Maternal and Paternal Influences on Infant Diet and Growth Throughout the First Year of Life.

Aim and objectives: The overall aim of this research was to investigate maternal and paternal behaviours and attitudes and their influences on the diet and growth of infants in the first year of life. Specific objectives were to assess: maternal wellbeing and breastfeeding outcomes; weaning and supplementation practices; infant growth and body composition; and the views of fathers on having a breastfeeding partner. Methodology: The first study was a prospective observational study, involving the recruitment of 270 pregnant women from the public and semi-private antenatal clinics of the Coombe Women and Infants University Hospital. Mother-infant dyads were then followed-up at birth and at four, nine and 12 months post-partum. Data were obtained on maternal wellbeing and on infant milk feeding, weaning practices and growth. The second study was a cross-sectional study in which a semi-quantitative questionnaire explored the feeding experiences of 417 men whose partner breastfed. Results: Of the sample of 270 pregnant women, 55.9% (n151) initiated breastfeeding. From this initial sample, 172 mothers were followed-up at four months post-partum, and 36.0% (n62) of these mothers were distressed. Controlling for other factors, distress was significantly (p=0.01) more likely at this time if a mother was breastfeeding. Only two in five (42.9%, n47) of these mothers put supports in place to help them to breastfeed, and of the 417 men whose partner breastfed, almost half (49.4%, n117) were unable to help their partner when she experienced breastfeeding difficulties. Of the 158 infants followed-up to one year of age, the average age at which they were weaned on to solid food was 20.7 weeks and 86.1% (n136) were weaned at or after 17 weeks of age. Only 57.6% (n91), 34.2% (n54) and 23.4% (n37) of infants were being correctly supplemented with vitamin D at four, nine and 12 months of age, respectively. Supplementing as recommended was significantly more likely if mothers had received advice on doing so from a health professional. Regarding growth, 28.5% (n45) of infants grew rapidly during the first year of life, with male infants having a significantly (p\u3c0.01) higher fat-free mass at birth and at age one year, compared to females. Conclusions: Parents need structured guidance to assist them in preparing for breastfeeding. Health professionals must persist in promoting healthy weaning and vitamin D supplementation practices. Further research is needed to identify clinically useful ways in which the growth and body composition of infants can be assessed

Factors Associated with Maternal Wellbeing at Four Months Post-Partum in Ireland

This study aimed to examine factors associated with maternal wellbeing at four months post-partum in the Irish context. Socio-demographic, health behaviour and infant feeding data were collected in pregnancy, at birth and at 17 weeks post-partum. Maternal distress, body image and resilience were measured at 17 weeks post-partum. Binary logistic regression predicted maternal distress and statistical significance was taken at p \u3c 0.05. One hundred and seventy-two women were followed-up in pregnancy, at birth and at 17 weeks post-partum. Three in five (61.6%, n106) initiated breastfeeding. At 17 weeks post-partum, 23.8% (n41) were exclusively or partially breastfeeding and over a third (36.0%, n62) of all mothers were at risk of distress. In multivariate analyses, independent predictors of distress included: low maternal resilience (p \u3c 0.01, odds ratio (OR): 7.22 (95% confidence interval [CI]: 2.49–20.95)); unsatisfactory partner support (p = 0.02, OR: 3.89 (95% CI: 1.20–12.65)); older age (p = 0.02, OR: 1.11 (95% CI: 1.02–1.21)); and breastfeeding (p = 0.01, OR: 2.89 (95% CI: 1.29–6.47)). Routine assessment of emotional wellbeing and targeted interventions are needed to promote a more healthful transition to motherhood among women in Ireland

Predictors of Vitamin D Supplementation Amongst Infants in Ireland Throughout The First Year of Life

A prospective observational study was conducted. Self-complete questionnaires recorded socio-demographic characteristics, health behaviours and supplementation practices for 158 mother-infant dyads at 4, 9 and 12 months post-partum. A 2-day food diary was also obtained on 12-month-old infants to examine the contribution of diet to vitamin D intakes

Views of fathers in Ireland on the experience and challenges of having a breast-feeding partner

Objective this study investigated the relationship between fathers and breast feeding in Ireland. Design and method a cross-sectional semi-quantitative questionnaire with closed-ended and open-ended questions was posted to 1398 men with an Irish partner who had given birth 4–7 months previously. Fathers who specified that their partner breast fed their last or only child were questioned about their: influence on the breast feeding decision; ability to assist with breast feeding challenges; preferred type of information on breast feeding; perceived advantages and disadvantages to breast feeding; and views on breastfeeding in public. Data from closed-ended questions on breast feeding were presented using frequencies and associated percentages. Answers to open-ended questions on breast feeding were categorised into themes using content analysis. Each theme was assigned a numerical code and the themes developed were quantitatively counted and presented as frequencies and percentages. Findings of the 583 respondents (42% response rate), 417 (71.5%) had a partner who had breast-fed their last or only child. Most of the 417 fathers were employed (95.7%, n399), college-educated (76.7%, n320) and married (87.8%, n366). Most (75.5%, n315) fathers were involved in the breast feeding decision. The majority (77.5%, n323) of fathers were unprepared for at least one aspect of breast feeding, most commonly that their partner encountered difficulties in establishing breast feeding. Of those fathers with a partner who experienced difficulties with breastfeeding (56.8%, n237), half (49.4%, n117) were unable to help their partner to overcome her breast feeding difficulties. Two-fifths (41.0%, n133) of fathers felt deprived of bonding time. Almost one in ten (9.4%, n39) fathers felt uncomfortable with an unrelated woman breast feeding in public, and this increased to three in ten or one third (34.3%, n143) if the woman in question was their partner. Key conclusion while fathers in a well-educated and socially advantaged sample are largely supportive of breast feeding, significant challenges remain in terms of their ability to support breast feeding in an informed and practical manner. Implications for practice women who are practically and emotionally supported by their partners are more likely to successfully breast feed, but the male perspective of breast feeding in Ireland has been given little attention. This study supports earlier and more effective engagement of fathers throughout the breast feeding process, and highlights areas of concern with respect to the role of fathers in breast feeding

Obesity is an Independent Predictor of Breastfeeding Initiation When Socioeconomic Status is Controlled For

Breastfeeding initiation rates vary across Europe, with rates as low as 56%(1) in Ireland and rates in excess of 90%(2) in the Nordic countries. A host of factors, including demographic, social, psychological and physical factors, influence the initiation, intensity and duration of breastfeeding. The extent to which modifiable factors influence breastfeeding initiation should be ascertained in order to prioritise support services for breastfeeding. Obesity is a known modifiable factor which inhibits breastfeeding initiation. This study aimed to determine the extent to which obesity inhibits breastfeeding initiation while controlling for socioeconomic status and other confounding factors. The Infant Cohort dataset from the Growing Up in Ireland study was used for this analysis. This dataset contains information on breastfeeding initiation for 11, 131 9-month-old infants. Factors that were significant (

Identifying Novel Data-Driven Dietary Patterns via Dimensionality Reduction and Associations with Socioeconomic Profile and Health Outcomes in Ireland

Dietary patterns and body mass index (BMI) play a significant role in the development of noncommunicable diseases (NCDs), which are the leading cause of mortality worldwide, including Ireland. A cross-sectional survey was conducted across Ireland to collate respondents’ socioeconomic profiles, health status, and dietary patterns with a representative sample size of 957 adult respondents. Principal component analysis (PCA) and statistical analyses were subsequently employed. To the author’s knowledge, this is the first study to use recent (2021) nationally representative data to characterise dietary patterns in Ireland via dimensionality reduction. Five distinct dietary patterns (“meat-focused”, “dairy/ovo-focused”, “vegetable-focused”, “seafood-focused”, and “potatofocused”) were identified and statistically characterised. The “potato-focused” group exhibited the highest mean BMI (26.88 kg/m2), while the “vegetable-focused” group had the lowest (24.68 kg/m2). “Vegetable-focused” respondents were more likely to be associated with a categorically healthy BMI (OR = 1.90) and urban residency (OR = 2.03). Conversely, “meat-focused” respondents were more likely to have obesity (OR = 1.46) and rural residency (OR = 1.72) along with the “potato-focused” group (OR = 2.15). Results show that data-derived dietary patterns may better predict health outcomes than self-reported dietary patterns, and transitioning to diets focusing on vegetables, seafood, and lower meat consumption may improve health

Patient experiences of a physiotherapy-led multidisciplinary rehabilitative intervention after successful treatment for oesophago-gastric cancer

Purpose To qualitatively explore the perceived impact of a 12-week rehabilitative intervention for oesophago-gastric cancer survivors on their physical, mental and social wellbeing. Methods Of the 21 participants who completed the intervention, 19 took part in a semi-structured focus group interview. Four audio-taped focus groups were held, ranging in size from two to eight participants. Focus groups were transcribed and analysed using a descriptive qualitative approach. Results At recruitment, participants were 23.5 ± 15.2 months post-surgery and all had suboptimal fitness levels. Participants reported improvements in their physical capacity and ability to carry out activities of daily living during the intervention. These improvements led to increased confidence and social connectivity. Other participants were a valuable source of information and reassurance, while support from family members was variable. Future interventions should educate participants on how to maintain gains achieved during the intervention. Conclusions Participating in an exercise-based multidisciplinary rehabilitative intervention reduces isolation and helps oesophago-gastric cancer survivors to safely negotiate their physical, emotional and social needs as they move further down the path of recovery

Implementation of a Food Science and Nutrition Module in a Dental Undergraduate Curriculum

Although it is generally acknowledged that nutrition should be a core subject in curricula, most dental programmes do not specifically include nutrition education.1–5 The rationale for improving the nutrition education of dental students is supported by the multidirectional and synergistic relationship between nutrition and oral health.6,7 As highlighted recently, achieving a population-wide reduction in free sugar consumption has now become a central tenet for public health authorities and professional healthcare workers globally.8 However, dentists do not have the confidence or competencies to assess or deliver appropriate dietary interventions

Rehabilitation strategies following oesophagogastric and Hepatopancreaticobiliary cancer (ReStOre II) : a protocol for a randomized controlled trial

BACKGROUND: Curative treatment for upper gastrointestinal (UGI) and hepatopancreaticobiliary (HPB) cancers, involves complex surgical resection often in combination with neoadjuvant/adjuvant chemo/chemoradiotherapy. With advancing survival rates, there is an emergent cohort of UGI and HPB cancer survivors with physical and nutritional deficits, resultant from both the cancer and its treatments. Therefore, rehabilitation to counteract these impairments is required to maximise health related quality of life (HRQOL) in survivorship. The initial feasibility of a multidisciplinary rehabilitation programme for UGI survivors was established in the Rehabilitation Strategies following Oesophago-gastric Cancer (ReStOre) feasibility study and pilot randomised controlled trial (RCT). ReStOre II will now further investigate the efficacy of that programme as it applies to a wider cohort of UGI and HPB cancer survivors, namely survivors of cancer of the oesophagus, stomach, pancreas, and liver. METHODS: The ReStOre II RCT will compare a 12-week multidisciplinary rehabilitation programme of supervised and self-managed exercise, dietary counselling, and education to standard survivorship care in a cohort of UGI and HPB cancer survivors who are > 3-months post-oesophagectomy/ gastrectomy/ pancreaticoduodenectomy, or major liver resection. One hundred twenty participants (60 per study arm) will be recruited to establish a mean increase in the primary outcome (cardiorespiratory fitness) of 3.5 ml/min/kg with 90% power, 5% significance allowing for 20% drop out. Study outcomes of physical function, body composition, nutritional status, HRQOL, and fatigue will be measured at baseline (T0), post-intervention (T1), and 3-months follow-up (T2). At 1-year follow-up (T3), HRQOL alone will be measured. The impact of ReStOre II on well-being will be examined qualitatively with focus groups/interviews (T1, T2). Bio-samples will be collected from T0-T2 to establish a national UGI and HPB cancer survivorship biobank. The cost effectiveness of ReStOre II will also be analysed. DISCUSSION: This RCT will investigate the efficacy of a 12-week multidisciplinary rehabilitation programme for survivors of UGI and HPB cancer compared to standard survivorship care. If effective, ReStOre II will provide an exemplar model of rehabilitation for UGI and HPB cancer survivors. TRIAL REGISTRATION: The study is registered with ClinicalTrials.gov, registration number: NCT03958019, date registered: 21/05/2019