Journal Articles
Permanent URI for this collectionhttps://mro.massey.ac.nz/handle/10179/7915
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Item Maternal depressive symptoms in and beyond the perinatal period: Associations with infant and preschooler sleep(Oxford University Press on behalf of Sleep Research Society, 2024-10-29) Carter ML; Paine S-J; Sweeney BM; Taylor J; Signal TLStudy Objectives (1) To describe sleep in infancy and early childhood among children born to mothers with and without clinically significant depressive symptoms, and (2) to explore the relationships between maternal depressive symptoms and sleep patterns and problems during infancy and early childhood. Methods Secondary analysis of longitudinal data from the Moe Kura: Mother and Child, Sleep and Wellbeing in Aotearoa/New Zealand study. Data were collected in pregnancy (T1), 12 weeks postpartum (T2), and 3 years post-birth (T3). Participants were 262 Māori and 594 non-Māori mother–child dyads. Chi-square and independent t-tests measured bivariate associations between maternal mood (T1, T2, and T3) and child sleep characteristics (T2 and T3). Binary logistic regression models examined longitudinal and concurrent associations between maternal depressive symptoms and infant and preschooler sleep. Adjusted models accounted for key socio-demographic variables, as well as infant sleep variables in preschooler models. Results Bivariate associations were found between prior and concurrent depressive symptomology and many of the infant and preschooler sleep outcomes. In adjusted models, prenatal depressive symptoms remained independently associated with shorter-than-recommended sleep durations in preschoolers. In these models, concurrent depression was also associated with night waking, night LSRSP, and perceived sleep problems at 12 weeks postpartum, and CSHQ-determined and perceived sleep problems at 3 years post-birth. Conclusions Longitudinal and cross-sectional associations were found between maternal depressive symptoms and child sleep. Sleep appears to be one pathway by which maternal depression confers risk for suboptimal child health outcomes. Findings support the need for earlier and better maternal mental health services.Item Household food insecurity and novel complementary feeding methods in New Zealand families.(John Wiley and Sons Ltd, 2024-09-02) Katiforis I; Smith C; Haszard JJ; Styles SE; Leong C; Taylor RW; Conlon CA; Beck KL; von Hurst PR; Te Morenga LA; Daniels L; Brown KJ; Rowan M; Casale M; McLean NH; Cox AM; Jones EA; Bruckner BR; Jupiterwala R; Wei A; Heath A-LMOptimal nutrition during infancy is critical given its influence on lifelong health and wellbeing. Two novel methods of infant complementary feeding, commercial baby food pouch use and baby-led weaning (BLW), are becoming increasingly popular worldwide. Household food insecurity may influence complementary feeding practices adopted by families, but no studies have investigated the use of BLW and baby food pouches in families experiencing food insecurity. The First Foods New Zealand study was a multicentre, observational study in infants 7.0-9.9 months of age. Households (n = 604) were classified into one of three categories of food insecurity (severely food insecure, moderately food insecure, and food secure). The use of complementary feeding practices was assessed via a self-administered questionnaire, both at the current age (mean 8.4 months) and retrospectively at 6 months. Mothers experiencing severe food insecurity had 5.70 times the odds of currently using commercial baby food pouches frequently (≥5 times/week) compared to food secure mothers (95% CI [1.54, 21.01]), reporting that pouches were 'easy to use' (89%) and made it 'easy to get fruits and vegetables in' (64%). In contrast, no evidence of a difference in the prevalence of current BLW was observed among mothers experiencing moderate food insecurity (adjusted OR; 1.28, 95% CI [0.73, 2.24]) or severe food insecurity (adjusted OR; 1.03, 95% CI [0.44, 2.43]) compared to food secure mothers. The high prevalence of frequent commercial baby food pouch use in food insecure households underscores the need for research to determine whether frequent pouch use impacts infant health.Item Baby Food Pouches, Baby-Led Weaning, and Iron Status in New Zealand Infants: An Observational Study.(MDPI (Basel, Switzerland), 2024-05-15) McLean NH; Haszard JJ; Daniels L; Taylor RW; Wheeler BJ; Conlon CA; Beck KL; von Hurst PR; Te Morenga LA; McArthur J; Paul R; Katiforis I; Brown KJ; Gash MC; Rowan MM; Casale M; Cox AM; Jones EA; Jupiterwala RM; Bruckner B; Fleming L; Heath A-LM; Chen Y; Tran PV; Felt BTIron deficiency in infants can impact development, and there are concerns that the use of baby food pouches and baby-led weaning may impair iron status. First Foods New Zealand (FFNZ) was an observational study of 625 New Zealand infants aged 6.9 to 10.1 months. Feeding methods were defined based on parental reports of infant feeding at "around 6 months of age": "frequent" baby food pouch use (five+ times per week) and "full baby-led weaning" (the infant primarily self-feeds). Iron status was assessed using a venepuncture blood sample. The estimated prevalence of suboptimal iron status was 23%, but neither feeding method significantly predicted body iron concentrations nor the odds of iron sufficiency after controlling for potential confounding factors including infant formula intake. Adjusted ORs for iron sufficiency were 1.50 (95% CI: 0.67-3.39) for frequent pouch users compared to non-pouch users and 0.91 (95% CI: 0.45-1.87) for baby-led weaning compared to traditional spoon-feeding. Contrary to concerns, there was no evidence that baby food pouch use or baby-led weaning, as currently practiced in New Zealand, were associated with poorer iron status in this age group. However, notable levels of suboptimal iron status, regardless of the feeding method, emphasise the ongoing need for paying attention to infant iron nutrition.Item Knowledge, attitudes and behaviours towards vitamin D and sun exposure of parents of infants and young children and health professionals in New Zealand.(SAGE Publications, 2023-07-02) Von Hurst P; Mazahery H; Reynolds E; Thomson A; Franklin M; Conlon CBACKGROUND: Vitamin D deficiency may result in adverse long-term health consequences in adulthood if it occurs during fetal development, infancy and childhood. To effectively improve vitamin D status of infants/toddlers, there needs to be knowledge and awareness of vitamin D among parents and health professionals. AIMS: The aim of this study was to investigate parents' and health professionals' knowledge, attitudes and behaviours towards vitamin D and sun exposure over two timepoints. METHODS: The study was an ecological study over two timepoints (Parents 2009 and 2021; Health professionals 2010 and 2019) and used an online questionnaire. RESULTS: The analysis included 9834 parents (2009 n = 8032; 2021 n = 1802) and 283 health professionals (2010 n = 193; 2019 n = 90). Parents and health professionals had good knowledge of vitamin D sources, roles and risk factors for deficiency over two timepoints. There were however some confusions regarding the vitamin D content of breast milk, exclusive breastfeeding as a risk factor for deficiency, and ineffectiveness of sun exposure through glass windows in relation to vitamin D synthesis. In 2019, only 37% of health professionals indicated giving advice on supplements for infants/toddlers. Most parents and health professionals believed there was not enough information available to parents regarding vitamin D (>90%) and that skin cancer prevention messages make it difficult to get information about vitamin D across (>70%). CONCLUSION: Although parents and health professionals had good knowledge in most areas, knowledge of some specific sources and risk factors for vitamin D deficiency was poor.Item Starting complementary feeding with vegetables only increases vegetable acceptance at 9 months: a randomized controlled trial(Oxford University Press on behalf of the American Society for Nutrition, 2022-07-09) Rapson JP; Von Hurst PR; Hetherington MM; Mazahery H; Conlon CABACKGROUND: Starting complementary feeding (CF) with vegetables only may improve vegetable acceptance throughout childhood. OBJECTIVES: We aimed to test whether exposure to vegetables only during the first 4 wk of CF increases later vegetable acceptance compared with a control group receiving fruit and vegetables. METHODS: In this randomized, controlled, parallel-group study, 117 Auckland infants received either vegetables only (veg-only, n = 61) or a combination of fruit and vegetables (control, n = 56) for a duration of 4 wk, starting from the first day of CF at ∼4-6 mo of age. The primary outcome measure was intake of target vegetables (broccoli, spinach) provided by the study at 9 mo of age. Daily intake of vegetables (FFQs) at 9 mo was a supporting measure. Infants' iron status (serum ferritin, hemoglobin) was examined at all time points. RESULTS: The veg-only infants consumed more broccoli and spinach than controls [mean difference (95% CI): 11.83 (0.82, 22.84) g, P = 0.036 and 10.19 (0.50, 19.87) g, P = 0.039, respectively]. Intake of pear was comparable among intervention groups (P = 0.35). At 9 mo, veg-only infants consumed target vegetables at a faster rate [mean difference (95% CI): broccoli, 3.37 (1.26, 5.47), P = 0.002; spinach, 4.12 (0.80, 7.45), P = 0.016] and showed greater acceptance for target vegetables [mean difference (95% CI): broccoli, 0.38 (0.07, 0.70), P = 0.019; spinach, 032 (0.04, 0.60), P = 0.024] than controls. The rate of eating and acceptance of pear was comparable among intervention groups (P = 0.42 and P = 0.98, respectively). Also, veg-only infants consumed more vegetables than controls [86.3 (52.5, 146.3) compared with 67.5 (37.5, 101.3) g, respectively, P = 0.042]. Introducing vegetables as the first food was not associated with 9-mo iron status. CONCLUSIONS: Providing vegetables as first foods increased vegetable intake at 9 mo of age and may be an effective strategy for improving child vegetable consumption and developing preferences for vegetables in infancy.Item Moe Kitenga: a qualitative study of perceptions of infant and child sleep practices among Māori whānau(SAGE Publications, 2020-06-21) George M; Theodore R; Richards R; Galland B; Taylor R; Matahaere M; Te Morenga LInsufficient sleep is a strong risk factor for unhealthy weight gain in children. Māori (the indigenous population of Aotearoa (New Zealand)) children have an increased risk of unhealthy weight gain compared to New Zealand European children. Interventions around sleep could provide an avenue for improving health and limiting excessive weight gain with other meaningful benefits for whānau (extended family) well-being. However, current messages promoting good sleep may not be realistic for many Māori whānau. Using qualitative methods, the Moe Kitenga project explored the diverse realities of sleep in 14 Māori whānau. We conclude that for infant sleep interventions to prevent obesity and improve health outcomes for Māori children, they must take into account the often pressing social circumstances of many Māori whānau that are a barrier to adopting infant sleep recommendations, otherwise sleep interventions could create yet another oppressive standard that whānau fail to live up to.Item Impact of a Modified Version of Baby-Led Weaning on Infant Food and Nutrient Intakes: The BLISS Randomized Controlled Trial(MDPI (Basel, Switzerland), 2018-06-07) Williams Erickson L; Taylor RW; Haszard JJ; Fleming EA; Daniels L; Morison BJ; Leong C; Fangupo LJ; Wheeler BJ; Taylor BJ; Te Morenga L; McLean RM; Heath A-LMDespite growing international interest in Baby-Led Weaning (BLW), we know almost nothing about food and nutrient intake in infants following baby-led approaches to infant feeding. The aim of this paper was to determine the impact of modified BLW (i.e., Baby-Led Introduction to SolidS; BLISS) on food and nutrient intake at 7⁻24 months of age. Two hundred and six women recruited in late pregnancy were randomized to Control (n = 101) or BLISS (n = 105) groups. All participants received standard well-child care. BLISS participants also received lactation consultant support to six months, and educational sessions about BLISS (5.5, 7, and 9 months). Three-day weighed diet records were collected for the infants (7, 12, and 24 months). Compared to the Control group, BLISS infants consumed more sodium (percent difference, 95% CI: 35%, 19% to 54%) and fat (6%, 1% to 11%) at 7 months, and less saturated fat (-7%, -14% to -0.4%) at 12 months. No differences were apparent at 24 months of age but the majority of infants from both groups had excessive intakes of sodium (68% of children) and added sugars (75% of children). Overall, BLISS appears to result in a diet that is as nutritionally adequate as traditional spoon-feeding, and may address some concerns about the nutritional adequacy of unmodified BLW. However, BLISS and Control infants both had high intakes of sodium and added sugars by 24 months that are concerning.