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Maternal note-taking and infant care: a pilot randomised controlled trial
  1. Caroline J Kistin1,2,
  2. Alejandra Barrero-Castillero1,
  3. Sheilajane Lewis2,
  4. Rachel Hoch2,
  5. Barbara L Philipp2,
  6. Howard Bauchner3,
  7. C Jason Wang4
  1. 1Division of General Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA
  2. 2Department of Pediatrics, Boston Medical Center, Boston, Massachusetts, USA
  3. 3Journal of the American Medical Association, Chicago, Illinois, USA
  4. 4Center for Policy, Outcomes and Prevention and Division of General Pediatrics, Stanford University School of Medicine, Stanford, California, USA
  1. Correspondence to Dr Caroline J Kistin, Division of General Pediatrics, Boston Medical Center, Boston University School of Medicine, 88 E Newton St, Vose 3, Boston, MA 02118, USA; caroline.kistin{at}


Design A pilot randomised controlled trial was conducted with postpartum mothers to assess the feasibility and impact of note-taking during newborn teaching. Controls received standard teaching; the intervention group received pen and paper to take notes. Subjects were called 2 days post-discharge to assess infant sleep position, breastfeeding, car seat use, satisfaction and information recall.

Results 126 mothers were randomised. There was a consistent trend that intervention subjects were more likely to report infant supine sleep position (88% vs 78%, relative risks (RR) 1.13; 95% CI 0.95 to 1.34), breastfeeding (96% vs 86%, RR 1.11; 95% CI 0.99 to 1.25) and correct car seat use (98% vs 87%, RR 1.12; 95% CI 1.00 to 1.25). Satisfaction and information recall did not differ. Among first-time mothers, intervention subjects were significantly more likely to report infant supine sleep position (95% vs 65%, RR 1.46; 95% CI 1.06 to 2.00).

Conclusions Maternal note-taking is feasible and potentially efficacious in promoting desirable infant care.

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  • Funding This research was funded in part by grant T32 HP10263-01 from Kirchstein-NRSA (Kistin) and by the Joel and Barbara Alpert Endowment for the Children of the City (Kistin).

  • Competing interests None.

  • Ethical approval Boston University Medical Center IRB.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data for the study are available upon request from the corresponding author Kistin.

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