Early human development最新文献

{"title":"Fetal bilateral hyperechogenic kidneys: Prenatal progression and long-term postnatal outcome","authors":"Kavyesh Vivek ,&nbsp;Sandra Subtil ,&nbsp;Elisabetta Sanna ,&nbsp;Francois Dos Santos ,&nbsp;Iris Derwig ,&nbsp;Christoph Lees ,&nbsp;Marie-Klaire Farrugia","doi":"10.1016/j.earlhumdev.2025.106222","DOIUrl":"10.1016/j.earlhumdev.2025.106222","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the prenatal progression and long-term outcome of fetal bilateral hyperechogenic kidneys (HK).</div></div><div><h3>Design</h3><div>Retrospective study 2005–2016. Fetal/maternal demographics, scan findings, postnatal diagnoses and outcomes were collected from electronic patient records and post-mortem reports.</div></div><div><h3>Results</h3><div>Data available for 65 out of 72 fetuses with bilateral HK. Forty-five (69 %) had normal amniotic fluid index (AFI); of these, 23 had isolated HK and all survived the neonatal period. The remaining patients with normal AFI had other renal and multi-system anomalies; diagnoses included 13 trisomies and genetic syndromes — only one patient with suspected bladder outlet obstruction survived. Of 20 pregnancies with reduced AFI, HK were isolated in 5 fetuses, and only one survived (diagnosed with 17q12 microdeletion). The remaining 15 fetuses had multisystem anomalies and none survived; diagnoses included Meckel-Gruber Syndrome and Dandy-Walker malformation. Survival with bilateral HK and oligohydramnios was 5 %. Overall survival was 25/65 (38 %); follow-up data was available for 23 patients. HK resolved in 17 (74 %) and persisted in 6 children, who were followed-up for median 15 years (4–19 years). Of these, 3 patients developed bilateral renal cysts and were diagnosed with HNF1b/17q12 deletion kidney disease (one patient is in CKD2a, whereas the rest have normal renal function). The remaining patients were found to have a PKD1 variant; bilateral renal cysts (lost to follow-up before a genetic diagnosis) and a unilateral hydronephrosis: all have normal renal function.</div></div><div><h3>Conclusion</h3><div>Isolated HK with normal AFI is associated with survival past the neonatal period and normal renal function in most cases (96 %). As normal kidney function may be due to glomerular hyperfiltration in early childhood to teenage years, long-term follow up is advisable, in particular for those with a genetic diagnosis that predisposes to chronic renal impairment in adulthood (HNF1b, 17q12 deletion in this study). HK in the presence of reduced AFI carries a poor prognosis, with only 5 % survival (this patient had 17q12 deletion related kidney disease). Overall survival in this study was 38 % in the first year and 34 % long-term.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"202 ","pages":"Article 106222"},"PeriodicalIF":2.2,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143463461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes from an enhanced developmental screening programme in Singapore","authors":"Sita Padmini Yeleswarapu ,&nbsp;Chui Mae Wong ,&nbsp;Yoke Hwee Chan ,&nbsp;Lourdes Mary Daniel ,&nbsp;Olivia Xia Jiawen ,&nbsp;David Chee Chin Ng ,&nbsp;Xiaoxuan Guo ,&nbsp;Ratnaporn Siriamornsarp ,&nbsp;Pratibha Keshav Agarwal","doi":"10.1016/j.earlhumdev.2025.106220","DOIUrl":"10.1016/j.earlhumdev.2025.106220","url":null,"abstract":"<div><h3>Introduction</h3><div>Historically, low referral rates of 3–4 % have been reported from Singapore primary health care. Early identification of and intervention for developmental delays and autism enable achievement of optimal outcomes. An enhanced developmental screening (EDS) programme was introduced in primary care to improve identification of developmental delays and autism for children aged 18 and 30 months. This study evaluated prevalence of positive screening for developmental delays/autism at 18 months, identified associated socio-demographic risk factors and studied the correlation between primary care screening tools with outcomes following tertiary care assessments.</div></div><div><h3>Methods</h3><div>In primary care, EDS was conducted using Parents' Evaluation of Developmental Status (PEDS), Parents' Evaluation of Developmental Status: Developmental Milestones (PEDS:DM), Ages &amp; Stages Questionnaires-Third Edition (ASQ-3) and Modified Checklist for Autism in Toddlers, Revised - Follow-Up (M-CHATR/F) along with collection of socio-demographic data. Tertiary care assessment included Developmental Profile-3 (DP-3) screening and, a developmental paediatrician consultation.</div></div><div><h3>Results</h3><div>Of 4212 children screened at 18 months, 14 % screened positive for developmental delays and 2 % for autism at primary care. Lower maternal education, ethnic minority status and lower socioeconomic status were associated with a positive screen. Moderate- strong correlation was seen between the ASQ-3 gross motor domain and DP-3 physical domain, moderate correlation between the communication domains of the 2 tools and the ASQ-3 personal-social domain with DP-3 adaptive domain.</div></div><div><h3>Conclusion</h3><div>EDS enabled improved identification of children for developmental delays/autism. Identification of socio-demographic risk factors will enable children from such families to be identified early and referred for intervention.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"202 ","pages":"Article 106220"},"PeriodicalIF":2.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143480516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac function and neurological development in complicated monochorionic pregnancies: Current evidence and clinical implications","authors":"Miriam Lopian ,&nbsp;Asma Khalil","doi":"10.1016/j.earlhumdev.2025.106221","DOIUrl":"10.1016/j.earlhumdev.2025.106221","url":null,"abstract":"<div><div>Monochorionic twin pregnancies, characterized by a shared placenta and unique vascular architecture, face significantly elevated risks of perinatal complications compared to dichorionic and singleton pregnancies. This review examines the pathophysiology, cardiovascular, and neurological adaptations in three primary complications of monochorionic pregnancies: Twin-to-Twin Transfusion Syndrome (TTTS), Selective Fetal Growth Restriction (sFGR), and Twin Anemia Polycythemia Sequence (TAPS).</div><div>TTTS disrupts hemodynamic balance, leading to distinct cardiac dysfunctions and increased neurodevelopmental injury (NDI). In sFGR, unequal placental sharing induces cardiovascular and neurological disparities between twins, while TAPS causes chronic anaemia and polycythemia with associated risks of brain injury. Advances in fetal therapy, such as fetoscopic laser surgery, have significantly improved survival, yet long-term sequelae remain concerning.</div><div>This review emphasizes the importance of specialised prenatal care, multidisciplinary management, and comprehensive postnatal follow-up to mitigate adverse outcomes.</div><div>The findings call for further research into the mechanisms of fetal adaptation and injury, aiming to refine diagnostic tools and therapeutic strategies.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"202 ","pages":"Article 106221"},"PeriodicalIF":2.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143421826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Key factors in parental end-of-life decision making for surgical necrotizing enterocolitis: A Delphi study","authors":"Rosa Verhoeven ,&nbsp;Elisabeth M.W. Kooi ,&nbsp;Sylvia A. Obermann-Borst ,&nbsp;Nanon H.M. Labrie ,&nbsp;Rosa Geurtzen ,&nbsp;A.A. Eduard Verhagen ,&nbsp;Jan B.F. Hulscher","doi":"10.1016/j.earlhumdev.2025.106219","DOIUrl":"10.1016/j.earlhumdev.2025.106219","url":null,"abstract":"<div><h3>Background/objectives</h3><div>In severe cases of necrotizing enterocolitis (NEC) in preterm neonates, surgery may be the only option for survival. However, the consequences of active treatment are not always in the infant's best interest, urging parents and physicians to consider palliative care as an alternative. This study aims to identify key factors parents prioritize when making this decision, as a preliminary step towards developing a decision support tool.</div></div><div><h3>Methods</h3><div>Three Dutch parent panels (without experience with NEC/preterm birth, with experience but without loss, and with loss due to NEC/preterm birth) were asked to rate 31 literature-based and self-suggested decision factors. Factors were rated on a scale of 1 to 9 in a two-round Delphi study. Factors that reached a median score of six or higher by one or more panels after the second Delphi round were discussed in a consensus meeting of the steering committee.</div></div><div><h3>Results</h3><div>Sixty-six participants completed both Delphi rounds. Nine factors were excluded after the final round, including parental physical and mental health, finances, and religion. Of the other 22 factors, the steering committee decided upon 15 key factors to serve as a base for the decision support tool. Most important factors included chance of death, short- and long-term physical consequences, and future independence. Additionally, parents were influenced by doctors' opinions and feelings of responsibility and hope.</div></div><div><h3>Conclusion</h3><div>This study highlights fifteen decision factors for Dutch parents facing surgical NEC. These insights will inform the development of a decision support tool aiding parents in making informed end-of-life decisions.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"203 ","pages":"Article 106219"},"PeriodicalIF":2.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143521249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Worldwide prevalence and disability from preterm-associated developmental intellectual disability during childhood and adolescence","authors":"Fang Wang ,&nbsp;Kun Feng","doi":"10.1016/j.earlhumdev.2025.106218","DOIUrl":"10.1016/j.earlhumdev.2025.106218","url":null,"abstract":"<div><h3>Objective</h3><div>To comprehensively assess the prevalence and years lived with disability (YLDs) of preterm-associated developmental intellectual disability (PDID) in children and adolescents born preterm (CABP) from 1990 to 2021.</div></div><div><h3>Method</h3><div>Using data from the Global Burden of Disease 2021, the burden of PDID in CABP (0–19 years) at global, regional and national levels was assessed by joinpoint regression, age-period-cohort (A-P-C) analysis, and cross-country health inequality analysis.</div></div><div><h3>Results</h3><div>Globally, there were 12,114,153 prevalent cases and 915,937 YLDs of PDID in CABP in 2021, with much higher values in males than in females. Moreover, the prevalent cases and YLDs demonstrated significant increasing trends, whereas only the age-standardized rate of prevalence showed a slight decline from 1990 to 2021 worldwide, with a slight increase in the proportion of severe cases. The age subgroup analysis showed a significant reduction in the burden of PDID in children aged &lt;5 years. The A-P-C analysis found that, in contrast to middle to high-sociodemographic index (SDI) regions, the risk of PDID was highest in children aged &lt;5 years, and that period and cohort effects were unfavourable in low-SDI regions. The results of cross-country health inequality analysis showed that the burden of PDID in CABP was concentrated in low-SDI countries, while SDI-related inequalities generally decreased between 1990 and 2021.</div></div><div><h3>Conclusion</h3><div>Overall, the global burden of PDID in CABP has increased from 1990 to 2021, while the burden in children under 5 years of age has decreased globally. Despite reduced health inequalities, low-SDI regions still bear a significant burden.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"202 ","pages":"Article 106218"},"PeriodicalIF":2.2,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143379346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lending a helping hand to preterm infants: Randomized controlled trial of the impact of ‘sticky mittens’ on exploratory behavior and later development","authors":"Ruth M. Ford ,&nbsp;Manuela Stets ,&nbsp;Sarah Redsell ,&nbsp;Angela D'Amore ,&nbsp;Samantha Johnson","doi":"10.1016/j.earlhumdev.2025.106215","DOIUrl":"10.1016/j.earlhumdev.2025.106215","url":null,"abstract":"<div><div>Research with 3-month-old infants from the general population has shown benefits to their exploratory behavior from play involving ‘sticky mittens’. Sticky mittens are Velcro-covered mittens that are used with Velcro-covered toys to enable pre-reaching infants to grab and move toys simply by swatting at them. Our randomized controlled trial examined whether sticky mittens play, supervised by parents in the home environment, could similarly improve the exploratory behavior and later development of preterm infants. Participants (<em>N</em> = 62, 25–33 weeks of gestation) were recruited at 3 months of age corrected for prematurity and assigned randomly to either an intervention or active control group. For up to 5–10 min per day for three weeks, the intervention group used sticky mittens regularly while the control group instead watched their caregiver move the toys. Object-oriented exploratory behavior was evaluated immediately before and after the intervention, and caregivers completed questionnaires about their infant's development until 15 months' corrected age. Results showed that the intervention group made significantly greater gains than the control group in mouthing, <em>F</em> = 9.24, <em>p</em> = .004, η_p² = 0.13, and bimanual exploration of the toys at or near the mouth, <em>F</em> = 8.07, <em>p</em> = .006, η_p² = 0.12. However, the groups showed equivalent development over the next year as gauged by parent-report questionnaires <em>p</em>'s &gt; 0.05. While the sticky mittens intervention has immediate benefits for preterm infants' exploratory behavior, more research is needed before conclusions can be drawn regarding the longer-term impact on their development.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"202 ","pages":"Article 106215"},"PeriodicalIF":2.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143349206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extra-uterine placental transfusion and intact-cord stabilisation of moderately preterm to term infants in caesarean deliveries - A feasibility study with historical control (INTACT-2)","authors":"Elisabeth Sæther ,&nbsp;Ola Andersson ,&nbsp;Tor Åge Myklebust ,&nbsp;Solveig Bjellmo ,&nbsp;Stine Bernitz ,&nbsp;Solhild Stridsklev ,&nbsp;Beate Horsberg Eriksen","doi":"10.1016/j.earlhumdev.2025.106208","DOIUrl":"10.1016/j.earlhumdev.2025.106208","url":null,"abstract":"<div><div>Background: Although delayed umbilical cord clamping (DCC) is universally recommended, implementation has been difficult in caesarean deliveries. The study objective was to test if extra-uterine placental transfusion (delivering the placenta before cord clamping) to facilitate intact-cord stabilisation could be a feasible and safe alternative to DCC (≥ 1 min) for moderately preterm to term infants with caesarean delivery in regional anaesthesia and their mothers. Methods: This feasibility study included infants with GA 32⁰ to 42³ weeks with planned or emergency caesarean delivery. Primary outcome was intervention compliance. Safety outcomes were prevalence of blood loss ≥1000 ml or postoperative wound infection in mothers, and prevalence of early cord clamping (ECC), low 5-min Apgar scores and hypothermia in infants. Results: We included 123 mother-infant pairs in the intervention group and 158 in the historical control group. The intervention was successfully completed in 121 of 123 cases. There were no statistically significant differences in maternal outcomes. Significantly less infants in the intervention group had ECC before 60 s (OR 0.07, CI (0.01–0.51), <em>P</em> = 0.009) and 5-min Apgar scores &lt;7 (<em>P</em> = 0.003) compared to historical controls. There was no significant difference in infant hypothermia. Conclusion: Extra-uterine placental transfusion may be a reasonable alternative to DCC for term and near term preterm infants with caesarean delivery in regional anaesthesia. The intervention may be especially useful in low-income birth settings with high prevalence of iron deficiency/anaemia and no mobile resuscitation equipment.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"202 ","pages":"Article 106208"},"PeriodicalIF":2.2,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143377797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical validation of an abridged AIMS: Streamlining motor screening in the first-year infant","authors":"Teresa Fair-Field ,&nbsp;Bharath Modayur","doi":"10.1016/j.earlhumdev.2025.106207","DOIUrl":"10.1016/j.earlhumdev.2025.106207","url":null,"abstract":"<div><div>This study validates an abridged version of the Alberta Infant Motor Scale (AIMS), termed the “salient set,” to streamline infant screening using video analysis and machine learning. Twenty-one retrospective infant videos were manually tagged by trained occupational therapists using only the 15-item salient set with support vector regressors (SVRs) trained on a larger sample (<em>n</em> = 102) predicting the true (full) AIMS score. The SVR demonstrated strong concurrent validity of the salient set with the full 58-item AIMS (Pearson correlation: 0.99). The abridged set showed high screening sensitivity (1.0) and specificity (0.895), while reducing evaluation time by 67 %. The salient set offers a useful contribution to machine learning by detecting an abridged set of items while still accurately and appropriately identifying infants for EI referral.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"202 ","pages":"Article 106207"},"PeriodicalIF":2.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143133518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early postnatal transitional circulation in fetal growth restricted neonates","authors":"Lisa Bjarkø ,&nbsp;Drude Fugelseth ,&nbsp;Guttorm Haugen ,&nbsp;Eirik Nestaas","doi":"10.1016/j.earlhumdev.2024.106170","DOIUrl":"10.1016/j.earlhumdev.2024.106170","url":null,"abstract":"<div><h3>Background</h3><div>Fetal growth restriction (FGR) may impact early postnatal transitional circulation.</div></div><div><h3>Aim</h3><div>Echocardiographic assessment of left ventricular cardiac output, superior vena cava (SVC) and ductus venosus (DV) blood flow in FGR neonates first three days after birth.</div></div><div><h3>Study design</h3><div>Prospective observational study.</div></div><div><h3>Subjects</h3><div>FGR and Non-FGR neonates.</div></div><div><h3>Outcome measures</h3><div>Left ventricular cardiac output, SVC and DV blood flow day one, two, and three.</div></div><div><h3>Results</h3><div>Adjusting for gestational age (GA), birth weight, sex, and twin/singleton, flow measurements were similar between Late-FGR (GA ≥ 32 weeks, <em>n</em> = 23) and Non-FGR (GA ≥ 32 weeks, <em>n</em> = 39). On day three, Late-FGR had significantly lower left ventricular stroke volume (Estimated Marginal Means (Standard Error) 0.99 (0.08) vs 1.22 (0.06) mL/kg, <em>p</em> = 0.027) and higher heart rate (134 (5) vs 119 (4) beats/min, <em>p</em> = 0.032). Left ventricular cardiac output and left ventricular stroke volume decreased significantly from day one to three in both groups; Late-FGR 170 (8) to 149 (8) mL/min/kg, <em>p</em> = 0.007, and 1.34 (0.07) to 1.17 (0.07) mL/kg, <em>p</em> = 0.015, and Non-FGR 161 (6) to 144 (6) mL/min/kg, <em>p</em> = 0.002, and 1.27 (0.06) to 1.16 (0.06) mL/kg, <em>p</em> = 0.021. SVC flow remained unchanged from day one to three in Late-FGR (92 (6) to 83 (6) mL/min/kg, <em>p</em> = 0.161) and decreased significantly in Non-FGR (83 (5) to 71 (5) mL/min/kg, <em>p</em> = 0.021). DV blood flow remained unchanged. No measurements differed between Early-FGR (GA 30⁺⁰–31⁺⁶ weeks) and Late-FGR.</div></div><div><h3>Conclusions</h3><div>Late-FGR had limited impact on left ventricular cardiac output, SVC and DV blood flow in early neonatal period. Most adaptive circulatory changes occurred early during transition.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"201 ","pages":"Article 106170"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does paced bottle-feeding improve the quality and outcome of bottle-feeding interactions?","authors":"Alison K. Ventura ,&nbsp;Vivian M. Drewelow ,&nbsp;Taylor N. Richardson","doi":"10.1016/j.earlhumdev.2024.106181","DOIUrl":"10.1016/j.earlhumdev.2024.106181","url":null,"abstract":"<div><h3>Background</h3><div>Responsive feeding is recommended and occurs when caregivers use infants' behavioral cues to guide the timing, pacing, and duration of feeding. Paced bottle-feeding is an approach designed to promote responsive bottle-feeding by mimicking the behavioral benefits of breastfeeding. This study evaluates the efficacy of paced bottle-feeding compared to typical bottle-feeding and breastfeeding for promoting responsive feeding and other markers of healthy feeding outcomes, such as slower feeding rates and lower likelihood of spitting up.</div></div><div><h3>Methods</h3><div>This within-subject, experimental study involved 29 mothers and their typically developing full-term infants. Participants were observed during three feeding conditions: <em>Breastfeeding</em>, <em>Typical bottle-feeding</em>, and <em>Paced bottle-feeding</em>. Each feeding session was video-recorded and coded using the Nursing Child Assessment Caregiver-Child Interaction Feeding Scale. Outcome measures included maternal sensitivity to infant cues, infant clarity of cues, infant milk intake, meal duration, and feeding rate. Mixed linear models were used for data analysis.</div></div><div><h3>Results</h3><div>Maternal sensitivity to infant cues and infant clarity of cues were similar between paced bottle-feeding and typical bottle-feeding but lower than breastfeeding. Paced bottle-feeding led to significantly longer feeding durations and slower feeding rates than typical bottle-feeding, with no significant differences in milk intake. Infant clarity of cues moderated impacts of feeding condition on maternal sensitivity to infant cues; when infants exhibited lower clarity of cues, maternal sensitivity to infant cues was lowest during typical bottle-feeding compared to paced bottle-feeding and breastfeeding.</div></div><div><h3>Conclusions</h3><div>Paced bottle-feeding effectively slowed feeding rates and extended meal durations. Paced bottle-feeding was also associated with greater maternal sensitivity to infant cues compared to typical bottle-feeding when infants had lower clarity of cues. These findings provide preliminary evidence of the potential for paced bottle-feeding to promote responsive feeding.</div></div>","PeriodicalId":11435,"journal":{"name":"Early human development","volume":"201 ","pages":"Article 106181"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}