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The complexity and specificity of joint care in perinatal psychiatry call for a rethinking of gentleness. Allowing oneself to make it the object of reflection in its own right means summoning up an essential dimension of welcoming, carrying and meeting the other, which are at the heart of support. Articulating adversity and fragility, creativity and destructiveness, gentleness is a quality, a texture on which a care team can rely from both a clinical and an institutional point of view.

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BACKGROUND: The COVID-19 pandemic has resulted in widespread disruptions to primary healthcare delivery and shifts to virtual care. Reduced in-person paediatric primary care visit rates have been reported. However, the extent to which access to primary preventative care has been impacted remains unclear. The objective of this scoping review is to characterise the utilisation of preventative primary care and its association with child development for children ages 0-5 years old during the COVID-19 era. In addition, we will determine if specific groups of children are at greater risk for reduced access to care. METHODS: A systematic search will be conducted for studies published between March 11, 2020, and October 2023 in the following databases: MEDLINE (Ovid), Embase (Ovid), Cochrane Library (CENTRAL and CDSR), Web of Science, and CINAHL (EBSCOhost). This scoping review will follow the methodological framework developed by Arksey and O'Malley and updated by the Joanna Briggs Institute (JBI). Studies related to primary preventative care of children aged 0-5 years old conducted in English and in high-income countries will be screened. Studies published before March 11, 2020, in acute care and low-middle-income settings will be excluded. Results will be summarised for appointments attended, delayed, and missed. In addition, we will summarise findings on the impact of COVID-19 on child development. Findings will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. DISCUSSION: Further investigation is required to better understand the relationship between attendance of preventative primary care for children and its effects on child development. The findings obtained from this review will offer essential context to guide policy-making and healthcare service planning for the period following the pandemic.

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BACKGROUND: Historically, once the baby was born, the mother and baby were separated shortly after birth into a postnatal ward and a baby nursery. Overtime, with advances in neonatology led to an increasing number of neonates being separated from their mothers at birth for specialised neonatal care if they required additional needs. As more research has been undertaken there is an increasing focus that mothers and babies should be kept together from birth, termed couplet care. Couplet care refers to keeping the mother and baby together. Despite this evidence, in practice, this is not happening. AIM: to examine the barriers to nurses and midwives providing couplet care of the infant requiring additional needs in postnatal and nursery. METHODS: A thorough literature review relies on a well-developed search strategy. This resulted in a total of 20 papers that were included in this review. RESULTS: This review revealed five main themes or barriers to nurses and midwives providing couplet care: models of care, systems and other barriers, safety, resistance, and education. DISCUSSION: Resistance to couplet care was discussed as being caused by feelings of lack of confidence and competence, concerns around maternal and infant safety and an under-recognition of the benefits of couplet care. CONCLUSION: The conclusion is that there is still a paucity of research in relation to nursing and midwifery barriers to couplet care. Although this review discusses barriers to couplet care, more specific original research on what nurses and midwives themselves perceive to be the barriers to couplet care in Australia is needed. The recommendation is therefore to undertake research into this area and interview nurses and midwives to ascertain their perspectives.

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La baja adherencia a la lactancia materna en los primeros seis meses de vida del bebé es un gran problema en Colombia. Investigar las percepciones de las madres adolescentes es esencial para el incentivo a la lactancia materna exclusiva. Así, el objetivo de este estudio fue conocer las percepciones sobre la lactancia materna y describir las características sociodemográficas de madres adolescentes lactantes que participan en el Programa de Crecimiento y Desarrollo de la Corporación Hospital San Juan de Dios UniRemington en Colombia. Se trata de un estudio observacional cualitativo transversal realizado entre 2020 y 2021 mediante entrevistas semiestructuradas. Estas se realizaron según un guión de preguntas abiertas a madres adolescentes que amamantan a bebés menores de 2 años, utilizando grabadora de audio, diarios de campo y datos sociodemográficos obtenidos de registros hospitalarios. La muestra y resultados se basearon en la saturación de datos, según las narrativas organizados en temas a partir del análisis temático junto con repeticiones de observaciones y descripciones de datos sociodemográficos. De las diez jóvenes, el 70% tenía un bajo nivel de escolarización y su percepción de la lactancia estaba relacionada con su conocimiento de los beneficios de la lactancia para la nutrición del bebé y el vínculo madre-hijo, pero con muchas dificultades esta realidad se ha convertido en una utopía. Hubo una díada de alegría y dolor en las vivencias. Se concluyó que las percepciones estaban relacionadas con la falta de apoyo médico y familiar para madres adolescentes. Se sugieren más estudios en diferentes poblaciones maternas.

Low adherence to breastfeeding in the first six months of a baby's life is a major problem in Colombia. Investigating the perceptions of adolescent mothers is essential to encourage exclusive breastfeeding. Thus, the objective of this study was to learn about the perceptions of breastfeeding and to describe the sociodemographic characteristics of breastfeeding adolescent mothers who participated in the Growth and Development Program of the Hospital San Juan de Dios UniRemington Corporation in Colombia. This is a cross-sectional qualitative observational study conducted between 2020 and 2021 using semi-structured interviews. These were carried out according to a script of open-ended questions to teenage mothers who were breastfeeding babies under 2 years of age, using tape recorders and field diaries and sociodemographic data obtained from hospital registers. The sample and results were based on data saturation according to narratives organized into themes from the thematic analysis together with repetitions of observations and descriptions of sociodemographic data. Of the ten young women, 70% had a low level of schooling and their perception of breastfeeding was related to their knowledge of the benefits of breastfeeding for baby nutrition and mother-child bond, but with many difficulties this reality has become a utopia. There was a dyad of joy and pain in the experiences. It was concluded that the perceptions were related to the lack of medical and family support for adolescent mothers. Further studies in different maternal populations are suggested.

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We examined how well-baby care nurses perceive communication with parents regarding their children's obesity and identified main communication barriers. Pediatric obesity is a significant public health concern, and health care personnel are among the first to detect overweight and the first to offer assistance to parents. Yet, research suggests that when nurses identify a weight problem in children, they may have trouble initiating this discussion. This qualitative study, using semi-structured interviews with 20 public health nurses, addressed potential obstacles nurses face when discussing young children's weight. Lack of time and workload were the most significant barriers to meaningful conversation with parents. Instructing parents toward a healthy lifestyle, while specifically relating to the child's weight, is perceived as part of the nurse's role, but execution was flawed. Trust and good communication between the nurse and parents are seen as critical ingredients to provide future guidance around a child's weight. Nurses want parents to feel comfortable to discuss children's weight problems, but are worried that such a discussion may impair previously established trust. Nurses should receive comprehensive training to address childhood obesity, including specific communication skills to implement when discussing this stigmatized and sensitive topic.

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Background Postpartum depression has been linked to undesirable outcomes for mother-infant dyads, interfering with childcare and breastfeeding practices. This study aimed to determine the prevalence of depressive symptoms among mothers during the postpartum period and its association with breastfeeding and postpartum experiences. Methodology This cross-sectional study involved mothers of hospitalized infants (n = 219) at two tertiary hospitals in Klang Valley, Malaysia. Mothers were screened for postpartum depression using the Edinburgh Postnatal Depression Scale with a cut-off of ≥12 for positive screening for depression. Mothers were asked to complete questionnaires on breastfeeding experience, which included breastfeeding self-efficacy and challenges. The questionnaires also collected information on postnatal experiences, including birth outcomes, anxiety and stress levels, and social support. Multiple linear regression was used to ascertain the association of postpartum depression levels with breastfeeding and postnatal experiences. Results Overall, 30% of mothers in this study screened positive for depression. Based on multiple linear regression, a higher score of postpartum depression was significantly associated with unpleasant breastfeeding and postnatal experiences reflected by increased scores of anxiety and stress, lower infant birth weight, increased breastfeeding problems, and lower level of social support (p < 0.005). Conclusions Maternal emotions, birth outcomes, breastfeeding issues, and social support were associated with postpartum depression. Efforts should be made to increase maternal support, and screening for maternal depression during infant hospital stays should be encouraged.

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Objective: To determine if the use of a simple self-administered Postpartum Questionnaire for Mothers (PQM) at the well-baby visit (WBV) increased the proportion of women who received health care and contraception by 6 months postpartum (PP). Methods: This was a single-site, system-level, intervention. Women were recruited from the pediatric clinic when presenting with their infants for a 2-month WBV. During phase 1 of the study, a control group was enrolled, followed by an 8-week washout period; then enrollment of the intervention group (phase 2). During phase 2, the PQM was administered and reviewed by the pediatrician during the infant's visit; the tool prompted the pediatrician to make a referral for the mother's primary or contraceptive care as needed. Data were collected at baseline and at 6 months PP, and additional data were extracted from the electronic medical record. Results: We found that PP women exposed to the PQM during their infant's WBV were more likely to have had a health care visit for themselves between 2 and 6 months PP, compared with the control group (relative risk [RR] 1.66, [confidence interval (CI) 0.91-3.03]). In addition, at 6 months PP, women in the intervention group were more likely to identify a primary care provider (RR 1.84, [CI 0.98-3.46]), and more likely to report use of long-acting reversible contraception (LARC) (RR 1.24, [CI 0.99-1.58]), compared with women in the control group. Conclusion: A simple self-administered PQM resulted in an increase in women's receipt of health care and use of LARC by 6 months PP. Clinical Trial Registration: Use of a reproductive life planning tool at the pediatric well-baby visit with postpartum women, NCT03448289.

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Draize rabbit eye irritation and skin irritation tests are widely used in the chemical industry as traditional methods to evaluate the safety of cosmetics. However, great differences among laboratories have caused great doubt in the industry. In addition, with vigorous development of the global animal protection movement, developed countries have launched the "3R" campaign, and various kinds of in vitro alternative methods have emerged. Hen's egg test on the chorioallantoic membrane (HET-CAM), which is similar to the structure of the human cornea and has a clear and complete vascular system, is based on the characteristics of the chorioallantoic membrane (CAM) in mid-term SPF egg embryos. The reconstructed human epidermis (EpiSkin®) is composed of normal human keratinocytes that are histologically similar to human epidermises seen in vivo, and it is cultured on a collagen matrix. Similar to EpiSkin®, Human Corneal Epithelium (SkinEthic™) is another reconstructed 3D human-corneal structure that is an alternative to the traditional eye irritation test. Three in vitro methods were conducted to evaluate the safety of 12 baby care products, which included the most common types. In addition, a consumer research study was also carried out for two weeks to evaluate the safety. The results of the reconstructed human epidermis model, human corneal epithelium model and consumer research showed that no irritation was found in any test products; however, HET-CAM tests showed positive results.

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The Baby Care Scale (BCS) was designed to assess the involvement of father in infant care during pregnancy and the postpartum period. This study aimed to examine the psychometric characteristics of the BCS - antenatal (BCS-AN) and BCS - postnatal (BCS-PN) versions. A sample of 100 primiparous fathers completed the BCS-AN and/or the BCS-PN and self-reported the measures of anxiety and depressive symptoms and of father-infant emotional involvement during pregnancy and the postpartum period, respectively. Good internal consistency was found for both the BCS-AN and the BCS-PN. A two-factor model was found for both versions of the instrument: (1) household tasks and (2) infant care tasks. The BCS-AN and BCS-PN subscales revealed good internal consistency. Higher scores on the BCS-AN predicted higher scores on the BCS-PN. Significant associations were found among the BCS (BCS-AN and BCS-PN), depressive and anxiety symptoms, and father-infant emotional involvement, revealing good criterion validity. This study suggested that both the BCS-AN and the BCS-PN are reliable multidimensional self-report measures that assess the involvement of father in infant care during pregnancy and the postpartum period.

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PURPOSE: Parents with disabilities face many challenges in fulfilling their daily roles. Previous literature has shown that assistive technology (AT) can be a viable solution to help an individual with a disability participate in everyday roles. Although AT can increase ability of parents with disabilities to care for their children, there are many barriers that prevent them from getting the AT that they need. Some of these barriers include a lack of training and awareness by healthcare providers regarding AT options, a lack of rehabilitation therapists' feeling they are competent to provide AT options for their clients. and funding barriers. One issue that impacts the ability to get funding for AT is the lack of research supporting the efficacy of the technology. An AT device specifically designed for parents with disabilities is an adaptive crib called PediaLift. Health insurance companies are resistant to funding the PediaLift stating that there is no evidence in the literature to support its efficacy. MATERIALS AND METHODS: In this study, we investigated the efficacy of the Pedialift crib by using the Quebec User Evaluation of Satisfaction with Assistive Technology 2.0 (QUEST 2.0) survey and the Canadian Occupational Performance Measure (COPM) with individuals who have already purchased and used the device. RESULTS: Findings revealed that overall users were satisfied with the device and services provided. CONCLUSION: Participants were more able to participate in the role of parenting after obtaining the Pedialift.

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INTRODUCTION: Educating a mother of a premature baby and providing a structured written educational information can enhance better understanding and practice. This article describes the development and implementation of a health educational package for preemie moms in the care of their premature baby after neonatal intensive care unit discharge. SUBJECTS AND METHODS: The package known as "Preemie Mom: A Guide for You" was designed based on Stufflebeam's model and has four phases: (1) content evaluation from available sources of information, (2) input evaluation based on mothers' need related to premature baby care, (3) process evaluation for package designing and content drafting, and (4) product evaluation to determine its feasibility. The contents were extracted and collated for validation by consulting various specialists in related fields. A final draft was drawn based on comments given by experts. Comments from the mothers were taken for formatting, visual appearance, and content flow for easy understanding and usage. RESULTS: All ten existing articles and eight relevant documents were gathered and critically appraised. The package was designed based on 11 main components related to the care of premature baby after discharge. The content validation was accepted at a minimum score of 0.85 for the item-level content validity index analysis. Both experts and mothers were agreed that the package is easy to use and well accepted as a guide after discharge. The agreement rate by the mothers was at 93.33% and greater for the front page, writing style, structure, presentation, and motives of the package. CONCLUSIONS: "Preemie Mom: A Guide for You" is a validated health educational package and ready to be used to meet the needs of the mother for premature baby care at home.

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OBJECTIVE: To examine the effects of a home follow-up program in Turkey on care problems, anxiety, and depression levels of mothers after the birth of a premature baby. METHODS: A semi-experimental study with a pretest-posttest control group design. Eighty premature newborns and their mothers were included in the study. Nursing care was given to mothers and babies in the study group through a total of four home visits on weeks 1, 2, 3, and days 40-42 in Kirikkale, Turkey guided by the Nursing Diagnosis System and Nursing Interventions Classification (NIC) system of the North American Nursing Diagnosis Association (NANDA). Data were collected from a sociodemographics form, home care needs evaluation form, Edinburgh Postpartum Depression Scale, and State Anxiety Inventory. RESULTS: There were no significant differences between groups for nursing diagnoses at baseline, while the study group resulted in significantly fewer problems on days 40-42, compared to the control group. Mothers had a comparatively lower depression and state anxiety risk in the study group compared to the control group. CONCLUSIONS: Providing home-based nursing care for preterm mothers and babies during the first 40-42 days has the potential to decrease postnatal care problems, including maternal depression and state anxiety levels.

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PURPOSE: This study was made to develop a scale instrument to determine obsessive and compulsive behaviors of mothers in the postpartum period with regard to baby care. DESIGN AND METHODS: This methodologically was conducted with 233 mothers between February and October 2017. FINDINGS: Age average of the women was detected as 28.47 ± 15.47. Four items were removed from the scale because their factor load was under 0.400. It was determined that scale consists of nine items and sole factor. Cronbach alpha internal consistency reliability coefficient is 75. PRACTICAL IMPLICATIONS: Results of this study demonstrate that "Obsessive and Compulsive Behaviors Scale of Mothers in Postpartum Period Regarding Baby Care" is a valid and reliable measurement instrument.

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Baby care books that promote strict infant care routines are popular, but little research has considered their impact upon maternal infant care behaviours. We explored whether mothers who have read these books guide their infant care behaviours based on their concepts and how this is associated with infant feeding, night-time care, and response to infant's needs. Three hundred and fifty-four U.K. mothers with a baby aged 0-12 months completed an online questionnaire exploring use of baby care books, motivations for use, whether guidance was followed, and infant care behaviours. Mothers who read the books were drawn to them for information about how to settle their infant, infant sleep, and infant feeding behaviour. Those who read the books were less likely to breastfeed, feed responsively, have their infant sleep in the same room, cuddle their infant to sleep, or respond promptly to infant cries. Although the causality between reading these books and care cannot be determined through this study design, and is likely bidirectional with some reading the books to confirm existing preferences, around 25-40% of mothers noted the information determined their care decisions. Regardless of specific causal pathways, there is an association between these books and behaviours that go against infant feeding and responsive care recommendations. Understanding what drives mothers to follow these books and increasing support for new mothers in these areas is important. The findings will be important for those supporting mothers in the perinatal period in starting conversations around responsive infant care.

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The negative consequences of untreated postpartum depression (PD) for both the woman and her infant are well established. The impact of maternal depression has led to recommendations on systematic perinatal depression screening. Unfortunately, large-scale initiatives on PD screening have found no benefit unless systems are in place to facilitate appropriate interventions for women who screen positive. Pediatric primary care has been a focus of efforts to support screening and management of PD because pediatric providers, unlike adult healthcare providers, have the most frequent contact with postpartum women through well-child visits. Well-child visits thus present an unparalleled opportunity to detect and intervene with PD. Literature reviews suggest that specific strategies are feasible within pediatric settings and could benefit both the woman and her child. In this article, we present a stepped care approach for screening and managing PD, integrating common elements found in existing pediatric-based models. A stepped care approach is ideal because PD is a heterogeneous condition, with a range of presentations and hence responsiveness to various interventions. This care pathway begins with systematic screening for depression symptoms, followed by a systematic risk assessment for women who screen positive and care management based on risk profiles and responsiveness. This approach allows pediatric providers to be optimally flexible and responsive in addressing the majority of women with PD within the context of the family-centered medical home to improve child well-being. Challenges to managing PD within pediatrics are discussed, including strategies for addressing them. Implications for research, policy, and practice are discussed.

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Introduction Postpartum depression (PPD) is a mental health problem frequently experienced by mothers in the first year postpartum. Early detection and treatment can help to reduce its negative effect on the development of the newborn child. Well-baby care (WBC) is a promising screening setting for early detection of PPD. This systematic review investigates the evidence of the effectiveness of screening for PPD in WBC settings regarding mother and child outcomes. Methods Three electronic databases were searched: SCOPUS, PsychINFO and CINAHL. Two reviewers independently performed the study selection. Data extraction was based on a predefined data extraction form. Results Six studies were included; a quality assessment rated two studies as strong and four as weak. Four studies measuring outcomes at process level showed improvement in detection, referral and/or treatment rates. Four studies, including the two strong ones, where screening and enhanced care were combined, showed improvements in the Edinburgh Postnatal Depression Scale scores of the mothers in the intervention groups. No improvements were reported on other outcomes at parent level or at child level. At child level, weight was the only outcome that was measured. Discussion This review provides limited yet positive evidence for the value of screening for PPD in a WBC setting. The outcomes are comparable with studies on screening for PPD in general. The evidence that we found is very promising but the small number of available studies shows a need for additional high-quality studies, to strengthen the evidence regarding the potential benefits of screening in a WBC setting.

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INTRODUCTION: In the care of preterm newborn, practices that favor the participation of mothers in care are recommended. The use of appropriate instruments by professionals can contribute to strengthen maternal participation. OBJECTIVE: To analyse the contributions of the use of the Newborn Behavioral Observations (NBO) for the maternal care of preterm neonates. METHODS: Descriptive qualitative study, using participant observation and semi-structured interviews with 14 mothers of preterm newborns who underwent NBO. Data was submitted to content analysis, assinted by the software MAXQda 12. RESULTS: It was found that the mothers' prior perceptions of the newborn´s capacities or how they react to environmental stimuli do not differ from what was observed and reported by them after NBO. However, it was verified that NBO confirms this perception and broadens the mothers' understanding of the meaning of the newborn's behavior. Participating in the NBO helped the mothers to identify strategies to find the needs of the newborn, qualifying the care already performed by them and opening new possibilities for maternal care. CONCLUSION: The NBO is an instrument that favors the mother's learning about the behavior of the newborn and contributes to the construction of practices with potential to be used by them within daily care. This allows us to consider it as a tool that favors the mother-baby relationship, contributes to the mother's participation in the care, and supports the mother in the construction of her autonomy for the continuity of the newborn's care after hospital discharge.

INTRODUÇÃO: Na assistência ao recém-nascido pré-termo são recomendadas práticas que favorecem a participação das mães no cuidado. O uso de instrumentos apropriados pelos profissionais pode contribuir para o fortalecimento da participação materna. OBJETIVO: Analisar as contribuições do uso da Newborn Behavioral Observations (NBO) para o cuidado materno de recém-nascidos prematuros. MÉTODO: Estudo qualitativo descritivo, utilizando observação participante e entrevista semi-estruturada, com 14 mães de recém-nascidos pré-termo que realizaram a NBO. Os dados foram submetidos à análise temática de conteúdo, assistida pelo software MAXQda 12. RESULTADOS: Verificou-se que a percepção prévia das mães em relação às capacidades do recém-nascido ou ao modo como ele reage aos estímulos do ambiente não difere do que foi observado e relatado por elas após a NBO. Entretanto, verifica-se que a realização da NBO confirma essa percepção e amplia a compreensão das mães acerca do significado do comportamento do recém-nascido. Participar da NBO favoreceu que as mães identificassem estratégias para atender às necessidades de cuidado do recém-nascido, qualificando o cuidado já realizado por elas e abrindo novas possibilidades para o cuidado materno. CONCLUSÃO: A NBO é um instrumento que favorece o aprendizado da mãe sobre o comportamento do recém-nascido e contribui para a construção de práticas com potencial para serem utilizadas por elas no cotidiano do cuidado. Isso nos permite considerá-la um instrumento que favorece a relação mãe-filho, contribui para a participação da mãe no cuidado, e apóia a mãe na construção da sua autonomia para a continuidade do cuidado do recém-nascido após a alta hospitalar.

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As family-centered care has become the expected standard, many facilities follow the mother-baby model, in which care is provided to both a woman and her newborn in the same room by the same nurse. My facility employed a traditional model of nursing care, which was not evidence-based or financially sustainable. After implementing the mother-baby model, we experienced an increase in exclusive breastfeeding rates at hospital discharge, increased patient satisfaction, improved staff productivity and decreased salary costs, all while the number of births increased. Our change was successful because it was guided by the use of quality improvement tools, change theory and evidence-based practice models.

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AIM: This study compares women's postpartum fatigue, baby-care activities, and maternal-infant attachment following vaginal and cesarean births in rooming-in settings. BACKGROUND: Postpartum women admitted to baby-friendly hospitals are asked to stay with their babies 24 hours a day and to breastfeed on demand regardless of the type of childbirth. METHODS: The study used a descriptive cross-sectional study design. A total of 120 postpartum women were recruited from two accredited baby-friendly hospitals in southern Taiwan. Three structured questionnaires were used to collect data, on which an analysis of covariance was conducted. RESULTS: Women who experienced a cesarean birth had higher postpartum fatigue scores than women who had given birth vaginally. Higher postpartum fatigue scores were correlated with greater difficulty in baby-care activities, which in turn resulted in weaker maternal-infant attachment as measured in the first 2 to 3 days postpartum. CONCLUSIONS: Hospitals should implement rooming-in in a more flexible way by taking women's postpartum fatigue and physical functioning into consideration.

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