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Theses and Dissertations

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Browsing Theses and Dissertations by Author "Baker, Susan, committee member"

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    Developing and evaluating a website on infant feeding, specifically breastfeeding, for child care providers
    (Colorado State University. Libraries, 2006) Clark, Alena Michelle, author; Jennifer Anderson, advisor; Adams, Elizabeth, committee member; Baker, Susan, committee member; Barrett, Karen, committee member
    Research studies have shown that breastfeeding provides a multitude of benefits to infants, mothers and communities. Yet, many women cease breastfeeding before the recommended times. A common reason women cease breastfeeding is because of returning to work or school. Because child care providers often provide care to these infants, further research on the role of child care providers on infant feeding practices, specifically breastfeeding, is warranted. This research project occurred in three phases. First, a needs assessment survey was conducted to determine the knowledge, attitudes, behaviors and training needs of child care providers on infant feeding, specifically breastfeeding, in child care centers. The most appropriate medium to integrate best practice information and provide educational tools to child care providers was also examined. Based on the first phase of this project, a website for child care providers on infant feeding, specifically breastfeeding, was determined to be the desired medium for child care providers. Because no other infant feeding website for child care providers was available, InfaNET Nutrition for Child Care Providers website was developed during the second phase of this project based upon the needs assessment results and facilitated group discussions' feedback. The Social Learning Theory was used as the theoretical framework for the development of the content information on the website. A process evaluation with infant feeding experts, child care providers and web design experts deemed the website ready to be tested. Thirdly, a quasi-experimental research design with a control and intervention group was completed. The target population viewed the website as a well-liked and effective means to provide infant feeding information. Results also showed that between the pre- and post-test intervention, the intervention group had more statistically significant positive changes in attitude and behaviors than the control group. Child care providers already possessed a desirable level of knowledge in regards to storing, preparing and feeding infants' breastmilk and formula, but not in distinguishing hunger cues or introducing solid foods. The behavior and attitude changes were not sustained at follow-up, but results showed there was a non-significant positive trend in knowledge for the intervention group.
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    The effects of docosahexaenoic acid intake during pregnancy and lactation on infant growth and neurocognitive development and the associated effects of genetic variants of the FADS1 FADS2 gene cluster
    (Colorado State University. Libraries, 2014) Miller, Stacy Marie, author; Harris, Mary, advisor; Chicco, Adam, committee member; Baker, Susan, committee member; Frye, Melinda, committee member
    Maternal docosahexaenoic acid (DHA) intake during pregnancy and/or lactation has been positively associated with infant growth and neurocognitive development. However, randomized controlled clinical trials (RCT) report mixed results. Several RCT that failed to demonstrate an effect of DHA supplementation have found correlations between DHA status and cognitive benefits, possibly due to a failure to account for total maternal DHA intake. The majority of studies to date investigating neurocognitive development have not examined the effect of supplementing women with DHA during both pregnancy and lactation and fail to determine the effects of maternal genetic variation on infant neurocognitive development. Single nucleotide polymorphisms (SNPs) within the fatty acid desaturase (FADS)1 FADS2 gene cluster encoding for Δ5- and Δ6-desaturase enzymes were previously reported to be associated with altered omega-3 (n-3) and omega-6 (n-6) fatty acid proportions of erythrocyte, plasma phospholipids and breastmilk, possibly effecting DHA transfer to the infant. This study was conducted to determine the relationship between DHA intake in women obtaining varying amounts of DHA daily during pregnancy and lactation and infant neurocognitive development in the first year of life and the association of maternal SNPs in the FADS1 FADS2 gene cluster. One hundred and fifteen pregnant women were randomized to receive purified tuna oil supplement containing 300 mg of DHA and 67 mg EPA per day or an identical placebo (Sunola oil) for the last trimester of pregnancy through the first 3 months of lactation in a double-blinded placebo controlled clinical trial. Two SNPs in the FADS1 FADS2 gene cluster, rs174575 and rs174561, were genotyped from maternal DNA and erythrocyte, plasma phospholipid and breastmilk fatty acids and daily DHA intake from food frequency questionnaires (FFQ) were analyzed. Neurocognitive development of the infants was measured using the Mental Development Index (MDI) of the Bayley Scales of Infant Development III (BSID-III) at 4 and 12 months of age. Gestational length in days was calculated based upon last menstrual period and birth date. Infant birth weights and lengths were obtained from pediatric medical records at delivery and at 2 months of age. Total daily DHA intake was estimated to range from 18 mg to 1.374 g per day calculated from all sources of DHA, including food and supplementation. Data was analyzed based on treatment group, placebo versus DHA, and by total daily DHA intake broken into three groups: low = 0-299 mg per day DHA, medium = 300-599 mg per day DHA, high = ≥600 mg per day DHA. DHA portion of 2 month breastmilk fatty acids directly correlated with daily DHA intake (r=0.37, p=0.0002). Erythrocyte and breastmilk DHA proportions significantly increased in women homozygous for the major allele (SNP rs174575, p=0.0002 and p=0.030, respectively; SNP rs174561, p=0.003 and p=0.040, respectively) in the high daily DHA intake compared to the low intake group. However, daily DHA intake had no effect significantly increasing DHA proportions in women homozygous for the minor alleles of both SNPs studied. Infants born to mothers in the high DHA intake group showed significantly higher scores on the 12 month cognitive scale of the MDI of the BSID-III (p=0.018), compared to the low intake group. No significant differences were seen between treatment groups or DHA intake groups on any of the 4 month infant cognitive testing. Genotype had no direct effect on BSID-III scores, however, ANCOVA for 12 month cognitive MDI subtest showed a statistically significant interaction between SNP rs174575 genotype and daily DHA intake group (p=0.023). Additionally, infants born to mothers in the DHA treatment group had an increase of 4.5 days in gestational age (p=0.048) and significantly lower incidence of preterm birth (5%; n=3) compared to infants born to mothers in the control group (18%; n=10; χ2=4.97, p=0.026). No significant differences were seen between treatment groups or DHA intake groups in infant growth measurements at birth or at 2 months of age, although 2 month breastmilk DHA proportion of fatty acids was negatively correlated with 2 month weight (r= -0.22, p=0.048). An intake of 600 mg of DHA per day or greater during the third trimester of gestation throughout the first three months of breastfeeding was associated with improved infant neurocognitive development. Genetic variants of the FADS1 FADS2 gene cluster influence erythrocyte and breastmilk fatty acids, and increased DHA intake does not effectively increase DHA proportions in minor allele carriers. Additionally, DHA supplementation increased gestational length and decreased preterm birth risk, however, did not affect infant birth weights. DHA supplementation during pregnancy and lactation could be beneficial for improving the neurocognitive development of infants, however, genetic variation may affect DHA transfer to the infant.