ObjectivesTo examine the association between breast feeding outcomes and place of birth (home vs hospital birth).DesignPopulation-based cross-sectional study.SettingIreland and UK.Participants10 604 mother–infant pairs from the Growing Up in Ireland study (GUI, 2008–2009) and 17 521 pairs from the UK Millennium Cohort Study (UKMCS, 2001–2002) at low risk of delivery complications were included in the study.Primary and secondary outcome measuresBreast feeding initiation, exclusivity and duration.ResultsHome birth was found to be significantly associated with breast feeding at all examined time points, including at birth, 8 weeks, 6 months and breast feeding exclusively at 6 months. In GUI, adjusted OR was 1.90 (95% CI 1.19 to 3.02), 1.78 (1.18 to 2.69), 1.85 (1.23 to 2.77) and 2.77 (1.78 to 4.33), respectively, and in UKMCS it was 2.49 (1.84 to 3.44), 2.49 (1.92 to 3.26), 2.90 (2.25 to 3.73) and 2.24 (1.14 to 4.03).ConclusionsHome birth was strongly associated with improved breast feeding outcomes in low-risk deliveries. While the association between home birth and breast feeding is unlikely to be directly causal, further research is needed to determine which factor(s) drive the observed differences, to facilitate development of perinatal care that supports breast feeding.

In this cross-sectional study, we found that breastfeeding duration was inversely associated with infant fussiness and positively associated with infant unpredictability.

Children frequently refrain from disclosing being bullied. Early identification of bullying by healthcare professionals in children may prevent adverse health consequences. The aim of our study was to determine whether Health Care Utilisation (HCU) is higher in 9-year-olds who report being bullied and factors influencing type of HCU. The study consists of cross-sectional surveys of Child Cohort of Irish National Longitudinal Study of Children (Wave 1), 8,568 9-year-olds, and their carers. Being bullied was assessed by a self-reported questionnaire completed by children at home. HCU outcomes consisted of the following: visits to GP, Mental Health Practitioner (MHP), Emergency Department (ED), and nights in hospital by parent interview. Bivariate logistic regression and gender-stratified Poisson models were used to determine association. Victimisation by bullying independently increased visits to GP (OR 1.13, 95% confidence interval (CI): 1.03 to 1.25; p = 0.02), MHP (OR 1.31, 95% CI: 1.05 to 1.63; p = 0.02), though not ED visits (OR 0.99, 95% CI: 0.87 to 1.13; p = 0.8) or nights in hospital (OR 1.07 95% CI: 0.97 to 1.18; p = 0.2), adjusting for underlying chronic condition(s) and socio-demographic confounders. Victimised girls made higher GP visits (RR 1.14, 95% CI: 1.06 to 1.23; p < 0.001) and spent more nights in hospital (RR 1.10, 95% CI: 1.04 to 1.15; p < 0.001). Victimised boys were more likely to contact MHPs (RR 1.21, 95% CI: 1.02 to 1.44; p = 0.03). 9-year-old bullied subjects were more likely to utilise primary care services than non-bullied 9-year-olds. Different HCU patterns were observed according to gender and gender differences in the presentation of victimisation. Our findings may lead to the development of clinical practice guidelines for early detection and appropriate management of bullied children.

BackgroundBeing victimised by bullying is strongly associated with having an underlying chronic condition. The aim of this study was to determine whether primary and/or secondary healthcare utilisation (HCU) is increased in children who are bullied independent of having an underlying chronic illness or disability.MethodsCross-sectional survey of the first wave of the childhood (9-year-old) cohort of the Irish National Longitudinal Study of Children, encompassing 8,568 9-year-olds and their primary carers. Bully victimisation was assessed by a self-reported questionnaire completed by the child at home. The principal HCU outcomes obtained by interview-administered questionnaire with the primary caregiver at home were: visits to general practitioner (GP), Mental Health Practitioner (MHP) and nights spent in hospital in the previous 12 months.ResultsIn logistic regression models, being victimised by bullying independently increased GP visits (OR = 1.13, 95% CI: 1.03–1.25, p = 0.02); MHP visits (OR = 1.31, 95% CI: 1.05–1.63, p = 0.02), though not nights in hospital (OR = 1.07 95% CI: 0.97–1.18, p = 0.18), irrespective of presence of chronic illness or disability. Gender stratified Poisson models demonstrated that victimised girls made increased GP visits (RR = 1.14, 95% CI: 1.06–1.23, p < 0.001) and spent nights in hospital (RR = 1.10, 95% CI: 1.04–1.15, p < 0.001); whereas victimised boys were more likely to contact MHPs (OR = 1.21, 95% CI: 1.02–1.44, p = 0.03).Conclusion9-year-olds who are victims of bullying are more likely to utilise healthcare services. Different types of HCU patterns were observed by gender. Our study suggests health professionals need to be vigilant that medically unexplained symptoms and behavioural problems in children may be manifestations of bully victimisation, which may present differently in boys and girls. This has important implications for early detection of bullying and appropriate management of victimised children.