Newborn behavior and risk of postnatal depression in the mother

The aim of this study was to assess which behavioral characteristics of the newborn infant are associated with an increased risk of postnatal depression (PND) in the mother. A total of 497 mothers from a prospective cohort study were recruited during the last trimester of pregnancy. Infants were evaluated at 3 days with the Brazelton Neonatal Behavioral Scale. Maternal PND was assessed at 6 weeks postpartum with the Edinburgh Postnatal Depression Scale. Behavioral characteristics of the infant predicted the occurrence of PND, independent of other risk factors for PND: The lower the infants' orientation performance, the higher the risk that the mother would present with PND 6 weeks after delivery. As orientation capacities play a key role in the interactional skills developed between mothers and their infants, an infant who is difficult to engage in interaction may contribute to the risk of PND.

Infants Can Learn Decontextualized Words Before Their First Birthday

Can infants below age 1 year learn words in one context and understand them in another? To investigate this question, two groups of parents trained infants from age 9 months on 8 categories of common objects. A control group received no training. At 12 months, infants in the experimental groups, but not in the control group, showed comprehension of the words in a new context. It appears that infants under 1 year old can learn words in a decontextualized, as distinct from a context-bound, fashion. Perceptual variability within the to-be-learned categories, and the perceptual similarity between training sets and the novel test items, did not appear to affect this learning.

What's in a name? Lexical knowledge drives infants' visual preferences in the absence of referential input

Seventeen-month-old infants were presented with pairs of images, in silence or with the non-directive auditory stimulus 'look!'. The images had been chosen so that one image depicted an item whose name was known to the infant, and the other image depicted an image whose name was not known to the infant. Infants looked longer at images for which they had names than at images for which they did not have names, despite the absence of any referential input. The experiment controlled for the familiarity of the objects depicted: in each trial, image pairs presented to infants had previously been judged by caregivers to be of roughly equal familiarity. From a theoretical perspective, the results indicate that objects with names are of intrinsic interest to the infant. The possible causal direction for this linkage is discussed and it is concluded that the results are consistent with Whorfian linguistic determinism, although other construals are possible. From a methodological perspective, the results have implications for the use of preferential looking as an index of early word comprehension.

Early social experience and individual differences in infants' joint attention

Fifty-nine healthy infants were filmed with their mothers and with a researcher at two, four, six and nine months in face-to-face play, and in toy-play at six and nine months. During toy-play at both ages, two indices of joint attention (JA)—infant bids for attention, and percent of time in shared attention—were assessed, along with other behavioural measures. Global ratings were made at all four ages of infants’ and mothers’ interactive style. The mothers varied in psychiatric history (e.g., half had experienced postpartum depression) and socioeconomic status, so their interactive styles were diverse. Variation in nine-month infant JA — with mother and with researcher — was predicted by variation in maternal behaviour and global ratings at six months, but not at two or four months. Concurrent adult behaviour also influenced nine-month JA, independent of infant ratings. Six-month maternal behaviours that positively predicted later JA (some of which remained important at nine months) included teaching, conjoint action on a toy, and global sensitivity. Other behaviours (e.g., entertaining) negatively predicted later JA. Findings are discussed in terms of social-learning and neurobiological accounts of JA emergence.

Life and death in a civitas capital: metabolic disease and trauma in the children from late Roman Dorchester, Dorset

The impact that “Romanization” and the development of urban centers had on the health of the Romano-British population is little understood. A re-examination of the skeletal remains of 364 nonadults from the civitas capital at Roman Dorchester (Durnovaria) in Dorset was carried out to measure the health of the children living in this small urban area. The cemetery population was divided into two groups; the first buried their dead organized within an east–west alignment with possible Christian-style graves, and the second with more varied “pagan” graves, aligned north–south. A higher prevalence of malnutrition and trauma was evident in the children from Dorchester than in any other published Romano-British group, with levels similar to those seen in postmedieval industrial communities. Cribra orbitalia was present in 38.5% of the children, with rickets and/or scurvy at 11.2%. Twelve children displayed fractures of the ribs, with 50% of cases associated with rickets and/or scurvy, suggesting that rib fractures should be considered during the diagnosis of these conditions. The high prevalence of anemia, rickets, and scurvy in the Poundbury children, and especially the infants, indicates that this community may have adopted child-rearing practices that involved fasting the newborn, a poor quality weaning diet, and swaddling, leading to general malnutrition and inadequate exposure to sunlight. The Pagan group showed no evidence of scurvy or rib fractures, indicating difference in religious and child-rearing practices but that both burial groups were equally susceptible to rickets and anemia suggests a shared poor standard of living in this urban environment.

Hypo-accommodation responses in hypermetropic infants and children

Aims: Accommodation to overcome hypermetropia is implicated in emmetropisation. This study recorded accommodation responses in a wide range of emmetropising infants and older children with clinically significant hypermetropia to assess common characteristics and differences. Methods: A PlusoptiXSO4 photorefractor in a laboratory setting was used to collect binocular accommodation data from participants viewing a detailed picture target moving between 33cm and 2m. 38 typically developing infants were studied between 6-26 weeks of age and were compared with cross-sectional data from children 5-9 years of age with clinically significant hypermetropia (n=15), corrected fully accommodative strabismus (n=14) and 27 age-matched controls. Results: Hypermetropes of all ages under-accommodated compared to controls at all distances, whether corrected or not (p<0.00001) and lag related to manifest refraction. Emmetropising infants under-accommodated most in the distance, while the hypermetropic patient groups underaccommodated most for near. Conclusions: Better accommodation for near than distance is demonstrated in those hypermetropic children who go on to emmetropise. This supports the approach of avoiding refractive correction in such children. In contrast, hypermetropic children referred for treatment for reduced distance visual acuity are not likely to habitually accommodate to overcome residual hypermetropia left by an under-correction.

Megnin re-analysed: the case of the newborn baby girl, Paris, 1878

This paper analyses acarological evidence from a 130-year-old forensic investigation. It was the first case in forensic acarology, i.e., the first case where mites provided substantial information to estimate the post-mortem interval (PMI). In 1878, the mites found in the mummified body of a newborn baby girl in Paris, France, were studied by acarologist and forensic entomologist Jean Pierre M,gnin. M,gnin estimated around 2.4 million mites in the skull and identified them as Tyroglyphus longior (Gervais), a junior synonym of Tyrophagus longior. He suggested that the arrival of these mites at the corpse would have occurred by phoresy on carrier insects, roughly 5 months before the autopsy. There is no doubt about the identification of the mites, M,gnin was a highly respected acarologist. However, two main factors affecting the biology of Tyrophagus mites were not included in the original analysis. First, M,gnin stated that the mites were phoretic. However, he probably did not have access to information about the natural history of the species, because as a rule Tyrophagus mites are non-phoretic. Considering the omnipresence of Tyrophagus mites in soil, most likely the mites will have arrived almost immediately after death. Second, temperature was not taken into account during the estimations of the mite population growth rate. The new analysis is based on current knowledge of Tyrophagus biology and includes temperature, estimated following a handful of weather reports of the years 1877 and 1878. The new projections indicate that non-phoretic mites may have colonised the body just after death and the colony would have built up over 8 months, contrary to the 5 months proposed by M,gnin. This new lapse of time agrees with the PMI proposed by Brouardel: on 15 January 1878 he postulated the death of the newborn to have occurred some 8 months before the autopsy.

Weaning preterm infants: a randomised controlled trial

Objective: To assess the effect on growth and iron status in preterm infants of a specially devised weaning strategy compared with current best practices in infant feeding. The preterm weaning strategy recommended the early onset of weaning and the use of foods with a higher energy and protein content than standard milk formula, and foods that are rich sources of iron and zinc. Subjects and design: In a blinded, controlled study, 68 preterm infants (mean (SD) birth weight 1470 (430) g and mean (SD) gestational age 31.3 (2.9) weeks) were randomised to either the preterm weaning strategy group (n = 37) or a current best practice control group (n = 31), from hospital discharge until 1 year gestation corrected age (GCA). Main outcome measures: Weight, supine length, occipitofrontal head circumference, and intakes of energy, protein, and minerals were determined at 0, 6, and 12 months GCA. Levels of haemoglobin, serum iron, and serum ferritin were assayed at 0 and 6 months GCA. Results: Significant positive effects of treatment included: greater increase in standard deviation length scores and length growth velocity; increased intake of energy, protein, and carbohydrate at 6 months GCA and iron at 12 months GCA; increased haemoglobin and serum iron levels at 6 months GCA. Conclusions: The preterm weaning strategy significantly influenced dietary intakes with consequent beneficial effects on growth in length and iron status. This strategy should be adopted as the basis of feeding guidelines for preterm infants after hospital discharge. School of Applied Statistics Faculty of Life Sciences

Potential roles and clinical utility of prebiotics in newborns, infants, and children: proceedings from a global prebiotic summit meeting, New York City, June 27-28, 2008

Initial bacterial colonization, including colonization with health-positive bacteria, such as bifidobacteria and lactobacilli, is necessary for the normal development of intestinal innate and adaptive immune defenses. The predominance of beneficial bacteria in the gut microflora of breast-fed infants is thought to be, at least in part, supported by the metabolism of the complex mixture of oligosaccharides present in human breast milk, and a more adult-type intestinal microbiota is found in formula-fed infants. Inadequate gut colonization, dysbiosis, may lead to an increased risk of infectious, allergic, and autoimmune disorders later in life. The addition of appropriate amounts of selected prebiotics to infant formulas can enhance the growth of bifidobacteria or lactobacilli in the colonic microbiota and, thereby, might produce beneficial effects. Among the substrates considered as prebiotics are the oligosaccharides inulin, fructo-oligosaccharides, galacto-oligosaccharides, and lactulose. There are some reports that such prebiotics have beneficial effects on various markers of health. For example, primary prevention trials in infants have provided promising data on prevention of infections and atopic dermatitis. Additional well-designed prospective clinical trials and mechanistic studies are needed to advance knowledge further in this promising field. (J Pediatr 2009;155:S61-70).

Effects of probiotic or prebiotic supplemented milk formulas on fecal microbiota composition of infants

The aim of the study was to evaluate whether supplementation of milk-formulas with prebiotic fructooligosaccharides or a probiotic, Lactobacillus johnsonii La1 (La1), could modulate the composition of the fecal microbiota of formula-fed infants, compared to breastfed (BF) infants. Ninety infants close to 4 months of age were randomized into one of three groups to be blindly assigned to receive for 13 weeks: a) an infant formula (Control), b) the same formula with fructo-oligosaccharides (Prebio), or c) with La1 (Probio). At the end of this period, all infants received the control formula for 2 additional weeks. Twenty-six infants, breastfed throughout the study, were recruited to form group BF. Fecal samples were obtained upon enrolment and after 7 and 15 weeks. Bacterial populations were assessed with classical culture techniques and fluorescent in situ hybridisation (FISH). Seventy-six infants completed the study. On enrolment, higher counts of Bifidobacterium and Lactobacillus and lower counts of enterobacteria were observed in BF compared to the formula-fed infants; these differences tended to disappear at weeks 7 and 15. No major differences for Clostridium, Bacteroides or Enterococcus were observed between the groups or along the follow up. Probio increased fecal Lactobacillus counts (P<0.001); 88% of the infants in this group excreted live La1 in their stools at week 7 but only 17% at week 15. Increased Bifidobacterium counts were observed at week 7 in the 3 formula groups, similar to BF infants. These results confirm the presence of higher counts of bifidobacteria and lactobacilli in the microbiota of BF infants compared to formula-fed infants before dietary diversification, and that La1 survives in the infant digestive tract.

Effects of bovine alpha-lactalbumin and casein glycomacropeptide-enriched infant formulae on faecal microbiota in healthy term infants

Objective: Certain milk factors may promote the growth of a host-friendly gastrointestinal microbiota, for example, one that is predominated by bifidobacteria, a perceived healthpromoting genus. This may explain why breast-fed infants experience fewer intestinal infections than their formula-fed counterparts who are believed to have a more diverse microbiota, which is similar to that of adults. The effects of formulas supplemented with 2 such ingredients from bovine milk, a-lactalbumin (alpha-lac) and casein glycomacropeptide (GMP), on gut flora were investigated in this study. Patients and Methods: Six-week-old (4-8 wk), healthy term infants were randomised to a standard infant formula or 1 of 2 test formulae enriched in alpha-Jac with higher or lower GMP until 6 months. Faecal bacteriology was determined by the culture-independent procedure fluorescence in situ hybridisation. Results: There was a large fluctuation of bacterial counts within groups with no statistically significant differences between groups. Although all groups showed a. predominance of bifidobacteria, breast-fed infants had a small temporary increase in counts. Other bacterial levels varied in formula-fed groups, which overall showed an adult-like faecal microflora. Conclusions: It can be speculated that a prebiotic effect for alpha-lac and GMP is achieved only with low starting populations of beneficial microbiota (eg, infants not initially breast-fed.

The neural basis of maternal responsiveness to infants: an fMRI study

Using fMRI, we examined the neural correlates of maternal responsiveness. Ten healthy mothers viewed alternating blocks of video: (i) 40 s of their own infant; (ii) 20 s of a neutral video; (iii) 40 s of an unknown infant and (iv) 20 s of neutral video, repeated 4 times. Predominant BOLD signal change to the contrast of infants minus neutral stimulus occurred in bilateral visual processing regions BA minus neutral stimulus occurred in bilateral visual processing regions (BA 38), left amygdala and visual cortex (BA 19), and to the unknown infant minus own infant contrast in bilateral orbitofrontal cortex (BA 10,47) and medial prefrontal cortex (BA 8). These findings suggest that amygdala and temporal pole may be key sites in mediating a mother's response to her infant and reaffirms their importance in face emotion processing and social behaviour.

Mental health of parents caring for infants

The postpartum period is a sensitive time due to the presence and demands of the developing infant. The care provided by a mother to her infant during this period may be compromised if she is suffering from postnatal depression or postpartum psychosis. Evidence has been emerging which suggests that postnatal depression and postpartum psychoses have adverse effects on the quality of the mother-infant relationship and also on the infants subsequent cognitive and emotional development. Presented is a review of the literature relating to how these conditions impact on parenting and infant outcomes, what measures are in place to detect these conditions and evidence-based models of best clinical practice are proposed.

Discrepancy between parental reports of infants' receptive vocabulary and infants' behaviour in a preferential looking task

Two experiments are described which explore the relationship between parental reports of infants' receptive vocabularies at 1; 6 (Experiment 1a) or 1-3, 1;6 and 1;9 (Experiment 1b) and the comprehension infants demonstrated in a preferential looking task. The instrument used was the Oxford CD1, a British English adaptation of the MacArthur-Bates CD1 (Words & Gestures). Infants were shown pairs of images of familiar objects, either both name-known or both name-unknown according to their parent's responses on the CD1. At all ages, and on both name-known and name-unknown trials, preference for the target image increased significantly from baseline when infants heard the target's label. This discrepancy suggests that parental report underestimates infants' word knowledge.