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Objective To determine influences on incidence of breast milk feeding (BMF) at time of discharge and 6 months later among infants cared for in the neonatal intensive care unit (NICU). Design A 2-year prospective descriptive NICU hospital-based cohort design. Setting Academic Center Level III–IV NICU. Participants Five hundred and thirty-five infants cared for in NICU and a subgroup of one hundred twenty-nine participant mothers who answered questionnaires. Methods Pre-discharge data were collected using maternal and infant medical records. Post discharge data were collected from maternal questionnaires. Results At NICU discharge, biophysiologic stressors predictive of not receiving BMF included birth weight < 1500 grams (p<0.035), heart surgery (p= 0.014), and inhaled nitric oxide treatment (p=.002). Teenage mothers were less likely to BMF (p= 0.022). After discharge, BMF duration correlated with BMF duration of a prior infant (p<0.009). Most mothers reported BMF > 4 months, 91% continued pumping, and 89% indicated an interest in a hospital support group. Logistic regression analysis (R2 0.45) identified factors that significantly increased the likelihood of BMF > 4 months: BMF plan (p<0.001), convenience (p=0.018), and family as resource (p=0.025). Negative associations were: awareness of immune benefits (p=0.025), return to work (p=0.002), and infants requiring surgical ligation of the patent ductus arterious (p=0.019). Conclusions Social and medical stressors contribute to BMF duration pre and post NICU discharge. We speculate that active NICU BMF support targeting vulnerable infants and their families and assisting with plans for BMF pre and post discharge will help overcome barriers.

Over the past decade, the experimental therapeutics approach has gained currency as an organizing framework for research in mental health. However, examples of this approach outside of person-directed therapeutic and preventive interventions have been relatively uncommon. This article describes an experimental therapeutics approach to mental health and human services research that considers the role of social and ecological determinants in a person's recovery from mental disorder. To illustrate this approach, this article decomposes an employment intervention to show three of its components and identifies the targets for two components: social relationships and health insurance. These targets can be engaged by provider-, community-, or policy-level interventions. Such applications of an experimental therapeutics approach to research on mental health services can enhance the rigor of studies and thereby contribute to the well-being of persons living with mental disorders in the United States.

Background Parent–child interactions are crucial for child development. The COVID-19 pandemic has negatively affected mental health and increased parenting challenges impacting parent–child functioning. Objective This study examined parent factors related to more and less enriching child activities during the pandemic through Bronfenbrenner’s Ecological Systems framework. Methods A convenience sample of parents ( N = 708), primarily mothers ( n = 610; 87.4%) aged 35.59 years old ( SD = 5.59; range = 21–72), with children ages 2–8 years completed an online questionnaire between April 14-June 1, 2020. Participants mostly resided in Canada, had an income of > $100,000, and identified as White (82.4%). Parent–child activities were measured as total weekly time and combined time across activities within two categories: hands-on play and screen time. Bivariate correlations informed blockwise linear regression models. Results For families with childcare needs, parental anxiety was associated with higher total hands-on play, combined hands-on play, and combined screen time. Families without childcare needs indicated parenting stress was associated with lower total hands-on play and combined hands-on play, and higher supervised screen time. Family structure and indices of socioeconomic status were also predictive of activities across childcare needs and child ages. Conclusions To promote high-quality parent–child interactions and positive developmental outcomes during the pandemic, childcare needs and parent wellbeing should be supported, while evidence-based guidelines for child screen time should be further researched in this context.

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