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Hosseini A, Sistani S, Sabooree A, Mollaei M, Mofidi SA, Dara N, Sayyari A, Hajipour M. Identifying and evaluating factors related to feeding disorders in children using the path analysis method. PRZEGLAD GASTROENTEROLOGICZNY 2025; 20:55-61. [PMID: 40191508 PMCID: PMC11966512 DOI: 10.5114/pg.2025.148478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 02/11/2024] [Indexed: 04/09/2025]
Abstract
Introduction Pediatric feeding disorders (PFDs) refer to the impaired consumption of food that is inappropriate for a child's age group. Understanding the causes and influencing factors of PFDs is crucial for managing these disorders. Aim This study aimed to analyze the factors associated with PFDs using the path analysis method. Material and methods A cross-sectional study was conducted on 500 children aged 6 months to 18 years who visited gastroenterology and child nutrition clinics. Data were collected through interviews with mothers and physicians, and analyzed using the path analysis method. The model included latent variables such as feeding disorders and birth status, as well as observed variables such as socio-economic status, food group, feeding practices, destructive behaviors, sleep, and body mass index (BMI) z-score. Results We conducted three path analyses. The socio-economic status (SES) directly and indirectly plays a role in feeding disorders in children; the total effect on feeding disorders was positive (β = 0.075). The direct effect of SES on the intake of food groups was positive (β = 0.190), on BMI z-score was positive (β = 0.100), and it was generally associated with a negative effect on feeding disorders (β = -0.05). The total effect of destructive behaviors on body mass was negative (β = 0.262) and on feeding disorders was positive (β = -0.041). Children who had regular sleep had significantly fewer feeding disorders (total effect: -0.369). Conclusions Socio-economic status, destructive behaviors, sleep, and BMI were found to be factors influencing eating disorders in children.
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Affiliation(s)
- Amirhossein Hosseini
- Pediatric Gastroenterology, Hepatology and Nutrition Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeedeh Sistani
- Pediatric Gastroenterology, Hepatology and Nutrition Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Maryam Mollaei
- Internal Administer of the Iranian Society of Pediatrics, Midwife, Iran
| | - Seyed Ali Mofidi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Naghi Dara
- Pediatric Gastroenterology, Hepatology and Nutrition Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Aliakbar Sayyari
- Pediatric Gastroenterology, Hepatology and Nutrition Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahmoud Hajipour
- Pediatric Gastroenterology, Hepatology and Nutrition Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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2
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Tzitiridou-Chatzopoulou M, Zournatzidou G, Orovou E, Lithoxopoulou M, Drogouti E, Sklavos G, Antoniou E, Tsakalidis C. Evaluating Malnutrition Practices and Mother's Education on Children Failure to Thrive Symptoms Using Entropy-Weight and TOPSIS Method. CHILDREN (BASEL, SWITZERLAND) 2024; 11:903. [PMID: 39201838 PMCID: PMC11353107 DOI: 10.3390/children11080903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 07/17/2024] [Accepted: 07/25/2024] [Indexed: 09/03/2024]
Abstract
BACKGROUND/OBJECTIVES Failure to thrive (FTT) is mostly caused by insufficient consumption of nutrient-rich food, recurrent infections like diarrhea and intestinal worms, substandard caregiving practices, and limited availability of health and other vital services. Furthermore, there was a correlation between the educational level of mothers and the occurrence of FTT in children aged 6-12 months. Thus, the objective of the current research is twofold: (i) to investigate other factors related to FTT and (ii) to evaluate the impact of them on FTT in Sub-Saharan African countries and their urban areas. METHODS We used weight entropy and TOPSIS methods to approach the research question. In particular, the entropy-weight method is effective for precisely evaluating the relative significance of the selected criteria for TOPSIS computation. Thus, data were retrieved from the database of UNICEF for the year 2019 for nine Sub-Saharan countries, and based on the methods used, five criteria have been selected for consideration. Those of mothers in higher education were identified as having a higher weight, which means that this can affect positively the ability of mothers to mitigate the situation of FTT and protect their children. RESULTS The findings of the study highlight the factors of maternal education at a higher level and unhealthy habits as those with the greatest weight and impact on the FTT. Moreover, the results indicate that the association between maternal education, and especially higher education, and FTT is stronger in Ethiopia. Despite the limited amount of research on the specified relationship in Sub-Saharan countries, this study is among the initial ones to examine it. CONCLUSIONS The current study can aid policymakers in devising appropriate policies and implementing effective measures to tackle FTT in Sub-Saharan Africa, like enhancing the number of mothers in these countries to be integrated into the educational system to help both themselves and their children mitigate or avoid the symptoms of FTT.
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Affiliation(s)
| | - Georgia Zournatzidou
- Department of Business Administration, University of Western Macedonia, 51100 Grevena, Greece;
| | - Eirini Orovou
- School of Healthcare Sciences, Midwifery Department, University of Western Macedonia, 50100 Kozani, Greece;
| | - Maria Lithoxopoulou
- Neonatal Intensive Care Unit, 2nd Neonatal Department, Aristotle University of Thessaloniki, “Papageorgiou” General Hospital of Thessaloniki, 54635 Thessaloniki, Greece; (M.L.); (E.D.); (C.T.)
| | - Eftychia Drogouti
- Neonatal Intensive Care Unit, 2nd Neonatal Department, Aristotle University of Thessaloniki, “Papageorgiou” General Hospital of Thessaloniki, 54635 Thessaloniki, Greece; (M.L.); (E.D.); (C.T.)
| | - George Sklavos
- Department of Business Administration, University of Thessaly, 41500 Larissa, Greece;
| | - Evangelia Antoniou
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece;
| | - Christos Tsakalidis
- Neonatal Intensive Care Unit, 2nd Neonatal Department, Aristotle University of Thessaloniki, “Papageorgiou” General Hospital of Thessaloniki, 54635 Thessaloniki, Greece; (M.L.); (E.D.); (C.T.)
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Cooke R, Goulet O, Huysentruyt K, Joosten K, Khadilkar AV, Mao M, Meyer R, Prentice AM, Singhal A. Catch-Up Growth in Infants and Young Children With Faltering Growth: Expert Opinion to Guide General Clinicians. J Pediatr Gastroenterol Nutr 2023; 77:7-15. [PMID: 36976274 PMCID: PMC10259217 DOI: 10.1097/mpg.0000000000003784] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 03/15/2023] [Indexed: 03/29/2023]
Abstract
Faltering growth (FG) is a problem regularly seen by clinicians in infants and young children (<2 years of age). It can occur due to non-disease-related and disease-related causes and is associated with a wide range of adverse outcomes, including shorter-term effects such as impaired immune responses and increased length of hospital stay, and longer-term consequences, including an impact on schooling and cognitive achievements, short stature, and socioeconomic outcomes. It is essential to detect FG, address underlying causes and support catch-up growth where this is indicated. However, anecdotal reports suggest misplaced fear of promoting accelerated (too rapid) growth may deter some clinicians from adequately addressing FG. An invited international group of experts in pediatric nutrition and growth reviewed the available evidence and guidelines on FG resulting from disease-related and non-disease-related effects on nutritional status in healthy term and small for gestational age infants and children up to the age of 2 years in low-, middle-, and high-income countries. Using a modified Delphi process, we developed practical consensus recommendations to provide clarity and practical recommendations for general clinicians on how FG should be defined in different young child populations at risk, how FG should be assessed and managed, and the role of catch-up growth after a period of FG. We also suggested areas where further research is needed to answer remaining questions on this important issue.
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Affiliation(s)
| | | | | | - Koen Joosten
- Hirabai Cowasji Jehangir Medical Research Institute, Pune, India
| | | | - Meng Mao
- Sichuan University, Chengdu, China
| | - Rosan Meyer
- Imperial College, London, United Kingdom
- Winchester University, Winchester, United Kingdom
| | | | - Atul Singhal
- the Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
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4
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Wright CM, Corlett L, Hughes P, Puckering C. How much do preverbal children signal a wish to be fed? Nested case control study comparing weight faltering and healthy infants. Appetite 2023; 181:106380. [PMID: 36403866 DOI: 10.1016/j.appet.2022.106380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 10/11/2022] [Accepted: 11/13/2022] [Indexed: 11/19/2022]
Abstract
We aimed to 1/develop an observational tool to rate non-verbal cues infants give when being fed 2/test whether these differ between healthy children and those with weight faltering (WF) 3/describe how well these predict whether offered food is eaten. SUBJECTS and methods: The study used videos of infants eating a standardised meal studied in a case control study nested within the Gateshead Millennium Study (GMS). Infants with weight faltering (WF) were each matched to 2 healthy controls. Half the control videos (N = 28) were used to develop the scale. Food offers were identified and the child's head, eyes, hands, and mouth position/activity rated as signalling a readiness to be fed (engaged), or not (disengaged) as well as whether food was accepted; 5 of these videos were used to assess inter-rater and test-re- test reliability. The scale was then applied to the videos of 28 WF infants (mean age 15.3 months) and 29 remaining controls (mean age 15.8 months) to identify and code all feeding events. RESULTS test-re-test rates varied from 0.89 for events to 0.74 for head; inter-rater reliability varied from 0.78 for hands to 0.67 for mouth. From 2219 observed interactions, 48% showed at least one engaged element, and 73% at least one disengaged; 67% of interactions resulted in food eaten, with no difference between WF and control. Food was eaten after 73% interactions with any engagement, but also in 62% with disengagement. CONCLUSIONS Infants were commonly disengaged during meals, but a majority accepted food despite this. Those with weight faltering did not differ compared to healthy controls.
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Affiliation(s)
- Charlotte M Wright
- PEACH Unit, Department of Child Health, School of Medicine, University of Glasgow Royal Hospital for Sick Children, Dalnair Street, Glasgow, G£ 8SJ, UK.
| | - Lauren Corlett
- Division of Community Based Sciences, Section of Psychological Medicine, University of Glasgow, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow, G12 0XH, UK
| | - Patrick Hughes
- PEACH Unit, Department of Child Health, School of Medicine, University of Glasgow Royal Hospital for Sick Children, Dalnair Street, Glasgow, G£ 8SJ, UK
| | - Christine Puckering
- Dept of Child and Adolescent Psychiatry, Institute of Health and Wellbeing, Royal Hospital for Sick Children, Glasgow, G3 8SJ, UK
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5
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Chee Din MA, Mohd Fahmi Teng NI, Abdul Manaf Z. Maternal depression and child feeding practices: Determinants to malnutrition among young children in Malaysian rural area. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057221147800. [PMID: 36633122 PMCID: PMC9982386 DOI: 10.1177/17455057221147800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Maternal depression may affect child feeding practices and growth. OBJECTIVE The objective of this study is to determine the relationship between child feeding practices and current maternal depression with malnutrition among young children in a rural community. METHODS This is a case-control study consisting of 52 Malay mothers of malnourished children (case) and 50 Malay mothers of well-nourished children (control) in Kuala Langat, Selangor, Malaysia. Structured questionnaires on child feeding practices and Beck Depression Inventory: Second Edition questionnaire were distributed to mothers. RESULTS Depressed mothers stopped exclusive breastfeeding (2.8 ± 2.1 months) earlier than non-depressed mothers (3.7 ± 2.0 months; p = 0.045). Binary logistic regression analysis showed current maternal depression was a primary contributor associated with risk of malnutrition in children (adjusted odds ratio: 2.5, 95% confidence interval: 1.08-6.09), and followed by the number of children (adjusted odds ratio: 1.3, 95% confidence interval: 1.02-1.77). CONCLUSION Mothers who experienced depression were twice as likely to have malnourished children. Each additional child in the family will increase the risk of malnutrition by 1.3 times. Maternal depression is associated with child feeding practices and malnutrition among young children in the studied population. Preliminary screening to identify depression symptoms should be conducted to all mothers as early as the first trimester to prevent the incidence of malnutrition in children.
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Affiliation(s)
- Maizatul Azlina Chee Din
- Centre for Dietetics Studies, Maternal,
Infant and Young Child (MiCHILD) Research Group, Faculty of Health Sciences,
Universiti Teknologi MARA, Puncak Alam, Selangor, Malaysia,Non-Communicable Disease Section,
Disease Control Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Nur Islami Mohd Fahmi Teng
- Centre for Dietetics Studies, Maternal,
Infant and Young Child (MiCHILD) Research Group, Faculty of Health Sciences,
Universiti Teknologi MARA, Puncak Alam, Selangor, Malaysia,Nur Islami Mohd Fahmi Teng, Centre for
Dietetics Studies, Maternal, Infant and Young Child (MiCHILD) Research Group,
Faculty of Health Sciences, Universiti Teknologi MARA, Cawangan Selangor, Kampus
Puncak Alam, Bandar Puncak Alam, Selangor 42300, Malaysia.
| | - Zahara Abdul Manaf
- Dietetic Programme, Centre for Healthy
Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia,
Kuala Lumpur, Malaysia
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Cortés-Macías E, Selma-Royo M, Rio-Aige K, Bäuerl C, Rodríguez-Lagunas MJ, Martínez-Costa C, Pérez-Cano FJ, Collado MC. Distinct breast milk microbiota, cytokine, and adipokine profiles are associated with infant growth at 12 months: an in vitro host-microbe interaction mechanistic approach. Food Funct 2023; 14:148-159. [PMID: 36472137 DOI: 10.1039/d2fo02060b] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Breast milk (BM) is important for adequate infant development, and it contains bioactive compounds, such as bacteria, cytokines and some adipokines which play a role in infant microbial, metabolic, and immunological maturation. However, little is known about its impact on growth and development in early life. The objective of this study was to evaluate the impact of milk microbiota, cytokine, and adipokine profiles on the risk of overweight at 12 months of life to find the possible mechanisms of host-microbe interactions. In this study, BM samples from 100 healthy women collected during 15 d after birth were included. BM microbiota was analysed by 16S rRNA gene sequencing, and cytokine and adipokine levels were measured by the Luminex approach. In addition, infant weight and length were recorded during the first 12 months and z-scores were obtained according to the WHO databases. Infants were classified as risk of overweight (ROW) and no-risk of overweight (NOROW) based on their body mass index z-score (BMIZ) and infant weight-for-length z-score (WLZ) at 12 months. In order to study host-microbe interactions, epithelial intestinal and mammary cell lines were exposed to milk microbes to assess the host response by interleukin (IL)-6 production as a potential inflammatory marker. BM was dominated by Staphylococcus and Streptococcus genera, and the most abundant cytokines were IL-6 and IL-18. Leptin levels were positively correlated with the pregestational body mass index (BMI). Higher relative abundance of the Streptococcus genus was associated with higher IL-10 and higher relative abundance of the Bifidobacterium genus was associated with lower IL-6 concentrations in milk. Infant WLZ at 12 months could be partially predicted by Streptococcus genus proportions and IL-10 and IL-18 levels in BM. BM microbiota significantly induced cytokine responses in mammary epithelial cells. Higher levels of IL-6 production were observed in mammary cells exposed to BM microbiota from mothers with ROW offspring compared to mothers with NOROW offspring. In conclusion, BM microbiota is related to the cytokine profile. IL-10 and IL-18 levels and the abundance of the Streptococcus genus could affect early infant development. Further research is needed to clarify the specific impact of BM microbiota and cytokines on infant growth and the risk of overweight.
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Affiliation(s)
- Erika Cortés-Macías
- Department of Biotechnology, Institute of Agrochemistry and Food Technology-, National Research Council (IATA-CSIC), Valencia, Spain.
| | - Marta Selma-Royo
- Department of Biotechnology, Institute of Agrochemistry and Food Technology-, National Research Council (IATA-CSIC), Valencia, Spain.
| | - Karla Rio-Aige
- Physiology Section, Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona (UB), 08028 Barcelona, Spain.,Nutrition and Food Safety Research Institute (INSA-UB), 08921 Santa Coloma de Gramenet, Spain
| | - Christine Bäuerl
- Department of Biotechnology, Institute of Agrochemistry and Food Technology-, National Research Council (IATA-CSIC), Valencia, Spain.
| | - María José Rodríguez-Lagunas
- Physiology Section, Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona (UB), 08028 Barcelona, Spain.,Nutrition and Food Safety Research Institute (INSA-UB), 08921 Santa Coloma de Gramenet, Spain
| | - Cecilia Martínez-Costa
- Department of Pediatrics, School of Medicine, University of Valencia, Valencia, Spain.,Pediatric Gastroenterology and Nutrition Section, Hospital Clínico Universitario Valencia, INCLIVA, Valencia, Spain
| | - Francisco J Pérez-Cano
- Physiology Section, Department of Biochemistry and Physiology, Faculty of Pharmacy and Food Science, University of Barcelona (UB), 08028 Barcelona, Spain.,Nutrition and Food Safety Research Institute (INSA-UB), 08921 Santa Coloma de Gramenet, Spain
| | - Maria Carmen Collado
- Department of Biotechnology, Institute of Agrochemistry and Food Technology-, National Research Council (IATA-CSIC), Valencia, Spain.
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7
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Myers S, Emmott EH. Communication Across Maternal Social Networks During England's First National Lockdown and Its Association With Postnatal Depressive Symptoms. Front Psychol 2021; 12:648002. [PMID: 34045995 PMCID: PMC8144711 DOI: 10.3389/fpsyg.2021.648002] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 04/12/2021] [Indexed: 01/28/2023] Open
Abstract
Postnatal/postpartum depression (PND/PPD) had a pre-COVID-19 estimated prevalence ranging up to 23% in Europe, 33% in Australia, and 64% in America, and is detrimental to both mothers and their infants. Low social support is a key risk factor for developing PND. From an evolutionary perspective this is perhaps unsurprising, as humans evolved as cooperative childrearers, inherently reliant on social support to raise children. The coronavirus pandemic has created a situation in which support from social networks beyond the nuclear family is likely to be even more important to new mothers, as it poses risks and stresses for mothers to contend with; whilst at the same time, social distancing measures designed to limit transmission create unprecedented alterations to their access to such support. Using data from 162 mothers living in London with infants aged ≤6 months, we explore how communication with members of a mother's social network related to her experience of postnatal depressive symptoms during the first "lockdown" in England. Levels of depressive symptoms, as assessed via the Edinburgh Postnatal Depression Scale, were high, with 47.5% of the participants meeting a ≥11 cut-off for PND. Quasi-Poisson regression modelling found that the number of network members seen in-person, and remote communication with a higher proportion of those not seen, was negatively associated with depressive symptoms; however, contact with a higher proportion of relatives was positively associated with symptoms, suggesting kin risked seeing mothers in need. Thematic qualitative analysis of open text responses found that mothers experienced a burden of constant mothering, inadequacy of virtual contact, and sadness and worries about lost social opportunities, while support from partners facilitated family bonding. While Western childrearing norms focus on intensive parenting, and fathers are key caregivers, our results highlight that it still "takes a village" to raise children in high-income populations and mothers are struggling in its absence.
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Affiliation(s)
- Sarah Myers
- UCL Anthropology, University College London, London, United Kingdom
- BirthRites Independent Max Planck Research Group, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Emily H. Emmott
- UCL Anthropology, University College London, London, United Kingdom
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8
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Naumenko DJ, Dykes J, O'Connor GK, Stanley Z, Affara N, Doel AM, Drammeh S, Dunger DB, Faal A, Ong KK, Sosseh F, Prentice AM, Moore SE, Bernstein RM. A Novel method for the identification and quantification of weight faltering. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2021; 175:282-291. [PMID: 33386624 PMCID: PMC8247282 DOI: 10.1002/ajpa.24217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 11/16/2020] [Accepted: 12/13/2020] [Indexed: 11/25/2022]
Abstract
Objective We describe a new method for identifying and quantifying the magnitude and rate of short‐term weight faltering episodes, and assess how (a) these episodes relate to broader growth outcomes, and (b) different data collection intervals influence the quantification of weight faltering. Materials and methods We apply this method to longitudinal growth data collected every other day across the first year of life in Gambian infants (n = 124, males = 65, females = 59). Weight faltering episodes are identified from velocity peaks and troughs. Rate of weight loss and regain, maximum weight loss, and duration of each episode were calculated. We systematically reduced our dataset to mimic various potential measurement intervals, to assess how these intervals affect the ability to derive information about short‐term weight faltering episodes. We fit linear models to test whether metrics associated with growth faltering were associated with growth outcomes at 1 year, and generalized additive mixed models to determine whether different collection intervals influence episode identification and metrics. Results Three hundred weight faltering episodes from 119 individuals were identified. The number and magnitude of episodes negatively impacted growth outcomes at 1 year. As data collection interval increases, weight faltering episodes are missed and the duration of episodes is overestimated, resulting in the rate of weight loss and regain being underestimated. Conclusions This method identifies and quantifies short‐term weight faltering episodes, that are in turn negatively associated with growth outcomes. This approach offers a tool for investigators interested in understanding how short‐term weight faltering relates to longer‐term outcomes.
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Affiliation(s)
- Daniel J Naumenko
- Growth and Development Lab, Department of Anthropology, University of Colorado Boulder, Boulder, Colorado, USA.,Health and Society Program, Institute of Behavioral Science, University of Colorado Boulder, Boulder, Colorado, USA
| | - James Dykes
- Health and Society Program, Institute of Behavioral Science, University of Colorado Boulder, Boulder, Colorado, USA
| | - G Kesler O'Connor
- Department of Applied Mathematics, University of Colorado Boulder, Boulder, Colorado, USA
| | - Zofia Stanley
- Department of Applied Mathematics, University of Colorado Boulder, Boulder, Colorado, USA
| | - Nabeel Affara
- Department of Pathology, University of Cambridge, Cambridge, UK
| | - Andrew M Doel
- Department of Women and Children's Health, King's College London, London, UK
| | - Saikou Drammeh
- MRC Unit The Gambia at London School of Hygiene and Tropical Medicine, Banjul, Gambia
| | - David B Dunger
- Department of Paediatrics, University of Cambridge School of Clinical Medicine, Cambridge, UK.,Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK
| | - Abdoulie Faal
- MRC Unit The Gambia at London School of Hygiene and Tropical Medicine, Banjul, Gambia
| | - Ken K Ong
- Department of Paediatrics, University of Cambridge School of Clinical Medicine, Cambridge, UK.,MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Fatou Sosseh
- MRC Unit The Gambia at London School of Hygiene and Tropical Medicine, Banjul, Gambia
| | - Andrew M Prentice
- MRC Unit The Gambia at London School of Hygiene and Tropical Medicine, Banjul, Gambia
| | - Sophie E Moore
- Department of Women and Children's Health, King's College London, London, UK.,MRC Unit The Gambia at London School of Hygiene and Tropical Medicine, Banjul, Gambia
| | - Robin M Bernstein
- Growth and Development Lab, Department of Anthropology, University of Colorado Boulder, Boulder, Colorado, USA.,Health and Society Program, Institute of Behavioral Science, University of Colorado Boulder, Boulder, Colorado, USA
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9
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Madhoun LL, Crerand CE, O'Brien M, Baylis AL. Feeding and Growth in Infants With Cleft Lip and/or Palate: Relationships With Maternal Distress. Cleft Palate Craniofac J 2020; 58:470-478. [PMID: 32924577 DOI: 10.1177/1055665620956873] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To examine relationships between early feeding and growth and maternal distress in infants with and without cleft lip and/or palate (CL/P). DESIGN Cross-sectional. SETTING Pediatric academic medical center in the Midwestern United States. PARTICIPANTS Mothers of infants 1 to 12 weeks old with CL/P (n = 30) and without CL/P (control group, n = 30) were recruited at craniofacial clinic or pediatrician appointments. MAIN OUTCOME MEASURE(S) Maternal responses on the Feeding/Swallowing Impact Survey (FS-IS), Parenting Stress Index, Fourth Edition, Short Form (PSI-4-SF), and Edinburgh Postnatal Depression Scale. Infant feeding history and growth measurements were obtained. RESULTS Having an infant with CL/P revealed greater impact on maternal health-related quality of life due to feeding problems (F = 4.83, P = .03). Mothers of infants with CL/P reported average range Total Stress scores on the PSI-4-SF, which were higher than controls (F = 4.12, P = .05). Edinburgh Postnatal Depression Scale scores did not differ between groups. Compared to controls, infants with cleft palate had lower percentiles for weight (t = 4.13, P = .04) and length (t = 2.93, P = .01). Higher FS-IS scores were associated with longer feeding duration (r = 0.32, P = .01) and lower weight (r = -0.31, P = .02) and length (r = -0.32, P = .02). CONCLUSIONS Despite receiving early team care and feeding interventions, mothers of infants with CL/P reported higher stress and more challenges with feeding and growth. Future studies should examine targeted psychosocial interventions to improve feeding and growth outcomes in infants with CL/P.
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Affiliation(s)
- Lauren L Madhoun
- Department of Plastic and Reconstructive Surgery, 2650Nationwide Children's Hospital, Columbus, OH, USA.,Department of Plastic and Reconstructive Surgery, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Canice E Crerand
- Department of Plastic and Reconstructive Surgery, 2650Nationwide Children's Hospital, Columbus, OH, USA.,Department of Plastic and Reconstructive Surgery, The Ohio State University College of Medicine, Columbus, OH, USA.,Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA.,Center for Biobehavioral Health, The Abigail Wexner Research Institute at 2650Nationwide Children's Hospital, Columbus, OH, USA
| | - Meghan O'Brien
- Department of Plastic and Reconstructive Surgery, 2650Nationwide Children's Hospital, Columbus, OH, USA
| | - Adriane L Baylis
- Department of Plastic and Reconstructive Surgery, 2650Nationwide Children's Hospital, Columbus, OH, USA.,Department of Plastic and Reconstructive Surgery, The Ohio State University College of Medicine, Columbus, OH, USA.,Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA.,Department of Speech and Hearing Science, The Ohio State University, Columbus, OH, USA
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10
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Slomian J, Honvo G, Emonts P, Reginster JY, Bruyère O. Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes. ACTA ACUST UNITED AC 2020; 15:1745506519844044. [PMID: 31035856 PMCID: PMC6492376 DOI: 10.1177/1745506519844044] [Citation(s) in RCA: 540] [Impact Index Per Article: 108.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Introduction: The postpartum period represents the time of risk for the emergence of
maternal postpartum depression. There are no systematic reviews of the
overall maternal outcomes of maternal postpartum depression. The aim of this
study was to evaluate both the infant and the maternal consequences of
untreated maternal postpartum depression. Methods: We searched for studies published between 1 January 2005 and 17 August 2016,
using the following databases: MEDLINE via Ovid, PsycINFO, and the Cochrane
Pregnancy and Childbirth Group trials registry. Results: A total of 122 studies (out of 3712 references retrieved from bibliographic
databases) were included in this systematic review. The results of the
studies were synthetized into three categories: (a) the maternal
consequences of postpartum depression, including physical health,
psychological health, relationship, and risky behaviors; (b) the infant
consequences of postpartum depression, including anthropometry, physical
health, sleep, and motor, cognitive, language, emotional, social, and
behavioral development; and (c) mother–child interactions, including
bonding, breastfeeding, and the maternal role. Discussion: The results suggest that postpartum depression creates an environment that is
not conducive to the personal development of mothers or the optimal
development of a child. It therefore seems important to detect and treat
depression during the postnatal period as early as possible to avoid harmful
consequences.
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Affiliation(s)
- Justine Slomian
- 1 Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Germain Honvo
- 1 Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Patrick Emonts
- 2 Department of Obstetrics and Gynaecology, CHU Liège, Liège, Belgium
| | - Jean-Yves Reginster
- 1 Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Olivier Bruyère
- 1 Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium.,3 Department of Sport Science, University of Liège, Liège, Belgium
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11
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Parental Perception of Children's Weight Status: Love Overpasses Scientific Evidence! A Cross-Sectional Observational Study. High Blood Press Cardiovasc Prev 2019; 27:29-34. [PMID: 31802420 DOI: 10.1007/s40292-019-00352-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 11/28/2019] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Age, gender, body mass index percentiles and the adherence to Mediterranean diet were investigated as potential predictor factors in this assessment. AIM To assess the parental perception of children's weight status. METHODS This cross-sectional observational study was carried out during a corporate wellness program (Ferrari Formula Benessere) implemented by Ferrari S.p.A. and managed by Med-Ex s.r.l. The children's real weight status was assessed through Body Mass Index percentiles (ArthroPlus software-WHO). RESULTS 328 children (66.4%) were normal-weight, 10 were underweight (2%), 66 were overweight (13.4%) and 90 were obese (18.2%). 289 children (59%) were classified correctly by parents, while 205 children (41%) were not. 64 of 66 overweight children and 90 of 90 children with obesity have been completely underestimated (53 of 90 children with obesity were judged normal weight). The parents' probability to estimate children's weight status correctly decreased increasing body mass index percentiles paradoxically [OR = 0.96 (0.95-0.97)] and was lower in boys [OR = 0.65 (0.44-0.98)]. Although not statistically significant, children with higher adherence to Mediterranean diet seems to have higher probability to be correctly estimated [low adherence: reference, medium adherence: OR = 1.06 (0.61-1.85), high adherence: OR = 1.48 (0.81-2.75)]. CONCLUSIONS A high percentage of children is overweight or obese and almost half of parents classified their weight status incorrectly. Increasing children's body mass index percentiles decreases the probability to be correctly classified.
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12
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Pre- and post-natal maternal anxiety and early childhood weight gain. J Affect Disord 2019; 257:136-142. [PMID: 31301614 DOI: 10.1016/j.jad.2019.06.068] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 05/25/2019] [Accepted: 06/30/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND While maternal depression has been linked to impaired child growth, the relationship between anxiety and child weight gain is unknown. The study objective was to investigate maternal pre- and post-natal anxiety in relation to child weight gain. METHODS Data included 1168 children in the Avon Longitudinal Study of Parents and Children. Child height and weight were measured at the median ages of 25 and 31 months postnatally and used to calculate body mass index (BMI). Maternal anxiety was measured with the Crown-Crisp Experiential Index at 18 and 32 gestational weeks, and two and 21 months postpartum. Mothers scoring in the top 15% at one or more of the four time points were considered to have anxiety. Maternal depressive symptoms were measured using the Edinburgh Postnatal Depression Scale-7 (EPDS-7) at these same time points. Maternal depression was defined as EPDS-7 scores of >10. We used Generalized Estimating Equations to assess whether child BMI trajectories varied by the presence of maternal anxiety. Parallel analyses were conducted for maternal depression. RESULTS Among children of mothers who had anxiety at least at one timepoint, the BMI changes associated with a three-month increase in child age increased by 0.06 (95% CI:0.004-0.12) compared to BMI changes in children of mothers without anxiety. Maternal depressive symptoms were not associated with child BMI trajectories. LIMITATIONS Maternal anxiety and depressive symptoms were based on maternal self-report. CONCLUSION Maternal anxiety around childbirth was associated with modest increases in child BMI gain during the child's second year of life.
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13
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Kjaer TW, Faurholt-Jepsen D, Medrano R, Elwan D, Mehta K, Christensen VB, Wojcicki JM. Higher Birthweight and Maternal Pre-pregnancy BMI Persist with Obesity Association at Age 9 in High Risk Latino Children. J Immigr Minor Health 2019; 21:89-97. [PMID: 29397484 DOI: 10.1007/s10903-018-0702-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Childhood obesity is increasing especially in Latinos and early intervention is essential to prevent later obesity complications. Latino children (n = 201) recruited at two San Francisco hospitals were assessed at birth including infant anthropometrics and feeding practices and followed to age 9 with annual anthropometric assessments. We evaluated the relationship between perinatal risk factors and obesity at age 9 and chronic obesity (obesity at both 5 and 9 years). Higher birthweight [odds ratio (OR) 2.48, 95% confidence interval (CI) 1.06-5.81] and maternal pre-pregnancy body mass index (BMI) (OR 1.09, 95% CI 1.00-1.18) were associated with increased risk for obesity at 9 years. Higher maternal pre-pregnancy BMI (OR 1.10, 95% CI 1.01-1.20) was associated with chronic obesity. Additionally, prenatal depression symptoms were protective (OR 0.33, 95% CI 0.11-0.94) against chronic obesity. We found no association between maternal age and education, exclusive breastfeeding at 4-6 weeks, rapid infant weight gain, and obesity or chronic obesity. Perinatal risk factors for obesity including higher birthweight and maternal pre-pregnancy BMI persisted until age 9, whereas, other variables significant at age 5 in our cohort and other populations including exclusive breastfeeding and rapid infant weight gain were no longer associated with increased risk.
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Affiliation(s)
- Thora Wesenberg Kjaer
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA.,School of Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Daniel Faurholt-Jepsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg C, Denmark
| | - Rosalinda Medrano
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
| | - Deena Elwan
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
| | - Kala Mehta
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Vibeke Brix Christensen
- Department of Pediatrics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Janet M Wojcicki
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA.
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14
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Savage JS, Hohman EE, McNitt KM, Pauley AM, Leonard KS, Turner T, Pauli JM, Gernand AD, Rivera DE, Symons Downs D. Uncontrolled Eating during Pregnancy Predicts Fetal Growth: The Healthy Mom Zone Trial. Nutrients 2019; 11:E899. [PMID: 31010102 PMCID: PMC6520673 DOI: 10.3390/nu11040899] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 04/12/2019] [Accepted: 04/18/2019] [Indexed: 12/12/2022] Open
Abstract
Excess maternal weight gain during pregnancy elevates infants' risk for macrosomia and early-onset obesity. Eating behavior is also related to weight gain, but the relationship to fetal growth is unclear. We examined whether Healthy Mom Zone, an individually tailored, adaptive gestational weight gain intervention, and maternal eating behaviors affected fetal growth in pregnant women (n = 27) with a BMI > 24. At study enrollment (6-13 weeks gestation) and monthly thereafter, the Three-Factor Eating Questionnaire was completed. Ultrasounds were obtained monthly from 14-34 weeks gestation. Data were analyzed using multilevel modeling. Higher baseline levels of uncontrolled eating predicted faster rates of fetal growth in late gestation. Cognitive restraint was not associated with fetal growth, but moderated the effect of uncontrolled eating on fetal growth. Emotional eating was not associated with fetal growth. Among women with higher baseline levels of uncontrolled eating, fetuses of women in the control group grew faster and were larger in later gestation than those in the intervention group (study group × baseline uncontrolled eating × gestational week interaction, p = 0.03). This is one of the first intervention studies to use an individually tailored, adaptive design to manage weight gain in pregnancy to demonstrate potential effects on fetal growth. Results also suggest that it may be important to develop intervention content and strategies specific to pregnant women with high vs. low levels of disinhibited eating.
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Affiliation(s)
- Jennifer S Savage
- Center for Childhood Obesity Research, The Pennsylvania State University, University Park, State College, PA 16802, USA.
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, State College, PA 16802, USA.
| | - Emily E Hohman
- Center for Childhood Obesity Research, The Pennsylvania State University, University Park, State College, PA 16802, USA.
| | - Katherine M McNitt
- Center for Childhood Obesity Research, The Pennsylvania State University, University Park, State College, PA 16802, USA.
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, State College, PA 16802, USA.
| | - Abigail M Pauley
- Exercise Psychology Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, State College, PA 16802, USA.
| | - Krista S Leonard
- Exercise Psychology Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, State College, PA 16802, USA.
| | - Tricia Turner
- Diagnostic Medical Sonography, South Hills School of Business and Technology, State College, PA 16801, USA.
| | - Jaimey M Pauli
- Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA 17033, USA.
- Department of Maternal & Fetal Medicine, Penn State College of Medicine, Hershey, PA 17033, USA.
| | - Alison D Gernand
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, State College, PA 16802, USA.
| | - Daniel E Rivera
- Control Systems Engineering Laboratory, School for Engineering of Matter, Transport, and Energy, Arizona State University, Tempe, AZ 85287, USA.
| | - Danielle Symons Downs
- Exercise Psychology Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, State College, PA 16802, USA.
- Department of Obstetrics and Gynecology, Penn State College of Medicine, Hershey, PA 17033, USA.
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15
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Male infants and birth complications are associated with increased incidence of postnatal depression. Soc Sci Med 2019; 220:56-64. [DOI: 10.1016/j.socscimed.2018.10.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 09/18/2018] [Accepted: 10/14/2018] [Indexed: 12/13/2022]
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16
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Ajami M, Abdollahi M, Salehi F, Oldewage-Theron W, Jamshidi-Naeini Y. The Association between Household Socioeconomic Status, Breastfeeding, and Infants' Anthropometric Indices. Int J Prev Med 2018; 9:89. [PMID: 30450172 PMCID: PMC6202780 DOI: 10.4103/ijpvm.ijpvm_52_17] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 07/01/2017] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The growth, learning, and contribution to active life in the communities are better in well-nourished children, and various factors influence infants' feeding. In this study, we assessed whether household socioeconomic status (SES) affects infants' length-for-age, weight-for-age (indicators of health and nutritional status) and breastfeeding (BF) (a necessity for optimal growth and health) status. METHODS In this cross-sectional study, 150 households with infants of 1-1.5 years old were interviewed on these variables: family size, dwelling ownership, duration of BF, exclusive BF (EBF) for 6 months, parents' age, parents' ethnicity, birth order, delivery type, and parents' education. Weight and length at 4 and 12 months were obtained from centers' records. To determine SES, we assessed total years of parents' education and household asset ownership by an index of nine owned assets. RESULTS The average of 4-month length in the low SES group was significantly lower than the two others (P < 0.05). In middle socioeconomic group, duration of BF was significantly higher (19.5 ± 7.3 months vs. 18.0 ± 8.0 months in low and 17.5 ± 7.9 months in high SES groups) (P < 0.05). Comparing illiterate mothers, university degree holders and university students were 73% less likely to not having EBF. Moreover, those with middle SES showed to be about 40% less likely to not having EBF. CONCLUSIONS Nutritional status, duration of BF, and EBF might be determined by household SES and maternal education. Therefore, these findings can be used to decide how to focus on appropriate target groups in family education planning to improve children's development to its most possible.
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Affiliation(s)
- Marjan Ajami
- Department of Food and Nutrition Policy and Planning Research, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Morteza Abdollahi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Forouzan Salehi
- Department of Community Nutrition, Ministry of Health and Medical Education, Tehran, Iran
| | - Wilna Oldewage-Theron
- Department of Nutritional Sciences, College of Human Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Yasaman Jamshidi-Naeini
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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17
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Soboka M, Feyissa GT. The impact of maternal postnatal depression on infant growth in sub-Saharan African countries: a systematic review protocol. ACTA ACUST UNITED AC 2018; 14:58-67. [PMID: 27532140 DOI: 10.11124/jbisrir-2016-2281] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
REVIEW QUESTION/OBJECTIVE The objective of this review is to examine the effect of maternal postnatal depression on the growth of infants aged one or under in sub-Saharan African countries.
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Affiliation(s)
- Matiwos Soboka
- 1Department of Psychiatry, Jimma University, Jimma, Ethiopia 2Department of Health Education and Behavioural Sciences, Jimma University, Jimma, Ethiopia 3The Ethiopian Malaria Alert Centre: a Collaborating Center of the Joanna Briggs Institute
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18
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Myers S, Johns SE. Postnatal depression is associated with detrimental life-long and multi-generational impacts on relationship quality. PeerJ 2018; 6:e4305. [PMID: 29472995 PMCID: PMC5817936 DOI: 10.7717/peerj.4305] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 01/10/2018] [Indexed: 01/20/2023] Open
Abstract
Postnatal depression (PND) is known to be associated with a range of detrimental child and adolescent outcomes, resulting from its disruptive impact on mother-child relationship quality. However, until now little has been known about the impact of PND on the longer-term relationships between mothers and their children, and any intergenerational effects this may have. Mother-child relationship quality is of interest from an evolutionary perspective as it plays a role in the accrual of offspring embodied capital, thus affecting offspring quality and offspring’s capacity to subsequently invest in their own children. Relationships with offspring also mediate grandparent-grandchild relations; if PND negatively affects long-term mother–offspring relationship quality, it is also likely to negatively affect grandmaternal investment via reduced grandmother–grandchild relationship quality. Here, we use responses to a retrospective questionnaire study of postmenopausal women, largely from the UK and US, to assess the impact of PND occurring in generation 1 on mother–child relationship quality across the life course of the child (generation 2) with whom it was associated, and also on the relationship quality with grandchildren (generation 3) from that child. Average mother-child relationship quality was lower when the child’s birth was associated with PND. Multi-level regression modelling found that mother-child relationship quality decreased as PND symptom severity increased after controlling for individual effects and a variety of other factors known to influence relationship quality (individual mothers n = 296, mother-child dyads n = 646). Additionally, intergenerational relationships appear to be affected, with PND negatively associated with grandmother-grandchild relations (individual grandmothers n = 125, relations with grandchildren from n = 197 grandmother-parent dyads). That PND has long-term detrimental consequences for mother-child relationships, well beyond adolescence, highlights the need for investment in strategies to prevent PND and its cascade of negative multigenerational effects.
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Affiliation(s)
- Sarah Myers
- School of Anthropology and Conservation, University of Kent, Canterbury, Kent, United Kingdom
| | - Sarah E Johns
- School of Anthropology and Conservation, University of Kent, Canterbury, Kent, United Kingdom
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19
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Kachi Y, Fujiwara T, Yamaoka Y, Kato T. Parental Socioeconomic Status and Weight Faltering in Infants in Japan. Front Pediatr 2018; 6:127. [PMID: 29765936 PMCID: PMC5938368 DOI: 10.3389/fped.2018.00127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 04/16/2018] [Indexed: 11/17/2022] Open
Abstract
Background: Previous studies in the UK and Denmark found no significant association between low socioeconomic status (SES) and weight faltering. However, to our knowledge, there are no studies from other developed countries. We examined the association between parental SES and weight faltering in infants up to 1.5 years of age, and investigated whether the inequalities changed between 2001 and 2010 in Japan. Methods: We used data from two Japanese population-based birth cohorts started in 2001 (n = 34,594) and 2010 (n = 21,189). Parental SES was assessed as household income and parental education when the infant was 6 months old. Weight faltering was defined as the slowest weight gaining in 5% of all children in each cohort. Logistic regression analyses were conducted with adjustment for covariates. The relative index of inequality was used to assess relative impact of parental SES on weight faltering. Results: Infants in the lowest quartile of household income were 1.29 (95% confidence interval [CI]: 1.10, 1.52) and 1.27 (95% CI: 1.03, 1.56) times more likely to experience weight faltering than those in the highest income quartile both in the 2001 and 2010 cohorts, respectively. The relative index of inequality for household income was 1.66 (95% CI: 1.36, 1.96) in 2001 and 1.86 (95% CI: 1.42, 2.31) in 2010. Conclusions: Infants from lower income families have a greater risk of weight faltering in Japan. Additionally, the income-related inequalities in weight faltering did not change between the two cohorts. Social policies to address maldistribution of weight faltering due to household income are needed.
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Affiliation(s)
- Yuko Kachi
- Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan.,Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan.,Department of Public Health, Kitasato University School of Medicine, Kanagawa, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yui Yamaoka
- Center on Child Abuse and Neglect, University of Oklahoma Health Science Center, Oklahoma City, OK, United States
| | - Tsuguhiko Kato
- Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan
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20
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Bakare MO, Bello-Mojeed MA, Munir KM, Duduyemi OO, Orovwigho AO, Odetunde OI, Taiwo OG, Olofinlade JA, Omotoso ON, Famurewa OH, Omolabi OO, Jejeloye AO. Improving access to interventions among mothers screened positive for post-partum depression (PPD) at National Programme on Immunization (NPI) clinics in south-western and south-eastern Nigeria – A service development report. MATTERS 2017; 2017. [PMID: 29104868 PMCID: PMC5665652 DOI: 10.19185/matters.201707000005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Muideen O Bakare
- Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Centre, Federal Neuropsychiatric Hospital, Lagos; University Center for Excellence in Developmental Disabilities, Boston Children Hospital; Childhood Neuropsychiatric Disorders Initiatives, Federal Neuropsychiatric Hospital, Enugu, Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Department of Paediatric, University of Nigeria Teaching Hospital; Childhood Neuropsychiatric Disorders Initiatives, Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Unit, Federal Neuropsychiatric Hospital; Childhood Neuropsychiatric Disorders Initiatives, Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Centre, Federal Neuropsychiatric Hospital, Lagos; Childhood Neuropsychiatric Disorders Initiatives, Enugu State University of Science and Technology, Child and Adolescent Centre, Federal Neuropsychiatric Hospital
| | - Mashudat A Bello-Mojeed
- Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Centre, Federal Neuropsychiatric Hospital, Lagos; University Center for Excellence in Developmental Disabilities, Boston Children Hospital; Childhood Neuropsychiatric Disorders Initiatives, Federal Neuropsychiatric Hospital, Enugu, Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Department of Paediatric, University of Nigeria Teaching Hospital; Childhood Neuropsychiatric Disorders Initiatives, Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Unit, Federal Neuropsychiatric Hospital; Childhood Neuropsychiatric Disorders Initiatives, Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Centre, Federal Neuropsychiatric Hospital, Lagos; Childhood Neuropsychiatric Disorders Initiatives, Enugu State University of Science and Technology, Child and Adolescent Centre, Federal Neuropsychiatric Hospital
| | - Kerim M Munir
- Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Centre, Federal Neuropsychiatric Hospital, Lagos; University Center for Excellence in Developmental Disabilities, Boston Children Hospital; Childhood Neuropsychiatric Disorders Initiatives, Federal Neuropsychiatric Hospital, Enugu, Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Department of Paediatric, University of Nigeria Teaching Hospital; Childhood Neuropsychiatric Disorders Initiatives, Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Unit, Federal Neuropsychiatric Hospital; Childhood Neuropsychiatric Disorders Initiatives, Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Centre, Federal Neuropsychiatric Hospital, Lagos; Childhood Neuropsychiatric Disorders Initiatives, Enugu State University of Science and Technology, Child and Adolescent Centre, Federal Neuropsychiatric Hospital
| | - Olaniyi O Duduyemi
- Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Centre, Federal Neuropsychiatric Hospital, Lagos; University Center for Excellence in Developmental Disabilities, Boston Children Hospital; Childhood Neuropsychiatric Disorders Initiatives, Federal Neuropsychiatric Hospital, Enugu, Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Department of Paediatric, University of Nigeria Teaching Hospital; Childhood Neuropsychiatric Disorders Initiatives, Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Unit, Federal Neuropsychiatric Hospital; Childhood Neuropsychiatric Disorders Initiatives, Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Centre, Federal Neuropsychiatric Hospital, Lagos; Childhood Neuropsychiatric Disorders Initiatives, Enugu State University of Science and Technology, Child and Adolescent Centre, Federal Neuropsychiatric Hospital
| | - Andrew O Orovwigho
- Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Centre, Federal Neuropsychiatric Hospital, Lagos; University Center for Excellence in Developmental Disabilities, Boston Children Hospital; Childhood Neuropsychiatric Disorders Initiatives, Federal Neuropsychiatric Hospital, Enugu, Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Department of Paediatric, University of Nigeria Teaching Hospital; Childhood Neuropsychiatric Disorders Initiatives, Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Unit, Federal Neuropsychiatric Hospital; Childhood Neuropsychiatric Disorders Initiatives, Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Centre, Federal Neuropsychiatric Hospital, Lagos; Childhood Neuropsychiatric Disorders Initiatives, Enugu State University of Science and Technology, Child and Adolescent Centre, Federal Neuropsychiatric Hospital
| | - Odutola I Odetunde
- Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Centre, Federal Neuropsychiatric Hospital, Lagos; University Center for Excellence in Developmental Disabilities, Boston Children Hospital; Childhood Neuropsychiatric Disorders Initiatives, Federal Neuropsychiatric Hospital, Enugu, Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Department of Paediatric, University of Nigeria Teaching Hospital; Childhood Neuropsychiatric Disorders Initiatives, Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Unit, Federal Neuropsychiatric Hospital; Childhood Neuropsychiatric Disorders Initiatives, Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Centre, Federal Neuropsychiatric Hospital, Lagos; Childhood Neuropsychiatric Disorders Initiatives, Enugu State University of Science and Technology, Child and Adolescent Centre, Federal Neuropsychiatric Hospital
| | - Olufemi G Taiwo
- Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Centre, Federal Neuropsychiatric Hospital, Lagos; University Center for Excellence in Developmental Disabilities, Boston Children Hospital; Childhood Neuropsychiatric Disorders Initiatives, Federal Neuropsychiatric Hospital, Enugu, Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Department of Paediatric, University of Nigeria Teaching Hospital; Childhood Neuropsychiatric Disorders Initiatives, Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Unit, Federal Neuropsychiatric Hospital; Childhood Neuropsychiatric Disorders Initiatives, Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Centre, Federal Neuropsychiatric Hospital, Lagos; Childhood Neuropsychiatric Disorders Initiatives, Enugu State University of Science and Technology, Child and Adolescent Centre, Federal Neuropsychiatric Hospital
| | - Jushua A Olofinlade
- Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Centre, Federal Neuropsychiatric Hospital, Lagos; University Center for Excellence in Developmental Disabilities, Boston Children Hospital; Childhood Neuropsychiatric Disorders Initiatives, Federal Neuropsychiatric Hospital, Enugu, Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Department of Paediatric, University of Nigeria Teaching Hospital; Childhood Neuropsychiatric Disorders Initiatives, Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Unit, Federal Neuropsychiatric Hospital; Childhood Neuropsychiatric Disorders Initiatives, Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Centre, Federal Neuropsychiatric Hospital, Lagos; Childhood Neuropsychiatric Disorders Initiatives, Enugu State University of Science and Technology, Child and Adolescent Centre, Federal Neuropsychiatric Hospital
| | - Olakunle N Omotoso
- Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Centre, Federal Neuropsychiatric Hospital, Lagos; University Center for Excellence in Developmental Disabilities, Boston Children Hospital; Childhood Neuropsychiatric Disorders Initiatives, Federal Neuropsychiatric Hospital, Enugu, Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Department of Paediatric, University of Nigeria Teaching Hospital; Childhood Neuropsychiatric Disorders Initiatives, Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Unit, Federal Neuropsychiatric Hospital; Childhood Neuropsychiatric Disorders Initiatives, Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Centre, Federal Neuropsychiatric Hospital, Lagos; Childhood Neuropsychiatric Disorders Initiatives, Enugu State University of Science and Technology, Child and Adolescent Centre, Federal Neuropsychiatric Hospital
| | - Olayinka H Famurewa
- Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Centre, Federal Neuropsychiatric Hospital, Lagos; University Center for Excellence in Developmental Disabilities, Boston Children Hospital; Childhood Neuropsychiatric Disorders Initiatives, Federal Neuropsychiatric Hospital, Enugu, Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Department of Paediatric, University of Nigeria Teaching Hospital; Childhood Neuropsychiatric Disorders Initiatives, Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Unit, Federal Neuropsychiatric Hospital; Childhood Neuropsychiatric Disorders Initiatives, Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Centre, Federal Neuropsychiatric Hospital, Lagos; Childhood Neuropsychiatric Disorders Initiatives, Enugu State University of Science and Technology, Child and Adolescent Centre, Federal Neuropsychiatric Hospital
| | - Oladipupo O Omolabi
- Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Centre, Federal Neuropsychiatric Hospital, Lagos; University Center for Excellence in Developmental Disabilities, Boston Children Hospital; Childhood Neuropsychiatric Disorders Initiatives, Federal Neuropsychiatric Hospital, Enugu, Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Department of Paediatric, University of Nigeria Teaching Hospital; Childhood Neuropsychiatric Disorders Initiatives, Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Unit, Federal Neuropsychiatric Hospital; Childhood Neuropsychiatric Disorders Initiatives, Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Centre, Federal Neuropsychiatric Hospital, Lagos; Childhood Neuropsychiatric Disorders Initiatives, Enugu State University of Science and Technology, Child and Adolescent Centre, Federal Neuropsychiatric Hospital
| | - Adebayo O Jejeloye
- Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Centre, Federal Neuropsychiatric Hospital, Lagos; University Center for Excellence in Developmental Disabilities, Boston Children Hospital; Childhood Neuropsychiatric Disorders Initiatives, Federal Neuropsychiatric Hospital, Enugu, Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Child and Adolescent Unit, Federal Neuropsychiatric Hospital, Enugu; Department of Paediatric, University of Nigeria Teaching Hospital; Childhood Neuropsychiatric Disorders Initiatives, Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Unit, Federal Neuropsychiatric Hospital; Childhood Neuropsychiatric Disorders Initiatives, Childhood Neuropsychiatric Disorders Initiatives, Child and Adolescent Centre, Federal Neuropsychiatric Hospital, Lagos; Childhood Neuropsychiatric Disorders Initiatives, Enugu State University of Science and Technology, Child and Adolescent Centre, Federal Neuropsychiatric Hospital
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21
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Munsch S, Dremmel D, Kurz S, De Albuquerque J, Meyer AH, Hilbert A. Influence of Parental Expressed Emotions on Children's Emotional Eating via Children's Negative Urgency. EUROPEAN EATING DISORDERS REVIEW 2016; 25:36-43. [PMID: 27790790 DOI: 10.1002/erv.2489] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 09/23/2016] [Accepted: 10/11/2016] [Indexed: 01/10/2023]
Abstract
We investigated whether parental expressed emotion (criticism and emotional overinvolvement) is related to children's emotional eating and whether this relationship is mediated by children's negative urgency. One hundred children, aged 8 to 13 years, either healthy or have binge-eating disorder and/or attention-deficit/hyperactivity disorder, completed the questionnaires, along with their parents. Parental criticism and, to a lesser extent, parental emotional overinvolvement were both positively related to children's emotional eating, and this relationship was mediated by children's negative urgency. Further exploratory analyses revealed that the mediating role of children's negative urgency in the relationship between parental criticism and children's emotional eating was pronounced in the clinical group of children with binge-eating disorder and attention-deficit/hyperactivity disorder but almost absent in the healthy control group. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
- Simone Munsch
- Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Daniela Dremmel
- Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Susanne Kurz
- Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | | | - Andrea H Meyer
- Integrated Research and Treatment Center of Adiposity Diseases, University of Leipzig Medical Center, Leipzig, Germany
| | - Anja Hilbert
- Department of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Basel, Switzerland.,Department of Medical Psychology and Medical Sociology, University of Leipzig Medical Center, Leipzig, Germany
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22
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Fletcher S, Wright C, Jones A, Parkinson K, Adamson A. Tracking of toddler fruit and vegetable preferences to intake and adiposity later in childhood. MATERNAL AND CHILD NUTRITION 2016; 13. [PMID: 27046078 DOI: 10.1111/mcn.12290] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 11/12/2015] [Accepted: 12/14/2015] [Indexed: 12/19/2022]
Abstract
This study examined whether toddlers' liking for fruit and vegetables (FV) predicts intake of FV later in childhood, how both relate to childhood adiposity and how these were moderated by factors in infancy. Children in the Gateshead Millennium Study were recruited at birth in 1999-2000. Feeding data collected in the first year were linked to data from a parental questionnaire completed for 456 children at age 2.5 years (30 m) and to anthropometry, skinfolds and bioelectrical impedance and 4-day food diary data collected for 293 of these children at age 7 years. Aged 30 months, 50% of children were reported to like eight different vegetables and three fruits, but at 7 years, children ate a median of only 1.3 (range 0-7) portions of vegetables and 1.0 portion of fruit (0-4). Early appetite, feeding problems and food neophobia showed significant univariate associations with liking for FV aged 30 m, but the number of vegetables toddlers liked was the only independent predictor of vegetable consumption at age 7 years (odds ratio (OR) 1.28 p < 0.001). Liking for fruit aged 30 m also independently predicted fruit intake (OR = 1.31, p = 0.016), but these were also related to deprivation (OR = 2.69, p = 0.001) maternal education (OR = 1.28, p = 0.039) and female gender (OR = 1.8, p = 0.024). Children eating more FV at age 7 years had slightly lower body mass index and skinfolds. An early liking for FV predicted increased later intake, so increasing early exposure to FV could have long term beneficial consequences.
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Affiliation(s)
- Suzanne Fletcher
- School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Charlotte Wright
- School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Angela Jones
- Institute of Health and Society and Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK
| | - Kathryn Parkinson
- Institute of Health and Society and Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK
| | - Ashley Adamson
- Institute of Health and Society and Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK
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23
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Myers S, Burger O, Johns SE. Postnatal depression and reproductive success in modern, low-fertility contexts. EVOLUTION MEDICINE AND PUBLIC HEALTH 2016; 2016:71-84. [PMID: 26976787 PMCID: PMC4790780 DOI: 10.1093/emph/eow003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 01/12/2016] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND OBJECTIVES Postnatal depression (PND) presents a puzzling phenomenon to evolutionary anthropologists as it is highly prevalent and yet detrimental to child development and maternal health. Adaptive explanations have been proposed, but have not been tested with data that directly link PND to female fertility. METHODOLOGY A survey was designed to gather complete reproductive histories and retrospective measures of PND to measure the effects of PND on fitness. Respondents were born between 1930 and 1967, with the majority based in the UK during their childrearing years. The hypothesis that PND is detrimental to fitness is assessed using Mann-Whitney U tests on completed fertility. Binary logistic regression modelling is used to test the hypothesis that PND reduces the likelihood of parity progression. RESULTS Women experiencing PND at their first or second birth have lower completed fertility, with PND at the first birth leading to lowered fertility. Logistic regression analyses show that this is the result of reductions in the likelihood of parity progression to a third birth when PND is experienced at the first birth or when repeat bouts occur. CONCLUSIONS AND IMPLICATIONS Our results call into question adaptationist arguments, contribute to the growing understanding of the importance of emotional wellbeing to fertility decision making, and given the economic consequences of markedly below replacement fertility, highlight a potential new source of financial incentive to invest in screening and preventative measures to ensure good maternal mental health.
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Affiliation(s)
- Sarah Myers
- School of Anthropology and Conservation, Marlowe Building, University of Kent, Canterbury, Kent CT2 7NR, UK
| | - Oskar Burger
- School of Anthropology and Conservation, Marlowe Building, University of Kent, Canterbury, Kent CT2 7NR, UK
| | - Sarah E Johns
- School of Anthropology and Conservation, Marlowe Building, University of Kent, Canterbury, Kent CT2 7NR, UK
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24
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Maternal Depressive Symptoms and Attained Size Among Children in the First 2 Years of Life. Acad Pediatr 2016; 16:75-81. [PMID: 26498256 DOI: 10.1016/j.acap.2015.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 10/08/2015] [Accepted: 10/16/2015] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To evaluate the relation of maternal depressive symptoms with attained size and whether it is stronger for young children in low-income families. METHODS Secondary analysis was performed of longitudinal data from enrollment and parents surveys from the Healthy Steps for Young Children National Evaluation among 4745 children who made at least one visit to a Healthy Steps site. Length and weight data from medical records were converted to z scores and percentiles for length for age and weight for length at 6, 12, and 24 months using 2000 Centers for Disease Control and Prevention growth standards. Analyses evaluated the relation of maternal depressive symptoms at 2 to 4 months using a modified 14-item Center for Epidemiologic Depression Scale with attained size and child, maternal, and family characteristics. Regression models estimated the relation of symptoms with z scores and logistic regression the relation for short stature (below 10th percentile for length for age), adjusted for covariates. RESULTS Maternal depressive symptoms were associated with z scores for length for age at 6, 12, and 24 months and short stature at 6 and 24 months for children in low/middle-income families. The z scores at 24 months remained significantly lower for children in low/middle-income families whose mothers reported depressive symptoms, after adjustment for covariates. The odds of short stature were significantly increased at 6 months in the total sample and among low/middle-income families for children whose mothers reported symptoms. Other measures of attained size were not associated with depressive symptoms. CONCLUSIONS The link between maternal symptoms and young children's risk of short stature reinforces recommendations for increased screening for postpartum depressive symptoms and for clinicians to review growth charts with parents for impaired/unfavorable patterns.
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Cueto S, León J, Miranda A, Dearden K, Crookston BT, Behrman JR. Does pre-school improve cognitive abilities among children with early-life stunting? A longitudinal study for Peru. INTERNATIONAL JOURNAL OF EDUCATIONAL RESEARCH 2015; 75:102-114. [PMID: 28428683 PMCID: PMC5394429 DOI: 10.1016/j.ijer.2015.09.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Several studies in developing countries have found that children who experience growth faltering in the first years of life show lower cognitive abilities than their peers. In this study, we use the Young Lives longitudinal dataset in Peru to analyze if attending pre-school affects cognitive abilities at age five years, and if there is an interaction with HAZ at age one year. Using instrumental variables we found, for receptive vocabulary, a positive effect of attending Jardines (formal) pre-schools; the effect of attending PRONOEI (community-based) pre-schools was not significant. More years attending Jardines was more beneficial for children who were better nourished. We suggest working to improve the quality of PRONOEIs, and with teachers on targeting children of lower nutritional status.
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Affiliation(s)
- Santiago Cueto
- Group for the Analysis of Development, Av. Grau 915, Barranco, Lima 4, Peru
| | - Juan León
- Group for the Analysis of Development, Av. Grau 915, Barranco, Lima 4, Peru
| | - Alejandra Miranda
- Group for the Analysis of Development, Av. Grau 915, Barranco, Lima 4, Peru
| | - Kirk Dearden
- Center for Global Health & Development, Boston University, Crosstown Center, 801 Massachusetts Avenue Boston, MA 02118, United States
| | - Benjamin T Crookston
- The College of Life Sciences, Brigham Young University, 2137 LSB Provo UT 84602, United States
| | - Jere R Behrman
- University of Pennsylvania, 3718 Locust Walk, Philadelphia, PA 19104, United States
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26
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Li B, Xu Y, Pan D, Xiao Q, Gao Q, Chen X, Peng X, Du Y, Gao P. Effect of immobilization stress on the appetite and stomach ghrelin expression in maternal mice. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2015; 8:15993-15999. [PMID: 26884874 PMCID: PMC4730087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Accepted: 11/24/2015] [Indexed: 06/05/2023]
Abstract
Maternal stress exerts long-lasting postnatal growth on offspring, which persist into adulthood. However, the effect of maternal stress on appetizing system has not been widely reported. In this study, we found that maternal immobilization stress (IS) during lactation resulted in low body weight and food intake. Immunohistochemistry showed an increase in stomach ghrelin protein expression. The central regulation of body weight and food intake occurs in the hypothalamus, which contains multiple neuronal systems that play important roles in the regulation of energy homeostasis. These systems including multiple neuropeptides involve in the ghrelin pathway of appetite regulation. Therefore, real time reverse transcription polymerase chain reaction (RT-PCR) was used to measure the change of mRNA expression of ghrelin pathway related hormones in order to explore the mechanisms involved in the appetite regulation. Expression levels of the hypothalamic 5-hydroxytryptamine 2c receptor (5-HT2cR) and 5-HT2bR, which are essential for the development and function of ghrelin and leptin, were decreased, as well as those of corticotrophin releasing factor (CRF) and pro-opiomelanocortin (POMC). While the expression of growth hormone secretagogue receptor (GHSR), neuropeptide-Y (NPY) and agouti-related protein (AgRP) showed an increase with significant difference. These results suggest that stress in a postpartum mother has persistent effects on the body weight of their offspring. Increased ghrelin and decreased leptin expression in the stomach may play a role in these effects.
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MESH Headings
- Agouti Signaling Protein/metabolism
- Animals
- Appetite Regulation
- Corticotropin-Releasing Hormone/metabolism
- Disease Models, Animal
- Eating
- Feeding Behavior
- Female
- Gastric Mucosa/metabolism
- Ghrelin/genetics
- Ghrelin/metabolism
- Hypothalamus/metabolism
- Hypothalamus/physiopathology
- Lactation/genetics
- Lactation/metabolism
- Leptin/metabolism
- Maternal Exposure
- Mice, Inbred ICR
- Neuropeptide Y/metabolism
- Postpartum Period
- Pro-Opiomelanocortin/metabolism
- Receptor, Serotonin, 5-HT2B/metabolism
- Receptor, Serotonin, 5-HT2C/metabolism
- Receptors, Ghrelin/metabolism
- Restraint, Physical/psychology
- Stress, Psychological/genetics
- Stress, Psychological/metabolism
- Stress, Psychological/physiopathology
- Stress, Psychological/psychology
- Time Factors
- Weight Gain
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Affiliation(s)
- Bing Li
- Department of Central Laboratory, Jinshan Hospital of Fudan UniversityShanghai, China
| | - Yuemei Xu
- Department of TCM, Jinshan Hospital of Fudan UniversityShanghai, China
| | - Danqing Pan
- Department of TCM, Jinshan Hospital of Fudan UniversityShanghai, China
| | - Qian Xiao
- Department of TCM, Jinshan Hospital of Fudan UniversityShanghai, China
| | - Qi Gao
- Department of TCM, Jinshan Hospital of Fudan UniversityShanghai, China
| | - Xin Chen
- Department of TCM, Jinshan Hospital of Fudan UniversityShanghai, China
| | - Xiuhua Peng
- Department of Animal Experiments, Shanghai Public Health Clinical CenterChina
| | - Yuling Du
- Department of TCM, Jinshan Hospital of Fudan UniversityShanghai, China
| | - Pengfei Gao
- Department of TCM, Jinshan Hospital of Fudan UniversityShanghai, China
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27
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Crapnell TL, Woodward LJ, Rogers CE, Inder TE, Pineda RG. Neurodevelopmental Profile, Growth, and Psychosocial Environment of Preterm Infants with Difficult Feeding Behavior at Age 2 Years. J Pediatr 2015; 167:1347-53. [PMID: 26490123 PMCID: PMC4662882 DOI: 10.1016/j.jpeds.2015.09.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 07/07/2015] [Accepted: 09/03/2015] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To examine the association of difficult feeding behaviors in very preterm infants at age 2 years with growth and neurodevelopmental outcomes and family factors and functioning. STUDY DESIGN Eighty children born ≤30 weeks gestation were studied from birth until age 2 years. Feeding difficulties were assessed using the Eating Subscale of the Infant-Toddler Social Emotional Assessment at age 2 years, along with growth measurement and developmental testing. Maternal mental health and family factors were assessed using standardized questionnaires. ANOVA and χ(2) analyses were performed to determine associations between feeding difficulties and growth, neurodevelopmental outcomes, and family characteristics. RESULTS Twenty-one children (26%) were at risk for feeding difficulties, and an additional 18 (23%) had definite feeding difficulties at age 2 years. Those with feeding difficulties were more likely to be subject to a range of neurodevelopmental problems, including impaired cognition (P = .02), language (P = .04), motor (P = .01), and socioemotional (P < .007) skills. Compared with the parents of children with fewer feeding difficulties, parents of the children with feeding difficulties had higher parenting stress (P = .02) and reported more difficulty managing their child's behavior (P = .002) and more frequent parent-child interaction problems (P = .002). No associations were found between difficult feeding behaviors and growth, maternal mental health, or family factors. CONCLUSION Difficult feeding behaviors in children born very preterm appear to be highly comorbid with other developmental and family challenges, including neurodevelopmental impairment and parent-child interaction difficulties. Focusing on improving feeding skills, in conjunction with supporting positive parent-child interactions, may be beneficial for improving outcomes.
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Affiliation(s)
- Tara L Crapnell
- Program in Occupational Therapy, Washington University School of Medicine, St Louis, MO
| | - Lianne J Woodward
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Cynthia E Rogers
- Department of Pediatrics, Washington University School of Medicine, St Louis, MO; Department of Psychiatry, Washington University School of Medicine, St Louis, MO
| | - Terrie E Inder
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Roberta G Pineda
- Program in Occupational Therapy, Washington University School of Medicine, St Louis, MO; Department of Pediatrics, Washington University School of Medicine, St Louis, MO.
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28
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Romano C, Hartman C, Privitera C, Cardile S, Shamir R. Current topics in the diagnosis and management of the pediatric non organic feeding disorders (NOFEDs). Clin Nutr 2015; 34:195-200. [DOI: 10.1016/j.clnu.2014.08.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 07/24/2014] [Accepted: 08/29/2014] [Indexed: 10/24/2022]
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Hindmarch P, Hawkins A, McColl E, Hayes M, Majsak-Newman G, Ablewhite J, Deave T, Kendrick D. Recruitment and retention strategies and the examination of attrition bias in a randomised controlled trial in children's centres serving families in disadvantaged areas of England. Trials 2015; 16:79. [PMID: 25886131 PMCID: PMC4359386 DOI: 10.1186/s13063-015-0578-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 01/22/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Failure to retain participants in randomised controlled trials and longitudinal studies can cause significant methodological problems. We report the recruitment and retention strategies of a randomised controlled trial to promote fire-related injury prevention in families with pre-school children attending children's centres in disadvantaged areas in England. METHODS Thirty-six children's centres were cluster randomised into one of three arms of a 12-month fire-related injury prevention trial. Two arms delivered safety interventions and there was one control arm. Retention rates compared the numbers of participants responding to the 12-month questionnaire to the number recruited to the trial. Multivariable random effects logistic regression was used to explore factors independently associated with participant retention. RESULTS The trial exceeded its required sample size through the use of multiple recruitment strategies. All children's centres remained in the study, despite increased reorganisation. Parent retention was 68% at 12 months, ranging from 65% to 70% across trial arms and from 62% to 74% across trial sites. There was no significant difference in the rates of retention between trial arms (p = 0.58) or between trial sites (p = 0.16). Retention was significantly lower amongst mothers aged 16-25 years than older mothers [adjusted odds ratio (AOR) 0.57, 95% CI 0.41, 0.78], those living in non-owner occupied accommodation than in owner occupied accommodation (AOR 0.53, 95% CI 0.38, 0.73) and those living in more disadvantaged areas (most versus least disadvantaged quintiles AOR 0.50, 95% CI 0.30, 0.82). CONCLUSIONS Studies recruiting disadvantaged populations should measure and report attrition by socioeconomic factors to enable determination of the extent of attrition bias and estimation of its potential impact on findings. Where differential attrition is anticipated, consideration should be given to over-sampling during recruitment and targeted and more intensive strategies of participant retention in these sub-groups. In transient populations collection of multiple sources of contact information at recruitment and throughout the study may aid retention. TRIAL REGISTRATION Clinicaltrials.gov identifier: NCT01452191 ; Date of registration: 10 October 2011, ISRCTN65067450.
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Affiliation(s)
- Paul Hindmarch
- Institute of Health & Society, Baddiley-Clark Building, Newcastle University, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK.
| | - Adrian Hawkins
- Institute of Health & Society, Baddiley-Clark Building, Newcastle University, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK.
| | - Elaine McColl
- Institute of Health & Society, Baddiley-Clark Building, Newcastle University, Richardson Road, Newcastle upon Tyne, NE2 4AX, UK.
| | - Mike Hayes
- Child Accident Prevention Trust, Canterbury Court (1.09), 1-3 Brixton Road, London, SW9 6DE, UK.
| | - Gosia Majsak-Newman
- Clinical Research & Trials Unit, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, NR4 7UY, UK.
| | - Joanne Ablewhite
- Division of Primary Care, School of Medicine, Floor 13, Tower Building, University Park, Nottingham, NG7 2RD, UK.
| | - Toity Deave
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, BS16 1QY, UK.
| | - Denise Kendrick
- Division of Primary Care, School of Medicine, Floor 13, Tower Building, University Park, Nottingham, NG7 2RD, UK.
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Yam KY, Naninck EFG, Schmidt MV, Lucassen PJ, Korosi A. Early-life adversity programs emotional functions and the neuroendocrine stress system: the contribution of nutrition, metabolic hormones and epigenetic mechanisms. Stress 2015; 18:328-42. [PMID: 26260665 DOI: 10.3109/10253890.2015.1064890] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Clinical and pre-clinical studies have shown that early-life adversities, such as abuse or neglect, can increase the vulnerability to develop psychopathologies and cognitive decline later in life. Remarkably, the lasting consequences of stress during this sensitive period on the hypothalamic-pituitary-adrenal axis and emotional function closely resemble the long-term effects of early malnutrition and suggest a possible common pathway mediating these effects. During early-life, brain development is affected by both exogenous factors, like nutrition and maternal care as well as by endogenous modulators including stress hormones. These elements, while mostly considered for their independent actions, clearly do not act alone but rather in a synergistic manner. In order to better understand how the programming by early-life stress takes place, it is important to gain further insight into the exact interplay of these key elements, the possible common pathways as well as the underlying molecular mechanisms that mediate their effects. We here review evidence that exposure to both early-life stress and early-life under-/malnutrition similarly lead to life-long alterations on the neuroendocrine stress system and modify emotional functions. We further discuss how the different key elements of the early-life environment interact and affect one another and next suggest a possible role for the early-life adversity induced alterations in metabolic hormones and nutrient availability in shaping later stress responses and emotional function throughout life, possibly via epigenetic mechanisms. Such knowledge will help to develop intervention strategies, which gives the advantage of viewing the synergistic action of a more complete set of changes induced by early-life adversity.
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Affiliation(s)
- Kit-Yi Yam
- a Swammerdam Institute for Life Sciences, Center for Neuroscience, University of Amsterdam , XH Amsterdam , The Netherlands and
| | - Eva F G Naninck
- a Swammerdam Institute for Life Sciences, Center for Neuroscience, University of Amsterdam , XH Amsterdam , The Netherlands and
| | - Mathias V Schmidt
- b Department Stress Neurobiology and Neurogenetics , Max Planck Institute of Psychiatry , Munich , Germany
| | - Paul J Lucassen
- a Swammerdam Institute for Life Sciences, Center for Neuroscience, University of Amsterdam , XH Amsterdam , The Netherlands and
| | - Aniko Korosi
- a Swammerdam Institute for Life Sciences, Center for Neuroscience, University of Amsterdam , XH Amsterdam , The Netherlands and
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31
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Abstract
PURPOSE OF REVIEW To summarize the latest information on the nutritional management of food protein-induced enterocolitis syndrome (FPIES), focusing on the foods implicated and how to avoid these whilst maintaining a nutritionally sound diet. RECENT FINDINGS A number of foods are implicated in FPIES such as milk, soy and grains, particularly rice. The number of foods implicated in FPIES per individual differs, but the majority of reported cases have two or fewer food triggers involved. SUMMARY FPIES is a complex presentation of non-IgE-mediated food allergy. Dietary management is complicated as both common food allergens as well as atypical food allergens can trigger FPIES. Sound nutritional advice is required to ensure appropriate food avoidance, adequate consumption of other foods and sufficient nutritional intake to maintain and ensure growth and development.
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Mallan KM, Daniels LA, Wilson JL, Jansen E, Nicholson JM. Association between maternal depressive symptoms in the early post-natal period and responsiveness in feeding at child age 2 years. MATERNAL AND CHILD NUTRITION 2014; 11:926-35. [PMID: 24784325 DOI: 10.1111/mcn.12116] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Maternal depression is a known risk factor for poor outcomes for children. Pathways to these poor outcomes relate to reduced maternal responsiveness or sensitivity to the child. Impaired responsiveness potentially impacts the feeding relationship and thus may be a risk factor for inappropriate feeding practices. The aim of this study was to examine the longitudinal relationships between self-reported maternal post-natal depressive symptoms at child age 4 months and feeding practices at child age 2 years in a community sample. Participants were Australian first-time mothers allocated to the control group of the NOURISH randomized controlled trial when infants were 4 months old. Complete data from 211 mothers (of 346 allocated) followed up when their children were 2 years of age (51% girls) were available for analysis. The relationship between Edinburgh Postnatal Depression Scale (EPDS) score (child age 4 months) and child feeding practices (child age 2 years) was tested using hierarchical linear regression analysis adjusted for maternal and child characteristics. Higher EPDS score was associated with less responsive feeding practices at child age 2 years: greater pressure [β = 0.18, 95% confidence interval (CI): 0.04-0.32, P = 0.01], restriction (β = 0.14, 95% CI: 0.001-0.28, P = 0.05), instrumental (β = 0.14, 95% CI: 0.005-0.27, P = 0.04) and emotional (β = 0.15, 95% CI: 0.01-0.29, P = 0.03) feeding practices (ΔR(2) values: 0.02-0.03, P < 0.05). This study provides evidence for the proposed link between maternal post-natal depressive symptoms and lower responsiveness in child feeding. These findings suggest that the provision of support to mothers experiencing some levels of depressive symptomatology in the early post-natal period may improve responsiveness in the child feeding relationship.
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Affiliation(s)
- Kimberley M Mallan
- School of Exercise and Nutrition Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Lynne A Daniels
- School of Exercise and Nutrition Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.,Nutrition and Dietetics, School of Medicine, Flinders University, Adelaide, South Australia, Australia
| | - Jacinda L Wilson
- School of Exercise and Nutrition Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Elena Jansen
- School of Exercise and Nutrition Sciences, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Jan M Nicholson
- Parenting Research Centre, Melbourne, Victoria, Australia.,School of Early Childhood, Faculty of Education, Queensland University of Technology, Brisbane, Queensland, Australia
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Are diet and feeding behaviours associated with the onset of and recovery from slow weight gain in early infancy? Br J Nutr 2014; 111:1696-704. [PMID: 24502920 DOI: 10.1017/s0007114513004182] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Infants with slow weight gain cause concern in parents and professionals, but it is difficult to be certain whether such infants are genetically small or whether their energy intake is insufficient. The aim of the present study was to assess the impact of diet and feeding behaviours on slow weight gain early in infancy. The sample was 11 499 term infants from the Avon Longitudinal Study of Parents and Children (ALSPAC). A total of 507 cases of slow weight gain from birth to 8 weeks were identified and the remaining 10 992 infants were used as controls. It was found that infants who gained weight slowly between birth and 8 weeks were more likely to exhibit feeding problems such as weak sucking and slow feeding during this period. Feeding problems were substantially reduced during the recovery phase (8 weeks to 2 years) when these infants exhibited enhanced catch-up in weight. The proportion of mothers breast-feeding in the 4th week after birth was higher for slow weight gainers, but they were more likely to switch to formula at the start of recovery. During recovery, slow-weight gain infants had a slightly higher energy intake from formula and solids than controls. In conclusion, feeding problems seem to be the most important factors associated with the onset of early slow weight gain. Subsequently, a reduction of feeding problems and an increase in overall energy intake may contribute to their weight recovery. Health professionals should look for feeding problems in the first few weeks after birth and help mothers establish adequate feeding practices.
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Bakare MO, Okoye JO, Obindo JT. Introducing depression and developmental screenings into the national programme on immunization (NPI) in southeast Nigeria: an experimental cross-sectional assessment. Gen Hosp Psychiatry 2014; 36:105-12. [PMID: 24140169 DOI: 10.1016/j.genhosppsych.2013.09.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Revised: 09/12/2013] [Accepted: 09/14/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This study investigates the possibility of introducing depression and developmental screening tools into the National Programme on Immunization (NPI) in southeast Nigeria. The specific objectives were to determine the prevalence of postpartum depression (PPD) among mothers attending immunization clinics and to assess the association of maternal PPD and infant growth in relation to World Health Organization (WHO) recommendations. METHODS Four hundred and eight (408) mothers completed the sociodemographic questionnaire and the self-report Edinburgh Postnatal Depression Scale (EPDS). The weights, lengths and head circumferences of their infants were recorded, while the WHO recommended equivalents at 50th percentiles were also recorded for each child. The mothers were then interviewed with the major depressive episode module of Mini International Neuropsychiatric Interview (M.I.N.I.) to make diagnosis of depression. RESULTS About 24.8% and 15.2% of the mothers were found to be depressed using EPDS and major depressive episode module of M.I.N.I., respectively. It was found that maternal PPD is significantly associated with the growth parameters of weights and lengths of the infants studied but not their head circumference. CONCLUSIONS NPI may provide appropriate forum for early screening of mothers for PPD and interventions in Nigeria. The NPI would also serve a useful avenue of screening for developmental concerns in Nigerian children.
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Affiliation(s)
- Muideen O Bakare
- Childhood Neuropsychiatric Disorders Initiatives (CNDI), Premier Layout, Enugu, Enugu State, Nigeria; Child and Adolescent Unit, Federal Neuropsychiatric Hospital, New Haven, Enugu, Enugu State, Nigeria.
| | - Jane O Okoye
- Department of Psychological Medicine Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria.
| | - James T Obindo
- Department of Psychiatry, University of Jos/Jos University Teaching Hospital, Jos, Plateau State, Nigeria.
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Yilgwan CS, Utoo TB, Hyacinth HI. Maternal characteristics influencing birth weight and infant weight gain in the first 6 weeks post-partum: A cross-sectional study of a post-natal clinic population. Niger Med J 2013; 53:200-5. [PMID: 23661878 PMCID: PMC3640239 DOI: 10.4103/0300-1652.107553] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: To investigate the relationship between certain maternal characteristic and infant birth weight and weight gain in puerperal women seen at a tertiary health centre. Materials and Methods: We measured the weight of 318, randomly selected infants after a complete physical examination at birth and at 6 weeks postnatal using standard procedures and related them to certain maternal characteristics. Results: There were 318 women and baby pairs. Maternal ages ranged from 16 to 42 years, with a mean of 25.6±1.3 years. Mean birth weight of babies was 3.10±1.89 kg; mean gestational age was 36±4.6 weeks, with 9.4% and 3.0% of babies born having low birth weight or Macrosomia respectively. Mothers from the North of the country, multiparity and systolic and/or diastolic hypertensions were factors associated with low birth weight. At 6 weeks, 27.1% of infants failed to gain weight as expected for their age. Similarly, 37.0% of infants born to mothers with some tertiary education showed slowed weight gain compared with those who had secondary (19.2%) or primary (14.7%) education, P=0.03. Maternal weight at delivery positively correlated with birth weight of the infant (r=0.357, P<0.001). However, maternal weight and blood pressure negatively correlated with infant weight gain at 6 weeks post-delivery. Conclusion: Our study demonstrates that certain maternal characteristics could play a role in the birth weight and early infant weight gain, and are preventable through simple public health approaches.
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Affiliation(s)
- Christopher S Yilgwan
- Department of Paediatrics, University of Jos, Jos University Teaching Hospital, Jos Nigeria
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Abstract
OBJECTIVE The goal of this study was to investigate growth outcomes in term infants with weight faltering. METHODS Conditional weight gain was calculated on term infants from the Avon Longitudinal Study of Parents and Children. Cases of weight faltering were infants with a conditional weight gain below the fifth centile. Outcome growth measurements included weight and length/height (from 9 months to 13 years), BMI, mid-arm circumference, and waist circumference (at 7, 10, and 13 years). RESULTS Weight data were available on 11 499 infants; 507 had "early" weight faltering (before 8 weeks), and 480 had "late" weight faltering (between 8 weeks and 9 months). The early group showed enhanced weight gain from 8 weeks until 2 years, then gained weight at the same rate as the controls. Gain in height was proportionally slower than gain in weight through childhood. By 13 years, they had BMI, mid-arm circumference, and waist circumference similar to the controls. The late group showed steady weight gain throughout childhood; enhanced weight gain compared with the controls only occurred between 7 and 10 years. Gain in height was proportional to gain in weight. This group remained considerably lighter and shorter than the controls up to the age of 13 years. CONCLUSIONS Children with weight faltering before 8 weeks showed a different pattern of "catch-up" to those with weight faltering later in infancy. By 13 years, the anthropometric profile of the 2 groups was within population norms.
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Affiliation(s)
- Zia ud Din
- Department of Human Nutrition, KP Agricultural University, Peshawar, Pakistan
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Ertel KA, Kleinman K, van Rossem L, Sagiv S, Tiemeier H, Hofman A, Jaddoe VW, Raat H. Maternal perinatal depression is not independently associated with child body mass index in the Generation R Study: methods and missing data matter. J Clin Epidemiol 2012; 65:1300-9. [DOI: 10.1016/j.jclinepi.2012.05.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2012] [Revised: 05/17/2012] [Accepted: 05/23/2012] [Indexed: 01/25/2023]
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Ruiz-Castell M, Carsin AE, Barbieri FL, Paco P, Gardon J, Sunyer J. Child patterns of growth delay and cognitive development in a Bolivian mining city. Am J Hum Biol 2012; 25:94-100. [PMID: 23132674 DOI: 10.1002/ajhb.22346] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Revised: 09/28/2012] [Accepted: 10/10/2012] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES This study aims to (1) follow up and characterize infant growth patterns during the first year of life in Bolivia, and (2) determine whether there exists an association between weight gain and cognitive development in children living near contaminated mining industries. METHODS Data on 175 children participating to the ToxBol (Toxicity in Bolivia) birth cohort were analyzed. Rapid-growth during the first 6 months was defined as a change in weight z-score > 0.67 while slow-growth was defined as a weight z-score change of < -0.67. Neurodevelopment was evaluated using the Bayley Scales of Infant Development at 10.5-12.5 months of age. Mixed models were used to examine the association between cognitive development and weight gain. RESULTS Rapid growers weighed less at birth (P < 0.01). However, they revealed a higher body mass index at 12 months of age (0.70 ± 0.73, P < 0.01). After adjustment for confounding, rapid growth was not associated with cognitive development (coef = 0.49, 95% confidence interval = -4.10, 5.08). CONCLUSIONS In this Bolivian cohort, children born smaller were more likely to grow/develop faster and attain greater weight and length. Their cognitive development was not affected by their growth patterns.
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Affiliation(s)
- María Ruiz-Castell
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Dr. Aiguader, 88 08003 Barcelona, Spain.
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Surkan PJ, Ettinger AK, Ahmed S, Minkovitz CS, Strobino D. Impact of maternal depressive symptoms on growth of preschool- and school-aged children. Pediatrics 2012; 130:e847-55. [PMID: 22966023 PMCID: PMC4074625 DOI: 10.1542/peds.2011-2118] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The aim of our study was to examine whether maternal depressive symptoms at 9 months postpartum adversely affect growth in preschool- and school-aged children. METHODS We used data from the US nationally representative Early Childhood Longitudinal Study, Birth Cohort. We fit multivariable logistic regression models to study maternal depressive symptoms at 9 months postpartum (using the Center for Epidemiologic Studies Depression Scale) in relation to child growth outcomes, ≤ 10% height-for-age, ≤ 10% weight-for-height, and ≤ 10% weight-for-age at 4 and 5 years. RESULTS At 9 months, 24% of mothers reported mild depressive symptoms and 17% moderate/severe symptoms. After adjustment for household, maternal, and child factors, children of mothers with moderate to severe levels of depressive symptoms at 9 months' postpartum had a 40% increased odds of being ≤ 10% in height-for-age at age 4 (odds ratio = 1.40, 95% confidence interval: 1.04-1.89) and 48% increased odds of being ≤ 10% in height-for-age at age 5 (odds ratio = 1.48, 95% confidence interval: 1.03-2.13) compared with children of women with few or no depressive symptoms. There was no statistically significant association between maternal depressive symptoms and children being ≤ 1 0% in weight-for-height and weight-for-age at 4 or 5 years. CONCLUSIONS Maternal depressive symptoms during infancy may affect physical growth in early childhood. Prevention, early detection, and treatment of maternal depressive symptoms during the first year postpartum may prevent childhood height-for-age ≤ 10th percentile among preschool- and school-aged children.
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Affiliation(s)
- Pamela J. Surkan
- Departments of International Health and,Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Anna K. Ettinger
- Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Saifuddin Ahmed
- Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Cynthia S. Minkovitz
- Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Donna Strobino
- Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Abstract
In this paper we set out to explore the prevalence of child undernutrition found in community studies in affluent societies, but a preliminary literature review revealed that, in the absence of a gold standard method of diagnosis, the prevalence largely depends on the measure, threshold and the growth reference used, as well as age. We thus go on to explore describe the common clinical ‘syndromes’ of child undernutrition: wasting, stunting and failure to thrive (weight faltering) and how we have used data from two population-based cohort studies, this paper to explore how much these different ‘syndromes’ overlap and the extent to which they reflect true undernutrition. This analysis revealed that when more than one definition is applied to the same children, a majority are below the lower threshold for only one measure. However, those with both weight faltering and low BMI in infancy, go on in later childhood to show growth and body composition patterns suggestive of previous undernutrition. In older children there is even less overlap and most children with either wasting or low fat seem to be simply growing at one extreme of the normal range. We conclude that in affluent societies the diagnosis of undernutrition is only robust when it relies on a combination of both, that is decline in weight or BMI centile and wasting.
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Maternal experiences of racial discrimination and child weight status in the first 3 years of life. J Dev Orig Health Dis 2012; 3:433-41. [DOI: 10.1017/s2040174412000384] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Among US racial/ethnic minority women, we examined associations between maternal experiences of racial discrimination and child growth in the first 3 years of life. We analyzed data from Project Viva, a pre-birth cohort study. We restricted analyses to 539 mother–infant pairs; 294 were Black, 127 Hispanic, 110 Asian and 8 from additional racial/ethnic groups. During pregnancy, mothers completed the Experiences of Discrimination survey that measured lifetime experiences of racial discrimination in diverse domains. We categorized responses as 0, 1–2 or ⩾3 domains. Main outcomes were birth weight for gestational age z-score; weight for age (WFA) z-score at 6 months of age; and at 3 years of age, body mass index (BMI) z-score. In multivariable analyses, we adjusted for maternal race/ethnicity, nativity, education, age, pre-pregnancy BMI, household income and child sex and age. Among this cohort of mostly (58.2%) US-born and economically non-impoverished mothers, 33% reported 0 domains of discrimination, 33% reported discrimination in 1–2 domains and 35% reported discrimination in ⩾3 domains. Compared with children whose mothers reported no discrimination, those whose mothers reported ⩾3 domains had lower birth weight for gestational age z-score (β −0.25; 95% CI: −0.45, −0.04), lower 6 month WFA z-score (β −0.34; 95% CI: −0.65, −0.03) and lower 3-year BMI z-score (β −0.33; 95% CI: −0.66, 0.00). In conclusion, we found that among this cohort of US racial/ethnic minority women, mothers’ report of experiencing lifetime discrimination in ⩾ 3 domains was associated with lower fetal growth, weight at 6 months and 3-year BMI among their offspring.
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Kang Sim DE, Cappiello M, Castillo M, Lozoff B, Martinez S, Blanco E, Gahagan S. Postnatal Growth Patterns in a Chilean Cohort: The Role of SES and Family Environment. Int J Pediatr 2012; 2012:354060. [PMID: 22666275 PMCID: PMC3361171 DOI: 10.1155/2012/354060] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Revised: 02/18/2012] [Accepted: 03/04/2012] [Indexed: 11/17/2022] Open
Abstract
Objective. This study examined how family environmental characteristics served as mediators in the relationship between socioeconomic conditions and infant growth in a cohort of Chilean infants. Methods. We studied 999 infants, born between 1991 and 1996, from a longitudinal cohort which began as an iron deficiency anemia preventive trial. SES (Graffar Index), the Life Experiences Survey, and the Home Observation for Measurement of the Environment (HOME) were assessed in infancy. Using path analysis, we assessed the relationships between the social factors, home environment, and infant growth. Results. During the first year, weight and length gain averaged 540 grams/month and 6.5 cm/month, respectively. In the path analysis model for weight gain, higher SES and a better physical environment were positively related to higher maternal warmth, which in turn was associated with higher average weight gain. Higher SES was directly related to higher average length gain. Conclusions. In our cohort, a direct relationship between SES and length gain developed during infancy. Higher SES was indirectly related to infant weight gain through the home environment and maternal warmth. As the fastest growing infants are at risk for later obesity, new strategies are needed to encourage optimal rather than maximal growth.
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Affiliation(s)
- D. E. Kang Sim
- Division of Child Development and Community Health, University of California, San Diego, 9500 Gilman Drive No. 0927, La Jolla, CA 92093-0927, USA
| | - M. Cappiello
- Division of Child Development and Community Health, University of California, San Diego, 9500 Gilman Drive No. 0927, La Jolla, CA 92093-0927, USA
| | - M. Castillo
- Institute of Nutrition and Food Technology (INTA), University of Chile, El Líbano 5524, Santiago, Chile
| | - B. Lozoff
- Center for Human Growth and Development, University of Michigan, Ann Arbor 300 North Ingalls, 10th Floor, Ann Arbor, MI 48109-5406, USA
| | - S. Martinez
- Division of Child Development and Community Health, University of California, San Diego, 9500 Gilman Drive No. 0927, La Jolla, CA 92093-0927, USA
| | - E. Blanco
- Division of Child Development and Community Health, University of California, San Diego, 9500 Gilman Drive No. 0927, La Jolla, CA 92093-0927, USA
| | - S. Gahagan
- Division of Child Development and Community Health, University of California, San Diego, 9500 Gilman Drive No. 0927, La Jolla, CA 92093-0927, USA
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Weightman AL, Morgan HE, Shepherd MA, Kitcher H, Roberts C, Dunstan FD. Social inequality and infant health in the UK: systematic review and meta-analyses. BMJ Open 2012; 2:bmjopen-2012-000964. [PMID: 22700833 PMCID: PMC3378945 DOI: 10.1136/bmjopen-2012-000964] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES To determine the association between area and individual measures of social disadvantage and infant health in the UK. DESIGN Systematic review and meta-analyses. DATA SOURCES 26 databases and websites, reference lists, experts in the field and hand-searching. STUDY SELECTION 36 prospective and retrospective observational studies with socioeconomic data and health outcomes for infants in the UK, published from 1994 to May 2011. DATA EXTRACTION AND SYNTHESIS 2 independent reviewers assessed the methodological quality of the studies and abstracted data. Where possible, study outcomes were reported as ORs for the highest versus the lowest deprivation quintile. RESULTS In relation to the highest versus lowest area deprivation quintiles, the odds of adverse birth outcomes were 1.81 (95% CI 1.71 to 1.92) for low birth weight, 1.67 (95% CI 1.42 to 1.96) for premature birth and 1.54 (95% CI 1.39 to 1.72) for stillbirth. For infant mortality rates, the ORs were 1.72 (95% CI 1.37 to 2.15) overall, 1.61 (95% CI 1.08 to 2.39) for neonatal and 2.31 (95% CI 2.03 to 2.64) for post-neonatal mortality. For lowest versus highest social class, the odds were 1.79 (95% CI 1.43 to 2.24) for low birth weight, 1.52 (95% CI 1.44 to 1.61) for overall infant mortality, 1.42 (95% CI 1.33 to1.51) for neonatal and 1.69 (95% CI 1.53 to 1.87) for post-neonatal mortality. There are similar patterns for other infant health outcomes with the possible exception of failure to thrive, where there is no clear association. CONCLUSIONS This review quantifies the influence of social disadvantage on infant outcomes in the UK. The magnitude of effect is similar across a range of area and individual deprivation measures and birth and mortality outcomes. Further research should explore the factors that are more proximal to mothers and infants, to help throw light on the most appropriate times to provide support and the form(s) that this support should take.
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Affiliation(s)
- Alison L Weightman
- Support Unit for Research Evidence (SURE), Information Services, Cardiff University, Cardiff, UK
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To what extent do weight gain and eating avidity during infancy predict later adiposity? Public Health Nutr 2011; 15:656-62. [DOI: 10.1017/s1368980011002096] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectiveTo determine the extent to which weight gain and eating behaviours in infancy predict later adiposity.DesignPopulation-based, prospective, longitudinal birth cohort study. Weights collected in infancy were used to calculate Z-scores for weight gain to age 1 year conditional on birth weight (CWG). To avoid multiple significance tests, variables from the parent questionnaire completed at age 1 year describing eating avidity were combined using general linear modelling to create an infancy avidity score. Anthropometry, skinfold thicknesses and bioelectrical impedance data collected at age 7–8 years were combined using factor analysis, to create an adiposity index.SettingGateshead, UK.SubjectsMembers of the Gateshead Millennium Study cohort with data at both time points (n 561).ResultsCWG in infancy significantly predicted adiposity at age 7 years, but related more strongly to length and lean mass. High adiposity (> 90th internal percentile) at age 7 years was significantly associated with high CWG (relative risk 2·76; 95 % CI 1·5, 5·1) in infancy, but less so with raised (> 74th internal percentile) eating avidity in infancy (relative risk 1·87; 95 % CI 0·9, 3·7). However, the majority of children with high weight gain (77·6 %) or avidity (85·5 %) in infancy did not go on to have high adiposity at age 7 years.ConclusionsRapid weight gain in infancy and the eating behaviours which relate to it do predict later adiposity, but are more strongly predictive of later stature and lean mass.
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Hart SL, Jackson SC, Boylan LM. Compromised weight gain, milk intake, and feeding behavior in breastfed newborns of depressive mothers. J Pediatr Psychol 2011; 36:942-50. [PMID: 21642337 PMCID: PMC3156587 DOI: 10.1093/jpepsy/jsr031] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2010] [Revised: 03/29/2011] [Accepted: 03/30/2011] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To explore depressed mood in the breastfeeding dyad. METHOD N = 50 mothers of 12-day-olds reported depressed mood (EPDS) and anxiety (STAI), then were videotaped while breastfeeding. Infants were weighed before and after breastfeeding. RESULTS An ANCOVA on weight gain, which controlled for infant age and birth weight, found EPDS inversely related to weight gain. Following a significant MANCOVA on infant biobehavioral measures, ANCOVAs which controlled for birth weight, age, hunger at time of testing, and degree of exclusivity in breastfeeding, found EPDS inversely related to infants' milk intake and latch quality. Following a significant MANOVA on maternal behaviors, ANOVAs revealed EPDS inversely related to mothers' sensitive positioning and touch frequency. Contrastingly, anxiety was associated with increased touch. CONCLUSION In the breastfed newborn, mothers' depressed mood is associated with lesser weight gain, lower milk intake, poorer latch to the breast, and receiving less frequent touch and less-sensitive positioning at the breast by mother.
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Affiliation(s)
- Sybil L Hart
- Department of Human Development and Family Studies, Texas Tech University, Lubbock, TX 79409-1230, USA.
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Abstract
An understanding of how infant eating behaviour relates to later obesity is required if interventions in infancy are to be attempted. The aim of this paper is to review findings from the Gateshead Millennium Study to describe (i) what we have already established about the relationship between infant feeding transitions, infancy weight gain and eating behaviour and (ii) describe new analyses that examine how infant eating behaviour and temperament relate to infancy weight gain and childhood adiposity. The Gateshead Millennium Study recruited 1029 infants at birth and parents completed questionnaires five times in the first year. We have already described how starting solids and ceasing breast-feeding seems to be a response to rapid early weight gain, rather than a cause, and that parents identify and respond to the individual appetite characteristics of their child. A number of questions about eating behaviour at 12 months were used to construct an infancy eating avidity score that was positively associated with height at age 7-8 years, but not with an adiposity index constructed using bioelectrical impedance, waist and skinfolds. Infancy eating avidity score was associated with greater fussiness and lower satiety responsivity on the Child Eating Behaviour Questionnaire at age 6-8 years. Temperament measured at age 6 weeks and 8 months showed no consistent associations with either infancy weight gain or adiposity at 6-8 years. While infancy may seem a logical time to intervene with children at risk of future obesity, the collective findings from this substantial population-based study largely suggest otherwise.
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Semple MG, Taylor-Robinson DC, Lane S, Smyth RL. Household tobacco smoke and admission weight predict severe bronchiolitis in infants independent of deprivation: prospective cohort study. PLoS One 2011; 6:e22425. [PMID: 21811609 PMCID: PMC3139660 DOI: 10.1371/journal.pone.0022425] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Accepted: 06/23/2011] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To examine demographic, environmental and clinical factors associated with severe bronchiolitis in infants admitted to hospital and quantify the independent effects of these factors. DESIGN Prospective cohort study. SETTING Alder Hey Children's Hospital, Liverpool, United Kingdom. PARTICIPANTS 378 infants admitted to hospital with a diagnosis of bronchiolitis, of whom 299 (79%) were antigen positive to respiratory syncytial virus (RSV). OUTCOME Severity of disease during admission, defined as "no need for supplemental oxygen" (reference group), "any need for supplemental oxygen" and "any need for mechanical ventilation". RESULTS Univariate analysis found male sex (p = 0.035) and tobacco smoking by a household member (p<0.001) were associated with need for both supplemental oxygen and mechanical ventilation. Premature birth, low gestation, low birth weight, low admission weight and low corrected age on admission were also associated with need for mechanical ventilation (all p≤0.002). Deprivation scores (IMD 2004) were significantly higher in households where a member smoked compared to non-smoking households (p<0.001). The odds of smoking predicted by deprivation were 7 times higher (95%CI (3.59, 14.03)), when comparing the least and most deprived quintiles of the study population. Family history of atopic disease and deprivation score were not associated with severe disease. Multivariate multinomial logistic regression which initially included all covariates, found household tobacco smoking (adjusted OR = 2.45, 95%CI (1.60, 3.74) predicted need for oxygen supplementation. Household tobacco smoking (adjusted OR = 5.49, (2.78, 10.83)) and weight (kg) on admission (adjusted OR = 0.51, (0.40, 0.65)) were both significant predictors in the final model for mechanical ventilation. The same associations and similar size of effects were found when only children with proven RSV infection were included in analysis. CONCLUSIONS Low admission weight and householder tobacco smoking increased the risk of severe bronchiolitis in infants admitted to hospital. These effects were independent of a standard deprivation measure. NIHR Study Ref. DHCS/G121/10.
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Affiliation(s)
- Malcolm G Semple
- Department of Women's and Children's Health, University of Liverpool, Liverpool, United Kingdom.
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Jones AR, Parkinson KN, Drewett RF, Hyland RM, Pearce MS, Adamson AJ, Gateshead Millennium Study Core Team. Parental perceptions of weight status in children: the Gateshead Millennium Study. Int J Obes (Lond) 2011; 35:953-62. [PMID: 21673651 PMCID: PMC3154641 DOI: 10.1038/ijo.2011.106] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To investigate parents' perceptions of weight status in children and to explore parental understanding of and attitudes to childhood overweight. DESIGN Questionnaires and focus groups within a longitudinal study. SUBJECTS 536 parents of Gateshead Millennium Study children, of which 27 attended six focus groups. MAIN OUTCOME MEASURES Parents' perception of their child's weight status according to actual weight status as defined by International Obesity Taskforce (IOTF) cutoffs. Focus group outcomes included parental awareness of childhood overweight nationally and parental approaches to identifying overweight children. RESULTS The sensitivity of parents recognising if their child was overweight was 0.31. Prevalence of child overweight was underestimated: 7.3% of children were perceived as 'overweight' or 'very overweight' by their parents, 23.7% were identified as overweight or obese using IOTF criteria. 69.3% of parents of overweight or obese children identified their child as being of 'normal' weight. During focus groups parents demonstrated an awareness of childhood overweight being a problem nationally but their understanding of how it is defined was limited. Parents used alternative approaches to objective measures when identifying overweight in children such as visual assessments and comparisons with other children. Such approaches relied heavily on extreme and exceptional cases as a reference point. The apparent lack of relevance of childhood overweight to their child's school or own community along with scepticism towards both media messages and clinical measures commonly emerged as grounds for failing to engage with the issue at a personal level. CONCLUSION Parents' ability to identify when their child was overweight according to standard criteria was limited. Parents did not understand, use or trust clinical measures and used alternative approaches primarily reliant on extreme cases. Such approaches underpinned their reasoning for remaining detached from the issue. This study highlights the need to identify methods of improving parental recognition of and engagement with the problem of childhood overweight.
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Affiliation(s)
- A R Jones
- Institute of Health and Society, Human Nutrition Research Centre, Newcastle University, Newcastle upon Tyne, UK.
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Robertson J, Puckering C, Parkinson K, Corlett L, Wright C. Mother–child feeding interactions in children with and without weight faltering; nested case control study. Appetite 2011; 56:753-9. [DOI: 10.1016/j.appet.2011.02.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2010] [Revised: 12/03/2010] [Accepted: 02/18/2011] [Indexed: 11/24/2022]
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Ross LF. Are we adequately protecting vulnerable patients in longitudinal observational studies? J Pediatr 2011; 158:1036-7; author reply 1037. [PMID: 21300370 DOI: 10.1016/j.jpeds.2010.12.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2010] [Accepted: 12/22/2010] [Indexed: 10/18/2022]
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