Me and My Baby Are One; The Mother's Experience of Continuous Kangaroo Care: A Qualitative Study

Introduction: Infant hospitalization in Neonatal Intensive Care Unit (NICU) causes the separation of mother from her infant. Kangaroo Care (KC) is a bio-care method for preterm newborns. This study was conducted with the aim of investigating the experiences of mothers that could be helpful for the further development and expansion of continuous kangaroo mother care (C-KMC). Material and Method: This is a qualitative study with a content analysis approach. In order to collect data, in-depth individual interviews were conducted with thirteen mothers who were able to care their infants in the form of C-KMC. The sampling was of purposeful type; the interviews were recorded and their contents were written accurately and word by word. Findings: Analysis of mothers' experiences led to the emergence of three main themes of mother’s positive attitude, facilitator factors and barriers to perform C-KMC. Conclusion: The results of this study showed that performing KMC caused a sense of calm, empowerment and satisfaction of the mother and had many medical benefits for the infant. On the other hand, physicians and nurses can act as facilitators or barriers based on the support they make from mothers. Also, the support of the spouse and family plays an important role in continuing to perform the continuous KMC by the mother.

Breastfeeding and aspects of the baby's oral health and its relationship with infant hospitalization and use of antibiotics

The present study aimed to verify the influence of breastfeeding on children's oral and systemic health, verifying children's hospitalization, use, indication and type of antibiotics used. This is a cross-sectional longitudinal study with a sample of 42 children at 30 months of age. The logistic regression test was used at a significance level of 5% for statistical analysis. Among the children, 64.28% had already been weaned before reaching 6 months of age; 11.90% had caries lesion. Simplified Oral Hygiene Index (OHI-S) was performed in 38 children, from which 92.10% had regular OHI-S and 07.90% had poor OHI-S. Of the 42 children, the indication for antibiotics use was 50% for pharyngitis, 28.83% for pneumonia, 08.33% for cold, 04.17% for sinusitis, 04.17% for bronchitis, 04.17% for stomatitis, 04.17 % for virus and 04.17% for ocular cellulitis. In this study, there was no relationship between early weaning, oral health conditions, hospitalization and antibiotics use. Presence of caries in early childhood was found in 11.90% of children. All children presented unsatisfactory OHI-S and there was no relationship between this variable and the others. Much of the indication for the use of antibiotics was for the treatment of respiratory tract infections, with beta lactams being the most used.

Infant hospitalization due to primary care health-sensitive conditions in a southern brazilian state

Objetivo: O objetivo desta pesquisa foi analisar as internações hospitalares em menores de cinco anos residentes no estado do Paraná, no período de 2008 a 2012. Métodos: Trata-se de estudo ecológico, descritivo, de abordagem quantitativa. A seleção das internações foi baseada na Lista de Condições Sensíveis à Atenção Primária, os dados foram coletados em banco de domínio público e analisados descritivamente. Resultados: Os achados demonstram que as afecções respiratórias são as grandes causadoras de internações no público estudado. Outro grupo causal com taxas relevantes de internação é o de doenças infecciosas e parasitárias. As doenças perinatais também se destacaram como causadoras de internações. Conclusão: Nota-se uma consonância entre o que se percebe empiricamente na realidade assistencial pediátrica e os achados do estudo. Levanta-se a questão de como as ações de prevenção e educação em saúde têm sido desenvolvidas pela atenção primária.

Postpartum Psychosis

This chapter on postpartum psychosis notes that the risk of postpartum psychosis in the general population is very rare at less than 1%. In a mother with a known history of schizophrenia, this risk increases to 25%. Psychotic symptoms appearing postpartum may also be evidence of a bipolar disorder. The presence of elevated mood, increased activity levels and energy, poor sleep, and a family history of manic episodes all increase the likelihood that a bipolar disorder is present. Women with a personal or family history of a bipolar disorder are at an elevated risk of developing a mania or depression with psychotic symptoms postpartum. Postpartum psychosis due to any cause is a psychiatric emergency and treatment should be initiated early and aggressively to ensure the safety of mother and infant. Hospitalization and/or separation of the baby and mother may be necessary. The use of medication to treat schizophrenia or bipolar disorder during pregnancy may decrease the risk of a postpartum psychosis. With appropriate postpartum medication and support, the majority of women experiencing postpartum psychosis recover well and the risk of recurrent psychotic symptoms can be greatly reduced.

Kin-based alloparenting and infant hospital admissions in the UK Millennium cohort

Background and objectives Kin-selected altruism is an evolutionary explanation for why biological kin other than parents are willing childcare providers or alloparents. Kin alloparents may increase lineage fitness by reducing maternal energy depletion and improving child survival through childcare activities. The aim of this research was to apply the hypothesis that kin-based alloparental care has benefits for child health in a western, educated, industrialized, rich, democratic context. Methodology The hypothesis was tested using the first sweep of the UK Millennium Cohort Study (n = 18 552 infants). The outcome was number of hospitalizations by age 9 months, and the main predictors were kin-based alloparental care during work hours, socioeconomic position and infant health-related variables and their interactions with kin-based alloparenting. Analysis of hospitalizations was carried out using negative binomial regression. Results Kin alloparents were primary day carers in 17% of households. Infants whose main care arrangement during work hours was with kin allocarers had statistically significantly fewer hospitalizations than infants in all other care arrangements combined (Incidence rate ratio = 0.86, P < 0.03), and when contrasted with maternal day care (Incidence rate ratio = 0.79, P < 0.02). Conclusions and implications Kin-based allocare was associated with about a 15% reduction in the risk of infant hospitalization in the first 9 months. The difference appeared to be due in part to a difference in the risk of hospitalization for infectious diseases. Sensitivity analyses indicated that infants cared for by their mother during the day rather than in day-care facilities were most at risk of hospitalization compared with those in kin-based care. Lay summary Modern industrialized societies are generally characterized by nuclear family households, with grandparents and other extended family often living a considerable distance away. Studies carried out in societies which have not undergone the fragmentation of extended families have shown that grandmothers and other biological kin reduce infant mortality, most likely because they distribute the burden of infant care so that it does not fall exclusively on the mother. Here, the hypothesis that grandparental and other family care would be beneficial for infant health in the contemporary UK was testing using the UK Millennium cohort. Infant health was measured as number of hospitalizations in the first 9 months from birth. The main findings were that kin-based infant care, which was most commonly by grandparents, was associated with a 15% reduction in the risk of hospitalization in infants up to 9 months of age. Further analysis suggested that the difference was larger for risk of infant hospitalization due to infectious diseases rather than non-infectious diseases. The results also suggested that the finding may have been driven by increased risk for infants of mothers caring for their infant during normal working hours with no other help, such as from the father or pay-for day-care.

Clinical Progress Note: High Flow Nasal Cannula Therapy for Bronchiolitis Outside the ICU in Infants

Viral bronchiolitis is the most common indication for infant hospitalization in the United States.1 The treatment mainstay remains supportive care, including supplemental oxygen when indicated.1 High flow nasal cannula (HFNC) therapy delivers humidified, heated air blended with oxygen, allowing much higher flow rates than standard nasal cannula therapy and is being used more frequently in inpatient settings.

Validación de “The Parental Stressor Scale Infant Hospitalization modificado, al español” en una unidad cuidados intensivos pediátricos

Introducción: Las unidades de cuidados intensivos son conocidas como ambientes de alto estrés para los familiares, este puede ser mayor cuando el paciente es un hijo/hija y los padres deben enfrentar la enfermedad y el ambiente hospitalario. El instrumento “The Parental Stressor Scale Infant Hospitalization (PSSIH), es una herramienta utilizada para medir estresores en Unidades de Cuidados Intensivos Pediátricos (UCIP), sin embargo, la escala no está validada en Chile. El objetivo de este estudio es validar y adaptar culturalmente el instrumento “The Parental Stressor Scale Infant Hospitalization modificado” en madres/padres de niños hospitalizados en la UCIP de un Hospital Universitario.Método: Estudio instrumental de validación. Luego de traducir y contratraducir la versión en inglés del instrumento, un grupo de 10 profesionales expertos evaluó la adaptación al español. Luego 10 padres/ madres de niños hospitalizados en la UCIP evaluaron la comprensión del instrumento. Las propiedades psicométricas del instrumento fueron evaluadas utilizando un análisis factorial exploratorio y alfa de Cronbach.Resultados: Se aplicó en una muestra de 221 padres/madres la versión chilena del “PSSIH modificado”, tuvo mínimas modificaciones semánticas y los jueces expertos consideraron adecuado el instrumento, por lo que no fue necesario borrar ningún ítem. Se eligió la solución de 3 dimensiones, que explicaron el 48,89% de la varianza total del instrumento. El alfa de Cronbach fue de 0,885, 0,902 y 0,703 respectivamente para cada dimensión.Conclusión: El PSSIH modificado ha demostrado ser un instrumento confiable y valido en una muestra de niños chilenos hospitalizados en una Unidad de Cuidados Intensivos Pediátricos de un hospital universitario , cuyo nombre en español es “Escala de Evaluación de Estresores Parentales en niños hospitalizados en Unidades de Cuidados Intensivos Pediátricos” (EEEP – UCIP).