Determinants of infant behavior and growth in breastfed late preterm and early term infants:a secondary data analysis

Background Late preterm and early term infants are at increased risk of poor growth,behavioral problems,and developmental delays.This study aimed to investigate the impact of maternal and infant characteristics,feeding practices,and breastmilk composition on infant behavior following late preterm and early term delivery,and to evaluate the association between infant behavior and growth.Methods Data from 52 Chinese mothers and their late preterm/early term infants participating in the Breastfeed a Better Youngster study were used.Maternal and infant characteristics were collected using questionnaires at 1 week postpartum.Breastmilk macronutrient content was measured using a human milk analyzer,and infant behavior was assessed using a 3-day infant behavior diary at 8 weeks postpartum.Feeding practices were collected at both time points using questionnaires.Multivariate models were used to assess associations between potential predictors and infant behavior and between infant behavior and growth.Results Exclusive breastfeeding was associated with greater sleep duration(P=0.02)and shorter crying duration(P=0.01).Mothers with a vocational education reported greater distress duration(P=0.006).Greater colic duration was associated with higher maternal annual income(P=0.004).There was no significant association between infant behavior and growth(all P>0.05).Conclusions Exclusive breastfeeding might promote more favorable infant behaviors in late preterm/early term infants,while the development of infant distress behaviors was associated with some maternal characteristics(maternal education and annual income).However,due to the limitations of diary methods,determinants of infant behavior should ideally be assessed using more objective measures in larger samples.

Maternal mental health and well-being during the COVID-19 pandemic in Beijing, China

Background The aim of this study is to evaluate the impact of the coronavirus disease 2019(COVID-19)pandemic on breastfeeding women and to identify predictors of maternal mental health and coping.Methods Mothers aged≥18 years with a breast-fed infant≤18 months of age during the COVID-19 pandemic in Beijing,China,completed a questionnaire.Descriptive analysis of lockdown consequences was performed and predictors of these outcomes were examined using stepwise linear regression.Results Of 2233 participants,29.9%,20.0%and 34.7%felt down,lonely,and worried,respectively,during the lockdown;however,85.3%felt able to cope.Poorer maternal mental health was predicted by maternal(younger age,higher education)and infant(older age,lower gestation)characteristics,and social circumstances(husband unemployed or working from home,receiving advice from family,having enough space for the baby,living close to a park or green space).Conversely,better maternal mental health was predicted by higher income,employment requiring higher qualifications,more personal space at home,shopping or walking>once/week and lack of impact of COVID-19 on job or income.Mothers with higher education,more bedrooms,fair division of household chores and attending an online mother and baby group>once/week reported better coping.Conclusion The findings highlight maternal characteristics and circumstances that predict poorer mental health and reduced coping which could be used to target interventions in any future public health emergencies requiring social restrictions.