The MNCHP Bulletin is a bi-weekly electronic bulletin that highlights current trends, new resources and initiatives, upcoming events and more in the preconception,prenatal and child health field.

June 1, 2012

The next bulletin will be releasedJune 15, 2012.

In this week’s issue:

I. NEWS VIEWS

1.Are Cesarean Sections Contributing to Childhood Obesity?

2.Parental fear contributing to sedentary lifestyle of Canadian children: report

3.More TV, Less Self-Esteem, Except for White Boys

4.Map project shows third of Edmonton kids start school a step behind

5.Can Michigan lead nation in early childhood education? Business leaders propose plan to help

6.Benefits of hypothermia for infants who experience oxygen deficiency at birth continue through early childhood

7.Fever During Pregnancy May Raise Odds for Autism in Offspring

8.Teen Pregnancy Rates in Mississippi Force Focus on Sex Ed

II. RECENT REPORTS AND RESEARCH

9.Effects of interventions in pregnancy on maternal weight and obstetric outcomes: meta-analysis of randomised evidence

10.The Distribution of Physical Activity in an After-school Friendship Network

11.Developmental Status of 1-Year-Old Infants Fed Breast Milk, Cow’s Milk Formula, or Soy Formula

12.Maternal antidepressant use and adverse outcomes: a cohort study of 228,876 pregnancies

13.2012 Active Healthy Kids Canada Report Card On Physical Activity For Children And Youth

14.Fertility awareness and parenting attitudes among American male and female undergraduate university students

15.The Early Development Instrument (EDI) in Manitoba: Linking Socioeconomic Adversity and Biological Vulnerability at Birth to Children’s Outcomes at Age 5

16.UNICEF’s Report Card : Measuring Child Poverty

17.British Columbia's Early Years Annual Report 2010/2011

III. CURRENT INITIATIVES

18.Best Start Resource Centre to launch a new website for parents, as part of its Healthy Baby Healthy Brain awareness campaign

19.Request for Proposals (RFP): The Best Start ResourceCentre seeks a researcher/writer to develop a resource on: Effective Supports for Pregnant and Parenting Aboriginal Teens: A Resource for Service Providers in Ontario

20.Request for Proposals (RFP): The Best Start Resource Centre seeks aresearcher/writer to develop a resource on: How to be inclusiveof Aboriginal populations in parent/child programs, resources and services in Ontario

21.Physical Activity Resource Centre (PARC) French Services Survey

IV. UPCOMING EVENTS

22.Doing the Work - Rural and Remote, CAST Canada

23.Canadian Association for the Advancement of Women and Sport Mothers in Motion: Provincial Workshops for Stakeholders

24. Motherisk Update Webcast: Breaking the Cycle: Advances in Secondary Prevention of In Utero Drug and Alcohol Exposure

25.Workshop: Harm Reduction Strategies

V. RESOURCES

26.Licensing details for The Welcome to Parenting program

27.Journey 2 Quit: A Workbook to Help You Quit Smoking

28.Aboriginal Comic book exploring maternal-child health : It Takes a Village

29. Ottawa Public Health Bilingual Car Seat Installation Videos on YouTube

30.The Health Communicator’s Social Media Toolkit

31.The Power of Play

VI. FEATURED BEST STARTRESOURCES

32. Best Start Aboriginal Sharing Circle Virtual Network Now Live/Réseau virtuel Best Start Aboriginal Sharing Circleen ligne

I. NEWS & VIEWS

1. Are Cesarean Sections Contributing to Childhood Obesity?

In a study published in the journal Archives of Disease in Childhood, researchers found that babies born by cesarean section were more than twice as likely to be obese by age 3 as those born vaginally.

The study involved 1,255 children born in the Boston area between 1999 and 2002, whose mothers agreed to provide their prenatal and gestational weight information, as well as height and weight measurements for their babies at birth and then until they reached 3 years old.

About 23% of the babies were born by c-section. Of these children, 15.7% were obese by age 3, compared with 7.5% of children born vaginally.

2. Parental fear contributing to sedentary lifestyle of Canadian children: report

Active play is disappearing from the lives of Canadian children, in part because of parents’ fear of letting kids play outdoors, according to a new report by Active Healthy Kids Canada.

In its annual report card released on Tuesday, Active Healthy Kids Canada gave a letter grade of F to both the physical activity levels and screen-based sedentary behaviours of today’s children and youth. According to the report, 46 per cent of Canadian kids get three hours or less of active play per week and spend nearly eight hours a day in front of screens.

3. More TV, Less Self-Esteem, Except for White Boys

Children’s self-esteem generally goes down as TV watching goes up. But white boys are the exception, according to a new study published in the journal Communications Research.

Researchers from Indiana University surveyed close to 400 boys and girls between the ages of 7 and 12, of whom 59 percent were black, and slightly less than half white, to see if there was a correlation between time spent in front of the TV and children’s self-esteem. They tallied the amount of TV watched and had the participants complete an 11-item questionnaire intended to measure overall feelings of self-worth.

The existing research on the impact of TV on children’s health has focused on body image and eating disorders, Nicole Martins, an assistant professor of telecommunications at Indiana University and co-author of the study, told ABCNews.com. Given that children spend more than seven hours a day with some sort of media (computers, TV, video games), examining the influence of media on how they feel about themselves seemed long overdue, she said.

The study authors said that while white male TV characters tend to hold positions of power in prestigious occupations, have a lot of education and beautiful wives, the TV roles of girls and women tend to be less positive and more one-dimensional. Female characters are often sexualized, and success is often measured according to how they look.

Black men and boys are often criminalized on TV, the researchers said, which can affect their feelings of self-worth.

According to the study, self-esteem has significant behavioral and emotional ramifications, and it is often correlated with motivation, persistence and academic achievement, particularly among children.

But Alan Kazdin, a professor of psychology and child psychiatry at Yale University, said self-esteem had not been found to relate causally to anything at all. While it can be one measure of clinical depression, that does not mean it characterizes or causes depression.

“As citizens, we think of self-esteem as very important,” said Kazdin. “But I deal with aggressive and violent children who have self-esteem that can be much higher than the average child. Yes, every parent wants their child to feel good about themselves, but high self-esteem is not an elixir to get you through life. It is not the protective factor we’d like it to be.”

Building confidence in children, and helping them gain skills and competencies that contribute to a better life, such as learning instruments, playing sports or sticking with a difficult school lesson, will help do that. If children do not have friends, setting up “light play dates” will help build socialization skills, a “really important aspect of life,” Kazdin said.

Martins suggested that parents limit TV time, and as Kazdin suggested, help their kids gain skills that will improve their lives.

“Too much time in front of the screen may displace real-life experiences, such as playing a musical instrument, playing ball in the backyard, that could build a child’s feeling of self-worth,” said Martins. “Another option would be to actively mediate children’s media use so that they can more easily understand fantasy from reality.

“Simple distinctions and conversations like this help mitigate the impact such an image might have on self-esteem and comparisons to media characters,” she said.

4. Map project shows third of Edmonton kids start school a step behind

A province wide analysis of young children shows nearly 32 per cent of kindergarten kids in Edmonton are experiencing “great difficulty in one or more areas of development,” compared with 27 per cent across Alberta and 25 per cent in Canada.

The problems are most pronounced when it comes to communication skills and general knowledge, where 33 per cent are struggling, according to initial results from the early child development mapping project (ECMap). As well, 29 per cent face problems with emotional maturity and 28 per cent with physical health and well-being, according to the Edmonton numbers posted this week. Twenty-five per cent have trouble with social competence and 21 per cent have trouble with thinking and language skills.

5. Can Michigan lead nation in early childhood education? Business leaders propose plan to help

Can Michigan become a leader in childhood development and education? Not on the track it’s on, according to officials. “If we’re serious about economic development in the state, and the role of government in investing in our future and supporting economic development, you cannot ignore early childhood (development),” said Paul Hillegonds, senior vice president corporate affairs at DTE Energy, this morning during a panel discussion for the Detroit Regional Chamber’s Mackinac Policy Conference.

6. Benefits of hypothermia for infants who experience oxygen deficiency at birth continue through early childhood

NIH study shows increased survival from treatment for oxygen deficiency at birth

A treatment to reduce the body temperatures of infants who experience oxygen deficiency at birth has benefits into early childhood, according to a follow-up study by a National Institutes of Health research network.

Children who received the hypothermia treatment as infants were more likely to have survived to ages 6 and 7, when they were evaluated again, than were children who received routine care, the study found. They were no more likely than the routine care group to experience a physical or cognitive impairment, it said. The report appears in the New England Journal of Medicine.

7. Fever During Pregnancy May Raise Odds for Autism in Offspring

Women who develop fevers while pregnant may be more than twice as likely to have a child with autism spectrum disorder or another developmental delay, a new study suggests.

Exactly how, or even if, fevers may increase the risk for autism is unknown, and experts were quick to say women should not panic if they do develop a fever while pregnant because taking fever-reducing medications cuts the risk.

8. Teen Pregnancy Rates in Mississippi Force Focus on Sex Ed

With her hair in a ponytail and her smile quick and wide, it's hard to tell that high school junior Donyell Hollins has been pulling all-nighters for most of the semester to take care of her infant daughter. Her situation isn't unusual in the small Delta town of Marks, but unlike teen mothers in previous decades, 18-year-old Hollins is benefiting from a change in attitude that's paving the way for frank discussions about parenting skills, career goals and contraception.

Instructors from the Delta Health Partners Healthy Start Initiative come to Hollins' high school monthly to teach lessons that incorporate some of the newest theories on the relationship between poverty and teen motherhood. It's a far cry from decades past, when women in Hollins' situation were given little guidance and often left to drop out and languish.

Part of the goal is to change patterns of communication about sex that have persisted for years.

II. RECENT REPORTS AND RESEARCH

9. Effects of interventions in pregnancy on maternal weight and obstetric outcomes: meta-analysis of randomised evidence

Objective

To evaluate the effects of dietary and lifestyle interventions in pregnancy on maternal and fetal weight and to quantify the effects of these interventions on obstetric outcomes.

Design

Systematic review and meta-analysis.

Data sources

Major databases from inception to January 2012 without language restrictions.

Study selection

Randomised controlled trials that evaluated any dietary or lifestyle interventions with potential to influence maternal weight during pregnancy and outcomes of pregnancy.

Data synthesis

Results summarised as relative risks for dichotomous data and mean differences for continuous data.

Results

We identified 44 relevant randomised controlled trials (7278 women) evaluating three categories of interventions: diet, physical activity, and a mixed approach. Overall, there was 1.42 kg reduction (95% confidence interval 0.95 to 1.89 kg) in gestational weight gain with any intervention compared with control. With all interventions combined, there were no significant differences in birth weight (mean difference −50 g, −100 to 0 g) and the incidence of large for gestational age (relative risk 0.85, 0.66 to 1.09) or small for gestational age (1.00, 0.78 to 1.28) babies between the groups, though by itself physical activity was associated with reduced birth weight (mean difference −60 g, −120 to −10 g). Interventions were associated with a reduced the risk of pre-eclampsia (0.74, 0.60 to 0.92) and shoulder dystocia (0.39, 0.22 to 0.70), with no significant effect on other critically important outcomes. Dietary intervention resulted in the largest reduction in maternal gestational weight gain (3.84 kg, 2.45 to 5.22 kg), with improved pregnancy outcomes compared with other interventions. The overall evidence rating was low to very low for important outcomes such as pre-eclampsia, gestational diabetes, gestational hypertension, and preterm delivery.

Conclusions

Dietary and lifestyle interventions in pregnancy can reduce maternal gestational weight gain and improve outcomes for both mother and baby. Among the interventions, those based on diet are the most effective and are associated with reductions in maternal gestational weight gain and improved obstetric outcomes.

10. The Distribution of Physical Activity in an After-school Friendship Network

New, effective approaches to obesity prevention are urgently needed. Social network interventions warrant our attention. Social networks play a significant role in adult and adolescent obesity. The role of social networks in pediatric obesity has not been examined.

Afterschool friendship ties play a critical role in setting physical activity patterns in children as young as 5 to 12 years. Children’s activity levels can be changed by the activity level of their social network during a 12-week afterschool program.

11. Developmental Status of 1-Year-Old Infants Fed Breast Milk, Cow’s Milk Formula, or Soy Formula

Abstract

Although soy protein–based infant formula is known to support physical growth equal to that of infants fed cow's milk–based formula, data are lacking on developmental status of infants fed soy formula compared with breast milk or milk formula.

Infants fed soy protein–based formula scored within normal limits on standardized developmental testing and did not differ from infants fed cow’s milk–based formula. Breastfed infants have a slight advantage on cognitive development compared with formula-fed infants.

12. Maternal antidepressant use and adverse outcomes: a cohort study of 228,876 pregnancies

Rachel M. Hayes, PhD, et al.

Objective

Describe antidepressant medication use patterns during pregnancy and pregnancy outcomes.

Study Design

Cohort of 228,876 singleton pregnancies covered by Tennessee Medicaid, 1995-2007.

Results

Of 23,280 pregnant women with antidepressant prescriptions prior to pregnancy, 75% filled none in the second or third trimesters of pregnancy and 10.7% used antidepressants throughout pregnancy. Filling 1, 2, and 3+ antidepressants during second trimester was associated with shortened gestational age by 1.7 (1.2- 2.3), 3.7 (2.8- 4.6), and 4.9 (3.9- 5.8) days, controlling for measured confounders. Third trimester selective serotonin reuptake inhibitor (SSRI) use was associated with infant convulsions; adjusted odds ratios were 1.4 (0.7-2.8); 2.8 (1.9- 5.5); and 4.9 (2.6-9.5) for filling 1, 2, and 3 prescriptions respectively.

Conclusions

Most women discontinue antidepressant medications prior or during the first trimester of pregnancy. Second trimester antidepressant use is associated with preterm birth, and third trimester SSRI use is associated with infant convulsions.

13. 2012 Active Healthy Kids Canada Report Card On Physical Activity For Children And Youth

"Active Healthy Kids Canada is the “go-to” source for knowledge, insight and understanding into the complex and multifaceted issue of child and youth physical activity. We collect, assess and synthesize the most current data and literature examining physical activity levels and the individual characteristics, influences and outcomes that affect those levels.... Disparities that exist in relation to individual characteristics, such as income, ability level, region, age and gender are considered, and affect the final grades. A child’s physical activity level affects outcomes such as mental health and body weight; in turn, these outcomes may affect a child’s overall levels of physical activity."

14. Fertility awareness and parenting attitudes among American male and female undergraduate university students

BACKGROUND

In the USA, the postponement of childbearing reflects contemporary social norms of delaying marriage, pursing educational goals and securing economic stability prior to attempting conception. Although university students are more likely to delay childbearing, it is unclear to what extent they are aware of age-related fertility decline. The current study is the first of its kind to assess fertility awareness and parenting attitudes of American undergraduate university students.

METHODS

Two-hundred forty-six randomly selected undergraduate university students (138 females and 108 males) completed an online self-report survey adapted from the Swedish Fertility Awareness Questionnaire. Students were evenly distributed between the freshman, sophomore, junior and senior classes with a mean age of 20.4 years.

RESULTS

Participants wanted to have their first and last child within the window of a woman's fertility. However, participants demonstrated a lack of fertility awareness by vastly overestimating the age at which women experience declines in fertility, the likelihood of pregnancy following unprotected intercourse and the chances that IVF treatments would be successful in the case of infertility. Nearly 9 in 10 participants want to have children in the future and viewed parenthood as a highly important aspect of their future lives.