Making mother-baby coupling work well.
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Vision makes a substantial contribution to the pattern and rate of normal development. Considering infant development in 3 phases, global, integrative and specific the most important attributes to vision of development within each phase are discussed. A method for assessment of the aspects of vision most relevant to each child's current developmental needs is described and a philosophy outlined whereby the findings can be represented as a balanced practical prescription for development. The development of the visual system is often delayed in visually handicapped babies; some reasons are put forward and a concern that many may never achieve their potential maximum visual competence is expressed. A method for evaluating the current stage of visual development in a visually handicapped baby is described in which the findings form the starting point of a programme towards achieving maximum visual competence as young as possible.
OBJECTIVE: Two-thirds of women globally give birth at home, yet little data are available on use of skin-to-skin care (STSC) in the community. We describe the acceptability of STSC in rural Uttar Pradesh, India, and measured maternal, newborn, and ambient temperature in the home in order to inform strategies for introduction of STSC in the community. STUDY DESIGN: Community-based workers in intervention clusters implemented a community mobilization and behavior change communication program that promoted birth preparedness and essential newborn care, including adoption of STSC, with pregnant mothers, their families, and key influential community members. Acceptance of STSC was assessed through in-depth interviews and focus groups, and temperature was measured during home visits on day of life 0 or 1. RESULTS: Incidence of hypothermia (<36.5 degrees C) was high in both low birth weight (LBW) and normal birth weight (NBW) infants (49.2%, (361/733) and 43% (418/971), respectively). Mean body temperature of newborns was lower (P<0.01) in ambient temperatures <20 degrees C (35.9+/-1.4 degrees C, n=225) compared to > or =20 degrees C (36.5+/-0.9 degrees C, n=1450). Among hypothermic newborns, 42% (331/787) of their mothers had a lower temperature (range -6.7 to 0.1 degrees C, mean difference 0.4+/-1.2 degrees C). Acceptance of STSC was nearly universal. No adverse events from STSC were reported. STSC was perceived to prevent newborn hypothermia, enhance mother's capability to protect her baby from evil spirits, and make the baby more content. CONCLUSION: STSC was highly acceptable in rural India when introduced through appropriate cultural paradigms. STSC may be of benefit for all newborns and for many mothers as well. New approaches are needed for introduction of STSC in the community compared to the hospital.
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There is an increasing trend in midwifery towards shorter hospitalization, and in a world where 24-48 h will be the norm, the challenge for the baby-friendly hospital in the new century will be to establish community support services for all mothers and to make all of our hospitals and communities "Baby and breastfeeding friendly".
The highly technical environment of a special care baby unit may make parents feel their baby no longer belongs to them. By encouraging active parental involvement in their baby's care, nurses can help promote parent-infant bonding.
An increasing number of infants have undergone massive intestinal resection for various reasons: uncontrollable diarrhea, malabsorption, and failure to thrive makes these babies a difficult management problem and threatens their survival and later "quality of life." Five short gut babies have had a 3-cm small bowel reversal operation as part of the total salvage effort. It is recognized that very skilled care by dedicated personnel and parents, utilizing i.v. nutrition and special feeding techniques, is probably the most significant factor in achieving success with these babies. It is believed small bowel reversal helps in keeping these infants alive while their intestinal tract is making the adjustments necessary for long-term survival.
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OBJECTIVE: To explore women's experiences and perceptions of baby feeding and to explore the explanations offered by women who choose to either breast or bottle feed. DESIGN: A qualitative study, which was prospective in design. Participants were interviewed three times: the first stage was between six and 14 weeks of pregnancy; the second stage was between 34 and 39 weeks; and the third stage was between six and 14 weeks after childbirth. PARTICIPANTS: 19 participants were recruited to the study group via 12 antenatal clinics in Coventry, UK. FINDINGS AND DISCUSSION: The data indicate that participants make baby-feeding decisions either prior to conception or early in the pregnancy. Findings also indicate that both breast and bottle feeders possessed knowledge of the benefits of breast feeding, but this did not seem to influence decision making. One of the most significant factors influencing the decision to bottle feed appears to be a desire for paternal involvement. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: To increase the incidence of breast feeding, health-care professionals should consider the need for preconceptual health promotion. The role of paternal involvement in baby-feeding decisions also needs to be acknowledged and men need to be included in breast-feeding promotion campaigns.
In an attempt to answer the question of what influences mothers' decisions on how to feed their babies, a questionnaire was administered to 200 mothers when their babies were approximately 1 year of age. The questions covered a wide variety of factors, including socio-economic, educational, housing and family details, employment, ante- and perinatal experiences, maternal beliefs, support systems and actual feeding practices. Those mothers who had breast-fed their babies for longer than 36 weeks were compared with those who had stopped before 12 weeks. The most important factors distinguishing the two groups, as decided by stepwise regression analysis, were the beliefs that breast-feeding helps teething and does not make the baby irritable; also female babies were more likely to be breast-fed and the postnatal income of the mother was important. It is believed that these factors, together with the other, less statistically significant differences, should be used when formulating breast-feeding promotion strategies. The importance of income, and therefore of employment, underlines the necessity for legislation requiring large-scale employers of women to provide crèches and breast-feeding breaks for female staff.
Use of the baby pacifier or sucker has been the subject of controversy, due to the serious consequences that such habit may bring upon the infant. Different theoretical points of view have been set forth as to why should a child need such an object. Methods used by parents in an attempt to make the baby stop sucking a comforter go from passive suggestion to aggressive menace, sometimes carried out in reality.
A cell preparation, useful for studying the regulation of metabolism, was developed by making monolayer baby hamster kidney cells permeable. Hypertonically treated cells were permeable to nucleotides, but retained their gross cellular morphology, intact organelles, 100% of their DNA, and 91% of their total protein. The permeable cell synthesized DNA, RNA, and protein rapidly when supplied with the appropriate substrates and cofactors. They either could remain permeable or were able to "reseal" when replaced in complete medium under appropriate conditions. Optimal conditions for DNA synthesis were established for permeable cells, giving rates equal to those of intact cells. Replication rather than repair was shown by the cell-cycle dependence of DNA synthesis and its discontinuous nature. Ribonucleotide reductase was active in permeable cells, permitting equal rates of DNA synthesis when ribonucleotide diphosphates or deoxyribonucleotide triphosphates were provided. Hydroxyurea did not inhibit DNA synthesis in permeable cells supplied with deoxyribonucleotide di- or triphosphates, but drastically inhibited DNA synthesis when ribonucleotide diphosphates were supplied. Hydroxyurea is therefore primarily an inhibitor of ribonucleotide reductase. Permeability was reversed, exposing permeable cells to [(3)H]thymidine triphosphate, which was incorporated, which labeled nuclei of cells that went on to mitosis. The reversible permeability procedure should prove especially useful in studying the functions of poorly penetrating compounds, such as drugs. Intact cells were unaffected by cytosine arabinoside triphosphate, while cells that had been made permeable and resealed were killed.