Health care use among young children in day care: results in a randomized trial of early intervention

Article Abstract:

Child development programs are often carried out in group settings, which are environments thought to have an increased risk of infection, especially of the respiratory and gastrointestinal (digestive) tracts. Such risks may be particularly relevant for groups such as low-birth-weight (LBW) infants, who have higher rates of acute and chronic illness than normal-weight babies, and whose families tend to have no, or inadequate, medical insurance. To determine whether, in fact, premature LBW infants suffer adverse health consequences from enrollment in child development centers (CDCs), a study of 985 such infants was carried out. The study was part of the Infant Health and Development Program, a multi-site, controlled study. After discharge from the hospital, infants were randomly assigned to either the intervention group (INT; 335 infants) or follow-up group (522 infants). Three interventions were offered to the INT group: home visits and parent groups during the first three years, and attendance at a CDC for at least four hours daily between the ages of 12 and 36 months. All children were evaluated by clinic staff at regular intervals through the age of 36 months; during these evaluations, mothers were asked questions concerning the frequency and type of medical care used in recent weeks. Comparisons were made between INT and follow-up infants with respect to their use of medical care. Results showed no differences between the groups in the number of hospitalizations over the three-year period. INT children had an average of slightly fewer than two more physician visits than follow-up children over the three years. Infants with fewer hospitalizations tended to be female, heavier at birth, in better health at birth, and to have mothers with more education. The results show that high-quality day care does not lead to excessive use of health services by participants. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Usage, Medical care, Infants, Day care centers, Infant care

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The health and developmental status of very low-birth-weight children at school age

Article Abstract:

Children who are born at very low-birth-weights (1,500 grams or less) may be at risk for more childhood diseases than those weighing more at birth. Of 1,868 children assessed at birth, one year and eight to 10 years-of-age, 247 weighed 1,000 grams (g) or less at birth, 364 weighed from 1,001 to 1,500 g, 724 weighed from 1,501 to 2,500 g, and 533 weighed more than 2,500 g. The percentage of children who had one or more medical condition was significantly higher among the children who had a birth weight of 1,500 g or less. Almost one-half the children with a birth weight of less than 1,000 g had an IQ of less than 85, but no significant difference in IQ was seen among the other three groups of children. Children who weighed 1,500 g or less at birth had a higher risk of developing behavioral problems compared to those who weighed more than 1,500 g. The amount of education held by mothers of these children did not affect their level of health regardless of birth weight, except for the IQ of children who weighed more than 1,000 g at birth.

Children, Infants (Premature), Premature infants, Growth, Infant development, Elementary school students

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Low-birth-weight infants born to adolescent mothers: effects of coresidency with grandmother on child development

Article Abstract:

Low-birth-weight infants born to teenage mothers who live with the grandmother appear to have improved cognitive development and health. Cognitive development, behavior and health were assessed in 272 three-year-old children who had been low-birth-weight and who were born to mothers between the ages of 15 and 24. Children who were not living with the grandmother and whose mothers were black or Hispanic or had poor verbal skills were more likely to have a low child IQ score. Maternal age by itself was not significantly related to child outcome, but it was related to poverty. Among children of mothers between the ages of 15 and 17 and 20 and 24, living in poverty was strongly associated with low IQ score. Children who were black or Hispanic or who had a very low birth rate had the lowest health scores. Living with the grandmother was significantly associated with improved health among children whose mothers had poor verbal ability. Programs should target mothers with low verbal ability who may have already dropped out of school.

Influence, Environmental aspects, Teenage pregnancy, Child development, Grandmothers

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