Search Results (284)

Obesity is a multifactorial condition that influences metabolic, endocrine, inflammatory, circadian, and behavioral systems. These disruptions can adversely affect the initiation of lactogenesis II—the critical process marking the onset of copious milk secretion following childbirth. In mothers with obesity, prolonged inflammation within the mammary gland, a blunted hormonal response (notably of prolactin), altered progesterone and estrogen dynamics, high leptin levels, and misaligned circadian rhythms contribute significantly to delayed lactogenesis. In addition, mechanical difficulties and psychological factors further hinder effective breastfeeding. This report synthesizes evidence from human epidemiological studies and animal models that elucidate the diverse mechanisms linking maternal obesity to delayed lactogenesis. We review the role of obesity-associated inflammatory mediators in impairing mammary tissue remodeling, the endocrine aberrations that impair lactogenic signaling, the consequences of circadian disruption on hormonal rhythmicity, and the behavioral influences that challenge effective breastfeeding. Finally, we discuss the clinical implications of these findings and propose future research directions targeting endocrine modulation, anti-inflammatory therapy, circadian interventions, and enhanced lactation support strategies for mothers with obesity. Full article

Background/Objectives: Internalizing disorders are highly prevalent during adolescence. Previous research has shown that psychological inflexibility (PI) in both adolescents and their parents contributes to internalizing problems. However, how parental and adolescent PI relate to one another in explaining these difficulties remains unclear. The present exploratory study examined whether adolescent PI mediates the relationship between maternal PI and internalizing problems in adolescents. Methods: The study sample included 81 mother–adolescent dyads (80% female adolescents). Mothers completed a general self-report measure of PI, while adolescents completed self-report measures assessing both PI and internalizing problems. Results: The results showed that adolescent PI partially mediated the relationship between maternal PI and internalizing difficulties in female adolescents, whereas the mediation model was not significant for male adolescents. Conclusions: Findings suggest that mothers with high levels of psychological inflexibility may foster similar patterns in their children, particularly in daughters, thereby increasing adolescents’ vulnerability to increased psychological distress. Full article

Objectives: The objectives are to evaluate the influence of different maternal characteristics on ultrasound image quality and operator satisfaction, and to assess, preliminarily, a rating scale to stratify the difficulty level of ultrasound examination in early gestation. Methods: A multicentric observational study of ultrasound scans was carried out on singleton pregnant women undergoing routine gestational ultrasound at 11–14 weeks and 19–21 weeks of gestation at two Prenatal Care Centers in the Apulia region (Southern Italy). Inclusion criteria included the presence of one or more limiting features, i.e., obesity, retroverted uterus, myomas, previous abdominal surgery, and limited echo-absorption. Each woman was given an overall pre-echographic limiting score from 0 to 9. The outcome measure was the operator’s satisfaction with the examination, scored on a Likert scale. Nested linear regression models (raw, semi- and fully adjusted) were built for each of the two trimesters on the pre-ecographic limiting score (0–9 points) as dependent variables, with the operator’s satisfaction as the regressor. Results: The whole sample included 445 pregnant women. The two-center samples did not show statistically different baseline features. The operator’s satisfaction with the sonographic examination was significantly (and inversely) related to the pre-echographic limiting score, regardless of the mother’s age, the operator performing the ultrasound, the Hospital Center where the ultrasound examination was performed, and the duration of the sonographic examination. Conclusions: A number of maternal conditions need to be monitored for good ultrasound performance; using a specific rating scale to stratify the level of difficulty of the ultrasound examination at early gestation could represent a potentially useful tool, although it requires further validation. Full article

Maternal mental illness significantly impacts caregiving, influencing both mothers and their children. This narrative review examines the challenges faced by mothers with conditions such as depression, anxiety, bipolar disorder, and schizophrenia, which often disrupt caregiving routines, emotional stability, and social integration. These difficulties can hinder secure attachments and contribute to adverse developmental outcomes in children, including heightened risks of anxiety, depression, behavioral issues, and cognitive impairments. Children of mothers with mental illnesses are 1.8 times more likely to develop emotional or behavioral problems and face a 2.7 times higher risk of suicidal ideation during adolescence. Intergenerational transmission of mental illness is also prevalent, with affected children showing a 2.5 times greater likelihood of developing mental illnesses in adulthood. Effective interventions include cognitive behavioral therapy (CBT), family-based approaches, and community programs integrating parenting education and mental health resources. These strategies have demonstrated improvements in maternal well-being and child resilience. The review highlights the need for comprehensive policies addressing maternal mental health, early intervention for children, and culturally sensitive support systems to break cycles of intergenerational mental illness. Future research should prioritize evaluating long-term intervention effectiveness and exploring innovative tools like digital mental illnesses solutions to support affected families. Full article

Background/Objectives: Parenting stress, the emotional strain resulting from the demands of child-rearing, can profoundly affect both parental well-being and children’s emotional and behavioral development. This study examined the impact of maternal parenting stress during early childhood on the longitudinal progression of children’s internalizing, externalizing, and attention deficit hyperactivity disorder (ADHD) symptoms, from early childhood through adolescence. Methods: The study included 406 mother–child pairs from the Rhea mother–child cohort in Crete, Greece. Maternal parenting stress was assessed at age 4 using the Parental Stress Scale (PSS). Children’s symptoms were evaluated at ages 4 (Strengths and Difficulties Questionnaire, ADHD Test), 6, 11, and 15 years (Child Behavior Checklist, Conners’ Parent Rating Scale) through maternal reports. Multivariate mixed regression models, incorporating a random intercept for each child and a random slope for age at follow-up, were used to analyze the trajectories of symptoms from ages 4 to 15. Group-based trajectory modeling was applied to identify trajectory groups from 4 to 15 years, and multinomial logistic regression models were implemented to examine the associations between parental stress and group trajectories. Results: The results revealed that higher parental stress at age 4 was significantly associated with increased internalizing (b = 0.94, 95% CI: 0.68, 1.21), externalizing (b = 1.03, 95% CI: 0.75, 1.30), and ADHD symptoms (b = 0.86, 95% CI: 0.58, 1.14) over the study period. Notably, the impact of parenting stress on behavioral problems decreased with age (interaction with age, p = 0.032). Additionally, higher parenting stress at age 4 was linked to a greater likelihood of belonging to adverse symptom trajectories, including high decreasing, low increasing, and stable high trajectories for both internalizing and externalizing problems. Conclusions: These findings underscore the importance of early maternal parenting stress as a predictor of long-term emotional and behavioral difficulties in children, emphasizing the need for early intervention programs that support maternal mental health and children’s emotional development. Full article

Background: Childhood hearing loss is a public health problem of critical importance associated with speech development, academic achievement, and quality of life. Parents’ awareness and knowledge about risk factors contribute to early detection and timely intervention.  Objective: This study aims to examine Jordanian mothers’ knowledge of childhood hearing loss risk factors and investigate the impact of education level and socioeconomic status (SES) on the accuracy and comprehensiveness of this knowledge with the moderating effect of health literacy. Material and Methods: The approach employed an embedded mixed-methods design with a dominant quantitative strand supported by qualitative data, utilizing quantitative surveys (n = 250), analyzed using structural equation modeling (SEM) in SmartPLS, and qualitative interviews (n = 10), analyzed thematically to expand upon the quantitative findings by exploring barriers to awareness and healthcare-seeking behaviors. Results: The accuracy and comprehensiveness of knowledge of hearing loss risk factors were also positively influenced by maternal knowledge of hearing loss risk factors. Maternal knowledge was significantly associated with both education level and socioeconomic status (SES). Furthermore, maternal knowledge and accuracy were significantly moderated by health literacy, such that mothers with higher health literacy exhibited a stronger relationship between knowledge and accuracy. Qualitative findings revealed that individuals encountered barriers to accessing reliable information and comprehending medical advice and faced financial difficulties due to limited options for healthcare services. Conclusions: These results underscore the need for maternal education programs that address specific issues, provide simplified healthcare communication, and enhance access to pediatric audiology services. Future research should explore longitudinal assessments and intervention-based strategies to enhance mothers’ awareness and detect early childhood hearing loss. Full article

Background: Neonatal influenza is a rare condition. Young infants have immature immune defenses and are unable to receive direct vaccination; this can result in significant illness. Maternal anti-influenza immunization during pregnancy provides passive antibodies to the newborn via transplacental transfer, significantly decreasing the incidence and severity of influenza in early infancy. Nevertheless, the vaccination coverage during pregnancy remains low in many regions, leaving certain neonates without adequate protection. Methods: We present three cases of laboratory-confirmed influenza infection in neonates admitted to the “Sf. Ioan” Clinical Emergency Pediatric Hospital in Galați and conduct a literature review. The clinical presentation, co-infections, timing of antiviral therapy, laboratory findings, maternal vaccination status, and outcomes (including the hospitalization duration and recovery) were systematically analyzed for each case. Results: All three neonates were full-term and previously healthy, born to mothers who had not received influenza vaccinations during their pregnancies. They presented at ages ranging from 2 to 4 weeks with fever, respiratory symptoms including a cough, nasal congestion, and respiratory distress, as well as feeding difficulties. One case involved a co-infection with Bordetella pertussis, which manifested as a severe paroxysmal cough, cyanosis, and apnea. Laboratory findings in the cases with influenza alone indicated leukopenia accompanied by normal C-reactive protein levels. In the co-infection case, leukocytosis, lymphocytosis, and thrombocytosis were observed. All the infants received oseltamivir treatment within 48 h of the symptom onset; the case with pertussis co-infection also received azithromycin. Each infant required supplemental oxygen, but none necessitated mechanical ventilation. Clinical improvement was observed in all cases, with hospitalization ranging from 6 to 7 days and complete recovery without complications. Conclusions: Neonatal influenza may result in considerable morbidity, particularly in infants born to unvaccinated mothers. Positive outcomes, however, have been correlated with early diagnosis and antiviral treatment. Pertussis co-infection may exacerbate clinical progression, underscoring the importance of maternal immunization against both influenza and pertussis. In this case series, we aim to present three cases of laboratory-confirmed influenza in neonates born to mothers who were not immunized against influenza during pregnancy. These cases highlight the clinical presentations of neonatal influenza, underscore the risks associated with pertussis co-infection, and reinforce the importance of maternal influenza and Tdap vaccination for preventing severe outcomes in newborns. Full article

Objective: This cross-sectional study examined assumptions about the role of parenting qualities in predicting child problems. Background: Children with ADHD often experience distress, partially linked to less adaptive parenting practices. Our working assumptions are that: parental mindfulness, insecure parent attachment styles, and parental child rejection have a significant impact upon the severity of child problems and therefore should be addressed in parental training. Methods: A total of 122 Israeli parents (55 fathers (Mage = 43.8; SD = 4.01) and 67 mothers (Mage = 41.6; SD = 4.59)) of 75 children with attention deficit hyperactivity disorder (ADHD) (Mage = 8.4; SD = 1.56) completed self-report measures: the Experience of Close Relationships scale (ECR), the Mindfulness Attention Awareness Scale (MAAS), the Parental Acceptance–Rejection Questionnaire (PARQ), and Achenbach Child Behavior Checklist (CBCL). Data were analyzed using descriptive statistics, Pearson correlations, and structural equation modeling (SEM). Results: The key finding was that a latent ‘parental rejection/non-warmth’ factor mediated the relationship between (a) parents’ anxious attachment and child behavior problems, and (b) parental mindfulness and child problems. Parental rejection emerged as the strongest predictor of child difficulties. Conclusions: Parental training for parents of children with ADHD should prioritize reducing rejection while also addressing mindfulness and anxious attachment style to promote child well-being. Clinical Trial Registration: Group training for parents whose children suffer from ADHD and comorbidity using a behavioral-dynamic approach (SPBT). Registered at Veeva Vault. Full article

Autism spectrum disorder (ASD) is a complex neurological and developmental condition that occurs in approximately 1 in 100 children. ASD is a lifelong condition defined by difficulties with social communication, restricted interests, and repetitive behaviors, among other symptoms. Currently, we understand that there is no cure and the disorder can only be managed with occupational therapy alongside limited medical treatments. Reasons underlying the pathogenesis of ASD are still not well understood, but recent studies point to the influence of epigenetic dysregulation in ASD development, which opens up avenues to novel diagnosis and treatment options. In this review, we summarize recent findings and emerging therapeutics for ASD, with a focus on implications of epigenetic regulatory pathways and factors. We expound the implications of these findings to enable preventive measurements for mothers to reduce the impact of ASD at birth, non-invasive diagnostic tests for early detection, and personalized medicine management. Finally, we discuss several critical issues to be addressed and future directions of this important research field. Full article

Background/Objectives: Parental emotion socialization is a key influence on children’s emotional regulation and psychosocial development. This study examined how supportive and non-supportive parental responses to children’s negative emotions are associated with internalizing and externalizing problems and social competence among Greek children aged 6–12 years. Methods: A non-experimental, cross-sectional correlational study using convenience sampling was conducted with 100 Greek parents who completed the Coping with Children’s Negative Emotions Scale and the Child Behavior Checklist. Correlation and multiple regression analyses were used to examine associations between parenting responses and child outcomes, controlling for child age, child gender, and parent gender. Results: Minimization/devaluation responses were significantly associated with higher internalizing problems (β = 0.396, p = 0.009), externalizing problems (β = 0.264, p = 0.048), and total problems (β = 0.320, p = 0.012). Punitive responses significantly predicted externalizing (β = 0.383, p = 0.003) and total problems (β = 0.304, p = 0.004). Supportive strategies (e.g., emotion-focused and problem-focused responses) did not significantly predict lower problem scores but were positively correlated with social competence (e.g., problem-focused response: ρ = 0.25, p = 0.017). Parent gender predicted minimization/devaluation responses, with mothers scoring higher than fathers (β = 0.308, p = 0.006). Conclusions: Non-supportive parental responses—especially punitive and dismissive behaviors—are robustly associated with increased behavioral and emotional difficulties in children. While supportive strategies may contribute to social competence, their benefits appear diminished in the presence of negative parenting practices. These findings highlight the importance of culturally sensitive interventions tailored to Greek family dynamics. Despite limitations such as the use of self-report measures and a non-representative sample, this study contributes valuable insights into emotion socialization and child adjustment in a specific cultural context. Full article

Research suggests that maternal stress is related to aspects of child development. Positive and stimulating interactions, such as shared reading, may act as protective factors, mitigating the negative effects of maternal stress on children’s development and behavior. This cohort study investigated the predictive relationship between maternal stress and children’s milestones and behavioral problems, with maternal interactive style during shared reading as a moderator. A total of 91 mother–child dyads participated. During the shared reading session, conducted in a private room at a research center, each mother and child interacted freely while reading a book, without specific instructions. The sessions were video-recorded and later analyzed by trained researchers using an established method. Children’s data were assessed using questionnaires completed by the mother on the same day. Descriptive, bivariate, and multivariate analyses were performed to build regression models with moderation analysis. Results revealed that maternal stress significantly predicted children’s internalizing and externalizing symptoms. Notably, more affectionate interactions during shared reading can moderate the effect of stress on children’s externalizing difficulties. These findings suggest that fostering positive and engaging interactions between mothers and children, such as shared reading, may have a beneficial impact on children’s behavioral development, even in the presence of maternal stress. Full article

There has been scant research on the experiences of families caring for adults with intellectual disability who use challenging behaviour as a way of making their needs known. The aim of this scoping review was to synthesize the qualitative research data on the family support experiences of adult family members with intellectual disability who use challenging behaviour in this way. A systematic search was undertaken from five databases during December 2024 and updated in April 2025. A total of 20 studies were included in the review. Data were analysed using a thematic analysis method. The number of study participants in these studies ranged from 4 to 30. Most of them were parents and predominantly mothers. The results show that caring for adults with intellectual disability and challenging behaviour reflects a dual reality. The negative experiences refer to caregiving difficulties and inadequate formal support, while the positive experiences are associated with support from informal sources and caregivers’ fulfilment and gains. The available research did not offer sufficient data for a synthesis of how families might be affected by challenging behaviour. Future research should investigate how the negative and positive aspects of their families can be shaped to make a positive impact on caring for people with intellectual disability and co-existing challenging behaviour. Full article

Children with Down syndrome often face significant feeding difficulties and health comorbidities that may contribute to undernutrition or obesity. This study assessed dietary habits and nutritional status among 104 children with Down syndrome in Croatia, representing 11.5% of this population. Results showed that over 30% of children aged 1 to 15 were overweight. Over 60% never consumed whole grain bread, while more than 50% avoided fish, nuts, or seeds. Despite rural families more frequently producing their own food (meat p = 0.009; fruits/vegetables p = 0.035), no significant improvement was observed in the children’s diets compared to their urban counterparts. Urban children consumed milk (p = 0.008) and fermented dairy (p = 0.005) more often. Children of university-educated mothers had higher vegetable (p = 0.031), meat (p = 0.025), olive oil (p = 0.003), and nut (p = 0.029) consumption, and a lower intake of processed meats (p = 0.008) and salty snacks (p = 0.040). Families spending less than 50% of income on food also showed significantly healthier dietary patterns. Feeding difficulties in children with Down syndrome are commonly associated with sensory sensitivities, oral-motor impairments, and comorbid medical conditions. These challenges are often intensified by parental anxiety, delayed introduction of diverse foods, and inadequate professional support. Collectively, these factors contribute to selective eating, poor nutrient intake, and disordered eating behaviors. This study underscores the need for individualized nutritional interventions that address the unique physiological and sensory requirements of both children and adults with Down syndrome. Effective strategies should extend beyond general dietary recommendations to include early exposure to a variety of food textures, specialized feeding support, and the management of coexisting health conditions. Family education and engagement play a crucial role in achieving positive nutritional outcomes. Empowering parents and caregivers—especially those in socioeconomically disadvantaged or rural communities—can facilitate the alignment of food accessibility with healthy dietary practices. The findings of this research offer valuable guidance for the development and implementation of national strategies aimed at enhancing the nutrition and long-term health of individuals with Down syndrome. Full article

Background/Objectives: Breastfeeding is widely recognized as the best way to feed infants and has numerous health benefits for both mothers and infants. However, despite its well-documented benefits, breastfeeding rates remain lower than recommended in many parts of the world. This systematic review examines factors that create barriers for mothers trying to breastfeed, covering studies published between 2003 and 2025. Methods: A total of 18 studies were included in this systematic review, selected from the following databases: PsycINFO, MEDLINE, Academic Search Complete, Communication and Mass Media Complete, ERIC, SocINDEX, and CINAHL. Studies were selected based on predefined inclusion criteria, focusing on peer-reviewed articles that examined factors influencing breastfeeding practices. Data extraction and quality assessment were performed independently by two reviewers using standardized tools. The review analyzed personal, cultural, economic, and health-related barriers. Results: The analysis revealed multiple barriers to breastfeeding, categorized into personal, sociocultural, economic, and healthcare-related factors. Common challenges included a lack of counseling, latching difficulties, insufficient workplace support, and cultural misconceptions. The heterogeneity of study designs posed challenges in synthesizing the findings. Conclusions: More targeted policies and programs are needed to address these barriers and help mothers succeed in breastfeeding. Improving breastfeeding outcomes worldwide will require better healthcare, social support, and an understanding of cultural influences. Full article

Objective: This study aimed to explore the association between adolescents’ health risk behaviours (excessive use of alcohol, (e)cigarette smoking, cannabis use) and familial factors. A special objective of this study was to compare findings between Bulgarian and Lithuanian adolescents aged 15 years. Material and Methods: National samples from the WHO Health Behaviour in School-aged Children (HBSC) survey in 2021/2022 were analysed. The focus was on adolescents aged 15 (n = 64,349), including those from Bulgaria (n = 793) and Lithuania (n = 1137). The set of outcome variables included drunkenness, smoked cigarettes, e-cigarettes, and used cannabis (all variables were measured during the last 30 days); their indicators were child’s talking separately to their father and separately to their mother, as well as the four-item family support scale. All variables were dichotomised and their associations were analysed using Structural Equation Modelling with a WLSMV estimator. Results: In the total sample, the prevalence of drunkenness was 14.9%, cigarette smoking at 12.6%, e-cigarette smoking at 18.4%, and cannabis use at 5.9%; while in Bulgaria, in contrast to Lithuania, these behaviours were much more prevalent, at 27.0%, 29.9%, 29.8%, and 11.1%, respectively. The use of substances was significantly associated with selected familial factors, which were more pronounced among girls than boys in most subsamples. Low family support showed the strongest association with increased substance use (in the total sample, regression weight B varied from 0.231 to 0.382). Adolescents’ difficulty in talking to mother was more pronounced (B = 0.123 to 0.204) than difficulty in talking to their father (B = 0.058 to 0.140). Comparison of data samples from Bulgaria and Lithuania showed stronger relationships in Bulgarian adolescents compared to other countries, which are more pronounced among boys. In addition, among Bulgarian adolescents, easy communication with their father had an inverse association (increasing prevalence) with cannabis use. Conclusions: Adolescent health risk behaviours, such as use of substances, are associated with familial factors, including parent–teen communication and family support. Generally, these associations are more pronounced among girls than boys, and more evident among Bulgarian adolescents than their Lithuanian counterparts. Identifying environmental factors in families helps to plan interventions to prevent development of multiple health risk behaviours in adolescents. Full article