The effect of Russian Maternity Home routines on breastfeeding and neonatal weight loss with special reference to swaddling.

BACKGROUND: Few investigations have considered evaluating the effects of certain combinations of ward routines like swaddling of the baby and separation of mother and baby on infant variables such as neonatal weight loss. AIMS: To study the effect of different ward routines in respect to proximity to mother and type of infant apparel, on breastfeeding parameters (amount of ingested milk, volume of supplements, number of breastfeeds, total duration of breastfeeding time) day 4 after birth as well as recovery from neonatal weight loss and infant's weight on day 5. STUDY DESIGN AND SUBJECTS: In a randomized trial with factorial design four treatment groups including 176 mother-infant dyads were studied 25-120 min after birth. Randomized treatments focused on care routines administered to the infants after delivery and later in the maternity ward as well as to the type of clothing the infants received. Group 1 infants were placed skin-to-skin with their mothers after delivery, and had rooming-in while in the maternity ward. Group 2 infants were dressed and placed in their mothers' arms after delivery, and roomed-in with mothers in the maternity ward. Group 3 infants were kept in the nursery both after birth and while their mothers were in the maternity ward. Group 4 infants were kept in the nursery after birth, but roomed-in with their mothers in the maternity ward. Equal numbers of infants were either swaddled or clothed in baby attire. Breastfeeding parameters were documented during day 4 after birth. Infant's weight was measured daily. RESULTS: Babies who were kept in the nursery received significantly more formula and significantly less breast-milk, than did babies who roomed-in with their mothers. Swaddling did not influence the breastfeeding parameters measured. However, swaddled babies who had experienced a 2-h separation period after birth and then were reunited with their mothers tended to have a delayed recovery of weight loss compared to those infants who were exposed to the same treatment but dressed in clothes. Furthermore, swaddled babies who were kept in the nursery and received breast-milk supplements had a significantly delayed recovery of weight loss after birth when compared to those infants ingesting only breast-milk. On day 5, regression analyses of predicted weight gain in the exclusively breastfed infants indicated a significant increase per 100 ml breast-milk (59 g), compared to the predicted weight gain on day 5 per 100 ml supplements in the swaddled babies (14 g) (P=0.001). CONCLUSION: Supplements given to the infants in the nursery had a negative influence on the amount of milk ingested. In addition, supplement feeding or a short separation after birth when combined with swaddling was shown to have a negative consequence to infant weight gain.

Skin-to-skin contact may reduce negative consequences of "the stress of being born": a study on temperature in newborn infants, subjected to different ward routines in St. Petersburg.

AIM: To evaluate how different delivery-ward routines influence temperature in newborn infants. METHODS: A total of 176 newborn mother-infant pairs were included in a randomized study. The babies were kept skin-to-skin on the mother's chest (Skin-to-skin group), held in their mother's arms, being either swaddled or clothed (Mother's arms group), or kept in a cot in the nursery, being either swaddled or clothed (Nursery group). Temperature was measured in the axilla, on the thigh, back and foot at 15-min intervals at from 30 to 120 min after birth. RESULTS: During this time period the axilla, back and thigh temperatures rose significantly in all the treatment groups. The foot temperature displayed a significant fall in the babies in the Nursery group and this decrease was greatest in the swaddled babies. In contrast, foot temperature rose in the babies in the Mother's arms group and in particular in babies in the Skin-to-skin group. Foot temperature remained high in the Skin-to-skin group, whereas the low temperature observed in the Nursery group gradually increased and two days after birth the difference was no longer significant. CONCLUSION: The results show that delivery-ward routines influence skin temperature in infants in the postnatal period. Allowing mother and baby the ward routine of skin-to-skin contact after birth may be a "natural way" of reversing stress-related effects on circulation induced during labour.

The meaning of postponed motherhood for women in the United States and Sweden: aspects of feminism and radical timing strategies.

This exploratory study considered certain psychosocial, medical, and cultural aspects of the phenomenon of postponed motherhood for one cohort of white women born between 1947 and 1953 in Sweden and the United States. A cross-cultural comparison was made of the experience of pregnancy and the early perinatal period in 15 American and 16 Swedish women to find out (a) whether timing decisions reflected the influence of feminist ideology toward a reproductive strategy radically different from the conventional one, and (b) whether the pattern of delayed motherhood was culture specific. Results indicated that the patterns of delayed motherhood were culture specific. Feminist ideology clearly influenced the timing of the American women's first birth but was evident in Sweden. Women in the U.S. exhibited more nonconventional behaviors and attitudes, whereas Swedish women were more conventional. However, the husbands in both groups were remarkably similar in infant caretaking behaviors, regardless of culture and level of education attainment. These findings indicate postponed motherhood has different meanings in the cultural context of these two Western industrialized societies.

The 'good mother'--a comparative study of Swedish, Italian and American maternal behavior and goals.

This paper is based on a comparative, psychologically informed ethnographic study of maternal goals and infant care during the first year of life for 20 mothers and infants in each of three Western settings: Stockholm, Sweden, outside Rome, Italy, and suburban Boston, in the United States. Two research questions were posed to consider cultural ideas and ideals about mothering; How was the 'good mother' defined? How did sample women themselves, mother? Research hypotheses were that definitions of a good mother would be culture-specific with minimal within-culture variance. Furthermore, the frequency of maternal behaviors would also exhibit culture specific patterns. Research methods included event based behavioral observations of infant-caregiver interactions in the home, daily routine questionnaires, maternal attitude interviews, and ethnographic observations of community and family life. Research hypothesis were confirmed. Results revealed culture-specific variation in conceptions of the 'good mother'. Cultural differences were reflected in the short- and long-term goals which the sample women described for their children. Patterns of infant care, in turn, were consistent with the cultural values expressed, as well as the cultural norms of social interaction.

Maternal age and transition to motherhood: prenatal and perinatal assessments.

The purpose of this short-term longitudinal study was to document the contents and consequences of the timing of first birth to two groups of Swedish mothers in respect to biomedical, behavioral, psychological and social variables. Fifty-one primiparous women participated in the study during pregnancy through the first 4 months postpartum. Women were assigned to group dependent upon age: those 20-29 years of age in Group 1; and those 30-39 years of age in Group 2. Methods included standard ethnographic procedures, semi-structured open-ended interviews and pre-coded questionnaires. Infant assessments included the Brazelton examination and the Neonatal Perception Inventory. Results indicated group specific maternal behavioral patterns. Group 2 mothers were more anxious during pregnancy and more likely to regard certain aspects of their transition to motherhood as problematic (e.g. breastfeeding). Additional findings included biomedical variance between groups of infants: the Group 2 infants weighed less and were less healthy than the infants born to younger mothers. Results are discussed in respect to medical precedents and psychological impact as well as the cultural patterning of motherhood.