Search

This article presents the elements of the Oral Motor Intervention section of the Infant Care Path for Physical Therapy in the Neonatal Intensive Care Unit (NICU). The types of physical therapy interventions presented in this path are evidence based as well as infant driven and family focused. In the context of anticipated maturation of suck-swallow-breathe coordination, the timing and methods for initiation of oral feedings and transition from gavage to full breast or bottle-feedings are presented with supporting evidence. (Contains 4 figures.)

Family involvement is essential to the developmental outcome of infants born into Neonatal Intensive Care Unit (NICU). In this article, evidence has been presented on the parent's perspective of having an infant in the NICU and the context of family. Key points to an educational assessment are also reviewed. Throughout, the parent's concerns and the educational needs of the family are shared, and strategies are given to help therapists enhance their teaching skills and ways to partner with parents. This article also introduces the NICU Discharge Path for parents "Preparing for Your Baby to Come Home". The Path educates parents on the steps towards home and encourages their participation in the process. (Contains 2 figures.)

This paper reports predictors for center care utilization prior to 18 months of age in Norway, a country with a welfare system providing up to one-year paid parental leave and universal access to subsidized and publicly regulated center care. A community sample of 1103 families was interviewed about demographics, family, and child characteristics when their child was 6 months old, and the child's entry into center care prior to 18 months of age was recorded. Utilization rate was 72.2%. Parents' preference that their child entered center care prior to 18 months of age was the strongest predictor of utilization. Nonwestern immigrant status and lower socio-economic status predicted lower utilization. Age of entry was higher for children in two-parent families. Mother's severe health problems, parents' preferences for entry prior to 18 months, and high child activity levels predicted earlier entry. Our findings suggest that in a context of universally accessible subsidized center care, family and child factors beyond preferences for center care predicted utilization only to a very limited extent. (Contains 3 tables.)

The literature on infant care and education indicates that infant fieldwork has distinct learning opportunities that could work as an important supplement to more traditional field placements. The following study supports these assertions by providing an in-depth look at the experiences of three preservice early childhood teachers while engaging in fieldwork with infants over the course of one semester. The preservice teachers' perspectives and descriptions, as generated through individual interviews, reflective journals, and a focus group interview, were used to illuminate the unique aspects of working with infants and the impact of the fieldwork on their development as teachers. The findings suggest that structured experiences in the infant classroom pushed the preservice teachers to construct new ideas about development, curriculum, the role of the teacher, working with parents and families, and building relationships with children. The infant fieldwork also provided the preservice teachers with valuable opportunities to practice critical teaching skills--such as observation, collaborating with parents and families, and individualizing care and to make new connections between theory and practice.

This study aims to better understand the social ecology of infant care (IC) as experienced and perceived by mothers living in a deprived Arab Bedouin community in Israel, where children's health indicators are poor. We used the integrative model of Garcia Coll et al. (Garcia Coll C, Lamberty G, Jenkins R "et al." An integrative model for the study of developmental competencies in minority children. "Child Dev" 1996; 67: 1891-914) and constructs of the Health Beliefs Model as a study framework for conducting focus groups with 106 mothers in 2007. Results show that mothers believe IC and infant well-being are high priorities. However, distal barriers, including land disputes, a transition from herding to low-paid labor and lifestyle changes have interacted with proximal barriers in Bedouin families, including poor living conditions, poverty and weakened familial relations to inhibit adequate IC practices. Specifically, distal and proximal barriers affect IC directly (e.g. lack of nearby clinics) or indirectly (mothers' self-efficacies) to limit mothers' choices and control over IC, thereby posing threats to infant health. Our findings demonstrate the importance of understanding the complexity of social context in shaping IC among marginalized minority mothers and suggest new ground for addressing proximal and distal barriers through policy interventions. Without contending with both, interventions to strengthen mothers' self-efficacy will have limited success in improving the environment of IC and, consequently, infant health.

Nearly 20 years after the passage of the Family and Medical Leave Act (FMLA), it is time to take stock of U.S. policy on parental leave, particularly as it affects infant care and child development. While the FMLA has certainly expanded access to job-protected leave, large sectors of the workforce are left out and, in the absence of paid leave, cannot afford to use it even if they are eligible. "Time Off With Baby" explores the lessons learned from the many nations that offer paid parental leave as well as from a relatively new part-paid leave policy in California. Drawing on research across the fields of maternal and child health, child development, and economics, the authors conclude that paid family leave for infant care is a wise investment. The authors see little downside to offering a modest paid leave policy for infant care and great cost to having the United States continue to be the only advanced industrialized nation without such a policy.

The long-term effects of the Cues intervention to reduce anxiety and enhance the interactive behavior of mothers of very low birth weight (VLBW) infants were investigated. A randomized trial comparing the Cues intervention to an attention control condition was conducted. A total of 122 mothers of newborns weighing less than 1,500 g were randomized, and 96 participated in a follow-up assessment when the infants were 6 months corrected age. Maternal outcomes included anxiety, posttraumatic stress and depression, and mother-infant interaction. The Bayley Scales were used to assess infant development. Mother's anxiety was not significantly lower in the Cues group (27.8 [SD = 7.9]) compared with the control group (30.5 [SD = 10.0]; p = 0.14). Mothers in the Cues group were not more sensitive in interactions with their infants. There were no differences between groups with respect to infant development. Thus, there was no evidence of any differential beneficial effects of the Cues program. (Contains 1 figure and 4 tables.)

In a relationship-based approach to infant-family work, front-line staff members are frequently called upon to manage their emotions in order to offer a presence that will promote and maintain an effective relationship with parents. The work of managing emotions to elicit a desired response in others is called "emotional labor," and it comes at a significant cost to the worker. Awareness of this construct is important for staff and supervisors in order to moderate the effects of this invisible work. The presence of emotional labor in infant-family work is a primary rationale for the need for reflective supervision in this field.

Many neonatal intensive care units (NICUs) are experiencing changes in their approaches to preterm infant care as they consider and incorporate the philosophy of individualized developmental care. The aim of this systematic review is to research current literature documenting the short-term effects of developmental care and the Newborn Individualized Developmental Care and Assessment Program (NIDCAP). The following databases were reviewed: PubMED, CINAHL, and PsychINFO by using the keywords developmental care, individualized care, preterm infant, early intervention, and NIDCAP. Fifty-four articles were found with a total of 15 matching the selection criteria. All 15 articles were assessed using a research design developed by the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM). Twelve of the 15 articles contained strong Levels of Evidence (I or II). Our findings suggest evidence supporting developmental care and NIDCAP, however, further research documenting outcomes for preterm infants receiving developmental care and/or NIDCAP is needed. (Contains 2 tables.)

Training birth attendants (TBAs) to provide essential maternal and infant health care services during delivery and ongoing community care in developing countries. Despite inadequate evidence of relevance and effectiveness of TBA training programmes, there has been a policy shift since the 1990s in that many donor agencies funding TBA training programmes redirected funds to providing skilled attendants during delivery. This study aimed to assess the ways in which a TBA training programme in India has been successful in disseminating evidence-based knowledge on birthing practices. TBAs practicing within 16 villages targeted by training programme initiatives were administered with structured questionnaires. The post training birthing practices of trained (24) and untrained (14) TBAs was compared and birthing practices adopted by women assisted by trained (16) and untrained (9) TBAs was analysed. Positive post training practices were hand washing, use of a clean blade for cutting the cord, immediate breastfeeding and weighing of babies. Nevertheless, the training could be further improved with up to date and evidence-based information and more comprehensive instructions. The findings suggest an integration of local and evidence-based knowledge is needed to improve the training. Raising community awareness of public health measures related to maternal and child health is also recommended.

Infant brain development is a dynamic process dependent upon endogenous and exogenous stimulation and a supportive environment. A critical period of brain and neurosensory development occurs during the third trimester and into the "fourth" trimester (first three months of life). Disruption, damage, or deprivation in the infant's social and physical environment can create permanent deficits in the developing neurosensory systems. Implications for infant child care environments are discussed, and a review of quality and standards in infant child care environments leads to a call for improvements to optimize child development.

This paper is aimed at analyzing verbal and nonverbal strategies in terms of body contact, face-to-face contact, and discourse style during the first three months of life in two cultural communities that have been characterized as embodying different cultural models of parenting: German middle-class, and Nso farmer families. It can be demonstrated that the Nso mothers have significantly higher rates of body contact during the assessments of free-play interactions during the first 12 weeks than the German women. The German women on the other hand demonstrate the expected increase of face-to-face contact, whereas the Nso women demonstrate a significantly lower and stable pattern of face-to-face contact over the assessments. The German mothers use an agentic discourse style, whereas the Nso mothers use a relational discourse style. Moreover, body contact and a relational discourse style form one parenting strategy, whereas face-to-face contact and the agentic discourse style form another parenting strategy. The results demonstrate culture-specific parenting strategies that not only differ with respect to the amount of behaviors expressed, but also the developmental course of particular behaviors. It is also evident that socialization strategies are expressed in different behavioral channels. The role of sociodemographic variables is particularly discussed with respect to their impact for defining sociocultural environments. (Contains 2 tables and 4 figures.)

Considerable debate exists regarding whether religiousness promotes or impedes greater father involvement in parenting. Our study addresses this issue using a Midwestern longitudinal data set that tracks the transition to first parenthood for 169 married couples. We focus on performance of the "messier" tasks of infant care. We find little evidence that religiousness enhances father involvement in this domain. Biblically conservative couples exhibit a greater gender gap in child care than others, with mothers more involved than fathers. The gender gap is also greater the more fathers work outside the home, the greater mothers' knowledge of infant development, and the less adaptable the infant. Average daily child care is lower the greater spouses' work hours, but higher with difficult pregnancies or fussy babies.

This article uses time-diary data from the Longitudinal Study of Australian Children (LSAC; N = 2,157 weekday diaries; N = 2,110 weekend diaries) to examine differences in infants' time with a resident father at age 4-19 months according to fathers' duration of leave around the birth. Results showed that those infants whose fathers took 4 weeks' leave or longer spent no more time with their father than did infants whose fathers took a shorter leave or no leave. We observed a positive association between any leave and sole father care on weekend days but not weekdays. The findings suggest that moderate increases in leave duration may not promote greater father involvement in Australia.

Teachers of infants need a large bunch of key ideas and activities of all kinds to unlock in each child the treasures of loving kindness, thoughtful and eloquent use of language, intense active curiosity to learn, willingness to cooperate, and the deep desire to work hard to master new tasks. Teachers can tune in to each child's special personality--especially the child's temperament. There are three primary, mostly inborn, styles of temperament. Some babies are more low-key; they tend to be slow to warm up to new caregivers, new foods, and new surroundings. Others are more feisty and sometimes irritable. Easygoing babies are typically friendly, happy, accept new foods and caregivers without much fuss, and adapt fairly quickly and more flexibly after experiencing distress or sudden change. Here are some ideas that teachers can use during interactions with infants to optimize each child's development.

The focus of this article is to express the importance of early referral to early intervention in the natural environment of a child with feeding disorder. It is also to get the facts about treating feeding disorders early, in order to prevent long-term problems with feeding, to the people who are in any way involved in the life and care of an infant who is not eating enough by mouth. All states currently have an early intervention program. Therapy services must take place in the child's natural environment whenever possible, because evidence shows therapy is better carried out if worked into the child's daily routines. The natural environment is usually in the family home or the child's daycare. In all states, there exist certain conditions that can automatically qualify a child for early intervention services. The author discusses how to qualify for early intervention services and present three common scenarios depicting the eligibility determination process and its possible outcomes.

Finding high-quality infant care continues to be challenging for many families. Such challenges are even greater for single mothers with limited resources and English language skills. Several years ago, this challenge formed the basis for an urban, center-based program called the Pregnant-Mothers Support Group (PSG). The PSG served single, pregnant women with low incomes who met Early Head Start eligibility criteria and needed infant care for their soon-to-be-born babies. The PSG provided a unique opportunity for pregnant women to explore some of these issues for themselves within a supportive setting. This article discusses how PSG provided opportunities for mothers to share information and build support systems and networks with each other and how attending the meetings helped mothers learn, strengthen, practice, and apply interpersonal skills in their everyday lives. ["Optimizing Mothers' Social Networks: Information-Sharing Strategies" was written with Liana Giannoni.]

Teacher research served as both the content and frame of analysis for this study. Parallel teacher research projects took place over the course of a year as preservice teachers engaged in their first experience with teacher research as part of an infant-toddler development course and the first author (their instructor) engaged in teacher research of her own to assess the effectiveness of this project in enhancing the students' professional preparation to work with families of infants and toddlers. Seven preservice teachers who ranged from 20 to 49 years of age participated. Students engaged in research training, conducted parent interviews, collaboratively analyzed their findings, and advocated for parents by giving presentations at the local and national level. Data collected included student reflections, a postproject survey, and the first author's reflections on her teaching practices. Qualitative findings regarding the students' experiences and construction of knowledge throughout the project are shared in addition to the first authors' reflections on the lessons she learned as a teacher educator during this primarily student-led project. Implications for teacher education practices are included.

One hundred ten Mexican American adolescents (12-17 years) who provide infant care for their older sisters were studied to determine the effects of family caregiving responsibilities on adolescents' adjustment. Controlling for prior adjustment and family context factors, providing many hours of caregiving predicted an increase in youths' school absences and disciplinary problems. Frequent conflict surrounding caregiving was associated with increased stress and depression and lower school grades. Older girls appear to select into caregiving and experience the most problematic outcomes. Strong family obligations were not protective against caregiving stress but, rather, further compromised youths' well-being for those who were highly involved in their family's care.

High school chemistry can be intimidating to some students, so it is critical that we engage students in nonthreatening preparatory investigations during middle school. Based on the learning cycle model (Bybee and Landes 1990), this lesson invites students to investigate disposable diapers. As they explore the properties of sodium polyarcylate, a super-absorbent polymer exposed to water and simulated urine (colored salt water), students practice many inquiry skills: observation, measurement, graphing, and data analysis. (Contains 4 figures.)

Maternal characteristics can affect a mother's decision to breastfeed. This study used a cross-sectional design to assess maternal variables and infant feeding patterns among nursing mothers attending an immunisation clinic in Ibadan, Nigeria. A total of 264 mothers who consecutively attended the immunisation clinic and met certain inclusion criteria were interviewed. A majority of mothers (204, 77.2%) were in the middle of the reproductive age span (24-35 years); 180 (68.2%) had attended tertiary educational institutions. Almost all the mothers (257, 97.3%) had good knowledge about exclusive breast-feeding. Exclusive breast-feeding decreased with the age of the infant; by six months of age, only 40% of infants were exclusively breastfed. Of the mothers who practiced exclusive breast-feeding, 30 (18.5%) initiated breast-feeding within 30 minutes after birth. There may be a need to increase the emphasis placed on the time that complementary feeding should be introduced. (Contains 3 tables.)

Women's cradling side preference has been related to contralateral hemispheric specialization of processing emotional signals; but not of processing baby's facial expression. Therefore, 46 nulliparous female volunteers were characterized as left or non-left holders (HG) during a doll holding task. During a signal detection task they were then asked to detect the emotional baby faces in a series of baby portraits with neutral and emotional facial expressions, presented either to the left or the right visual field (VFP). ANOVA revealed a significant HG x VFP interaction on response bias data (p less than 0.05). Response bias was lowest when emotional baby faces were presented in the visual field of cradling side preference, suggesting that women's cradling side preference may have evolved to save cognitive resources during monitoring emotional baby face signals. (Contains 1 figure and 1 table.)

While there has been extensive research exploring quality in childcare programs for children older than three years, less attention has been directed to the nature of infants' experiences in centre-based childcare programs. In this study, six childcare workers and six centre directors located in centre-based childcare programs in metropolitan Australia were interviewed about their beliefs about quality care and training for infants. In each of the participating centres, the infant programs were also observed using an observational measure that focused on the nature of adult-infant interactions. Both centre directors and childcare workers expressed beliefs that quality in infant care was related to affective dimensions (e.g. care, love, attention) and programming for infants' learning and development. They also expressed views that infant care training should have a strong practical focus to provide the necessary knowledge and skills for interacting with infants. Only centre directors discussed beliefs about quality programming explicitly in terms of the impact on infants' learning. Further, the centre directors were more likely to reflect on the nature of staff learning when engaged in infant care training programs. Implications for training are discussed. (Contains 2 tables.)

University training clinics offer state-of-the-art treatment opportunities for clients, particularly for underserved and underinsured client populations. Little has been published regarding the implementation of Dialectical Behavior Therapy (DBT) in settings such as a university training clinic, which may face challenges in utilizing such a comprehensive treatment. This single-case study describes the application of a DBT-informed treatment with a female BPD client, highlighting how the modifications made can ease implementation in a rural university training clinic. Data collected from DBT diary cards document minimal time demands required for the use of between session-coaching, along with clinically meaningful changes in suicidality and misery ratings, and effective DBT skill use. A discussion of the unique components and contributions of this case to informing potential DBT modifications within university clinics are presented. (Contains 2 figures.)

Maternal self-efficacy for breast-feeding may contribute to success in breast-feeding. This study aimed to increase breast-feeding self-efficacy and actual breast-feeding through an intervention based on Bandura's self-efficacy theory. A total of 90 pregnant women participated in the study. The women who were assigned to a breast-feeding self-efficacy intervention showed significantly greater increases in breast-feeding self-efficacy than did the women in the control group. Furthermore, at 4 weeks postpartum, women in the intervention group showed a trend toward breast-feeding their infants longer and more exclusively than did those in the control group. Greater increases in breast-feeding self-efficacy were associated with a significantly higher level of breast-feeding. Replicating previous research, breast-feeding self-efficacy was significantly related to concurrent breast-feeding behavior, and high antenatal breast-feeding self-efficacy predicted a higher level of later breast-feeding in control-group women. These findings have implications for breast-feeding support programs and for the potential general utility of self-efficacy-based interventions in health education. (Contains 1 table.)

Infant feeding guidelines recommend exclusive breast-feeding to the age of 6 months; complementary foods should not be introduced before this age. This study examined parent and infant psychosocial determinants of the early introduction of complementary foods. Analyses were conducted on a representative sample of children born in Quebec (Canada) in 1998 (n = 2,223), surveyed through the Quebec Longitudinal Study of Child Development. Of the children, 61% received complementary foods prior to the age of 4 months. A multiple logistic regression analysis revealed the early introduction of complementary foods was more likely when mothers were younger, less educated, of lower socioeconomic class, and when they felt they had little influence on their child's development. Higher parental confidence in caring for the infant was also associated with the early introduction of complementary foods (p [less than or equal] 0.05). Future research must carefully consider the psychosocial aspects involved in adhering to infant feeding guidelines. (Contains 3 tables.)

The authors designed an active learning project for a child development course in which students apply core concepts to a hypothetical baby they "raise" during the term. Students applied developmental topics to their unique, developing child. The project fostered student learning and enthusiasm for the material. The project's versatility makes it easily adaptable to a wide variety of courses and formats depending on instructor objectives or student population. Furthermore, the project avoids obstacles that commonly underlie instructor reluctance when considering the implementation of role-play assignments. (Contains 1 table.)

The quality of care offered in four different types of non-parental child care to 307 infants at 10 months old and 331 infants at 18 months old was compared and factors associated with higher quality were identified. Observed quality was lowest in nurseries at each age point, except that at 18 months they offered more learning activities. There were few differences in the observed quality of care by child-minders, grandparents and nannies, although grandparents had somewhat lower safety and health scores and offered children fewer activities. Cost was largely unrelated to quality of care except in child-minding, where higher cost was associated with higher quality. Observed ratios of children to adults had a significant impact on quality of nursery care; the more infants or toddlers each adult had to care for, the lower the quality of the care she gave them. Mothers' overall satisfaction with their child's care was positively associated with its quality for home-based care but not for nursery settings. (Contains 8 tables and 1 note.)

Popular culture today characterizes middle-class parents as being consumed with anxiety about their children. Drawing on more than 100 consumer reviews of baby monitors published on Epinions.com, the author examines how parents respond to that anxiety. Although Epinions.com reviewers are not representative of the population at large, they do represent married, well-educated women. The author demonstrates that in their discussions of monitors, parents normalize parental anxiety and that they depict the baby as both fragile (and thus in need of care) and mischievous (and thus in need of control). In addition, the author shows that as parents adapt to the anxieties associated with parenting by monitoring their babies, they gain some forms of freedom while accepting tethering and that they gain the new skills of interpretation through technology. In the conclusion, issues are raised about the links between parental monitoring of babies and increasing surveillance in contemporary society. (Contains 8 notes.)

In this article, interviews with eight managers and questionnaires from 75 practitioners are analysed to explore their perceptions of the role of pacifiers (or dummies) within the nursery. Managers and practitioners source their knowledge from the media, family/friends, and short professional speech and language courses; however, their perceptions of pacifiers derive from mainly contested research that has filtered into the public domain. This creates tensions between perceived parental rights to offer a child a pacifier, current UK guidelines and participants' own, often ambivalent, views. The article engages with Foucauldian concepts to explore how authoritative knowledge filters into everyday practice and to deconstruct relations of power within the early years setting.

A randomized controlled trial involving 128 infants born prematurely compared basic developmental care (nests and incubator covers) and the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) intervention (behavior observations and guidance by a trained developmental specialist) in relation to effects on parental stress and infant behavior and temperament during the first year of life. Children in the NIDCAP group who received intervention for more than 1.5 months demonstrated more social-relatedness behavior at 1 year. Parents in the NIDCAP group reported that the intervention provided positive experiences for them and reported a positive effect on the well-being of their infant. No statistically significant or noteworthy effects were found between the groups on measures of temperament, problem behavior, or parental stress. Implications for NIDCAP implementation are discussed.

The author explores the extent to which infants and toddlers are regularly in the care of nonparental relatives, friends, and neighbors and notes the limited research on the quality of care provided by family, friends, and neighbors. (Note: This article is an excerpt from "Who's Watching the Babies?: Improving the Quality of Family, Friend, and Neighbor Care," published by "ZERO TO THREE" in 2008; ERIC# ED501178.)

It is well-known and documented that the premature birth of an infant and its subsequent hospitalization in the Neonatal Intensive Care Unit (NICU) is a source of considerable stress for parents. However, little is known about the parents' emotional state and functioning during the months following the infant's discharge from the NICU. The present study compares parental stress and perceptions of parental competence among mothers and fathers of preterm infants two months after discharge from the NICU in Israel with those of parents of full-term infants. The findings show that even at this point in time parents of preterm infants still show higher levels of parental stress and lower perceptions of parental competence than do parents of full-term infants. The importance of the findings for the design of intervention and treatment programs is discussed.

Paseos, which are defined as trips away from the mission authorized by the Franciscan priests, were common among Indians baptized at Mission San Francisco during the period between 1700s to 1800s. Indians went on these journeys in order to harvest acorns and other wild foods, to hunt and fish, and to visit friends and family outside the mission. It was documented that baptized Bay Area Indians' responses to the Catholicism the Franciscan missionaries preached were far from uniform. While some Indians appear to have conformed their lives thoroughly to the priests' religion, the actions of others expressed a great deal of ambivalence. Many Indians chose to situate important life events, including birth and death, outside the confines of Mission San Francisco. This article takes a look at the varied religious experiences of the baptized Indians at Mission San Francisco de Asis from 1776-1821. (Contains 4 figures and 58 notes.)

Action Learning is now a well established strategy for reflective inquiry in healthcare. Whilst a great deal is know about action learning there has been inadequate research on the process of learning that takes place, and the impact that this holds for individuals, groups or organisations. This article reports on the findings of 15-month action learning program based in a special care nursery. A realistic evaluation of the program uncovered individual and group journeys and provide evidence that action learning is an effective strategy in practice development. (Contains 2 tables and 1 figure.)

When their infants were 6 months of age, mothers were assessed for self-efficacy (low, moderate, and high illusory control) and knowledge of infant development to determine their impact on mothers' behavioral sensitivity and affect during a feeding task at 9 months (N=70). Mothers' sensory sensitivity to digital images of infants' negative and positive expressions assessed in a signal detection task at 6 months was hypothesized to mediate this relation. Mothers with moderate illusory control exhibited greatest behavioral sensitivity and positive affect. Low knowledge was associated with reduced sensitivity for mothers with low illusory control only. When viewing the negative expression, mothers with moderate illusory control and high knowledge exhibited greatest sensory sensitivity, and mothers with high illusory control and moderate/high knowledge were least sensitive. Although sensory sensitivity was not a mediating variable, its relation to both illusory control and subsequent maternal measures during feeding was informative. Although greater sensory sensitivity predicted more sensitive behavior and more positive affect, only for maternal affect was the relation independent of illusion of control effects.

This paper explores factors related to the use, amount and type of non-maternal child care infants experience in their first year, reporting on a prospective longitudinal study of 1201 families recruited from two different regions in England. The selection and timing of non-maternal child care was investigated within a socio-ecological model that took account of child and family characteristics as well as maternal psychological factors. Family socio-demographic background (education, occupation and income level) was the most consistent predictor of the amount and nature of non-maternal care infants received. Infants who started in non-maternal child care before the age of 3 months were more likely to come from relatively disadvantaged families; in contrast the mothers of infants starting in child care between 4 and 10 months were more advantaged. Disadvantaged families were more likely to use familial care, while more advantaged families were likely to use purchased child care. Children who began non-maternal care later (3-10 months) and spent more hours in care were more likely to be from ethnic minorities (Asian) and have mothers who believed that maternal employment had more benefits and fewer risks for their child. First born children were also more likely to experience non-maternal care after the age of 3 months. Infants rated by their mothers at 3 months as less "adaptable" in temperament and at 10 months as more "fussy" spent more hours in child care. Finally, the type of child care selected was related to the families' socio-economic background, maternal beliefs and attitudes, and birth order. Findings are compared with the US large scale National Institute of Child Health and Human Development (NICHD) study and considered in the light of national policies.

Objective: To study how early father involvement and children's biobehavioral sensitivity to social contexts interactively predict mental health symptoms in middle childhood. Method: Fathers' involvement in infant care and maternal symptoms of depression were prospectively ascertained in a community-based study of child health and development in Madison and Milwaukee, WI. In a subsample of 120 children, behavioral, autonomic, and adrenocortical reactivity to standardized challenges were measured as indicators of biobehavioral sensitivity to social context during a 4-hour home assessment in 1998, when the children were 7 years of age. Mental health symptoms were evaluated at age 9 years using parent, child, and teacher reports. Results: Early father involvement and children's biobehavioral sensitivity to context significantly and interactively predicted symptom severity. Among children experiencing low father involvement in infancy, behavioral, autonomic, and adrenocortical reactivity became risk factors for later mental health symptoms. The highest symptom severity scores were found for children with high autonomic reactivity that, as infants, had experienced low father involvement and mothers with symptoms of depression. Conclusions: Among children experiencing minimal paternal caretaking in infancy, heightened biobehavioral sensitivity to social contexts may be an important predisposing factor for the emergence of mental health symptoms in middle childhood. Such predispositions may be exacerbated by the presence of maternal depression. (Contains 3 figures and 2 tables.)

Recent estimates of Shaken Baby Syndrome awareness suggest that approximately half of all American adults have not heard of the often devastating risks of shaking an infant. Using a sample of 288 undergraduate students, we developed a measure of attitudes around infant care practices. A total of 264 community participants completed a revised survey. Between-group comparisons, exploratory factor analyses, and internal consistency tests were employed to determine the directionality and reliability of any scale structure present in the data. A five factor structure fits the data reliably, and each of these factors seems to represent a unique dimension. Implications for using this measure clinically and preventatively are discussed.

This paper investigates non-maternal infant care in the first year of life, examining the relationships between child care ideals, attitudinal, sociodemographic and psychological characteristics of mothers at three months postpartum and their child care experiences at 10 months. Predictors of child care use, satisfaction with non-maternal care and confidence in the relationship and communication with caregivers are examined. Realising ideals predicted more hours of child care use, although not greater satisfaction. Those with the father or a grandparent as the caregiver were more satisfied, as were mothers with more progressive attitudes to child rearing and to maternal employment. Higher socioeconomic status mothers and those using nurseries were less satisfied. Relationships with caregivers were poorer for those who believed that maternal employment may have more negative consequences for children. (Contains 1 endnote, 5 tables, and 1 figure.)

Using a sample of 42 Korean mothers whose infants are cared for by someone at non-maternal child care facilities, this study first examined both main effects and interaction effects between maternal knowledge of infant development and maternal self-efficacy on parenting behavior. Second, the combined effects of variables of interest in this study including maternal knowledge of infant development, maternal self-efficacy, and parenting behavior on the child developmental outcome were investigated. Significant relationships between maternal knowledge of infant development and parenting behavior and child development outcome were detected. Only main effects of maternal knowledge of infant development were detected. Furthermore, maternal knowledge of infant development was the only significant predictor of infant developmental outcome. Research implications were discussed both on the continuum of findings from previous studies with Western samples and in terms of provision of effective early intervention programs for this targeted population.

For successful communication to exist between a caregiver and infant, the caregiver must feel confident about her/his ability to parent and also have specific and accurate knowledge about the behaviours required for optimal care-giving; lack of this knowledge may lead to feelings of uncertainty and less than optimal communication. Studies indicate that the highest levels of caregiver distress were experienced by caregivers who had low feelings of self-efficacy and infants with functional limitations. Many caregivers of blind infants have high levels of distress and low self-efficacy due to lack of information, resources, and support. Research indicates that a majority of care givers of atypically developing infants are able to "bring the best" to their infants when appropriately supported by a professional or intervention. Infant massage is an inexpensive and easily utilized intervention which may help increase caregiver self-efficacy and promote sensitive communication in dyads where the infant is blind.

Most Family Today share the care of their babies and toddlers with someone else--often an early childhood professional, a teacher, or a family child care provider. Each family and professional must learn to work and make decisions together to support the child's healthy development and to ensure the family's well-being. Although it is the norm for many families, sharing the care isn't always easy. Different people have different caregiving styles, based on their cultural beliefs and values and their childhood experiences. It can be difficult for families to let go and temporarily put their child's care in another's hands--even if the other person is a skilled early childhood teacher. And it can be difficult for teachers to acknowledge and include families in the daily activities of an early childhood setting.

Expanded newborn screening programs and subsequent detection of rare genetic disorders challenge parents and their medical providers to learn about the treatment and management of these disorders. Many people seek medical information on the Internet but may encounter requests for registration or fees, or find that resources are out of date, difficult to understand, or buried in advertisements. The U.S. National Library of Medicine (NLM), a component of the National Institutes of Health, provides web-based resources that address the challenges of newborn screening education. These resources include MedlinePlus[R], Genetics Home Reference[TM], ClinicalTrials.gov, and PubMed[R]. NLM websites are not commercial, do not require registration or fees, and provide varied levels of information for a continuum of audiences from low-literacy consumers to health professionals. Using phenylketonuria as an example, this study describes the information that parents and their medical providers can find through NLM resources. NLM has embraced the digital age and provides the public with reliable, accurate, and up-to-date educational materials. (Contains 1 table and 6 figures.)

The term "pilot study" has been used over the years to describe the evaluation of the many elements involved in deciding whether a proposed condition should be added to a newborn screening (NBS) panel, and until recently, was unilaterally used to describe the evaluation of the assay to be used before the condition was officially adopted by a state for its newborn screening panel. Since Guthrie's introduction of screening for PKU, each time a new condition was added to the panel, the screening assay itself was validated through a population-based trial, in which the test was performed with de-identified samples to avoid association between the test result and the infant. This is considered by the laboratory as the "pilot phase" of adding a new condition. To advance the science of NBS, especially to accommodate new technologies that may provide new types of information (genetic versus physiological) for each new condition, pilot programs are essential. Involvement of the clinical community serves to improve these evaluations and provides the needed clinical validation of decisions made as a result of it. This paper describes the historical context of pilot programs in population-based NBS that utilize laboratory-based markers as indicators of concern; specifically, three applications that demonstrate different approaches to the use of pilots in adding conditions to a NBS panel are described.

Newborn screening and genetic technologies are expanding and changing rapidly, increasing the demand for genetic specialty services. Because of the scarcity and geographic maldistribution of genetic specialty services, access to these services is a critical issue. This article discusses some of the efforts initiated by the Maternal and Child Health Bureau of the Health Resources and Services Administration, particularly the establishment of regional genetic and newborn screening collaboratives to improve access to these services and expertise. (Contains 1 table.)

Newborn screening has existed as a state-based public health service since the early 1960s. Every state and most territorial jurisdictions have comprehensive newborn screening programs in place, but in the United States a national newborn screening policy does not exist. This results in different administrative infrastructures, screening requirements, laboratory and follow-up services, medical management approaches, and related activities across the country. Federal initiatives and support have contributed to limited evaluations of various aspects of individual newborn screening programs at the national level, but funding is an issue. The national evaluation strategies have taken various forms, all with the intent of improving the screening system through review of actions taken and suggestions for future improvements. While participation in the national evaluation effort for newborn screening laboratory practices includes all US programs, and this has aided in improving quality and harmonizing protocols, other national evaluation activities have been only moderately successful. National data reporting of quality indicators for various program elements must be comprehensive and timely, and the elements must be universally accepted in order to meet the evaluation and improvement needs of the national newborn screening system. A comprehensive real time national evaluation activity will likely require additional resources and enforcement incentives. Limited federal actions through grant incentives and selected reporting requirements provide a possible means of stimulating programs to participate in national harmonization efforts. (Contains 3 tables and 1 figure.)