Screening of postpartum depression among new mothers in Istanbul: a psychometric evaluation of the Turkish Edinburgh Postnatal Depression Scale

OBJECTIVE:This study is the first concerted effort to ascertain factor structure of EPDS using evidence based analytical techniques. It is the most widely used scale for assessing postpartum depression in Turkey, and yet no investigations have been conducted to assess it factor structure. This study was conducted from April 2012 to April 2018 at the Marmara University Hospital operating under the name of Marmara University Pendik Training and Research Hospital in Istanbul Turkey. RESULTS:A total of 1700 women were included in this study, who responded to the EPDS, in addition to demographic characteristics and well-being of their offspring. A total of 1615 mothers provided adequate data for inclusion in analysis. Standardized Chronbach's alpha for EPDS was 0.81 with corrected item-total correlations ranging from 0.35 to 0.62. Parallel analysis, MAP Velicer Test and Hull's method dictated retaining of one factor structure. All the items revealed adequate communalities (> 0.20) except item 2 (enjoyment) and item 10 (self-harm). Their communalities were 0.16 and 0.19, however, these items were not dropped. All of the items yielded moderate to strong factor loadings. Minimum factor loading was for item 2 (0.40) and highest for item 8 (0.71)

Possums-based parental education for infant sleep: cued care resulting in sustained breastfeeding

For infants and their families, sleep consolidation is important in maturing neural and circadian rhythms, and in family dynamics. The Possums Infant Sleep Program is a cued care approach to infant sleep, responding to infant cues in a flexible manner, dialing down the infant's sympathetic nervous system. The current study evaluated the effect of the Possums program on infant sleep and breastfeeding in infants (6-12 months) from a well-child outpatient clinic in Turkey, with the program intervention group (n = 91) compared with usual care (n = 92). In total, 157 mother-infant dyads completed the study. Infant sleep and breastfeeding rates were assessed at baseline and after 3 months. Nocturnal wakefulness, daytime sleep duration, naps, and night wakening decreased in both groups. Nocturnal sleep duration and the longest stretch of time the child was asleep during the night increased significantly in both groups without any change in total sleep duration. Night wakening was significantly lower and nocturnal sleep duration was significantly higher in the intervention group. However, mixed effects model analyses indicated no significant differences between the groups on any of the sleep outcomes after adjusting for confounders. Despite this, breastfeeding rates were significantly higher in the intervention group compared with those in the usual care group at follow-up. Conclusion: The Possum infant sleep program provided equivalent positive results on sleep parameters compared to usual care while advocating a more cued response. The critical difference was evident in sustained breastfeeding

Evidence Based Approach to Breastfeeding Difficulties

Emzirme sorunları doğum sonrası ilk bir ayda yaklaşık %70 sıklıkla yaygın görülmekte, emzirmenin erkensonlanması, postpartum depresyon gibi olumsuz sonuçlar doğurmaktadır. Annenin emzirme konusunda profesyoneldestek alması ise sadece anne sütüyle emzirme başarısını arttırmaktadır. Bu yazının amacı sadece anne sütüylebeslenmenin önündeki en büyük engellerden, yaygın görülen emzirme sorunlarını kanıta dayalı olarak güncelaraştırmalar eşliğinde tartışmaktır. Bebeğin memeye yerleşme sorunları ve ağrılı meme ucu emzirme ile ilgilikaygıların başında gelmektedir. Bu sorunların erken saptanmaması halinde sütte azalma ve bebekte yetersiz tartı alımıile sonuçlanmaktadır. Son yıllarda yapılan ultrason çalışmaları emzirme konusunda yeni bilgiler ortaya koymaktadır.Başarılı emzirmede anne bebek ikilisinin erken ten tene teması, doğum sonrası 1-2 saatlik pencere dönemininkaçırılmayarak bebeğin primitif reflekslerinin harekete geçirilmesi, annenin güvenini kıran müdahaleci yaklaşımlaryerine, anneye özgüven kazandırılması, rahat bir emzirme için bedenen ve ruhen hazırlanması, uygun memedeyerleşimle, sık emzirme önerilmektedir. Anne sütünü arttırmak için kullanılan bitkisel ürünlerde standardize dozolmaması, olası kirleticiler, alerjik potansiyelleri ve olası ilaç etkileşimleri nedeniyle kullanılması önerilmemektedir.Breastfeeding difficulties are common with a reported occurrence of approximately 70%, leading to_x000D_ adverse outcomes such as early cessation of breastfeeding and postpartum depression. Professional breastfeeding_x000D_ support is associated with a higher success of exclusive breastfeeding. The aim of this paper is to discuss the common_x000D_ breastfeeding difficulties, one of the biggest obstacles to exclusive breastfeeding, in light of evidence-based research._x000D_ Poor latching and nipple pain are the main concerns about breastfeeding. Failure to diagnose these problems result in_x000D_ low milk supply and inadequate weight gain of the baby. Recent ultrasound studies reveal new information about_x000D_ breastfeeding. For a successful breastfeeding early skin to skin contact of the mother-infant dyad, stimulating the_x000D_ baby’s primitive reflexes without missing the postpartum 1-2-hour window period, giving self-confidence to the_x000D_ mother, instead of hands on interventional approaches, preparing the mother physically and mentally for a_x000D_ comfortable breastfeeding, frequent breastfeeding in an optimal position is recommended. Herbal products used to_x000D_ increase breast milk supply are not recommended due to the lack of standardized doses, possible pollutants, allergic_x000D_ potential and possible drug interactions_x000D

Effects of the COVID-19 pandemic on perinatal outcomes: a retrospective cohort study from Turkey

Background Lockdowns, pregnant women's fear from hospitalization in addition to uncertainties about appropriate birthing practices at the beginning of the pandemic may have affected the health outcomes of mother-infant couples. We aimed to explore whether pregnancy outcomes including the rates of cesarean delivery (CS), preterm, and low birth weight (LBW) births have changed during the pandemic period compared with the pre-pandemic period. Methods We applied a population-based retrospective cohort, before-after approach in 2020 vs. similar calendar months in 2019 for five periods [Jan-Feb (pre-pandemic); March-May (1st wave and lockdown); June-August; September-October; November-December (2nd wave and lockdown)]. The data was modelled through multiple logistic regressions using key outcomes; CS, preterm, and LBW births as the dependent variables, and adjustments were made for independent variables in SPSS software. We evaluated the modification of years by periods by adding interaction term (yearXperiod) to the model. Results The rate of CS in hospital births increased from 57.7% in 2019 to 60.2% in 2020. CS rates were significantly increased during the 3rd and 4th periods. The overall preterm rate was 11%. When singleton pregnancies were considered, adjusted multivariable analyses showed a decrease in preterm proportions during all time periods with respect to the pre-pandemic period. The percentage of LBW was 7.7% during the pandemic period and was found to be significantly reduced compared to the pre-pandemic period. There was a significant reduction in LBW rates in all periods except the second lockdown period. Conclusions Our findings suggested significant reductions in preterm and LBW births possibly due to the indirect effects of the pandemic. Moreover, strategies need to be considered to address the increased CS rates and shifting of maternity service utilization to private facilities

Seeing the pandemic through children's eyes: Exploring Turkish children's views on COVID-19 pandemic by focus-group discussions

BackgroundThe direct and indirect effects of the COVID-19 pandemic on children and youth people are well documented. Little is known about children\"s experiences of the pandemic in their own words. We aimed to explore Turkish children\"s experiences and views about the pandemic, across private and public educational systems. MethodsSix focus group discussions were conducted online with 30 children aged between 7 to 18 years in 2021. Children were enrolled through snowball sampling technique according to developmental age groups. A thematic analysis was conducted. ResultsWe identified five themes: Compliance with public health measures about preventing the spread of COVID-19, changes in daily routines, emotional responses to the pandemic, distance education, and adaptive responses. Overall, children were well informed and receptive to the public health preventive measures with the exception of older children\"s tendency to disregard physical distancing with friends. They reported frustration with those who did not comply with measures and believed that the authorities should strictly enforce public health requirements. Emotional responses comprised fear of family members and themselves being infected, anxiety produced by the uncertainty of the virus, and the loss of social support. There was a perceived disparity between students from public and private schools regarding academic self-competence. Positive aspects of the pandemic included positive interactions with family members and the acquisition of new hobbies. Although most children acknowledged the support of their parents to deal with challenges, children of health workers were particularly isolated in terms of emotional support. ConclusionOur findings offer additional insights and validate previous research on the negative and positive effects of COVID-19 from the child\"s perspective across private and public educational systems. This study contributes to global advocacy efforts aimed at understanding the impact of the pandemic on children

Impact of lockdown and school closure on children's health and well-being during the first wave of COVID-19: a narrative review

Background In the context of containment measures against the COVID-19 pandemic, the aims were to examine the impact of lockdown and school closures on childs' and adolescents' health and well-being and social inequalities in health. Methods Literature review by searching five databases until November 2020. We included quantitative peer-reviewed studies reporting health and well-being outcomes in children (0-18 years) related to closure measures' impact due to COVID-19. A pair of authors assessed the risk of bias of included studies. A descriptive and narrative synthesis was carried out. Findings Twenty-two studies, including high-income, middle-income and low-income countries, fulfilled our search criteria and were judged not to have an increased risk of bias. Studies from Australia, Spain and China showed an increase in depressive symptoms and decrease in life satisfaction. A decrease in physical activity and increase in unhealthy food consumption were shown in studies from two countries. There was a decrease in the number of visits to the emergency department in four countries, an increase in child mortality in Cameroon and a decrease by over 50% of immunisations administered in Pakistan. A significant drop of 39% in child protection medical examination referrals during 2020 compared with the previous years was found in the UK, a decrease in allegations of child abuse and neglect by almost one-third due to school closures in Florida, and an increase in the number of children with physical child abuse trauma was found in one centre in the USA. Interpretation From available reports, pandemic school closure and lockdown have adverse effects on child health and well-being in the short and probably long term. We urge governments to take the negative public health consequences into account before adopting restrictive measures in childhood

The role of social support on the relationships between internet use and sleep problems in adolescents during COVID-19 pandemic: a multicentre study

Background: This study examines the frequency of problematic internet use and sleep problems in adolescents aged 14–18 years during the COVID-19 pandemic and identifies the impact of factors such as sociodemographic characteristics, internet habits, changes in daily life, and perceived social support on these problems. Methods: This multicentre study was a questionnaire-based online survey study. The questionnaire included the Young Internet Addiction Scale, the Pittsburgh Sleep Quality Index, and the Multidimensional Scale of Perceived Social Support, as well as questions about demographic information, internet habits, and changes in daily life during pandemic. Several multivariate Backward logistic regression models were run to determine the variables that predicted problematic internet use and poor sleep quality. Results: It was determined that the frequency of problematic internet use was 15.5%, and the frequency of poor sleep quality was 47.8%. Poor sleep quality was found 2.5 times higher in problematic internet users. The perceived social support was found insufficient in adolescents with problematic internet use and poor sleep quality. Various factors such as the excessive use of internet and social media, low school success, lack of physical activity, lack of rules for internet use at home, and worsening of relationships with parents were found to be predictive factors for these problems. Conclusions: Problematic internet use during the pandemic is associated with worsening sleep quality in adolescents. It is important to create special interventions for problematic internet use and sleep problems that develop in adolescents as a result of restrictions during the pandemic

Increasing sleep health awareness in pediatric settings: creating opportunities for generating a more sleep-literate health care workforce

Sleep health is one of the major contributors to mental and physical health and as such should be an essential component of informed community and policy conversations around health. Non-physiological sleep problems are commonly referred to as Behavioral Sleep Problems (BSP) and include difficulties initiating sleep alone, bedtime resistance, difficulties re-initiating sleep after normally occurring overnight waking (requiring parental assistance to re-settle) and/or early morning wakening. BSP affects up to 40% of children under two years of age. Despite the high prevalence and impact of sleep disturbance, training and education curricula for pediatric medical and allied health professions include little information or awareness building about sleep, particularly in strategies to ameliorate sleep for children and their families. An evident need to train health professionals working with children in evidence-based pediatric behavioral sleep care is emerging. A recent partnership between Turkey and Australia has tackled this problem. By developing a scientific collaborative network between the two countries and using existing evidence-based methods, clinical information was shared between health professional workforces in these two countries as effective ways of translating knowledge in pediatric sleep interventions. Systematic training of primary and tertiary medical and allied health professionals must be considered as standard practice in tertiary education settings