tag:theconversation.com,2011:/global/topics/infants-27465/articlesInfants – The Conversation2024-03-01T13:43:16Ztag:theconversation.com,2011:article/2083402024-03-01T13:43:16Z2024-03-01T13:43:16ZGut microbiome: meet Bifidobacterium breve, keeping babies healthy<figure><img src="https://images.theconversation.com/files/539057/original/file-20230724-21-ezb4di.jpg?ixlib=rb-1.1.0&rect=40%2C0%2C4500%2C2997&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-illustration/bacteria-bifidobacterium-grampositive-anaerobic-rodshaped-which-1036394278">Kateryna Kon/Shutterstock</a></span></figcaption></figure><p><em>Bifidobacterium breve</em>, or <em>B breve</em> for short, is a bacterial species that’s found in the human intestine. It’s especially relevant <a href="https://www.frontiersin.org/articles/10.3389/fmicb.2016.01204/full">in early life</a>, being one of the most abundant bacteria in the newborn gut.</p>
<p><em>B breve</em> is a species of the genus <em>Bifidobacterium</em> and is considered key in the development of a healthy gut. It has been studied extensively over the years to uncover how it benefits us from our first days of life.</p>
<p>Some of the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4908950/">benefits</a> associated with this species include protection against pathogens, modulation of the immune system, and provision of nutrients through the breakdown of non-digestible carbohydrates from the diet.</p>
<p>We’re still learning about the origin of <em>B breve</em>. But <a href="https://journals.asm.org/doi/10.1128/AEM.02037-15">vertical transmission</a>, where the origin is the mother and the transfer to the baby occurs either during or after birth, is understood to be the main source of microbes at an early age.</p>
<p>A <a href="https://www.nature.com/articles/s41467-023-38694-0">study</a> carried out by MicrobeMom (a project I was part of during my PhD) has shown that <em>Bifidobacterium</em> strains including <em>B breve</em> are indeed transferred from mother to infant. We didn’t investigate the precise mode of transfer, but one of the key factors influencing the outcome was vaginal birth, so it’s likely these bacteria are passed on during childbirth.</p>
<p>Our research also showed that <em>B breve</em> was the most frequently isolated of the <em>Bifidobacterium</em> species. It was present in vaginal samples from the mother, stool samples from the infant and the mother, as well as breast milk. In fact, <em>B breve</em> represented 80% of the total <em>Bifidobacterium</em> isolated from breast milk.</p>
<p>This highlights the pivotal role that the mother’s gut microbiome has in fostering a baby’s gut health.</p>
<h2><em>Bifidobacterium</em> and the infant gut</h2>
<p><em>Bifidobacterium</em> in general are known for being one of the first <a href="https://journals.asm.org/doi/full/10.1128/mmbr.00036-17">colonisers</a> of the infant gut. This is because of their important role degrading carbohydrates from the diet that the infant gut cannot digest. </p>
<p>This has a positive effect not only on the development of the gut but also the baby’s <a href="https://www.cell.com/cell/pdf/S0092-8674(21)00660-7.pdf">immune system</a>. The mechanism for this is quite complex, but in general terms <em>Bifidobacterium</em> have been shown to interact with human immune cells and to modify <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5722804/">immune responses</a>.</p>
<p>The human microbiome changes constantly, and <em>Bifidobacterium</em> is a good example of this. The amount of <em>Bifidobacterium</em> in our gut changes during our lifespan, as does the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4990546/">composition</a> of specific <em>Bifidobacterium</em> species, in response to our diet.</p>
<p><em>Bifidobacterium</em> is the most abundant bacteria in the first months of life, when a baby is breastfed, and when microbial diversity (the variety of bacteria, viruses and other microbes we carry) is still very low. The <a href="https://www.bmj.com/content/361/bmj.k2179">microbiota</a> begins to change when solid food is introduced, and we have less <em>Bifidobacterium</em> as we get older when the <a href="https://www.frontiersin.org/articles/10.3389/fmicb.2016.01204/full">microbial diversity</a> in our gut increases.</p>
<p>Species such as <em>Bifidobacterium adolescentis</em> and <em>Bifidobacterium longum</em> are typically associated with adulthood, due to their ability to degrade plant-derived carbohydrates found in fruit and vegetables. But <em>B breve</em> and certain other species are generally associated with infancy. </p>
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Read more:
<a href="https://theconversation.com/why-breastfed-babies-have-improved-immune-development-new-findings-156008">Why breastfed babies have improved immune development – new findings</a>
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<h2>Breast milk</h2>
<p>Human milk is a complex fluid capable of satisfying all the nutritional requirements of a newborn. It also provides extensive <a href="https://www.nhs.uk/conditions/baby/breastfeeding-and-bottle-feeding/breastfeeding/benefits/">health benefits</a>, such as reduced risk of various infections. Its composition changes over the period of lactation, adapting to the requirements of the infant. </p>
<p>Breast milk is one of the <a href="https://pubmed.ncbi.nlm.nih.gov/32552141/">main factors</a> that influences the infant microbiota, as breastfeeding <a href="https://www.nature.com/articles/s41564-021-00970-4">increases the number</a> of <em>Bifidobacterium</em> in the infant gut.</p>
<p>One specific component of breast milk that affects the composition of the microbiome is <a href="https://academic.oup.com/glycob/article/22/9/1147/1988076?login=true">human milk oligosaccharides</a>, which are the most abundant carbohydrates present in breast milk after lactose.</p>
<p>These carbohydrates cannot be digested by the human gut, which is where <em>B breve</em> plays an important role. It’s among the microbes that can degrade <a href="https://www.nature.com/articles/srep38560">human milk oligosaccharides</a>, and in this way, they promote its persistence in the gut.</p>
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<img alt="A woman sitting on a couch breastfeeding her baby." src="https://images.theconversation.com/files/539059/original/file-20230724-29-8askj2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/539059/original/file-20230724-29-8askj2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/539059/original/file-20230724-29-8askj2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/539059/original/file-20230724-29-8askj2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/539059/original/file-20230724-29-8askj2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/539059/original/file-20230724-29-8askj2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/539059/original/file-20230724-29-8askj2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption"><em>B breve</em> helps to break down certain carbohydrates present in breast milk.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/newborn-baby-boy-sucking-milk-mothers-1968728029">Nastyaofly/Shutterstock</a></span>
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<h2>Prebiotics and probiotics</h2>
<p>Human milk oligosaccharides are considered prebiotics – carbohydrates, indigestible by the human gut, that promote the growth of beneficial bacteria in the gut, such as <em>B breve</em>.</p>
<p><em>B breve</em> is regarded as a <a href="https://isappscience.org/for-scientists/resources/probiotics/">probiotic</a> – a bacterial species whose intake has a benefit for the host.</p>
<p>Nowadays, human milk oligosaccharides can be found in formula milk, aiming to facilitate the same changes in the microbiota through their prebiotic effects.</p>
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Read more:
<a href="https://theconversation.com/gut-instinct-how-the-way-youre-born-and-fed-affect-your-immune-system-65104">Gut instinct: how the way you're born and fed affect your immune system</a>
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<p><em>B breve</em> is used as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6265827/">a supplement</a> to treat and prevent gastrointestinal problems such as diarrhoea, often administered in combination with other probiotic bacteria such <em>Lactobacillus</em> or other <em>Bifidobacterium</em> species. It’s also commercially available in combination with prebiotics.</p>
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<p><em>This article is part of <a href="https://theconversation.com/uk/topics/meet-your-gut-microbes-150943?utm_source=InArticleTop&utm_medium=TCUK&utm_campaign=Health2024">Meet Your Gut Microbes</a>, a series about the rich constellation of bacteria, viruses, archaea and fungi that live in people’s digestive tracts. Scientists are increasingly realising their importance in shaping our health – both physical and mental. Each week we will look at a different microbe and bring you the most up-to-date research on them.</em></p>
<hr><img src="https://counter.theconversation.com/content/208340/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Rocío Sánchez Gallardo receives funding from a peer reviewed research grant from Science Foundation Ireland (SFI).</span></em></p>B breve has benefits for a baby from their first days of life.Rocío Sánchez Gallardo, PhD candidate, School of Microbiology & APC Microbiome Institute, University College CorkLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2119722023-11-09T14:15:03Z2023-11-09T14:15:03ZHow autistic parents feel about breastfeeding and the support they receive – new research<figure><img src="https://images.theconversation.com/files/550058/original/file-20230925-15-aytg7n.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C5020%2C3321&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Almost half the study's respondents found breastfeeding to be a positive experience most or all of the time. </span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/young-mother-breastfeeding-her-newborn-child-516261334">Lolostock/Shutterstock</a></span></figcaption></figure><p>Surprisingly little is still known about autism and breastfeeding. A few years ago, <a href="https://journals.sagepub.com/doi/full/10.1177/13623613221089374">we reviewed</a> all of the research evidence and found limited information about the experiences of autistic parents – beyond highlighting that the sensory differences when breastfeeding could be very challenging for them. We also found that communication by health professionals didn’t always meet the <a href="https://www.autisticuk.org/post/autistic-mothers-experiences-of-breast-and-formula-feeding-babies-what-does-the-evidence-s">needs</a> of autistic parents.</p>
<p>So, for our newly released <a href="https://doi.org/10.1111/mcn.13581">study</a>, we asked 152 autistic parents from across the UK about their breast- and formula-feeding experiences. Some 87% of those who breastfed were strongly motivated to keep breastfeeding even if they ran into difficulties, while only 54% of all the parents we interviewed used any infant formula. This is a substantially lower rate of formula use than we’d typically see in the UK, where <a href="https://doc.ukdataservice.ac.uk/doc/7281/mrdoc/pdf/7281_ifs-uk-2010_report.pdf">88% of babies</a> receive some infant formula during their first six months.</p>
<p>Almost half of our respondents found breastfeeding to be a positive or enjoyable experience most or all of the time. This included the experience of feeling bonded with their baby and enjoying learning about breastfeeding.</p>
<p>That said, many of these autistic parents described experiencing sensory difficulties, with touch-related issues being their most frequently reported challenge. These issues ranged from discomfort caused by “little hands” touching their skin, to pain from infants suckling, biting and “latching on” to the breast. </p>
<p>Some 10% of our participants expressed breastmilk all of the time. This is higher than we would expect in an average group of parents, as expressing milk for every feed is <a href="https://onlinelibrary.wiley.com/doi/10.1111/j.1365-2648.2012.06035.x">usually only done</a> when babies are premature or parents have returned to work. On the other hand, the feeling and sound of breast pumps could be unbearable for some of the parents we interviewed.</p>
<h2>Interoception</h2>
<p>Most people know about the five basic human senses: touch, sight, sound, smell and taste. But we also have three other senses that are just as important. The <a href="https://www.sciencedirect.com/topics/neuroscience/vestibular-system">vestibular system</a> helps us keep our balance and move around safely; <a href="https://www.sciencedirect.com/topics/neuroscience/proprioception#:%7E:text=Proprioception%20refers%20to%20the%20sense,have%20receptors%20involved%20in%20proprioception.">proprioception</a> lets us know how our muscles and joints are moving; and <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/interoception">interoception</a> tells us about what is happening inside our bodies, such as our heart rate, breathing and digestion.</p>
<p>Autistic people often have <a href="https://www.sciencedirect.com/science/article/abs/pii/S073657481630096X">different interoceptive experiences</a> to non-autistic people – such as either not knowing or being acutely aware that they are hungry, thirsty or need the toilet. </p>
<p>With regard to breastfeeding, 41% of our participants who breastfed told us that their interoceptive experiences relating to the <a href="https://www.breastmilkcounts.com/breastfeeding-basics/the-let-down/">milk let-down reflex</a> (the response from your body that causes breastmilk to flow) was uncomfortable or painful always or most of the time. This included having “a feeling of dread” or the let-down reflex feeling odd in some way. One of our parents noted that “it felt like I had an old-fashioned telephone ringing in my breasts”.</p>
<h2>Adaptation strategies</h2>
<p>Whether our parents breast- or formula-fed, the intensity of babies’ frequent feeding could be overwhelming – a <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1468-2397.2009.00684.x">well-known issue</a> among the general population of parents too. However, for autistic parents, carefully developed strategies to stay regulated and de-stress, such as going for a walk or watching an episode of a favourite TV show, could be disrupted by the busy routine of new parenthood.</p>
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<img alt="A woman looks at her phone while breastfeeding her baby." src="https://images.theconversation.com/files/550067/original/file-20230925-25-cnncei.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/550067/original/file-20230925-25-cnncei.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=899&fit=crop&dpr=1 600w, https://images.theconversation.com/files/550067/original/file-20230925-25-cnncei.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=899&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/550067/original/file-20230925-25-cnncei.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=899&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/550067/original/file-20230925-25-cnncei.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1130&fit=crop&dpr=1 754w, https://images.theconversation.com/files/550067/original/file-20230925-25-cnncei.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1130&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/550067/original/file-20230925-25-cnncei.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1130&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/portrait-young-confident-woman-modern-living-2049690128">BAZA Production/Shutterstock</a></span>
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<p>The parents in our study had done a lot of problem-solving to reduce the sensory challenges of feeding their babies. This included adapting their clothing and distracting themselves during feeding by looking at a mobile phone, for example. </p>
<p>There is evidence that bonding is <a href="https://onlinelibrary.wiley.com/doi/10.1111/nhs.12918">not negatively impacted</a> by the use of smartphones when breastfeeding in a general population. So, these types of distraction should be encouraged for all parents who are finding breastfeeding hard but want to continue doing so.</p>
<p>While 76% of our parents had received some form of breastfeeding support, nearly three-quarters of these parents (71%) still reported feeling unsupported. Issues included there not being enough breastfeeding support available, and health professionals providing conflicting information – concerns that also found in the accounts of <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/mcn.13355">non-autistic parents</a>.</p>
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Read more:
<a href="https://theconversation.com/dehumanising-policies-leave-autistic-people-struggling-to-access-health-education-and-housing-new-review-202997">'Dehumanising policies' leave autistic people struggling to access health, education and housing – new review</a>
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<p>It also appears that those supporting infant feeding, such as midwives and health visitors, did not have a good understanding of autistic communication. For example, some parents felt they were not listened to or that their concerns were dismissed.</p>
<p>Furthermore, some parents felt that staff did not appear to understand the specific sensory and interoceptive differences that could affect autistic people while breastfeeding.</p>
<h2>Room for improvement</h2>
<p>Overall, our study suggests there is a need for better understanding of autism among those providing infant feeding support. The national autism training <a href="https://www.annafreud.org/training/national-autism-trainer-programme/">programme</a>, which is developed and delivered by autistic adults, aims to improve this situation across England. Ideally, similar programmes should be implemented in the other UK nations.</p>
<p>A second area for improvement is for autistic parents, their partners and other people supporting them to be aware of potential feeding issues in advance, so they can be better prepared. Our project provides a <a href="https://www.youtube.com/@AutismMenstruationToMenopause/videos">suite of videos</a>, designed and created by autistic health professionals and parents, to help provide this information in an autism-friendly way.</p><img src="https://counter.theconversation.com/content/211972/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Aimee Grant receives funding from UKRI and the Wellcome Trust. She is a non-executive director of Disability Wales. We wish to thank Prof Amy Brown, who was also part of the research team.</span></em></p><p class="fine-print"><em><span>Kathryn Williams receives funding for her PhD studentship from the Economic and Social Research Council. She is affiliated with Autistic UK CIC, where she is a voluntary non-executive director.</span></em></p><p class="fine-print"><em><span>Catrin Griffiths does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>New research sheds light on how autism affects how we feed our babies, and vice versa.Aimee Grant, Senior Lecturer in Public Health and Wellcome Trust Career Development Fellow, Swansea UniversityCatrin Griffiths, Research Officer, Swansea UniversityKathryn Williams, PhD Candidate, Cardiff UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2143032023-10-05T15:14:59Z2023-10-05T15:14:59ZBaby formula preparation machines might not reach NHS recommended temperatures for killing bacteria – new research<figure><img src="https://images.theconversation.com/files/550876/original/file-20230928-21-25f2uo.jpg?ixlib=rb-1.1.0&rect=46%2C0%2C5184%2C3445&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The NHS recommends using water heated to at least 70C for mixing with formula powder.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/preparation-mixture-baby-feeding-on-white-556921537">279photo Studio/Shutterstock</a></span></figcaption></figure><p>When you have a new baby, it can feel as though there are suddenly thousands of things to worry about. One of the biggest concerns for parents in the early weeks is feeding.</p>
<p>Our <a href="https://doi.org/10.1111/mcn.13567">new study</a> has raised questions about one popular feeding device – the formula preparation machine. We found that only 15% of formula preparation machines tested dispensed water that appeared to be hot enough to meet NHS recommendations for preparing baby formula. In comparison, a majority of samples prepared using a kettle did meet the recommended temperature.<br>
Almost <a href="https://doc.ukdataservice.ac.uk/doc/7281/mrdoc/pdf/7281_ifs-uk-2010_report.pdf">three quarters</a> of babies in the UK receive some formula in the first six weeks after birth. This goes up to 88% within the first six months. Infant formula comes ready to drink in bottles and powdered, which parents need to mix with very hot water. Around <a href="https://static1.squarespace.com/static/59f75004f09ca48694070f3b/t/6053645514d0f3072adec94e/1616077909798/Marketing_of_infant_milk_in_the_UK-what_do_parents_see_and_believe_finala.pdf">80%</a> of parents who use formula use a powdered version at least half the time.</p>
<p>NHS guidance states that formula should be prepared using a kettle <a href="https://www.nhs.uk/conditions/baby/breastfeeding-and-bottle-feeding/bottle-feeding/making-up-baby-formula/">to boil</a> 1 litre of water, leaving the water to cool for no more than 30 minutes before adding it to the formula. This is so that it remains at a temperature of at least 70C when it is mixed with the powder. This is needed to <a href="https://www.who.int/publications/i/item/9789241595414">kill any bacteria</a>. </p>
<h2>Formula preparation machines</h2>
<p>In recent years, a range of formula preparation machines have been sold in the UK. Some dispense a small amount of hot water to which powder should be added, the bottle shaken and then the bottle topped up with cold water. Other machines dispense prepared formula in to a bottle. Our past <a href="https://static1.squarespace.com/static/59f75004f09ca48694070f3b/t/6053645514d0f3072adec94e/1616077909798/Marketing_of_infant_milk_in_the_UK-what_do_parents_see_and_believe_finala.pdf">research</a> suggests that more than half of parents use a formula preparation machine. </p>
<p>Some <a href="https://www.southtees.nhs.uk/services/maternity/infant-feeding/formula-feeding/">NHS trusts</a> (as well as the <a href="https://www2.hse.ie/babies-children/bottle-feeding/preparing-baby-formula/#:%7E:text=The%20Food%20Safety%20Authority%20of,for%20preparing%20your%20baby's%20bottle.">Irish government</a>), have stated that parents should not use these machines to prepare formula, due to there being problems with these devices that could lead to babies becoming unwell. This may be based on concerns that the water may not remain at a <a href="https://static1.squarespace.com/static/59f75004f09ca48694070f3b/t/5f58858c11457f399bae4a61/1599636878436/Bacterial_contamination_Aug20.pdf">hot enough temperature</a> to kill any bacteria in the powder. This matters because it increases the risk of gastrointestinal infection. </p>
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<img alt="A man feeds a baby with a bottle." src="https://images.theconversation.com/files/550878/original/file-20230928-27-d1ixap.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/550878/original/file-20230928-27-d1ixap.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/550878/original/file-20230928-27-d1ixap.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/550878/original/file-20230928-27-d1ixap.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/550878/original/file-20230928-27-d1ixap.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/550878/original/file-20230928-27-d1ixap.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/550878/original/file-20230928-27-d1ixap.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p>Formula-fed babies are <a href="https://www.unicef.org.uk/wp-content/uploads/sites/2/2012/11/Preventing_disease_saving_resources.pdf">more likely</a> to get bacterial gastrointestinal infections than breastfed babies. There are two main ways that bacteria can get into formula. Firstly, powdered formula itself cannot be made sterile because of how it is manufactured, meaning it can get <a href="https://www.cdc.gov/cronobacter/infection-and-infants.html#:%7E:text=Powdered%20formula%20is%20not%20sterile,processing%20facilities%20that%20make%20it.">contaminated</a>. This means that a brand new, unopened tub of formula <a href="https://static1.squarespace.com/static/59f75004f09ca48694070f3b/t/624edeb6873c47686bd34825/1649335991943/Bacterial+contamination_April+22.pdf">can contain</a> harmful bacteria such as <em>Salmonella</em> and <em>Cronobacter</em>. </p>
<p>Secondly, bacteria can be introduced into the formula in the home <a href="https://www.nature.com/articles/s41598-019-46181-0">by parents</a> or carers if they do not wash their hands or adequately sterilise all feeding equipment before making a bottle.</p>
<p>Using water boiled in a kettle and cooled to above 70C <a href="https://iris.who.int/bitstream/handle/10665/43659/9789241595414_eng.pdf?isAllowed=y&sequence=1">kills</a> harmful bacteria that cause gastrointestinal infections. Because of this, it is the only method of preparing formula which is currently <a href="https://www.nhs.uk/conditions/baby/breastfeeding-and-bottle-feeding/bottle-feeding/making-up-baby-formula/">recommended</a> by the NHS.</p>
<p>However, <a href="https://static1.squarespace.com/static/59f75004f09ca48694070f3b/t/6053645514d0f3072adec94e/1616077909798/Marketing_of_infant_milk_in_the_UK-what_do_parents_see_and_believe_finala.pdf">we found</a> that many parents do not feel confident about preparing bottles of formula safely.</p>
<h2>What we found</h2>
<p>We asked 143 parents to test the temperature of the water they used to prepare a bottle of formula at home. <a href="https://doi.org/10.1111/mcn.13567">We found</a> that only 15% of the 74 infant formula preparation machines tested appeared to produce water that reached NHS recommended temperatures for preparing bottles of formula.</p>
<p>But among the parents in our study who used a kettle to make up their formula, 78% of temperatures reported were above the recommended NHS level. </p>
<p>This is concerning, as temperatures below 70C can be harmful to babies’ health, and also given such a high number of parents use formula preparation machines. </p>
<h2>Advice</h2>
<p>If you are formula feeding, more information and support about preparing bottles is available on the <a href="https://www.nhs.uk/conditions/baby/breastfeeding-and-bottle-feeding/bottle-feeding/making-up-baby-formula/">NHS website</a>. The NHS guide recommends using a kettle to boil the water.</p>
<p>The Food Standards Agency (FSA) <a href="https://www.swansea.ac.uk/press-office/news-events/news/2023/10/study-raises-concerns-over-powdered-infant-formula-preparation-machines.php">recommend</a> that if you already have a formula preparation machine, you use a food thermometer to test the temperature of the water it produces. If you do this, do not put the thermometer into the bottle that you use to feed your baby, as the thermometer could introduce bacteria, so you will need to do this separately to making a bottle. </p>
<p>If your thermometer shows the water is below 70C, the machine should not be used to prepare bottles of formula and you should use a kettle instead. The FSA recommend that parents should notify both the manufacturer and their <a href="https://www.gov.uk/find-local-trading-standards-office">local trading standards</a> department or <a href="https://www.citizensadvice.org.uk/">Citizens Advice</a>. </p>
<p>We have shared our results with the <a href="https://www.gov.uk/government/organisations/office-for-product-safety-and-standards">Office for Product Safety and Standards</a>, the UK’s product safety regulator, who have purchased examples of formula preparation machines to assess compliance. We have also shared our findings with the <a href="https://www.food.gov.uk/">FSA</a>, who safeguard public health and protect consumers in relation to food across the UK.</p><img src="https://counter.theconversation.com/content/214303/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Aimee Grant receives funding from UKRI and the Wellcome Trust. She has previously received funding from the NIHR, HEFCW, and public health charities. Aimee is affiliated with Disability Wales. The Finding the Formula study, which is reported on in this article, was funded by UKRI and the Food Standards Agency. We wish to thank Dr Vicky Sibson, Dr Rebecca Ellis, Abbie Dolling, Tara McNamara, Jonie Cooper, Susan Dvorak, Sharon Breward, Phyll Buchanan and Dr Emma Yhnell who were also part of the study team, and the parents who provided data for this study.
</span></em></p><p class="fine-print"><em><span>Amy Brown has received research funding from UKRI, HEFCW, Infant feeding charities, local councils, health trusts and Public Health Wales. </span></em></p><p class="fine-print"><em><span>Sara Jones was paid for her time as a study manager from the UKRI funding for this project. She has also received funding from MRC and infant feeding charities.</span></em></p>New research finds that 85% of formula preparation machines tested were dispensing water that did not appear to reach NHS recommended temperatures for preparing bottles of formula.Aimee Grant, Senior Lecturer in Public Health and Wellcome Trust Career Development Fellow, Swansea UniversityAmy Brown, Professor of Child Public Health, Swansea UniversitySara Jones, Senior lecturer at Lactation and Infant Feeding Translational research centre, Swansea UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2113152023-08-29T15:34:37Z2023-08-29T15:34:37ZBreastfeeding increased during the pandemic but what does that tell us about how to improve rates?<figure><img src="https://images.theconversation.com/files/541982/original/file-20230809-25-3v08a2.jpg?ixlib=rb-1.1.0&rect=20%2C30%2C6689%2C4436&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/serious-calm-careful-young-black-mom-1426845311">SeventyFour/Shutterstock</a></span></figcaption></figure><p>During the pandemic, there had been concerns from healthcare professionals that the restrictions placed on daily life would lead to a disruption in breastfeeding. But <a href="https://bmjpaedsopen.bmj.com/content/7/1/e001907.full#ref-13">our new research</a> shows that the number of women who continued to exclusively breastfeed for six months increased. </p>
<p>And in fact, women were 40% more likely to exclusively breastfeed for six months during COVID than they were before the pandemic or now, post-pandemic. </p>
<p>The World Health Organization (WHO) <a href="https://www.who.int/health-topics/breastfeeding#tab=tab_2">recommends</a> exclusively breastfeeding for the first six months of a baby’s life. But the UK has had the <a href="https://www.unicef.org.uk/babyfriendly/about/breastfeeding-in-the-uk/">lowest</a> breastfeeding rates globally. Only <a href="https://www.thelancet.com/series/maternal-and-child-nutrition">0.5% of women breastfed</a> their baby until they were one year old in the UK. This is compared to 27% of mothers in the <a href="https://www.thelancet.com/series/maternal-and-child-nutrition">United States</a>, 35% in <a href="https://www.thelancet.com/series/maternal-and-child-nutrition">Norway</a> and 44% in <a href="https://www.thelancet.com/series/maternal-and-child-nutrition">Mexico</a>, who were still breastfeeding after one year. </p>
<p>When COVID hit, there had been concern that the virus could be <a href="https://link.springer.com/article/10.1007/s42399-020-00498-4">passed</a> from mothers to babies. </p>
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<img alt="" src="https://images.theconversation.com/files/542294/original/file-20230811-4652-hn8w80.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/542294/original/file-20230811-4652-hn8w80.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/542294/original/file-20230811-4652-hn8w80.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/542294/original/file-20230811-4652-hn8w80.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/542294/original/file-20230811-4652-hn8w80.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/542294/original/file-20230811-4652-hn8w80.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/542294/original/file-20230811-4652-hn8w80.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p><em>This article is part of <a href="https://theconversation.com/uk/topics/womens-health-matters-143335">Women’s Health Matters</a>, a series about the health and wellbeing of women and girls around the world. From menopause to miscarriage, pleasure to pain the articles in this series will delve into the full spectrum of women’s health issues to provide valuable information, insights and resources for women of all ages.</em></p>
<p><em>You may be interested in:</em></p>
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<p>Numerous studies reported a lack of support for expectant and new mothers who were breastfeeding during the pandemic. For instance, <a href="https://www.sciencedirect.com/science/article/pii/S019566632031607X?via%3Dihub">one in three</a> women intending to breastfeed reported lacking assistance with proper positioning, while <a href="https://www.sciencedirect.com/science/article/pii/S019566632031607X?via%3Dihub">one in four</a> women stated insufficient hospital-based breastfeeding support. This was probably due to strained healthcare systems and the push to minimise infection risks. </p>
<p>Support for new mothers lessened, which hindered breastfeeding. And pregnant women reported very high levels of <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0267176">anxiety and stress</a>, including uncertainty about the <a href="https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-022-07856-8">vaccine</a>. </p>
<p>We conducted surveys with women who gave birth in Wales between 2018 and 2021 and we examined anonymised NHS breastfeeding health data collected by midwives and health visitors. </p>
<p>Surprisingly, breastfeeding rates up to six months peaked in 2020, a time of strict pandemic restrictions. This conflicts with the anticipated decrease in breastfeeding rates due to reduced access to professional and social support. </p>
<p><a href="https://bmjpaedsopen.bmj.com/content/7/1/e001907.full">Our research</a> also shows that approximately six in ten women in Wales breastfeed for their baby’s first feed, but only three in ten are still breastfeeding at ten weeks. And more than 80% of women are not breastfeeding at all by six months. </p>
<p>This finding has surprised us and others working in healthcare since the pandemic had such a profound impact on daily life worldwide.</p>
<figure class="align-center ">
<img alt="A mother holds the hand of her baby who is breastfeeding." src="https://images.theconversation.com/files/544600/original/file-20230824-28-x6xlx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/544600/original/file-20230824-28-x6xlx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/544600/original/file-20230824-28-x6xlx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/544600/original/file-20230824-28-x6xlx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/544600/original/file-20230824-28-x6xlx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/544600/original/file-20230824-28-x6xlx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/544600/original/file-20230824-28-x6xlx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Breastfeeding rates up to six months peaked at the height of the pandemic.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/newborn-baby-boy-sucking-milk-mothers-1968727780">Nastyaofly/Shutterstock</a></span>
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<p><a href="https://bmjpaedsopen.bmj.com/content/7/1/e001907.full#ref-13">Our study</a> also shows that when pregnant women report that they do not intend to breastfeed, then they are very unlikely to start breastfeeding. About 30% of women do not intend to breastfeed at all. </p>
<p>However, when women say in pregnancy that they intend to breastfeed, then approximately 90% of these women do start doing so. They are also 27 times more likely to breastfeed for six months compared to women who did not intend to breastfeed. </p>
<h2>The time factor</h2>
<p>But what is it that helps women who do want to breastfeed, do so for longer? We know that even without the support systems and training by midwives, more women who wanted to breastfeed were able to for longer during the pandemic. </p>
<p>These findings could mean that one thing women really need to help them to breastfeed is more time at home with their baby, more time with their partner at home with them, more privacy and more flexible working. </p>
<p>If we want to increase breastfeeding levels, it is possible that what the pandemic has taught us is the need to address working environments as well as medical services. </p>
<h2>Breastfeeding benefits</h2>
<p>Breastfeeding has many benefits, including fewer <a href="https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-019-1693-2">infections</a>, increased <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8894195/#:%7E:text=Breastfeeding%20was%20positively%20associated%20with,%2Dbreastfed%20participants%20(19).">intelligence</a> and the prevention <a href="https://jamanetwork.com/journals/jamapediatrics/fullarticle/1107563#:%7E:text=Breastfed%20babies%20seem%20to%20be,she%20is%206%20months%20old.">obesity and diabetes</a>. Breastfeeding also has <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)01024-7/fulltext">advantages for mothers</a> as it lessens the risk of cancers, postpartum bleeding and helps with weight loss after birth. </p>
<p>It is better for the <a href="https://www.unicef.org.uk/babyfriendly/breastfeeding-and-climate-change/#:%7E:text=Breastfeeding%20also%20requires%20less%20water,footprint%20(Binns%2C%202021).">environment</a> and can be cheaper for some families.</p>
<p>But a <a href="https://www.nature.com/articles/s41372-023-01646-z">study</a> by Yale School of Medicine earlier this year found that a year of breastfeeding can also cost families up to US$11,000 (£8,700) with increased food intake, vitamins, supplements and supplies. It stressed that the barrier of cost may impact a mother’s decision to breastfeed. </p>
<p>But the cost of breastfeeding involves more than just money. Another more hidden cost is the time dedicated to breastfeeding or pumping breast milk. This highlights how women need more time at home and how we should be reassessing working environments, especially for lower income families.</p>
<p>The short term gains of getting parents back to work should not outweigh the long term benefits to our society from having healthier families. If we want to improve breastfeeding rates in the UK, then we need to look at the working lives of women and their partners across the nation.</p><img src="https://counter.theconversation.com/content/211315/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>This work is funded by the National Centre for Population Health and Wellbeing Research and the National Core Studies funded by the Medical Research Council.</span></em></p><p class="fine-print"><em><span>Sinead Brophy receives funding from Health Care Research Wales for Born In Wales and the National Centre for Population Health, MRC for Health Data Research UK, ESRC for Administrative Data Research. </span></em></p>New research shows that breastfeeding rates peaked in 2020, a time of strict COVID restrictions.Hope Jones, Research Assistant at the National Centre for Population Health and Wellbeing Research, Swansea UniversitySinead Brophy, Professor in Public Health Data Science, Swansea UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2047162023-08-14T19:37:44Z2023-08-14T19:37:44ZCanada’s welfare system is failing mothers with infants<figure><img src="https://images.theconversation.com/files/541320/original/file-20230805-15-xi8j4t.jpg?ixlib=rb-1.1.0&rect=0%2C82%2C3670%2C2351&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Food insecurity can impact both a mother’s ability or decision to breastfeed, and also the ability to purchase baby formula.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><iframe style="width: 100%; height: 100px; border: none; position: relative; z-index: 1;" allowtransparency="" allow="clipboard-read; clipboard-write" src="https://narrations.ad-auris.com/widget/the-conversation-canada/canadas-welfare-system-is-failing-mothers-with-infants" width="100%" height="400"></iframe>
<p>The Canadian government issued a <a href="https://theconversation.com/federal-budget-2023-grocery-rebate-is-the-right-direction-on-food-insecurity-but-theres-a-long-road-ahead-201926">one-time grocery rebate</a> in July, targeted at low-income Canadians. While the rebate provided some relief to people struggling with soaring inflation, <a href="https://theconversation.com/federal-budget-2023-grocery-rebate-is-the-right-direction-on-food-insecurity-but-theres-a-long-road-ahead-201926">it is far from enough</a> to address the depth of poverty and intensity of food insecurity faced by the lowest income Canadians. </p>
<p>During the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4981537/">most vulnerable time of life</a>, mothers and infants living on welfare are experiencing food insecurity, which can have <a href="https://www.healthaffairs.org/doi/10.1377/hlthaff.2015.0645">lifelong impacts</a>. Governments need to make policy changes to better serve mothers and their children. </p>
<h2>Infant food insecurity</h2>
<p>Food insecurity is defined as having “<a href="https://proof.utoronto.ca/food-insecurity/">inadequate or insecure access to food due to financial constraints</a>.” Maternal food insecurity can result in many health-damaging effects, ranging from <a href="https://bmjopen.bmj.com/content/10/1/e033296">adverse birth outcomes</a> to <a href="https://www.healthaffairs.org/doi/10.1377/hlthaff.2015.0645">mental health issues</a>. Infant food insecurity can result in long-term developmental impacts, including effects on <a href="https://doi.org/10.1016/j.pcl.2019.12.004">cognition and brain development</a>. </p>
<p>Experts have outlined how <a href="https://theconversation.com/why-are-babies-going-hungry-in-a-food-rich-nation-like-canada-165789">food insecurity can impact a mother’s ability or decision to breastfeed</a>. Food-insecure mothers might cease breastfeeding much sooner because they feel they have inadequate breastmilk supply. In addition, they might struggle to afford infant formula.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/524793/original/file-20230508-29-dhs4uw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A woman feeding a baby from a bottle." src="https://images.theconversation.com/files/524793/original/file-20230508-29-dhs4uw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/524793/original/file-20230508-29-dhs4uw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/524793/original/file-20230508-29-dhs4uw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/524793/original/file-20230508-29-dhs4uw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/524793/original/file-20230508-29-dhs4uw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/524793/original/file-20230508-29-dhs4uw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/524793/original/file-20230508-29-dhs4uw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Mothers and infants living on welfare are experiencing food insecurity, which can have lifelong impacts.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>While food-insecure mothers initiate breastfeeding at the same rate as food-secure mothers, <a href="https://www.ctvnews.ca/health/study-finds-moms-living-in-poverty-struggle-to-breastfeed-their-babies-longer-1.3853616?cache=yes">rates drop steeply within the first two months</a>. Mothers who are undernourished themselves might perceive they have less than adequate milk supply and often stop breastfeeding for this reason, <a href="https://www.ubcpress.ca/out-of-milk">believing the baby will suffer because they have an inadequate diet</a>. </p>
<p>For low-income mothers, breastfeeding might seem to be the most cost-effective way of feeding their infants. However, other research shows that <a href="https://pubmed.ncbi.nlm.nih.gov/32162282/">both formula and breastfeeding are unaffordable to mothers who receive welfare</a>. </p>
<h2>Problems with the welfare system</h2>
<p>Approximately <a href="https://maytree.com/wp-content/uploads/Social_Assistance_Summaries_All_Canada.pdf">four to six per cent of people</a> in most provinces and territories receive welfare benefits. The number is slightly lower in the Yukon and Alberta and significantly higher in Nunavut where it is just under 28 per cent. </p>
<p>While some provinces and territories provide more financial resources to pregnant women and mothers than others, incomes remain low and inadequate to achieve food security. </p>
<p>For example, Nova Scotia welfare recipients receive a total of <a href="https://novascotia.ca/coms/employment/documents/ESIA_Program_Policy_Manual.pdf">$51 per month in maternal nutrition allowance</a> during pregnancy and up to 12 months after birth. However, this is often not enough support for low-income mothers to adequately feed their infants.</p>
<p><a href="https://proof.utoronto.ca/2023/new-data-on-household-food-insecurity-in-2022/">COVID-19 increased household food insecurity rates for households with children in both Canada</a> and the <a href="https://www.ers.usda.gov/amber-waves/2022/february/food-insecurity-for-households-with-children-rose-in-2020-disrupting-decade-long-decline/">United States</a></p>
<p>Allowances for pregnant women and mothers of infants receiving welfare are similarly low across Canada. These low rates create food insecurity for these vulnerable families and must be rectified via provincial, territorial and federal government policies. </p>
<h2>Charity alone is not enough</h2>
<p>Some might assume that charities and food banks will provide vital support for low-income families. A recent study found that during the peak of the COVID-19 pandemic, many community organizations <a href="https://doi.org/10.1080/14927713.2022.2054460">answered the increased call for food</a>. </p>
<p>While community organizations were critical in filling pandemic gaps, they alone cannot address the root cause of food insecurity: inadequate incomes. That problem continues, and the number of people relying on food banks has <a href="https://www.cbc.ca/news/canada/toronto/60-rise-use-of-food-banks-programs-canada-2023-1.6711094">increased exponentially in the past couple of years</a>.</p>
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Read more:
<a href="https://theconversation.com/as-governments-shirk-their-responsibilities-non-profits-are-more-important-than-ever-205169">As governments shirk their responsibilities, non-profits are more important than ever</a>
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</p>
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<p>Additionally, many food banks are <a href="https://ca.style.yahoo.com/at-breaking-point-canadian-food-banks-struggling-insecurity-inflation-214221464.html">struggling to provide enough food</a>. The demand for food now far outstrips the donations most food banks receive. A sustainable solution to food insecurity is needed, particularly for pregnant women and mothers of infants. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/541322/original/file-20230805-21-3ju57z.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A person in a grey t-shirt placing food items on a shelf" src="https://images.theconversation.com/files/541322/original/file-20230805-21-3ju57z.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/541322/original/file-20230805-21-3ju57z.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=402&fit=crop&dpr=1 600w, https://images.theconversation.com/files/541322/original/file-20230805-21-3ju57z.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=402&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/541322/original/file-20230805-21-3ju57z.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=402&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/541322/original/file-20230805-21-3ju57z.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=505&fit=crop&dpr=1 754w, https://images.theconversation.com/files/541322/original/file-20230805-21-3ju57z.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=505&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/541322/original/file-20230805-21-3ju57z.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=505&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A volunteer places products on shelves at a food bank in Ottawa. Food banks alone cannot address the root cause of food insecurity: inadequate incomes.</span>
<span class="attribution"><span class="source">THE CANADIAN PRESS/Adrian Wyld</span></span>
</figcaption>
</figure>
<h2>Child welfare laws</h2>
<p>In addition, child welfare laws need to be changed to stop them from unfairly penalizing poorer parents. In Nova Scotia, the <a href="https://policyalternatives.ca/sites/default/files/uploads/publications/Nova%20Scotia%20Office/2023/03/CCPAChildPovertyReportCardFINAL.pdf"><em>Children and Family Services Act</em> stipulates</a> that parents’ failure to provide adequate nutrition is grounds for child apprehension.</p>
<p><a href="https://policyalternatives.ca/sites/default/files/uploads/publications/Nova%20Scotia%20Office/2023/03/CCPAChildPovertyReportCardFINAL.pdf">The 2022 Report Card on Child and Family Poverty in Nova Scotia</a> recommended removing this stipulation. <a href="https://fernwoodpublishing.ca/book/ineligible">Experts have highlighted</a> the punitive nature of such requirements. These kinds of regulations punish mothers for their poverty and food insecurity, rather than increasing the financial support they receive.</p>
<h2>Impact of inflation</h2>
<p>There are also reforms that need to take place around welfare rates that would create a more liveable income source for mothers and infants in particular. </p>
<p>As the 2022 report card on poverty in Nova Scotia shows, welfare rates are not indexed to inflation in the province. This has resulted in <a href="https://www.cbc.ca/news/canada/nova-scotia/ns-income-assistance-rates-unchanged-1.6788662">benefits stagnating</a> despite a few modest increases in the past several years. Only three provinces and territories <a href="https://maytree.com/wp-content/uploads/Welfare_in_Canada_2021.pdf">index welfare rates to inflation:</a> New Brunswick, Québec and the Yukon. In Québec, <a href="https://inroadsjournal.ca/quebecs-distinct-welfare-state-on-poverty-among-families-with-children-quebec-%E2%80%A8and-the-rest-of-canada-have-taken-different-paths/">this has resulted in lower income inequality</a>. </p>
<p>The province has also recently launched a <a href="https://www.cbc.ca/news/canada/montreal/quebec-basic-income-program-begins-advocates-say-many-low-income-people-excluded-1.6730003">basic income program</a> and although the eligibility requirements exclude many, it does increase income recipients would otherwise receive from welfare benefits.</p>
<p>With inflation affecting the price of food, the depth of food insecurity for mothers receiving welfare payments will only grow. Welfare rates must reflect the income necessary to feed pregnant and new mothers and provide them the support they need to care for their children.</p><img src="https://counter.theconversation.com/content/204716/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Laura Fisher receives funding from the Social Sciences and Humanities Research Council of Canada.</span></em></p>Low-income mothers with infants are struggling with food insecurity, which can lead to long-term health impacts for both mothers and children.Laura Fisher, PhD student, Sociology, Dalhousie UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2050592023-07-28T12:52:44Z2023-07-28T12:52:44ZBreastfeeding: mothers taking prescription medicines faced with a lack of information – new review<figure><img src="https://images.theconversation.com/files/534299/original/file-20230627-15-svfyno.jpg?ixlib=rb-1.1.0&rect=85%2C0%2C9504%2C6260&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Most medicines are safe for most breastfed babies, while serious harm to infants is rare.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/mother-son-sitting-on-sofa-breastfeeding-2251534251">Krakenimages.com/Shutterstock</a></span></figcaption></figure><p>Breastfeeding is a cornerstone of early childhood nutrition and development. However, taking prescription medicines can reduce breastfeeding rates because parents who take such medications often face a lack of information about their potential impact on babies or how medicines affect lactation. </p>
<p>To better understand the effects of medicines on breastfeeding, we conducted a <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0284128">systematic review</a> of the available information. We scoured electronic databases for research on the impact of prescription medicines on breastfeeding. These studies examined how medicines affected milk composition, milk production and the health of breastfed infants. </p>
<p>We found a limited number of high-quality studies, with only ten established databases reporting on breastfeeding, medicines and infant outcomes together. And, unfortunately, none of these studies covered educational outcomes, making it difficult to assess potential long-term risks, harms and benefits.</p>
<p>Our research shows that more data collection is needed. And our work and <a href="https://doi.org/10.1371/journal.pone.0225133">other research</a> highlights there is a need for additional support to help breastfeeding mothers overcome physical barriers, including delayed milk production and <a href="https://pubmed.ncbi.nlm.nih.gov/28027444/">anxiety</a> about the use of prescription medicine.</p>
<hr>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/542294/original/file-20230811-4652-hn8w80.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/542294/original/file-20230811-4652-hn8w80.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=600&fit=crop&dpr=1 600w, https://images.theconversation.com/files/542294/original/file-20230811-4652-hn8w80.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=600&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/542294/original/file-20230811-4652-hn8w80.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=600&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/542294/original/file-20230811-4652-hn8w80.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=754&fit=crop&dpr=1 754w, https://images.theconversation.com/files/542294/original/file-20230811-4652-hn8w80.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=754&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/542294/original/file-20230811-4652-hn8w80.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=754&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption"></span>
</figcaption>
</figure>
<p><em>This article is part of <a href="https://theconversation.com/uk/topics/womens-health-matters-143335">Women’s Health Matters</a>, a series about the health and wellbeing of women and girls around the world. From menopause to miscarriage, pleasure to pain the articles in this series will delve into the full spectrum of women’s health issues to provide valuable information, insights and resources for women of all ages.</em></p>
<p><em>You may be interested in:</em></p>
<p><em><a href="https://theconversation.com/five-old-contraception-methods-that-show-why-the-pill-was-a-medical-breakthrough-207572">Five old contraception methods that show why the pill was a medical breakthrough
</a></em></p>
<p><em><a href="https://theconversation.com/the-orgasm-gap-and-why-women-climax-less-than-men-208614">The orgasm gap and why women climax less than men</a></em></p>
<p><em><a href="https://theconversation.com/science-experiments-traditionally-only-used-male-mice-heres-why-thats-a-problem-for-womens-health-205963">Science experiments traditionally only used male mice – here’s why that’s a problem for women’s health</a></em></p>
<hr>
<h2>Safety</h2>
<p>Most medicines are safe for most breastfed babies, while serious harm to infants is rare. In most cases, the benefits of breastfeeding outweigh the risks of harms associated with medicine use. Still, this can be a complex issue and it’s essential to weigh the benefits and risks carefully.</p>
<p>There are some medicines that require extra checks on infants and their ability to breastfeed. For example, infants whose mothers use antibiotics such as amoxicillin and erythromycin (which are known to be safe to use during breastfeeding), should be checked for oral thrush and diarrhoea, as prompt treatment is important. </p>
<p>The <a href="https://bnf.nice.org.uk">British National Formulary</a> (BNF) offers advice on the prescribing and administration of medicines. Infants of mothers taking certain medicines, such as those for epilepsy, mental health conditions, sedatives, or opioids, should be monitored for signs of sedation, sleepiness, poor feeding, weight loss and irritability. </p>
<p>Health professionals should also assess how effectively the baby is feeding by observing suckling and attachment to the breast. This is important because these types of medicines can interfere with an infant’s ability to feed and receive adequate nutrition.</p>
<p>The BNF expresses reservations regarding prescribing some sedative medicines that pass into breastmilk, where there is a risk of infant sedation, as with benzodiazepines (such as diazepam), and some anti-seizure medicines such as phenobarbital or primidone. </p>
<p>It recommends avoiding certain medicines during breastfeeding altogether, including some antipsychotics, such as olanzapine and clozapine, and the antidepressants escitalopram and fluoxetine. But other antidepressants, such as citalopram, may be used with caution. Most antipsychotic injections should be avoided during breastfeeding too, as should fingolimod which is used to treat multiple sclerosis. </p>
<p>Breastfeeding while using many medicines for serious illness, such as cancer, should be discussed with medical professionals. There may be little or no information from human studies, and there may be too little information to guarantee safety. Examples include many monoclonal antibodies used to treat cancer, and the immunosuppressant, mycophenolate mofetil, which is used to prevent the rejection of kidney, heart or liver transplants.</p>
<h2>Advice</h2>
<p>Mothers taking medicines should not blame themselves for being hesitant towards breastfeeding. Medical advice should be sought before birth. And families should not feel compelled to choose between breastfeeding and continuing with prescription medicines.</p>
<p>It’s essential for doctors, pharmacists and other health professionals to consult reliable information sources, including <a href="https://wicworks.fns.usda.gov/resources/lactmed">LactMed</a> and <a href="https://www.e-lactancia.org/">E-lactancia</a>, or contact the <a href="https://www.breastfeedingnetwork.org.uk/detailed-information/drugs-in-breastmilk/">Drugs in Breastmilk helpline</a>.</p>
<p>To help families who need prescription medicines, it is crucial for public health teams controlling the collection of routine healthcare data to treat data collection on medicine use during and after pregnancy and during labour as a priority. This would allow research into the benefits and harms of medicine use before and during breastfeeding. </p>
<p>Such information would help parents make informed decisions regarding their medical treatment, breastfeeding and monitoring infants. It would also help minimise parental anxiety and potentially harmful false dilemmas.</p><img src="https://counter.theconversation.com/content/205059/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sue Jordan receives funding from the ConcePTION project. The ConcePTION project has received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement No 821520. This Joint Undertaking receives support from the European Union’s Horizon 2020 research and innovation programme and EFPIA. Funding was awarded to SJ, SLL. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. </span></em></p><p class="fine-print"><em><span>Sophia Komninou does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Not enough data is being collected about the impact taking prescription medication has on breastfeeding.Sophia Komninou, Lecturer in Public Health Nutrition, Swansea UniversitySue Jordan, Professor of Medicines Management and Health Services Research, Swansea UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2083322023-07-07T14:19:46Z2023-07-07T14:19:46ZPandemic babies behind on communication at age two – but other developmental areas remain unaffected<figure><img src="https://images.theconversation.com/files/536115/original/file-20230706-23-go0p6m.jpg?ixlib=rb-1.1.0&rect=9%2C0%2C6631%2C3733&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/childcare-concept-portrait-cute-little-african-1980128651">Prostock-studio/Shutterstock</a></span></figcaption></figure><p>The world changed for all of us when we were suddenly plunged into a pandemic in 2020. COVID sent us into a series of lockdowns in a bid to control the spread of the virus until a vaccine could be developed. </p>
<p>Most of us knew that a vaccine would be the key to our post-pandemic lives. But what about those of us who knew nothing of the world before COVID? </p>
<p>Our research group wanted to understand what life was like for babies born during the pandemic, and what it might mean for their general health and development. </p>
<p>In our <a href="https://adc.bmj.com/content/early/2023/06/20/archdischild-2022-325271">latest paper</a>, we found that by age two, with the important exception of communication, these pandemic babies were very similar to babies born before the pandemic in behaviour and development. </p>
<p>We followed families of babies born in Ireland in the first three months of the pandemic, between March and May 2020. A total of 354 families and their babies visited us at six, 12 and 24 months of age. </p>
<p>The visits, particularly the earlier ones, were sometimes the only trips the families made outside the home. We were struck by some babies’ wariness towards our experienced paediatric staff, which was often explained by comments from parents like “she hasn’t been out much”.</p>
<p>At each of the visits, we asked the parents for lots of information on their babies’ lives and development by way of questionnaires.</p>
<p>Usually, in a study like this, it’s best to compare the babies to a control group of other babies born at the same time but without the same challenges. As most of the world was in lockdown, we did the next best thing. We compared the lockdown babies to <a href="https://www.infantcentre.ie/research/research-studies/baseline/">a similar group of babies</a> born in Ireland before the pandemic. This is a limitation of our study, but there were no comparable groups of babies available at the same time.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/generation-covid-pregnancy-birth-and-postnatal-life-in-the-pandemic-160644">Generation COVID: pregnancy, birth and postnatal life in the pandemic</a>
</strong>
</em>
</p>
<hr>
<h2>Social lives and development</h2>
<p>We found these lockdown babies had <a href="https://pubmed.ncbi.nlm.nih.gov/35984697/">tiny social circles</a>. Because of COVID restrictions, activities such as parent and baby groups were called off, and there were no visits to other homes. </p>
<p>At six months, an average of only three people had kissed the babies, including their parents – suggesting they hadn’t met many relatives or family friends. One in four babies had not met another child their own age by their first birthday.</p>
<p>We also asked parents what it felt like to raise a baby during the pandemic. Words such as “lonely”, “isolating” and “challenging” appeared repeatedly. Some positive themes emerged too, including parental bonding with the new baby and more family time due to the lockdown restrictions.</p>
<figure class="align-center ">
<img alt="A woman on the floor at home with her baby who is playing with toys." src="https://images.theconversation.com/files/536117/original/file-20230706-29-5vhlx9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/536117/original/file-20230706-29-5vhlx9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/536117/original/file-20230706-29-5vhlx9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/536117/original/file-20230706-29-5vhlx9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/536117/original/file-20230706-29-5vhlx9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/536117/original/file-20230706-29-5vhlx9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/536117/original/file-20230706-29-5vhlx9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Our research sought to understand how ‘pandemic babies’ have fared.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/joyful-mother-baby-boy-playing-toys-2293650585">StockPhotoDirectors/Shutterstock</a></span>
</figcaption>
</figure>
<p>We looked at ten developmental milestones <a href="https://pubmed.ncbi.nlm.nih.gov/36220496/">at the babies’ first birthday</a>. Among these, fewer pandemic babies had said their first word, could point or wave “bye-bye”, and slightly more babies could crawl. </p>
<p>This makes sense when you think about it. Babies were probably hearing fewer words since they were getting out and about less. Also, the pandemic babies were likely to be very familiar with their home so there were few new things to point to. And as parents were working from home and visitors didn’t generally come to the house, there may have been less need to learn how to wave goodbye. It’s possible more pandemic babies crawled because they were more likely to have spent more time at home exploring.</p>
<p>At <a href="https://adc.bmj.com/content/early/2023/06/20/archdischild-2022-325271">age two</a>, we were interested to see whether these developmental differences had shifted. We asked parents questions about communication at this point including whether the child could say two or three words together to convey an idea, whether they could correctly point at something when asked (for example, point at the ball), and whether they could follow a simple command (for example, put the toy on the table).</p>
<p>The children born during the pandemic again had slightly lower scores in the communication portion of the questionnaire, even after we adjusted for factors such as the mother’s education level and the child’s age when the questionnaire was completed.</p>
<p>But reassuringly, the pandemic babies had similar scores to those born before COVID in the other developmental areas we looked at, including motor skills and problem-solving ability.</p>
<p>We were also relieved to see no differences in reported behaviour between pandemic-born babies and those born earlier. We asked parents almost 100 questions about their child’s behaviour including about sleep problems, anxious behaviour, how emotionally reactive they were, and whether they were socially withdrawn.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/pandemic-babies-how-covid-19-has-affected-child-development-155903">Pandemic babies: how COVID-19 has affected child development</a>
</strong>
</em>
</p>
<hr>
<h2>What can we do?</h2>
<p>Research groups in <a href="https://pubmed.ncbi.nlm.nih.gov/34982107/">other countries</a> have also shown that babies born shortly before or during the pandemic had <a href="https://www.frontiersin.org/articles/10.3389/fped.2021.662165/full">slightly lower developmental scores</a>.</p>
<p>Now that pandemic measures are gone, it’s really important for all babies born during the pandemic to explore the exciting world. Families should meet with relatives and friends to expose their babies to a wider range of people, and babies should meet their peers at play groups. We also know that <a href="https://pubmed.ncbi.nlm.nih.gov/37188518/">talking to babies</a> and reading to small children is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6927670/">highly beneficial</a>. </p>
<p>All babies should have developmental screening, which is often provided by national programmes. If families have any particular concerns it’s important they contact their healthcare provider to discuss the child’s development in more detail. This enables early and directed support to be provided to children who are found to have a specific developmental issue.</p><img src="https://counter.theconversation.com/content/208332/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>How did this strange new world affect babies born during the height of the pandemic? Our research sought to find out.Susan Byrne, Senior Lecturer, Department of Paediatrics and Future Neuro, RCSI University of Medicine and Health SciencesJonathan Hourihane, Head of Paediatrics, RCSI University of Medicine and Health SciencesLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2038282023-06-05T12:06:11Z2023-06-05T12:06:11ZBirth of a story: How new parents find meaning after childbirth hints at how they will adjust<figure><img src="https://images.theconversation.com/files/529856/original/file-20230602-19-u8qb1f.jpg?ixlib=rb-1.1.0&rect=94%2C549%2C4418%2C2943&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Having a new baby can upend everything about your old life.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/newborn-baby-boy-being-cradled-by-new-parents-in-royalty-free-image/1307728623">Cavan Images/Cavan via Getty Images</a></span></figcaption></figure><p>Gather a group of new parents and the conversation will likely turn to their childbirth stories – ranging from the joyful to the gnarly to the positively traumatic. <a href="https://slate.com/human-interest/2022/01/birth-stories-feminist-history-internet-sharing.html">Birth story podcasts and websites</a> feature a curated range of birth experiences, and you can buy embossed leather “birth story” journals as a baby shower gift. People are fascinated by this pivotal, emotionally complex and literally life-and-death experience.</p>
<p>Birth narratives might also contain clues about how the adjustment to parenthood will go.</p>
<p><a href="https://www.penguinrandomhouse.com/books/203434/the-uses-of-enchantment-by-bruno-bettelheim/">People have long used stories</a> to understand difficult experiences. Stories may be particularly valuable as a source of “meaning-making,” the process of finding order in chaos by making sense of unexpected events, identifying silver linings and discovering the patterns and connections that thread seemingly random events together into a coherent narrative.</p>
<p>In a new study led by <a href="https://scholar.google.com/citations?user=YRIcV6YAAAAJ&hl=en&oi=ao">Geoffrey Corner</a>, a former graduate student in <a href="https://dornsife.usc.edu/nestlab/">my lab</a>, we found that the levels of meaning-making in the stories new parents told about their baby’s birth <a href="https://doi.org/10.1037/fam0001062">predicted their relationship quality and parenting stress</a> in the child’s first months.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/529857/original/file-20230602-23-6cutjo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="three moms with infants on mats facing an instructor with a doll in a baby yoga class" src="https://images.theconversation.com/files/529857/original/file-20230602-23-6cutjo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/529857/original/file-20230602-23-6cutjo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/529857/original/file-20230602-23-6cutjo.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/529857/original/file-20230602-23-6cutjo.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/529857/original/file-20230602-23-6cutjo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/529857/original/file-20230602-23-6cutjo.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/529857/original/file-20230602-23-6cutjo.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">When new moms come together, the talk often turns to their childbirth stories.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/baby-massage-class-switzerland-new-mothers-learn-how-to-news-photo/629429057">BSIP/Universal Images Group via Getty Images</a></span>
</figcaption>
</figure>
<h2>Constructing meaning in your own life</h2>
<p>Finding meaningful themes and patterns in life’s seeming randomness is a fundamentally human activity. As writer Joan Didion put it, “<a href="https://www.penguinrandomhouse.com/books/40775/we-tell-ourselves-stories-in-order-to-live-by-joan-didion-introduction-by-john-leonard/">we tell ourselves stories in order to live</a>.”</p>
<p>“Meaning-making” can buffer despair in the wake of tragedy. Holocaust survivor Victor Frankl’s memoir, “<a href="http://www.beacon.org/Mans-Search-for-Meaning-P602.aspx">Man’s Search for Meaning</a>,” argued that meaning and purpose can prevent the bitterness and disillusionment that can otherwise fester after great loss. Research on what psychologists call <a href="https://doi.org/10.1207/s15327965pli1501_01">post-traumatic growth</a> has found that the level of “meaning-making” in people’s narratives about a difficult event predicts their mental health over time.</p>
<p>For example, studies have found <a href="https://doi.org/10.1037/a0018301">links between meaning-making and resilience</a> in cancer patients, bereaved parents and caregivers. Cancer survivors might discover that their chemo ordeal brought them closer to friends and family, or helped them step back from the hustle of everyday life and embrace a slower pace.</p>
<p>Although childbirth is typically experienced as a joyful rather than a tragic event, it can still be unpredictable, frightening and even life-threatening. Indeed, psychologists have begun to recognize that particularly difficult labors <a href="https://doi.org/10.1080/02646838.2015.1031646">can trigger post-traumatic stress symptoms</a>, not just in mothers but in their partners as well. Even normal, nontraumatic births require parents to cope with hours, sometimes days, of pain and discomfort. Therefore, we hypothesized that meaning-making might be an important part of couples’ birth narratives, potentially promoting resilience in new parents.</p>
<p>To test these hypotheses, we collected birth stories from 77 couples who were participating in our lab’s <a href="https://dornsife.usc.edu/nestlab/research/">longitudinal study of the transition to parenthood</a>. We visited couples at the hospital within a day or two of their infant’s birth, and audio-recorded them sharing their stories together. We told couples, “We’d like to hear you tell the story of your birth experience. Start from the beginning and tell us as much as you remember.”</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/529858/original/file-20230602-29-rszklh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="three masked medical workers hold newborn above mother's body during C-section operation" src="https://images.theconversation.com/files/529858/original/file-20230602-29-rszklh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/529858/original/file-20230602-29-rszklh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=443&fit=crop&dpr=1 600w, https://images.theconversation.com/files/529858/original/file-20230602-29-rszklh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=443&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/529858/original/file-20230602-29-rszklh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=443&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/529858/original/file-20230602-29-rszklh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=557&fit=crop&dpr=1 754w, https://images.theconversation.com/files/529858/original/file-20230602-29-rszklh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=557&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/529858/original/file-20230602-29-rszklh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=557&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Parents may need to process even a normal childbirth with healthy outcomes.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/caesarian-babys-first-breath-royalty-free-image/125951777">Peter Dazeley/The Image Bank via Getty Images</a></span>
</figcaption>
</figure>
<h2>Listening for meaning-making in birth stories</h2>
<p>A team of coders listened to each story and recorded examples of meaning-making, using three categories established in the research literature:</p>
<ul>
<li><p>Sense-making: Identifying reasons that an event might have unfolded the way it did or making connections that show why an event was meaningful. For example, one mother in our sample found meaning in her long labor, describing her baby as “very brave and tough” because she survived hours of pushing. </p></li>
<li><p>Benefit-finding: Pointing out silver linings or unexpected positive effects of a difficult experience. For example, after a difficult birth, one parent in our sample stated, “It was scary, but the nurses and the doctors were so nice to us.”</p></li>
<li><p>Change in identity: Describing how an event has transformed one’s sense of self. As a parent in our sample said, “I feel like my life has changed completely with the baby now here.”</p></li>
</ul>
<p>Although couples told their story together, we tracked meaning-making separately for each partner. We also rated how much each partner participated in telling their story so we could adjust for their levels of engagement in sharing their birth narrative.</p>
<p>The couples in our <a href="https://doi.org/10.1037/fam0001062">sample were avid “meaning makers”</a>: Almost all the participants made at least some meaning-making statements in their birth stories. Of the three categories of meaning-making, “change in identity” language surfaced least often, appearing in about 37% of the birth stories. Mothers tended to use more “sense-making” and “benefit-finding” language than fathers. And both members of a couple tended to use similar amounts of meaning-making language. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/529859/original/file-20230602-27-200pws.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="infant on mother's chest in hospital bed with father smiling down at baby" src="https://images.theconversation.com/files/529859/original/file-20230602-27-200pws.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/529859/original/file-20230602-27-200pws.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=487&fit=crop&dpr=1 600w, https://images.theconversation.com/files/529859/original/file-20230602-27-200pws.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=487&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/529859/original/file-20230602-27-200pws.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=487&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/529859/original/file-20230602-27-200pws.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=612&fit=crop&dpr=1 754w, https://images.theconversation.com/files/529859/original/file-20230602-27-200pws.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=612&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/529859/original/file-20230602-27-200pws.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=612&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A new parent’s meaning-making can affect them and their partner.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/mixed-race-family-admiring-their-newborn-baby-at-royalty-free-image/1248789907">SelectStock/E+ via Getty Images</a></span>
</figcaption>
</figure>
<h2>Becoming mom or dad</h2>
<p>After we had coded all of the narratives, we next looked to see whether “meaning-making” predicted relationship satisfaction and parenting stress in our couples. The transition to parenthood can be a “<a href="https://doi.org/10.2307/347802">crisis event” for the couple relationship</a> and is often linked with <a href="https://theconversation.com/have-children-heres-how-kids-ruin-your-romantic-relationship-57944">declines in relationship quality</a>.</p>
<p>But when mothers used more “sense-making” and “benefit-finding” language, they showed a smaller drop in their relationship satisfaction than moms who used less. Fathers who used more “sense-making” and “benefit-finding” language reported lower parenting stress at six months postpartum than dads who used less.</p>
<p>And partners of fathers who used more “change in identity” language also reported lower parenting stress later on, suggesting that dads who experience the transition to parenthood as transformative may be able to help mothers cope better with new parenthood. On the flip side, though, when mothers showed more meaning-making, their partners actually reported more parenting stress at six months postpartum. It may be that when mothers find the birth experience to be more personally meaningful, partners feel left out or pressured to step up their own parenting.</p>
<p>Overall, these results supported our initial hunch that meaning-making might be detectable in birth narratives and forecast parents’ psychological adjustment after birth. Greater meaning-making language seemed to benefit the couple relationship and largely buffer parenting stress.</p>
<p>This study was limited by a fairly small sample of cohabiting heterosexual parents. Nevertheless, it highlights the value of stories in shaping family transitions. For therapists working with new parents in the wake of a difficult birth, encouraging couples to seek meaning in their birth story may help ease their transition to parenthood. Journaling and storytelling exercises may help couples process their feelings about their childbirth experiences. After all, the birth of a baby is also the birth of a story – and that story is well worth telling.</p><img src="https://counter.theconversation.com/content/203828/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Darby Saxbe receives funding from the National Institutes of Health and the National Science Foundation. </span></em></p>How you tell the story of a momentous event can help you make sense of what happened. Research finds new moms’ and dads’ narratives around childbirth held clues about their transition to parenthood.Darby Saxbe, Associate Professor of Psychology, USC Dornsife College of Letters, Arts and SciencesLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2047852023-05-29T19:50:46Z2023-05-29T19:50:46ZPandemic babies’ developmental milestones: Not as bad as we feared, but not as good as before<figure><img src="https://images.theconversation.com/files/528474/original/file-20230526-23-qh7azn.jpg?ixlib=rb-1.1.0&rect=301%2C760%2C3838%2C2282&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Scientists and physicians raised concerns early in the pandemic that increased parental stress, COVID infections, reduced interactions with other babies and adults, and changes to health care may affect child development.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><iframe style="width: 100%; height: 100px; border: none; position: relative; z-index: 1;" allowtransparency="" allow="clipboard-read; clipboard-write" src="https://narrations.ad-auris.com/widget/the-conversation-canada/pandemic-babies--developmental-milestones--not-as-bad-as-we-feared--but-not-as-good-as-before" width="100%" height="400"></iframe>
<p>The COVID-19 pandemic created conditions that <a href="https://doi.org/10.1017/S2040174420000847">threatened children’s healthy development</a>. </p>
<p>Scientists and physicians raised concerns early in the pandemic, pointing out that increased parental stress, COVID infections, reduced interactions with other babies and adults and changes to health care <a href="https://doi.org/10.1111%2Fcdev.13653">could affect child development</a>. Furthermore, some children could be especially vulnerable to the pandemic circumstances. </p>
<p>With these concerns in mind, we started a <a href="https://doi.org/10.2196/25407">longitudinal study of pregnant Canadians</a> to understand how pandemic stressors might influence later child development. </p>
<p><a href="https://doi.org/10.1016/j.jad.2020.07.126">Our initial findings</a> were alarming: the rates of anxiety and depression among pregnant individuals were two to four times higher during the early phase of the pandemic compared to numerous pregnancy studies prior to the pandemic. This worrisome increase in mental health problems <a href="https://doi.org/10.1016/j.psychres.2021.113912">was seen worldwide</a>. </p>
<h2>Impact on children’s development</h2>
<p>To determine how the pandemic might be affecting children’s development, we measured developmental milestones in 3,742 12-month-old infants born during the first 18 months of the pandemic. We then compared these infants to a similar group of 2,898 Canadian infants born between 2015 and 2018. </p>
<figure class="align-center ">
<img alt="A pregnant woman and a doctor both wearing face masks in the doctor's office" src="https://images.theconversation.com/files/528483/original/file-20230526-27-wmxs0a.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/528483/original/file-20230526-27-wmxs0a.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/528483/original/file-20230526-27-wmxs0a.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/528483/original/file-20230526-27-wmxs0a.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/528483/original/file-20230526-27-wmxs0a.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/528483/original/file-20230526-27-wmxs0a.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/528483/original/file-20230526-27-wmxs0a.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Rates of anxiety and depression among pregnant individuals were two to four times higher during the early phase of the pandemic compared to numerous pregnancy studies prior to the pandemic.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>The study evaluated developmental milestones using the <a href="https://agesandstages.com/products-pricing/asq3/">Ages and Stages Questionnaire-3</a>. The ASQ-3 is a parent report of child behaviour that can help identify children at risk of developmental delays in five separate domains: Communication, Gross Motor, Fine Motor, Personal-Social and Problem Solving.</p>
<p>In a study to be published in the <em>Journal of Developmental and Behavioral Pediatrics</em>, we found that most children born during the pandemic were doing fine, with almost 90 per cent meeting their key developmental milestones in each area. This should be reassuring for parents, caregivers and communities, because it suggests that most children are developing normally despite adverse early circumstances.</p>
<p>However, a slightly higher proportion of children born during the pandemic were at risk of developmental delay in Communication, Gross Motor and Personal-Social domains, compared to children born before the pandemic. Our findings <a href="https://doi.org/10.1097/jxx.0000000000000653">are consistent</a> with <a href="https://doi.org/10.1101/2021.08.10.21261846">prior smaller studies</a> showing <a href="https://doi.org/10.1001/jamapediatrics.2021.5563">only small increases in the risk</a> for poor verbal, motor and cognitive performance among 12-month-old infants born during the pandemic.</p>
<figure class="align-center ">
<img alt="A woman smiling and playing with her baby in her lap" src="https://images.theconversation.com/files/528494/original/file-20230526-27-cc84m2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/528494/original/file-20230526-27-cc84m2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/528494/original/file-20230526-27-cc84m2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/528494/original/file-20230526-27-cc84m2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/528494/original/file-20230526-27-cc84m2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/528494/original/file-20230526-27-cc84m2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/528494/original/file-20230526-27-cc84m2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Engaging an infant in conversation or song (even a pre-verbal infant) is a powerful way to encourage language learning.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>The largest effects we observed were in the Communication and Personal-Social domains. Infants born during the pandemic were almost twice as likely to score below cutoffs compared to pre-pandemic infants. </p>
<p>This represents an increase of about one to two additional children in 100 who are at risk, but highlights some potentially concerning effects of the pandemic on early child development. Across Canada, this could result in service demands for 20,000-40,000 additional preschool children.</p>
<p>Although small in absolute terms, these increases have important implications, since already limited resources will need to increase to meet the needs of more children. Certainly, it will be important to continue monitoring infants/children born during the pandemic to determine how long-lasting these effects are. </p>
<p>Reassuringly, <a href="https://doi.org/10.1016/S0749-3797(02)00655-4">early interventions</a> can be <a href="https://doi.org/10.1016/j.ehb.2009.01.002">highly effective</a> for children who are struggling. </p>
<h2>Concerns about child development</h2>
<figure class="align-center ">
<img alt="A smiling baby crawling towards the camera in the foreground, and a young man smiling in the background" src="https://images.theconversation.com/files/528624/original/file-20230526-15-805x46.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/528624/original/file-20230526-15-805x46.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/528624/original/file-20230526-15-805x46.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/528624/original/file-20230526-15-805x46.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/528624/original/file-20230526-15-805x46.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/528624/original/file-20230526-15-805x46.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/528624/original/file-20230526-15-805x46.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Provide your child with many opportunities for one-on-one interaction with a caring and responsive adult.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>Parents should be mostly reassured by these findings. Despite the disruptions to nearly every aspect of life during the pandemic, the majority of children continue to show healthy development. Parents with concerns about their child’s development may find these suggestions helpful:</p>
<ol>
<li><p>Provide your child with many opportunities for one-on-one interaction with a caring and responsive adult. The <a href="https://developingchild.harvard.edu/resourcetag/serve-and-return/">Harvard Center on the Developing Child</a> describes the back-and-forth interactions that form the key processes of child development as “serve and return.” </p></li>
<li><p>Believe in “ordinary magic.” This is the phrase that child development expert <a href="https://doi.org/10.1037//0003-066x.56.3.227">Ann Masten</a> uses to describe how resilience emerges from ordinary, everyday processes and interactions. Children develop resilience when they have access to the right environments, the right relationships and the right chances to be able to safely explore themselves and the world around them.</p></li>
<li><p>Talk and sing with your child. Engaging an infant in conversation or song (even a pre-verbal infant) is a powerful way to encourage <a href="https://doi.org/10.1016/j.dr.2005.11.002">language learning</a>.</p></li>
<li><p>There is a wide range of development that is considered “normal.” It is okay for your child to be at a different stage than other children their age, as long as your child is still showing signs of development. </p></li>
<li><p>If you are concerned about your child’s development after some time of monitoring, discuss your concerns with a qualified health professional to determine if further investigation is needed.</p></li>
</ol>
<p>Overall, the findings of our study (and others) suggest that the effects of the pandemic on infant development (at least to one year of age) have not been as bad as we feared. However, a greater number of children will likely require further evaluation and support compared to pre-pandemic.</p><img src="https://counter.theconversation.com/content/204785/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Gerald Giesbrecht receives funding from the Canadian Institutes of Health Research (CIHR) and the Alberta Children's Hospital Foundation. </span></em></p><p class="fine-print"><em><span>Catherine Lebel receives funding from the Canadian Institutes of Health Research (CIHR), the Natural Sciences and Engineering Research Council (NSERC), Brain Canada, the Azrieli Foundation, Alberta Children's Hospital Foundation, and the Canada Research Chairs program.</span></em></p><p class="fine-print"><em><span>Lianne Tomfohr-Madsen receives funding from the Canadian Institutes of Health Research (CIHR), the Social Sciences and Humanities Research Council (SSHRC), Brain Canada, Calgary Health Trust, the Alberta Children's Hospital Foundation and the Weston Foundation. </span></em></p>Research findings are mostly reassuring for parents — despite the disruptions to nearly every aspect of life during the COVID-19 pandemic, most children continue to show healthy development.Gerald Giesbrecht, Associate Professor of Pediatrics, University of CalgaryCatherine Lebel, Associate Professor of Radiology, University of CalgaryLianne Tomfohr-Madsen, Associate Professor, Canada Research Chair in Mental Health and Intersectionality, University of British ColumbiaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2048732023-05-19T12:40:40Z2023-05-19T12:40:40ZTalking puppy or finger puppet? 5 tips for buying baby toys that support healthy development<figure><img src="https://images.theconversation.com/files/525990/original/file-20230512-25-2f6227.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Tech toys may claim to be educational – but those claims often aren't backed by science. </span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/cute-little-boy-playing-with-a-railroad-train-toy-royalty-free-image/1281267794">boonchai wedmakawand/Moment Collection/Getty Images</a></span></figcaption></figure><p>Picking out a baby toy – whether it’s for your own child or a friend’s kid or the child of a family member – can be overwhelming. Although Americans spend <a href="https://www.statista.com/outlook/dmo/ecommerce/toys-hobby-diy/toys-baby/united-states">US$20 billion</a> a year on baby toys, it’s difficult to know which toy will be fun, educational and developmentally appropriate. The options seem endless, with search results at common retail sites in the hundreds, if not thousands. Is price a reliable indicator of quality? Are technological enhancements useful? </p>
<p>Our <a href="https://www.museumofplay.org/app/uploads/2023/04/15-1-Article-2-Transforming-Toybox.pdf">peer-reviewed study</a> – published in the American Journal of Play in April 2023 – surveyed the toy market for babies and toddlers age 0-2 at two major U.S. national retailers, with an eye toward differences between battery-powered toys, like the <a href="https://store.leapfrog.com/en-us/store/p/speak-learn-puppy/_/A-prod80-610100">LeapFrog Speak and Learn Puppy</a>, and traditional toys, such as the <a href="https://www.homefurniturelife.com/shop/magic-years-jungle-animals-finger-puppets-4-pc-set/">Magic Years Jungle Finger Puppet</a>. </p>
<p>We found significant differences between these two toy types in terms of how they’re marketed – with more traditional toys marketed as supporting physical development and more technological toys aimed at cognitive development. However, these companies do not always have researchers investigating whether the toys actually help children learn.</p>
<p>As <a href="https://scholar.google.com/citations?hl=en&user=KhghzJQAAAAJ&view_op=list_works&sortby=pubdate">researchers who study toys</a> and <a href="https://scholar.google.com/citations?user=5KTeq2UAAAAJ&hl=en">how children learn and play</a>, we offer five tips before you buy your next baby toy.</p>
<h2>1. Consider your goal</h2>
<p>When purchasing a toy, consider whether you have any particular developmental goal in mind. For instance, do you want your baby to develop fine motor skills by playing with a <a href="https://reachformontessori.com/busy-boards/">busy board</a>, or to <a href="https://doi.org/10.1111/mono.12280">practice spatial skills</a> by building a block tower? </p>
<h2>2. Look for open-ended toys</h2>
<p>Many parents and caregivers know that children often <a href="https://theconversation.com/when-kids-like-the-box-more-than-the-toy-the-benefits-of-playing-with-everyday-objects-202301">love playing with the box</a> more than the toy inside it. One reason is that boxes are open-ended toys – they can become anything a young child dreams up. Conversely, a toy cellphone directs the type of play much more rigidly. </p>
<p>A good rule of thumb is to choose toys that require <a href="https://www.brookings.edu/blog/education-plus-development/2018/12/10/the-science-of-toys-a-guide-for-the-perplexed-shopper/">90% activity from the child and only about 10% input from the toy</a>. For example, infants can explore a set of realistic miniature animals sensorially – usually by putting them in their mouths – and then later use them for pretend play, or even to create animal footprints in play dough. Contrast this experience with a large plastic elephant that needs to sit on the floor and lights up and makes elephant sounds. Here, a child is limited in play, with the goal being to make the object light up or play a sound. </p>
<figure class="align-center ">
<img alt="Father and young son play together with toy cars" src="https://images.theconversation.com/files/526565/original/file-20230516-27-epnrbq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/526565/original/file-20230516-27-epnrbq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/526565/original/file-20230516-27-epnrbq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/526565/original/file-20230516-27-epnrbq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/526565/original/file-20230516-27-epnrbq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/526565/original/file-20230516-27-epnrbq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/526565/original/file-20230516-27-epnrbq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Parents tend to talk to kids more when they play together with traditional toys versus tech toys.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/cute-little-african-kid-son-playing-toy-cars-with-royalty-free-image/1158481693">iStock / Getty Images Plus</a></span>
</figcaption>
</figure>
<h2>3. Recognize gender biases</h2>
<p>Several major retailers have <a href="https://www.latimes.com/business/la-fi-target-gender-labeling-20150810-story.html">removed gender-based toy sections</a> over the past decade, opting for “kids” instead of “boys” and “girls.” </p>
<p>However, if you enter the store of one of those major toy retailers today, you will still find some aisles filled with pink toys and dolls, while other aisles feature monster trucks and primary-colored blocks. A toy sword might not be labeled as “for boys,” yet shoppers often perceive it that way based on <a href="https://doi.org/10.1007/s11199-017-0858-4">their own gender socialization and beliefs</a>. If you look only in certain aisles or at stereotypical toys, you might miss out on toys that your child would enjoy regardless of gender. </p>
<h2>4. Be wary of marketing claims</h2>
<p>The makers of tech toys often make claims about their educational potential that are not backed by science. For example, an electronic shape sorter might claim to help children develop emotional skills because the toy says “I love you!” </p>
<p>Be skeptical of such claims, and use your own experience and insights to evaluate the educational potential of a toy. You might read the retailer and manufacturer descriptions, but also see what the toy actually does. If it fosters caregiver-child interactions or helps to develop a specific skill – like how building blocks support spatial skills, and finger puppets build fine motor skills – then it is likely a toy worth considering. </p>
<h2>5. Prioritize human interactions</h2>
<p>Keep in mind that toys are not chiefly designed to create baby geniuses – they are meant to be fun! So think broadly about whether you want a new toy to support physical, social, emotional, cognitive or creative development while keeping it fun. And remember that no toy can replace <a href="https://doi.org/10.1111/infa.12378">joyful, high-quality interactions</a> between caregivers and children.</p>
<p>Research suggests that <a href="https://doi.org/10.1542/peds.2018-3348">caregivers are less responsive and communicative</a> when playing with tech toys versus traditional toys with their children. So choosing traditional toys, such as nonelectronic shape sorters and building blocks, may be one way to foster the types of interactions that support healthy development.</p>
<p>Overall, research suggests that, in most cases, traditional toys provide <a href="https://www.doi.org/10.1542/peds.2018-3348">better interactions and experiences</a> than technological toys. When purchasing a toy, think through the experiences you want the baby in your life to have, think broadly about the goals of a particular toy, try to provide opportunities for <a href="https://doi.org/10.3389/fpsyg.2018.01124">high-quality interactions</a> and remember to have fun.</p><img src="https://counter.theconversation.com/content/204873/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jennifer M. Zosh has consulted for the Lego Group. </span></em></p><p class="fine-print"><em><span>Brenna Hassinger-Das does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Two experts on children’s play explain why you should be skeptical of toys that are advertised as being educational, and what to look for instead.Brenna Hassinger-Das, Assistant Professor of Psychology, Pace University Jennifer M. Zosh, Professor of Human Development and Family Studies, Penn StateLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1952922022-11-27T13:09:07Z2022-11-27T13:09:07ZRSV FAQ: What is RSV? Who is at risk? When should I seek emergency care for my child?<figure><img src="https://images.theconversation.com/files/497240/original/file-20221124-14-7r3k7l.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C5100%2C2868&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">RSV is the leading cause for hospital stays in infants in developed countries.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><h2>What is RSV?</h2>
<p>Respiratory syncytial virus (RSV) is <a href="https://doi.org/10.1093/cid/ciaa1719">one of many viruses that causes infection of the ear, nose, throat and lungs</a>. It <a href="https://doi.org/10.7150/ijbs.64762">infects people of all ages</a> and can be found worldwide.</p>
<h2>Who is at risk of RSV?</h2>
<p>RSV is an important cause of lung infections in children under two years of age, and is the leading reason for <a href="https://doi.org/10.1155/2017/4521302">hospital stays in children under one year of age (infants) in developed countries</a>. Premature infants, adults above 65 years of age and those with chronic heart and lung conditions are at <a href="https://doi.org/10.1056/nejmoa043951">higher risk for severe disease and hospitalization</a>.</p>
<h2>Why is RSV so prevalent this season?</h2>
<p>Infections due to RSV occur throughout the year, with higher numbers of infections in the late fall to early spring in North America. The start and end of RSV season changes slightly each year, <a href="http://dx.doi.org/10.15585/mmwr.mm6702a4">and infections peak in January and February</a>. Typically, RSV infections occur in two-year cycles — <a href="https://doi.org/10.1001/jamanetworkopen.2021.24650">a year of increased numbers and higher severity of illness alternating with a milder year</a>.</p>
<p>Most children will have had one RSV infection by two years of age, and some may have had more than one infection. Unfortunately, having been infected by RSV does not provide long lasting immunity, although re-infections are usually milder. Although antibodies (proteins made by the immune system in response to infection) are made against RSV, they only last six to 12 months and <a href="https://doi.org/10.1093/infdis/jiac192">require repeated exposure to keep high antibody levels</a>. </p>
<p>This likely explains why RSV infections have an alternating severe-mild cycle: in a bad year, patients develop high levels of antibodies that help protect against infection or a bad infection in the subsequent year.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/rsv-experts-explain-why-rates-of-this-virus-are-surging-this-year-194403">RSV: experts explain why rates of this virus are surging this year</a>
</strong>
</em>
</p>
<hr>
<h2>How does RSV spread?</h2>
<p>RSV is spread through two ways:</p>
<ul>
<li><p>Contact with an object that has been sneezed on, coughed on, drooled on, touched or been in the mouth of a person who is sick with RSV. That person, who now has germs on their hands, becomes sick when he/she touches their nose or mouth.</p></li>
<li><p>Breathing in the virus when the infected person coughs or sneezes, within one metre of others, without covering their nose or mouth.</p></li>
</ul>
<h2>What are the symptoms of RSV?</h2>
<p>In general, approximately three to seven days after being infected, people will develop symptoms of a common cold including fever, runny or stuffy nose, sore throat, cough and decreased energy. Patients may complain of muscle aches and their appetite may decrease. Some may have difficulty breathing. The symptoms of infection due to RSV are identical to the symptoms of other respiratory viruses.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/KlHjKaGiWFY?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">CBC covers the surge in children needing treatment for respiratory viruses.</span></figcaption>
</figure>
<p>Some patients develop pneumonia (infection of the lungs). Infants may develop bronchiolitis — inflammation (swelling) of the very small tubes that deliver air (oxygen) to the lungs. Infants with bronchiolitis commonly have wheezing — a whistling sound when they breathe out. This whistling sound sometimes is only heard using a stethoscope, but sometimes can be heard even without one. </p>
<p>Bronchiolitis and pneumonia can lead to lower oxygen levels in the blood in some patients. It is important to remember that other respiratory viruses can also lead to pneumonia and bronchiolitis.</p>
<h2>How is RSV treated?</h2>
<p>Since RSV is a virus, use of antibiotics will not lead to shortening of the illness nor will it lead to shortening the period that sick people are infectious to others. There are no antivirals for treatment of RSV infections. Most patients can be managed at home:</p>
<ul>
<li><p>Antipyretics (medications to lower fever) if fever is present. Lowering the fever does not lead to shortening of the illness, but will also treat any muscle aches and the general feeling of being unwell.</p></li>
<li><p>Saline sprays or drops help with nasal congestion, and can be used often without the risk of overdose.</p></li>
<li><p>Commercially available nasal aspirators can be used to help infants and children breathe easier </p></li>
<li><p>Encourage fluids to reduce the risk of dehydration — offer small amounts, but offer often. Fluids for infants should be breastmilk or formula. Older children can be offered a variety of fluids including oral rehydration fluids like <a href="https://www.webmd.com/drugs/2/drug-11147/pedialyte-oral/details">Pedialyte</a>, chicken broth, popsicles, ice cream and jello. Extended periods of only water should be avoided, as should relying on soda. A few days without solid food is not harmful.</p></li>
</ul>
<h2>When should I seek emergency care for my child for RSV?</h2>
<p>Although most patients can be managed at home, there are several reasons to seek medical care. They include:</p>
<ul>
<li>Breathing too hard to sleep or feed properly even when fever is not present;</li>
<li>For infants, feeding has been significantly reduced below normal; </li>
<li>Being excessively sleepy or difficult to wake;</li>
<li>Not urinating in 12 hours.</li>
</ul>
<p>Patients with RSV infections will need to be hospitalized if they need:</p>
<ul>
<li>extra oxygen;</li>
<li>intravenous fluids if they are dehydrated.</li>
</ul>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/497244/original/file-20221124-7159-xc0qpb.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="a hospital sign directing people to EMERGENCY CHILDREN / URGENCE ENFANTS" src="https://images.theconversation.com/files/497244/original/file-20221124-7159-xc0qpb.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/497244/original/file-20221124-7159-xc0qpb.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=349&fit=crop&dpr=1 600w, https://images.theconversation.com/files/497244/original/file-20221124-7159-xc0qpb.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=349&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/497244/original/file-20221124-7159-xc0qpb.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=349&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/497244/original/file-20221124-7159-xc0qpb.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=439&fit=crop&dpr=1 754w, https://images.theconversation.com/files/497244/original/file-20221124-7159-xc0qpb.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=439&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/497244/original/file-20221124-7159-xc0qpb.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=439&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Ontario has asked thousands of family health-care workers to work evenings and weekends to help ease the burden on overwhelmed children’s hospitals.</span>
<span class="attribution"><span class="source">THE CANADIAN PRESS/Adrian Wyld</span></span>
</figcaption>
</figure>
<h2>How do I protect myself and my family from RSV?</h2>
<p>Although there are no vaccines against RSV, a scientifically prepared antibody, palivizumab, <a href="https://doi.org/10.14745/ccdr.v48i78a08">is recommended to reduce the risk of complications of RSV infection in premature infants and children with chronic lung or heart disease who meet certain criteria</a>. Palivizumab is given as monthly injections during RSV season.</p>
<p>The same general measures that protect against COVID-19 and other respiratory viruses lead to reduced risk of getting infected with RSV:</p>
<ul>
<li>Wash your hands well and often;</li>
<li>Stay two meters from others when in public places — patients with RSV may be infected and capable of infecting others before they have symptoms;</li>
<li>Wear a mask when in enclosed public places.</li>
</ul>
<p>Be a good neighbour and reduce the risk that others will get sick:</p>
<ul>
<li>Stay home from school or work if you are sick;</li>
<li>Cough etiquette — cough into your elbow or a tissue. This reduces the chance that viruses are on your hands, which can then be passed onto others or objects that others may handle.</li>
</ul><img src="https://counter.theconversation.com/content/195292/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Athena McConnell is affiliated with Sanofi as a member of an advisory board related to the development of nirsevimab, an alternate monoclonal antibody against RSV. </span></em></p>As visits to emergency departments surge — and in some cases overwhelm hospitals — here are answers to frequently asked questions about Respiratory syncytial virus (RSV).Athena McConnell, Associate Professor, Pediatric Infectious Diseases, University of SaskatchewanLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1944592022-11-20T23:15:54Z2022-11-20T23:15:54Z‘We had to Google a lot’: what foster and kinship carers looking after babies told us about the lack of support<figure><img src="https://images.theconversation.com/files/496033/original/file-20221117-5721-zv4b19.jpg?ixlib=rb-1.1.0&rect=0%2C17%2C3000%2C1976&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>Foster and kinship carers are volunteers who provide day-to-day care to children who are unable to live safely with their parents. A kinship carer is someone who is either related to the child or has a previous relationship with the child (such as a neighbour or family friend). Prior to placement in their care, a foster carer is a stranger to the child.</p>
<p>There are roughly 9,000 foster carer households and 15,600 kinship carer <a href="https://www.aihw.gov.au/reports/child-protection/child-protection-australia-2020-21/contents/carers/how-many-children-were-placed-with-foster-or-relative/kinship-carers">households</a> in Australia, providing care to nearly 46,000 <a href="https://www.aihw.gov.au/reports/child-protection/child-protection-australia-2020-21/contents/out-of-home-care/how-many-children-were-in-out-of-home-care">children</a>. Babies (under one year of age) enter out-of-home care at a higher rate than any other aged children. </p>
<p>Foster and kinship carers undergo an extensive screening process prior to <a href="https://www.facs.nsw.gov.au/families/carers/about-foster-care/chapters/how-to-become-a-foster-carer">authorisation</a> and should receive ongoing <a href="https://www.facs.nsw.gov.au/families/carers/about-foster-care/chapters/legal-rights-and-responsibilities">support and training</a> to assist them in their caregiving role. </p>
<p>However, <a href="https://researchdirect.westernsydney.edu.au/islandora/object/uws:67738">our research</a>, launched recently at the <a href="https://www.eventsforchange.org.au/npc2022/1993808">National Permanency Conference</a>, found these carers are not well supported to care for babies. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/496038/original/file-20221118-9929-rrwt6n.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A man snuggles an infant." src="https://images.theconversation.com/files/496038/original/file-20221118-9929-rrwt6n.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/496038/original/file-20221118-9929-rrwt6n.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=334&fit=crop&dpr=1 600w, https://images.theconversation.com/files/496038/original/file-20221118-9929-rrwt6n.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=334&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/496038/original/file-20221118-9929-rrwt6n.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=334&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/496038/original/file-20221118-9929-rrwt6n.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=419&fit=crop&dpr=1 754w, https://images.theconversation.com/files/496038/original/file-20221118-9929-rrwt6n.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=419&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/496038/original/file-20221118-9929-rrwt6n.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=419&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Babies who require separation from their parents due to safety issues often experience developmental trauma and struggle to form healthy attachments, so it’s crucial carers are educated about attachment.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/adoption-law-should-be-reformed-to-give-children-legal-connections-to-both-of-their-families-heres-why-127521">Adoption law should be reformed to give children legal connections to both of their families – here's why</a>
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</em>
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<hr>
<h2>40% of carers got no information or training on infant care</h2>
<p>Typically, when a person discovers they are becoming a parent, they have access to pregnancy and parenting classes, and many other resources to prepare them to care for their baby. </p>
<p>When a baby is born, parents are taught by nurses and midwives how to hold, feed, bath and settle their baby. </p>
<p>After leaving the hospital, many also receive home visiting services which provide ongoing support for parents and their babies. </p>
<p>Unfortunately, foster and kinship carers of infants do not receive this same level of support. </p>
<p>We surveyed 232 foster and kinship carers who had provided care to a baby in out-of-home care sometime in the past five years. We also interviewed 13 carers to understand how to best support them in their caregiving role.</p>
<p>The survey asked carers whether they had received information or training related to eight key areas regarding infants:</p>
<ul>
<li><p>nutrition</p></li>
<li><p>feeding</p></li>
<li><p>bathing</p></li>
<li><p>sleeping and settling</p></li>
<li><p>immunisation</p></li>
<li><p>developmental milestones</p></li>
<li><p>attachment; and </p></li>
<li><p>trauma.</p></li>
</ul>
<p>Around 25% of carers received information on infant nutrition (such as what formula to use or when to introduce solids) and about 33% were given information on feeding (such as how to bottle-feed a baby). </p>
<p>Only 16% of carers reported receiving information to help them bathe a baby, settle a crying baby or put them to bed.</p>
<p>Only 25% of carers received information regarding childhood immunisation and 20% received information regarding typical developmental milestones (such as when babies should be able to lift their head, roll over or crawl).</p>
<p>These rates are surprisingly low given that the health care system provides <a href="https://www.health.nsw.gov.au/kidsfamilies/MCFhealth/maternity/Pages/baby-bundle.aspx">basic caregiving information</a> to all expectant parents either shortly before or after the birth of a child. </p>
<p>Babies who require separation from their parents due to safety issues often experience developmental trauma and <a href="https://aifs.gov.au/webinars/childrens-attachment-needs-context-out-home-care">struggle to form healthy attachments</a> to others. </p>
<p>Poor attachment and during infancy can have major negative <a href="https://www1.health.nsw.gov.au/pds/Pages/doc.aspx?dn=PD2019_008">long-term effects on children</a>. </p>
<p>Despite this, only 25% of carers received information on attachment and about 33% received information on developmental trauma. </p>
<p>In total, 40% of the carers in our study received no information or training at all related to caring for a baby. </p>
<h2>‘We had to Google a lot of information’</h2>
<p>The carers in our study were resourceful.</p>
<p>We asked those who reported receiving information or training whether it had been offered to them or if they had found it themselves. </p>
<p>The majority reported finding the information themselves. While this shows a desire to provide good quality care, it is concerning as we don’t know whether this information is from a credible source. </p>
<p>As one carer told us:</p>
<blockquote>
<p>We had to Google a lot of information because we hadn’t had a baby for so long!</p>
</blockquote>
<p>Carers were also motivated. While only 29% of carers reported receiving home visiting services, over 80% reported taking the babies in their care to the community health nurse. </p>
<p>Also, it should not be assumed carers don’t need information because they’ve done it before. </p>
<p>Just over 30% of the carers surveyed had no previous parenting experience before providing out-of-home care. </p>
<p>Many of those with parenting experience had not cared for a baby for several years. </p>
<p>In their interviews carers described themselves as “unprepared” and needing a “refresher” before receiving care of a baby. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/496036/original/file-20221117-25-6oy5pn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A woman looks at a screen while holding a baby." src="https://images.theconversation.com/files/496036/original/file-20221117-25-6oy5pn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/496036/original/file-20221117-25-6oy5pn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/496036/original/file-20221117-25-6oy5pn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/496036/original/file-20221117-25-6oy5pn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/496036/original/file-20221117-25-6oy5pn.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/496036/original/file-20221117-25-6oy5pn.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/496036/original/file-20221117-25-6oy5pn.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Some carers reported having to Google information on how to care for the baby they were fostering.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<h2>Three key recommendations</h2>
<p>The United Nations says <a href="https://www.unicef.org.au/united-nations-convention-on-the-rights-of-the-child?&mkwid=&pcrid=&pkw=&pmt=&pdv=c&plid=&gclid=Cj0KCQiAsdKbBhDHARIsANJ6-jegX348F-SVej2b_SjZPJPZXWDgtIOkX7-eH5vWwjuTzLCAIt22FZsaAupvEALw_wcB&gclsrc=aw.ds">governments have the responsibility</a> to ensure children grow and develop healthily.</p>
<p>This includes babies living in out-of-home care. But how can carers provide quality care if they are not trained and supported to do so? </p>
<p>When carers are not supported, they may worry about their ability to meet the needs of the baby in their care. This anxiety and self-doubt can cause carers to stop providing care. </p>
<p>As one carer put it:</p>
<blockquote>
<p>I’m still in two minds myself about whether I would do this again.</p>
</blockquote>
<p>Australia is already facing a <a href="https://www.abc.net.au/news/2022-09-12/foster-carers-needed-victoria-children-out-of-home-care-increase/101418620">shortage of carers</a> and increasing numbers of babies are requiring care.</p>
<p>The carers in our study found caring for babies to be “rewarding” but indicated they would welcome training and support, such as home visiting services, to help them provide the best possible care to babies. </p>
<p>We recommend that foster and kinship carers caring for babies are provided:</p>
<ol>
<li>training related to basic infant care</li>
<li>credible resources, and </li>
<li>home visiting services.</li>
</ol>
<p>This will help retain carers and ensure the best possible care is provided to babies in out-of-home care.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/we-checked-the-records-of-6-000-kids-entering-care-only-a-fraction-received-recommended-health-checks-177634">We checked the records of 6,000 kids entering care. Only a fraction received recommended health checks</a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/194459/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>This research was jointly funded by My Forever Family and the School of Nursing and Midwifery at Western Sydney University. Stacy Blythe is an authorised foster carer for the NSW Department of Communities and Justice. . </span></em></p><p class="fine-print"><em><span>Emma Elcombe does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>We surveyed 232 foster and kinship carers who had provided care to a baby in out-of-home care sometime in the last five years. Many were not well supported to care for babies.Stacy Blythe, Deputy Director Translational Research and Social Innovation Group at the Ingham Institute, Associate Professor, School of Nursing and Midwifery, Western Sydney UniversityEmma Elcombe, Senior Research Officer, School of Nursing and Midwifery, Western Sydney UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1896142022-11-15T13:22:55Z2022-11-15T13:22:55ZHey, new parents – go ahead and ‘spoil’ that baby!<figure><img src="https://images.theconversation.com/files/492648/original/file-20221031-19-qf207o.jpg?ixlib=rb-1.1.0&rect=0%2C7%2C5200%2C3448&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">How to soothe a crying baby? Try everything.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/woman-handing-crying-baby-boy-bottle-royalty-free-image/100955175?phrase=crying baby parent&adppopup=true">Tripod/Getty Images</a></span></figcaption></figure><p>When an infant cries, parents frequently wonder whether they should soothe the baby or let the baby calm itself down. If they respond to every sob, won’t the baby cry more? Isn’t that spoiling the baby?</p>
<p>I hear these questions a lot as <a href="https://scholar.google.com/citations?user=vtfvXqMAAAAJ&hl=en">a professor of child development and family science</a>. The notion of spoiling a baby remains common in the U.S., <a href="https://www.zerotothree.org/resource/help-your-child-develop-self-control/">despite evidence</a> that infants who have parents who respond to their needs are better at <a href="https://doi.org/10.1037/0893-3200.16.4.447">calming themselves down later in life</a>.</p>
<p>Many of the students I teach say that their parents resisted calming their cries and that they turned out just fine. Of course, there are <a href="http://doi.org/10.1016/j.infbeh.2008.10.007">individual differences in early childhood development</a>. There is no “<a href="http://doi.org/10.1111/cdep.12446">one size fits all</a>” for parenting. </p>
<p>That said, for decades now, developmental scientists have studied emotional regulation in children and the caregiver-infant bond. There is an answer to the common question of whether it’s better to comfort a crying baby or let them learn to calm themselves down. Let me explain …</p>
<h2>Emotional regulation during infancy</h2>
<p>Infants are born with a remarkable number of capabilities. Indeed, <a href="http://doi.org/10.1177/1745691619895071">research shows</a> that babies seem to <a href="https://doi.org/10.1038/s41598-019-39511-9">“know” a lot more about the world we live and grow in</a> than previously believed. For instance, infants <a href="https://www.nature.com/articles/358749a0">possess an understanding of numbers</a>, <a href="https://doi.org/10.1037/0012-1649.23.5.655">object permanence</a> and even <a href="https://www.nytimes.com/2010/05/09/magazine/09babies-t.html">morality</a>.</p>
<p>However, infants’ abilities are still immature. They rely on their caregivers to fine-tune those skills, <a href="http://doi.org/10.1126/science.1128727">much like other young mammals</a>. </p>
<p>And one thing newborns cannot do is <a href="https://www.ncbi.nlm.nih.gov/books/NBK225568/">regulate their own distress</a> – whether that distress comes from feeling <a href="http://doi.org/10.1016/j.copsyc.2017.02.009">cold, hunger, pain or any other discomfort</a>. That ability does not develop until approximately 4 months of age. So infants need their parents’ help to calm down. </p>
<p>Since crying is one of the first ways infants communicate <a href="https://doi.org/10.1016/0031-9384(94)00345-6">their needs to caregivers and others</a>, <a href="http://doi.org/10.1016/j.infbeh.2010.01.001">it is imperative</a> for the infant-parent bond that caregivers <a href="https://doi.org/10.1037/0012-1649.40.6.1123">respond to their infant cries</a>.</p>
<p>Moreover, <a href="http://doi.org/10.1093/cercor/bhv306">research shows</a> that infant cries elicit an apparent psychological need in others to <a href="https://doi.org/10.1016/S0163-6383(80)80020-8">ease their distress</a>. As such, infant cries serve a fundamental purpose for both infant and caregiver.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/492649/original/file-20221031-19-p24klo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Gay fathers trying to calm a crying newborn. The group is lying on bed with large window and sunlight in the background." src="https://images.theconversation.com/files/492649/original/file-20221031-19-p24klo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/492649/original/file-20221031-19-p24klo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/492649/original/file-20221031-19-p24klo.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/492649/original/file-20221031-19-p24klo.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/492649/original/file-20221031-19-p24klo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/492649/original/file-20221031-19-p24klo.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/492649/original/file-20221031-19-p24klo.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Caregivers who respond to infant needs show babies that they are worthy of love and care.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/calming-newborn-royalty-free-image/1160661226?phrase=crying%20baby%20parent&adppopup=true">Willie B. Thomas/Getty Images</a></span>
</figcaption>
</figure>
<p>Critically, infants also learn from the responsiveness of their caregivers <a href="https://doi.org/10.1037/0012-1649.40.6.1068">what it feels like to calm down</a>. This feeling is similar to the internal changes that adults and older children feel when they regulate their emotions – that is, their heart rate slows and they feel at ease. This repeated experience gives <a href="https://doi.org/10.1111/j.1467-8624.2008.01255.x">infants new life skills</a>: Longitudinal research indicates that infants whose caregivers respond to their distress are better able to <a href="http://doi.org/10.1017/S0954579408000023">regulate emotion and behavior as they get older</a>.</p>
<p>For babies, self-soothing likely means sucking on a pacifier or a fist. Later in life, those foundational infant calming skills learned in response to parental care develop into more adultlike habits for <a href="https://doi.org/10.1111/j.1469-7610.2008.02050.x">regulating distress</a>, like counting to 10 or taking deep breaths.</p>
<h2>Caregiver-infant bonding</h2>
<p>Parental responsiveness to infant cries also affects the infant-caregiver relationship. Caregivers provide the first information for infants about the predictability of the social world, the trustworthiness of others and about their own self-worth. </p>
<p>This lays the foundation for the quality of the <a href="https://doi.org/10.1037/fam0000794">lifelong relationship</a> between a caregiver and child. When infants are soothed in times of distress, they learn that their caregiver is trustworthy and reliable. They also learn that they are <a href="http://www.jstor.org/stable/23093743">worthy</a> of caring, loving relationships, which positively influences their <a href="http://doi.org/10.1111/j.1551-6709.2010.01112.x">future relationships</a>. </p>
<p>Caregiver responsiveness is also associated with a cascade of <a href="https://doi.org/10.1037/dev0000862">well-documented outcomes</a> in infants, children and adolescents, including <a href="http://doi.org/10.1542/peds.2005-1284">cognitive functioning</a>, <a href="http://doi.org/10.1016/j.ecresq.2020.01.002">language development</a>, <a href="https://doi.org/10.3389/fpsyg.2022.870669">self-esteem</a> and <a href="http://doi.org/10.1037/dev0000579">future sensitivity to infant needs</a>. </p>
<p>The absence of caregiver responsiveness, on the other hand, is <a href="https://doi.org/10.1037/0012-1649.35.2.569">linked to later behavioral difficulties</a> and <a href="https://doi.org/10.1111/j.1469-7610.2009.02202.x">developmental challenges</a>. Studies show that neglected children can struggle to bond with their peers and to cope with rejection.</p>
<p>Though one study recently reported that these <a href="https://doi.org/10.1111/jcpp.13223">ill effects might not apply</a> at night – as in, when parents let babies “cry it out” to teach them to sleep – the major consensus in the literature is that before 4 months of age babies should not be left to cry. I recommend no earlier than 6 months because of the formation of the attachment bond, and highly encourage caregivers to consider the individual abilities of their child. Indeed, some children are able to self-regulate better than others. In addition, there are <a href="https://www.npr.org/sections/health-shots/2019/07/15/730339536/sleep-training-truths-what-science-can-and-cant-tell-us-about-crying-it-out">alternative ways</a> to help babies learn to self-soothe at night that include responding to infant distress.</p>
<p>Fortunately, caregivers are biologically <a href="https://psycnet.apa.org/record/2002-02628-003">primed to care for their infants</a>. Research with animals and humans demonstrates that there are <a href="https://doi.org/10.1016/j.copsyc.2017.02.011">hormones that drive caregiving</a>. </p>
<h2>Go ahead, ‘spoil’ that baby</h2>
<p>My best advice, based on the scientific literature, is that parents should respond promptly and consistently to infant cries through at least 6 months of age. </p>
<p>But take a pragmatic approach. </p>
<p>Caregivers know the idiosyncrasies of their infants: Some may be more placid, while others are more excitable. Likewise, culture drives the goals caregivers set for themselves and their children. So, responsiveness and adaptive caregiver-infant relationships will look different for different families. Parents should act accordingly, <a href="https://doi.org/10.1111/cdep.12446">fitting their responsiveness</a> to their infant’s needs and their <a href="https://doi.org/10.1080/14616734.2022.2030132">cultural context</a>. </p>
<p>However you look at it, responding to an infant’s every cry is not “spoiling” the baby. Instead, the act of soothing a crying infant provides the baby with the tools they will use to soothe themselves in the future.</p><img src="https://counter.theconversation.com/content/189614/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Amy Root receives funding from National Institute of Child Health and Human Development.</span></em></p>A professor of child development explains why it’s OK – recommended, in fact – to respond to an infant’s every cry, sob and whimper.Amy Root, Professor of Applied Human Sciences, West Virginia UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1891152022-10-06T13:44:06Z2022-10-06T13:44:06ZNigerian newborns weigh less if their mothers use biomass fuel - a major health risk<figure><img src="https://images.theconversation.com/files/487412/original/file-20220929-21-m1469e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Low birth weight is the primary cause of infant morbidity and mortality in Nigeria. </span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/young-babies-sleep-together-under-a-heat-lamp-at-the-lagos-news-photo/81924722?adppopup=true">Bennett Raglin/WireImage</a></span></figcaption></figure><p>Babies should ideally weigh <a href="https://www.medicalnewstoday.com/articles/325630#average-weights">about 2,500g or more at birth</a>. Birth weight is a <a href="https://academic.oup.com/ije/article/30/6/1233/651751">vital indicator</a> of foetal and neonatal health. If a newborn weighs less than 2,500g – because they are preterm or their growth in the womb was restricted for some reason – they are <a href="https://reliefweb.int/report/nigeria/nigeria-profile-preterm-and-low-birth-weight-prevention-and-care">more at risk</a> of death, disability and noncommunicable diseases. </p>
<p>The low birth weight infant’s tiny body is not as strong as it should be. The baby might struggle to gain weight and fight infection. And with so little body fat, these babies often have difficulty staying warm in normal temperatures.</p>
<p>Low birth weight is <a href="https://www.tandfonline.com/doi/full/10.3402/gha.v9.28822">the primary cause</a> of infant morbidity and mortality in Nigeria.</p>
<p>The factors that are known to influence a baby’s weight at birth <a href="https://www.panafrican-med-journal.com/content/article/20/108/full/">include</a> duration of pregnancy, and maternal characteristics like age, parity (the number of times a woman has given birth) and illness, as well as adverse environmental exposures.</p>
<p>One factor that hasn’t been studied much in Nigeria is the type of cooking fuel that the baby’s mother uses or is exposed to during pregnancy. My research group suspected this might be a significant factor because of the high prevalence of low birth weight in Nigeria and the fact that biomass fuel is <a href="https://ng.boell.org/en/clean-cooking-energy">commonly used</a>.</p>
<p>Nigeria <a href="https://pubmed.ncbi.nlm.nih.gov/25103583/#:%7E:text=Two%2Dthirds%20of%20small%2Dfor,Pakistan%2C%20Nigeria%2C%20and%20Bangladesh.">is among the five countries</a> where most preterm and small-for-gestational-age infants are born. <a href="https://www.countdown2015mnch.org/documents/2012Report/Nigeria_Report_ExecSum.pdf">About 5.9 million babies are born in Nigeria each year</a>, and 15% of these newborns have a low birth weight accounting for 25% of infant mortality. </p>
<p>Our <a href="https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0000419">study</a> explored the association between biomass cooking fuel and birth weight among full term births in Kaduna, northwestern Nigeria. We found there was a link – and this was supported by <a href="https://dhsprogram.com/pubs/pdf/SR264/SR264.pdf">data from the nationally representative Demographic and Health Survey</a>. Mothers in Kaduna who were exposed to biomass fuel gave birth to infants who were on average 113g lighter than those using liquefied petroleum gas, which is <a href="https://group.met.com/en/media/energy-insight/what-is-lpg-liquefied-petroleum-gas#:%7E:text=LPG%20is%20a%20cleaner%20energy,use%20natural%20gas%20as%20fuel.">a cleaner fuel</a>. Nationally, mothers using biomass had infants weighing 50g lower at birth than those using clean fuel.</p>
<p>Exposure to biomass fuel combustion during pregnancy <a href="https://pubmed.ncbi.nlm.nih.gov/18639310/">could adversely affect</a> foetal growth or increase preterm birth risk, resulting in a child born early or small for gestational age and thus creating further health risks for the child. </p>
<p>Biomass fuel includes wood, animal dung, charcoal and crop residues. It is used worldwide for cooking, heating and lighting. Biomass fuels and <a href="https://onlinelibrary.wiley.com/doi/10.1111/1467-8268.12348">kerosene</a> are still widely used in urban and rural Nigeria due to supply and demand issues driving household energy choices. </p>
<p>The study results show the importance of efforts to make safer fuel choices available.</p>
<h2>Kaduna and national Nigerian data</h2>
<p>Our study focused only on term infants because <a href="https://pubmed.ncbi.nlm.nih.gov/1536353/">duration of pregnancy independently affects</a> birth weight, and multiple factors influence preterm birth. </p>
<p>We conducted the primary analysis based on a study of 1,514 mother-child pairs in Kaduna, northwestern Nigeria. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9278217/">Kaduna</a> is the fourth largest city in Nigeria, with a population of 1.6 million. </p>
<p>To validate the primary analysis, we repeated it using data from 6,975 mother-child pairs in the most recent <a href="https://www.dhsprogram.com/publications/publication-fr359-dhs-final-reports.cfm">Nigeria Demographic and Health Survey 2018</a>.</p>
<p>The primary analysis classified cooking fuel types as liquefied petroleum gas, kerosene and biomass fuel (including charcoal, wood, crops or straw, and animal dung). In the survey, cooking fuels were categorised into low pollution fuel (electricity, liquefied petroleum gas and natural gas), kerosene and biomass fuel.</p>
<p>In both analyses, we observed that the impact of biomass use on birth weight was greater than the impact of liquefied petroleum gas or kerosene.</p>
<p>The results highlight the need for public health intervention. Reducing adverse birth outcomes like low birth weight will depend on addressing regional disparities in the key determinants. </p>
<p>Our results showed that birth order, household size, and socio-economic status influenced cooking fuel choice, which is consistent with <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7995525/">existing literature</a>. It is reasonable that the women least able to use clean cooking fuels will be those who:</p>
<ul>
<li><p>live in households of five or more people</p></li>
<li><p>live in poorer households</p></li>
<li><p>have given birth at least once before. </p></li>
</ul>
<p>This could be due to cost and unreliable fuel supply. Women with more children or living in larger households might also cook with bigger pots, requiring longer cooking times, which increases their exposure to indoor air pollution from biomass fuel use.</p>
<h2>Recommendations</h2>
<p>We recommend that pregnant women attending antenatal care be asked about cooking fuels and given help to minimise prenatal biomass exposure. Some recent intervention trials conducted in low- and middle-income countries, including Nigeria, have shown that transition from biomass fuel to cleaner fuels reduces air pollution and <a href="https://www.sciencedirect.com/science/article/pii/S0160412016306018">improves outcomes like birth weight</a>. </p>
<p>Interventions to reduce indoor air pollution could include a stove subsidy, fuel subsidy, fuel ban and behaviour change communication. </p>
<p>It’s important first to understand why a household uses a particular cooking fuel.</p>
<p>It is also vital to <a href="https://pubmed.ncbi.nlm.nih.gov/28055947/">learn</a> from other household health interventions, such as sanitation and nutrition. These can enhance an understanding of what bars or enables adoption of a new method.</p><img src="https://counter.theconversation.com/content/189115/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Musa Kana does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Pregnant women attending antenatal care should be asked about cooking fuels and given help to minimise prenatal biomass exposure to reduce low birth weight in Nigeria.Musa Kana, Perinatal Epidemiologist, Kaduna State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1876622022-09-28T20:45:27Z2022-09-28T20:45:27ZWill baby drop boxes from the Italian Renaissance become more common after Meloni win?<figure><img src="https://images.theconversation.com/files/486622/original/file-20220926-21-psj4vf.jpg?ixlib=rb-1.1.0&rect=154%2C7%2C4675%2C3134&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Although pregnancy was celebrated in Renaissance paintings, like the 'Primavera' by Botticelli, the reality was quite different. Will Giorgia Meloni's far-right government reverse abortion rights in Italy?</span> <span class="attribution"><span class="source">Uffizi Gallery</span></span></figcaption></figure><p>In Italy, abortion has been legal since 1978. But now that Giorgia Meloni’s Brothers of Italy party <a href="https://theconversation.com/what-will-its-first-far-right-leader-since-wwii-mean-for-italy-190655">has won the national election</a> and the far-right form a majority in both the Italian Parliament and Senate, <a href="https://www.nytimes.com/2022/09/23/world/europe/giorgia-meloni-italy-women.html">access to abortion in Italy could face new restrictions</a>.</p>
<p>Anti-abortion supporters like Movimento per la Vita <a href="https://www.politico.eu/article/italy-abortion-access-erodes-riding-united-states-wave/">have been buoyed</a> by Meloni’s recent win as well as this summer’s United States Supreme Court ruling on Roe v. Wade. </p>
<p>As an art historian, my work has always seemed safely detached from today’s reality. However, after these recent political shifts, it seems historical artifacts and practices are now painfully relevant.</p>
<h2>Revival from ages past</h2>
<p>In Piazza di San Remigio, a few streets away from the Arno river in Florence, Italy, there’s a rectangular, box-like contraption encased in the wall about the same size as a bank machine. It sits opposite the façade of the church that gives the piazza its name. Drawings of sweetly swaddled babies are visible inside the box behind its glass pane. </p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/477926/original/file-20220805-7920-nph7d7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/477926/original/file-20220805-7920-nph7d7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/477926/original/file-20220805-7920-nph7d7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/477926/original/file-20220805-7920-nph7d7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/477926/original/file-20220805-7920-nph7d7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/477926/original/file-20220805-7920-nph7d7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/477926/original/file-20220805-7920-nph7d7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/477926/original/file-20220805-7920-nph7d7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A culla per la vita (baby box) in Piazza di San Remigio, Florence, Italy.</span>
<span class="attribution"><span class="source">Sarah Wilkins</span>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>The contraption is a <a href="https://www.nytimes.com/2007/02/28/world/europe/28rome.html"><em>culla per la vita</em></a> or “cradle for life” where <a href="http://www.culleperlavita.it/dove_sono.php">desperate mothers can deposit unwanted infants</a> while retaining anonymity. Pressing a button opens the glass panel and the newborn can be placed inside the ventilated space on a receiving cloth. The partition closes automatically after ten seconds and cannot be reopened. </p>
<p>A sensor immediately notifies monitoring personnel and medical services who come to retrieve the infant.</p>
<p>This <em>culla per la vita</em> was installed in 2006 by the Florentine chapter of Movimento per la Vita, which aims to make abortions illegal in Italy. It is one of a growing national network of deposit points.</p>
<p>In the United States, there are over 100 baby boxes and, as in Italy, <a href="https://www.nytimes.com/2022/08/06/us/roe-safe-haven-laws-newborns.html?searchResultPosition=1">most are tied to anti-abortion, safe-haven movements</a>.</p>
<h2>No reproductive rights during the Renaissance</h2>
<p>The mechanized “baby box” or “baby hatch” is a revival of centuries-old cultural practices — first recorded as early as the 12th century and which particularly flourished during the Italian Renaissance. </p>
<p>In 15th and 16th-century Italy women had no reproductive rights. Without access to advanced medical care, women used all kinds of methods to end unwanted pregnancies, such as <a href="https://daily.jstor.org/abortion-remedies-medieval-catholic-nun/">time-honoured herbal abortifacients</a>, acidic substances, the insertion of foreign objects and folkloric practices.</p>
<p>Regardless of whether the pregnancy was wanted or not, the risk of death during childbirth was inescapable across all social classes. Although historical maternal mortality rates are hard to calculate, one estimate, using Florentine <em>Libri dei morti</em> (Books of the Dead), <a href="https://hdl-handle-net.ocadu.idm.oclc.org/2027/heb01278.0001.001">concludes that at least one out of five women of childbearing age died due to neonatal complications and trauma</a>. </p>
<p>It was not unheard of <a href="https://doi.org/10.1163/9789004375871_012">for women to write wills while pregnant</a>, especially when carrying their first child. The risk of complications was amplified by the pubescent age of many Renaissance brides. </p>
<h2>The ‘Primavera’ by Botticelli</h2>
<p>In Florence today, visitors flock to the city’s historic Uffizi galleries to experience the beauty of Botticelli’s <em>Primavera</em> and other Renaissance artworks. But whether viewers of the painting realize it or not, <em>Primavera</em> draws attention to stark inequalities for women. </p>
<p>The painting, some argue, <a href="https://www.jstor.org/stable/1358279">commemorates a marriage</a>, possibly that between Lorenzo di Pierfrancesco de’ Medici and Semiramide Appiani in 1482. At the far right of the panel, the god Zephyr pursues the terrified nymph Chloris. Raped by Zephyr, Chloris transforms into the goddess Flora, who holds a cluster of blossoms at her abdomen, emphasizing her fertility, and to the eyes of a new bride, foreshadowing her expected pregnancies.</p>
<p>While new mothers of the elite were served sweetmeats and delicacies and given lavishly painted <em>deschi di parto</em> (birth trays) to celebrate the delivery of a child, most Italian women of the time experienced harrowing deprivation.</p>
<h2>An early baby box</h2>
<p>In 1419, Florence’s Silk Guild commissioned Filippo Brunelleschi to design the famed Ospedale degli Innocenti, which opened in 1445.</p>
<p>The building’s <em>loggia</em>, or portico, features semicircular arches made of soft grey <em>pietra serena</em>, ornamented with glazed terracotta roundels of swaddled infants by Andrea della Robbia inserted in 1487.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/481337/original/file-20220826-1650-5xi5b8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Three arches, above the columns are terracotta figures of infants surrounded by a circular blue background." src="https://images.theconversation.com/files/481337/original/file-20220826-1650-5xi5b8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/481337/original/file-20220826-1650-5xi5b8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=402&fit=crop&dpr=1 600w, https://images.theconversation.com/files/481337/original/file-20220826-1650-5xi5b8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=402&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/481337/original/file-20220826-1650-5xi5b8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=402&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/481337/original/file-20220826-1650-5xi5b8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=505&fit=crop&dpr=1 754w, https://images.theconversation.com/files/481337/original/file-20220826-1650-5xi5b8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=505&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/481337/original/file-20220826-1650-5xi5b8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=505&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A few of the terracotta roundels in the portico of Brunelleschi’s Hospital of Innocents in Florence, Italy.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>Unwanted newborns were initially left in the loggia in the <em>pila</em> — an elevated basin or pillar — followed by the <em>finestra ferrata</em>, a small gated window, with dimensions that restricted the age of those accepted. Later, infants entered via <em>la ruota degli esposti</em> (“wheel of the exposed” or “foundling wheel”) — the <a href="https://www.routledge.com/Visual-Cultures-of-Foundling-Care-in-Renaissance-Italy/Presciutti/p/book/9781138316171">preferred method</a> of surrender by the 16th century. </p>
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Read more:
<a href="https://theconversation.com/after-a-newborn-was-found-in-a-recycling-bin-a-safe-haven-baby-hatch-may-save-lives-132851">After a newborn was found in a recycling bin, a safe haven baby hatch may save lives</a>
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<p>This cylindrical wooden device allowed the baby to be placed in an opening, rotated inwardly, and received inside. Infants often arrived wrapped with small talismans or a scrap with a scrawled name. Half a ribbon, a broken <a href="https://www.visitflorence.com/florence-museums/innocenti-museum.html">charm</a>, pendant, or coin, these marks of recognition were left with the child hoping for future reconciliation. The mother or relative kept the other half as proof of the long-lost familial relationship.</p>
<h2>Catholic doctrine barred burials</h2>
<p>Infant deaths were not just an earthly tragedy. Catholic doctrine forbade the baptism of deceased infants. Unbaptized infants who died quickly after birth, were officially <a href="https://doi.org/10.3390/rel11120678">barred from burial</a> in consecrated cemeteries and family chapels or tombs.</p>
<p>Midwives plunged unresponsive newborns into water or doused them with liquid in a desperate test for life. If revived, religious authorities <a href="https://doi.org/10.1177/146960531770434">allowed emergency baptisms by midwives or laypeople</a>.</p>
<p>Thousands of unwanted infants nevertheless survived their births. </p>
<p>Ultimately, the compassionate retrieval of abandoned infants may be a well-intentioned outcome to a highly complicated dilemma. However, we cannot forget the systemic torment of the mother by a world that does not provide adequate healthcare.</p>
<h2>Will abortion rights change under Meloni?</h2>
<figure class="align-right ">
<img alt="A woman in a white suit waves." src="https://images.theconversation.com/files/486618/original/file-20220926-16-wvyhhq.jpg?ixlib=rb-1.1.0&rect=242%2C206%2C5748%2C4041&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/486618/original/file-20220926-16-wvyhhq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=426&fit=crop&dpr=1 600w, https://images.theconversation.com/files/486618/original/file-20220926-16-wvyhhq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=426&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/486618/original/file-20220926-16-wvyhhq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=426&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/486618/original/file-20220926-16-wvyhhq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=535&fit=crop&dpr=1 754w, https://images.theconversation.com/files/486618/original/file-20220926-16-wvyhhq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=535&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/486618/original/file-20220926-16-wvyhhq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=535&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Fratelli d'Italia (‘Brothers of Italy’) leader Giorgia Meloni in Rome on Sept. 25.</span>
<span class="attribution"><span class="source">(AP Photo/Gregorio Borgia)</span></span>
</figcaption>
</figure>
<p>Despite the legality of abortion many Italian women struggle to obtain one. Almost 70 per cent of <a href="https://www.nytimes.com/2016/01/17/world/europe/on-paper-italy-allows-abortions-but-few-doctors-will-perform-them.html">gynecologists</a> — 83 per cent in Italy’s southern regions — <a href="https://www.ilpost.it/2021/03/29/aborto-obiezione-coscienza-italia/">are conscientious objectors</a>.</p>
<p>Giorgia Meloni has said that abolishing Italy’s abortion law is <a href="https://www.theguardian.com/world/2022/aug/22/abortion-rights-at-risk-in-region-led-by-party-of-italys-possible-next-pm">not on her agenda</a> but her party has been <a href="https://www.repubblica.it/politica/2022/09/15/news/meloni_aborto_legge_194_reazioni-365762519/?fbclid=IwAR2u8B44TEt_2ZMyTr2kG80B4f9SmaAr0NLsc57DQ_BPYuQmNIrUE2e4QKE">accused of impeding abortion access in some regions</a>.
For example, Marche’s regional council opposes abortions using pill RU 486 in clinics outside hospitals in contrast to Ministry of Health guidelines. </p>
<p>Meloni has said she wants women <a href="https://www.repubblica.it/politica/2022/09/15/news/meloni_aborto_legge_194_reazioni-365762519/?fbclid=IwAR2u8B44TEt_2ZMyTr2kG80B4f9SmaAr0NLsc57DQ_BPYuQmNIrUE2e4QKE">“to have the right to make a different choice” other than abortion</a>. The precise meaning of this statement is yet to be seen.</p><img src="https://counter.theconversation.com/content/187662/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Heather Coffey does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The baby drop box is a revival of centuries-old cultural practices from the Italian Renaissance when reproductive rights were zero.Heather Coffey, Assistant Professor of Art History, OCAD UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1827362022-06-08T12:32:43Z2022-06-08T12:32:43ZWhy can’t you remember being born, learning to walk or saying your first words? What scientists know about ‘infantile amnesia’<figure><img src="https://images.theconversation.com/files/467580/original/file-20220607-40973-et6p7r.jpg?ixlib=rb-1.1.0&rect=457%2C12%2C7786%2C5475&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Will either sibling remember this momentous meeting?</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/little-boy-meeting-his-cute-baby-sister-royalty-free-image/1367706938">ArtMarie/E+ via Getty Images</a></span></figcaption></figure><p>Whenever I teach about memory <a href="https://scholar.google.com/citations?user=wGGw7JQAAAAJ&hl=en&oi=ao">in my child development class</a> at Rutgers University, I open by asking my students to recall their very first memories. Some students talk about their first day of pre-K; others talk about a time when they got hurt or upset; some cite the day their younger sibling was born. </p>
<p>Despite vast differences in the details, these memories do have a couple of things in common: They’re all <a href="https://en.wikipedia.org/wiki/Autobiographical_memory">autobiographical</a>, or memories of significant experiences in a person’s life, and they typically didn’t happen before the age of 2 or 3. In fact, most people can’t remember events from the first few years of their lives – a phenomenon researchers have dubbed <a href="https://doi.org/10.1016/B978-012370877-9.00007-4">infantile amnesia</a>. But why can’t we remember the things that happened to us when we were infants? Does memory start to work only at a certain age?</p>
<p>Here’s what researchers know about babies and memory.</p>
<h2>Infants can form memories</h2>
<p>Despite the fact that people can’t remember much before the age of 2 or 3, research suggests that infants can form memories – just not the kinds of memories you tell about yourself. Within the first few days of life, <a href="https://doi.org/10.1111/j.2044-835X.1989.tb00784.x">infants can recall their own mother’s face</a> and distinguish it from the face of a stranger. A few months later, infants can demonstrate that they <a href="https://doi.org/10.1037/0012-1649.37.5.642">remember lots of familiar faces</a> by smiling most at the ones they see most often.</p>
<p>In fact, there are lots of <a href="https://www.brainhq.com/brain-resources/memory/types-of-memory/">different kinds of memories</a> besides those that are autobiographical. There are semantic memories, or memories of facts, like the names for different varieties of apples, or the capital of your home state. There are also procedural memories, or memories for how to perform an action, like opening your front door or driving a car. </p>
<p>Research from <a href="https://www.rutgers.edu/news/carolyn-rovee-collier-pioneer-whose-research-proved-infants-can-learn-dies-72">psychologist Carolyn Rovee-Collier’s</a> lab in the 1980s and 1990s famously showed that infants can form some of these other kinds of memories from an early age. Of course, infants can’t exactly tell you what they remember. So the key to Rovee-Collier’s research was devising a task that was sensitive to babies’ rapidly changing bodies and abilities in order to assess their memories over a long period.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/467578/original/file-20220607-15930-ust6na.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="baby lying on back in crib looking up at mobile suspended from above" src="https://images.theconversation.com/files/467578/original/file-20220607-15930-ust6na.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/467578/original/file-20220607-15930-ust6na.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/467578/original/file-20220607-15930-ust6na.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/467578/original/file-20220607-15930-ust6na.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/467578/original/file-20220607-15930-ust6na.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/467578/original/file-20220607-15930-ust6na.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/467578/original/file-20220607-15930-ust6na.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A mobile in motion can keep a baby entertained.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/asian-newborn-baby-feeling-joyful-and-happy-with-royalty-free-image/1372675707">Nattakorn Maneerat/iStock via Getty Images</a></span>
</figcaption>
</figure>
<p>In the version for 2- to 6-month-old infants, researchers place an infant in a crib with a mobile hanging overhead. They measure how much the baby kicks to get an idea of their natural propensity to move their legs. Next, they tie a string from the baby’s leg to the end of the mobile, so that whenever the baby kicks, the mobile moves. As you might imagine, infants quickly learn that they’re in control – they like seeing the mobile move and so they kick more than before the string was attached to their leg, showing they’ve learned that kicking makes the mobile move.</p>
<p>The version for 6- to 18-month-old infants is similar. But instead of lying in a crib – which this age group just won’t do for very long – the infant sits on their parent’s lap with their hands on a lever that will eventually make a train move around a track. At first, the lever doesn’t work, and the experimenters measure how much a baby naturally presses down. Next, they turn the lever on. Now every time the infant presses on it, the train will move around its track. Infants again learn the game quickly, and press on the lever significantly more when it makes the train move. </p>
<p>What does this have to do with memory? The cleverest part of this research is that after training infants on one of these tasks for a couple of days, Rovee-Collier later tested whether they remembered it. When infants came back into the lab, researchers simply showed them the mobile or train and measured if they still kicked and pressed the lever. </p>
<p>Using this method, Rovee-Collier and colleagues found that at 6 months, if infants are trained for one minute, they can remember an event a day later. The older infants were, the longer they remembered. She also found that you can <a href="https://eclass.uoa.gr/modules/document/file.php/PPP243/%CE%A5%CE%BB%CE%B9%CE%BA%CF%8C%202021/Rovee-Collier1999.pdf">get infants to remember events for longer</a> by training them for longer periods of time, and by giving them reminders – for example, by showing them the mobile moving very briefly on its own.</p>
<h2>Why not autobiographical memories?</h2>
<p>If infants can form memories in their first few months, why don’t people remember things from that earliest stage of life? It still isn’t clear whether people experience infantile amnesia because we can’t form autobiographical memories, or whether we just have no way to retrieve them. No one knows for sure what’s going on, but scientists have a few guesses.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/467577/original/file-20220607-24-histdj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="excited toddler sits in an airplane window seat" src="https://images.theconversation.com/files/467577/original/file-20220607-24-histdj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/467577/original/file-20220607-24-histdj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=870&fit=crop&dpr=1 600w, https://images.theconversation.com/files/467577/original/file-20220607-24-histdj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=870&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/467577/original/file-20220607-24-histdj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=870&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/467577/original/file-20220607-24-histdj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1094&fit=crop&dpr=1 754w, https://images.theconversation.com/files/467577/original/file-20220607-24-histdj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1094&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/467577/original/file-20220607-24-histdj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1094&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A lot of development needs to happen for him to remember an exciting experience.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/inspecting-my-private-jet-an-excited-child-playing-royalty-free-image/1062132748">FroggyFrogg/iStock via Getty Images</a></span>
</figcaption>
</figure>
<p>One is that autobiographical memories require you to have some sense of self. You need to be able to think about your behavior with respect to how it relates to others. Researchers have tested this ability in the past using a mirror recognition task called the <a href="https://psycnet.apa.org/record/1995-97661-006">rouge test</a>. It involves marking a baby’s nose with a spot of red lipstick or blush – or “rouge” as they said in the 1970s when the task was created.</p>
<p>Then researchers place the infant in front of a mirror. Infants younger than 18 months just smile at the cute baby in the reflection, not showing any evidence that they recognize themselves or the red mark on their face. Between 18 and 24 months, toddlers touch their own nose, even looking embarrassed, suggesting that they connect the red dot in the mirror with their own face – they have some sense of self. </p>
<p>Another possible explanation for infantile amnesia is that because infants don’t have language until later in the <a href="https://www.nidcd.nih.gov/health/speech-and-language">second year of life</a>, they can’t form narratives about their own lives that they can later recall.</p>
<p>Finally, the hippocampus, which is the region of the brain that’s largely responsible for memory, <a href="https://doi.org/10.1016/j.dcn.2015.08.009">isn’t fully developed in the infancy period</a>. </p>
<p>Scientists will continue to investigate how each of these factors might contribute to why you can’t remember much, if anything, about your life before the age of 2.</p><img src="https://counter.theconversation.com/content/182736/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Vanessa LoBue does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Psychologists know babies can form memories soon after birth. So why can’t people remember anything that happened to them before around age 2? A child development expert describes possible reasons.Vanessa LoBue, Assistant Professor of Psychology, Rutgers University - NewarkLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1829292022-05-12T13:09:02Z2022-05-12T13:09:02ZWhat’s causing the US baby formula shortage – and how to make sure it doesn’t happen again<figure><img src="https://images.theconversation.com/files/462578/original/file-20220511-18-x6ls08.jpg?ixlib=rb-1.1.0&rect=53%2C341%2C6000%2C3646&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">No easy formula.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/grocery-store-shelves-where-baby-formula-is-typically-news-photo/1240603860?adppopup=true">Stefani Reynolds/AFP via Getty Images</a></span></figcaption></figure><p><em>A <a href="https://www.nytimes.com/2022/05/10/us/baby-formula-shortage.html">baby formula shortage</a> has added to the woes of American parents already confronted with the pressures of <a href="https://www.theatlantic.com/culture/archive/2021/03/isolation-becoming-new-parent-during-pandemic/618244/">raising an infant during a pandemic</a> in a country <a href="https://www.forbes.com/sites/marybethferrante/2019/06/21/unicef-study-confirms-the-u-s-ranks-last-for-family-friendly-policies/?sh=176ff24133ba">ranked low for family-friendly policies</a>.</em></p>
<p><em>Media reports have highlighted the plight of mothers, fathers and caregivers across the U.S. who have <a href="https://www.seattletimes.com/seattle-news/baby-formula-shortage-in-washington-has-caregivers-parents/">scrambled to find scarce supplies</a>, or <a href="https://www.wfaa.com/article/news/local/texas/lake-jackson-texas-mom-drives-hour-baby-formula-amid-shortage/287-d1638ecb-4153-415d-ab63-58e342ec764f">driven long distances</a> to buy formula.</em></p>
<p><em>But what is behind the shortage? And how can it be prevented from happening again? The Conversation asked Dr. Steven Abrams, a leading <a href="https://dellmed.utexas.edu/directory/steven-a-abrams">expert on pediatric health</a> at the University of Texas who has advised both the formula industry and government on infant nutrition, these questions along with what advice he could give parents facing problems getting adequate supplies of infant formula.</em> </p>
<h2>1. Why there is a shortage of formula now?</h2>
<p>There are really two factors that have driven the current shortage. First, we have the <a href="https://theconversation.com/4-reasons-americans-are-still-seeing-empty-shelves-and-long-waits-with-christmas-just-around-the-corner-168635">supply chain problem</a>, which has affected all manner of goods since the onset of the pandemic. It eased off a little, but then at the beginning of 2022 it <a href="https://www.wired.com/story/supply-chain-crisis-data/">became worse</a>.</p>
<p>Then in February a <a href="https://wwmt.com/news/local/baby-formula-shortage-crisis-intensifies-as-sturgis-plant-remains-shut-down">major baby formula manufacturing plant in U.S. went down</a>. The FDA <a href="https://www.nbcboston.com/news/national-international/fda-to-allow-closed-abbott-plant-to-release-baby-formula-supply-amid-shortage/2717440/">shut down Abbott Nutrition’s factory</a> in Michigan. The closure came after Abbott’s nationwide <a href="https://www.similacrecall.com/us/en/home.html">recall of multiple brands of formula</a>, including routine Similac cow milk-based formulas such as Similac Advance and several specialty formulas for allergic babies, including Similac Alimentum and and Similac EleCare.</p>
<p>Closing the factory had to be done amid an <a href="https://www.fda.gov/food/outbreaks-foodborne-illness/fda-investigation-cronobacter-infections-powdered-infant-formula-february-2022">investigation into bacterial infections</a> in connection to powdered formula produced at the plant, and the deaths of at least two babies. The problem is there just isn’t much redundancy in U.S. infant formula production. In other words, there aren’t enough other factories to pick up the slack when one goes down. The Michigan plant is the largest producer in the country, so when it goes down, it put added strain on the entire U.S. formula distribution system, especially for certain formulas for babies with high-risk allergic diseases and metabolic disorders.</p>
<p>Over the last couple of weeks the shortage has gotten worse. I can’t say for sure why this has happened. But I suspect there has been some hoarding going on as parents get anxious. Stores can limit the amount of formula that people can buy, but that doesn’t stop people going online to buy more.</p>
<p>On top of that, the shortage has gained wide publicity in newspapers, on TV and in political speeches. All that publicity feeds into public sense that the system is failing, prompting more panic buying and hoarding.</p>
<h2>2. Who is the shortage affecting?</h2>
<p>A majority of parents will feed babies with formula at some point to meet their nutritional needs, especially older infants. At birth and in days immediately after, around 80% of babies receive <a href="https://www.cdc.gov/breastfeeding/data/reportcard.htm">all their nutrition through breast milk</a>. But by the age of 6 months, the <a href="https://www.cdc.gov/breastfeeding/data/reportcard.htm">majority of babies get at least some formula</a>. The proportion of year-old babies receiving formula is even higher. This is largely the result of social dynamics and pressures - mothers going back to work after giving birth, but not receiving sufficient support to produce and store sufficient amounts of breast milk.</p>
<p>But the shortage will affect some parents more than others. Not surprisingly, the most affected parents are those on the lowest income. The federal food program for poorer women, infants and children, <a href="https://www.fns.usda.gov/wic">called WIC</a>, provides formula for a majority of babies in low-income families. But costs have gone up and formula has become scarcer.</p>
<p>I’m hearing of some families driving two hours to find stores selling formula. Obviously that will be harder to do for poorer families as there are costs involved. Likewise, more affluent parents may be able to buy more expensive, so-called elite brand formulas.</p>
<p>The other thing to note is that the shortage is affecting both regular infant formula, and <a href="https://www.fda.gov/news-events/press-announcements/fda-takes-important-steps-improve-supply-infant-and-specialty-formula-products">specialized versions</a>. Regular or standard formula is the type most families are familiar with, and around 95% of formula-fed babies get the standard type. Specialized formula is for babies with unusual requirements, due to allergies, damaged intestines or special nutritional needs. Before the Michigan factory closed, it made most of the specialized infant formula used in the U.S. So it is an absolute crisis for families needing that type of formula.</p>
<h2>3. What are the potential consequences of the shortage?</h2>
<p>In the first six months, babies should <a href="https://www.cdc.gov/breastfeeding/faq/index.htm">only have breast milk or formula</a> – anything else fed to them will be nutritionally incomplete. So there is a risk that a shortage will mean that babies will not be getting the nutrition they need to develop. That could lead to a range of health problems affecting their physical growth and brain development.</p>
<p>Then there are concerns that parents may be using unsafe alternatives, like watering down their baby’s formula. People have been known to try and make their own by mixing powdered milk or vegan milk with vitamins. Not only are these alternatives <a href="https://www.cdc.gov/mmwr/volumes/70/wr/mm7033a4.htm">not nutritionally complete</a>, they may not be entirely sterile.</p>
<p>After the age of six months, things get a little better once the infant is able to start eating solid food. But even then, formula or breast milk remains the primary source of nutrition. So there may still be a risk of nutritional deficiencies, such as iron deficiencies.</p>
<h2>4. Are there any viable alternatives?</h2>
<p>Over the age of six months of age, for only reasonably short periods of time, <a href="https://healthychildren.org/English/tips-tools/ask-the-pediatrician/Pages/Are-there-shortages-of-infant-formula-due-to-COVID-19.aspx#.Ynr6sYw9zEQ.twitter">parents can feed infants whole cow milk</a> and look into iron supplements.</p>
<p>It isn’t ideal, and only applies for older babies. For those under six months old, cow milk is a real problem. It doesn’t have the right protein blend for babies and has next to no iron – risking anemia in very young babies. Cow milk also has a misbalance of minerals, especially for younger babies.</p>
<h2>5. So what guidance is there for low-income parents?</h2>
<p>It is challenging and I can’t provide a magic answer. But food banks and the WIC program have been a crucial lifeline. The WIC program in particular has proved itself to be very flexible during this shortage. When Abbott had to recall products and then couldn’t provide enough non-recalled formulas in states in which they were the WIC provider, WIC was able to change providers and reprogram EBT cards to allow low-income parents to buy different brands.</p>
<h2>6. What can be done to prevent this situation happening again in the U.S.?</h2>
<p>First we need to help families regain confidence in the formula production and supply system. This will prevent problems such as hoarding or making home brew formulas.</p>
<p>Then we need to look at how to make sure one plant going down doesn’t affect the whole system. The federal government can’t stockpile formula in the same way it might stockpile oil, as formula has a shelf life. But diversifying infant formula production is a possibility. This would involve making sure multiple factories and companies are making the formulas that this country needs. This doesn’t necessarily mean increased costs – competition could potentially drive down prices.</p>
<p>I believe America also needs to look at the country’s breast feeding support system. Don’t get me wrong, some parents will always need formula. But those who want to breast feed need everything possible done to support them. That includes better family leave policies, and help for low-income mothers who want to pump and store milk while they work.</p><img src="https://counter.theconversation.com/content/182929/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Steven A. Abrams received funding from Perrigo Nutrition for research related to food insecurity in Austin during the COVID-19 pandemic and has given paid presentations on nutritional physiology to Abbott Nutrition's educational unit, ANHI.</span></em></p>An infant nutrition expert explains what is behind the current formula shortage and what can be done to support hard-pressed parents.Steven A. Abrams, Professor of Pediatrics, The University of Texas at AustinLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1819272022-05-04T20:40:31Z2022-05-04T20:40:31ZGive the gift of sleep to moms with babies this Mother’s Day<figure><img src="https://images.theconversation.com/files/461184/original/file-20220504-18-shpiun.jpg?ixlib=rb-1.1.0&rect=183%2C0%2C3443%2C2160&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">There are many ways that families, health-care providers and communities can support the sleep of mothers of babies six months and older.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>Many possibilities for gifts come to mind to acknowledge Mother’s Day for new mothers — family and friends think about flowers or brunch. But because inadequate rest is often a <a href="https://doi.org/10.1016/j.sleepx.2019.100001">key source of distress for mothers</a>, we need to consider giving mothers the gift of sleep. </p>
<p>When infants are consistently unable to go back to sleep after waking up at night without parental help, mothers’ sleep is disrupted. This has been linked with<a href="https://doi.org/10.1016/j.jad.2018.12.032"> fatigue</a>, <a href="https://doi.org/10.1007/s10865-018-9967-y">worse maternal mood</a> and <a href="https://doi.org/10.1093/sleep/zsac090">more negative feelings about parenting</a> directed at infants during the day. </p>
<p>It can get worse too: prolonged sleep disruption is associated with mothers’ higher risk for <a href="https://doi.org/10.1016/j.jad.2015.01.017">developing mood disorders</a> such as postpartum depression and anxiety. </p>
<h2>Postpartum parental sleep</h2>
<p>A <a href="https://academic.oup.com/sleep/article/42/4/zsz015/5289255?login=false">large population-based German study</a> found that parental satisfaction with sleep declined sharply during the first postpartum year with greater declines for mothers than fathers. Parental sleep time and satisfaction also don’t recover to pre-baby norms until well after infancy. </p>
<p>Some mothers struggle with <a href="https://benthamopen.com/ABSTRACT/TOSLPJ-6-87">fragmented and inefficient sleep</a> because they must tend to infants who wake up frequently at night, and end up spending more time in bed trying to fall asleep. Other mothers are not able to meet their minimum sleep needs at all (<a href="https://www.thensf.org/how-many-hours-of-sleep-do-you-really-need/">seven hours per night as recommended by the National Sleep Foundation</a>). Many mothers experience both of these problems. Some mothers find it hard to fall asleep at night because they <a href="https://rdcu.be/cMfzj">feel anxious</a> about their baby awakening at any moment. </p>
<h2>Infant’s sleep patterns and effects on mothers’ sleep</h2>
<figure class="align-center ">
<img alt="A woman sitting on a bed comforting a crying baby" src="https://images.theconversation.com/files/461384/original/file-20220504-21-hf8q66.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/461384/original/file-20220504-21-hf8q66.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/461384/original/file-20220504-21-hf8q66.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/461384/original/file-20220504-21-hf8q66.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/461384/original/file-20220504-21-hf8q66.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/461384/original/file-20220504-21-hf8q66.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/461384/original/file-20220504-21-hf8q66.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Half of women with six- to 12-months-old infants reported their own sleep quality as poor.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>While parents expect some sleeplessness when caring for newborns and young babies less than six months old, <a href="https://rdcu.be/cMoND">many parents continue to struggle with sleep in later infancy</a> even though babies are developmentally able to sleep through the night. </p>
<p><a href="https://rdcu.be/cHXuZ">Our own study</a> of women with six- to 12-month-old infants found that half of women reported their own sleep quality as poor. Infants had an average of 2.4 wakes per night and almost one in five infants were not able to meet their minimum needs for sleep (12 hours total sleep in 24 hours based on recommendations from the <a href="https://jcsm.aasm.org/doi/10.5664/jcsm.5866">American Academy of Sleep Medicine</a>). </p>
<p>We also found that mothers’ poorer sleep quality was linked with <a href="https://www.uvic.ca/_assets/docs/rpkm/pti-ou-infographic.pdf">their increased anger and depression symptoms</a>. </p>
<p>Maternal feelings of anger and depression during the postpartum period create challenges for parenting because <a href="https://doi.org/10.1177/1745506519844044">mothers have more difficulty being emotionally available to children</a>. Well-rested parents bring their best efforts to parenting and getting good quality sleep promotes mothers’ engagement with their infants. The <a href="https://doi.org/10.1080/14767058.2020.1854718">stress of parenting infants can be decreased</a> by supporting mothers’ and infants’ sleep. </p>
<h2>How to support mothers’ and infants’ sleep</h2>
<p>Many mothers talk to health-care providers about their challenges with sleep; they are often told that their babies “will grow out of it.” Such a response dismisses parents’ concerns; <a href="https://doi.org/10.1111/jcpp.13303">almost 10 per cent of a large sample of Australian children</a> had sleep problems persisting from infancy to preschool age and another eight per cent had persistent sleep problems from infancy to middle childhood. </p>
<p>Families, health-care providers and communities can support the sleep of mothers of babies six months and older in a number of ways:</p>
<p>First, for mothers who are exclusively breastfeeding, partners can take part in nighttime infant care by settling infants to sleep at bedtime or taking the morning shift with the baby if the infant is an early riser. When the baby is taking expressed breast milk or formula, partners can give a nighttime feeding. </p>
<p>Mothers can also benefit from a stretch of sleep in the early morning, especially if they have been up several times at night. Research has linked <a href="https://doi.org/10.1111/mono.12147">greater partner involvement with infant care to better sleep</a> for moms and babies. </p>
<figure class="align-center ">
<img alt="A man bottle-feeding a baby on a bed while a woman sleeps behind him" src="https://images.theconversation.com/files/461188/original/file-20220504-19-etqg95.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/461188/original/file-20220504-19-etqg95.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/461188/original/file-20220504-19-etqg95.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/461188/original/file-20220504-19-etqg95.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/461188/original/file-20220504-19-etqg95.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/461188/original/file-20220504-19-etqg95.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/461188/original/file-20220504-19-etqg95.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Partners can take part in nighttime infant care by settling infants to sleep at bedtime or taking the morning shift with the baby if the infant is an early riser.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>Families can also use <a href="https://doi.org/10.1016/j.infbeh.2017.09.013">regular bedtime routines because they are associated with improved sleep</a> for infants. Parents can consider transitioning older infants (more than six months old) to their own sleep spaces and/or rooms because studies show that <a href="https://doi.org/10.1016/j.sleep.2015.08.016">infants who sleep alone have longer stretches of undisturbed sleep</a>. </p>
<p>Health-care providers can <a href="https://doi.org/10.1016/j.sleep.2018.11.007">teach parents about infant sleep patterns and evidence-based strategies</a> to get more sleep.</p>
<p>Community members, such as extended family and friends, can provide hands-on help — for example, spending time with the baby during the day so mom can nap — and an empathetic ear so that mothers do not feel alone. Community organizations that offer services for parents with infants can provide flexible programs to support sleep as part of parenting. </p>
<p>Employers can recognize sleep as a major stressor for parents with babies and offer flexibility around parental work schedules.</p>
<p>Supporting mothers’ and infants’ sleep can decrease the stressors of motherhood, improve maternal mood and mental health and promote better infant development. This Mother’s Day consider giving the gift of sleep to mom.</p><img src="https://counter.theconversation.com/content/181927/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Christine Ou receives funding from the University of Victoria. Christine Ou is affiliated with Pacific Post Partum Support Society, a non-profit peer support organization as a board member.</span></em></p><p class="fine-print"><em><span>Wendy Hall receives funding from the Social Sciences and Humanities Research Council of Canada. </span></em></p>Supporting mothers’ and infants’ sleep can decrease the stressors of motherhood, improve maternal mood and mental health and promote better infant development.Christine Ou, Assistant Professor, School of Nursing, University of VictoriaWendy Hall, Professor, School of Nursing, University of British ColumbiaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1739752022-03-03T13:27:09Z2022-03-03T13:27:09ZInfants need lots of active movement and play – and there are simple ways to help them get it<figure><img src="https://images.theconversation.com/files/441827/original/file-20220120-9087-1togzru.jpg?ixlib=rb-1.1.0&rect=38%2C7%2C5075%2C3396&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Experts believe that infants should get some interactive floor-based physical activity two to three times a day.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/mother-watching-baby-playing-with-ball-royalty-free-image/135385235?adppopup=true">Sam Edwards/OJO Images via Getty Images</a></span></figcaption></figure><p>When people set personal fitness goals and establish their physical exercise routines, there’s a group of cuddly individuals that is often left out – infants! </p>
<p>Historically, infant active movement has been perceived as a <a href="https://doi.org/10.1186/s12889-017-4503-5">personality characteristic</a>. It’s assumed that infants are plenty active on their own, without needing adult intervention to encourage movement.</p>
<p>However, research is revealing that the choices, behaviors and everyday habits of adults have a big influence on how much infants move.</p>
<p>I’m a <a href="https://www.unomaha.edu/college-of-education-health-and-human-sciences/health-kinesiology/about-us/directory/danae-dinkel.php">physical activity teacher</a> and <a href="https://scholar.google.com/citations?hl=en&user=T2U7pXkAAAAJ&view_op=list_works&alert_preview_top_rm=2&sortby=pubdate">researcher</a>. For the past five years I’ve conducted several studies exploring infant movement, seeking to identify what supports the development of lifelong physical activity habits. </p>
<p>I’ve learned that many parents and other caregivers want to encourage infants to actively play and move. However, they often don’t know for sure how much physical activity an infant needs, nor do they often recognize how their own behaviors might be limiting an infant’s physical activity. Fortunately, there are several easy – and fun – ways to add more physical activity to an infant’s daily life.</p>
<h2>Why infants need movement – and how much</h2>
<p>Study of infant movement is a relatively new field, so there is still a lot to learn. However, one of the field’s foundational studies was published in 1972, and it found that increased infant physical activity can <a href="https://journals.lww.com/nursingresearchonline/Abstract/1972/05000/THE_IMPACT_OF_PHYSICAL_PHYSIOLOGICAL_ACTIVITY_ON.3.aspx">improve motor development</a>. More recent research shows that increased infant movement can improve <a href="https://doi.org/10.1371/journal.pone.0082098">bone health</a> and <a href="https://doi.org/10.1186/s12966-022-01248-6">personal-social development</a> – skills related to improving their independence or interacting with others, such as feeding themselves or waving goodbye.</p>
<p>The <a href="https://apps.who.int/iris/handle/10665/311664">World Health Organization</a> suggests that infants should be physically active several times a day, especially through interactive floor-based play. Similarly, the <a href="https://www.healthychildren.org/English/healthy-living/fitness/Pages/Making-Fitness-a-Way-of-Life.aspx">American Academy of Pediatrics</a> recommends opportunities for interactive play throughout the day, along with at least 30 minutes of “tummy time” with an adult – which I’ll talk more about below.</p>
<p>Yet half the parents participating in our research reported that they <a href="https://doi.org/10.1111/jspn.12315">hadn’t heard</a> of these recommendations and did desire <a href="https://doi.org/10.1111/jspn.12315">more specific guidelines</a> on encouraging active play. </p>
<h2>What are the barriers?</h2>
<p>While research is ongoing, I and other researchers have identified three major barriers to infant active movement: screen time, restrictive devices and “gendered play” – gender-related stereotypes, beliefs and practices in relation to how children play. </p>
<p>The American Academy of Pediatrics and other organizations <a href="https://doi.org/10.1542/peds.2016-2591">discourage allowing infants any screen time</a> other than video chatting. However, a recent review found that children ages 0 to 2 years may be getting <a href="https://doi.org/10.1016/j.ypmed.2015.07.019">between 36 and 330 minutes of screen time per day</a>. A 2019 analysis of data gathered between 2008 and 2010 found that <a href="https://doi.org/10.1001/jamapediatrics.2019.4488">children’s screen time increased</a> from 53 minutes a day at age 1 to more than 150 minutes per day by age 3, which suggests that screen time habits begin taking shape at very early ages.</p>
<p>Furthermore, the <a href="https://apps.who.int/iris/handle/10665/311664">World Health Organization</a> suggests that infants should spend no more than one hour at a time in a restrictive device. Yet many adults overuse car seats, strollers, high chairs or other “containers” that constrain movement. For instance, in a 2018 study of child care centers in the U.S., Canada and Australia, <a href="https://doi.org/10.1016/j.infbeh.2017.11.008">only 38% to 41% of the facilities</a> followed this WHO guideline.</p>
<figure class="align-center ">
<img alt="Mother playing face to face with baby son on floor." src="https://images.theconversation.com/files/442392/original/file-20220124-13-aq1z6j.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/442392/original/file-20220124-13-aq1z6j.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/442392/original/file-20220124-13-aq1z6j.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/442392/original/file-20220124-13-aq1z6j.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/442392/original/file-20220124-13-aq1z6j.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/442392/original/file-20220124-13-aq1z6j.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/442392/original/file-20220124-13-aq1z6j.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Researchers have found that when infants get increased tummy time, they move more overall, and their gross motor skills and development improve.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/mother-playing-face-to-face-with-baby-son-on-floor-royalty-free-image/672158475?adppopup=true">JGI/Jamie Grill via Getty Images</a></span>
</figcaption>
</figure>
<p>Research into adult physical activity consistently shows that <a href="https://doi.org/10.1038/nature23018">males are more active than females</a>, regardless of age. <a href="https://doi.org/10.1016/j.infbeh.2020.101440">Our research suggests</a> this gap may begin during infancy and be related to gendered play. </p>
<p>In our 2020 study exploring infant motor development in relation to parents’ promotion of play, we found that parents of male infants more often encouraged play that <a href="https://doi.org/10.1016/j.infbeh.2020.101440">promoted gross motor skills</a>: movement involving the large muscles that support activities like walking, running or kicking. Parents of female infants more often made statements that promoted fine motor skills, which involve smaller movements of the hands and arms and support activities like reaching and grasping. We found that females had significantly higher fine motor skills than male.</p>
<p>We’ve documented <a href="https://doi.org/10.1186/s12889-021-10286-x">additional barriers as well</a>, including time spent eating, tending to the infant’s sleeping schedule or other care needs; a need to baby-proof surroundings; or weather and other environmental concerns.</p>
<h2>How to support infant movement</h2>
<p>Fortunately there are many ways to break down these barriers – and none requires buying expensive baby gear. </p>
<ul>
<li><p>Encourage tummy time: Two to three times a day, place an awake infant <a href="https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/Back-to-Sleep-Tummy-to-Play.aspx">on their tummy</a> for a few minutes, and then play and engage with them. This is the primary method of supporting movement for infants who are <a href="https://doi.org/10.1542/peds.2019-2168">not yet mobile</a>. </p></li>
<li><p>Explore movement together: Doing activities that help infants <a href="https://doi.org/10.1123/krj.2.4.221">learn about movement</a>, such as bouncing the child on one’s lap and <a href="https://www.alabamapublichealth.gov/healthystart/assets/PhysicalActivityPresentation.pdf">singing and playing patty-cake or peekaboo</a>, can encourage infants to move. Infants also watch what the adults around them do – including how active they are! In one of our studies, many mothers reported <a href="https://doi.org/10.1186/s12889-017-4503-5">being physically active themselves</a>, but few realized it was <a href="https://doi.org/10.1186/s12966-020-00966-z">important to role-model</a> regular physical activity for infants. </p></li>
<li><p>Create safe play space: As infants <a href="https://www.healthychildren.org/English/ages-stages/baby/Pages/Movement-4-to-7-Months.aspx">learn to move</a> and get better at controlling their feet and hands, even normal household objects, such as small items they can shove into their mouths and choke on, become potential hazards requiring adult intervention. Protect them by clearing clutter and removing potentially dangerous objects from a space that’s at least <a href="https://www.healthychildren.org/English/healthy-living/growing-healthy/Pages/baby-activity.aspx">5 feet by 7 feet</a>.</p></li>
<li><p>No equipment? No problem!: It doesn’t take new or costly gear to encourage infant movement. Use things around the house: Pillows can be piled into a “mountain” to crawl over. Mixing bowls and measuring cups can double as toys. Adults can also turn their own bodies into an infant climbing gym. For example, sit on the floor with legs spread out and encourage the infant to pull themselves up or crawl over them.</p></li>
<li><p>Get outside: National guidelines recommend <a href="http://nrckids.org/CFOC/Database/3.1.3.1">taking infants outside two to three times per day</a>, weather permitting. Our research suggests children are more physically active <a href="https://doi.org/10.1080/1350293X.2019.1579550">when they play in parks</a>, playgrounds and other open areas that allow for gross motor activities like crawling and walking. The <a href="https://doi.org/10.1080/00094056.2016.1251793">benefits of active outdoor play</a> may also include improved self-control, attention, communication and social development. </p></li>
</ul>
<p>To help motivate us, my family is taking the <a href="https://www.1000hoursoutside.com/">1,000 Hours Outside</a> challenge, a project encouraging both kids and adults to spend at least as much time outdoors as we do staring at screens.</p>
<p>[<em>Over 150,000 readers rely on The Conversation’s newsletters to understand the world.</em> <a href="https://memberservices.theconversation.com/newsletters/?source=inline-150ksignup">Sign up today</a>.]</p>
<p>Finally, it need not be up to parents alone. Research has linked social support by <a href="https://www.mdpi.com/2227-9067/6/10/115">siblings and peers</a>, <a href="https://doi.org/10.1177/1356336X19835240">child care providers</a> and <a href="https://doi.org/10.1186/1479-5868-10-68">teachers</a> with increased physical activity in children. </p>
<p>Trust me: As both a physical activity researcher and a working mother of three, including an 11-month-old just learning to walk, I can attest that when adults and older children play with my baby, it gives me an opportunity to accomplish something on my to-do list, and provides my infant with more opportunities to enjoy moving.</p><img src="https://counter.theconversation.com/content/173975/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Danae Dinkel receives funding from the National Institutes of Health. </span></em></p>Even babies who are not yet standing or walking get lots of benefits from active movement – but most infants aren’t getting enough physical activity.Danae Dinkel, Associate Professor, Department of Health and Kinesiology, University of Nebraska OmahaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1597712021-06-14T12:24:51Z2021-06-14T12:24:51ZNew technologies claiming to copy human milk reuse old marketing tactics to sell baby formula and undermine breastfeeding<figure><img src="https://images.theconversation.com/files/401396/original/file-20210518-23-ss0njf.jpg?ixlib=rb-1.1.0&rect=15%2C15%2C5099%2C3397&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Despite claims to the contrary, the real thing cannot be replicated.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/mixed-race-mother-nursing-newborn-baby-royalty-free-image/601801509">Jose Luis Pelaez Inc/DigitalVision via Getty Images</a></span></figcaption></figure><p>New products that <a href="https://www.foodnavigator-usa.com/Article/2020/12/17/TurtleTree-Labs-raises-6.2m-to-support-cell-cultured-milk-platform">claim to replicate mother’s milk</a> have entered the lucrative market for infant formula. </p>
<p>To an <a href="https://scholar.google.com/citations?user=0VycH7AAAAAJ&hl=en">anthropologist and public health scholar</a> who studies breastfeeding, these claims appear to be built on old patterns of misleading scientific statements – and reveal the power of marketing to exploit gaps created by inadequate societal support for breastfeeding. </p>
<p>The costs of undermining breastfeeding are enormous. <a href="https://doi.org/10.1016/S0140-6736(15)01024-7">Globally, over 823,000 child deaths</a> could be prevented annually with appropriate breastfeeding. Additionally, <a href="https://doi.org/10.1016/S0140-6736(15)01024-7">20,000 maternal deaths</a> could be averted each year worldwide from breast cancer. Poor communities of color around the world disproportionately shoulder this harm.</p>
<h2>The rise of commercial formula</h2>
<p><a href="https://www.routledge.com/Breastfeeding-New-Anthropological-Approaches/Tomori-Palmquist-Quinn/p/book/9781138502871">Throughout most of history and across cultures</a>, communities understood that breastfeeding ensured the best chance for infants to survive and thrive. Breastfeeding continued, on average, <a href="https://www.doi.org/10.4324/9781315145129-10">from two to four years</a>, with caregivers introducing new foods while continuing to breastfeed.</p>
<p>Attempts to fully replace human milk, <a href="https://www.springer.com/gp/book/9783030273927">usually with animal milk and gruels</a>, were relatively rare. Such attempts were most common when mothers were ill or dead, and caregivers couldn’t locate a lactating woman. <a href="https://www.springer.com/gp/book/9783030273927">Compared with breastfeeding, replacement feeding reduced babies’ chances of survival</a>.</p>
<p>Efforts to mimic breast milk <a href="https://uwpress.wisc.edu/books/0655.htm">escalated with the rise of scientific thinking and industrial capitalism</a> in Europe and the U.S. in the late 18th and early 19th centuries. Mass migration to urban centers eroded community support – and poor labor conditions made breastfeeding challenging. </p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/405394/original/file-20210609-14833-1th1a61.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Old advertisement for Nestlé formula with lead text that reads 'Don't Wait Too Long Before You Wean the Baby.'" src="https://images.theconversation.com/files/405394/original/file-20210609-14833-1th1a61.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/405394/original/file-20210609-14833-1th1a61.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=875&fit=crop&dpr=1 600w, https://images.theconversation.com/files/405394/original/file-20210609-14833-1th1a61.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=875&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/405394/original/file-20210609-14833-1th1a61.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=875&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/405394/original/file-20210609-14833-1th1a61.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1100&fit=crop&dpr=1 754w, https://images.theconversation.com/files/405394/original/file-20210609-14833-1th1a61.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1100&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/405394/original/file-20210609-14833-1th1a61.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1100&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Nestlé advertisement, 1911.</span>
<span class="attribution"><a class="source" href="https://www.aims.org.uk/journal/item/nestle">Nestlé</a></span>
</figcaption>
</figure>
<p>From the first commercial milk formula <a href="https://yalebooks.yale.edu/book/9780300188127/milk">patented in 1865 by Justus von Liebig</a>, formula-makers drew on science to gain the trust of medical providers and <a href="https://uwpress.wisc.edu/books/0655.htm">argue their products were as good as</a> – or even superior to – human milk. A study prepared for and published by Nestlé in 1878 <a href="https://yalebooks.yale.edu/book/9780300188127/milk">asserted that mother’s milk was deficient in key nutrients</a> and infants aged 6 to 8 weeks already required supplementation – with Nestlé’s food.</p>
<p>Physicians often claimed to support breastfeeding while undermining it in practice with poor advice and an increasing focus on formula feeding. Pioneering American pediatrician Emmett Holt advocated <a href="https://uwpress.wisc.edu/books/0655.htm">his own method of making formula</a>. <a href="https://archive.org/details/carefeedingof00holt/page/20/mode/2up">In his bestselling book, first published in 1894</a>, Holt claimed infants could be harmed by mother’s milk that was corrupted by emotion. Holt also advised mothers to schedule brief breastfeeding sessions and limit physical contact. Such advice <a href="https://dro.dur.ac.uk/26620/1/26620.pdf">impeded the physiology of breastfeeding</a>, which relies on frequent, responsive feedings and close contact – and contributed to growing reliance on supplementation with formula. </p>
<p>Physicians ultimately <a href="https://uwpress.wisc.edu/books/0655.htm">incorporated formula into their routine medical practices</a> and institutionalized them in <a href="https://history.wisc.edu/publications/brought-to-bed-childbearing-in-america-1750-1950/">hospital childbirth protocols</a>. </p>
<h2>Global spread</h2>
<p>In the first half of the 20th century, colonial administrations spread these new “scientific” infant care norms and products around the globe. They saw bottle-feeding as a <a href="https://doi.org/10.1093/ahr/121.4.1196">solution to infant mortality, disease and malnutrition</a> – and ultimately as an answer to labor shortages in the colonies. </p>
<p>In the 1950s, Nestlé used marketing techniques perfected in Europe to <a href="https://doi.org/10.1080/03086534.2020.1816624">dramatically expand its market in Africa</a>, <a href="https://doi.org/10.1093/ahr/121.4.1196">Asia and other parts of the world</a>. The growing number of infant deaths associated with the use of these products drew international attention and ultimately led to the <a href="https://doi.org/10.1093/ahr/121.4.1196">Nestlé boycott in 1977</a>. </p>
<p>Nestlé’s practices were not unique among formula-makers. Growing concerns about the <a href="https://doi.org/10.1111/j.1753-4887.1972.tb04042.x">role of inappropriate marketing practices</a> in declining breastfeeding rates and infant illness and death led to the development of the <a href="https://www.who.int/nutrition/publications/code_english.pdf">International Code of Marketing of Breast-milk Substitutes</a>, which was adopted by the World Health Assembly 40 years ago, in 1981. The U.S. was the <a href="https://doi.org/10.1136/archdischild-2011-301299">only nation that voted against it</a>, driven by formula lobbying efforts.</p>
<h2>Milking profits</h2>
<p>In the 1950s through the 1970s, multiple social movements fueled <a href="https://doi.org/10.2307/2080604">increased interest in breastfeeding in the U.S.</a>. Medical experts supported these movements with a growing body of <a href="https://doi.org/10.1093/ahr/121.4.1196">scientific research demonstrating the importance of breastfeeding for infant, child and maternal health</a>. But despite <a href="https://doi.org/10.1016/S0140-6736(15)01024-7">significant gains in breastfeeding</a> in some settings, like the U.S., the formula industry <a href="https://doi.org/10.1016/S0140-6736(15)01044-2">continues to expand</a>. </p>
<p>Between 2005 and 2019, global <a href="https://doi.org/10.1111/mcn.13097">formula sales increased 121%</a>, led by middle-income countries. The global industry is <a href="https://doi.org/10.1111/mcn.13097">currently valued at US$50.6 billion</a> and <a href="https://www.globenewswire.com/news-release/2021/01/29/2166545/0/en/Global-Infant-Formula-Market-Size-Will-Reach-USD-110-26-Billion-by-2026-Facts-Factors.html">projected to double by 2026</a>. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/401411/original/file-20210518-15-emjp6x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A woman stands in front of a massive grocery store display of infant formula." src="https://images.theconversation.com/files/401411/original/file-20210518-15-emjp6x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/401411/original/file-20210518-15-emjp6x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/401411/original/file-20210518-15-emjp6x.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/401411/original/file-20210518-15-emjp6x.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/401411/original/file-20210518-15-emjp6x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/401411/original/file-20210518-15-emjp6x.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/401411/original/file-20210518-15-emjp6x.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Infant formula is big business.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/rear-view-of-young-asian-mother-groceries-shopping-royalty-free-image/1255253039">d3sign/Moment via Getty Images</a></span>
</figcaption>
</figure>
<p>Formula-makers devote <a href="https://doi.org/10.1111/mcn.13097">billions of dollars each year to marketing</a> that co-opts scientific and medical authority and <a href="https://www.who.int/publications/i/item/9789240006010">undermines breastfeeding globally</a>. These marketing practices have <a href="https://www.who.int/publications/i/item/9789240006010">continued to defy the International Code of Marketing of Breast-milk Substitutes</a>. </p>
<p>As in the 19th century, <a href="https://www.savethechildren.org.uk/what-we-do/policy-and-practice/our-featured-reports/dont-push-it">formula marketing</a> still <a href="https://doi.org/10.1186/s12992-020-00597-w">presents breastfeeding as an inherently problematic</a>, unreliable process to which formula provides the solution. </p>
<p>Yet most breastfeeding challenges, like the perception of insufficient milk and the difficulties faced by lactating workers, are the product of <a href="https://doi.org/10.1016/S0140-6736(15)01044-2">structural and social conditions</a> that can be addressed by <a href="https://doi.org/10.1016/S0140-6736(15)01044-2">investing in policies</a> that provide quality perinatal care, skilled breastfeeding support, parental leave and workplace accommodations for lactating parents. </p>
<h2>More than a food</h2>
<p>Formula companies focus on human milk as the only important element of breastfeeding – and claim near equivalence between their product and human milk. Yet human milk is a living, life-sustaining substance with a <a href="https://www.routledge.com/Breastfeeding-New-Anthropological-Approaches/Tomori-Palmquist-Quinn/p/book/9781138502871">long evolutionary history and cultural meaning</a>. </p>
<p>Human milk is <a href="https://jhupbooks.press.jhu.edu/title/milk">specific to our species</a>. It is <a href="https://doi.org/10.1002/ajhb.23564">dynamic and adaptive</a> – ever-changing in response to local environments. Human milk contains <a href="https://doi.org/10.1002/ajhb.23564">bioactive compounds</a> and has <a href="https://doi.org/10.1002/ajp.22994">a unique microbiome that varies by setting and over time</a>. New technology, including <a href="https://www.foodnavigator-usa.com/Article/2020/12/17/TurtleTree-Labs-raises-6.2m-to-support-cell-cultured-milk-platform">the culturing of human cells</a>, cannot replicate any of this. </p>
<p>Through complex interactions among mothers, infants and their communities, breastfeeding provides infants with <a href="https://doi.org/10.1016/S0140-6736(15)01024-7">optimal nutrition and protection from infectious disease</a>. Across cultures, lactation and human milk create <a href="https://www.routledge.com/Breastfeeding-New-Anthropological-Approaches/Tomori-Palmquist-Quinn/p/book/9781138502871">relationships that bind families</a> and communities together. </p>
<p>Families need accurate information free of commercial influence to make informed decisions about breastfeeding. I believe when lactation is not possible or desired, <a href="https://doi.org/10.1016/S2214-109X(19)30402-4">families could benefit</a> from <a href="https://doi.org/10.1177/0890334419850820">donor human milk</a>. <a href="https://doi.org/10.1016/S0140-6736(15)01044-2">Government investment in policies</a> that protect, promote and support breastfeeding remains key to creating an environment in which breastfeeding can thrive.</p>
<p>[<em>Like what you’ve read? Want more?</em> <a href="https://theconversation.com/us/newsletters/the-daily-3?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=likethis">Sign up for The Conversation’s daily newsletter</a>.]</p><img src="https://counter.theconversation.com/content/159771/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Cecília Tomori has received funding from the National Institutes of Health, US Health Resources & Services Administration, Johns Hopkins University, and the University of Michigan.</span></em></p>Around the globe, 823,000 child deaths could be prevented annually with appropriate breastfeeding. Formula makers continue to defy a 40-year-old international code on marketing their product.Cecília Tomori, Associate Professor and Director of Global Public Health and Community Health, Johns Hopkins University School of NursingLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1608302021-05-18T14:30:50Z2021-05-18T14:30:50ZHow to bond with your baby if you were separated during the pandemic<figure><img src="https://images.theconversation.com/files/401230/original/file-20210518-19-pdqdvk.jpg?ixlib=rb-1.1.0&rect=8%2C0%2C5599%2C3741&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Keeping your baby close – such as in a sling – will soothe them and improve your bond.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/indoor-portrait-young-20-year-old-1197702385">shurkin_son/ Shutterstock</a></span></figcaption></figure><p>Women’s experiences of pregnancy, birth and postnatal care have been significantly affected by the pandemic. One challenge some mothers have faced <a href="https://gh.bmj.com/content/6/3/e004347?fbclid=IwAR1zbl5QH-bac3k1IIM7HT6iyLKMR7Xrsy1YSUADQn1aIfYCWX9h52bMfK4">around the world</a> was being separated from their baby because of <a href="http://humanrightsinchildbirth.org/wp-content/uploads/2020/05/Human-Rights-in-Childbirth-Pregnancy-Birth-and-Postpartum-During-COVID19-Report-May-2020.pdf">COVID-19 hospital policies</a>.</p>
<p>During the peak of the pandemic, <a href="https://www.theguardian.com/society/2020/nov/16/mothers-needlessly-separated-babies-hospital-covid-rules">some women</a> reported being <a href="https://www.bbc.co.uk/news/uk-england-leicestershire-55018081">separated from their infant</a> if either exhibited symptoms of COVID-19. There was also evidence of newborns who were sick or pre-term being <a href="https://gh.bmj.com/content/6/3/e004347">separated from their mothers</a> for confirmed or suspected COVID-19 infections. Research from around the world, including the <a href="https://www.nature.com/articles/s41372-020-00781-1">US</a>, <a href="https://onlinelibrary.wiley.com/doi/10.1111/apa.15620">Italy</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7661349/">the UK</a> has found that some neonatal intensive care units (NICUs) also <a href="https://onlinelibrary.wiley.com/doi/10.1111/apa.15620">severely restricted visiting</a> during the pandemic – even to those <a href="https://www.thejournal.ie/mothers-nicu-covid-19-restrictions-5070051-Apr2020/">without COVID-19</a>. </p>
<p>While some hospitals used <a href="https://www.bbc.co.uk/news/av/uk-wales-52731918">video messaging</a> for parents to connect with their baby, this is very poor substitute for being together. Separating mother and baby can have devastating impacts upon a mother’s emotional wellbeing, and can also <a href="https://journals.sagepub.com/doi/10.1177/0890334420949514">interrupt bonding and breastfeeding</a>. Research has also shown both <a href="https://www.liebertpub.com/doi/pdfplus/10.1089/bfm.2020.29153.ams">mothers</a> and <a href="https://www.mdpi.com/1660-4601/18/9/4695">infants</a> experience high stress when separated after birth. </p>
<p>Understandably, we have seen increased rates of <a href="https://www.frontiersin.org/articles/10.3389/fgwh.2020.00001/full?fbclid=IwAR1Dxl4">postnatal depression, anxiety and stress</a> during the pandemic. Greater numbers of women are also showing signs of <a href="https://link.springer.com/article/10.1186/s12884-020-03399-5">birth trauma and post traumatic stress</a>, likely due to altered care practices during birth and after delivery. Data from China also highlights how separation of mother and baby during the pandemic <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8033344/">negatively affected maternal-infant bonding</a>. </p>
<p>Breastfeeding has also been affected, with some mothers in the UK <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/mcn.13088">stopping early</a> because of the impact of not being able to visit their premature baby in the NICU. Establishing breastfeeding when separated from a baby is extremely challenging, and is <a href="https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.12797">associated with stopping breastfeeding</a> for a number of reasons, including that the stress of separation may inhibit <a href="https://connect.springerpub.com/content/sgrnn/20/4/35.abstract">how easily milk is released</a> from the breast. </p>
<p>Thankfully, due to falling infection rates, increased knowledge around how COVID-19 <a href="https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(20)30235-2/fulltext?fbclid=IwAR1HdDa2lQSh38D6hZZGtv-TFEfqGILbmUTZzsKXaIGq35ehJmZt_Rx6Ijw">impacts infants</a>, and sustained campaigning by organisations such as <a href="https://www.birthrights.org.uk/campaigns-research/coronavirus/">Birthrights in the UK</a>, restrictions are <a href="https://www.bbc.co.uk/news/uk-northern-ireland-56981447">now easing</a> in some parts of the world. However <a href="https://www.bbc.co.uk/news/uk-wales-56815893">variations still exist between areas</a> in the UK, with <a href="https://www.rcpch.ac.uk/sites/default/files/generated-pdf/document/BAPM---COVID-19%253A-Frequently-asked-questions-within-neonatal-services.pdf?fbclid=IwAR04HTDFoBOMhRtHmD8GNe4fdQjwKmJTmvRNrmgNS5mv05tZGIdLbhhzQqw">official guidance</a> still preventing mothers with COVID-19 visiting their babies in the NICU. Meanwhile, strict separation regulations remain in countries where cases are increasing, such as <a href="https://www.nature.com/articles/s41372-021-00959-1">India</a>. </p>
<p>But while the situation has largely improved since the height of the pandemic, the repercussions are still being felt. The experience of being separated has been tough for many. Separation can also <a href="https://journals.sagepub.com/doi/metrics/10.1177/0890334420949514">make it more difficult</a> for mothers to care for their infants when they are reunited. If you were separated from your baby and are struggling to feel a bond with them, there are many things you can do to heal and improve your relationship with your baby.</p>
<h2>Skin-to-skin contact</h2>
<p>Have as much <a href="https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/implementing-standards-resources/skin-to-skin-contact/">skin-to-skin contact</a> with your baby as you can. </p>
<p>Skin-to-skin isn’t just for newborns after birth. It can help <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD003519.pub4/full">calm and soothe</a> your baby and help to <a href="https://link.springer.com/article/10.1186/1746-4358-8-1">establish breastfeeding</a>. Research has shown that it can also <a href="https://www.sciencedirect.com/science/article/pii/S1877575613000311">help mothers connect emotionally</a> with their baby, even after being separated. </p>
<p>Try a <a href="https://www.nct.org.uk/baby-toddler/everyday-care/bathing-your-baby">bath with your baby</a>, relaxing in bed with them or simply spending time holding them with no clothes in between you. </p>
<h2>Baby massage</h2>
<p>Another option is to try some <a href="https://www.nct.org.uk/baby-toddler/everyday-care/baby-massage-tips-and-benefits">baby massage</a>, either at home or at a class when they re-open. Baby massage is the gentle, rhythmic stroking of your baby, often whilst gently talking or singing to them. </p>
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<img alt="A both massages her smiling baby's stomach." src="https://images.theconversation.com/files/401233/original/file-20210518-15-ymtzio.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/401233/original/file-20210518-15-ymtzio.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/401233/original/file-20210518-15-ymtzio.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/401233/original/file-20210518-15-ymtzio.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/401233/original/file-20210518-15-ymtzio.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/401233/original/file-20210518-15-ymtzio.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/401233/original/file-20210518-15-ymtzio.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Baby massage can help calm you and your baby.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/baby-massage-mother-massaging-infant-belly-312663317">Lex-art/ Shutterstock</a></span>
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<p>Baby massage can help you to <a href="https://pubmed.ncbi.nlm.nih.gov/12614602/">recognise and understand your baby’s cues</a> of whether they’re enjoying it and what helps soothe them most – and will increase feelings of connection to your baby. The hormone oxytocin is also released in you and your baby, which helps you both feel calmer and <a href="https://pubmed.ncbi.nlm.nih.gov/17138300/">more relaxed</a>. </p>
<h2>Keep your baby close</h2>
<p>Another way to regain connection with your baby is to keep them physically close as much as possible. </p>
<p>One easy way to do this is to carry them in a soft sling. The movement, the warmth of your body, and being close to your heart (which recreates a feeling of being back in the womb) <a href="https://www.sciencedirect.com/science/article/abs/pii/S0190740919311260">soothes your baby</a>. </p>
<p>Babies who are carried regularly <a href="https://www.magonlinelibrary.com/doi/abs/10.12968/johv.2013.1.4.218">cry less</a> on average. Carrying also <a href="https://pubmed.ncbi.nlm.nih.gov/32603951/">helps with bonding</a> and can reduce <a href="https://cdr.lib.unc.edu/concern/masters_papers/pg15bh008">symptoms of postnatal depression</a>. </p>
<h2>Breastfeeding and nurturing feeding</h2>
<p>Continuing to breastfeed can help you <a href="https://link.springer.com/article/10.1186/s13006-020-00319-3?fbclid=IwAR0EvkXILdRKwxQoBPE-581boqU_jFV1_onibC5qbBZ7A-1Xlu0b21-j-VE">bond with your baby</a>. If you stopped breastfeeding before you were ready to do so, know that it’s possible to restart breastfeeding at any time in a process called “<a href="https://theconversation.com/i-regret-stopping-breastfeeding-how-do-i-start-again-143183">relactation</a>”. Some women have chosen to <a href="https://theconversation.com/i-regret-stopping-breastfeeding-how-do-i-start-again-143183">start breastfeeding again</a> during the pandemic, due to mothers wanting to give their baby the possible protection of COVID-19 antibodies through their milk from maternal <a href="https://www.tandfonline.com/doi/abs/10.1080/22221751.2020.1780952">infection</a> or <a href="https://jamanetwork.com/journals/jama/article-abstract/2778766">vaccination</a>. A breastfeeding counsellor or lactation consultant can help you to work out if that’s something you want to do, and how to do it. You can contact <a href="https://www.nationalbreastfeedinghelpline.org.uk/">free helplines</a> for support with relactation or any breastfeeding difficulties you are having. </p>
<p>If you are <a href="https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/bottle-feeding-resources/infant-formula-responsive-bottle-feeding-guide-for-parents/">bottle feeding</a>, try holding your baby close while you feed them, giving them loving eye contact will help you both to bond. Even if your baby is older and eating solid foods, <a href="https://www.tandfonline.com/doi/full/10.1080/17571472.2015.1133012">eye contact</a> while feeding is a powerful connecting tool.</p>
<p>If you were separated from your baby at any point during the pandemic and are struggling, don’t be afraid to reach out and talk to others about how you feel. This might be a trusted friend, a health professional, a therapist, or counsellor. If you are struggling with the memories, are feeling anxious or depressed, or experiencing feelings of grief and loss, know that these are all valid emotions. Talking and working through these, whichever way works best for you, can help you process the experience and help strengthen the bond with your baby. </p>
<p>Finally, be kind to yourself and your baby - and remember you have plenty of time to bond with them, and that your relationship will grow and develop as your baby does.</p><img src="https://counter.theconversation.com/content/160830/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Amy Brown has previously received funding from the ESRC, NIHR, HEFCW, UKRI, Infant feeding charities and Public Health Wales. She is a trustee for First Steps Nutrition Trust. She is author of eight infant feeding and parenting books published by Pinter and Martin Ltd.</span></em></p><p class="fine-print"><em><span>Karleen Gribble is a member of the international interagency collaboration the Infant and Young Child Feeding in Emergencies Core Group. She has been involved in the development of international policy, guidance, and training on infant feeding in emergencies and and has acted as a consultant to UNICEF, WHO, and Save the Children. She has received funding from the Sydney Partnership for Health, Education, Research, and Enterprise (SPHERE) for a project on the experiences of Australian mothers of giving birth during the COVID-19 pandemic. Karleen is an Australian Breastfeeding Association Community Educator and Counsellor and a member of the Public Health Association of Australia.</span></em></p>Being separated is shown to have a negative impact on wellbeing, and can interrupt bonding with the baby.Amy Brown, Professor of Child Public Health, Swansea UniversityKarleen Gribble, Adjunct Associate Professor, School of Nursing and Midwifery, Western Sydney UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1601462021-05-18T12:23:22Z2021-05-18T12:23:22ZThe typical child care worker in the US earns less than $12 an hour<figure><img src="https://images.theconversation.com/files/400624/original/file-20210513-20-1kvhhcj.jpg?ixlib=rb-1.1.0&rect=11%2C0%2C7844%2C5229&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Taking care of little ones is physically demanding work.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/teacher-keshawna-edwards-zips-up-the-coat-of-montana-mason-news-photo/1232802545">Matt Roth for The Washington Post via Getty Images</a></span></figcaption></figure><figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/400616/original/file-20210513-20-19npgiq.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/400616/original/file-20210513-20-19npgiq.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=255&fit=crop&dpr=1 600w, https://images.theconversation.com/files/400616/original/file-20210513-20-19npgiq.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=255&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/400616/original/file-20210513-20-19npgiq.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=255&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/400616/original/file-20210513-20-19npgiq.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=321&fit=crop&dpr=1 754w, https://images.theconversation.com/files/400616/original/file-20210513-20-19npgiq.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=321&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/400616/original/file-20210513-20-19npgiq.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=321&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<p>The American Families Plan, announced by President Joe Biden in <a href="https://www.whitehouse.gov/briefing-room/statements-releases/2021/04/28/fact-sheet-the-american-families-plan/">April 2021</a>, aims to make child care more affordable for parents. Importantly, it also seeks to ensure caregivers are paid a <a href="https://livingwage.mit.edu/">living wage</a> – enough to meet basic needs given the local cost of living. If passed, all workers in child care and pre-K programs that receive federal subsidies would earn at least US$15 per hour. Preschool teachers and child care workers with similar qualifications as kindergarten teachers would be paid in line with what kindergarten teachers earn. </p>
<p>Currently, child care workers who care for infants and toddlers tend to earn much less than those who care for older children.</p>
<p>In 2019, child care workers across the United States earned <a href="https://cscce.berkeley.edu/workforce-index-2020/">an average wage of $11.65</a> per hour. That includes people who worked in child care centers and schools as well as private homes. As a result, in several states, <a href="https://cscce.berkeley.edu/workforce-index-2020/">over 25%</a> of those workers – <a href="https://www.npr.org/sections/coronavirus-live-updates/2020/08/19/903913689/1-in-5-child-care-jobs-were-lost-since-pandemic-started-women-are-affected-most">overwhelmingly women</a> – live at or below the poverty level.</p>
<p>Although early childhood caregivers saw a slight increase in wages in 2020, to <a href="https://www.bls.gov/oes/current/oes399011.htm">$12.88 per hour</a>, it was a temporary bump due to some being <a href="https://castro.house.gov/media-center/press-releases/-castro-haaland-urge-house-leadership-to-establish-family-care-for-essential-workers-and-vulnerable-family-caregivers-during-covid-19">classified as essential workers</a> or receiving <a href="https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/N/NC_Emergency_Child_Care_Operations_Guidelines_Application_Form_03252020.pdf?ver=2020-03-25-203439-153">hazard pay</a> during the COVID-19 pandemic. </p>
<p>The median annual income for a child care worker is about <a href="https://www.bls.gov/oes/current/oes399011.htm">$25,500</a> for 12 months of work, compared to a preschool teacher’s median salary of just under <a href="https://www.bls.gov/ooh/education-training-and-library/preschool-teachers.htm">$32,000</a> for, often, 10 months. A kindergarten teacher, meanwhile, earns roughly <a href="https://www.bls.gov/ooh/education-training-and-library/kindergarten-and-elementary-school-teachers.htm#tab-5">$58,000</a>, typically for 10 months.</p>
<h2>Critical development years</h2>
<p>As experts in <a href="https://scholar.google.com/citations?user=-jT5usEAAAAJ&hl=en">child development</a> and <a href="https://scholar.google.com/citations?user=V-FwbJkAAAAJ&hl=en">infant and toddler mental health</a>, we know how important high-quality care is for a child’s development. </p>
<p>A child’s brain develops rapidly from ages 0-5 when the <a href="https://doi.org/10.1038/35081509">foundational structures</a> for learning and human interaction are established. Research shows that <a href="https://doi.org/10.1017/S0954579407000326">sensitive and stimulating caregiving</a>, where materials and experiences are carefully selected to engage a child’s senses, set off a series of connections between neurons in their brain. </p>
<p>A caregiver helps a child thrive by providing consistent attention, <a href="https://developingchild.harvard.edu/science/key-concepts/serve-and-return/">back-and-forth communication</a> and emotional responsiveness – during routine times of diapering and feeding, as well as during planned activities. </p>
<p>Failure to respond or responses that are provided by a primary caregiver experiencing <a href="https://doi.org/10.1038/nrn.2018.1">higher levels of anxiety</a> have been shown to have an impact on the way <a href="https://doi.org/10.1002/wcs.1387">the child’s brain develops</a>. </p>
<h2>Impact of low wages</h2>
<p>According to the Center for the Study of Child Care at University of California Berkeley, <a href="https://cscce.berkeley.edu/workforce-index-2020/">caregivers in only 10 states</a> are paid what’s considered a living wage. As a result, nearly half of this workforce nationwide depends on public income support programs like food stamps or Medicaid.</p>
<p>The salary inequities can’t be explained away by lower levels of academic training or easier workdays. Early childhood educators with bachelor’s degrees earn <a href="https://cscce.berkeley.edu/workforce-index-2020/the-early-educator-workforce/early-educator-pay-economic-insecurity-across-the-states/">as little as half</a> of what K-8 teachers with the same credentials earn. </p>
<p>And whether caregivers are sitting on the floor playing with a child or lifting them into highchairs, the job is physically demanding – especially <a href="https://worldpopulationreview.com/state-rankings/child-care-ratio-by-state">in states</a> like Florida and Texas where one caregiver may be responsible for 10 or more toddlers. Plus, the average toddler weighs <a href="https://www.cdc.gov/growthcharts/clinical_charts.htm">over 25 pounds</a>.</p>
<p>Low wages, few benefits, stressful work conditions and feeling like their work isn’t valued are factors affecting the <a href="https://learningpolicyinstitute.org/sites/default/files/product-files/Teacher_Turnover_REPORT.pdf">high turnover rates</a> and staffing shortage in child care.</p>
<p>A shortage of qualified staff hurts employers, but it also affects the young children who depend on them for care. Continuously changing caregivers influences quality of <a href="https://doi.org/10.1002/imhj.21666">interaction and attachment</a>. During such a critical period of growth in a child’s life, when development depends on the caregiver’s attention to a child, we believe caregivers should be paid a wage that makes it possible for them to afford health care – including mental health services, should they be needed – and minimizes distraction from worries about their own economic stability.</p>
<p>[<em>Like what you’ve read? Want more?</em> <a href="https://theconversation.com/us/newsletters/the-daily-3?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=likethis">Sign up for The Conversation’s daily newsletter</a>.]</p><img src="https://counter.theconversation.com/content/160146/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Melissa Jozwiak previously received funding from State of New Mexico PreK for universal prek.
</span></em></p><p class="fine-print"><em><span>Carl Sheperis does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The Biden administration wants workers in child care and pre-K programs to earn at least $15 per hour.Melissa M. Jozwiak, Associate Professor of Early Childhood, Texas A&M University-San AntonioCarl Sheperis, Professor of Mental Health Counseling, Texas A&M University-San AntonioLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1316772021-03-11T04:11:40Z2021-03-11T04:11:40ZWhat are breath-holding spells, the common phenomenon that causes children to faint?<figure><img src="https://images.theconversation.com/files/380589/original/file-20210125-13-1q7oslz.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C4000%2C2664&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>It’s time to leave the playground but your 12-month-old daughter doesn’t want to. She gets angry, cries out loudly, breathing all the way out and then holds her breath. She turns blue around the mouth and faints.</p>
<p>This is understandably very scary for any parent. But the good news is these episodes, called breath-holding spells, are common, not dangerous, resolve as children get older, and don’t cause any long-term damage.</p>
<h2>What are breath-holding spells?</h2>
<p>Breath-holding spells affect up to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6696822/pdf/CPR-15-22.pdf">one in every 22 children</a> under six years. There are two types. </p>
<p>“Cyanotic” or blue spells are the type we describe above, and are usually triggered by anger or frustration. </p>
<p>“Pallid” or pale spells are typically triggered by pain or fear, and are less common. At the start children open their mouths, but there may not be a cry. They then hold their breath, turn pale and may faint. </p>
<p>In both cases the spells last less than 60 seconds. At the end of an episode when the child regains consciousness, children may return to normal, be slightly drowsy or upset.</p>
<p>Breath-holding spells typically start when the child is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6696822/pdf/CPR-15-22.pdf">aged between six and 18 months</a>. The spells can occur multiple times a day or very infrequently. Some 90% of children <a href="https://raisingchildren.net.au/babies/behaviour/common-concerns/breath-holding#the-two-types-of-breath-holding-nav-title">grow out of the episodes</a> by the time they turn six.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/fight-flight-or-faint-why-some-people-pass-out-when-they-see-blood-or-feel-pain-57348">Fight, flight or ... faint? Why some people pass out when they see blood or feel pain</a>
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<h2>What causes breath-holding spells?</h2>
<p>We don’t know exactly why some children have breath-holding spells, but we think <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6696822/pdf/CPR-15-22.pdf">multiple factors could play a role</a>.</p>
<p>Small <a href="https://pubmed.ncbi.nlm.nih.gov/16208053/">studies</a> have shown children who experience cyanotic breath-holding spells have differently functioning autonomic nervous systems (the part of the nervous system which controls things like heart rate and breathing rate). They have higher resting-heart rate and blood pressure, and pupils that have an exaggerated response to light in certain conditions (these things are not dangerous for children). But it’s unclear precisely how these differences may be linked to breath-holding spells. </p>
<p>For children who have pallid breath-holding spells, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6696822/pdf/CPR-15-22.pdf">research suggests</a> the vagus nerve — which helps control body functions when we’re at rest — is overactive, and causes the heart to slow down.</p>
<p>Studies have also shown breath-holding spells are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6696822/pdf/CPR-15-22.pdf">more common</a> in children with iron deficiency, though we’re not sure why this is.</p>
<figure class="align-center ">
<img alt="A little girl having a tantrum sits against a white brick wall." src="https://images.theconversation.com/files/380590/original/file-20210125-17-1hns1z6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/380590/original/file-20210125-17-1hns1z6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=339&fit=crop&dpr=1 600w, https://images.theconversation.com/files/380590/original/file-20210125-17-1hns1z6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=339&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/380590/original/file-20210125-17-1hns1z6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=339&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/380590/original/file-20210125-17-1hns1z6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=426&fit=crop&dpr=1 754w, https://images.theconversation.com/files/380590/original/file-20210125-17-1hns1z6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=426&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/380590/original/file-20210125-17-1hns1z6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=426&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Frustration or anger can trigger breath-holding spells.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<h2>If this happens to your child, should you be worried?</h2>
<p>Although breath-holding spells can be very scary — particularly the first time — they are not cause for concern.</p>
<p>Parents often have two questions. First, are they a sign there’s something wrong with my child? And second, will they cause long-term damage to my child’s brain and development? The answer to both these questions is no. </p>
<p>As they’re such a common problem, we know generally they’re not a sign of an underlying illness, and they don’t have long-term effects (likely because the spells are not associated with significant oxygen deprivation to the brain).</p>
<p><a href="https://www.healthline.com/health/iron-deficiency-anemia">Iron deficiency anaemia</a>, which can be associated with breath-holding spells, is very easily treated. Your child’s GP can test for this and prescribe <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1718051/">iron supplements</a> if needed.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/no-i-dont-wanna-wahhhh-a-parents-guide-to-managing-tantrums-87175">'No, I don't wanna... wahhhh!' A parent's guide to managing tantrums</a>
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</p>
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<h2>What should an adult do during and after a breath-holding spell?</h2>
<p>You should:</p>
<ul>
<li><p>stay calm and remember the spell will be over in less than 60 seconds</p></li>
<li><p>remove any objects around your child which may cause injury if they faint</p></li>
<li><p>if your child faints, lay them on their side.</p></li>
</ul>
<p>You should not:</p>
<ul>
<li><p>try to stimulate your child to breathe by shaking them (this won’t help and may cause injury)</p></li>
<li><p>put anything in the child’s mouth, including your fingers.</p></li>
</ul>
<p>After a spell is over, you should:</p>
<ul>
<li><p>try to treat the child as normal; don’t punish them or reward them or make a fuss </p></li>
<li><p>perform first aid to any injuries that might have occurred during fainting.</p></li>
</ul>
<p>You can find good information on how to handle breath-holding spells online through resources including the <a href="https://raisingchildren.net.au/babies/behaviour/common-concerns/breath-holding#the-two-types-of-breath-holding-nav-title">Raising Children’s Network</a> and the <a href="https://www.rch.org.au/kidsinfo/fact_sheets/Breath_holding/">Royal Children’s Hospital</a>. </p>
<figure class="align-center ">
<img alt="A doctor examines a toddler sitting on the mother's lap." src="https://images.theconversation.com/files/380591/original/file-20210125-23-1988yq6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/380591/original/file-20210125-23-1988yq6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/380591/original/file-20210125-23-1988yq6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/380591/original/file-20210125-23-1988yq6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/380591/original/file-20210125-23-1988yq6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/380591/original/file-20210125-23-1988yq6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/380591/original/file-20210125-23-1988yq6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">You can discuss your child’s breath-holding spells with your GP.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<h2>Is there anything you can do to prevent breath-holding spells?</h2>
<p>Aside from treating any iron deficiency anaemia, there are no medications for breath-holding spells. Parents can only try to prevent the spells by preventing the events that trigger them. </p>
<p>Ways to do this include distracting your child if they’re upset and giving them plenty of warning if their activity is going to change, such as a five-minute countdown before leaving the playground. </p>
<p>Of course, it won’t always be possible to stop a child from becoming frustrated or angry.</p>
<h2>When should you see a doctor?</h2>
<p>It’s generally a good idea to see a GP after your child’s first spell, just so they can go through what happened with you and ensure it was a breath-holding spell. </p>
<p>If the spells are occurring very frequently, then seeing your GP and getting tested for iron deficiency anaemia is a good idea. Other reasons to see a doctor include if the spells start at less than six months of age, or if your child displays signs of a seizure (such as shaking in their arms and legs).</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/why-iron-is-such-an-important-part-of-your-diet-69974">Why iron is such an important part of your diet</a>
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</em>
</p>
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<img src="https://counter.theconversation.com/content/131677/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Shivanthan Shanthikumar receives funding from a Vertex Pharmaceuticals via a Vertex Innovation Award for research activities related to his PhD. </span></em></p><p class="fine-print"><em><span>David Tingay receives funding from the National Health and Medical Research Council (Clinical Career Development Fellowship Grant ID 1053889 and Ideas Grant ID 1182676) and Medical Research Future Fund (International Clinical Trial Collaborations Grant ID 1170957). </span></em></p>It’s understandably frightening and distressing when your child stops breathing and passes out. But breath-holding spells are actually fairly common in young children, and not dangerous.Shivanthan Shanthikumar, Respiratory Medicine Fellow, Murdoch Children's Research InstituteDavid Tingay, Clinical Neonatologist and Respiratory Physiologist, Murdoch Children's Research InstituteLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1558412021-02-26T13:25:21Z2021-02-26T13:25:21ZWhat are phthalates, and how do they put children’s health at risk?<figure><img src="https://images.theconversation.com/files/386581/original/file-20210225-19-1wfq2w3.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C5362%2C3583&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Phthalates can be found in many common products and types of plastic packaging.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/plastic-bags-and-bottles-royalty-free-image/1127955502">Curtoicurto via Getty Images</a>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span></figcaption></figure><p>You may not realize it, but you likely encounter phthalates <a href="https://www.cdc.gov/biomonitoring/Phthalates_FactSheet.html">every day</a>. These chemicals are found in many plastics, including food packaging, and they can migrate into food products during processing. They’re in personal care products like shampoos, soaps and laundry detergents, and in the vinyl flooring in many homes. </p>
<p>They’re also in the news again after an editorial by scientists in the <a href="https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.2020.306014">American Journal of Public Health</a> included an urgent call for better federal regulation of the chemicals.</p>
<p>In particular, scientists are urging state and federal agencies to eliminate phthalates (pronounced THAL-ates) from products used by pregnant women and children. Despite evidence of the harm these chemicals can cause, federal regulation in the United States has been minimal beyond <a href="https://www.federalregister.gov/documents/2018/01/26/2018-01451/prohibition-of-childrens-toys-and-child-care-articles-containing-specified-phthalates-revision-of">children’s toys</a>. A recent move by the General Mills-owned food brand Annie’s to <a href="https://www.annies.com/faq/">eliminate phthalates from its macaroni and cheese</a> suggests stricter rules are feasible.</p>
<p>So, what’s the risk, and what can you do about it? </p>
<p>I’m an <a href="https://scholar.google.com/citations?user=wKXbh1UAAAAJ&hl=en">environmental epidemiologist</a> who studies the impact of pregnant women’s exposure to environmental chemicals. Here are answers to three important questions about phthalates.</p>
<h2>Who’s at risk?</h2>
<p>Ortho-phthalates, commonly referred to as phthalates, are synthetic chemicals that are used to manufacture plastic. They help make plastic more flexible and harder to break. </p>
<p>Despite their abundance in many products, phthalates can be harmful to <a href="https://www.sciencedirect.com/science/article/pii/S0160412018329908">pregnant women</a> and <a href="https://www.sciencedirect.com/science/article/pii/S0013935115001899?via%3Dihub">their children</a>. These chemicals can disrupt the endocrine system, the glands that release hormones as the body’s chemical messengers. Studies suggest that can lead to pregnant women <a href="https://www.sciencedirect.com/science/article/pii/S0160412021000684">delivering their babies early</a>. Other studies have found that children born to mothers exposed to high levels of phthalates can have a <a href="https://www.sciencedirect.com/science/article/pii/S0013935115001899?via%3Dihub">lower IQ</a> and poorer social communication development, and that these children are also more likely to develop <a href="https://ehp.niehs.nih.gov/doi/10.1289/EHP2358">ADHD</a> and <a href="https://www.sciencedirect.com/science/article/abs/pii/S0161813X18303255?via%3Dihub">behavior problems</a>. Researchers have also found effects on the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1280349/">genital development of male infants</a> born to mothers exposed to phthalates during pregnancy.</p>
<p>While phthalates can be found in nearly everyone, <a href="https://www.sciencedirect.com/science/article/pii/S0160412018329908">minority women have been found to be especially burdened</a>. Studies show that many <a href="https://doi.org/10.1016/j.envres.2018.03.030">beauty products</a> targeted at these communities contain high levels of chemicals.</p>
<p><a href="http://doi.org/10.1097/MOP.0b013e32835e1eb6">Infants and young children</a> may experience high phthalate levels because they often put plastic products in their mouths as they explore the world.</p>
<p>Phthalates can enter food at <a href="https://www.cdc.gov/biomonitoring/Phthalates_FactSheet.html">many places</a> in the supply chain, including through plastic tubing for liquids during production, plastic storage containers and even food preparation gloves. Foods that are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4050989/">high in fat</a> in particular can absorb phthalates through exposure during processing. Eating out doesn’t avoid the risk. A <a href="https://doi.org/10.1016/j.envint.2018.02.029">study of U.S. children and adults</a> showed that those who ate food outside of their homes had higher phthalate levels.</p>
<h2>How do I know if a product has phthalates?</h2>
<p>Figuring out which products have high levels of phthalates isn’t always easy. While <a href="https://phthalates.americanchemistry.com/">phthalates</a> are required to be listed on ingredients labels, they are sometimes included instead as part of the fragrance, which <a href="https://www.safecosmetics.org/fragrance-disclosure/learn-more/trade-secrets/">allows them to be excluded</a> from the ingredients list. </p>
<p>Many companies have voluntarily removed phthalates, and many consumer products are now labeled “phthalate free.” The <a href="https://www.ewg.org/skindeep/">Environmental Working Group</a>’s Skin Deep website also offers a way to search for details about chemicals in cleaning and personal care products.</p>
<h2>How do I keep my family safe?</h2>
<p>Phthalates are <a href="https://www.cdc.gov/biomonitoring/Phthalates_FactSheet.html">rapidly metabolized</a> and generally removed from the body once exposure stops. Until there is better regulation, a few simple changes can make a big difference in promoting health and reducing phthalate levels in the home. </p>
<p>One <a href="http://doi.org/10.1289/ehp.1003170">easy change</a> is to swap out all plastic food packaging containers with glass containers. If that’s not possible, it’s best to let food cool to room temperature before placing it in plastic food storage containers. </p>
<p>Don’t microwave anything in plastic, because phthalates can <a href="http://doi.org/10.3390/ijerph110100507">migrate from food storage containers</a> into food. </p>
<p>You can also reduce phthalate exposure by checking labels to avoid using products that include phthalates, by <a href="http://doi.org/10.1289/ehp.1003170">eating less processed food</a> that might have absorbed phthalates during production, and by cooking more meals at home.</p><img src="https://counter.theconversation.com/content/155841/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Stephanie Eick does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Scientists issued an urgent call for better federal regulation of these endocrine-disrupting chemicals. Here’s what you can do to reduce your family’s risk.Stephanie Eick, Postdoctoral Researcher in Reproductive Health, University of California, San FranciscoLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1554432021-02-22T13:26:06Z2021-02-22T13:26:06ZHow safe is your baby food?<figure><img src="https://images.theconversation.com/files/385363/original/file-20210219-19-p33c1o.jpg?ixlib=rb-1.1.0&rect=92%2C423%2C4552%2C2996&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">One study found that 95% of baby foods tested contained at least one heavy metal.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/baby-being-fed-royalty-free-image/522813035">Plume Creative via Getty Images</a></span></figcaption></figure><p>Heavy metals including lead, arsenic and mercury can be found in commercial baby foods at levels well above what the federal government considers safe for children, a new <a href="https://oversight.house.gov/sites/democrats.oversight.house.gov/files/2021-02-04%20ECP%20Baby%20Food%20Staff%20Report.pdf">congressional report</a> warns.</p>
<p>Members of Congress asked seven major baby food makers to hand over test results and other internal documents after a <a href="https://www.healthybabyfood.org/sites/healthybabyfoods.org/files/2019-10/BabyFoodReport_FULLREPORT_ENGLISH_R5b.pdf">2019 report</a> found that, out of 168 baby food products, 95% contained at least one heavy metal. Foods with rice or root vegetables, like carrots and sweet potatoes, had some of the highest levels, but they weren’t the only ones. </p>
<p>How concerned should parents be and what can they do to reduce their child’s exposure?</p>
<p>As a professor and pharmacist, I have investigated health safety concerns for several years <a href="https://doi.org/10.1177/1060028019881692">in drugs</a> and <a href="https://doi.org/10.1177/1060028019900504">dietary supplements</a>, including contamination with heavy metals and the chemical <a href="http://doi.org/10.1001/jamanetworkopen.2020.35158">NDMA</a>, a likely carcinogen. Here are answers to four questions parents are asking about the risks in baby food.</p>
<h2>How do heavy metals get into baby food?</h2>
<p>Heavy metals come from the natural erosion of the <a href="http://doi.org/10.1155/2011/870125">Earth’s crust</a>, but humans have dramatically accelerated environmental exposure to heavy metals, as well. </p>
<p>As <a href="https://www.eia.gov/energyexplained/coal/coal-and-the-environment.php">coal</a> is burned, it releases heavy metals into the air. Lead was commonly found in gasoline, paint, pipes and pottery glazes for decades. A pesticide with both <a href="http://doi.org/10.1289/ehp.114-a470">lead and arsenic</a> was widely used on crops and in orchards until it was banned in 1988, and phosphate-containing fertilizers, including organic varieties, still contain small amounts of <a href="https://doi.org/10.1007/BF00747683">cadmium, arsenic, mercury and lead.</a> </p>
<p>These heavy metals still contaminate soil, and irrigation can expose more soil to heavy metals in water.</p>
<p>When food is grown in contaminated soil and irrigated with water containing heavy metals, the food becomes contaminated. Additional heavy metals can be introduced during manufacturing processes.</p>
<p>The United States has made major strides to reduce the use of fossil fuels, filter pollutants and remove lead from many products such as gasoline and paint. This reduced exposure to <a href="https://www.epa.gov/air-trends/lead-trends">lead in the air</a> by 98% from 1980 to 2019. Processes can now also remove a proportion of the heavy metals from <a href="http://doi.org/10.1016/j.chemosphere.2019.04.198">drinking water</a>. However, the heavy metals that accumulated in the soil over the decades is an ongoing problem, especially in <a href="http://doi.org/10.1021/es400521h">developing countries</a>. </p>
<h2>How much heavy metal is too much?</h2>
<p>The <a href="https://apps.who.int/food-additives-contaminants-jecfa-database/search.aspx">World Health Organization</a> and the <a href="https://www.fda.gov/food/metals-and-your-food/survey-data-lead-womens-and-childrens-vitamins">Food and Drug Administration</a> have defined tolerable daily intakes of heavy metals. However, it’s important to recognize that for many heavy metals, including lead and arsenic, there is no daily intake that is completely devoid of long-term health risk.</p>
<p>For lead, the FDA considers 3 micrograms per day or more to be cause for concern <a href="https://www.fda.gov/food/metals-and-your-food/lead-food-foodwares-and-dietary-supplements">in children</a>, well below the level for adults (12.5 micrograms per day).</p>
<p>Young children’s bodies are smaller than adults, and lead can’t be <a href="http://doi.org/10.1515/intox-2015-0009">stored as readily in the bone</a>, so the same dose of heavy metals causes much greater blood concentrations in young children where it can do more damage. In addition, young brains are more rapidly developing and are therefore at greater risk of neurological damage.</p>
<figure class="align-center ">
<img alt="Baby food jars" src="https://images.theconversation.com/files/385364/original/file-20210219-23-8bp35z.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/385364/original/file-20210219-23-8bp35z.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=404&fit=crop&dpr=1 600w, https://images.theconversation.com/files/385364/original/file-20210219-23-8bp35z.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=404&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/385364/original/file-20210219-23-8bp35z.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=404&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/385364/original/file-20210219-23-8bp35z.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=507&fit=crop&dpr=1 754w, https://images.theconversation.com/files/385364/original/file-20210219-23-8bp35z.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=507&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/385364/original/file-20210219-23-8bp35z.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=507&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Root vegetables, such as sweet potatoes and carrots, have some of the highest levels of heavy metals.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/hand-spooning-baby-food-royalty-free-image/95468925">Tetra Images via Getty Images</a></span>
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<p>These lead levels are <a href="https://www.fda.gov/food/metals-and-your-food/lead-food-foodwares-and-dietary-supplements">about one-tenth</a> of the dose needed to achieve a blood lead concentration associated with major neurological problems, including the development of behavioral issues like aggression and attention deficit disorder. That doesn’t mean lower doses are safe, though. Recent research shows that <a href="http://doi.org/10.1515/intox-2015-0009">lower blood lead levels</a> still impact neurological function, just not as dramatically.</p>
<p>For other heavy metals, the daily intake considered tolerable is based on <a href="https://apps.who.int/food-additives-contaminants-jecfa-database/search.aspx">body weight</a>: mercury is 4 micrograms per kilogram of body weight; arsenic is not currently defined but before 2011 it was 2.1 micrograms per kilogram of body weight. </p>
<p>Like with lead, there is a considerable safety margin between the tolerable dose and the dose that poses high risk of causing neurological harm, <a href="http://doi.org/10.1515/intox-2015-0009">anemia</a>, <a href="http://doi.org/10.1155/2011/870125">liver and kidney damage and an increased risk of cancer</a>. But even smaller amounts still carry risks.</p>
<p>One example of the exposure infants can face is a <a href="https://www.healthybabyfood.org/sites/healthybabyfoods.org/files/2019-10/BabyFoodReport_FULLREPORT_ENGLISH_R5b.pdf">brand of carrot baby food</a> found to have 23.5 parts of lead per billion, <a href="http://www.endmemo.com/sconvert/ppbug_g.php">equivalent</a> to 0.67 micrograms of lead per ounce. Since the average 6-month-old eats 4 ounces of vegetables a day, that would be 2.7 micrograms of lead a day – almost the maximum tolerable daily dose.</p>
<h2>What can parents do to reduce a child’s exposure?</h2>
<p>Since the amount of heavy metals varies so dramatically, food choices can make a difference. Here are a few ways to reduce a young child’s exposure.</p>
<p>1) Minimize the use of <a href="https://www.fda.gov/regulatory-information/search-fda-guidance-documents/guidance-industry-action-level-inorganic-arsenic-rice-cereals-infants?">rice-based products</a>, including rice cereal, puffed rice and rice-based teething biscuits. Switching from rice-based products to those made with oats, corn, barley or quinoa could reduce the ingestion of arsenic by 84% and total heavy metal content <a href="https://www.healthybabyfood.org/sites/healthybabyfoods.org/files/2019-10/BabyFoodReport_FULLREPORT_ENGLISH_R5b.pdf">by about 64%</a>, according to the study of 168 baby food products by the group Healthy Babies Bright Futures.</p>
<p>Using frozen banana pieces or a clean washcloth instead of a rice cereal based teething biscuit was found to reduce the total heavy metal exposure <a href="https://www.healthybabyfood.org/sites/healthybabyfoods.org/files/2019-10/BabyFoodReport_FULLREPORT_ENGLISH_R5b.pdf">by about 91%</a>.</p>
<p>2) Switch from fruit juices to water. Fruit juice is not recommended for small children because it is laden with sugar, but it also is a source of heavy metals. Switching to water could reduce the intake of heavy metals <a href="https://www.healthybabyfood.org/sites/healthybabyfoods.org/files/2019-10/BabyFoodReport_FULLREPORT_ENGLISH_R5b.pdf">by about 68%</a>, according to the report.</p>
<p>3) Alternate between root vegetables, such as carrots and sweet potatoes, and other vegetables. The roots of plants are in closest contact with the soil and have higher concentrations of heavy metals than other vegetables. Switching from carrots or sweet potatoes to other vegetables could decrease the total heavy metal content on that day <a href="https://www.healthybabyfood.org/sites/healthybabyfoods.org/files/2019-10/BabyFoodReport_FULLREPORT_ENGLISH_R5b.pdf">by about 73%</a>. Root vegetables have vitamins and other nutrients, so you don’t have to abandon them altogether, but use them sparingly.</p>
<p>Making your own baby food may not reduce your child’s exposure to heavy metals. It depends on the heavy metal dosage in each of the ingredients that you are using. Organic may not automatically mean the heavy metal content is lower because soil could have been contaminated for generations before its conversion, and neighboring farm water runoff could contaminate common water sources.</p>
<h2>Is anyone doing anything about it?</h2>
<p>The <a href="https://oversight.house.gov/sites/democrats.oversight.house.gov/files/2021-02-04%20ECP%20Baby%20Food%20Staff%20Report.pdf">congressional report</a> calls for the FDA to <a href="https://www.fda.gov/food/cfsan-constituent-updates/fda-response-questions-about-levels-toxic-elements-baby-food-following-congressional-report">better define acceptable limits</a> for heavy metals in baby food. It points out that the heavy metal levels found in some baby foods far exceed the maximum levels allowed in bottled water. It also recommends standards for testing in the industry, and suggests requiring baby food makers to report heavy metals amounts on their product labels so parents can make informed choices.</p>
<p>Baby food manufacturers are also discussing the issue. The <a href="https://www.edf.org/media/baby-food-council-taking-challenge-reducing-heavy-metals-young-kids-food">Baby Food Council</a> was created in 2019 to bring together major infant and toddler food companies and advocacy and research groups with the goal of reducing heavy metals in baby food products. They created a <a href="https://foodscience.cals.cornell.edu/industry-partnership-program/cifs-ipp-councils/">Baby Food Standard and Certification Program</a> to work collaboratively on testing and certification of raw ingredients. Ultimately, baby food makers will need to consider changing farm sources of raw ingredients, using fewer seasonings and altering processing practices.</p>
<p>The U.S. has made important inroads in reducing heavy metals in air and water since the 1980s, dramatically lowering exposure. With additional focus, it can further reduce heavy metal exposure in baby food, too.</p>
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<p class="fine-print"><em><span>C. Michael White does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Reports from baby food companies show questionable levels of arsenic, lead and other heavy metals. Here’s what parents need to know.C. Michael White, Distinguished Professor and Head of the Department of Pharmacy Practice, University of ConnecticutLicensed as Creative Commons – attribution, no derivatives.