Observational Evidence of For-Profit Delivery and Inferior Nursing Home Care: When Is There Enough Evidence for Policy Change?

This research was financially supported by the Social Sciences and Humanities Research Council

Factors associated with breastfeeding initiation:A comparison between France and French-speaking Canada

Background: Breastfeeding is associated with multiple domains of health for both mothers and children. Nevertheless, breastfeeding initiation is low within certain developed countries. Furthermore, comparative studies of initiation rates using harmonised data across multiple regions is scarce. Objective: The aim of the present study was to investigate and compare individual-level determinants of breastfeeding initiation using two French-speaking cohorts. Methods: Participants included ~ 3,900 mothers enrolled in two cohort studies in Canada and France. Interviews, questionnaires, and medical records were utilised to collect information on maternal, family, and medical factors associated with breastfeeding initiation. Results: Rates of breastfeeding initiation were similar across cohorts, slightly above 70%. Women in both Canada and France who had higher levels of maternal education, were born outside of their respective countries and who did not smoke during pregnancy were more likely to initiate breastfeeding with the cohort infant. Notably, cohort effects of maternal education at the university level were found, whereby having 'some university' was not statistically significant for mothers in France. Further, younger mothers in Canada, who delivered by caesarean section and who had previous children had reduced odds of breastfeeding initiation. These results were not found for mothers in France. Conclusions and Implications for Practice: While some similar determinants were observed, programming efforts to increase breastfeeding initiation should be tailored to the characteristics of specific geographical regions which may be heavily impacted by the social, cultural and political climate of the region, in addition to individual and family level factors.European Commission - Seventh Framework Programme (FP7

Smoking and medication during pregnancy predict repeated unintentional injuries in early childhood but not single unintentional injuries

This study investigates prospectively the development of single and repeated unintentional injuries from birth to 42 months in a random population sample of new-born children in Quebec (Canada) (N = 1,770). The outcome measures are single unintentional injuries (SUI) and repeated unintentional injuries (RUI). Results showed that the risk factors for SUI differed from the risk factors for RUI. SUI was predicted by mother’s antisocial behavior during high school (OR = 1.72) and mother’s age at first birth (OR = 1.82) with children from older mothers at higher likelihood of SUI. Also, boys (OR = 1.36) and hyperactive children (OR = 1.06) were at increased risk of SUI. RUI was predicted by maternal smoking during pregnancy (OR = 1.68), medication on prescription (OR = 1.53) and medication without prescription (OR = 1.54). Boys (OR = 2.01), children with a difficult temperament (OR = 1.13) and those with single mothers had higher rates of RUI (OR = 2.05). Maternal perception of impact (OR = 1.15) and maternal feelings of self-efficacy (OR = 0.87; marginally significant) were also associated with RUI. These results show that maternal and child risk factors identified during pregnancy and just after birth can predict SUI as well as RUI in early childhood. However, the only common risk factor for SUI and RUI is the child’s sex, with boys being at higher risk than girls. Implications of these findings and suggestions for prevention are discussed

: Eur Child Adolesc Psychiatry

Recent studies have shown that the association between maternal depression and child outcome can be moderated by children's experience of childcare (e.g., daycare) during early childhood (0–5 years). We also know that maternal depression in the child's early years has long-term associations with child development. However, the moderating role of childcare quality on long-term associations between maternal depression and child outcome has not been thoroughly investigated. This article examined longitudinal associations between probable maternal depression (PMD) during early childhood (0–5 years) and childcare quality on children’s emotional and behavioral development at the age of 7–8 years (N = 207). Childcare quality was evaluated through observations within the settings. PMD during early childhood was assessed using complementary information from interviews conducted with the mother and current maternal symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. Internalizing and externalizing behaviors were reported by the mother, father and the child at age 7–8 years. Results indicate that when mothers reported clinically relevant depression in early childhood, 7-8-year-old children demonstrate fewer behavioral problems if they attended a higher quality childcare setting. The moderating role of childcare quality remained after considering current maternal depression symptoms. Therefore, it is important to ensure high-quality childcare during early childhood to optimize child development

Association between nonmaternal care in the first year of life and children's receptive language skills prior to school entry: the moderating role of socioeconomic status

BACKGROUND: Studies have suggested that nonmaternal care (NMC) may either carry risks or be beneficial for children’s language development. However, few tested the possibility that NMC may be more or less protective for children with different family backgrounds. This study investigates the role of the family environment, as reflected in the socioeconomic status (SES), in the association between NMC in the first year of life and children’s receptive language skills prior to school entry. METHOD: A representative sample of 2,297 Canadian children aged between 0 and 11 months at their first assessment was followed over 4 years. Receptive language skills were assessed with the Peabody Picture Vocabulary Test Revised (PPVT-R) when the child was 4 to 5 years old. RESULTS: After controlling for selection factors, SES was found to moderate the association between NMC and receptive language skills: Full-time NMC in the first year of life was associated with higher PPVT-R scores among children from low SES families (d = .58), but not among children from adequate SES families. CONCLUSION: Full-time NMC in infancy may contribute to reducing the cognitive inequalities between children of low and adequate SES

J Child Psychol Psychiatry

BACKGROUND: Child-care services during early childhood provide opportunities for social interactions that may facilitate children's learning of acceptable social behaviors. Furthermore, they may reduce exposure to family adversity for some children. The aim of this study was to determine whether intensity of exposure to child-care services prior to age 5 years has a beneficial effect on disruptive behavior problems during adolescence, and whether the effect is more pronounced for children from low socioeconomic families. METHODS: N = 1,588 participants from the Quebec Longitudinal Study of Child Development were assessed 14 times from 5 months to 17 years. Intensity of child-care exposure was measured from 5 months to 5 years of age. Main outcomes were self-reported physical aggression and opposition from age 12 to 17 years. Family socioeconomic status (SES) was measured at 5 months. Factors explaining differences in child-care use were controlled using propensity score weights (PSW). RESULTS: Children exposed to moderate-intensity child-care services (part-time child-care services before 1(1/2) years and full time afterward) reported lower levels of physical aggression (d = -.11, p = .056) and opposition (d = -.14, p = .029) during adolescence compared to children exposed to low-intensity child-care services. A significant child care by SES interaction (p = .017) for physical aggression indicated that the moderate-intensity child-care effect was specific to children from low SES families (d = -.36, p = .002). No interaction with socioeconomic status was found for opposition. CONCLUSIONS: Moderate-intensity child-care services from infancy to school entry may prevent disruptive behavior during adolescence, especially for disadvantaged children