Maternal Depression and Early Parenting: A Comparison Between Culturally and Linguistically Diverse and Australian born Mothers

Objective: To examine the risk of perinatal depression, parenting stress and infant sleep practices in Australian culturally and linguistically diverse (CaLD) women. Method: Within the Mercy Pregnancy and Emotional Wellbeing Study, we examined 487 pregnant women of whom 52 were CaLD and 435 non-CaLD. Depression was measured using the Structured Clinical Interview for DSM-IV and the Edinburgh Postnatal Depression Scale. In addition, Parenting Stress Index and infant sleep measures were collected. Results: Fewer CaLD women had a depression diagnosis but there were no differences between CaLD and non-CaLD women for perinatal mental health symptoms. More mothers in the CaLD group were bed sharing with their infant during the night at six months; however, bedsharing was only associated with higher parenting stress for non-CaLD mothers. Conclusions: Findings suggest both differences in infant sleep parenting practices and in parenting stress but not general emotional wellbeing. Future research is required to replicate these findings.

Interventions to Improve Safer Sleep Practices in Families With Children Considered to Be at Increased Risk for Sudden Unexpected Death in Infancy: A Systematic Review

Background: Advice to families to follow infant care practices known to reduce the risks of Sudden Unexpected Death in Infancy (SUDI) has led to a reduction in deaths across the world. This reduction has slowed in the last decade with most deaths now occurring in families experiencing social and economic deprivation. A systematic review of the literature was commissioned by the National Child Safeguarding Practice Review Panel in England. The review covered three areas: interventions to improve engagement with support services, parental decision-making for the infant sleep environment, and interventions to improve safer sleep practices in families with infants considered to be at risk of SUDI.Aim: To describe the safer sleep interventions tested with families with infants at risk of SUDI and investigate what this literature can tell us about what works to reduce risk and embed safer sleep practices in this group.Methods: Eight online databases were systematically searched in December 2019. Intervention studies that targeted families with infants (0–1 year) at increased risk of SUDI were included. Studies were limited to those from Western Europe, North America or Australasia, published in the last 15 years. The Quality Assessment Tool for Studies with Diverse Designs was applied to assess quality. Data from included studies were extracted for narrative synthesis, including mode of delivery using Michie et al.'s Mode of Delivery Taxonomy.Results: The wider review returned 3,367 papers, with 23 intervention papers. Five types of intervention were identified: (1) infant sleep space and safer sleep education programs, (2) intensive or targeted home visiting services, (3) peer educators/ambassadors, (4) health education/raising awareness interventions, (5) targeted health education messages using digital media.Conclusion: Influencing behavior in families with infants at risk of SUDI has traditionally focused on “getting messages across,” with interventions predominantly using education and awareness raising mechanisms. This review found evidence of interventions moving from “information giving” to “information exchange” models using personalized, longer term relationship-building models. This shift may represent an improvement in how safer sleep advice is implemented in families with infants at risk, but more robust evidence of effectiveness is required.Systematic Review Registration:https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/901091/DfE_Death_in_infancy_review.pdf, identifier: CRD42020165302.

Pengaruh Metode Kangguru terhadap Penurunan Suhu Tubuh, Frekuensi Menyusu dan Durasi Tidur Bayi

Immunizations sometimes have side effects once they are given to babies. DPT immunization is one that has a low-grade fever side effect and sometimes results in high fever and seizures. One of the efforts to treat fever in infants is the kangaroo method. Through this method, heat transfer occurs between mother and baby, increasing the frequency of breastfeeding which can meet the fluid needs of the feverish baby and facilitate the baby in increasing the duration of quiet sleep, less crying and less activity. The purpose of this study was to determine the effect of the kangaroo method on decreasing body temperature, feeding frequency and infant sleep duration. Sampling using Porbability Sampling with Simple Random Sampling technique, totaling 30 people and divided into 2 groups of 15 people each, namely the experimental and control groups. The results of the analysis are based on several assumptions of One way MANOVA, namely there is linearity between variables, the data is normally distributed, multicollinearity is not detected and the covariance matrix between groups is assumed to be the same as the Box'M value p = 0.006 > 0.001. The results of the multivariate test showed that there was a significant difference between the two groups with a value of F (3.26) = 49.334, p< 0.001; Wilk’s ʌ 0.149, ƞp2 = 0.851, then the univariate results showed that group differences caused significant differences in body temperature, feeding frequency and sleep duration with p < 0.001. The results of the bonferroni correction further test showed that the average decrease in body temperature, feeding frequency and duration of infant sleep in the experimental group was better than the control group with p < 0.001. This study proves that the kangaroo method has an effect on decreasing body temperature, breastfeeding frequency and infant sleep duration after DPT immunization.

Profile of paediatric sleep patients and polysomnography findings: Experience from an exclusive paediatric sleep clinic in India

Objectives: The objectives of the study were to describe the profile of patients attending an exclusive paediatric sleep clinic in India. Materials and Methods: Children aged 1 month–18 years, attending an exclusive paediatric sleep clinic, were assessed using standardized questionnaires. Children underwent sleep coaching, were treated medically, or underwent polysomnography based on the decision of the paediatric pulmonologist. Level 1 polysomnography was conducted by trained personnel. Results: Of 186 children, 36.5% were for infant sleep issues, 24.7% suspected obstructive sleep apnea (OSA), 18.2% neuromuscular diseases with sleep problems, 15.6% genetic disorders with sleep problems, 4.3% parasomnias, and 0.5% abnormal movements during sleep. Of the 85 paediatric polysomnographies conducted, 9.4% were normal studies, 87% had OSA, 1.1% restless leg syndrome, and 2.3% were inadequate studies. Conclusion: Sleep disorders in children are not uncommon and paediatricians need to be aware and identify them early. More number of exclusive paediatric sleep clinics need to be established in India.

Child maltreatment severity and sleep variability predict mother–infant RSA coregulation

Regulatory processes underlie mother-infant interactions and may be disrupted in adverse caregiving environments. Child maltreatment and sleep variability may reflect high-risk caregiving, but it is unknown whether they confer vulnerability for poorer mother–infant parasympathetic coordination. The aim of this study was to examine mother–infant coregulation of respiratory sinus arrhythmia (RSA) in relation to child maltreatment severity and night-to-night sleep variability in 47 low-income mother–infant dyads. Maternal and infant sleep was assessed with actigraphy and daily diaries for 7 nights followed by a mother–infant still-face procedure during which RSA was measured. Higher maltreatment severity was associated with weakened concordance in RSA coregulation related to the coupling of higher mother RSA with lower infant RSA, suggesting greater infant distress and lower maternal support. In addition, higher infant sleep variability was associated with infants’ lower mean RSA and concordance in lagged RSA coregulation such that lower maternal RSA predicted lower infant RSA across the still-face procedure, suggesting interrelated distress. The findings indicate that adverse caregiving environments differentially impact regulatory patterns in mother–infant dyads, which may inform modifiable health-risk behaviors as targets for future intervention.