This study explores the stability and change in maternal life satisfaction and psychological distress following the birth of a child with a congenital anomaly using 5 assessments from the Norwegian Mother and Child Cohort Study collected from Pregnancy Week 17 to 36 months postpartum. Participating mothers were divided into those having infants with (a) Down syndrome (DS; n = 114), (b) cleft lip/palate (CLP; n = 179), and (c) no disability (ND; n = 99,122). Responses on the Satisfaction With Life Scale and a short version of the Hopkins Symptom Checklist were analyzed using structural equation modeling, including latent growth curves. Satisfaction and distress levels were highly diverse in the sample, but fairly stable over time (retest correlations: .47-.68). However, the birth of a child with DS was associated with a rapid decrease in maternal life satisfaction and a corresponding increase in psychological distress observed between pregnancy and 6 months postpartum. The unique effects from DS on changes in satisfaction (Cohen's d = -.66) and distress (Cohen's d = .60) remained stable. Higher distress and lower life satisfaction at later assessments appeared to reflect a persistent burden that was already experienced 6 months after birth. CLP had a temporary impact (Cohen's d = .29) on maternal distress at 6 months. However, the overall trajectories did not differ between CLP and ND mothers. In sum, the birth of a child with DS influences maternal psychological distress and life satisfaction throughout the toddler period, whereas a curable condition like CLP has only a minor temporary effect on maternal psychological distress.
We examined the well-being of mothers and non-mothers reporting exclusive opposite-gender sexual partners (OG), same-gender sexual partners (SG), or both (BI) in a representative sample of 20,773 participants (11,034 women) 15-years-old or older from the population of Quebec province in Canada. Participants completed a self-administered questionnaire and SG and BI women (n = 179) were matched to a sample of OG women (n = 179) based on age, income, geographical area, and children (having at least one 18-year-old or younger biological or adopted child at home). We assessed social milieu variables, risk factors for health disorders, mental health, and quality of mothers' relationship with children. The findings indicated a sexual orientation main effect: Mothers and non-mothers in the SG and BI group, as compared to their OG controls, were significantly less likely to live in a couple relationship, had significantly lower levels of social support, higher prevalence of early negative life events, substance abuse, suicide ideation, and higher levels of psychological distress. There were no Sexual Orientation X Parenthood status effects. The results further indicated that sexual orientation did not account for unique variance in women's psychological distress beyond that afforded by their social milieu, health risk factors, and parenthood status. No significant differences were found for the quality of mothers' relationship with children. SG-BI and OG mothers with low levels of social integration were significantly more likely to report problems with children than parents with high levels of social integration. We need to understand how marginal sexualities and their associated social stigma, as risk indicators for mothers, interact with other factors to impact family life, parenting skills, and children's adjustment.
Teaching safety rules is a common way parents attempt to moderate injury risk for elementary-school children, but few studies have examined the nature of this teaching. The present study explored whether mothers' safety rules varied with type of injury (falls, poisoning, burns and cuts), the nature of these teaching strategies about rules, and how effective these rules were to moderate children's risk behaviour when in a setting having 'contrived' hazards that were targeted by these rules.
Mothers completed an interview about safety rules, and children's behaviour was unobtrusively observed in a 'contrived hazards' situation having hazards relevant to falls, poisoning, burns and cuts.
Mothers had significantly fewer rules addressing fall risks than other types of injuries, and fall-related rules were highly hazard-specific in nature, rather than aimed at teaching general principles for appraising fall risks. For all types of injuries except falls, children interacted with fewer hazards for which there were rules.
Rules can have preventive properties that can serve to moderate children's interacting with hazards when alone, but this seems to vary depending on the type of rule that has been taught. Given that falls are a leading cause of injury hospitalization for children and that parents are not emphasizing fall prevention as much as other types of injuries, efforts should be extended to promote parents' shifting their prevention approaches to better address this particular injury risk.
To compare alcohol cleaning and natural drying of newborn umbilical cords.
Prospective, randomized controlled trial.
Tertiary-level university teaching hospital and level II community hospital.
Of 1,876 singleton full-term newborns enrolled, 1,811 completed the study.
Newborns, from birth until separation of the cord, were randomized to either (a) umbilical cleansing with 70% isopropyl alcohol at each diaper change or (b) natural drying of the umbilical site without special treatment.
Umbilical infection, cord separation time, maternal comfort, and cost.
No newborn in either group developed a cord infection. Primary care providers obtained cultures for cord concerns in 32 newborns (1.8%), with colonization for normal flora, Staphylococcus aureus, and Group B streptococcus proportionately equal in alcohol and air dry groups. Cord separation time was statistically significantly different (alcohol group, 9.8 days; natural drying group, 8.16 days; t = 8.9, p =
To identify methylphenidate profiles over several years in a national sample of boys and examine behavioral and sociodemographic predictors of use.
Five cycles of a Canadian survey were used, resulting in 1447 boys followed from 2 to 3 years to 10 to 11 years. Mother reports of boys' methylphenidate use from 4 to 5 years to 10 to 11 years were used to identify profiles over time. Mother-reported sociodemographic and child behavior data at 2 to 3 years were then used to predict methylphenidate profiles.
Three methylphenidate profiles were identified: no use (87.2%); slow-rising, intermittent (11.2%); and fast-rising, stable (1.6%). Sociodemographic variables were not significant predictors. Boys with greater hyperactivity-impulsivity, greater inattention, and less disruptive behavior were more likely to belong to the fast-rising, stable methylphenidate profile. Although 13% of boys were using methylphenidate over time, there were 2 heterogeneous profiles. In the first profile, there were very few initial users followed by a steady increase in the number of boys using methylphenidate over time. Among these boys, however, use was inconsistent over time. In the second profile, there was a sharp onset of methylphenidate use on school entry, followed by consistent use thereafter.
These findings have implications for the treatment effectiveness of attention deficit-hyperactivity disorder symptoms. It is important to continue examining the role of disruptive behavior because its co-occurrence with attention deficit-hyperactivity disorder symptoms and methylphenidate use is complex.
The effectiveness of a family-centered maternity program in promoting a positive feeling toward the infant and in preparing the mothers for their new role was evaluated. Seventy-three married primiparous women completed measures of anxiety and depression as well as a series of questionnaires relating to their attitudes toward pregnancy, the baby, and the hospital experience. Statistical analyses revealed that the women in the family-centered maternity program, when compared with those in the traditional program, had a more positive attitude toward their babies while in the hospital. In addition, they reported having received more experience in caring for their babies and more help from the hospital personnel in preparing for the mothering role.
Rooming-in, the practice of caring for mother and newborn together in the same room immediately from birth, is preferred for the general postpartum population but is not yet standard practice of care for newborns of substance-using women. Such newborns are usually separated from their mothers and admitted to a neonatal intensive care unit and treated for substance withdrawal if necessary. We compared clinical and psychosocial outcomes associated with traditional standard care models versus an interdisciplinary rooming-in model of care for substance-exposed newborns.
We conducted a retrospective comparative review of a cohort of substance-exposed newborns. Data were extracted from the British Columbia Perinatal Health Program database to populate the standard care and rooming-in groups. The main study outcomes were neonatal admission to NICU, breastfeeding, presence of neonatal withdrawal, length of stay, and custody status at discharge.
Rooming-in was associated with a significant decrease in admissions to NICU and a shorter NICU length of stay for term infants, increased likelihood of breastfeeding (either exclusively or in combination with formula) during the hospital stay, and increased odds of the baby being discharged home with the mother. There were no significant differences between groups with respect to the presence of neonatal substance withdrawal or breastfeeding status at discharge.
Rooming-in may facilitate a smooth transition to extrauterine life for substance-exposed newborns by decreasing NICU admissions and NICU length of stay for term infants, encouraging breastfeeding, and increasing maternal custody of infants at discharge. This review supports the finding that rooming-in is both safe and beneficial for substance-exposed babies.