To identify factors linked with emotional and behavioural problems in school age (6-to 17-year-old) children of women with breast cancer. Reports of children's emotional and behavioural problems were obtained from patient mothers, their healthy partners, the children's teacher and adolescents using the Child Behaviour Checklist and Mental Health subscale of the Child Health Questionnaire. Parents reported on their own level of depression and, for patients only, their quality of life. Family functioning was assessed using the Family Assessment Device and Cohesion subscale of the Family Environment Scale. Using a cross-sectional within groups design, assessments were obtained (N ¼ 107 families) where the patients were 3 -36 months postdiagnosis. Risk of problems in children were linked with low levels of family cohesion, low affective responsiveness and parental over-involvement as reported by both child and mother. Adolescents reported family communication issues, which were associated with externalising behaviour problems. Maternal depression was related to child internalising problems, particularly in girls. Whether the mother was currently on or off chemotherapy was not associated with child problems nor was time since cancer diagnosis. These findings held across child age. Where mothers have early stage breast cancer, a substantial minority of their school-aged children have emotional and behavioural problems. Such cases are characterised by the existence of maternal depression and poor family communication, rather than by the mother's treatment status or time since diagnosis. Targeted treatments, which focus on maternal depression and family communication may benefit the children and, through improved relationships, enhance the patients' quality of life.

When mothers have breast cancer, a substantial minority of their adolescent children have psychological and stress response-related problems linked with poor family functioning. These results argue in favour of a family-oriented approach to psychological support of breast cancer patients.

Betaine increases the synthesis of creatine, an energy-rich amino acid that increases adenosine triphosphate (ATP) and has neuroprotective properties which may improve post-natal lamb survival. This study determined whether maternal betaine supplementation during gestation would improve body weight, thermoregulation, time to stand and suck, colostrum intake and survival to weaning of twin lambs. Twin-bearing Merino ewes received dietary betaine at either 0 g/day (Control, CTL), 2 g/day from ram introduction to parturition (Early betaine, EB) or 4 g/day from Day 80 of gestation to parturition (Late betaine, LB). Ewes were housed individually during parturition and measures were collected at 4, 24 and 72 h and Day 7 post-partum, and at marking (53.2 ± 0.2 days of age) and weaning (99.3 ± 0.2 days of age). The EB treatment resulted in heavier lambs at weaning compared with CTL and LB lambs (p < 0.05). Time to stand and suck from birth was longer in EB lambs (p < 0.05), whereas, the interval from birth to first suck was shorter for LB lambs (p < 0.05). Lamb survival rate was the highest for LB lambs at 72 h and Day 7 (p < 0.05), and lowest for EB lambs on Day 7 (p < 0.05). These data indicated that betaine supplementation at 4 g/day during the second half of pregnancy improved twin lamb survival to Day 7 and shortened the interval from birth to first suck; whereas feeding ewes 2 g/day of betaine for the duration of pregnancy increased twin lamb body weight at weaning, but increased both the time to attain behavioural milestones and mortalities before Day 7.

No abstract

Context Arginine supplementation can counter the negative effects of fetal growth restriction in ewes bearing multiple lambs by increasing birth weight and brown adipose fat stores in lambs; however ruminal degradation limits its bioavailability and necessitates ruminal protection. The arginine precursor citrulline increases circulating arginine after a single oral dose without ruminal protection, and bolus intravenous infusion of citrulline increases maternal and fetal circulating arginine for at least 4 h post infusion. Responses to oral and chronic citrulline have not, however, been evaluated in neonatal lambs. Aims This experiment sought to determine whether orally fed citrulline would increase circulating plasma concentrations of citrulline and arginine in pregnant Merino ewes. Methods Pregnant Merino ewes were fed citrulline (CIT, 8 g/day, n = 9) or no supplement (CON, n = 9) from Day 125 of gestation (DG 125) until parturition. Ewe (DG 125) and neonatal lamb serum (<2 h old) was analysed for circulating plasma citrulline and arginine concentrations. Key results Circulating concentrations of citrulline were higher in CIT than CON ewes 4 h post feeding at DG 125, and in CIT compared to CON neonatal lambs. Despite higher citrulline concentrations, supplementation did not increase maternal or neonatal circulating arginine concentrations. Conclusions Maternal supplementation with this dose of citrulline was not effective in increasing circulating levels of arginine. Implications Further studies may be merited in pregnant sheep to determine whether higher doses of oral citrulline can increase arginine availability during gestation.