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Background: Parents of extremely preterm children face many challenges and uncertainties. The information and support provided by clinicians -both before and after birth- is invaluable to help them make informed decisions about their child's future. Objective: To explore the information needs of parents of extremely preterm infants. Methods: All parents of infants born <29 weeks' gestational age and seen for neonatal follow-up between the ages of 18 months and 7 years were consecutively recruited over a one-year period. Parents were asked: \"Knowing what you know now, what do you wish doctors would have told you about prematurity before and/or after your child's birth?\" Answers were analyzed using mixed methods by medical professionals and a patient-partner. Results: 45% of the 249 parents (98% participation rate), were satisfied with the medical information and support they received. Prenatally, 16% felt that more practical information was needed in term of the function of babies born preterm (not only diagnoses), some parents would have liked prematurity to be mentioned in their normal pregnancy follow-up. 19% of parents wanted to know more about the life-trajectory of babies in the NICU, as well as how they could be part of the team to help their baby. 22% wished discharge to be improved, to be better prepared for the future: \"BPD does not help. We would have liked to know what leaving on oxygen meant, that she should not go to daycare, the risk with infections, RSV shots, sleeping problems many preemies have. This could have been done weeks before we left the hospital.\" Fourteen percent wished they had known more about resources for psychosocial support. Parents (14%) wished for clinicians to be more optimistic and to give them hope: \"Before birth, I would have liked to know that most micro preemies do well.\" Conclusion: Although half the parents are satisfied with information and support received, the other half recommends improvements, mainly to make it positive and practical. Diagnoses did not help parents prepare for the future prenatally, in the NICU or at discharge, but function and what parents could do (in a practical fashion) did.

Hospitals should reduce the number of times mothers and ill babies are separated, according to a report.Hospitals should reduce the number of times mothers and ill babies are separated, according to a report.

The inappropriate marketing and aggressive promotion of breastmilk substitutes (BMS) undermines breastfeeding and harms child and maternal health in all country contexts. Although a global milk formula ‘sales boom’ is reportedly underway, few studies have investigated its dynamics and determinants. This study takes two steps. First, it describes trends and patterns in global formula sales volumes (apparent consumption), by country income and region. Data are reported for 77 countries, for the years 2005–19, and for the standard (0–6 months), follow‐up (7‐12 m), toddler (13‐36 m), and special (0‐6 m) categories. Second, it draws from the literature to understand how transformations underway in first‐food systems – those that provision foods for children aged 0–36 months – explain the global transition to higher formula diets. Total world formula sales grew by 115% between 2005 and 2019, from 3.5 to 7.4 kg/child, led by highly‐populated middle‐income countries. Growth was rapid in South East and East Asia, especially in China, which now accounts for one third of world sales. This transition is linked with factors that generate demand for BMS, including rising incomes, urbanisation, the changing nature of woman's work, social norms, media influences and medicalisation. It also reflects the globalization of the baby food industry and its supply chains, including the increasing intensity and sophistication of its marketing practices. Policy and regulatory frameworks designed to protect, promote and support breastfeeding are partially or completely inadequate in the majority of countries, hence supporting industry expansion over child nutrition. The results raise serious concern for global child and maternal health.

In 2011, seven thousand American \"baby boomers\" (those born between 1946 and 1964) turned sixty-five daily. As this largest U.S. generation ages, cities, municipalities, and governments at every level must grapple with the allocation of resources and funding for maintaining the quality of life, health, and standard of living for an aging population. InThe New Neighborhood Senior Center, Joyce Weil uses in-depth ethnographic methods to examine a working-class senior center in Queens, New York. She explores the ways in which social structure directly affects the lives of older Americans and traces the role of political, social, and economic institutions and neighborhood processes in the decision to close such centers throughout the city of New York. Many policy makers and gerontologists advocate a concept of \"aging in place,\" whereby the communities in which these older residents live provide access to resources that foster and maintain their independence. But all \"aging in place\" is not equal and the success of such efforts depends heavily upon the social class and availability of resources in any given community. Senior centers, expanded in part by funding from federal programs in the 1970s, were designed as focal points in the provision of community-based services. However, for the first wave of \"boomers,\" the role of these centers has come to be questioned. Declining government support has led to the closings of many centers, even as the remaining centers are beginning to \"rebrand\" to attract the boomer generation. However,The New Neighborhood Senior Centerdemonstrates the need to balance what the boomers' want from centers with the needs of frailer or more vulnerable elders who rely on the services of senior centers on a daily basis. Weil challenges readers to consider what changes in social policies are needed to support or supplement senior centers and the functions they serve.

Objective: The aim of this study was to determine crying and sleep problems in infants, perinatal and maternal factors influencing infant crying and sleep behavior, and to evaluate the emotional and behavioral reactions of the mothers towards excessive crying and nocturnal-waking problems. Method: A questionnaire including 30 questions related maternal, infantile and perinatal features was used in this descriptive study. Totally 107 infants aged between 0-12 months were followed in the neonatal outpatient clinic comprised the study sample. Mothers not having communication problem and postpartum depression and volunteered to participate to the study were interviewed face to face. Descriptive statistics, Spearman correlation and Mann Whitney U test were used for data analysis. Logistic regression analyses were utilized to determine risk factors for excessive crying and nocturnal-waking in infants. Results: There was a positively significant correlation between total crying hours during a day and the frequency of nocturnal-waking at the 1st month p0.005 . Birth by cesarean was identified as a risk factor for excessive crying OR=2.661 and prolonged stay in incubator OR=1.031 was revealed as a risk factor for nocturnal-waking p=0.021 . The findings concluded that a high median of infant crying was associated with maternal negative feelings including sadness, helplessness, anger and guilt. The behavioral reactions of the mothers toward infant crying favorably dispersed including breastfeeding 69.2% , taking in arms 30.8% , checking diaper 20.6% , burping 14.0 , and walking around at home 8.4% . Conclusion: In the presence of delivery by cesarean and prolonged stay in incubator, excessive crying and the frequency of nocturnal-waking in infants were found to increase more. Mothers should be supported whose babies born by cesarean and stay prolonged time in incubator in terms of excessive crying and nocturnal-waking problems

Gut microbiota plays a key role in multiple aspects of human health and disease, particularly in early life. Distortions of the gut microbiota have been found to correlate with fatal diseases in preterm infants, however, developmental patterns of gut microbiome and factors affecting the colonization progress in preterm infants remain unclear. The purpose of this prospective longitudinal study was to explore day-to-day gut microbiome patterns in preterm infants during their first 30 days of life in the neonatal intensive care unit (NICU) and investigate potential factors related to the development of the infant gut microbiome. A total of 378 stool samples were collected daily from 29 stable/healthy preterm infants. DNA extracted from stool was used to sequence the V4 region of the 16S rRNA gene region for community analysis. Operational taxonomic units (OTUs) and α-diversity of the community were determined using QIIME software. Proteobacteria was the most abundant phylum, accounting for 54.3% of the total reads. Result showed shift patterns of increasing Clostridium and Bacteroides, and decreasing Staphylococcus and Haemophilus over time during early life. Alpha-diversity significantly increased daily in preterm infants after birth and linear mixed-effects models showed that postnatal days, feeding types and gender were associated with the α-diversity, p< 0.05-0.01. Male infants were found to begin with a low α-diversity, whereas females tended to have a higher diversity shortly after birth. Female infants were more likely to have higher abundance of Clostridiates, and lower abundance of Enterobacteriales than males during early life. Infants fed mother's own breastmilk (MBM) had a higher diversity of gut microbiome and significantly higher abundance in Clostridiales and Lactobacillales than infants fed non-MBM. Permanova also showed that bacterial compositions were different between males and females and between MBM and non-MBM feeding types. In conclusion, infant postnatal age, gender and feeding type significantly contribute to the dynamic development of the gut microbiome in preterm infants.