1017/s0021932003001615.
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This study identified the influences of neonatal and maternal factors on premature birth and low birth weight in New South Wales, Australia. Bivariate and multivariate analyses were used to explore the association of selected neonatal and maternal characteristics with premature birth and low birth weight. The findings of this study showed that premature birth and low birth weight rate significantly varied by infant sex, maternal age, marital status, Aboriginality, parity, maternal smoking behaviour during pregnancy and maternal hypertension. First-born infants, and infants born to mothers aged less than 20 years, or who were single, separated/divorced, Aboriginal or who smoked during the pregnancy, were at increased risk of being premature or of low birth weight. This study also found that risk factors for premature births and low birth weight were similar in both singleton and multiple births. Gestational age was confirmed to be the single most important risk factor for low birth weight. The findings of this study suggest that in order to reduce the incidence of low birth weight and premature births, health improvement strategies should focus on antismoking campaigns during pregnancy and other healthcare programmes targeted at the socially disadvantaged populations identified in the study.
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Dawson, Samantha L., Jeffrey M. Craig, Gerard Clarke, Mohammadreza Mohebbi, Phillip Dawson, Mimi LK Tang, and Felice N. Jacka. "Targeting the Infant Gut Microbiota Through a Perinatal Educational Dietary Intervention: Protocol for a Randomized Controlled Trial." JMIR Research Protocols 8, no. 10 (October 21, 2019): e14771. http://dx.doi.org/10.2196/14771.
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Background The early life gut microbiota are an important regulator of the biological pathways contributing toward the pathogenesis of noncommunicable disease. It is unclear whether improvements to perinatal diet quality could alter the infant gut microbiota. Objective The aim of this study is to assess the efficacy of a perinatal educational dietary intervention in influencing gut microbiota in mothers and infants 4 weeks after birth. Methods The Healthy Parents, Healthy Kids randomized controlled trial aimed to recruit 90 pregnant women from Melbourne, Victoria, Australia. At week 26 of gestation, women were randomized to receive dietary advice from their doctor (n=45), or additionally receive a dietary intervention (n=45). The intervention included an educational workshop and 2 support calls aiming to align participants’ diets with the Australian Dietary Guidelines and increase intakes of prebiotic and probiotic foods. The educational design focused on active learning and self-assessment. Behavior change techniques were used to support dietary adherence, and the target behavior was eating for the gut microbiota. Exclusion criteria were age under 18 years, diagnosed mental illnesses, obesity, diabetes mellitus, diagnosed bowel conditions, exclusion diets, illicit drug use, antibiotic use, prebiotic or probiotic supplementation, and those lacking dietary autonomy. The primary outcome measure is a between-group difference in alpha diversity in infant stool collected 4 weeks after birth. Secondary outcomes include evaluating the efficacy of the intervention in influencing infant and maternal stool microbial composition and short chain fatty acid concentrations, epigenetic profile, and markers of inflammation and stress, as well as changes in maternal dietary intake and well-being. The study and intervention feasibility and acceptance will also be evaluated as secondary outcomes. Results The study results are yet to be written. The first participant was enrolled on July 28, 2016, and the final follow-up assessment was completed on October 11, 2017. Conclusions Data from this study will provide new insights regarding the ability of interventions targeting the perinatal diet to alter the maternal and infant gut microbiota. If this intervention is proven, our findings will support larger studies aiming to guide the assembly of gut microbiota in early life. Trial Registration Australian Clinical Trials Registration Number ACTRN12616000936426; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=370939 International Registered Report Identifier (IRRID) DERR1-10.2196/14771
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Kuswara, Konsita, Rachel Laws, Peter Kremer, Kylie D. Hesketh, and Karen J. Campbell. "The infant feeding practices of Chinese immigrant mothers in Australia: A qualitative exploration." Obesity Research & Clinical Practice 13, no. 1 (January 2019): 91–92. http://dx.doi.org/10.1016/j.orcp.2016.10.247.
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Kuswara, Konsita, Rachel Laws, Peter Kremer, Kylie D. Hesketh, and Karen J. Campbell. "The infant feeding practices of Chinese immigrant mothers in Australia: A qualitative exploration." Appetite 105 (October 2016): 375–84. http://dx.doi.org/10.1016/j.appet.2016.06.008.
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