The effects of skin-to-skin contact (SSC) on the maintenance of mothers' decision to breastfeed, the effects of breastfeeding and SSC on mother-infant interactions, and whether maternal depressive symptoms mediate these effects were investigated over infants' first 3 months. When infants were 1 week, 1 month, 2 months, and 3 months of age, mothers in the SSC and control groups reported the type of infant feeding provided and completed the Edinburgh Postnatal Depression Scale (EPDS; J.L. Cox, J.M. Holden, & R. Sagovsky, 1987); mother-infant interactions were coded on the Nursing Child Assessment Feeding Scale (NCAFS; G. Summer & A. Spietz, 1994). Percentage of breastfeeding dyads in the SSC group was stable over the 3 months; yet, fewer dyads in the control group were breastfeeding at the 2- and 3-month visits than at the 1-week visit. Breastfeeding dyads had higher NCAFS Caregiver subscale scores, indicating more positive maternal interactions, at 1 week, 2 months, and 3 months. NCAFS scores did not differ for the SSC and control groups. EPDS scores did not mediate the effect of SSC on breastfeeding or breastfeeding on NCAFS Caregiver subscale scores.
Overall, the computerized Canadian NVS performed as well as the interviewer-administered version for assessing health literacy levels of English- and French-speaking participants. This Canadian adaptation of the NVS provides Canadian researchers and public health practitioners with an easily administered health literacy assessment tool that can be used to address the needs of Canadians across health literacy levels and ultimately improve health outcomes.
A model of multiple domains of health literacy was mapped to 30 practitioners' accounts of their breastfeeding promotion practice in a region of Canada. Fundamental/basic literacy themes were consistent with earlier literature regarding practitioners' discomfort in addressing literacy issues with their clients. Scientific literacy was reflected in practitioners' dilemmas about using jargon and scientific evidence when discussing breastfeeding. Cultural literacy themes related to practitioners' understandings of the sociocultural context influencing adoption of breastfeeding. Civic literacy was reflected in the use of advocacy for creating supportive breastfeeding environments. Building capacity for health literacy, however, was not a conscious focus of practice.
The study investigated the longitudinal relation between mother–infant skin‐to‐skin contact (SSC) and mother–child interactions in middle childhood. Mothers and their 9‐year‐old children (born full term), who participated in a SSC study in the children’s infancy, engaged in conversations about remembered emotional events in the children’s lives that were assessed on the Autobiographical Emotional Events Dialogue. Mothers and children who had been in the SSC group showed more engagement and reciprocity in the dialogues than mothers and children who had been in the control group. Mothers’ sensitive guidance of the dialogues mediated the effect of SSC grouping on the children’s cooperation and involvement in the conversations. A higher proportion of dyads from the SSC group, than the control group, were classified as emotionally matched. Mother–infant SSC set the mother–infant relationship on a positive developmental trajectory that was related to mother–child emotional engagement in middle childhood.
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