Search Results (728)

Background: Short sleep and formula feeding during infancy are associated with increased risk of childhood obesity. Feeding practices and sleep arrangements vary during infancy and may also be dynamic, yet their impact on infant night sleep duration remains unclear. Understanding these relationships is crucial for formulating recommendations to support breastfeeding and address sleep concerns. Objective: We examined the association between feeding mode and parent-reported infant night sleep duration during the first postnatal year, while additionally evaluating night-weaning and bedsharing as contextual sleep-related practices. Methods: Infants in the Phoenix Metropolitan Area (n = 193) were followed up at 3, 8, 13, 26, 39, and 52 weeks post-birth. Sleep and feeding questionnaires were answered at each visit. A multilevel growth model estimated infant night sleep duration trajectories by feeding mode (ordinal: exclusive formula, mixed, exclusive breastfeeding), night-weaning, and bedsharing as time-variant predictors. Maternal education and household income were covariates to account for differences in study attrition. Results: Infant night sleep duration followed a curvilinear trajectory, starting at 7.92 h (95% CI: 5.78, 10.06) and increasing by 0.40 h/month (95% CI: 0.21, 0.60), with a deceleration over time (0.02 h/month², p < 0.001). Each increase in levels of breast milk consumption was associated with an increase in infant night sleep duration (B = 0.87 h, p < 0.001), but the association weakened as the infant aged (B = −0.07 h/month, p < 0.001). Despite 59.7% of bedsharing infants being exclusively breastfed, bedsharing was not significantly associated with infant night sleep duration. Similarly, night-weaning was not significantly associated with infant night sleep duration. Conclusions: Breastfeeding is associated with longer infant night sleep duration, whereas bedsharing showed no association despite its correlation with breastfeeding. This research highlights the importance of breastfeeding in early life, not only for its developmental benefits but also for its relationship with infant night sleep duration, an essential component of healthy infant growth. Full article

Objective: Using a two-point design, this study examined five parental identity development processes as predictors of personal growth following birth among first-time expecting mothers and fathers. Background: Although personal growth during the transition to parenthood has been documented and several factors promoting it have been identified, much remains unknown about what enables people to grow through this experience. Parental identity development, which has been linked to positive adjustment and well-being during this transition, represents an unexplored framework for understanding personal growth during this critical period. Method: A total of 169 first-time expectant parents (97 women, Mage = 31.9, SD = 3.46; 72 men, Mage = 32.1, SD = 3.43) participated in this two-point design study: 1–3 months before birth (T1) and 3–5 months after birth (T2). Results: Women showed an increase in personal growth following birth, while men showed a decrease. Only Identification with Commitment—one of the five parental identity processes—measured before birth predicted personal growth after birth for both genders. Among men, increases in three of these processes were associated with decreases in personal growth. Conclusions: These findings highlight the complex and gendered relationship between parental identity development and personal growth during the transition to parenthood, suggesting that these two frameworks are mutually informative: parental identity processes predict the emergence of personal growth, while personal growth outcomes reveal the complexity and nuance of parental identity formation during this pivotal period. Full article

Legal advocacy for parents involved in the public child welfare system in the United States is typically initiated only after a child has been removed and a dependency petition has been filed. For infants, removal at or shortly after birth constitutes a profound disruption of the parent–child attachment relationship and is increasingly recognized as an adverse childhood experience. This paper focuses on a summative program evaluation of the Family Intervention Response to Stop Trauma (FIRST) Legal Clinic in Washington State, a prevention-oriented model providing free, confidential legal advocacy and peer support to pregnant and postpartum parents prior to Child Protective Services (CPS) investigation or court involvement. Administrative data from 2019 to 2025 for 1232 eligible families were utilized to examine eligibility and referral patterns, reasons for ineligibility, and case outcomes. Findings demonstrated that eligible families with known outcomes avoided dependency court involvement entirely or experienced case closure without child removal, while a smaller proportion proceeded to dependency court filings. These findings highlight the need to reduce unnecessary child welfare system entry and mitigate traumatic disruption of the parent–child attachment relationship at birth by providing legal advocacy before investigation and court involvement. Full article

Background/Objectives: Botanical supplements are increasingly investigated for their potential to address women’s health concerns. Compounds that modulate progesterone receptor (PR) signaling may help manage gynecologic disorders such as endometriosis, uterine hyperplasia, and preterm birth. Because PR ligands often cross-react with the glucocorticoid receptor (GR), this study examined two botanical compounds, paeoniflorin from Paeonia lactiflora (white peony root) and isoorientin from Vitex agnus-castus (chasteberry), that were identified as modulators of GR or PR signaling. Methods: Luciferase reporter assays were performed in OVCAR5, Ishikawa PR-B, and T47D A1-2 cells to evaluate GR and PR signaling. GR target gene expression was measured by qPCR. A receptor binding assay and computational docking were used to assess interaction with GR. Adipogenesis was evaluated in 3T3-L1 cells using Oil Red O staining and FABP4 protein expression by Western blot. Results: Paeoniflorin and isoorientin inhibited dexamethasone-induced GR signaling in OVCAR5 and Ishikawa PR-B cells. In T47D A1-2 cells, a variant of T47D engineered to express GR, both compounds blocked luciferase induction stimulated by progesterone; this effect was not observed in the parental line that expresses PR but lacks GR. In OVCAR5 cells, paeoniflorin or isoorientin combined with dexamethasone downregulated GILZ and DUSP1/MKP1 mRNA. Isoorientin directly bound GR, and computational analysis supported potential binding poses. Both compounds also reduced lipid accumulation during 3T3-L1 adipocyte differentiation and decreased FABP4 expression, consistent with GR antagonist activity and reduced adipogenesis. Conclusions: These findings identify paeoniflorin and isoorientin as botanical modulators that suppress GR signaling and limit GR-dependent adipogenic responses across multiple cell-based models under controlled in vitro conditions. Full article

Objectives: This longitudinal study examined the association of parents’ dental anxiety during early pregnancy with the stability of brushing their own and their children’s teeth from the age of one to four years. Methods: The study used data from the FinnBrain Birth Cohort Study, which included 816 mothers and 379 fathers who completed questionnaires on dental anxiety at gestational week 14 and on toothbrushing frequency for themselves and their child at the ages of 1, 2, and 4 years. Dental anxiety was assessed using the Modified Dental Anxiety Scale. The stability of toothbrushing was categorized as stable good (twice daily or more at all time points), fluctuating, good at 4 years (fluctuates over time points, but good at age 4 years), fluctuating, poor (less than twice daily) at 4 years (fluctuates over time points, but poor at age 4 years), stable poor (poor at all time points). Unordered multinomial logit models regarding the association of parents’ dental anxiety on brushing their own and their children’s teeth were adjusted for education, and education and parents’ own toothbrushing, respectively. Results: Compared to the mothers who brushed their teeth twice daily throughout the study (“stable good”), those belonging to the “fluctuating, good at 4 years” group and those belonging to the “stable poor/poor at 4 years” group were more likely to have higher dental anxiety (OR = 1.07, 95% CI = 1.01–1.13 and OR = 1.04, 95% CI = 1.00–1.08, respectively). This association was not found among fathers. Parents’ dental anxiety was not associated with the brushing of their children’s teeth. Conclusions: Attending to the mother’s dental anxiety during pregnancy could improve her toothbrushing. Full article

Retinopathy of Prematurity (ROP) affects preterm infants worldwide, involving abnormal development of retinal blood vessels associated with supplemental oxygen use in neonatal care. Although there have been strides in identifying at-risk infants, implementing early screening, updating disease criteria through the International Classification of Retinopathy of Prematurity (ICROP), and developing new therapies, ROP remains a leading cause of preventable blindness. As preterm birth survival rates rise, the incidence of ROP continues to increase and is projected to rise even in countries with abundant resources and well-established care programs. Improving ROP care requires global standardization of screening, diagnosis, and management to prevent missed diagnoses and minimize outcome variability. Intravitreal anti-vascular endothelial growth factor (VEGF) injections are changing the landscape of ROP management, but longitudinal research is needed to determine their long-term safety in preterm infants. Effective ROP management relies on teamwork across disciplines and open communication with parents. Given that parents are lifelong caregivers of a child who may be affected by ROP-related vision impairment, including them in the care team and encouraging psychosocial support is vital. Socioeconomic disparities and limited access to ROP-trained ophthalmologists exacerbate disease burden, underscoring the need for innovative solutions to improve access to care. This perspective emphasizes the importance of globally standardizing ROP prevention and care, noting that efforts are still incomplete, equitable access has not been realized, and the long-term role of anti-VEGF agents in ROP treatment remains unclear. Full article

Background/Objectives: Seasonal influenza vaccination is pivotal for protecting high-risk populations, including those with chronic health conditions (CHCs), from severe complications and outcomes. This study aims to describe the sociodemographic characteristics of unvaccinated children (6 months–17 years old) with CHCs, the reasons why vaccine hesitant parents chose not to vaccinate their children, and the factors associated with seasonal influenza non-vaccination among these children. Methods: This cross-sectional analysis used a sub-sample from the 2023 Childhood COVID-19 Immunization Coverage Survey, which captured data between April and July 2023. Parent and child characteristics were explored, using frequencies and proportions. Weighted unadjusted, partially adjusted (with child age and sex at birth), and fully adjusted multivariable quasi-Poisson models were designed to identify socio-demographic factors associated with seasonal influenza non-vaccination. Results: A total of 649/1187 (55%) children with CHCs were unvaccinated against influenza during the 2022–2023 influenza season. Vaccine hesitant parents with unvaccinated children expressed concerns with vaccine effectiveness (39.1%) and safety (27.5%), as did parents who refused vaccination for their child (56.1% and 35.8%, respectively). Unvaccinated parents (RR: 4.549, 99% CI: 4.480, 4.619) and parents with low household income (RR: 1.428, 99% CI: 1.400, 1.456) were more likely to have unvaccinated children, whereas children who received an annual influenza vaccine (RR: 0.097, 99% CI: 0.094, 0.100) and did not have a disability (RR: 0.913, 99% CI: 0.904, 0.922) had a lower likelihood of non-vaccination. Conclusions: These findings highlight the need for renewed messaging and educational resources targeting vaccine hesitancy and misinformation prevalent among parents with vulnerable youth. Full article

Background: Birth asphyxia is a leading cause of neonatal mortality. More than half of these deaths are due to low-quality care. Objectives: To describe the frequency, sequence, timing, and duration of interventions after birth and newborn outcomes. Methods: This prospective observational study in rural Tanzania included newborns ≥28 weeks gestation. Trained research assistants observed and recorded all deliveries and resuscitations 24 h a day, 7 days a week, logging interventions in real time using the Liveborn Observation app. Results: Of 2564 newborns born, 2431 (94.9%) were enrolled in the study. Macerated stillbirth (n = 52), newborns with no parental consent (n = 67) or incomplete Liveborn data (n = 14) were excluded. Additionally, 2193/2431 (90.2%) newborns did not receive bag-mask ventilation (BMV), and 1755/2431 (72.2%) started breathing before 30 s from birth at median (quartiles) 6 (3, 13) s, 438/2431 (18.0%) started breathing beyond 30 s at 49 (38, 67) s. Moreover, 238/2431 (9.8%) received BMV at 82 (54, 120) s after birth, 1/3 within the first min. Finally, 159/238 (66.8%) were suctioned for 26 (17, 40) s. The first suction sequence was initiated at 44 (24, 78) s after birth. In 24/238 (10.1%) newborns, BMV continued for more than 10 min, with an increased risk of dying within 24 h (RR = 4.26, 95% CI; 1.3–10.0, p = 0.016) and seven days (RR = 8.14, 95% CI; 3.5–17.6, p < 0.001) compared to those ventilated for less than 10 min. Conclusions: Almost 10% of newborns received BMV at birth, but only one-third were ventilated within the first recommended minute. Excessive use of suctioning likely delayed the start of BMV, and prolonged ventilation beyond 10 min was associated with higher mortality. Full article

Background: Mutations in the retinoblastoma gene (RB1) are associated with risks of both retinoblastoma and other cancers. Parents of children with retinoblastoma can be categorised according to their likelihood of carrying a germline RB1 mutation. Some categories of such parents may have an increased risk of cancer. Methods: A cohort of 1180 parents of children with retinoblastoma were categorised according to the likelihood that they carried an RB1 mutation and followed up for cancer through national records. We calculated Standardised Incidence Ratios (SIRs) for all non-ocular cancers combined and for individual diagnostic groups, with expected numbers derived from national cancer registration rates. Finally, we pooled the all-cancers results from the present study with those from an earlier study of largely the same cohort with non-overlapping follow-up. Results: In total, 183 non-ocular cancers were identified among the parents. Parents who themselves had retinoblastoma had a significantly higher risk of non-ocular cancer than the general population: for fathers, the SIR was 3.56 (95% confidence interval (CI) 1.84–6.22); for mothers, it was 3.25 (1.49–6.18). For the very small group of parents known to be carrying a germline RB1 mutation but not affected by retinoblastoma, there was a lower and non-significant increase in risk (SIR = 1.9). Parents categorised as either possible carriers or probable non-carriers had similar observed risks to the general population. When the all-cancers results were pooled with those from an earlier study of very largely the same cohort with non-overlapping follow-up, the estimated lifetime SIR for non-ocular cancer among mutation-carrier parents after the birth of their affected child was 4.32 (95% CI 3.06–5.93). Conclusions: Our results confirm that parents who themselves had retinoblastoma have an increased risk of subsequent cancers, and parents who are not mutation carriers have a risk similar to the general population. Full article

Background: Despite the introduction in 2017 of mandatory vaccination for the hexavalent and the measles–mumps–rubella–varicella vaccines, childhood vaccination coverage in Sicily (Italy) remains below the recommended and safety threshold of 95%. A catch-up vaccination intervention was implemented for the pediatric population of the 2022–2023 birth cohorts residing in a health district of Palermo (Bagheria) where in 2024, 24-month coverage for polio and measles was 77.29% and 77.62%, respectively. Methods: A cross-sectional study with a before–after component was conducted between June 2025 and December 2025, with the aim of evaluating the increase in vaccination coverage. A questionnaire was administered to the parents of non-compliant children to investigate the determinants of infant vaccine hesitancy. Results: Collaboration with primary care pediatricians and the organization of active call sessions and extra vaccination sessions resulted in an increase in vaccination coverage of approximately 10–12 percentage points in both birth cohorts. The investigation of the determinants of vaccination adherence showed some significant associations: “perception of infectious disease risk” (OR: 7.91; p = 0.009) and “expectations of a positive outcome from vaccination” (OR: 8.62; p = 0.003). Vaccine information sources such as the internet and media were associated with refusal of catch-up vaccination (OR: 0.47, p < 0.001; and OR: 0.13, p = 0.026, respectively). Conclusions: Despite methodological limitations, such as the self-reported nature of the survey data, the study demonstrated the usefulness of local strategies aimed at vaccination catch-up, representing a valuable example of local public health practice and effectively contributing to improved vaccination coverage in the pediatric population. Full article

Aims: This study aimed to examine the associations between both birth weight (BW) and body mass index (BMI)/waist circumference (WC) measured at ages 7–10 years, and adolescent overweight (OW)/obesity (OB), and central OB at ages 11–13 years. Methods: Longitudinal data were collected from children’s and parents’ questionnaires. Anthropometric data were obtained from health check-ups. BW (kg) was categorized into three groups: <3.0, 3.0–3.9 and ≥4.0 (macrosomia). Underweight (UW)/normal weight (NW), OW and OB were defined based on sex- and age-specific reference values for Chinese children. Central OB was identified using the sex-specific waist-to-height ratio (WHtR) cutoffs. Results: Of the 1204 children, 14.5% had a BW < 3.0 and 15.6% had macrosomia. The rates of OB and central OB were 10.13% and 28.32%, respectively, among children aged 7–10 years and 6.23% and 23.34%, respectively, among those aged 11–13 years. An increasing BW z-score was associated with higher odds of OW/OB in girls aged 11–13 years. Childhood BMI and WC z-scores were associated with higher odds of OW/OB and central OB, respectively, at ages 11–13 years. Childhood OW/OB and central OB were associated with a higher risk of OW/OB and central OB, respectively, at ages 11–13 years. Conclusions: BW was modestly associated with OW/OB in girls. Childhood BMI was the strongest predictor of OW/OB, while childhood WC was a strong and significant predictor of central OB in early adolescence. These findings highlight that early school age is a critical period for risk identification and the implementation of future preventive strategies. Full article

Uterine malformation represents a rare disease with a prevalence of up to 7% of the general population. Background/Objectives: Higher pregnancy complication rates have been reported in the literature; thus, in our study, we aimed to examine not only the obstetric complications encountered but also the psychological interventions and multidisciplinary approaches for parental counseling in our department in the context of preterm birth at the limit of viability. Methods: A retrospective pilot study was conducted on all the women in our department between 2010 and 2017 with congenital uterine malformations associated with infertility or pregnancy. In the study group, we included women with AUCs (n = 26), while the control group included pregnant women with normal uteri (n = 25) (total: n = 51), and then pregnancy complications were investigated. Results: Highly significant pregnancy complications were observed in the study group, the most important being preterm birth (p = 0.003) in comparison with the control group. Out of 26 patients with AUCs, only 14 gave birth to a live fetus compared to 22 out of the 25 with normal pregnancies, meaning that failure to give birth to a live newborn statistically significantly increased among the former group (p = 0.004). In terms of birth weight (p = 0.0001), Apgar score (p = 0.029) and intensive care unit admission (p = 0.0001), we observed significant differences between the newborns in the study group versus controls, with an impact on mental state that required psychological support. Conclusions: A clear correlation was observed in our study between uterine congenital malformations and pregnancy complications. The most common pregnancy outcome was premature delivery, with statistical significance. In addition, higher neonate admissions to the intensive care unit associated with lower Apgar scores were encountered compared with normal pregnancies. Appropriate parental counseling by obstetricians, neonatologists and psychologists could enhance pregnancy outcomes. Full article

Social capital has been well established to have beneficial effects on a variety of behavioral, developmental, and health outcomes across the life course. In particular, social capital has been proven to be a protective factor benefiting health, particularly among young people. However, we know little about whether or how social capital might provide a protective effect against a very specific mental health challenge of young and mid-adult life: experiencing postpartum depression. Using linear regression models and restricted-use data from the National Study of Adolescent to Adult Health (five waves conducted beginning in 1995 when respondents were in grades 7–12 and following them into adulthood) on women who gave birth during early adulthood, and controlling for a variety of demographic factors (such as race, parental and partner social capital, SES), we aim to understand potential associations between social capital derived from families and romantic partners and postpartum depression symptomology. Our findings suggest the need for approaches that help pregnant women build and maintain key social connections and resources with fathers and partners. Full article

The adoption of the Anishinabek Nation Child Well-Being Law (ANCWBL) has given birth to a framework for Indigenous communities in Ontario, Canada, to exercise self-determination in governing child and family services, including service delivery and authority over policy and funding. This means an end to child and family services agencies that serve First Nations on reserves and are bound by provincial standards and legislation following a protection-based model. Instead, it begins a system of customary care that genuinely respects and supports the primary role of parent/guardian, family, and community in prevention-focused child welfare in accordance with standards based on Anishinabek cultures and the practice of consent. This conceptual essay highlights an Indigenous feminist perspective on the ANCWBL’s significance and its ability to address the historical suffering stemming from colonial child welfare practices and to institute child and family services by reinstating the rights of Indigenous children and women’s leadership in care as a communal responsibility. Full article

This study co-designed and developed multimodal educational games in collaboration with parents and teachers to engage girls in STEM from early childhood onward. Recent studies examine the supportive and complementary role of digital educational technology, such as multimodal games, in engaging girls in STEM education during primary and secondary schooling. Different skills, such as computational thinking, mathematical and scientific skills, can be developed via simulations, models, narrative-rich videos, and digital games. However, there is limited research on how parents and teachers perceive how multimodal games can engage children, especially girls in STEM, in early years learning environments, both at home and in formal educational classroom play-based learning contexts. Employing a multi-case study approach, the study conducted focus group discussions (N = 10) with 15 parents and 15 teachers of children from birth to 8 years of age. The theoretical framework underpinning Bronfenbrenner’s socioecological lens guided the thematic data analysis, particularly acknowledging theoretical ideas that a young girl’s natural learning environment comprises parents, siblings, peers, and early childhood professionals (e.g., educators) who play an essential role in the development of a child’s early STEM engagement. Findings indicate the essential role of the pedagogue (both parents and educators), with multimodal technologies (games) acting as the third teacher, being critical in scaffolding girls’ early STEM education by capitalising on multimodal learning environments. Implications pertain to designing hands-on, multimodal games that enable children to engage seamlessly with science and mathematics concepts through a variety of design features, including problem-solving, doing, constructing, role-play, and gamification. Full article