2.50
Hdl Handle:
http://hdl.handle.net/10755/157309
Type:
Presentation
Title:
MATERNAL/NEWBORN STRESS AND INFANT GERD
Abstract:
MATERNAL/NEWBORN STRESS AND INFANT GERD
Conference Sponsor:Western Institute of Nursing
Conference Year:2010
Author:Neu, Madalynn, PhD, RN
P.I. Institution Name:University of Colorado Denver
Title:Assistant Professor
Contact Address:Mail Stop C288-18, 13120 E. 19th Avenue, Aurora, CO, 80045, USA
PURPOSE: The purpose of this study is to explore maternal and infant stress in relation to infant symptoms of gastroesophageal reflux (GER).

RATIONALE/CONCEPTUAL BASIS/BACKGROUND: GER is the passage of gastric contents into the esophagus due to transient relaxation of the lower esophageal sphincter (LES). Approximately 67% of infants at 4 months of age have GER due to immaturity of the esophagus and stomach, high liquid diet, and short esophagus. GER disease (GERD) is defined as complications of GER. Symptoms include frequent regurgitation, irritability, and feeding difficulties. Discomfort from regurgitation and irritability interferes with sleep and may result in increased infant stress. Infants with feeding difficulties may associate feeding with discomfort and become stressed when fed. Mothers with irritable infants who are difficult to feed have reported feeling frustrated, angry, and stressed. Individuals with chronic stress may display higher than normal levels of daily cortisol levels. Elevated cortisol levels also were reported in children with sleep disruption and after a stressor in adults who had GERD. Stress as a precursor and consequence of the GERD symptom cluster has not been studied.

METHODS: Secondary data analysis was conducted on a study that compared physiologic and behavioral outcomes of kangaroo and traditional holding in 87 mother-preterm infant dyads. Weekly home visits were conducted for 8 weeks. We collected data about GERD for 70 of the infants (80%) during the home visits. Infants were born at 32 to 35 weeks gestational age at 5 hospitals in a mid-sized city in the Western United States. Dyads were recruited within 3 weeks postpartum.

RESULTS: Mothers of 22 infants (31%) referred them to the pediatrician because of GERD symptoms. Pediatricians ordered anti-reflux medication for 14 of these infants (64%). Mothers reported that infants demonstrated only partial relief from these symptoms of GERD and complained of continued fatigue and worry. Mothers who referred their infants to the pediatrician had higher life event scores at week 8 of the study F (2,59) = 3.7, p = .030 than the other two groups, and higher anxiety scores within 3 weeks after birth than the group without GERD symptoms F (2,62) = 7.1, p = .05. A subset of 70 mothers collected salivary cortisol from their infants at 8AM, 12PM, 4PM, and 8PM for two consecutive days during week 8 of the study. Area under the curve (AUC) was calculated for aggregated daily cortisol levels for the 56 (80%) infants shoe GERD status was known. Infants seen by a pediatrician for GERD symptoms had higher daily cortisol levels than infants not referred to a pediatrician and infants without GERD symptoms F (2,51) = 7.75, p = .002.

IMPLICATIONS: Evidence of stress was found in the early postpartum period and 2 to 3 months postpartum in mothers who had infants with GERD symptoms and at 2-3 months in infants with
GERD symptoms. More research on the effects of the mother and infant stress on GERD symptoms will inform interventions addressing stress and alleviating GERD symptoms in infants.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleMATERNAL/NEWBORN STRESS AND INFANT GERDen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157309-
dc.description.abstract<table><tr><td colspan="2" class="item-title">MATERNAL/NEWBORN STRESS AND INFANT GERD</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Neu, Madalynn, PhD, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Colorado Denver</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">Mail Stop C288-18, 13120 E. 19th Avenue, Aurora, CO, 80045, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">madalynn.neu@ucdenver.edu</td></tr><tr><td colspan="2" class="item-abstract">PURPOSE: The purpose of this study is to explore maternal and infant stress in relation to infant symptoms of gastroesophageal reflux (GER). <br/><br/>RATIONALE/CONCEPTUAL BASIS/BACKGROUND: GER is the passage of gastric contents into the esophagus due to transient relaxation of the lower esophageal sphincter (LES). Approximately 67% of infants at 4 months of age have GER due to immaturity of the esophagus and stomach, high liquid diet, and short esophagus. GER disease (GERD) is defined as complications of GER. Symptoms include frequent regurgitation, irritability, and feeding difficulties. Discomfort from regurgitation and irritability interferes with sleep and may result in increased infant stress. Infants with feeding difficulties may associate feeding with discomfort and become stressed when fed. Mothers with irritable infants who are difficult to feed have reported feeling frustrated, angry, and stressed. Individuals with chronic stress may display higher than normal levels of daily cortisol levels. Elevated cortisol levels also were reported in children with sleep disruption and after a stressor in adults who had GERD. Stress as a precursor and consequence of the GERD symptom cluster has not been studied. <br/><br/>METHODS: Secondary data analysis was conducted on a study that compared physiologic and behavioral outcomes of kangaroo and traditional holding in 87 mother-preterm infant dyads. Weekly home visits were conducted for 8 weeks. We collected data about GERD for 70 of the infants (80%) during the home visits. Infants were born at 32 to 35 weeks gestational age at 5 hospitals in a mid-sized city in the Western United States. Dyads were recruited within 3 weeks postpartum.<br/><br/>RESULTS: Mothers of 22 infants (31%) referred them to the pediatrician because of GERD symptoms. Pediatricians ordered anti-reflux medication for 14 of these infants (64%). Mothers reported that infants demonstrated only partial relief from these symptoms of GERD and complained of continued fatigue and worry. Mothers who referred their infants to the pediatrician had higher life event scores at week 8 of the study F (2,59) = 3.7, p = .030 than the other two groups, and higher anxiety scores within 3 weeks after birth than the group without GERD symptoms F (2,62) = 7.1, p = .05. A subset of 70 mothers collected salivary cortisol from their infants at 8AM, 12PM, 4PM, and 8PM for two consecutive days during week 8 of the study. Area under the curve (AUC) was calculated for aggregated daily cortisol levels for the 56 (80%) infants shoe GERD status was known. Infants seen by a pediatrician for GERD symptoms had higher daily cortisol levels than infants not referred to a pediatrician and infants without GERD symptoms F (2,51) = 7.75, p = .002. <br/><br/>IMPLICATIONS: Evidence of stress was found in the early postpartum period and 2 to 3 months postpartum in mothers who had infants with GERD symptoms and at 2-3 months in infants with <br/>GERD symptoms. More research on the effects of the mother and infant stress on GERD symptoms will inform interventions addressing stress and alleviating GERD symptoms in infants.<br/></td></tr></table>en_GB
dc.date.available2011-10-26T19:45:22Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T19:45:22Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.