Kangaroo Mother Care (KMC) is a fairly new concept to the patients and personnel at the R. K. Khan Hospital. Arising from one of the Governmental initiatives, KMC was introduced to KwaZulu Natal in 2001. The personnel at this hospital were briefly introduced to this alternate method of care for a low birth weight baby, by means of symposia and in-service. Soon after this in-service education, the personnel were requested to implement KMC. This study was undertaken to explore the perceptions of carers for the preparation and experience of KMC and to describe the experiences of the carers who have implemented KMC. Furthermore, this study determined whether carers received support during the implementation of KMC and in so doing to identify the sources of this support. The selection of this particular field of study arose out of the researcher's professional role in educating personnel in the theory and practice of midwifery. The lack of documented evidence to problems that they may have been encountered and management strategies to deal with these prompted this study. The intention was to obtain empirical findings so that personnel would be provided with appropriate and precise information on the subject. A phenomenological approach was used. The sample was obtained from the R. K. Khan Hospital neonatal unit. This is a regional hospital that is located in Chatsworth, Durban. The sample comprised often mothers who were practicing KMC in the post-natal ward, or mothers who were discharged and were still practicing KMC for the past two to four weeks. Data were collected by means of face-to-face interviews. Interviews were conducted using a semistructured interview guide. These interviews provided the researcher with rich, personal and narrative experiences of the carers before and during KMC. The results of this study indicated that KMC was indeed new to most of the mothers and this evoked apprehension, doubt and fear, but once the mothers had tried it and were successful, they felt a sense ofjoy. Nursing personnel formed part of the supportive environment for the mothers practicing KMC. The latter is a prerequisite for the success of KMC. Since KMC is associated with many benefits to the mother, the baby and the institution, for the future it could be incorporated into the midwifery curriculum for student midwives. Recommendations concerning nursing practice, nursing education and nursing research were made at the end of the study including the limitations affecting the study. / Thesis (M.Cur.)-University of Natal, Durban, 2003.

This study assessed how early motherhood influences maternal behavior and infant healthin Ethiopia. Data from the Ethiopian Demographic and Health Survey 2011 were used.Descriptive and Multinomial analysis were performed to observe the determinants of antenatalcare visits and birth weight. Cox regression model was employed for analyzing the risk of infantmortality. Findings clearly show that young maternal age at birth was associated with asignificantly lower number of ANC visits and increased the risk of infant mortality. However,there was no significant difference in the incidence of having babies with a low birth weight byage. Apart from maternal age at birth, education, wealth status, place of residence and ethnicityhad a stronger significant effect on outcome variables.In conclusion, this study demonstrated that young age at birth has an effect on utilizationof ANC service and infant health. For a favorable maternal behavior and infant health outcomewe strongly suggest that the following should be considered-: strong enforcement of minimumage at marriage abided by law, promoting young women’s education, and adequate andaffordable health care services in remote rural areas where health clinics are inaccessible.

The impact of within-litter weight variation on the productivity of pig enterprises is poorly understood. The objective of the study was to determine the effect of within-litter birth weight variation on litter performance at three weeks of age and at weaning. The study was conducted using records from 1 788 litters, collected between January 1998 and September 2010, from a pig herd at the Agricultural Research Council (ARC), Irene. The records consisted of piglet identity, breed of sow, breed of boar, parity number, date of farrowing, number of piglets born alive (NBA), individual piglet weight at birth, three weeks and at weaning. From these records, mean birth weight (MBWT), litter weight at birth (TBWT), within-litter birth weight coefficient of variation (CVB), minimum birth weight (MinB) and maximum birth weight (MaxB) were calculated. Mean weight at three weeks (MWTT), litter weight at three weeks (LWTT), within-litter weight coefficient of variation at three weeks (CVT), percent survival to three weeks (SURVT), mean litter weaning weight (MWWT), litter weight at weaning (LWWT), within-litter weaning weight coefficient of variation (CVW) and percent survival at weaning (SURVW) were computed as derivatives. The factors affecting CVB were analysed using the General Linear Model procedures (SAS, 2008). For the relationships between CVB and litter performance at three weeks and weaning, PROC STEPWISE was used. The PROC REG (SAS, 2008) was then used to test whether the relationships between CVB and CVT, SURVT, MWTT, LWTT, CVW, SURVW, MWWT, LWWT and LWWT. Multiparous sows farrowed litters with higher (P<0.05) CVB than gilts. The litter weight (TBWT) and NBA, fitted as covariates, also affected (P<0.05) CVB. The correlation between CVB and NBA was 0.30. The CVB had a linear relationship (P<0.05) with SURVT (SURVT = 83.21 - 0.20 CVB), CVT (CVT = 16.71 + 0.50 CVB), SURV (SURW = 87.9 – 0.04CVB) and CVW (CVW= 15.8 + 0.5CVB). An increase of CVT with CVB depended on parity (P<0.05). The rate of increase of CVT with CVB was highest in Parity 1 (b=0.41) followed by Parity 2 (b=0.36) then middle aged (Parity 3-5) sows (b=0.32). The CVB had no effect on MWTT, LWTT, MWWT and LWWT (P>0.05). The CVB was shown to be an important determinant of SURVT and SURVW. A uniform litter at birth is likely to lead to a homogenous litter at three weeks and weaning, thereby reducing costs of production. Pig producers should, therefore aim at producing homogenous litters at birth. / Thesis (M.Sc.Agric.)-University of KwaZulu-Natal, Pietermaritzburg, 2011.

The purpose of this study was to determine the relationship- between prenatal weight gain relative to initial weight and change in smoking habits relative to prepregnancy smoking habits on infant birth weight. The convenience sample was 100 women who had been prenatal clients at a clinic for low income women and who delivered term infants during a one year period. Women were selected who had term deliveries and were without medical problems during the pregnancy.Prepregnancy weight-for-height was determined using the 1959 Metropolitan Life Insurance Table. Weight gain throughout the pregnancy was charted on the appropriate graph. Changes in smoking habits during the pregnancy were evaluated verbally. Roy's Adaptation Model was the conceptual framework for this study. The physiological mode of this model depicts people as individuals who are constantly adapting to a changing environment. Procedures for the protection of human subjects were followed.The first research question illustrated that women who gained adequate weight and reduced or quit smoking had infants with higher birth weights. The second research question showed that, overall, women who quit or reduced the amount smoked early in pregnancy had infants with higher birth weights than women who quit or reduced later in pregnancy or-who did not change smoking habits. The third research question determined that nonsmokers had infants with higher birth weights than smokers.Women who smoke will have infants with lower birth weights than those that do not smoke. Women with inadequate weight gains during pregnancy are more likely to have infants: with lower birth weights than women with adequate weight gains. Health care providers must be able to relay, the risks of inadequate weight gain and smoking to pregnant women. / School of Nursing

The purpose of this study was to examine maternal and infant factors associated with body mass index (e.g., maternal weight gain, infant birth weight, infant feeding methods, and motor coordination) among obese pre-adolescents and adolescents aged 8-18 years enrolled in the Pediatric OverWeight Education and Research (POWER) program operated by Riley Hospital for Children in Indianapolis, IN, between October 2008 and September 2011. POWER, a three-phase, 12-month multi-disciplinary program to reduce childhood obesity funded by Indiana University Health, enrolls obese children (Body Mass Index [BMI] greater than the 95th percentile for age and gender) through referrals from pediatricians throughout Indiana. Prior to the child’s initial visit, each family completes a comprehensive background and family history profile, approved by the Indiana University-Purdue University (IUPUI) Institutional Review Board, that includes questions related to the obese child’s motor skill development, infant feeding methods, maternal prenatal weight gain, and infant birth weight. Data related to these four categories collected during Phase 1 (12 weeks) was examined using date from 253 pre-adolescents (8-12 years of age), and 285 adolescents (13-18 years of age), to determine their impact on the subjects’ BMI. No relationship between a mother’s prenatal weight gain and the child’s BMI was seen. There was a significant correlation between infant birth weight and BMI in the pre-adolescent group. Breastfed subjects entered the POWER program at a lower BMI than non-breast fed subjects and had consistently lower BMIs throughout the program compared to the non-breastfed subjects. Differences in physical activity were observed between adolescents and pre-adolescents. Paired analysis indicated the POWER program was associated with a significant reduction in BMI overall, and among both age groups throughout Phase 1 of the program. Adolescents were especially successful in reducing their BMI compared to preadolescents. Further research is needed to identify the association of maternal and infant factors and BMI among obese children. / Department of Family and Consumer Sciences

Background: Low birth weight (LBW) is a public health issue in the United States and around the globe. Although Low birth weight is an important predictor of subsequent health outcomes, the role of maternal age as a LBW risk factor is poorly understood. Determining whether or not maternal age is a risk factor for low birth weight can help reduce the incidence of LBW and maximize the health of offspring. Objective: This study examined the association between young mothers and LBW risk in a representative sample of Non-Hispanic Whites, Non-Hispanic Blacks and Hispanic American women. Factors such as mother’s age, smoking status, level of education, income, and marital status were evaluated to assess their associations with LBW outcome. Methodology: The selected study factors were analyzed using SPSS version 20. Data were obtained from the 2007-2008 National Health and Nutrition Examination Survey (NHANES). Young mothers were defined as females between the ages of 14 and19 years old that have a baby. A live born infant weighing less than 2,500 grams was considered to have LBW. Frequencies for the selected factors were created. Univariate and multivariate logistic regression analyses were also run to examine the association between young motherhood and LBW adjusting for maternal age, smoking, education, income and marital status. Results: There was no statistically significant association between young mothers and LBW in Non-Hispanic Whites (OR=.51; 95% CI=.12-2.13), Non-Hispanic Blacks (OR=.21; 95% CI=.03-1.59), and Hispanic Americans (OR=1.48; 95% CI=.74-2.97) women, after adjusting for maternal age, smoking, education, income and marital status. Conclusion: Although, the results of this study indicating the lack of association between young mothers and LBW is consistent with findings by some investigators (Reichman et al., 1997), there are several studies that have reported contrary results (Okosun et al., 2000). In light of these mixed findings, further research is necessary to examine the impact of young mothers on adverse birth outcomes, including, LBW.

Background: Differences in health and living conditions between urban and rural settings can be seen as an important example of gaps between population groups. Birth weight and child growth are important predictors for the future health of a person and at aggregate level, for the public health of a population.The general aim of this thesis is to describe and discuss birth weight, physical growth and breastfeeding of children, as well as associated factors, from birth to 24 months of age in urban and rural areas of Vietnam, thus contributing to the evidence base for health strategy and policy. Methods: Two Health and Demographic Surveillance Sites in Hanoi were used; urban Dodalab and FilaBavi in the rural part. To study rural birth weight 1999 to 2010 information was obtained for 10,114 newborn in FilaBavi. To study urban rural growth disparities 2008-2010, 1,466 children were followed for two years after birth with measurements of weight and length. A study of breastfeeding included 2,572 mothers followed for one year after delivery. Background information about households and mothers was taken from routine surveys in the two sites. Results: The mean birth weight in FilaBavi remained stable at about 3,100 grams, over the 12 years studied despite rapid economic and technological development. At the individual level we found birth weight to be associated with household economy and the education of mothers. In the urban rural comparison, the mean birth weight for urban boys and girls were 3,298 and 3,203 g as compared with 3,105 and 3,057 g for the rural infants. Children in the urban area grew faster than those in the rural area. There were markedly higher frequencies of stunting in the rural area compared with the urban. The initiation of breastfeeding during the first hour of life was more frequent in the urban area. Exclusive breastfeeding during the first three months of age was more commonly reported in the rural than in the urban area. Both birth weight and child growth were statistically significantly and positively associated with economic conditions and mother’s education. Conclusion: The results of the studies presented in this thesis show that there are large and important differences in child birth weight, child growth and infant breastfeeding between urban and rural areas. There are also major differences between the areas with respect to education and economic resources. All predictors of child birth weight and growth discussed are directly or indirectly associated with the social and economic conditions. Globalization and urbanization means obvious risks for increasing gaps between as well as within the rural and urban areas. Large discrepancies in a society will lead to serious public health problems in all segments of the population, not only the underprivileged.

This study was designed to measure the prevalence and nutritional impact of dairy product restriction in both pregnant and lactating women. Dairy product (DP) restriction was assessed in 2091 prenatal class attendees. Subsamples of 279 healthy pregnant and 175 exclusively breastfeeding women provided repeat 24-hour dietary recalls which were used to estimate nutrient intake and to assess dietary adequacy using adjusted nutrient distributions. Pregnancy outcome was recorded. Pregnancy. DP restriction was reported by 13.2% (95% CI: 12.7%,14.1%) of pregnant women. Significant differences were found in the proportion of restrictors (Rs, 20.8%) below the calculated EAR for adjusted protein intakes vs. nonrestrictors (NRs, 9.2%, chi 2 = 6.78, p = 0.009). Intake distributions of calcium and vitamin D were compared to their respective Als for descriptive purposes and were lower for Rs vs. NRs but dietary inadequacy could not be assessed. Infants of NRs weighed on average 120 g +/- 468.9 g more than those of Rs but this difference was not statistically significant (p = 0.06). However, in multiple regression analysis where maternal weight gain, age, education and pregravid weight were controlled for, restriction predicted a comparable loss in birthweight of 122.5 g's (p = 0.048) and vitamin D intakes were positively associated with fetal growth. Lactation. Restriction (≤250 ml milk/day) was reported by 23% (95% CI; 16%--29%) of exclusively lactating women. Protein was lower than the EAR for 60% of Rs and 37.8% of NRs (chi 2 = 6.22, p = 0.025). The proportion of Rs and NRs < EAR from diet differed for thiamin (15% vs. 0%, chi2 = 0.97, p < 0.001), riboflavin (15% vs. 1.5%, chi2 = 12.93, p < 0.001) and zinc (65.0% vs. 34.8%, chi2 = 11.6, p < 0.041). From diet and supplement intake vitamin D and calcium remained lower for Rs compared to NRs but inadequacy could not be assessed or compared. DP restriction was not associated with greater weight loss amo

This thesis presents quantitative tools for the metabolomic analysis of amniotic fluid (AF) using vibrational spectroscopy. A total of 300 AF samples were collected for this retrospective cohort study and both Raman and near infrared (NIR) spectra were measured. Spectral data was compressed using a Haar wavelet transform and stage-wise multilinear regression (MLR). Calibration models were calculated for glucose, lactate and uric acid concentrations in AF. Birth weight, gestational diabetes mellitus (GDM) and gestational age were classified with the resulting compressed Raman and NIR spectra, using a genetic algorithm (GA) and a cross-validation approach. Results show that both Raman and NIR spectra of AF were not able to estimate the concentrations of glucose, lactate or uric acid with high precision. However, metabolomic analysis of AF Raman and NIR spectra was capable of estimating the development of GDM, abnormal birth weights as well as gestational ages with sensitivities >75% and specificities >77%. In addition, Raman and NIR metabolomic profiles showed a statistical difference in patients delivering preterm. Of the two spectroscopic analyses studied, NIR spectroscopy of AF has the potential to become a robust and non-invasive diagnostic tool for maternal and fetal health.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 5 uppsatser.