Examining Exclusive Breastfeeding Practice in Indonesia, and its Association to Maternal Socio-demographic Determinants, to Inform Intervention Efforts Aimed at Reducing Infant Mortality Introduction Exclusive breastfeeding, the gold standard of infant feeding practices, has been identified as the single most effective strategy to improve child survival. However, this recommendation is not highly practiced in Indonesia, while Indonesia’s infant and under five mortality is still high. Interventions to promote, protect, and support breastfeeding practice are critical public health needs in Indonesia. Aim The current study examined socio-demographic factors associated with exclusive breastfeeding practice in Indonesia: whether maternal age, level of education, occupation status, wealth index, and region of residence, as well as breastfeeding initiation are associated with exclusive breastfeeding practice in Indonesia for mothers having infants up to age five months. Methods This study analyzed 1695 women having infant aged 0-5 month old data from the 2012 Indonesia Demographic Health Survey. Chi-square test was used for preliminary analysis and logistic regression analyses were used to primary analysis by using SAS 9.4 program. Results Exclusive breastfeeding practice in Indonesia was low (36.1%). Mothers aged 30-39 years old were more likely to exclusively breastfeed compare to mothers under 20 years old (OR=1.56, 95% CI 1.04-2.35). Mothers with high education level had higher odds to exclusively breastfeed compare to low education mothers. Unemployed mother were more likely to exclusively breastfeed than working mothers (OR=1.65, 95% CI 1.28-2.13). Mothers coming from richer wealth index were less likely to exclusively breastfeed compare to mothers having poorest wealth index (OR= 0.49, 95% CI 95% 0.34-0.72). Those who initiated breastfeeding early had increased odds to exclusively breastfeed than mothers who delayed breastfeeding initiation (OR=1.47 95% CI 1.19-1.83). Finally, mothers who lived in Eastern Indonesia were more likely to exclusively breastfeed compare to mothers who lived in Sumatera and Kalimantan (OR=1.82, 95% CI 1.30-2.55). Conclusion This study found characteristics of Indonesian mothers who were more likely to exclusively breastfeed compared to the reference group: aged 30-39 years old, high education level, unemployed, richer wealth index, and those who live in Eastern Indonesia; as well as, mother who initiate breastfeeding early. Having tailored strategies and interventions to targeted at-risk populations may increase the likelihood of exclusive breastfeeding practices, and ultimately, decreasing infant mortality rates in Indonesia.

Infants prefer familiar adults (e.g. parents) to unfamiliar adults (e.g. strangers), but they also vary in which strangers they prefer. By 6-months, infants look longer at attractive than unattractive faces (e.g., Langlois et al., 1987); and by 12-months, infants show approach behaviors toward attractive strangers and withdrawal behaviors toward unattractive strangers (Langlois, Roggman, & Rieser-Danner, 1990). These preferences may be due to a mechanism referred to as cognitive averaging (e.g., Rubenstein, Kalakanis, & Langlois, 1999). Infants cognitively average face exemplars to form a face prototype. Infants likely perceive attractive faces as familiar because these faces are similar to the face prototype; and they likely perceive unattractive faces as especially novel because these face are dissimilar from the face prototype. Even young infants may be more motivated to approach attractive than unattractive faces but do not fully express this motivation due to limitations in locomotion and communication. I applied EEG asymmetry to study neural correlates of approach and withdrawal motivation in response to attractive and unattractive faces with 6- and 10-month-olds. More specifically, I measured EEG alpha power at mid-frontal regions while 39 infants viewed a series of attractive and unattractive faces. Left EEG asymmetry relates to approach motivation whereas right EEG asymmetry relates to withdrawal motivation. I predicted infants would show greater left EEG asymmetry (i.e., approach motivation) when viewing attractive faces than when viewing unattractive faces, and that 6-montholds would show even greater left asymmetry than 10-month-olds due to developmental differences in stranger wariness. Results supported the main hypothesis but not hypotheses regarding age. Infant EEG asymmetry was greater in response to attractive faces than unattractive faces suggesting that infants are more motivated to approach attractive people than unattractive people as early as 6-months. These results link visual preferences evident at 6-months to overt behaviors evident by 12-months providing additional information regarding rudiments of attractiveness stereotypes. Furthermore, this investigation supports the use of EEG asymmetry methodology to measure infant approach/withdrawal motivation, providing infant researchers one more tool to better understand how infants evaluate novel individuals in their social environment as they decide whom to approach and whom to avoid. / text

Thesis advisor: Catherine Read / The purpose of this paper is to identify and examine the sources of paternal stress related to the NICU experience and the supports currently available. Once identified, the possible sources of stress will be incorporated into a checklist that will allow NICU staff to assess barriers to bonding and further personalize the interventions to facilitate the relationship between the parent and infant. / Thesis (BS) — Boston College, 2013. / Submitted to: Boston College. Connell School of Nursing. / Discipline: College Honors Program. / Discipline: Connell School of Nursing.

by Sophie S.F. Leung. / Thesis (M.D.)--Chinese University of Hong Kong, 1990. / Bibliography: leaves [194]-[203] / Chapter PART I --- INTRODUCTION / Chapter CHAPTER ONE --- GENERAL INTRODUCTION AND AIMS --- p.2 / Chapter CHAPTER TWO --- NUTRITIONAL STATUS OF HONG KONG INFANTS - A LITERATURE REVIEW --- p.4 / Chapter CHAPTER THREE --- ASSESSMENT OF NUTRITIONAL STATUS / Chapter 3.1 --- Methods of Assessment --- p.12 / Chapter 3.2 --- Physical Growth : Auxology --- p.15 / Chapter 3.2.1 --- Growth parameters --- p.16 / Chapter 3.2.2 --- In an individual --- p.17 / Chapter "3,2.3" --- In a population --- p.19 / Chapter 3.2.4 --- Reference standards --- p.19 / Chapter 3.2.5 --- Classification of malnutrition --- p.23 / Chapter 3.3 --- Dietary Surveys --- p.26 / Chapter 3.3.1 --- Methods of data collection --- p.26 / Chapter 3.3.2 --- Recommended dietary allowance / recommended nutrient requirement --- p.30 / Chapter 3.3.3 --- Use of RDA in interpretation of food consumption surveys --- p.32 / Chapter 3.3.4 --- Nutritional allowances for infant --- p.33 / Chapter PART II --- STUDY DESIGN AND RESULTS / Chapter CHAPTER FOUR --- MATERIALS AND METHODS / Chapter 4.1 --- The Research Team --- p.39 / Chapter 4.2 --- The Study Population --- p.39 / Chapter 4.3 --- Follow up --- p.41 / Chapter 4.4 --- Data on Morbidity and Infant Care Practice --- p.41 / Chapter 4.5 --- "Anthropometry (I) : Weight, Length, Head Circumference, Weight and Length Velcoity" --- p.42 / Chapter 4.5.1 --- Data collection --- p.42 / Chapter 4.5.2 --- Data analysis --- p.45 / Chapter 4.6 --- Anthropometry (II) : Mid-arm circumference --- p.46 / Chapter 4.7 --- "Anthropometry (III) : Triceps, Subscapular Skinfold Thickness" --- p.47 / Chapter 4.8 --- Dietary Data Collection and Analysis --- p.48 / Chapter 4.9 --- Number of Observations --- p.50 / Chapter 4.10 --- Haematological and Biochemical Study --- p.51 / Chapter CHAPTER FIVE --- "RESULTS (I) : DEMOGRAPHY, INFANT CARE PRACTICES AND MORBIDITY" / Chapter 5.1 --- Family Demographic Data --- p.58 / Chapter 5.1.1 --- "Ethnicity, age, weight and height" --- p.58 / Chapter 5.1.2 --- Occupation and family income --- p.59 / Chapter 5.1.3 --- Education --- p.59 / Chapter 5.1.4 --- Accommodation --- p.59 / Chapter 5.2 --- Study Infants --- p.60 / Chapter 5.2.1 --- "Sex, birth size and birth order" --- p.60 / Chapter 5.2.2 --- Mode of delivery --- p.61 / Chapter 5.3 --- Infant Care Arrangements and practices --- p.61 / Chapter 5.4 --- Morbidity --- p.62 / Chapter 5.5 --- Physical Examination --- p.63 / Chapter CHAPTER SIX --- RESULTS (II) : AUXOLOGY / Chapter 6.1 --- Physical Size --- p.73 / Chapter 6.1.1 --- "Weight, length and head circumference" --- p.73 / Chapter 6.1.2 --- Triceps and subscapular skinfold thickness --- p.74 / Chapter 6.1.3 --- Midarm circumference --- p.75 / Chapter 6.1.4 --- Midarm circumference/occipito frontal circumference --- p.75 / Chapter 6.2 --- Growth Velocity --- p.75 / Chapter 6.3 --- Difference between sex --- p.76 / Chapter CHAPTER SEVEN --- RESULTS (III) : NUTRIENT INTAKE / Chapter 7.1 --- Dietary Practice --- p.99 / Chapter 7.1.1 --- Early (preweaning period): birth to 6 months --- p.99 / Chapter 7.1.2 --- Late (weaning period): 6 to 24 months --- p.100 / Chapter 7.2 --- Specific Nutrient Intakes --- p.102 / Chapter 7.2.1 --- Energy --- p.102 / Chapter 7.2.2 --- Protein --- p.103 / Chapter 7.2.3 --- Fat --- p.103 / Chapter 7.2.4 --- "Iron, calcium, vitamin D and vitamin C" --- p.103 / Chapter 7.2.5 --- Sex differences in nutrient intake --- p.104 / Chapter CHAPTER EIGHT --- HAEMATOLOGICAL AND BIOCHEMICAL STUDY OF IRON AND VITAMIN D STATUS AT 18 MONTHS / Chapter 8.1 --- Iron --- p.122 / Chapter 8.2 --- Vitamin D --- p.123 / Chapter PART III --- DISCUSSION / Chapter CHAPTER NINE --- EVIDENCE FOR ADEQUATE NUTRITION IN THE STUDY INFANTS / Chapter 9.1 --- Use of Infant Formula Throughout Infancy --- p.130 / Chapter 9.2 --- High Protein Intake in Weaning Period --- p.131 / Chapter 9.3 --- No Iron Deficiency Anaemia and Rickets --- p.132 / Chapter 9.4 --- Normal Health and Activity --- p.132 / Chapter 9.5 --- Secular Change in Infant Growth Observed Over the Last Twenty Years --- p.133 / Chapter 9.6 --- No Correlation between Energy/Protein Intake and Weight/Length --- p.134 / Chapter 9.7 --- No Social Deprivation --- p.134 / Chapter CHAPTER TEN --- LIMITATIONS OF RDA AS A STANDARD TO INTERPRET DIETARY INTAKE DATA / Chapter 10.1 --- Iron --- p.142 / Chapter 10.2 --- Vitamin D --- p.143 / Chapter 10.3 --- Energy --- p.143 / Chapter CHAPTER ELEVEN --- RELEVANCE OF INTERNATIONAL REFERENCES AS STANDARDS TO INTERPRET ADEQUATE GROWTH IN CHINESE INFANTS / Chapter 11.1 --- Misinterpretation of Undernutrition in the Study Infants --- p.150 / Chapter 11.1.1 --- NCHS reference --- p.150 / Chapter 11.1.2 --- Midarm circumference --- p.151 / Chapter 11.1.3 --- Skinfold thickness --- p.152 / Chapter 11.2 --- Shape of Growth Curve --- p.153 / Chapter CHAPTER TWELVE --- FURTHER EVIDENCE FOR A GENETIC ROLE IN CAUSING SMALLNESS IN THE STUDY INFANTS / Chapter 12.1 --- Weight at Birth --- p.165 / Chapter 12.2 --- Weight at 2 Years --- p.166 / Chapter 12.3 --- Correlation with Parental Size --- p.166 / Chapter 12.4 --- Comparison with Canadian and Australian infants --- p.168 / Chapter 12.5 --- Comparison with NCHS --- p.169 / Chapter CHAPTER THIRTEEN --- PRACTICAL IMPLICATIONS OF THE STUDY / Chapter 13.1 --- Present Infant Feeding Practices --- p.185 / Chapter 13.2 --- Contribution to Current Knowledge on Infant Feeding --- p.187 / Chapter 13.3 --- "Updated Growth Standards of Hong Kong Chinese Infants, Birth to 2 Years" --- p.189 / Chapter 13.4 --- Implication for Further Research --- p.192

Motherhood is a rewarding, but challenging experience. Mothers are expected to balance parenting with multiple roles including employment. How mothers adjust is influenced by their confidence in their role, their mental health, the social support from their partner, family, and friends, and their perceptions of their infants (Mercer, 1995). Maternal confidence has been identified in the literature as an essential variable in the adaptation to motherhood and to the maternal role (Mercer, 1986; Walker, Crain, & Thompson, 1986). Low maternal confidence delays the transitioning into the maternal role/identity as well as limits the satisfaction in the mothering role (Mercer, 1986). Having infants with difficult temperament further impedes this transition resulting in frustration with new mothers and possibly depression (Andrews, 1990). This study used a descriptive correlational design to explore the relationship between infant temperament and selected maternal factors (education, prior childcare experience, social support, and depression) and maternal confidence. A convenience sample of 94 primiparous mothers with infants 6 weeks to 32 weeks participated in this study. SPSS statistical software version 10.0 was used to analyze data and answer the following research questions: 1) What is the relationship between infant temperament, and selected maternal factors (education, prior childcare experience, social support, and depression), and maternal confidence of first-time mothers during their child’s infancy?; 2) What are the differences in maternal confidence between first-time mothers with infants’ age 6 weeks - 16 weeks and first-time mothers with infants’ age 17 weeks – 32 weeks? Results revealed statistical significant relationships between infant temperament, social support, and depression with maternal confidence. Social support also had statistically significant relationships with education and depression. Infant temperament, social support, and depression predicted 20.6% of the variance with maternal confidence. There was also a significant difference between groups with mothers’ perception of their infants’ temperament. Healthcare providers need to be aware that mothers who suffer from depression, have low social support, and perceive their infants to have difficult temperament are at risk for having low confidence in the care they provide for their infants. Further research is needed to explore intervention methods aimed at increasing maternal confidence with new mothers.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2009. / Härtill 5 uppsatser.

Not available / text

Introduction and Rationale: Sudden infant death syndrome (SIDS) continues to be the leading cause of death in infants 28 days to 12 months old and the third leading cause of infant mortality (CDC, 2014; Task Force on SIDS, 2011a). SIDS has no identifiable cause although many hypotheses have existed and there are many known risk factors. Nicotine use is the second most modifiable risk factor for SIDS and to date there is no national public education campaign. Formal education is needed. Written education materials, such as brochures, are an effective way to increase knowledge and awareness of a health topic. Purpose and Objective: The purpose of this DNP Project was to create an educational brochure about SIDS and nicotine as a significant modifiable risk factor. The brochure is directed towards pregnant women and women with infants less than 12 months of age. The objective was to educate and inform mothers about SIDS, nicotine and its relation to SIDS, and the importance of abstaining from nicotine during and after pregnancy. Methods: The brochure was created using the Health Belief Model (HBM) as a framework. The HBM was used to explain health behavior modifications and was used as a foundation for education interventions. The model has successfully been applied to explain other preventative health behaviors and provide health education in various contexts. Results: The brochure was evaluated by two subject matter experts who have published peer reviewed articles using the HBM. Both subject matter experts found the HBM applied to the brochure appropriately. In their opinion, the content of the brochure should have positive impact for health modification in women who use nicotine and are pregnant or have a child less than 12 months of age. Conclusions: This DNP Project demonstrated SIDS as a current significant health problem and identified maternal nicotine use as the second most modifiable risk factor. Due to lack of current public education, a brochure was created using the HBM as a framework. Subject matter experts stated the brochure was created based on the HBM and will likely a have positive health influence on the intended population.

The quality of early infant-caregiver interactions determines the path of an infant's social, cognitive and emotional development. Theoretical and empirical evidence supporting this claim is reviewed, and the implications for early relationship-focussed interventions are considered. The study focuses on infants from birth to three years of age. Developmental psychology research findings are presented, and the role of risk and protective factors in planning preventative interventions are discussed. Recommendations are made for developing a centre-based relationship-enhancing early intervention program for infants and their depressed caregivers. The program is intended for implementation in a rural or periurban South African Primary Health Care setting. / Thesis (M.A.)- University of Natal, Pietermaritzburg, 2002.

The purpose of this study is to explore and describe the experiences of first-time mothers with colic infants. Based on the results, implications for clinical practice are described for the clinical psychologist with regards to providing psychological support for these mothers. The research design is qualitative, exploratory, descriptive and contextual. Data was collected by means of in-depth, semi-structured, phenomenological interviews and a descriptive analysis was done. The results show that the real versus the imagined experience of having a baby does not meet mothers' expectations. Furthermore, a colic baby elicits numerous anxieties including anxiety about the baby being damaged/ill, the feeding and leaving the baby in the care of others. Mothers battle with feelings of failure, which may be compounded by a stressful labour/delivery. Multiple attempts to soothe the baby or find an effective treatment result in feelings of helplessness and inadequacy. In turn, hopelessness and depression result. Mothers also perceive others' making judgments about their ability as a mother, while anxiety about failure undermines their capacity to accept support. Furthermore, mothers require affirmation from their baby. Their continued search for a cure offers hope that understanding and control can be gained. However, conflicting information and advice leave them feeling anxious and overwhelmed. Moreover, mothers feel disillusioned with medical personnel and the profession. Both medical and psychological factors are perceived as possible causes of, or contributing factors to, colic, and mothers experience guilt that stressors during their pregnancy may have contributed to their babies' being colicky. In addition, colic is seen as a punishment for perceived wrongdoings during pregnancy. Given the above, mothers need a containing figure, a function fulfilled by some husbands. If their own mothers are unavailable to contain their anxieties, substitute figures are found. In addition, practical support is experienced as helpful. Regarding maternal grandmothers, mothers identify with them, resulting in a new understanding of them and of the mother-daughter relationship. They also draw on their mothers' perception of their childhood experiences as positive or negative role models of parenting. Mothers feel ambivalent regarding the baby. They exhibit empathy although they perceive the baby as demanding, intrinsically difficult or rejecting. Consequently, mothers experience feelings of rage, resulting in fears of losing control and harming or abandoning the baby. These negative feelings are perceived as impacting on empathy for and bonding with the baby and result in feelings of shame and guilt. A colic baby is a source of stress in the couple's relationship, resulting in strained marital relations. Lastly, mothers renegotiate their identity as women and mothers. Several psychological defence mechanisms are used as a means of resolving emotional conflict and anxiety, and maintaining self-esteem. Clinical implications include adopting parent-infant psychotherapy as a framework for providing psychological support for these mothers. The study concludes that the colic period is stressful, places strain on the marital relationship and may pose a risk to the parent-infant relationship and child development. Lastly, psychological based interventions should be included as a resource for these mothers. / Thesis (M.A. (Psychology))--North-West University, Potchefstroom Campus, 2008.