735Dynamics and Determinants of Birth Spacing in India

Background Birth spacing is an important determinant of the high fertility populations and has a strong bearing on maternal and infant health. The birth interval is composed of three major components namely postpartum amenorrhoea (PPA), waiting time to conception and gestation. To manage the high fertility in India, the present study is aimed to investigate the differential pattern of duration of birth interval components with respect to various socio demographic, child mortality, family planning services etc. Methods The data for this analysis was taken from National Family Health Survey 2015-16 (NFHS-4), provides information on population, health and nutrition for India and each State / Union territory. It gathered information from 601,509 households from overall India. Results Cox’ regression explores infant mortality, lactation, use of contraceptive devices, son preference and religion are found significant (P < 0.01) factors on the dynamics of birth interval components After adjustment of the effects of other explanatory variables, duration of breast feeding (P < 0.01), infant mortality (P < 0.01) and family income (P < 0.05) are found to have their significant impacts on the variation of PPA whereas death of previous child in infancy (P < 0.01), sex of previous child (P < 0.05), lactation (P < 0.01), education of mother (P < 0.05), and use of effective contraceptives have are found to be significant factors influencing the duration of waiting time to conception. Conclusions Among the determinants, infant mortality, lactation and religion have significant impacts on both duration variables in the Cox’s stepwise regression models. Key messages To control the growth of population, birth spacing must be maintained.

Association of abnormal fetal echocardiography with some obstetric records

Background To evaluate the history of some obstetrical records of pregnant women who were referred for fetal echocardiography for any reason. Methods This was a retrospective study on 1772 documents of referred pregnant women, which was conducted in Narges diagnostic clinic staff (Ahvaz city, Iran) from 2017-2020. In this study, all document data of pregnant women who referred for fetal echocardiography for any reason have been reviewed. Results Our study showed that there is a significant relationship between abnormal fetal echocardiography with history of miscarriage, stillbirth and a previous child with Down syndrome. Conclusion Although our study showed that abnormal fetal echocardiography was associated with stillbirth, miscarriage, and a history of having a previous child with Down syndrome, but many cases had abnormal echocardiography didn't have a history of having a previous child with CHD, increased NT and high-risk aneuploidy screening test.

Brachial plexus injury in the child

Obstetric brachial plexus palsy (OBPP) was first described by the Scottish obstetrician William Smellie in 1779 who described, in a newborn, a case of unilateral arm paralysis which rapidly recovered. He attributed this palsy to compression of the axillary nerve against the humerus, probably wrongly in light of subsequent knowledge. The main risk factor for OBPP is high birth weight (>4000 g) and intrapartum shoulder dystocia causing traction on the brachial plexus. It has been demonstrated in cadaveric models that traction on the arm with the neck laterally flexed in the opposite direction causes rupture or avulsion of the brachial plexus. Upper roots are more likely to rupture due to strong ligamentous attachment to the spine whereas the lower roots are more likely to be avulsed. For unknown reasons, however, in the rare circumstance of small babies born breech, upper root avulsion is common. Other risk factors for OBPP include a previous child affected, prolonged labour, instrumented delivery, and multiparity, although each of these may be a surrogate for large birth weight.

Breastfeeding Practice and Association between Characteristics and Experiences of Mothers Living in Bangkok

Although the benefits of breastfeeding are widely recognized, only 14% of mothers in Thailand exclusively breastfed their children during the first six months of their lives in 2019, which dropped from 23% in 2016. This study aimed to assess the prevalence of exclusive breastfeeding (EBF) up to six months, current breastfeeding patterns, and key determinants that influence six-month EBF among mothers residing in Bangkok, Thailand. A cross-sectional study was conducted using a self-administered questionnaire survey. In total, 676 healthy mothers living in Bangkok, whose most recent child was between 6 and 18 months old, were recruited. Descriptive statistics, univariable analysis by Chi-square test, and multivariable logistic regression were performed to assess the association between six-month EBF and maternal characteristics and experiences of using maternal health services. The prevalence of six-month EBF of infants in Bangkok was 41%. The key determinants that influenced six-month EBF included: maternal age of more than 30 years; higher education level; higher maternal income; multi-parity; exposure to breastfeeding advice during pregnancy; intention to breastfeed for a long duration (≥6 months) during pregnancy; experience of six-month EBF in the previous child. This study draws health professionals’ and policy makers’ attention to further promote breastfeeding in particular types of mothers.

Repeated cesarean section and vaginal delivery after cesarean section in São Paulo State in 2012

Objectives: describe mothers, pregnancies and newborns’ characteristics according to the type of childbirth history and to analyze repeated cesarean section (RCS) and vaginal delivery after cesarean section (VBACS), in São Paulo State in 2012. Methods: data are from the Sistema de Informações sobre Nascidos Vivos (Live Birth Information Systems). To find the RCS’s group, the current type of childbirth equal to cesarean section was selected and from these all the previous cesareans. To identify the VBACS’s group all live birth with current vaginal delivery were selected and from these all previous cesareans. Mothers with a history of RCS and VBACS were analyzed according to the characteristics of the pregnancy, newborn and the childbirth hospital. Results: 273,329 mothers of live birth with at least one previous child were studied. 43% of these were born of RCS and 7.4% of VBACS. Mothers who underwent RCS are older and higher educated and their newborns presented a lower incidence of low birth weight. Early term was the most frequent rating for gestational age born of RCS. Live births were of VBACS and had greater proportions of late term. The RCS was more common in hospitals not affiliated with the Sistema Único de Saúde (SUS) (Public Health System) (44.1%). Conclusion: the high RCS’s rates, especially in the private sector, highlight the necessity of improvements in childbirth care model in São Paulo.

Maximizing the impact of the Canada Child Benefit: Implications for clinicians and researchers

Child poverty remains a persistent problem in Canada and is well known to lead to poor health outcomes. The Canada Child Benefit (CCB) is a cash transfer program in effect since 2016, which increased both the benefit amount and number of families eligible for the previous child benefit. While the CCB has decreased child poverty rates, not all eligible families have participated. Clinicians can play an important role in screening for uptake of the program and helping families navigate the application process through several free resources. While prior research on past programs has shown benefit of similar cash transfer programs to both child and parental outcomes (both health and social), the CCB has not yet been extensively studied. Research would be valuable in both assessing the cost effectiveness of the program, especially across different income groups, and improving implementation in hard-to-reach populations.

Pelatihan Pijat Oksitosin Untuk Meningkatkan Cakupan ASI Eksklusif

Mother's milk is the best food for babies in their early years. Mother's milk has proven advantages that cannot be replaced by any food and drink because it contains the most appropriate, complete and always adjusts to the baby's needs at all times. The process of breastfeeding should ideally be done as soon as the baby is born. Exclusive breastfeeding is given to babies for 6 months without additional food. Based on a survey conducted in the Postpartum Room (Nuri Room) of Bhayangkara Hospital, breastfeeding mothers have the motivation to give exclusive breast milk to their children and found that 5 out of 7 mothers did not know how to increase the production of breast milk so that their previous child, was given formula milk when breast milk did not come out / not smoothly. Activities undertaken to overcome the problem in the form of Oxytocin Massage Training. The method used by lecture, discussion, demonstration, simulation, and role play methods.The results obtained are increased knowledge of breastfeeding mothers and families about oxytocin massage that can serve to increase milk production. Air Susu Ibu merupakan makanan terbaik bayi pada awal usia kehidupannya. ASI terbukti mempunyai keunggulan yang tidak dapat digantikan oleh makanan dan minuman manapun karena ASI mengandung zat gizi yang paling tepat, lengkap dan selalu menyesuaikan dengan kebutuhan bayi setiap saat . Proses menyusui idealnya dapat segera dilakukan begitu bayi lahir. ASI eksklusif diberikan kepada bayi selama 6 bulan tanpa makanan tambahan. Berdasarkan survei yang dilakukan di Ruang Nifas (Ruang Nuri) RS Bhayangkara, ibu menyusui mempunyai motivasi untuk memberikan ASI ekslusif ke anaknya dan ditemukan 5 dari 7 ibu tidak mengetahui cara meningkatkan produksi ASI sehingga anak mereka yang sebelumnya, diberikan Susu Formula ketika ASI ibu tidak keluar/tidak lancar. Kegiatan yang dilakukan untuk mengatasi masalah berupa Pelatihan Pijat Oksitosin. Metode yang digunakan dengan metode ceramah, diskusi, demonstrasi, simulasi, dan role play. Hasil yang didapatkan yaitu meningkatnya pengetahuan ibu menyusui dan keluarga tentang Pijat oksitosin yang dapat berfungsi untuk meningkatkan produksi ASI.

The Children's Bill of Mauritius: A critical assessment of key aspects

This article critically assesses the Children's Bill that has been presented as a law that will revolutionise the sphere of children's rights in Mauritius. It is set to replace the Child Protection Act which was way below the required international standard for children's rights. Essential aspects of the Bill are reviewed by using as barometers the United Nations Convention on the Rights of the Child and the African Charter on the Rights and Welfare of the Child. Some of the aspects explored are the principle of the best interests of the child, the protection of the child, the child as a juvenile offender and the Children's Court. The article also compares the Bill to the previous Child Protection Act to evaluate the efficacy of the changes brought about by the Bill.