Human milk xanthine oxidase and neonatal salivary nucleotide precursors generate hydrogen peroxide; a novel pathway with potential role in regulating oral microflora

Background: Xanthine oxidase (XO) is a complex molybdeno-flavoprotein occurring with high activity in the milk fat globule membrane (MFGM) in all mammalian milk and is involved in the final stage of degradation of purine nucleotides. It catalyzes the sequential oxidation of hypoxanthine to xanthine and uric acid, accompanied by production of hydrogen peroxide and superoxide anion. Human saliva has been extensively described for its composition of proteins, electrolytes, cortisol, melatonin and some metabolites such as amino acids, but little is known about nucleotide metabolites. Method: Saliva was collected with swabs from babies; at full-term 1-4 days, 6-weeks, 6-months and 12-months. Unstimulated fasting (morning) saliva samples were collected directly from 77 adults. Breast milk was collected from 24 new mothers. Saliva was extracted from swabs and ultra-filtered. Nucleotide metabolites were analyzed by RP-HPLC with UV-photodiode array and ESI-MS/MS. XO activity was measured as peroxide production from hypoxanthine. Bacterial inhibition over time was assessed using CFU/mL or OD. Results: Median concentrations (μmol/L) of salivary nucleobases and nucleosides for neonates/6-weeks/6-months/12-months/adult respectively were: uracil 5.3/0.8/1.4/0.7/0.8, hypoxanthine 27/7.0/1.1/0.8/2.0, xanthine 19/7.0/2.0/2.0/2.0, adenosine 12/7.0/0.9/0.8/0.1, inosine 11/5.0/0.3/0.4/0.2, guanosine 7.0/6.0/0.5/0.4/0.1, uridine 12/0.8/0.3/0.9/0.4. Deoxynucleosides and dihydropyrimidines concentrations were essentially negligible. XO activity (Vmax:mean ± SD) in breast milk was 8.9 ± 6.2 μmol/min/L and endogenous peroxide was 27 ± 12 μmol/L; mixing breast milk with neonate saliva generated ~40 μmol/L peroxide,which inhibited Staphylococcus aureus. Conclusions: Salivary metabolites, particularly xanthine/hypoxanthine, are high in neonates, transitioning to low adult levels between 6-weeks to 6-months (p < 0.001). Peroxide occurs in breast milk and is boosted during suckling as an antibacterial system.

Supporting children's language and literacy skills : the effectiveness of shared book reading intervention strategies with parents

Parents are encouraged to read with their children from an early age because shared book reading helps children to develop their language and early literacy skills. A pragmatic Randomised Controlled Trial (RCT) research design was adopted to investigate the influence of two forms of a shared reading intervention (Dialogic Reading and Dialogic Reading with the addition of Print Referencing) on children’s language and literacy skills. Dialogic reading is a validated shared reading intervention that has been shown to improve children’s oral language skills prior to formal schooling (Whitehurst & Lonigan, 1998). Print referencing is another form of shared reading intervention that has the potential to have effects on children’s print knowledge as they begin school (Justice & Ezell, 2002). However, training parents to use print referencing strategies at home has not been researched extensively although research findings indicate its effectiveness when used by teachers in the early years of school. Eighty parents of Preparatory year children from three Catholic schools in low income areas in the outer suburbs of a metropolitan city were trained to deliver specific shared reading strategies in an eight-week home intervention. Parents read eight books to their children across the period of the intervention. Each book was requested to be read at least three times a week. There were 42 boys and 38 girls ranging in age from 4.92 years to 6.25 years (M=5.53, SD=0.33) in the sample. The families were randomly assigned to three groups: Dialogic Reading (DR); Dialogic Reading with the addition of Print Referencing (DR + PR); and a Control group. Six measures were used to assess children’s language skills at pre and post, and follow-up (three months after the intervention). These measures assessed oral language (receptive and expressive vocabulary), phonological awareness skills (rhyme, word completion), alphabet knowledge, and concepts about print. Results of the intervention showed that there were significant differences from pre to post between the two intervention groups and the control group on three measures: expressive vocabulary, rhyme, and concepts about print. The shared reading strategies delivered by parents of the dialogic reading, and dialogic reading with the addition of print referencing, showed promising results to develop children’s oral language skills in terms of expressive vocabulary and rhyme, as well as understanding of the concepts about print. At follow-up, when the children entered Year 1, the two intervention groups (DR and DR + PR) group had significantly maintained their knowledge of concepts about prints when compared with the control group. Overall, the findings from this intervention study did not show that dialogic reading with the addition of print referencing had stronger effects on children’s early literacy skills than dialogic reading alone. The research also explored if pre-existing family factors impacted on the outcomes of the intervention from pre to post. The relationships between maternal education and home reading practices prior to intervention and child outcomes at post were considered. However, there were no significant effects of maternal education and home literacy activities on child outcomes at post. Additionally, there were no significant effects for the level of compliance of parents with the intervention program in terms of regular weekly reading to children during the intervention period on child outcomes at post. These non-significant findings are attributed to the lack of variability in the recruited sample. Parents participating in the intervention had high levels of education, although they were recruited from schools in low socio-economic areas; parents were already highly engaged in home literacy activities at recruitment; and the parents were highly compliant in reading regularly to their child during the intervention. Findings of the current study did show that training in shared reading strategies enhanced children’s early language and literacy skills. Both dialogic reading and dialogic reading with the addition of print referencing improved children’s expressive vocabulary, rhyme, and concepts about print at post intervention. Further research is needed to identify how, and if, print referencing strategies used by parents at home can be effective over and above the use of dialogic reading strategies. In this research, limitations of sample size and the nature of the intervention to use print referencing strategies at home may have restricted the opportunities for this research study to find more effects on children’s emergent literacy skills or for the effectiveness of combining dialogic reading with print referencing strategies. However, these results did indicate that there was value in teaching parents to implement shared reading strategies at home in order to improve early literacy skills as children begin formal schooling.

Feeding attitudes, practices and traditional dietary beliefs of Chinese mothers with young children in Australia : a mixed methods study

Background and Objectives Obesity and some dietary related diseases are emerging health problems among Chinese immigrants and their children in developed countries. These health problems are closely linked to eating habits, which are established in the early years of life. Young children’s eating habits are likely to persist into later childhood and youth. Family environment and parental feeding practices have a strong effect on young children’s eating habits. Little information is available on the early feeding practices of Chinese mothers in Australia. The aim of this study was to understand the dietary beliefs, feeding attitudes and practices of Chinese mothers with young children who were recent immigrants to Australia. Methods Using a sequential explanatory design, this mixed methods study consisted of two distinct phases. Phase 1 (quantitative): 254 Chinese immigrant mothers of children aged 12 to 59 months completed a cross-sectional survey. The psychometric properties and factor structure of a Chinese version of the Child Feeding Questionnaire (CFQ, by Birch et al. 2001) were assessed and used to measure specific maternal feeding attitudes and controlling feeding practices. Other questions were developed from the literature and used to explore maternal traditional dietary beliefs and feeding practices related to their beliefs, perceptions of picky eating in children and a range of socioeconomic and acculturation factors. Phase 2 (qualitative): 21 mothers took part in a follow-up telephone interview to assist in explaining and interpreting some significant findings obtained in the first phase. Results Chinese mothers held strong traditional dietary beliefs and fed their children according to these beliefs. However, children’s consumption of non-core foods was high. Both traditional Chinese and Australian style foods were consumed by their children. Confirmatory factor analysis revealed that the original 7-factor model of the CFQ provided an acceptable fit to the data with minor modification. However, an alternative model with eight constructs in which two items related to using food rewards were separated from the original restriction construct, not only provided an acceptable fit to the data, but also improved the conceptual clarity of the constructs. The latter model included 24 items loading onto the following eight constructs: restriction, pressure to eat, monitoring, use of food rewards, perceived responsibility, perception of own weight, perception of child’s weight, and concern about child becoming overweight. The internal consistency of the constructs was acceptable or desirable (Cronbach’s α = .60 - .93). Mothers reported low levels of concern about their child overeating or becoming overweight, but high levels of controlling feeding practices: restriction, monitoring, pressure to eat and use of food rewards. More than one quarter of mothers misinterpreted their child’s weight status (based on mothers’ self-reported data). In addition, mothers’ controlling feeding practices independently predicted half of the variance and explained 16% of the variance in child weight status: pressuring the child to eat was negatively associated with child weight status (β = -0.30, p < .01) and using food rewards was positively associated with child weight status (β = 0.20, p < .05) after adjusting for maternal and child covariates. Monitoring and restriction were not associated with child weight status. Mothers’ perceptions of their child’s weight were positively associated with child weight status (β = 0.33, p < .01). Moreover, mothers reported that they mostly decided what (65%) and how much (80%) food their child ate. Mothers who decided what food their child ate were more likely to monitor (β = -0.17, p < .05) and restrict (β = -0.17, p < .05) their child’s food consumption. Mothers who let their child decide how much food their child ate were less likely to pressure their child to eat (β = -0.38, p < .01) and use food rewards (β = -0.24, p < .01). Mothers’ perceptions of picky eating behaviour were positively associated with their use of pressure (β = 0.21, p < .01) and negatively associated with monitoring (β = -0.16, p < .05) and perceptions of their child’s weight status (β = -0.13, p < .05). Qualitative data showed that pressuring to eat, monitoring and restriction of the child’s food consumption were common practices among these mothers. However, mothers stated that their motivation for monitoring and restricting was to ensure the child’s general health. Mothers’ understandings of picky eating behaviour in their children were consistent with the literature and they reported multiple feeding strategies to deal with it. Conclusion Chinese immigrant mothers demonstrated strong traditional dietary beliefs, a low level of concern for child weight, misperceptions of child weight status, and a high overall level of control in child feeding in this study. The Chinese version of the CFQ, which consists of eight constructs and distinguishes between the constructs using food rewards and restriction, is an appropriate instrument to assess feeding attitudes and controlling feeding practices among Chinese immigrant mothers of young children in Australia. Mothers’ feeding attitudes and practices were associated with children’s weight status and mothers’ perceptions of picky eating behaviour in children after adjusting for a range of socio-demographic maternal and child characteristics. Monitoring and restriction of children’s food consumption according to food selection may be positive feeding practices, whereas pressuring to eat and using food rewards appeared to be negative feeding practices in this study. In addition, the results suggest that these young children have high exposure to energy-dense, nutrient-poor food. There is a need to develop and implement nutrition interventions to improve maternal feeding practices and the dietary quality among children of Chinese immigrant mothers in Australia.

Environments for Healthy Living (EFHL) Griffith Birth Cohort Study : background and methods

The health of an individual is determined by the interaction of genetic and individual factors with wider social and environmental elements. Public health approaches to improving the health of disadvantaged populations will be most effective if they optimise influences at each of these levels, particularly in the early part of the life course. In order to better ascertain the relative contribution of these multi-level determinants there is a need for robust studies, longitudinal and prospective in nature, that examine individual, familial, social and environmental exposures. This paper describes the study background and methods, as it has been implemented in an Australian birth cohort study, Environments for Healthy Living (EFHL): The Griffith Study of Population Health. EFHL is a prospective, multi-level, multi-year longitudinal birth cohort study, designed to collect information from before birth through to adulthood across a spectrum of eco-epidemiological factors, including genetic material from cord-blood samples at birth, individual and familial factors, to spatial data on the living environment. EFHL commenced the pilot phase of recruitment in 2006 and open recruitment in 2007, with a target sample size of 4000 mother/infant dyads. Detailed information on each participant is obtained at birth, 12-months, 3-years, 5-years and subsequent three to five yearly intervals. The findings of this research will provide detailed evidence on the relative contribution of multi-level determinants of health, which can be used to inform social policy and intervention strategies that will facilitate healthy behaviours and choices across sub-populations.

Accuracy of weight status perception in contemporary Australian children and adolescents

Aim: To explore weight status perception and its relation to actual weight status in a contemporary cohort of 5- to 17-year-old children and adolescents. Methods: Body mass index (BMI), derived from height and weight measurements, and perception of weight status (‘too thin’, ‘about right’ and ‘too fat’) were evaluated in 3043 participants from the Healthy Kids Queensland Survey. In children less than 12 years of age, weight status perception was obtained from the parents, whereas the adolescents self-reported their perceived weight status. Results: Compared with measured weight status by established BMI cut-offs, just over 20% of parents underestimated their child's weight status and only 1% overestimated. Adolescent boys were more likely to underestimate their weight status compared with girls (26.4% vs. 10.2%, P < 0.05) whereas adolescent girls were more likely to overestimate than underestimate (11.8% vs. 3.4%, P < 0.05). Underestimation was greater by parents of overweight children compared with those of obese children, but still less than 50% of parents identified their obese child as ‘too fat’. There was greater recognition of overweight status in the adolescents, with 83% of those who were obese reporting they were ‘too fat’. Conclusion: Whilst there was a high degree of accuracy of weight status perception in those of healthy weight, there was considerable underestimation of weight status, particularly by parents of children who were overweight or obese. Strategies are required that enable parents to identify what a healthy weight looks like and help them understand when intervention is needed to prevent further weight gain as the child gets older.

Promoting active lifestyles in young children: investigating mothers’ decisions about their child’s physical activity and screen time behaviours

Objectives Given increasing trends of obesity being noted from early in life and that active lifestyles track across time, it is important that children at a very young age be active to combat a foundation of unhealthy behaviours forming. This study investigated, within a theory of planned behaviour (TPB) framework, factors which influence mothers’ decisions about their child’s 1) adequate physical activity (PA) and 2) limited screen time behaviours. Methods Mothers (N = 162) completed a main questionnaire, via on-line or paper-based administration, which comprised standard TPB items in addition to measures of planning and background demographic variables. One week later, consenting mothers completed a follow-up telephone questionnaire which assessed the decisions they had made regarding their child’s PA and screen time behaviours during the previous week. Results Hierarchical multiple regression analyses revealed support for the predictive model, explaining an overall 73% and 78% of the variance in mothers’ intention and 38% and 53% of the variance in mothers’ decisions to ensure their child engages in adequate PA and limited screen time, respectively. Attitude and subjective norms predicted intention in both target behaviours, as did intentions with behaviour. Contrary to predictions, perceived behavioural control (PBC) in PA behaviour and planning in screen time behaviour were not significant predictors of intention, neither was PBC a predictor of either behaviour. Conclusions The findings illustrate the various roles that psycho-social factors play in mothers’ decisions to ensure their child engages in active lifestyle behaviours which can help to inform future intervention programs aimed at combating very young children’s inactivity.

Psychosocial factors associated with controlling feeding practices of Indian and Australian-Indian mothers

This cross-sectional study examined the association between psychosocial factors (mothers’ perception of own and child weight, maternal self-efficacy in feeding and involvement of the mother-in-law in child-feeding) and controlling feeding practices (monitoring, restriction, pressure to eat and passive feeding). Participants were 531 affluent-Indian mothers in Australia and Mumbai with children aged 1-5 years. The psychosocial variables and feeding practices were measured using a combination of previously validated scales and study-developed items/scales. Multivariable regression analyses were stratified by sample (Australia and Mumbai) to investigate psychosocial factors related to the feeding practices, adjusting for covariates. Self-efficacy in feeding was associated with each of the feeding practices in at least one of the samples (β values between 0.1-0.2, p= 0.04-0.005). The greater involvement of the mother-in-law in child-feeding was related to the higher use of restriction in both samples (β values ≥0.2, p=0.02). In contrast, maternal weight perceptions were not consistently associated with feeding practices in either sample. The findings highlighted that unique (self-efficacy in feeding) and culturally-specific (involvement of the mother-in-law) variables not extensively researched within the context of child-feeding were important factors associated with Indian mothers’ feeding practices. Greater consideration of these factors may be required when tailoring child-feeding interventions for Indian mothers.

Pushing cultural competence boundaries in nutrition and dietetics training

A health workforce ready for safe practice is a government priority, and particularly critical to support indigenous communities closing ‘the gap’. Increased pressure exists on dietetic training programs for quality placements, with fewer opportunities for immersion in Aboriginal and Torres Strait Islander communities to demonstrate cultural competence. In 2012, Queensland University of Technology established a partnership with Apunipima Cape York Health Council with 56 weeks of dietetic placement for 8 students provided to achieve these aims. Clinical practice in Community Public Health Nutrition (CPHN) was structured in a standard 6 week placement, with Individual Case Management (ICM) and Foodservice Management (FSM) integrated across 8 weeks (4 each), with an additional 2 weeks ICM prior in a metropolitan indigenous health service. Students transitioned from urban to rural then remote sites, with new web-based technologies used for support. Strong learning opportunities were provided, with CPHN projects in antenatal and child health, FSM on standardisation of procedures in a 22 bed health facility, and ICM exposing students to a variety of cases via hospital in/outpatients, general clinics and remote community outreach. Supervisor focus group evaluation was positive, with CPHN and FSM enhancing capacity of service. Student focus group evaluation revealed placements exceeded expectations, with rating high, and strong confidence in cultural competence described. Students debriefed final and third year cohorts on their experiences, with increased awareness and enthusiasm for work with indigenous communities indicated by groups. With the success of this partnership, placements are continuing 2013, and new boundaries in dietetic training established.

Asthma and protracted bronchitis : who fares better during an acute respiratory infection?

Aim Acute respiratory infections (ARI) are common in children, and symptoms range from days to weeks. The aim of this study was to determine if children with asthma have more severe ARI episodes compared with children with protracted bronchitis and controls. Methods Parents prospectively scored their child's next ARI using the Canadian acute respiratory illness and flu scale (CARIFS) and a validated cough diary (on days 1–7, 10 and 14 of illness). Children were age- and season-matched. Results On days 10 and 14 of illness, children with protracted bronchitis had significantly higher median CARIFS when compared with children with asthma and healthy controls. On day 14, the median CARIFS were: asthma = 4.1 (interquartile range (IQR) 4.0), protracted bronchitis = 19.6 (IQR 25.8) and controls = 4.1 (IQR 5.25). The median cough score was significantly different between groups on days 1, 7, 10 and 14 (P < 0.001). A significantly higher proportion of children with protracted bronchitis (63%) were still coughing at day 14 in comparison with children with asthma (24%) and healthy controls (26%). Conclusion Children with protracted bronchitis had the most severe ARI symptoms and higher percentage of respiratory morbidity at day 14 in comparison with children with asthma and healthy controls.

Physical activity parenting measurement and research : challenges, explanations, and solutions

Physical activity (PA) parenting research has proliferated over the past decade, with findings verifying the influential role that parents play in children's emerging PA behaviors. This knowledge, however, has not translated into effective family-based PA interventions. During a preconference workshop to the 2012 International Society for Behavioral Nutrition and Physical Activity annual meeting, a PA parenting workgroup met to: (1) Discuss challenges in PA parenting research that may limit its translation, (2) identify explanations or reasons for such challenges, and; (3) recommend strategies for future research. Challenges discussed by the workgroup included a proliferation of disconnected and inconsistently measured constructs, a limited understanding of the dimensions of PA parenting, and a narrow conceptualization of hypothesized moderators of the relationship between PA parenting and child PA. Potential reasons for such challenges emphasized by the group included a disinclination to employ theory when developing measures and examining predictors and outcomes of PA parenting as well as a lack of agreed-upon measurement standards. Suggested solutions focused on the need to link PA parenting research with general parenting research, define and adopt rigorous standards of measurement, and identify new methods to assess PA parenting. As an initial step toward implementing these recommendations, the workgroup developed a conceptual model that: (1) Integrates parenting dimensions from the general parenting literature into the conceptualization of PA parenting, (2) draws on behavioral and developmental theory, and; (3) emphasizes areas which have been neglected to date including precursors to PA parenting and effect modifiers.

Adherence to physical activity and electronic media guidelines in Australian pre-school children

The aim of this study was to determine compliance with the National Association for Sport and Physical Education (NASPE) guideline for physical activity and American Academy of Pediatrics (AAP) recommendation for electronic media use among urban pre-school children in two large cities on the East Coast of Australia. Cross-sectional data were collected from 266 parents. Time spent using electronic media (watching television, DVDs or on the computer) and in physical activity were parent reported. The proportion who met each guideline was calculated. 56 per cent and 79% of children met the NASPE guideline on weekdays and weekends, respectively, while 73% and 70% met the AAP recommendation on weekdays and weekends, with no difference between boys and girls. A substantial minority do not meet physical activity and electronic media use recommendations, highlighting the need to better understand what factors contribute to physical activity and electronic media use among this group of pre-schoolers.

Lung recruitment and endotracheal suction in ventilated preterm infants measured with electrical impedance tomography

Aims Although suctioning is a standard airway maintenance procedure, there are significant associated risks, such as loss of lung volume due to high negative suction pressures. This study aims to assess the extent and duration of change in end-expiratory level (EEL) resulting from endotracheal tube (ETT) suction and to examine the relationship between EEL and regional lung ventilation in ventilated preterm infants with respiratory distress syndrome. Methods A prospective observational clinical study of the effect of ETT suction on 20 non-muscle-relaxed preterm infants with respiratory distress syndrome (RDS) on conventional mechanical ventilation was conducted in a neonatal intensive care unit. Ventilation distribution was measured with regional impedance amplitudes and EEL using electrical impedance tomography. Results ETT suction resulted in a significant increase in EEL post-suction (P < 0.01). Regionally, anterior EEL decreased and posterior EEL increased post-suction, suggesting heterogeneity. Tidal volume was significantly lower in volume-guarantee ventilation compared with pressure-controlled ventilation (P = 0.04). Conclusions ETT suction in non-muscle-relaxed and ventilated preterm infants with RDS results in significant lung volume increase that is maintained for at least 90 min. Regional differences in distribution of ventilation with ETT suction suggest that the behaviour of the lung is heterogeneous in nature.

Maternal feeding self-efficacy and fruit and vegetable intakes in infants. Results from the SAIDI study

Adequate consumption of fruits and vegetables (FV) is a characteristic of a healthy diet but remains a challenge in nutrition interventions. This cross-sectional study explored the multi-directional relationships between maternal feeding self-efficacy, parenting confidence, child feeding behaviour, exposure to new food and FV intake in a cohort of 277 infants. Mothers with healthy infants weighing ≥2500 g and ≥37 weeks gestation were recruited post-natally from 11 South Australian hospitals. Socio-demographic datawere collected at recruitment. At 6 months postnatal, infantswereweighed and measured, andmothers completed a questionnaire exploring their perceptions of child feeding behaviour and child exposure to newfoods. The questionnaire also included the Short Temperament Scale for Infants, Kessler 10 to measure maternal psychological distress and 5 items measuring maternal feeding self-efficacy. The number of occasions and variety of FV (number of subgroups within food groups) consumed by infants were estimated from a 24-hour dietary recall and 2 days food record. Structural equation modellingwas performed using Mplus version 6.11. Median (IQR) variety scores were 2 (1–3) for fruit and 3 (2–5) for vegetable intake. The most popular FV consumed were apple (n = 108, 45.0%) and pumpkin (n = 143, 56.3%). None of the variables studied predicted the variety of child fruit intake. Parenting confidence, exposure to new foods and child feeding behaviourwere indirectly related to child vegetable intake through maternal feeding self-efficacy while total number of children negatively predicted child vegetable variety (p < 0.05). This highlights the need for addressing antecedents of maternal feeding self-efficacy and the family eating environment as key strategies towards development of healthy eating in children.

The association between social support and levels of psychological distress in pregnant women in Australia

The purpose of this study was to explore associations between forms of social support and levels of psychological distress during pregnancy. Methods: A cross-sectional analysis of 2,743 pregnant women from south-east Queensland, Australia, was conducted utilising data collected between 2007-2011 as part of the Environments for Healthy Living (EFHL) project, Griffith University. Psychological distress was measured using the Kessler 6; social support was measured using the following four factors: living with a partner, living with parents or in-laws, self-perceived social network, and area satisfaction. Data were analysed using an ordered logistic regression model controlling for a range of socio-demographic factors. Results: There was an inverse association between self-perceived strength of social networks and levels of psychological distress (OR = 0.77; 95%CI: 0.70, 0.85) and between area satisfaction and levels of psychological distress (OR = 0.77; 95%CI: 0.69, 0.87). There was a direct association between living with parents or in-laws and levels of psychological distress (OR = 1.50; 95%CI: 1.16, 1.96). There was no statistically significant association between living with a partner and the level of psychological distress of the pregnant woman after accounting for household income. Conclusion: Living with parents or in-laws is a strong marker for psychological distress. Strategies aiming to build social support networks for women during pregnancy have the potential to provide a significant benefit. Policies promoting stable family relationships and networks through community development could also be effective in promoting the welfare of pregnant women.

Beliefs about infant regulation, early infant behaviors and maternal postnatal depressive symptoms

Background: Young infants may have irregular sleeping and feeding patterns. Such regulation difficulties are known correlates of maternal depressive symptoms. Parental beliefs regarding their role in regulating infant behaviours also may play a role. We investigated the association of depressive symptoms with infant feeding/sleeping behaviours, parent regulation beliefs, and the interaction of the two. Method: In 2006, 272 mothers of infants aged up to 24 weeks completed a questionnaire about infant behaviour and regulation beliefs. Participants were recruited from general medical practices and child health clinics in Brisbane, Australia. Depressive symptomology was measured using the Edinburgh Postnatal Depression Scale (EPDS). Other measures were adapted from the ALSPAC study. Results: Regression analyses were run controlling for partner support, other support, life events, and a range of demographic variables. Maternal depressive symptoms were associated with infant sleeping and feeding problems but not regulation beliefs. The most important infant predictor was sleep behaviours with feeding behaviours accounting for little additional variance. An interaction between regulation beliefs and sleep behaviours was found. Mothers with high regulation beliefs were more susceptible to postnatal depressive symptoms when infant sleep behaviours were problematic. Conclusion: Mothers of young infants who expect greater control are more susceptible to depressive symptoms when their infant presents challenging sleep behaviour.