ABSTRACT
BACKGROUND: While the impacts of atopic dermatitis (AD) on maternal and child sleep outcomes have been previously explored, less is known about the associations between infantile AD and sleep quality and quantity. OBJECTIVE: To describe the perceived causes of AD-associated maternal sleep disturbances and the association between AD severity and infant sleep outcomes. METHODS: Mothers with infants aged < 19 months old with a diagnosis of AD were recruited from social media and medical clinics in Winnipeg, Canada between October 2021 and May 2022. Infant AD severity was classified using maternal-reported data on the Patient-Oriented Scoring Atopic Dermatitis tool (PO-SCORAD). Quantitative data were collected via a series of questionnaires with a subset of mothers subsequently completing semi-structured interviews. Quantitative and qualitative data were integrated in the discussion. RESULTS: Mothers of infants with moderate/severe AD (6/12) were more likely to report their infant suffering from a higher degree of sleeplessness (i.e., ≥ 5 on a scale of 0-10) over the past 48 h compared to mothers of infants with mild AD (0/18). This was supported by qualitative findings where mothers described how their infant's sleep quality and quantity worsened with AD severity. Additionally, 7/32 mothers reported that their child's AD, regardless of severity, disturbed their sleep. Maternal sleep loss was most commonly attributed to infant itching (6/7), followed by worry (4/7). CONCLUSION: Infantile AD severity was associated with worse sleep outcomes for both mothers and infants. We propose that maternal and infantile sleep quality and quantity can be improved by reducing AD severity through adherence to topical treatments.
ABSTRACT
BACKGROUND: Childhood atopic dermatitis can have a negative effect on caregivers' quality of life and stress levels due to the burdensome nature of its treatment. Given that the condition often emerges in infancy, atopic dermatitis-related stress also carries the potential to negatively affect the developing mother-infant bond. While it is plausible that atopic dermatitis has a negative impact on maternal-infant bonding, these relationships have not been studied directly. In light of this gap, the current study investigated the association between infantile atopic dermatitis and the maternal-infant bond using a mixed-method design. METHODS: Mothers of infants (< 19 months) with atopic dermatitis were recruited from social media and medical clinics between October 2021 and May 2022. Mothers with infants unaffected by inflammatory skin conditions were also recruited to serve as a control group. Participants were asked to complete questionnaires related to their demographics, child's health, and mother-infant bond. Multiple linear regression analyses were used to assess bonding quality among cases and controls. A subset of cases were also asked to participate in semi-structured interviews focused on infantile atopic dermatitis and the maternal-infant bond. RESULTS: The final sample consisted of 32 cases and 65 controls. Scores on the impaired bonding and risk of abuse subscales did not significantly differ between cases and controls. However, mothers of infants with atopic dermatitis did report lower levels of caregiving anxiety (b = - 1.47, p < 0.01) and pathological anger/rejection (b = - 1.74, p = 0.02) relative to controls. Qualitative findings suggest that the topical therapies required to manage atopic dermatitis may strengthen the bond between some mothers and infants. CONCLUSION: Findings suggest that atopic dermatitis does not have a negative impact on maternal-infant bonding and may actually improve bonds in some cases. In light of this finding, clinicians may leverage the potentially positive impact of atopic dermatitis-related caregiving on the maternal-infant bond to encourage caregivers to remain adherent to their child's topical treatments.
ABSTRACT
BACKGROUND: Approximately 6-7% of Canadian children have food allergy. These families face substantial burdens due to the additional costs incurred purchasing allergy-friendly products necessary for management compared to families without food allergies. In the year prior to the COVID-19 pandemic, these costs were equivalent to an average of $200 monthly compared to families without food allergy. As food prices continue to rise, rates of food insecurity also increase, disproportionately affecting households with food allergy who have limited choices at food banks. METHODS: Families living or working in Winnipeg, Canada with an annual net income of about $70,000 or less the year prior to recruitment and a child under the age of 6 years old with a physician diagnosed milk allergy were recruited between January and February 2022. Participating families received bi-weekly home deliveries for six months, from March to August 2022, of subsidy kits containing ~$50 worth of milk allergy-friendly products. Semi-structured interviews, completed ± 2 weeks from the final delivery, were audio-recorded, transcribed verbatim, and analyzed thematically. RESULTS: Eight interviews, averaging 32 min (range 22-54 min), were completed with mothers from all different families. On average, mothers were 29.88 ± 4.39 years old and children were 2.06 ± 1.32 years old. All children reported allergies in addition to milk. Based on the data from these interviews, we identified 3 themes: food allergy causes substantial burden for families, "I have to get his allergy-friendly food first before getting to my basic needs", and perceived emotional and financial benefits of a milk allergy-friendly food subsidy program. CONCLUSIONS: This study, along with previous research, suggests that there is a need for assistance for families managing milk allergies. It also provides important information to inform development of programs which can address these financial challenges. Our in-kind food subsidy was perceived as having a positive impact on food costs and stress associated with food allergy management, however, parents identified a need for more variety in the food packages. Future programs should strive to incorporate a greater variety of products to address this limitation.
ABSTRACT
BACKGROUND: The entire school community contributes to the safety of students with food allergy. We sought to determine the food allergy perceptions and education needs of parents, students and school staff, with the goal of enhancing food allergy education in schools. METHODS: With ethics approval from the University of Manitoba and participating school divisions, elementary school principals emailed SurveyMonkey® Questionnaire Links to their parent/caregiver contact list and school staff. We compared anonymous responses of parents of children with and without food allergy, students with and without food allergy, and parents and school staff using chi-squared tests. RESULTS: Participants included 561 parents of school-age children (ages 7-12 years, 19% with food allergy), 61 students (23% with food allergy), and 203 school staff (62% teachers, 88% with experience managing food allergies in the classroom). Parents of children with and without food allergy considered food allergy when sending food to school (98% vs. 96%, p = 0.39). More parents of children with food allergy thought that greater information and awareness about food allergy was needed (74% vs. 44%, p < 0.0001). Students with food allergy were most interested (100%) in having other students learn not to bully and how to help during a reaction. Students without food allergy were most interested in learning how to prevent a reaction (70%). Fewer parents than school staff thought that food allergies in the classroom impacted teachers' time (2.1% vs. 21%, p < 0.0001) and that teachers knew how to treat allergic reactions to foods (34% vs. 94%, p < 0.0001). More parents than school staff thought that banning foods from classrooms kept allergic students safe (65% vs. 34%, p = 0.006) and that having a Food Allergy Educator speak at school would be helpful (99% vs. 67%, p < 0.0001). CONCLUSIONS: Food allergy education is necessary for the entire school community and should include parents of school-aged children with and without food allergy, students with and without food allergy, and teachers and school staff. These members of the school community recognized their own and others' needs for increased food allergy education and awareness in the school setting.
