Comprehensive Services: Charting Progress for Babies in Child Care Research-Based Rationale

This rationale presents research on factors that put babies and toddlers at risk for unhealthy development and the benefits of comprehensive health, mental health, and family support services. It also examines how state policies can improve care for babies. As part of the Charting Progress for Babies in Child Care project, this rationale supports the Policy Framework's recommendation to: Link necessary services for vulnerable babies and toddlers to child care settings

Birth outcomes for African and Caribbean babies in England and Wales: retrospective analysis of routinely collected data

Objectives: To compare mean birth weights, gestational ages and odds of preterm birth and low birth weight of live singleton babies of black African or Caribbean ethnicity born in 2005 or 2006 by mother's country of birth. Design: Secondary analysis of data from linked birth registration and NHS Numbers for Babies data set. Setting: Births to women in England and Wales in 2005 and 2006. Participants: Babies of African and Caribbean ethnicity born in England and Wales in 2005–2006, whose mothers were born in African and Caribbean countries or the UK. Birth outcomes for 51 599 singleton births were analysed. Main outcome measures: Gestational age and birth weight. Results: Mothers born in Eastern or Northern Africa had babies at higher mean gestational ages (39.38 and 39.41 weeks, respectively) and lower odds of preterm birth (OR=0.80 and 0.65, respectively) compared with 39.00 weeks for babies with mothers born in the UK. Babies of African ethnicity whose mothers were born in Middle or Western Africa had mean birth weights of 3327 and 3311 g, respectively. These were significantly higher than the mean birth weight of 3257 g for babies of the UK-born mothers. Their odds of low birth weight (OR=0.75 and 0.72, respectively) were significantly lower. Babies of Caribbean ethnicity whose mothers were born in the Caribbean had higher mean birth weight and lower odds of low birth weight than those whose mothers were born in the UK. Conclusions: The study shows that in babies of African and Caribbean ethnicity, rates of low birth weight and preterm birth varied by mothers' countries of birth. Ethnicity and country of birth are important factors associated with perinatal health, but assessing them singly can mask important heterogeneity in birth outcomes within categories particularly in relation to African ethnicity. These differences should be explored further

Tuning in to babies: Nurturing relationships in early childhood settings

Babies are born primed to engage with people and to explore the world around them. They are learning and developing from their day of birth in every context in which they find themselves. As babies’ participation in out-of-home early childhood education and care (ECEC) settings is rising (OECD, 2012), the quality of this education and care is of the utmost importance. This article explores why we should focus on babies in ECEC settings in Ireland, the unintended consequences of some policy actions, the specialised knowledge and relational skills required for working with babies, and some recommendations for policy and practice

The reasons why women with small for gestational age babies stop breastfeeding : a thesis presented in partial fulfilment of the requirements for the Master of Arts in Midwifery at Massey University

There has been a multitude of research literature on breastfeeding benefits, incidence and duration of breastfeeding, characteristics of women who breastfeed and formula feed, and variables associated with breastfeeding initiation and success in the 'general' breastfeeding population. Unfortunately there has been very little written about breastfeeding in women who deliver small for gestational age (SGA) babies. The literature has demonstrated that women with SGA babies have different characteristics to women in the general breastfeeding population as illustrated in the adjacent literature review. The literature review, which accompanies this thesis, has highlighted the multiple advantages associated with breastfeeding, which may be particularly beneficial for SGA babies. Whether women delivering SGA babies have different breastfeeding experiences, or reasons for discontinuing breastfeeding, however has never been investigated. The research presented in this thesis is part of a randomised-controlled trial entitled "The effect of educational information on the duration of breastfeeding in small for gestational age babies". Only one arm of this larger study has been analysed due to the restraints of a 75-point thesis. The full program of study is in progress. The primary aim of this arm was to determine why women with small for gestation age babies stop breastfeeding. Other influences on breastfeeding success were also investigated to determine if these external influences were statistically significant. The findings from this research project have demonstrated that women with SGA babies have the same breastfeeding concerns as women in the general breastfeeding population. The most commonly cited reason for stopping breastfeeding were concerns about 'not enough milk'. Forty four percent of the women cited the midwife as being the most 'valuable' support with their breastfeeding experience. Overall the women with SGA babies had very good breastfeeding rates at 3 and 6 months postnatally compared with the general breastfeeding population statistics. This is a credit to the midwives caring for these women and babies and may also be related to the fact that term SGA babies have been undernourished in utero and can often be hungry babies with 'catching up' to do. These research findings also support the idea that the introduction of supplementary bottles administered on the postnatal wards can have a detrimental effect on future breastfeeding success. However, small for gestational age infants are at increased risk of hypoglycaemia and supplemental feeding may be necessary if the infant is feeding poorly or shows evidence of hypoglycaemia. Any strategies that can improve the breastfeeding duration for SGA infants can result in a wide range of health benefits. The adjacent literature review demonstrates that breastfeeding is the best form of infant feeding and may be even more so for small term babies

Vitamin K policies and midwifery practice: questionnaire survey

Objectives: To investigate policies on neonatal vitamin K and their implementation. Design: Two phase postal survey. Setting: United Kingdom. Participants: A 10% random sample of midwives registered with the United Kingdom Central Council for nursing, midwifery, and health visiting. Of 3191 midwives in the sample, 2515 (79%) responded to phase one and 2294 (72%) completed questionnaires on their current jobs (November 1998 to May 1999). In phase two, 853 (62%) of 1383 eligible midwives gave details on 2179 of their earliest jobs (start dates before 1990). Results: All the midwives in clinical practice at the time of the survey (2271, 99%) reported that they were working in areas with official policies on neonatal vitamin K. Seven distinct policies were described: intramuscular vitamin K for all babies (1159, 51.0%); intramuscular vitamin K for babies at "high risk," oral for others (470, 20.7%); oral vitamin K for all babies (323, 14.2%); parental choice for all (124, 5.5%); parental choice for all except babies at high risk, (119, 5.2%); intramuscular vitamin K for babies at high risk only (33, 1.5%); oral vitamin K for babies at high risk only (17, 0.7%); and a disparate group of policies including intravenous vitamin K for some babies (26, 1.1%). Previous policies were (and some may still be) open to individual interpretation and were not always followed. Conclusions: Hospital policy is not necessarily a good guide to individual practice. The primary purpose of clinical records is to document patient care, and recording practices reflect this. There is considerable variation in vitamin K policies and midwifery practice in the United Kingdom, and there is no clear consensus on which babies should receive vitamin K intramuscularly

Brain food for babies

How does a mother supply a key building block of the brain required for neurodevelopment to her fetus in pregnancy? The critical requirement of docosahexaenoic acid (DHA) for fetal brain development, and the poor efficiency of its synthesis in humans, is a tricky metabolic problem to be overcome in pregnant women. Supplying this unique fatty acid to the fetus requires exquisite specificity and timing, processes that can unravel in disease conditions such as pre-eclampsia

Building Babies - Chapter 16

In contrast to birds, male mammals rarely help to raise the offspring. Of all mammals, only among rodents, carnivores, and primates, males are sometimes intensively engaged in providing infant care (Kleiman and Malcolm 1981). Male caretaking of infants has long been recognized in nonhuman primates (Itani 1959). Given that infant care behavior can have a positive effect on the infant’s development, growth, well-being, or survival, why are male mammals not more frequently involved in “building babies”? We begin the chapter defining a few relevant terms and introducing the theory and hypotheses that have historically addressed the evolution of paternal care. We then review empirical findings on male care among primate taxa, before focusing, in the final section, on our own work on paternal care in South American owl monkeys (Aotus spp.). We conclude the chapter with some suggestions for future studies.Deutsche Forschungsgemeinschaft (HU 1746/2-1) Wenner-Gren Foundation, the L.S.B. Leakey Foundation, the National Geographic Society, the National Science Foundation (BCS-0621020), the University of Pennsylvania Research Foundation, the Zoological Society of San Dieg

Parents' experiences of sharing neonatal information and decisions: Consent, cost and risk

This paper is about the care of babies with confirmed or potential neurological problems in neonatal intensive care units. Drawing on recent ethnographic research, the paper considers parents' experiences of sharing information and decisions with neonatal staff, and approaches that support or restrict parents' involvement. There are growing medico-legal pressures on practitioners to inform parents and involve them in their babies' care. Data are drawn from observations in four neonatal units in southern England, and interviews with the parents of 80 babies and with 40 senior staff. The paper compares standards set by recent guidance, with parents' views about their share in decision-making, their first meetings with their babies, 'minor' decision-making, the different neonatal units, being a helpless observer and missed opportunities. Parents' standards for informed decisions are summarised, with their reported views about two-way decision-making, and their practical need to know. Whereas doctors emphasise distancing aspects of the consent process, parents tend to value 'drawing together' aspects

Data Matters: Chicago's Babies

October is National Pregnancy and Infant Loss Awareness Month. The Social IMPACT Research Center took a look at infant mortality rates and low birth weight rates of Chicago Community Areas and compared these data to the public health goals as outlined in the Chicago Department of Public Health's Healthy Chicago 2020 agenda, to see how Chicago babies were faring on these health indicators