Longitudinal investigation of mineral composition in human milk and its correlation with infant anthropometric outcomes among Tibetan mother-infant dyads during the first 6 months postpartum

Nutrients in human milk,including minerals,relate growth and development of breast-fed infants.Tibetan mother-infant dyads possess unique characteristics on early nutrition due to their featured long-lasting lifestyle.This study longitudinally investigated the relationship between the mineral composition in human milk and the Z-scores of infants among Tibetan mother-infant dyads during their first 6 months postpartum through a prospective cohort study.The results show that the minerals of Na,Mg,K,Ca,Cu,Zn,and Se were of higher levels in colostrum than other lactation stages.Several minerals were below the recommended values for infants according to Chinese dietary guidelines.Besides,a large proportion of infant Z-scores were below-2 as lactation period continued.Multivariate statistical analysis revealed that classifications and correlations in varying degrees were observed between minerals in human milk and infant Z-scores.These findings will be advantageous for research upon Chinese early nutrition and progress of tailor-made infant formula.

Effect of maternal alcohol consumption on gestational diabetes detection and mother-infant’s outcomes in Kinshasa, DR Congo

Objectives: Since it has been suggested that moderate alcohol drinking would increase insulin sensitivity, which could benefit Gestational Diabetes Mellitus (GDM), the study aimed at evaluating alcohol consumption during pregnancy, and seeing whether this consumption influences GDM detection and maternal/perinatal outcomes. Study design: Women with already known diabetes and those with multiple pregnancy were excluded. All other pregnant women attending antenatal care unit of the university clinics, Kinshasa, DR Congo during the period from 1 March throughout 31 October 2010, were invited at 24-week gestation to enroll in O’Sullivan blood glucose testing and if eligible in 100-gram oral glucose tolerance test. Alcohol consumption, risk factors for GDM, and general characteristics such as age, parity, gestity, BMI, fat mass were registered. Diagnosed GDM was first treated with diet and exercise, thereafter with Metformin, and if necessary with insulin. For other (normal) women data remained blinded until confinement. Maternal and infant’s adverse outcomes such as maternal urinary infection, preeclampsia, cesarean section, intrauterine growth retardation, birth weight percentile 90 in our milieu), Apgar score at the first minute < 7, shoulder dystocia or other birth injury, neonatal hypoglycemia and fetal alcohol syndrome (FAS) were compared and analyzed according to GDM diagnosis as well to alcohol status. Results: Up to 240 pregnant women accepted to enroll into the study. Alcohol consumption concerned 78 (32.5%) of the women, most of them (61 = 25.42%) being heavy consumers. Risk factors for GDM and Physical and blood glucose characteristics were alike (p not significant) in both consumers and non consumers, except for history of HTA in the family that was significantly more frequent (p = 0.02) among drinkers. GDM’s prevalence was 9%. No adverse outcome was more prominent in any subgroup, except Apgar score < 7 at the first minute that was more frequent (p = 0.038) among neonates of GDM mothers. No FAS, neither shoulder dystocia nor neonatal hypoglycemia were diagnosed. When alcohol status was considered, Birthweight ≥ 3800 g was found more frequent (p = 0.0284) in alcohol consumers than in abstainers. Risk of this outcome was three times higher when history of family hypertension was present (odds ratio 2.694;CI: 0.536 - 13.544). Conclusions: The prevalence of alcohol consumption by pregnant women of our series (32.5%) seems not to impact the detection of GDM (9%). FAS was not diagnosed. Lack of significant differences in adverse outcomes between GDM and non GDM could be attributed to huge follow-up of GDM women. Influence of alcohol consumption on birth weight mostly in setting of familial history of hypertension remains to be addressed.

Impact of postnatal maternal depressive symptoms and infant’s sex on mother-infant interaction among Bangladeshi women

Aim: To investigate the impact of postnatal depressive symptoms and infant sex on perceived and observed mother-infant interaction among rural Bangladeshi women. Methods: Fifty women with depressive symptoms and their infants at 2 - 3 months were compared with 50 women without depressed symptoms and their infants, matched on geographic areas, parity and infant sex. The Edinburgh Postnatal Depression Scale assessed depressive symptoms, the Postpartum Bonding Questionnaire assessed the mother’s perception of bonding with the infant and mother-infant interactions were videotaped and analyzed with the Global Rating Scale. Results: Mothers with depressive symptoms were poorer, were less educated and rated lower infant bonding than mothers without depressive symptoms (p = 0.03), yet objective observation revealed no difference between the two groups regarding maternal interactive behavior (p = 0.57). However, infants, particularly boys (p = 0.002), of mothers with depressive symptoms fretted more in mother-infant interaction than infants of mothers without depressive symptoms (p = 0.009). Conclusion: Although mothers with depressive symptoms did not show less sensitivity in interactive behavior at 2 - 3 months than those without depressive symptoms, our results indicate that infants, particularly boys, of mothers with depressive symptoms may be negatively influenced by depressive symptoms.

The trajectories of physical growth in 4 months postnatal corrected age among preterm infants discharged from neonatal intensive care units and associated factors: A prospective study

Objectives Growth retardation is a risk for premature infants.In addition to demographic and perinatal factors,preterm infants’physical growth may be affected by neonatal intensive care unit(NICU)stress,maternal postpartum depression,and mother-infant interaction.This study aimed to investigate the trajectories of physical growth in 4 months corrected age among preterm infants discharged from the NICU and the impactors on these trajectories.Methods A prospective study was conducted among 318 preterm infants from September 2019 to April 2021 in Shanghai,China.Latent growth modeling was applied to identify the weight,length,and head circumference growth trajectories in 4 months corrected age and explore the effects of demographic and medical characteristics,infant stress during NICU stay,maternal postpartum depression,and mother-infant interaction on each trajectory.Results Unconditional latent growth models showed curve trajectories with increasingly slower growth in weight,length,and head circumference until 4 months of corrected age.Conditional latent growth models showed that a longer length of stay in the NICU and more skin punctures were negatively associated with weight at 40 weeks corrected gestational age(β=−0.43 and−0.19,respectively,P<0.05).The maternal postpartum depression between 40 weeks corrected gestational age and 1 month corrected postnatal age was associated with a lower growth rate of length(β=−0.17,P=0.040),while between 2 and 3 months corrected postnatal age,there were lower growth rates of weight and head circumference(β=−0.15 and−0.19,respectively,P<0.05).The mother-infant interaction scores between 40 weeks corrected gestational age and 1 month corrected postnatal age negatively predicted the growth rate of weight(β=−0.19,P=0.020).Conclusion The physical growth trajectories of preterm infants discharged from the NICU were influenced by infant stress during the NICU stay,maternal postpartum depression and mother-infant interaction.

Mothers’experiences of neonatal intensive care:A systematic review and implications for clinical practice

BACKGROUND Preterm birth is on the rise worldwide.Neonatal intensive care units(NICUs)have enabled many critically ill newborns to survive.When a premature baby is admitted to the NICU,the mother–infant relationship may be interrupted,affecting the mother's mental health.AIM To examine the maternal emotions associated with having a child in the NICU and provide suggestions for clinical practice.METHODS MEDLINE,CINAHL,PsychARTICLES,and PsychINFO were searched for relevant articles between 2005 to 2019,and six qualitative articles were chosen that explored the experiences of mothers who had a preterm infant in the NICU.The thematic analysis method was used to identify the most common themes.RESULTS Four main themes of the experience of mothers who had a preterm infant in the NICU were identified:Negative emotional impacts on the mother,support,barriers to parenting,and establishment of a loving relationship.CONCLUSION NICU environment is not conducive to mother-child bonding,but we stipulate steps that health care professionals can take to reduce the negative emotional toll on mothers of NICU babies.

Autonomic Nervous Activity in Multiparous Women during Early Postpartum Period: A Descriptive Study

Background: The purpose of the present study is to analyze the autonomic nervous activity in multiparas while resting, nursing, and rooming-in/rooming-out during days 1 to 3 of early postpartum period. Methods: Subjects were asked to record the actions they performed while wearing a heart rate monitor. Changes in autonomic nervous activity from 9 am to 12 pm and relaxation based on the relaxation (RE) scale were surveyed in multiparous women experiencing a normal postpartum period, on postpartum days 1 to 3. Results: Thirteen subjects were enrolled but heart rate data for all 3 days were available for only 5 of them. In these patients, the autonomic nervous activity (heat rate, high frequency [HF], or low frequency [LF]/HF) showed no significant differences between the days during any of the time periods. However, of the 3 days, day 2 demonstrated a lower HF and higher LF/HF. Subjective sense of relaxation was higher on postpartum day 3 compared to days 1 and 2, but there was no significant difference observed in the 3-day total score. Though no significant differences in HF and LF/HF at rest and during nursing were observed for any of the 3 days, there was a tendency for HF to be lower and LF/HF to be higher during nursing than at rest. Conclusions: Autonomic nervous activity demonstrated no significant major changes between the 3 days of postpartum (day 1 to 3). However, the lower HF and higher LF/HF during nursing and rooming-in suggest that even multiparas, who are supposedly accustomed to nursing and child-rearing, can be tense. Results suggest that multiparas require monitoring, personal care, and attention so that they can be relaxed and less tense while nursing and caring for their children.

Micro-traumatic Experiences and Psychotherapeutic Treatment

It’s becoming even more widely recognized from neurosciences, epigenetics, and clinical research on observation of infant-caregiver interaction that daily cumulated micro-traumatic experiences cause damages not only to one’s mental health and identity, but also to immune system, leading to metabolic, eating, sleeping, affective, behavioural, cognitive and linguistic, and social disorders in adults as well as in children and infants. Relational Psychoanalytic treatment argues that the therapeutic change is related to expanding levels of consciousness and exploring new ways of being in the world. Clinical examples are provided.

LONG-TERM IMMUNOGENICITY AND EFFICACY OF RECOMBINANT YEAST DERIVED HEPATITIS B VACCINE FOR INTERRUPTION OF MOTHER-INFANT TRANSMISSION OF HEPATITIS B VIRUS

Recombinant DNA Yeast-Derived Hepatitis B Vaccine (RYHB vaccine) is comparable to and can replace Plasma-Derived Hepatitis B Vaccine (PHB vaccine) for the prevention of mother-nfant transmission of hepatitis B virus (HBV), but the duration of immune efficacy of RYHB vaccine is not clear. This study indicates the long-term efficacy for the prevention of mother-infant transmission of HBV. One hundred and six neonates born to HBsAg-arrier mothers with HBeAg positive were randomly divided into two groups, one receiving 20 μg per dose of RYHB vaccine and the another receiving 20 μg per dose of PHB vaccine on the day of birth, at 1 month and at 6 months (three times). Physical examination and blood tests were performed for all infants at 6, 12, 24, 36, 48 and 60 months of age. The results showed that the protective efficacies at 6, 12, 24, 36, 48 and 60 months were 67%, 75%, 63%, 62%, 57% and 56%, respectively for the RYHB vaccine group and 58%, 76%, 51%, 41%, 24% and 18%, respectively for the PHB vaccine group. The protective efficacy was notably significant in the last two years. The study indicates that the duration of protective efficacy is over 5 years with RYHB vaccine, being longer than that of PHB vaccine. These recipients of RYHB vaccine showed no side effects, and the vaccine is regarded as safe and effective.

What makes a cry a cry？ A review of infant distress vocalizations

In contrast to the cries of human infants, sounds made by non-human infants in different stressful behavioral contexts （hunger or physical discomfort, isolation, capture by humans or predators） are usually treated as distinct types of vocalizations. However, if distress vocalizations produced by different species and in different contexts share a common motivational state and associated neurochemical pathways, we can expect them to share a common acoustic structure and adaptive function, showing only limited variation that corresponds to the infant＇s level of arousal. Based on this premise, we review the acoustic structure and adaptive function of two types of distress calls, those given when infants were isolated from their mothers （isolation caUs） or captured by humans （capture calls）. We conducted a within-context comparison examining the two call types across a diverse se- lection of mammalian species and other vertebrate groups, followed by a comparison of how acoustic structure and function dif- fers between these contexts. In addition, we assessed acoustic traits that are critical to the response of caregivers. Across verte- brate species, distress vocalizations produced in these two behavioral contexts tend to be tonal with a simple chevron, flat or de- scending pattern of frequency modulation. Reports that both isolation and capture calls of vertebrate infants serve to attract care- givers are universal, and the fundamental frequency of infant vocalizations is often critical to this response. The results of our re- view are consistent with the hypothesis that differences in the acoustic structure of isolation and capture distress vocalizations re- flect differences in arousal, and not discrete functions. The similarity in acoustic structure and caregiver response observed across vertebrates adds support to the hypothesis that the production and processing of distress vocalizations are part of a highly-conserved system of social vocal behaviour in vertebrates. Bioacoustic research may move forward by recognizing the commonality among different forms of infant solicitations that attract caregivers, and the commonality of these solicitations with vocalizations that attract conspecifics in still other behavioral contexts [Current Zoology 58 （5）： 698-726, 2012].