Fetal exposure to prenatal maternal stress can have lifelong consequences, with different types of maternal stress associated with different areas of child development. Fewer studies have focused on motor skills, even though they are strongly predictive of later development across a range of domains. Research on mechanisms of transmission has identified biological cascades of stress reactions, yet links between psychological stress reactions are rarely studied. This study investigates the relationship between different aspects of disaster-related prenatal maternal stress and child cognitive and motor development, and proposes a cascade of stress reactions as a potential mechanism of transmission. Mothers in the Queensland Flood Study (QF2011) exposed to a major flood during pregnancy completed questionnaires assessing flood exposure, symptoms of peritraumatic distress, dissociation, and posttraumatic stress (PTSD), and cognitive appraisal of the overall flood consequences. At 16 months post-partum, children's (N = 145) cognitive and motor development was assessed using the Bayley-III. Flood exposure predicted child cognitive development and maternal PTSD symptoms and negative cognitive appraisal were significantly negatively related to child motor development, with all relationships moderated by timing of exposure. Together, a cascade of stress reactions linked maternal flood exposure to poorer fine motor development. These findings suggest that the way stress reactions operate together is as important as the way they operate in isolation, and identifies a potential psychological mechanism of transmission for the effects of prenatal stress. Results have implications for conceptualizing prenatal stress research and optimizing child development in the wake of natural disasters. (PsycINFO Database Record

Hospitalization for illness or injury can be experienced by children and their families as traumatic, which can impede recovery and lead to ongoing problems. The provision of quality trauma-informed or psychosocial care by hospital staff may mitigate trauma-related problems; however, there is great variability in the use of psychosocial care practices. Most previous research is based on self-report data and focuses primarily on nurses and physicians. The current study aimed to investigate the use of psychosocial care practices among a range of staff in a large urban pediatric hospital, using observations and interviews. A coding matrix of practices and a set of interview questions were developed based on previous research. Participants included 18 direct care hospital staff and 10 patients. Trained observers observed 13 staff and 10 patients, and coded instances of psychosocial care; 17 staff participated in interviews. A large number of instances of psychosocial care were observed but there was substantial variability in overall use and the use of individual practices. Interviewed staff reported many benefits of psychosocial care for patients and staff, although there were some costs, including emotional fatigue. Contrary to current evidence, most staff reported they rely on visible triggers of distress or need before providing psychosocial care. Future research could investigate the optimal ratio of psychosocial to physical care practices, taking into account patient feedback and psychosocial and medical outcomes. To improve the consistency of psychosocial care, training could incorporate the practice examples documented here, include staff self-care, and encourage informal avenues of learning.

MatCH (Mothers and their Children's Health) is a nationwide Australian study to investigate the links between the history of health, wellbeing and living conditions of mothers and the health and development of their children. MatCH builds on the Australian Longitudinal Study on Women's Health (ALSWH), which began in 1996 and has surveyed more than 58,000 women in four nationally representative age cohorts. MatCH focuses on the three youngest offspring of the cohort of ALSWH participants randomly sampled from all women in Australia born in 1973-78 (N=5780 children of N=3039 mothers). These women, who had completed up to seven postal or online surveys since 1996, were invited in 2016-17 to complete surveys about the health and development of their three youngest children aged under 13. The mothers reported on their children's health conditions and symptoms, diet, anthropometric measures, childcare, screen time, physical activity, temperament, behaviour, language development, motor development and health service utilisation, as well as household and environmental factors. These data are being linked with each child's records from official sources including the Australian Early Development Census (collected at age five to six), the National Assessment Program -Literacy and Numeracy (collected at age eight, 10, 12 and 14) and other external datasets. MatCH will combine 20 years of maternal data with all the information on her children, taking into account the family setting. MatCH offers an unprecedented opportunity to advance our understanding of the relationship between maternal health and wellbeing and child health and development.

Background Rates of exclusive breastfeeding in Australia lag behind international targets. Reasons for non-exclusive breastfeeding are poorly understood. Research aims To describe demographic profiles of participants reporting different feeding practices, and reasons for not exclusively breastfeeding to 6 months. Methods Demographics for 2888 mothers (5340 children) and reasons for 1879 mothers (3018 children) from the Mothers and Their Children’s Health Study (a sub-study of the Australian Longitudinal Study on Women’s Health) were examined using descriptive statistics and multivariable regression. Results Only 34.4% of children were exclusively breastfed to 6 months. Five non-exclusive feeding practices were identified: never breastfed (3.9%), breastfed < 6 months (20.8%), and breastfed to 6 months but had formula (6.8%), solids (24.5%), or both formula and solids (9.7%). Mothers of children who received < 6 months of human milk were more likely to have a lower education, be overweight/obese, smoke, and live in cities (compared to mothers of children exclusively breastfed). Reasons for never breastfeeding and for breastfeeding < 6 months were primarily insufficient milk and breastfeeding difficulties (e.g., latching issues). Reasons for introducing solids were primarily cues for solids (e.g., showing interest). Reasons for formula were insufficient milk and practical considerations (e.g., return to work). Reasons for both solids and formula were diverse, including insufficient milk, weaning cues, and practical considerations. Conclusions Mothers who did not exclusively breastfeed to 6 months were a heterogeneous group, indicating that both targeted and universal strategies are required to increase rates of exclusive breastfeeding. Support should encompass the broad range of feeding practices.

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