Maternal misperception of under-five children weight status and associated factors: A cross-sectional study.

Maternal perceptions, about the nutritional status of their children, may have implications for timely health care seeking and feeding behaviour. Shreds of evidence are limited in this area that assessed maternal perception about the nutritional status of the children in the context of Bangladesh. The objective of this study is to assess the differences in mothers' perceptions about their children's nutritional status who are less than 5 years of age and their associated factors in the context of urban slum areas. A cross-sectional study (Quantitative approach) was conducted in two of the largest urban slums of Dhaka city. A total of 437 mother-children dyads were included in the final analysis. The outcome of interest was the mother's 'varied perceptions' regarding the nutritional status of their children under five. 'Varied perception' refers to the difference between a mother's subjective assessment of her child's nutritional condition and the anthropometrically measured nutritional status. The prevalence of mother's varied perceptions was around 46%, and among them, 37% of mothers underestimated and 9% overestimated their child's nutritional status. 'The child doesn't want to eat' (AOR = 3.69; 95% CI: 2.34-5.85; p < 0.001) and 'Feels light when carried' (AOR = 3.39; 95% CI: 1.69-6.81; p = 0.001) were the significant reasons behind the mother's perception about the nutritional status of their under-five children. About one in two mothers' perceptions about their children varied from the anthropometry-derived status. Various research findings indicate that providing health education on proper feeding practices for children, along with anthropometric measurements, can assist mothers in enhancing their understanding and assessing their child's nutritional status with greater accuracy. Further qualitative research may be instrumental in getting deeper insights into maternal perception to develop context-specific interventions.

Association between cardiovascular risk and maternal perception of BMI in Peruvian schoolchildren.

Introduction: In the modern era, the maternal perception of children's nutritional status has emerged as a critical area of study, given its potential influence on nutritional interventions and long-term child health. The relationship between this perception and children's Body Mass Index (BMI) by age is particularly intriguing, as it may reveal discrepancies between perception and reality. Objective: The aim of this study was to evaluate Peruvian mothers' perception of their children's Body Mass Index (BMI) in relation to age and to determine how this perception associates with the children's cardiovascular risk. The study also analyzed sociodemographic factors that might influence this perception. Methods: The study included 130 mothers of schoolchildren aged 5 to 11 from a school in Lima. Mothers' perceptions of their children's weight were assessed using pictograms, and sociodemographic characteristics were collected through a questionnaire. Weight and height measurements were taken to calculate BMI, and waist circumference was measured to classify cardiovascular risk. Results: A total of 57.4% of the schoolchildren presented with excess malnutrition, and 51.5% of the mothers incorrectly classified the actual BMI/Age of their children (kappa 0.11; p ≤ 0.05). Additionally, it was found that the schoolchild's age is associated with the mother's failure to accurately perceive her child's weight (OR 1.59). Lastly, there was a significant association between maternal perception and cardiovascular risk (p ≤ 0.05). Conclusion: There is a significant discrepancy between maternal perception and the actual nutritional status of children, which can increase cardiovascular risk. It is necessary to implement intervention and education strategies targeted at parents to enhance the recognition and management of childhood overweight and obesity.

Made to move: A review of measurement strategies to characterize heterogeneity in normal fetal movement.

Fetal movement is a crucial indicator of fetal well-being. Characteristics of fetal movement vary across gestation, posing challenges for researchers to determine the most suitable assessment of fetal movement for their study. We summarize the current measurement strategies used to assess fetal movement and conduct a comprehensive review of studies utilizing these methods. We critically evaluate various measurement approaches including subjective maternal perception, ultrasound, Doppler ultrasound, wearable technology, magnetocardiograms, and magnetic resonance imaging, highlighting their strengths and weaknesses. We discuss the challenges of accurately capturing fetal movement, which is influenced by factors such as differences in recording times, gestational ages, sample sizes, environmental conditions, subjective perceptions, and characterization across studies. We also highlight the clinical implications of heterogeneity in fetal movement assessment for monitoring fetal behavior, predicting adverse outcomes, and improving maternal attachment to the fetus. Lastly, we propose potential areas of future research to overcome the current gaps and challenges in measuring and characterizing abnormal fetal movement. Our review contributes to the growing body of literature on fetal movement assessment and provides insights into the methodological considerations and potential applications for research.

Status of home-based secondhand smoke exposure among children and its association with health risks in Japan.

Objectives: In Japan, secondhand smoke (SHS) exposure in children has changed with increased heated tobacco products (HTPs) and electronic cigarettes (e-cigs) use. We clarified the status of home-based SHS exposure among children, including HTPs and e-cigs, as well as maternal perceptions on SHS avoidance and examined its association with health risks. Methods: This cross-sectional questionnaire-survey-based study included 379 mothers who were raising children aged < 5 years. Results: We found that 31.1 % of the children had home-based SHS exposure, with widespread HTP and e-cig use among smoking mothers and family members (74.2 % and 67.0 %, respectively). Significantly (p < 0.05), HTP and cigarettes were used in the kitchen and gardens/balconies, and maternal perceptions of child SHS-exposure avoidance were lower among smokers than non-smokers. Non-smoking mothers also had low perceptions of smoking on balconies and having immediate post-smoking contact with their children (27.6 % and 27.9 %, respectively). Most non-smoking mothers (76.4 %) reported that they do not encourage family members to quit smoking. The structural equation model showed that the presence of smoking at home and low maternal perceptions was correlated with SHS-related child health risks, including respiratory diseases, otitis media, and dental caries. Conclusions: HTP and e-cig use in the household has been rapidly increasing even among mothers and family members, and the presence of smokers at home and low maternal perceptions may be associated with child health risks. Increasing the maternal awareness of the child health risks of home-based SHS, including HTPs and e-cigs, along with continued smoking-cessation support involving mothers and families, is indispensable.

Decreased fetal movements - An audit of predictors and an evaluation of management based on a locally developed flow chart.

OBJECTIVES: Decreased fetal movements (DFM) is associated with adverse pregnancy outcomes. We aimed to look at the risk factors associated with DFM and outcomes of women who presented with and without DFM and outcomes before and after the implementation of a locally developed flow chart based on an evidence-based guideline. STUDY DESIGN: This was a retrospective audit of 1165 women ≥ 28 weeks' gestation with a singleton pregnancy who presented with concerns regarding DFM. We compared labor and neonatal outcomes to 4706 in a control group who did not present with concerns regarding FM. We also compared the same pregnancy outcomes before and after the implementation of hospital guidelines on the management of DFM. Statistical analyses were performed primarily using Chi square analysis and relative risk. RESULTS AND CONCLUSIONS: 1165 women presented 1645 times with DFM. Women presenting with DFM were younger, (82.8% vs 79.0%, p= <0.01 were 20 to 34-years old), tended to have a higher BMI (42.9% vs 34.4%, p=<0.001 with BMI ≥ 30) and were more likely to have mental health conditions (31.1% vs 24.2%, p=<0.01). There was no difference in the composite neonatal outcome including stillbirth, 5 min APGAR < 7 and Special Care Nursery (SCN) admission between DFM and control (22.9 vs 24.8% respectively, P = 0.18). There was no difference in perinatal outcomes pre- and post-implementation of the hospital guidelines on DFM management. Women presenting with DFM were more likely to have an induction (40.7% vs 29.9% p=<0.01) but not more likely to have a caesarean section (30.9% vs 28.8% respectively, p = 0.16). There were increasing rates of IOL with increasing number of presentations for DFM. Adoption of and adherence to locally developed guidelines was an opportunity to ensure all clinicians provide consistent advice on management and timing of birth for women presenting with DFM.

Accuracy of Syrain Refugee Mothers' Perceptions of Newborn's Birth Size: Insights from a National Survey in Turkey.

This study aims to assess the accuracy of maternally perceived birth size and its associated factors among the Syrian refugees in Turkey, using the data from 2018 Turkey Demographic and Health Survey Syrian Migrant Sample (TDHS-SM-18). The study includes information on the last-born child, singleton pregnancies, births in healthcare facilities, children under 5 living with their mothers, with recorded birth weight (n = 969). The study categorizes the mother's perception of size into three groups : compatible, overestimated, and underestimated. Various factors, including sociodemographic characteristics, financial aspects, maternal characteristics, and child characteristics, are considered as explanatory variables. The analysis employs a complex sample multiple logistic regression model. The findings reveal that the majority of mothers accurately perceive the birth size, but 17.1% of them do not. Maternal factors such as region of residence, literacy, occupation, age at birth, and child factors such as birth order, birth interval, gender, and birth weight are identified as associated factors with maternal misperception. This study provides valuable insights into the accuracy of maternally perceived birth size and sheds light on the factors influencing this perception among Syrian refugee mothers in Turkey.

Knowledge, attitudes, and practices of mothers regarding childhood malaria in southeastern Gabon.

BACKGROUND: In Gabon, children under 5 years of age and pregnant women are the populations who are most at risk of malaria. Despite the presence of accessible health facilities, the community-based management of childhood fever remains a very common practice in Gabon, which may have serious consequences on child health. As such, the objective of this descriptive cross-sectional survey is to assess the mothers' perception and knowledge of malaria and its severity. METHODS: Different households were selected using the simple random sampling method. RESULTS: A total of 146 mothers from different households were interviewed in the city of Franceville, in southern Gabon. Among the households interviewed, 75.3% had a low monthly income (below the minimum monthly income of $272.73). Among the respondents, 98.6% of mothers had heard of malaria and 55.5% had heard of severe malaria. Regarding preventive measures, 83.6% of mothers used an insecticide-treated net as a means of protection. Self-medication was practiced by 68.5% of women (100/146). DISCUSSION: The use of health facilities was motivated by better care, the decision of the head of the family, but above all by the severity of the disease. Women identified fever as the main symptom of malaria, which could be beneficial for a quicker and more efficient management of the disease in children. Malaria educational campaigns should also increase awareness of severe forms of malaria and its manifestations. This study shows that Gabonese mothers react quickly when their children have fever. However, several external factors lead them to practice self-medication as a first resort. In this survey population, the practice of self-medication did not depend on social status, marital status, level of education, on the young age or inexperience of mothers (p > 0.05). CONCLUSIONS: The data revealed that mothers may underestimate severe malaria and delay medical care by self-medicating, which can have detrimental effects for children and hinder the regression of the disease.

Women's subjective perceptions and background factors associated with poor maternal childbirth experience among induced and spontaneous onset of labour: a two-year tertiary hospital cohort study.

BACKGROUND: Women undergoing induction of labour (IOL) more often have poor childbirth experience compared to women with spontaneous onset of labour (SOL). For understanding and optimizing childbirth experience in IOL, we investigated the subjective maternal reasons and perceptions leading to poor childbirth experience in IOL compared to SOL, as well as the background factors and delivery outcomes associated with the poor experience. METHODS: Two-year retrospective cohort study included 836/19442 deliveries (4.3%) with poor childbirth experience in induced or spontaneous onset at term in Helsinki University Hospital. Poor childbirth experience occurred in 389/5290 (7.4%) cases of IOL and in 447/14152 (3.2%) of SOL. Childbirth experience was measured after delivery using Visual Analog Scale (VAS) score, with poor experience defined as VAS < 5. The primary outcome of the study were the maternal reasons for poor childbirth experience. The parameters were collected in the hospital database and statistical analyses were performed by using Mann-Whitney U-test and t-test. RESULTS: The subjective maternal reasons for poor childbirth experience were pain (n = 529, 63.3%), long labour (n = 209, 25.0%), lack of support by care givers (n = 108, 12.9%), and unplanned caesarean section (CS) (n = 104, 12.4%). The methods of labour analgesia were similar among the women who expressed pain as the main reason compared with those who didn't. When comparing the reasons according to the onset of labour, IOL group more often reported unplanned CS (17.2% vs. 8.3%; p < 0.001) and lack of support by the care givers (15.4% vs. 10.7%; p = 0.04), while SOL group more often named pain (68.7% vs. 57.1%; p = 0.001) and rapid labour (6.9% vs. 2.8%; p = 0.007). In multivariable logistic regression model, IOL was associated with lower risk for pain compared to SOL (adjusted OR 0.6, 95%CI 0.5-0.8; p < 0.01). Primiparas more often reported long labour (29.3% vs. 14.3%; p < 0.001) and concern over own or baby's wellbeing (5.7% vs. 2.1%; p = 0.03) compared to multiparas. Women who feared childbirth more often reported lack of support compared to women with no fear (22.6% vs. 10.7%; p < 0.001). CONCLUSION: The main reasons for poor childbirth experience were pain, long labour, unplanned CS and the lack of support by care givers. The childbirth experience is complex and could be optimized by information, support and presence of care givers especially in induced labour.

Maternal perception of fetal movements: onset and associated factors.

OBJECTIVES: The purpose of this study was to determine the onset of fetal movements' perception and to identify parameters that affect this timing. METHODS: This was a prospective cohort study including singleton pregnancies that attended routine prenatal care, in a tertiary care center, in northern Greece, between January 2020 and July 2021. We collected data on medical and obstetric history, and invited women to record the time that they perceived the fetal movements for the first time, that being the primary outcome of the study. Furthermore, we studied the associations between this timing and several obstetric and sociodemographic parameters. RESULTS: In total, 2,009 women participated in the study. The mean gestational age at first perception of fetal movements was 19 weeks (±1.5). This ranged from as early as 14+0-14+6 weeks (0.1%) to 24+0-24+6 weeks (0.1%). The majority of women (73.3%) reported initial perception of fetal movements between 18+0 and 20+6 weeks. Following multivariate logistic regression analysis, we found that nulliparity (OR: 2.607; 95% CI: 1.876-3.622; p<0.001), anterior placental position (OR: 1.918; 95% CI: 1.575-2.336; p<0.001), increasing body mass index (OR: 1.063; 95% CI: 1.040-1.088; p=0.001) and advancing maternal age (OR: 1.062; 95% CI: 1.040-1.084; p<0.001) were associated with a delayed perception of fetal movements. Multiparous women reported the onset of fetal movements almost one week earlier on average (18.6±1.4 weeks) compared to nulliparous (19.4±1.4 weeks; MD: 0.843; 95% CI: 0.718-0.968; p<0.001). CONCLUSIONS: The onset of maternal perception of fetal movements is around 19 weeks and this timing may be delayed by higher maternal age, higher body mass index, nulliparity and anterior placental position.

Maternal perception of infant's intersubjectivity: a questionnaire.

INTRODUCTION: Intersubjectivity is a fundamental dimension of the mother-infant relationship. OBJECTIVE: Design of a questionnaire to assess maternal perception of the infant's intersubjectivity. DESIGN: After running a focus group with mothers of infants within their first year of life, items related to maternal perception of the infant's intersubjectivity were generated. These items were applied to a sample of 125 mothers and the results were submitted to principal components analysis. RESULTS: Principal components analysis (forced extraction to 3 factors, KMO = .752, Bartlett = 976.202, p = .000; explained variance = 42.12%) identified 22 items grouped in three factors: a) F1, 'Interactive Competence' (α = .817); b) F2, 'Emotional States' (α = .749), and c) F3, 'Initiative' (α = .647). Positive and significant correlations were observed among all MPIIQ factors (p ≤ .01). Maternal perception of infant's intersubjectivity varied according to the number of gestational weeks at birth (T = -1.15, p ≤ .05) and according to the infant´s age (F = 7.834, p ≤ .001). Mothers of preterm infants reported lower perception of infant's intersubjectivity whereas mothers of older infants reported higher perception of infant's intersubjectivity. CONCLUSION: The Maternal Perception of Infant's Intersubjectivity Questionnaire (MPIIQ) seems to be a sensitive instrument, able to discriminate different levels of maternal perception about the infant's intersubjective competences.

The COVID-19 Infodemic Through Facebook: Comparison of Content and the Accuracy of Breastfeeding Information.

Background The coronavirus disease (COVID-19) pandemic has resulted in a significant increase in the number of people seeking online support and information, particularly on social media. Nevertheless, the nature and trend of internet information, as well as its accuracy, are questionable. This study aimed to assess and compare the content, type/form, and degree of accuracy of breastfeeding information on Facebook before and during the COVID-19 pandemic (n = 288/phase). Methodology The data were gathered from Malaysian public and group/page Facebook posts (n = 456). Keyword searches were conducted using Malay and English breastfeeding terms. The dataset was screened and entered into a structured codebook. The Delphi approach was used to assess the accuracy of posts' content performed by breastfeeding experts. Results Sharing personal experience (53.2%) was the most common topic in breastfeeding-related posts, followed by seeking questions (39.3%) and knowledge (8.0%). Sharing personal stories and knowledge posts were higher during COVID-19 than before (p = 0.001), although the seeking questions category was higher before the pandemic (p = 0.001). Most information posted was in text form (94.5%). About half of the posts (46.5%) were misleading, while (43.7%) were accurate. There was a significant difference in the accuracy of online posts before and during the COVID-19 pandemic (p = 0.001). Conclusions Compared to the pre-pandemic phase, forms/types of information on Facebook remained consistent, whereas the breastfeeding information content and its degree of accuracy differed during the pandemic.We need to explore other aspects of breastfeeding online content as well as its engagement, especially during a pandemic. Knowing the infant feeding-related topics that have been discussed and questioned on social media, as well as the accuracy of the data, allows policymakers and scientific communities to plan strategies for spreading credible breastfeeding information online. This includes creating interactive online media types of visual guidelines, web resources, and breastfeeding apps.

Maternal perceptions of breastfeeding support in a birth hospital before and after designation to the Baby-Friendly Hospital Initiative: A quasi-experimental study.

OBJECTIVE: The purpose of this study was to examine maternal perceptions of postnatal breastfeeding support in the hospital before and after designation to the Baby-Friendly Hospital Initiative (BFHI). Further maternal and infant characteristics associated with the maternal perception of breastfeeding support were investigated. Our hypothesis was that mothers would perceive breastfeeding support more adherent to the standards of the BFHI after the hospital was designated to the BFHI compared with before. DESIGN: The study had a quasi-experimental non-equivalent two-group design. SETTING: The study was conducted in one postnatal ward and one neonatal intensive care unit in a public birth hospital in Finland. PARTICIPANTS: Postpartum mothers giving birth in the hospital before (pre-test group, n = 162) and after (post-test group, n = 163) designation to the BFHI participated. INTERVENTION: The aim of the BFHI is to support and promote breastfeeding by implementing the Ten Steps to Successful Breastfeeding into routine care. Implementation in the study hospital required staff training and revision of current hospital practices, which took place during 2017-2018. The postnatal ward and neonatal intensive care unit were designated to the Baby-Friendly Hospital in February 2019. MEASUREMENTS: Maternal perceptions of postnatal breastfeeding support were measured with a 20-item questionnaire developed for this study. Items were based on maternal self-report of the breastfeeding support in the hospital. A sum variable was created to measure the maternal perception of the support (scale 1-7), and higher scores indicated perception of breastfeeding support that is more adherent to the standards of the BFHI. Descriptive statics, nonparametric statistical tests, and multiple linear regression analysis were used to analyse data. FINDINGS: Mothers in the post-test group (median 6.1, IQR 5.4-6.4) perceived breastfeeding support more adherent to the standards the BFHI compared with mothers in the pre-test group (median 5.0, IQR 4.2-5.8) (p < 0.001). Fifteen of 20 of the measured breastfeeding support practices improved after the hospital's designation to the BFHI. The largest difference between groups was observed for multipara mothers (median 4.6 vs 6.0, p < 0.001), older mothers (> 35 years) (median 4.4 vs 5.8, p < 0.001), and mothers with a longer history of breastfeeding (6-12 months) (median 4.4 vs 6.2, p < 0.001). Before the BFHI designation, multipara mothers and mothers who gave birth to an infant with low Apgar scores (< 7) perceived breastfeeding support less adherent to the BFHI standards than did primiparas or mothers of an infant with high Apgar scores (≥ 7). After the BFHI designation, mothers who experienced preterm birth (GA < 37 weeks) perceived breastfeeding support less adherent to the BFHI standards compared with mothers who experienced a full-term birth. KEY CONCLUSIONS: Designation to the BFHI had a positive impact on breastfeeding support from the maternal perspective. Designation improved particularly multiparas' perceptions of receiving breastfeeding support that is in adherence with the standards of the BFHI. However, more emphasis should be placed, and further research should be conducted to ensure that mothers giving birth to a preterm infant receive breastfeeding support that is adherent to the BFHI standards. IMPLICATIONS FOR PRACTICE: Birth hospitals are recommended to implement the BFHI as it improves breastfeeding support in the hospital and provides mothers with a good basis and continuation for breastfeeding, even after hospital discharge. Maternal perceptions about the impact of BFHI designation are important to consider because mother - infant dyads are at the centre of that support, and their viewpoint may help to assess whether the designation to the BFHI in the unit is successful. Results of this study indicate that designation to BFHI improves breastfeeding support from the maternal perspective.

Maternal perception, concern and dissatisfaction with child weight and their association with feeding practices in the Generation XXI birth cohort.

What a mother thinks about her child's weight status might influence what and how she feeds her child. We examined the association between maternal perception, concern and dissatisfaction with child weight alongside feeding practices. Participants were from the Generation XXI birth cohort (n = 3233). A validated version of the Child Feeding Questionnaire and the Overt/Covert Control scale were used. Associations were evaluated by linear regression models (ß coefficients and 95 % confidence intervals (95 % CI) with Bonferroni correction). Perceived underweight was associated with practices promoting food intake, such as higher pressure to eat at ages 4 and 7 years (ß = 0·229; 95 % CI: 0·059, 0·398 and ß = 0·190; 95 % CI:0·005, 0·376, respectively) and lower restriction at age 4 (ß = -0·175; 95 % CI: -0·0310, -0·039). At age 7, perceived overweight was associated with higher covert control (ß = 0·203; 95 % CI: 0·029, 0·376). Mothers who were concerned about child weight reported higher restriction (ß = 0·226; 95 % CI: 0·142, 0·310 at 4 years and ß = 0·261; 95 % CI: 0·169, 0·353 at 7 years) and covert control (ß = 0·183; 95 % CI: 0·083, 0·282 at 4 years and ß = 0·171; 95 % CI: 0·073, 0·269 at 7 years). Maternal desire for a heavier child was associated with higher pressure to eat at both ages (ß = 0·285; 95 % CI: 0·163, 0·406 and ß = 0·393; 95 % CI: 0·266, 0·520), while the desire for a thinner child was related to higher covert control at 7 years of age (ß = 0·158; 95 % CI: 0·001, 0·316). Maternal perceptions and concern for child weight status are associated with feeding practices independently of actual weight status.

A community survey on maternal perception about the initiation of dental home for infants in Lagos, Nigeria.

INTRODUCTION: because efforts directed toward oral health promotion and disease prevention are fundamentally superior to dental rehabilitation after disease development, early preventive dental visits are widely encouraged by dental professional and academic stakeholders. Aim: this study aimed to determine the perceptions and practices of mothers with regards to the establishment of dental home at four local government areas (LGAs) in Lagos, Nigeria. METHODS: was a community-based descriptive household survey conducted amongst mothers in Alimosho, Ikorodu, Surulere and Epe LGAs of Lagos State. Socio-demographic data, information about the importance of primary teeth, knowledge about dental home as well as their child´s age at first dental visit and reasons for attending was obtained with a validated, structured interviewer administered questionnaire. Descriptive statistics, Chi-square and multivariable regression analysis were conducted, and the level of significance was set at P<0.05. RESULTS: the highest proportion of the mothers were aged between 26-30 years (27.4%; mean age: 34.58±7.8 years) and had a tertiary level of education (n=206, 59.9%); most respondents (n=80, 51.4%) did not know the age a child should be taken to the dental clinic for the first time and had not taken their child for any dental visit (n=229, 65.4%). Out of those who had previously taken their child for dental visits, the greater proportion (n=115, 95.0%) took the child when he/she was older than one year of age. Overall, only 126 (36.0%) respondents had a good perception about oral health and the need for a dental home while 224 (64.0%) respondents had poor knowledge. Logistic regression analysis of predictor variables that showed mothers with a tertiary level of education (OR=0.108; CI=0.0023-0.495) and those with 2-3 children (OR=0.482; CI=0.253-0.920) had significant lower odds of poor perception about the importance of a dental home. CONCLUSION: maternal knowledge and practices with regards to dental home were poor and inadequate. It is necessary to create more awareness among parents/caregivers, especially through antenatal and immunization clinics to establish the concept of dental home.

Maternal perception of paternal breastfeeding support: A secondary qualitative analysis.

OBJECTIVE: To describe how women perceive paternal support of breastfeeding and identify actions women value during the early breastfeeding postpartum. DESIGN: A qualitative secondary analysis of semi-structured interviews using thematic analysis collected after birth and via telephone at 1, 2, 3, and 4 weeks after discharge. SETTING: A regional medical center in the southeast region of the United States. PARTICIPANTS: Sixty-two women yielded 130 transcripts with 32 transcripts conducted after birth, and 19, 16, 27, and 36 transcripts conducted after discharge via telephone at weeks 1, 2, 3, and 4, respectively. FINDING: Women reported three themes of paternal support of breastfeeding (1) participating in the breastfeeding decision, (2) being a partner of breastfeeding, and (3) caring for breastfeeding mothers. CONCLUSION AND IMPLICATION FOR PRACTICE: Paternal support of breastfeeding is a learning process that requires teamwork for women and their partners to master breastfeeding. Women and their partners as co-parents solve breastfeeding problems and achieve their breastfeeding goals, which promotes maternal well-being and bonding with their infants. Future interventions will guide partners to support breastfeeding and women's postpartum physical and psychological needs.

Alteración de la percepción materna sobre el estado nutricional de sus hijos ¿nuevo factor de riesgo cardiovascular? / Perception of child nutritional status by their mothers: a new cardiovascular risk factor?

ANTECEDENTES: La obesidad infantil es un trastorno de prevalencia creciente que predispone a la obesidad, diabetes y enfermedades cardiovasculares en el adulto. Investigaciones recientes relacionan la percepción materna con el estado nutricional real de los niños, encontrando una distorsión entre imagen corporal de sus hijos con malnutrición por exceso (MNPE). MÉTODOS: Estudio descriptivo de corte transversal. La población objetivo fue 320 madres de escolares de 6 a 10 años y se utilizó un muestreo por conveniencia. Se incluyeron madres de hijos con MNPE. Se evaluó la percepción de las madres a través de un pictograma. Se efectuaron mediciones antropométricas de peso, talla y perímetro de cintura (PC), presión arterial (PA), glicemia y colesterol total. En el análisis estadístico se usó Stata 14 y Epidat 4.2. RESULTADOS: La muestra fue conformada por 100 díadas madre/hijo con MNPE. 69% de las madres presentaron escolaridad de enseñanza media, y 68% tenían nivel socioeconómico bajo. Respecto de los niños, 52% eran de sexo femenino, 38% presentaban riesgo de obesidad abdominal y el 47% tenían obesidad abdominal. La glicemia en ayunas estaba alterada en 35%, el colesterol total alterado en 12% y 31% presentaban PA elevada. El 60% de las madres de niños con MNPE subestimaron el estado nutricional de sus hijos. CONCLUSIONES: En relación a los factores de riesgo cardiovascular de los escolares, un alto porcentaje presenta índices de riesgo cardiovascular elevado: obesidad abdominal, PA alterada, colesterol total y glicemias alteradas. La alteración de la percepción materna sobre el estado nutricional de sus hijos, puede repercutir en forma significativa para el desarrollo y mantenimiento de la MNPE y, por consiguiente, constituye un factor de riesgo cardiovascular, estableciendo un punto clave de intervención.

BACKGROUND: Overnutrition in children is increasingly more prevalent and leads to obesity, diabetes and cardiovascular disease in adults. Recent research links distorted maternal perception of nutritional status in their children with the presence of obesity in adulthood). METHODS: A descriptive cross-sectional study was performed on mothers and their schoolchildren aged 6 to 10 years old. A basic inclusion criteria was the presence of overnutrition in children and the study related maternal perception with the actual degree of overnutrition in her child. Perception was evaluated using a pictogram. Weight, height, waist circumference, blood pressure (BP), blood sugar level and total cholesterol were measured in children Stata 14 and Epidat 2.0 were used for statistical analysis. RESULTS: 100 mother-child pairs were studied. All children had overnutrition. 69% of mothers had high-school level education and 68% belonged in the low socio-economic stratum. There were 52% of girls. According to waist circumference 38% were at risk of malnutrition and 47% already had abdominal obesity. 35% had an altered fasting blood sugar level, 12% an elevated total cholesterol, 31% an increased blood pressure. 60% of mothers of children with overnutrition underestimated the actual nutritional status (overnutrion) of their children. CONCLUSIONS: The presence of overnutrition and obesity indicators were high in this population. This occurred along with increased levels of BP, total cholesterol and altered blood sugar levels. The maternal perception of their children severely under estimated the level of overnutrition. This fact can have a significant impact on the development and maintenance of the excess type malnutrition and subsequent development of other cardiovascular risk factors. Therefore, improving the perception of mothers regarding the nutritional status of their children should be an important element for diminishing cardiovascular risk longterm.

Maternal Underestimation of Child's Weight at Pre-School Age and Weight Development between Age 5 and 12 Years: The ABCD-Study.

BACKGROUND: Healthcare monitoring of child growth reduces with age, which may increase parental influences on children's weight development. This study aimed to examine the association between maternal underestimation of child's weight at age 5/6 and weight development between 5 and 12 years. METHODS: We performed univariate and multivariate linear regression analyses with data on maternal perception of child's weight and weight development (∆SDS body-mass index; BMI) derived from the Amsterdam Born Children and their Development (ABCD) birth-cohort study. Underestimation was defined by comparing maternal perception of child's weight with the actual weight status of her child. Associations were studied in two groups: children with overweight (n = 207) and children with normal weight (n = 1982) at baseline (children with underweight were excluded). RESULTS: Underestimation was 5.5% in children with normal weight and 79.7% in children with overweight. Univariate analyses in children with normal weight and overweight showed higher weight development for children with underestimated vs. accurately estimated weights (respectively: ß = 0.19, p < 0.01; ß = 0.22, p < 0.05). After adjusting for child sex and baseline SDS BMI, the effect size became smaller for children with a normal weight (ß = 0.15, p < 0.05) and overweight (ß = 0.18, p > 0.05). Paternal and maternal BMI, ethnicity, and educational level explained the association further (remaining ß = -0.11, p > 0.05 in children with normal weight; ß = 0.06, p > 0.05 in children with overweight). CONCLUSIONS: The relationship between maternal underestimation of child's weight and higher weight development indicates a need for promoting a realistic perception of child's weight, this is also the case if the child has a normal weight.

Leitura materna sobre depressão pós-parto e sintomas psicofuncionais: um caso de psicoterapia mãe-bebê / Maternal perception about postpartum depression and psychofunctional symptoms: a case of mother-baby psychotherapy / Comprensión materna sobre depresión postparto y síntomas psicofuncionales: un caso de psicoterapia madre-bebé

Este estudo investigou as mudanças na leitura materna sobre seus sintomas depressivos e sobre os sintomas psicofuncionais do bebê num contexto de psicoterapia mãe-bebê em grupo. Participaram uma díade mãe-bebê em que a mãe apresentava depressão pós-parto e o bebê sintomas psicofuncionais. Os instrumentos empregados foram a Escala de Depressão Pós-Parto de Edimburgo (EPDS), Entrevista MINI, Entrevista sobre a Gestação e Parto, Entrevista sobre a Experiência da Maternidade e o questionário Symptom Check List (SCL). Foi utilizado o delineamento de estudo de caso único e realizada uma análise qualitativa, relacionando os materiais clínicos das onze sessões de psicoterapia com a literatura a partir de uma compreensão psicanalítica. Os resultados revelaram que os sintomas depressivos maternos e os sintomas psicofuncionais do bebê estavam mutuamente associados e que, a partir da intervenção utilizada, a leitura materna sobre seus sintomas e os do bebê foi modificada, associada a uma melhora dos sintomas em ambos.

This study examined the changes in maternal perception about her own depressive symptoms and the baby's psychofunctional symptoms in a context of mother-baby group psychotherapy. Participants were a mother-baby dyad in which the mother presented postpartum depression and the baby had psychofunctional symptoms. The instruments employed were: EPDS, MINI Interview, Interview on Pregnancy and Childbirth, Interview of the Maternity Experience, and SCL questionnaire. The single-case study design was used and a qualitative analysis was carried out, correlating the clinical materials from the eleven psychotherapy sessions with the theoretical knowledge found in the literature, based on a psychoanalytic understanding. The results revealed that the maternal depressive symptoms and the baby's psychofunctional symptoms were mutually associated and that, through the intervention, the maternal perception about her symptoms and the baby's was modified, associated with an improvement of the symptoms in both.

Este estudio investigó los cambios en la comprensión materna sobre sus síntomas depresivos y sobre los síntomas psicofuncionales del bebé en un contexto de psicoterapia madre-bebé en grupo. Participaron una díada madre-bebé en la que la madre presentaba depresión posparto y el bebé síntomas psicofuncionales. Los instrumentos utilizados fueron: EPDS, Entrevista MINI, Entrevista sobre la Gestación y el Parto, Entrevista sobre la Experiencia de la Maternidad y el cuestionario SCL. Se utilizó el delineamiento de estudio de caso único y realizó un análisis cualitativo, relacionando los materiales clínicos de las once sesiones de psicoterapia con la literatura a partir de una comprensión psicoanalítica. Los resultados revelaron que los síntomas depresivos maternos y los síntomas psicofuncionales del bebé estaban mutuamente asociados y que, a partir de la intervención utilizada, la comprensión materna sobre sus síntomas y del bebé fue modificada, asociada a una mejoría de los síntomas en ambos.

Percepción materna sobre el estado nutricional en escolares de 5 a 6 años pertenecientes a establecimientos de educación especial en la ciudad de Arica / Maternal perception of nutritional condition in students of 5 to 6 years old belonging to special education facilities from the city of Arica

La obesidad corresponde a la acumulación anormal de grasa en el organismo, además es un importante factor de riesgo para el desarrollo de enfermedades cardiovasculares, diabetes, cáncer, etc. En Chile, su prevalencia ha aumentado a lo largo de los años llegando a 24,4% en menores de primer año básico en el año 2018. Hay estudios que reportan que la distorsión de la percepción materna de la imagen corporal del niño podría ser un factor de riesgo para el desarrollo de obesidad infantil ya que de ella dependen principalmente los hábitos alimenticios que el niño adquiera. La sociedad y cultura en la que se desarrolle el individuo también juegan un rol fundamental. El objetivo del estudio fue analizar la percepción materna de la imagen corporal sobre el estado nutricional real del niño con necesidades educativas especiales. La investigación tuvo un diseño observacional de corte transversal. El estudio se realizó en 60 escolares, de 5 y 6 años de edad, pertenecientes a 5 establecimientos de educación especial en la ciudad de Arica. Se aplicó un cuestionario a las madres sobre su percepción del estado nutricional de sus hijos mediante siluetas y conceptos, luego se evaluó peso y estatura en los escolares. Se observó una prevalencia de 38,3% de malnutrición por exceso en la muestra de escolares con necesidades educativas especiales. Además, destaca que un 71,7% de las madres fueron capaces de reconocer el concepto que corresponde al estado nutricional real de su hijo, mientras que un 46,6% lo identificó por medio del uso de siluetas. Se concluyó que las madres con alteración de la percepción materna sobre el estado nutricional de los escolares muestran una tendencia a percibir a su hijo con sobrepeso u obesidad cuando se encuentra en la categoría normal.

Obesity corresponds to the abnormal accumulation of fat, negative situations for health. In childhood, it is an important risk factor for the development of cardiovascular diseases, diabetes, cancer, etc. In Chile, its prevalence has increased over the years reaching 24.4% in children of the first basic year in 2018. Studies indicate that the discrimination of the maternal perception of the child's body image could be a risk factor for the development of childhood obesity that depends on the eating habits that the child acquires. The society and culture in which the individual develops also plays a fundamental role. The objective of the study was to analyze the maternal perception of the body image on the real nutritional status of the child with special educational needs. The research has an observational and transversal design. The study was conducted in 60 students between 5 and 6 years old belonging to 5 special education establishments in the city of Arica. A questionnaire was applied to the mothers about their perception of the nutritional status of their children through silhouettes and concepts, then weight and height were evaluated in schoolchildren. A prevalence of 38.3% of excess malnutrition was observed in the sample of schoolchildren with special educational needs. In addition, it is highlighted that 71.7% of the mothers were able to recognize the concept that corresponds to the actual nutritional status of their child, while 46.6% identified it through the use of silhouettes. We concluded that mothers with an altered maternal perception of the nutritional status of schoolchildren show a tendency to perceive their child as overweight or obese when it is in the normal category.

Evaluating the changes in molar incisor hypomineralization prevalence: A comparison of two cross-sectional studies in two elementary schools in Mexico City between 2008 and 2017.

BACKGROUND: Little information is available on the trends over time of the prevalence of molar incisor hypomineralization (MIH). This condition may be preventing dental caries decline. AIM: (a) To compare the prevalence of MIH, in Mexico City schoolchildren, evaluated in 2008 with a group evaluated in 2017, (b) to identify the association of MIH with dental caries, and (c) to assess the mother's perception of her child's oral health status. DESIGN: Two cross-sectional studies performed in 2008 and in 2017 were compared. The oral examiner and the selected schools were the same in both surveys. RESULTS: A total of 549 schoolchildren were evaluated. The prevalence of MIH in the first survey was 20.3%, and 31.9 % in the second survey, (p = .002). Children with MIH were more likely to have dental caries. The odds ratio was 2.24 (p = .036) and 4.18 (p ˂ .001) in the first and second surveys, respectively. Mothers of children with MIH perceived worse oral health status of their children than the mothers whose children did not have MIH (odds ratio = 4.47, p ˂ .001). CONCLUSION: The findings portray a clear increase in prevalence of MIH and highlight the need for increased awareness about this condition among dentists and the general population.