Maternal infant-feeding decisions: reasons and influences.

The purpose of this prospective longitudinal study was to determine the reasons for and influences on mothers' infant-feeding decisions over the 6 months post-birth. The breastfeeding initiation rate of 41.7% had declined to 11.4% at 6 months. The major reasons for not choosing breastfeeding were embarrassment and discomfort with the idea. Younger, less-educated mothers with lower incomes were less likely to start breastfeeding, more likely to discontinue breastfeeding early, and more likely to feed their babies cheaper evaporated milks. Mothers gave up breastfeeding early because it was too difficult or because they were returning to work. Reasons given by both breastfeeding and bottle-feeding mothers for switching milks were that the baby was "not satisfied" on the milk or that it was "not agreeing with" the baby. Generally, the social network, rather then health professionals, had greater influence on mothers' decisions.

Perceived level and sources of stress in university professional schools.

The purpose of this study was to investigate the perception of level and sources of stress in students of two baccalaureate nursing programs, to compare these groups in their perceived stress and to compare the nursing groups to those enrolled in other health-related disciplines: Medicine, Pharmacy and Social Work. The study was descriptive correlational in design. The sample consisted of 552 full-time university students enrolled in years 2, 3 and 4 of their programs in selected disciplines. Data were collected by means of a questionnaire consisting of three main instruments: the Beck-Srivastava Stress Inventory (BSSI), the General Health Questionnaire 30-item version (GHQ-30) and a demographic profile. Data were analyzed using the SPSSx Statistical Package and included analysis of variance, frequency distribution, measures of correlation, item analysis and factor analysis. The results revealed that baccalaureate nursing students, regardless of year in program or university of attendance, experienced higher levels of stress and higher levels of physiological and psychological symptoms than students in other health-related disciplines. Identified stressors among the disciplines are also reported in the article.

The transition to home for mothers of healthy and initially ill newborn babies.

Mothers' difficulties with the transition of their baby from hospital to home have been studied for several years. An examination of a number of studies from the USA, Canada, and the UK has shown a remarkable similarity in the findings despite the demographic and cultural differences in the sample characteristics. It appears, then, that maternal responses to the transition to home are more tied to the experience than to the setting. The purpose of this paper is to place these findings within a framework that would provide a means for midwives and nurses to help mothers make this transition more comfortably and confidently than in the past. The framework chosen is the Transition Model as developed by Kenner (1988). This model suggests the problems with transition to home can be addressed under the following categories: 1. information needs; 2. grief; 3. parent-child development; 4. stress and coping; 5. social support.

Caffeine: how much is too much?

Too much caffeine can cause numerous physical and psychological symptoms of poor health. It could negatively affect reproduction and is suspected of causing some cancers. It can affect cardiovascular functioning, and can even produce symptoms similar to those of mental illness. Despite this broad range of known and suspected effects of caffeine, nurses rarely consider caffeine intake in initial nursing assessments of clients. They should.

The information and support needs of mothers of premature infants.

This research was a descriptive study that surveyed the support needs of a nonrandom convenience sample of 56 mothers of high-risk premature infants. The results indicated that these mothers' received information similar to that given to mothers of healthy full-term newborns and information that they wanted on the "colicky" or crying infant, noisy breathing, "spitting up," infant behavior, infant illness, and prematurity was not given to them. Mothers who reported that they needed more information and did not receive it were more anxious and less confident in caring for their infant. The majority of the mothers felt well-supported, although many of the mothers found the infant's first postdischarge week difficult.

Zinc supplementation in very-low-birth-weight infants.

Inadequate zinc intake may lead to poor growth and developmental outcome in very-low-birth-weight (VLBW; < 1,500 g) infants. Fifty-two infants (mean birth weight, 1,117 +/- 287 g; mean gestational age, 29 +/- 2.9 weeks) were randomly allocated to two groups. SUPP infants received a regular term formula plus zinc supplements (4.4 mg/L; final content, 11 mg/L); PLAC infants received the same formula plus placebo (final content, 6.7 mg/L). Infants started their formula at 1,853 +/- 109 g and consumed the formula for 6 months. All subjects were evaluated at 3, 6, 9, and 12 +/- 0.75 months corrected-for-gestational-age. At each evaluation, weight, length, and head circumference were measured, a Griffiths developmental assessment was performed, and a blood sample was taken. Higher plasma zinc levels (p < 0.05) were found in the SUPP group at 1 and 3 months, and improved linear growth velocity was found in the SUPP group over the study period for the whole group as well as for girls alone. Maximum motor development scores were higher (p = 0.018) in the SUPP (98 +/- 10) than the PLAC (90 +/- 8) group, indicating that increased zinc intake in early infancy may be beneficial to VLBW infants.

The difficult first week at home with a premature infant.

The results reported were obtained from the findings of a larger descriptive study that surveyed the support needs of 56 mothers of high-risk premature infants. Forty-eight percent of the mothers found the first week after their infant's discharge home difficult. Data analysis indicated the more premature the infant (birth weight r = 0.29, P = 0.03; gestational age r = 0.34, P = 0.008), and the greater the severity of illness as determined by length of hospital stay (r = -0.27, P = 0.04), the more likely the mother was to have a difficult first postdischarge week. The visit of the community health nurse during that first week was a significant factor in whether the mothers perceived the time as difficult (Fisher's exact test, P = 0.02). It was found, as well, that the community health nurses were less likely to visit mothers of very low-birth-weight infants during that week (Fisher's exact test, P = 0.02). Other variables related to difficulty during the first week were whether the infants had apnea in hospital (r = 0.33, P = 0.01), mothers' need for specific kinds of information such as knowledge about colic (chi 2 = 24.31, df = 12, P = 0.02), and an earlier scheduled visit to a physician for mothers whose infants were of lower birth weight (r = -0.26, P = 0.05), earlier gestational age (r = -0.34, P = 0.009), and had spent longer time in hospital (r = 0.37, P = 0.006).

Caffeine and its effects on pregnancy and the neonate.

In animal studies, fetal loss, decreased fetal weight and size, and major skeletal defects have been reported when dosages of more than 80 mg/kg of caffeine were used. Human epidemiologic studies that examine the relationship between caffeine use and congenital abnormalities are not conclusive; however, there is some evidence to suggest a caffeine effect upon fetal growth patterns. Because caffeine drinking is so often associated with the use of other drugs such as tobacco, it is difficult to ascertain which drug has the effect on growth, or if it is a combined effect from both drugs. A tripling of the half-life of caffeine in the last two trimesters of pregnancy resulting in much higher caffeine blood levels for both mother and fetus, combined with the neonate's inability to metabolize caffeine, could account for the indications of neonatal caffeine withdrawal observed in the first week after birth.

Outcome of infants of very low birth weight: a geographically based study.

The outcome of 143 live-born infants of very low birth weight (defined as less than 1500 g) who were born in 1980-81 to women resident in Newfoundland and Labrador is described. Sixty-one infants (43%) died during the first year of life. Of the 82 surviving infants 79 were followed for 18 months to 3 years. Eight (10%) were found to have evidence of severe neurodevelopmental abnormality, and nine (11%) were found to have various minor problems, including seizures, developmental delay and behavioural disorders. There was an inverse association between birth weight and mortality. Neonatal pneumothorax, seizures and clinical evidence of intraventricular hemorrhage were more commonly seen among infants who died; these factors also seemed to be predictive of an adverse long-term outcome. Continuous monitoring of the rates of death and disability among infants of very low birth weight born within a defined region should provide the basis for rational planning and delivery of neonatal intensive care.