Predictors of accurate maternal perception of their preschool child's weight status among Hispanic WIC participants

Childhood obesity is a growing problem in the United States. Parental perception of their children's weight status is a key factor that needs to be considered when developing prevention programs for preschool children. Using a randomly selected sample of participants of Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Los Angeles County, we assessed accuracy of maternal perceptions of their children's weight status by comparing children's weight classification to the mothers' response to the question “Do you consider your child to be overweight, underweight or about right weight for (his) (her) height?” Additionally, we identified possible predictors of accurate maternal perception of their children's weight status by conducting a logistic regression model with child's gender, child's birth weight, maternal age, maternal BMI, maternal education, maternal acculturation level, and maternal language preference as potential predictors. Almost all mothers in the study classified their overweight or obese child as being about the right weight (93.6% and 77.5% of mothers, respectively). Maternal BMI and child's birth weight were the only predictors of maternal perception of their child's weight. Both were negatively associated with accuracy, with higher maternal BMI and higher infant birthweight associated with less accurate maternal perception of child weight. Parents need to be educated on the importance of childhood obesity and how to identify if their children are overweight or obese. If parents fail to recognize that their overweight child is overweight, then it is unlikely that they will recognize that interventions targeting obesity are relevant to their families.     

Psychological effects of false-positive results in expanded newborn screening in China

Objectives

As more families participate expanded newborn screening for metabolic disorders in China, the overall number of false positives increases. Our goal was to assess the potential impact on parental stress, perceptions of the child''s health, and family relationships.

Methods

Parents of 49 infants with false-positive screening results for metabolic disorders in the expanded newborn screening panel were compared with parents of 42 children with normal screening results. Parents first completed structured interview using likert scales, closed and open questions. Parents also completed the parenting stress index.

Results

A total of 88 mothers and 41 fathers were interviewed. More mothers in the false-positive group reported that their children required extra parental care (21%), compared with 5% of mothers in the normal-screened group (P<0.001). 39% of mothers in the false-positive group reported that they worry about their child''s future development, compared with 10% of mothers in the normal-screened group (P<0.001). Fathers in the false-positive group did not differ from fathers in the normal-screened group in reporting worry about their child''s extra care requirements, and their child''s future development. Children with false-positive results compared with children with normal results were triple as likely to experience hospitalization (27%vs 9%, respectively; P<0.001).

Conclusions

The results showing false-positive screening results may affect parental stress and the parent-child relationship. Parental stress and anxiety can be reduced with improved education and communication to parents about false-positive results.     

Complicating the triangle of race,class and state: the insights of black feminists

This article complicates Wacquant's three-sided schema of race, class and state by adding a focus on gender, the experiences of black women, and a black feminist intersectional analysis. Welfare retrenchment in the USA relied on stereotypes of black women, especially the ‘Welfare Queen’, that were at once sexist and racist and implemented policies targeted specifically at them as the vilified beneficiaries of state largess. Attributing social inequality to black women's childbearing furthers race, gender and class oppression in the context of neo-liberalism by legitimizing intensified deprivation and surveillance. A focus on the regulation of black mothers brings to the fore the child welfare system as a critical institution of social supervision, on a par with workfare and prisonfare. A black feminist analysis of the intersection of welfare, prison and foster care in the systemic punishment of black mothers and of strategies for resistance illuminates how racism and neo-liberalism operate together in the USA.     

Strategic citizens of America: transnational inequalities and transformation of citizenship

This article analyses the process whereby ‘natural' citizens of one country mobilize their resources so that their children receive by birthright, the citizenship of a rich liberal democracy. Utilizing the case of Turkish upper classes, who give birth in the USA in order to benefit from the jus soli principle, we trace the emergence of new inequalities at the intersection of multiple citizenship regimes. We show that, by mobilizing resources in markets of health care, travel, and real estate, those with means can acquire US citizenship for their children in expectation of future benefits. Because they are able to access ‘valuable' citizenships, these actors can strategically combine privileges within nation states with inequalities between citizenship regimes at the global level for the children. Their differential access to citizenship enhances the gate-keeping functions of citizenship. Based on these observations, we draw an analogy between citizenship and property regimes, understood broadly.     

The child's best interest in gamete donation

Procreation with donor gametes is widespread and commonly accepted, but it involves ethical questions about the child's best interest. Understanding the historical structures of the moral discussion of gamete donation may contribute to reflecting on the child's best interest. This is why I have analysed the debate on gamete donation in the Netherlands, and this analysis has uncovered some striking discontinuities. Notions of the child's best interest have undergone a radical swing. In the past, it was considered acceptable to conceal the truth about the child's biological origin, but in the past two decades the general opinion has changed to the common belief that this information should be shared with the child. This changed notion of the child's best interest will be analysed using a framework encompassing three views of the child, which derive from the debate on children's rights. These three views each provide a different interpretation of the child's moral and political status. I conclude that the changed notion of the child's best interest results from a view of the child that focuses on autonomy and citizenship, and which frames the child's interests according to its legal status. I comment on this view and I champion an alternative one, namely ‘the embedded child’. This is a relational view based on care ethics that goes beyond what can be articulated in law, and that will help to establish a more balanced interpretation of the child's best interest at the practice and policy levels of gamete donation.     

Maternal short stature does not predict their children's fatness indicators in a nutritional dual‐burden sample of urban Mexican Maya

The co‐existence of very short stature due to poor chronic environment in early life and obesity is becoming a public health concern in rapidly transitioning populations with high levels of poverty. Individuals who have very short stature seem to be at an increased risk of obesity in times of relative caloric abundance. Increasing evidence shows that an individual is influenced by exposures in previous generations. This study assesses whether maternal poor early life environment predicts her child's adiposity using cross sectional design on Maya schoolchildren aged 7–9 and their mothers (n = 57 pairs). We compared maternal chronic early life environment (stature) with her child's adiposity (body mass index [BMI] z‐score, waist circumference z‐score, and percentage body fat) using multiple linear regression, controlling for the child's own environmental exposures (household sanitation and maternal parity). The research was performed in the south of Merida, Yucatan, Mexico, a low socioeconomic urban area in an upper middle income country. The Maya mothers were very short, with a mean stature of 147 cm. The children had fairly high adiposity levels, with BMI and waist circumference z‐scores above the reference median. Maternal stature did not significantly predict any child adiposity indicator. There does not appear to be an intergenerational component of maternal early life chronic under‐nutrition on her child's obesity risk within this free living population living in poverty. These results suggest that the co‐existence of very short stature and obesity appears to be primarily due to exposures and experiences within a generation rather than across generations. Am J Phys Anthropol 153:627–634, 2014. © 2013 Wiley Periodicals, Inc.     

Place,scale and the racial claims made for multiracial children in the 1990 US Census

Multiracial children embody ambiguities inherent in racial categorization and expose fictions of discrete races. Nevertheless, parents of multiracial children were asked for the 1990 US Census to report a single race for their offspring. Using confidential 1990 Census micro-data, we investigate the choices parents made for the three most common racially mixed household types (Asian-white, black-white and Latino-white) in twelve large metropolitan areas. We find that context affects the reporting of children's racial identity. We examine these effects with models that incorporate three spatial scales: households, neighbourhoods and metropolitan areas. Model estimates reveal that racial claims made by parents of Latino- and Asian-white (but not black-white) children varied significantly across metropolitan area. A neighbourhood's proportion white increased the probability that parents reported their children as white, while a neighbourhood's racial diversity increased the probability that black-white parents claimed a non-white race (black or ‘other’) for their children.     

Complexities in Research on Fathering: Illustrations from the Tufts Study of Young Fathers

Theory and research suggest that the transition to parenthood is a major life transition, and that adaptation to the parenting role is influenced by a complex set of factors, including the relationship with the child's mother, family of origin, and how the father is situated within sociocultural contexts. The father–]mother relationship is particularly important for men making the transition to fatherhood. This study examined patterns of fathering among young fathers (15–24 years) and investigated how fathers' relationships with the mothers of their young children (infants and toddlers) were related to fathering. In general, higher quality father–mother relationships were related to greater father involvement with children; when mothers were perceived as barriers to involved fathering fathers also had less accurate and adaptive parenting knowledge, attitudes, and behavior. Person-centered analyses revealed quite complex relations between father–mother relationships and father–child interaction. One pattern showed strong positive father–mother relationships associated with a disengaged pattern of father–child interaction, while another pattern showed sensitive and positive father–child engagement in the context of negative or distant father–mother relationships. Four patterns of association between fathering and mother–father relationships were demonstrated. Results highlight the complexity of understanding fathering and family relationships among young fathers.     

Maternal and paternal controlling feeding practices: reliability and relationships with BMI

Objective: This study aimed to examine the interrelationships between mothers' and fathers' reports on the child‐feeding questionnaire (CFQ), the BMI of parents and their children, and observations of parents' controlling feeding practices at mealtimes. Methods and Procedures: Twenty‐three mothers and twenty‐three fathers of children aged between 18 and 67 months reported on their child‐feeding practices, on their child's height and weight, and were observed during a normal family mealtime at home. Results: No associations were found between mothers' reported and observed feeding practices. Fathers' reported pressure to eat and restriction were associated with more controlling observed mealtime feeding practices. Mothers and fathers did not significantly differ in their reported or observed child‐feeding practices. Children's BMI was not related to maternal or paternal reported or observed feeding practices. More mealtime pressure was observed in parents with a higher BMI. Discussion: Fathers' self‐reports of their mealtime practices are reliable. Mothers' feeding practices may differ when fathers are present and further work should examine mothers at mealtimes with and without fathers. Although children's BMI was not related to parents' use of reported or observed control, parents with a higher BMI were more controlling, highlighting the importance of considering parents' own weight in future studies.     

Parental attitudes toward pediatric organ donation: a survey.

We conducted a telephone survey of parents in the National Capital Region to assess their intention to donate their child''s organs and to provide physicians with information that could help alleviate their concerns about approaching parents for consent. Of 339 parents who agreed to answer questions after being given details of their child''s "death" 288 (85%) said that they would be willing to donate their child''s organs. The degree of willingness was associated with the certainty of death, altruism and empathy toward children in need of an organ, previous discussion of organ donation with a family member and knowledge of an adolescent or adult child''s attitude toward donation. Factors that inhibited the intention to donate included uncertainty of death, insufficient information from medical professionals and fear of multilation. The child''s age was not significantly associated with intention to donate. Concordance between the results and actual donation rates in Canada and the United States supports the generalizability of the survey findings.     

Cultural Identity and Internationally Adopted Children: Qualitative Approach to Parental Representations

Approximately 30 000 children are adopted across national borders each year. A review of the literature on the cultural belonging of these internationally adopted children shows substantial differences between the literature from English-speaking countries and that from France and Europe in general. The objective of this study is to start from the discourse of French adoptive parents to explore their representations of their child''s cultural belonging and their positions (their thoughts and representations) concerning connections with the child''s country of birth and its culture. The study includes 51 French parents who adopted one or more children internationally. Each parent participated in a semi-structured interview, focused on the adoption procedure and their current associations with the child''s birth country. The interviews were analyzed according to a qualitative phenomenological method, Interpretative Phenomenological Analysis. The principal themes that emerged from our analysis of the interviews made it possible to classify the parents into three different groups. The first group maintained no association with the child''s country of birth and refused any multiplicity of cultural identities. The second group actively maintained regular associations with the child''s country of birth and culture and affirmed that their family was multicultural. Finally, the third group adapted their associations with the child''s birth country and its culture according to the child''s questions and interests. Exploring parental representations of the adopted child enables professionals involved in adoption to provide better support to these families and to do preventive work at the level of family interactions.     

Family networks in prenatal and postnatal health

Abstract

This paper examines the effects of kin access on prenatal health practices, birth outcome, and postnatal health practice for infants born to black and white mothers ages 21 to 28 in the U.S. during 1984–86. The data used for this research were compiled from three sources: (1) The National Longitudinal Survey of Youth; (2) The Children of the National Longitudinal Survey of Youth; (3) special kin access data files, which were created specifically for this study. Logistic regression procedures are used to assess the effects of kin proximity, maternal grandmother proximity, and presence of the child's father on health practices (N = 1,030) and birth outcome (N = 1,385), controlling for the mother's educational attainment, work experience, poverty, presence of the child's father, and birth order of the child. We find no evidence supporting the notion that kin access positively affects the prenatal and postnatal health practices of young mothers. The results suggest that young mothers who reside with their mothers or other adult kin, and those who are in close proximity to them, are no more likely to seek prenatal care during the first trimester, or to avoid smoking or drinking during pregnancy. Mothers who live with a sexual partner or husband are, however, somewhat more likely to seek prenatal care and to avoid alcohol use during pregnancy. Closer kin access is associated with a lower probability of breastfeeding. These results suggest that it will not be adequate to rely on kin networks or kin assistance to improve the prospect of healthy birth outcomes.     

Bioethics for clinicians: 9. Involving children in medical decisions

Medical decisions involving children raise particular ethical issues for physicians and other members of the health care team. Although parents and physicians have traditionally made most medical decisions on behalf of children, the developing autonomy of children is increasingly being recognized in medical decision-making. This poses a challenge for physicians, who must work with the child''s family and with other health care practitioners to determine the child''s role in decision-making. A family-centred approach respects the complex nature of parent-child relationships, the dependence and vulnerability of the child and the child''s developing capacity for decision-making.     

Diurnal testosterone variability is differentially associated with parenting quality in mothers and fathers

Previous studies on the relation between testosterone (T) levels and parenting have found ample evidence for the challenge hypothesis, demonstrating that high T levels inhibit parental involvement and that becoming a parent is related to a decrease in T levels in both mothers and fathers. However, less is known about the relation between T levels and more qualitative aspects of parenting. In the current study we examined basal T levels and diurnal variability in T levels in relation to mothers' and fathers' parenting quality. Participants included 217 fathers and 124 mothers with two children (3 and 5 years of age). Evening and morning salivary T samples were analyzed with radio-immunoassays to determine circulating T levels. Parental sensitivity (i.e., child-centered responsiveness) and respect for children's autonomy were observed during free play in the family home. The results showed that higher evening T levels in mothers were associated with more sensitivity to the oldest and youngest child. Diurnal T variability was more consistently associated with parenting behavior towards their children than basal T levels. For fathers, more diurnal variability in T was associated with more sensitivity and more respect for autonomy with their youngest children. For mothers, more diurnal variability in T was associated with less sensitivity to both children and less respect for the youngest child's autonomy. These findings suggest that the T system might act differently in relation to parenting behavior in males and females.     

Earliest Porotic Hyperostosis on a 1.5-Million-Year-Old Hominin,Olduvai Gorge,Tanzania

Meat-eating was an important factor affecting early hominin brain expansion, social organization and geographic movement. Stone tool butchery marks on ungulate fossils in several African archaeological assemblages demonstrate a significant level of carnivory by Pleistocene hominins, but the discovery at Olduvai Gorge of a child''s pathological cranial fragments indicates that some hominins probably experienced scarcity of animal foods during various stages of their life histories. The child''s parietal fragments, excavated from 1.5-million-year-old sediments, show porotic hyperostosis, a pathology associated with anemia. Nutritional deficiencies, including anemia, are most common at weaning, when children lose passive immunity received through their mothers'' milk. Our results suggest, alternatively, that (1) the developmentally disruptive potential of weaning reached far beyond sedentary Holocene food-producing societies and into the early Pleistocene, or that (2) a hominin mother''s meat-deficient diet negatively altered the nutritional content of her breast milk to the extent that her nursing child ultimately died from malnourishment. Either way, this discovery highlights that by at least 1.5 million years ago early human physiology was already adapted to a diet that included the regular consumption of meat.     

134 Battered Children: A Medical and Psychological Study

A controlled investigation of 134 battered children showed that nearly half had serious injuries and 21 died. Sixty-five had been battered more than once, 20 had permanent neurological sequelae, a quarter were low birth weight babies, and 10 had serious congenital defects. Twenty-three had been previously admitted to hospital with failure to thrive and the overlap with physical neglect was considerable. Mortality and morbidity among their siblings was also high. Difficulties with the child were attributable to interaction with neurotic mothers.The risk of battering diminishes after a child''s second birthday. The establishment of specialized hospital teams to tackle the overall problem is suggested as a method of improving management. Prevention may lie in educating mothers in the basic physical and psychological requirements of children and overcoming their reluctance to avail themselves of medical care.     

‘Keeping silent’: the problem of citizenship for Lilian Thuram

Abstract

Drawing upon translations of the football player Lilian Thuram's critiques of French racism and immigration, as well as other English language sources on the condition of banlieue life in France, this essay explores the relationship between citizenship and representation. Rather than merely reading Thuram as an athlete, I situate him as a political figure. The essay reads Thuram philosophically: as a figure who is familiar with and thinks the French and European political through its philosophical history. It is argued that Thuram's critiques are inexplicable unless they are understood as a redress to the very philosophical core of European modernity. Instead of presuming an inevitable relationship between citizenship and representation, this essay seeks to understand how representation works in relation to questions of citizenship and the limits of citizenship in contemporary Europe for those who are defined as Berber, black or Arab.     

The relationship between parents' anti-fat attitudes and restrictive feeding

Objective: Anti‐fat prejudice is a common attitude in our society, and it has implications for those who hold and are targets of this prejudice. Little is known, however, about how parents’ anti‐fat attitudes impact the ways they feed their young children. We hypothesized that parents’ attitudes about weight would predict parents’ restrictive feeding practices above and beyond the effects of the child's actual weight and the parents’ concern about child overweight. Research Methods and Procedures: A total of 126 mothers and 102 fathers returned surveys about anti‐fat attitudes, feeding practices (restriction for weight and restriction for health), and concern about child overweight. Results: Parental concern about child overweight was related to higher restrictive feeding practices for both mothers and fathers. Parents’ anti‐fat attitudes also predicted restrictive feeding above and beyond the effects of parent and child BMI and parental concern about overweight. Discussion: These findings suggest that parents’ anti‐fat attitudes impact the way they feed their children.     

New Method of Screening Young Children for Defects in Visual Acuity

The methods used at present for screening young children''s vision have disadvantages, such as that the child''s intelligence can affect the result. In a new method three white cards are used; these are printed with one, two, or three black blocks arranged so that if a child can correctly state the number of blocks at 6 metres the visual acuity is at least 6/9. When tested on 186 children the new method gave better results than conventional tests; eight children with defective vision were picked up only by the new method and none were missed.