Objective: The aim of this study was to investigate the differential effects of breastfeeding practice and having an intention to breastfeed (during pregnancy) on a mother’s maternal responsiveness to her infant after birth. Methods: Using longitudinal data from a subsample of 962 mother-infant dyads from a UK cohort study (Avon Longitudinal Study of Parents and Children), we investigated the influence of intention to breastfeed at 3 months pregnancy and breastfeeding practice and on mother-infant interactions at 12 months after birth. Breastfeeding intent and practice were assessed by questionnaires administered to the mothers. Intention to breastfeed in the first 3 months postpartum was measured at 32 weeks into the pregnancy, while breastfeeding practice (over first 12 months postpartum) was measured retrospectively at 15 months post partum. Results: Using logistic regression analyses, we found that intending to breastfeed at 32 weeks gestation significantly predicted maternal responsiveness, namely that an intention to breastfeed increased the odds of positive maternal responsiveness, independently of breastfeeding practice. However, we found the practice of breastfeeding was not an independent predictor of positive maternal responsiveness once intention to breastfeed was accounted for. Using a life course epidemiology approach we further demonstrated that maternal responsiveness is most positive when both the intention to breastfeed and breastfeeding practice are present. Conclusions: To our knowledge this is the first study to report that having the intention to breastfeed an infant is more strongly associated with positive maternal responsiveness than the act of breastfeeding itself. This may suggest that more responsive mothers choose to breastfeed rather than breastfeeding practice directly causing enhanced responsiveness. Further research will be needed to understand the nature of this intention and its relationships with maternal responsiveness. However, the results may also highlight the potential importance of parenting intentions/ preparations during pregnancy for a mothers developing abilities to be responsive to her infant after birth.

Infants are perceptually sensitive to rising pitch over falling pitch (Sullivan & Horowitz, 1983) and this is reflected in their ability to discriminate between questions and declaratives in maternal speech (Soderstrom, Ko, & Nevzorova, 2011). Questions are proposed to play a fundamental role in the acquisition process by soliciting vocalization on the part of the infant (Snow, 1977). In the current study, we explored whether infant vocal responses to questions were distinct from those to declaratives; in particular, whether the use of questions by mothers encouraged greater vocalization by infants. Contrary to our hypothesis, infant vocalizations were no more likely to occur in response to questions. Infants responded more to questions when they were defined by rising pitch contours rather than falling ones. Infants did not respond more to declaratives with rising pitch contours. Questions, in combination with rising pitch contour, may provide especially salient response cues for infants. We propose that infants rely on these perceptual cues to learn when to respond during vocal exchanges with their mothers.

Historically, the primary belief has been that asthma is an atopic disease with the strongest risk factor for developing asthma being exposure to an allergen. However, researchers have begun to question that long held belief and are beginning to study other postnatal environmental factors such as stress. Research delving into maternal postnatal distress and the subsequent effects seen upon the developing neonatal immune system as it pertains to asthma has gained momentum. With that in mind, the focus of this research was 1) to determine if skin infections are more likely to be seen in young children who have been exposed to maternal distress, 2) to determine if skin infections in children from infancy to age 2 are associated with asthma, independent of atopic dermatitis, and 3) to determine if the association between early life skin infection and asthma was independent of recent stress biomarkers such as cortisol and dehydroepiandrostrone (DHEA). To meet the objectives listed above, the 1995 SAGE (Study of Asthma, Genes and the Environment) Manitoba birth cohort of 13980 children was used. Maternal postnatal distress, skin infection and atopic dermatitis in the infant, asthma at age 11 and other risk factors for asthma were derived from Manitoba’s health care databases. For objective 3, data on stress biomarkers (Cortisol/DHEA ratio) were obtained from the SAGE nested case-control study. Multivariable logistic regression analysis confirmed the first objective that skin infections (adj. OR 1.25, 95% CI 1.13-1.39) and or atopic dermatitis (adj. OR 1.46, 95% CI 1.26-1.70) seen in children from birth to age 2 could be used as indirect markers of stress. The second objective determined that children who exhibited an early skin infection, from birth to age two, were at an increased risk for developing asthma by age 11 independent of atopic dermatitis. However, this finding was dependent upon frequency of health care use. Those children that exhibited an early skin infection and had less than 24 health care visits over 7 years were 1.33 times (95% CI 1.01-1.75) more likely to acquire asthma by age 11 than those who did not have an early skin infection. Children with fewer health care visits were 1.44 times more likely to have asthma. The third objective was not met because the association between early skin infection and asthma was not independent of the Cortisol/DHEA ratio. However, the univariate results for skin infection in the nested case-control study were not significant. The findings of this thesis may be used by family physicians or paediatricians when looking for tangible markers that may indicate infants at risk for developing asthma by school age.

WIC food packages are undergoing major revisions to accommodate the unique requirements of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in the twenty-first century. This dissertation is an evaluation of the impact of the revised WIC food packages through national-level surveys obtaining data before and after food package changes. In addition, a community-level metabolic/dietary study of obese women consuming either the original or revised food packages was performed. Since WIC has never revamped its entire program before, this is an opportunity to learn more about the impact of the revisions on WIC participants across the country, including Native Americans from Indian Tribal Organizations (ITOs). The National Food and Nutrition food frequency questionnaire (NATFAN) evaluates food and consumption practices of WIC participants, including Native Americans, for both the original and revised WIC food packages. The baseline surveys (NATFAN') were administered before the 2009 rollout of the revised WIC food packages (dates varied by state program). The post-rollout surveys (NATFAN'') were administered spring through winter of 2010-2011, and at least six months after the implementation of the revised WIC food packages. Hierarchical linear modeling, with restricted maximum likelihood approximation, was used to evaluate 100% juice, fruit, and vegetable frequency of consumption based upon NATFAN' and NATFAN'', including samples from states, territories, and ITOs. This research is important because it was national in scope and analyzed nutritional behaviors of a Native American subpopulation of WIC that is seldom documented in national nutrition research. For the metabolic/diet study, obese women 185% of the poverty level were given the original or revised WIC food packages (n=3). Three venous blood serum collections (0, 6, 12 weeks) were biomarker tested (cholesterol, glucose, C-reactive protein, etc.) in lipid and metabolic panels. Three, seventy-two hour dietary recalls were also assessed to determine fruit and vegetable consumption changes over the course of the study. This phase was important because it focused on the individual's actual consumption behaviors of specific WIC foods dispensed in the WIC food packages and assessed how such consumption affected the health of the individual.

No description available.

Infants are perceptually sensitive to rising pitch over falling pitch (Sullivan & Horowitz, 1983) and this is reflected in their ability to discriminate between questions and declaratives in maternal speech (Soderstrom, Ko, & Nevzorova, 2011). Questions are proposed to play a fundamental role in the acquisition process by soliciting vocalization on the part of the infant (Snow, 1977). In the current study, we explored whether infant vocal responses to questions were distinct from those to declaratives; in particular, whether the use of questions by mothers encouraged greater vocalization by infants. Contrary to our hypothesis, infant vocalizations were no more likely to occur in response to questions. Infants responded more to questions when they were defined by rising pitch contours rather than falling ones. Infants did not respond more to declaratives with rising pitch contours. Questions, in combination with rising pitch contour, may provide especially salient response cues for infants. We propose that infants rely on these perceptual cues to learn when to respond during vocal exchanges with their mothers.

Historically, the primary belief has been that asthma is an atopic disease with the strongest risk factor for developing asthma being exposure to an allergen. However, researchers have begun to question that long held belief and are beginning to study other postnatal environmental factors such as stress. Research delving into maternal postnatal distress and the subsequent effects seen upon the developing neonatal immune system as it pertains to asthma has gained momentum. With that in mind, the focus of this research was 1) to determine if skin infections are more likely to be seen in young children who have been exposed to maternal distress, 2) to determine if skin infections in children from infancy to age 2 are associated with asthma, independent of atopic dermatitis, and 3) to determine if the association between early life skin infection and asthma was independent of recent stress biomarkers such as cortisol and dehydroepiandrostrone (DHEA). To meet the objectives listed above, the 1995 SAGE (Study of Asthma, Genes and the Environment) Manitoba birth cohort of 13980 children was used. Maternal postnatal distress, skin infection and atopic dermatitis in the infant, asthma at age 11 and other risk factors for asthma were derived from Manitoba’s health care databases. For objective 3, data on stress biomarkers (Cortisol/DHEA ratio) were obtained from the SAGE nested case-control study. Multivariable logistic regression analysis confirmed the first objective that skin infections (adj. OR 1.25, 95% CI 1.13-1.39) and or atopic dermatitis (adj. OR 1.46, 95% CI 1.26-1.70) seen in children from birth to age 2 could be used as indirect markers of stress. The second objective determined that children who exhibited an early skin infection, from birth to age two, were at an increased risk for developing asthma by age 11 independent of atopic dermatitis. However, this finding was dependent upon frequency of health care use. Those children that exhibited an early skin infection and had less than 24 health care visits over 7 years were 1.33 times (95% CI 1.01-1.75) more likely to acquire asthma by age 11 than those who did not have an early skin infection. Children with fewer health care visits were 1.44 times more likely to have asthma. The third objective was not met because the association between early skin infection and asthma was not independent of the Cortisol/DHEA ratio. However, the univariate results for skin infection in the nested case-control study were not significant. The findings of this thesis may be used by family physicians or paediatricians when looking for tangible markers that may indicate infants at risk for developing asthma by school age.

This study considers the reproductive experiences of women in Sheffield between 1870 and 1939, encompassing the development of concepts of maternal and infant welfare, and debates over birth control and abortion. It focuses on the impact of state and voluntary enterprise, on the development of health professions and hospitals, and on the position of mothers. The study shows that high infant mortality was caused primarily by poor sanitation. Unlike other areas, Sheffield had low rates of both maternal employment and bottle feeding, suggesting that these were not significant factors. The decline in infant mortality was due to a combination of factors; the removal of privy middens and slum areas, and the development of welfare clinics and health visiting services. High maternal mortality was prevalent mainly in areas of skilled working class employment; not middle class areas as in other cities. There was no inverse correlation between infant and maternal mortality in Sheffield. Maternal mortality was caused by high rates of sepsis following illegal abortion. The reduction in mortality was due to a cyclical decline in the virulence of the causative bacteria, and the application of sulphonamide drugs to control it. The development of antenatal and birth control clinics had little impact. Despite early action to train midwives in Sheffield, midwifery remained a largely part time, low status occupation throughout the period. The hospitalisation of normal childbirth occurred early in Sheffield, and demand for beds outstripped supply, demonstrating that women were able to shape the development of services. Local authority and voluntary groups generally co-operated in the delivery of services, which were developed along pragmatic lines with little reference to debates about eugenics or national deterioration. The growth of welfare schemes was circumscribed by the available resources. Central government provided enabling legislation, but schemes were planned and implemented at the local level.

Thesis (MNursing (Advanced Practice))--University of South Australia, 1996

Thesis (LL. M.)--University of Toronto, 2004. / Adviser: R. Cook.