Fathering on Tenuous Ground: A Qualitative Meta-Synthesis on Teen Fathering Background: Although teen fathers are a vulnerable group of parents, they have received far less attention than teen mothers. Purpose: We conducted a systematic search of qualitative studies that examined their prenatal and postpartum experience to better understand teen fathers' concerns, strengths, and vulnerabilities. Methods: We searched nine electronic databases through September 2017; 29 studies represented in 30 articles met study criteria. All authors independently extracted data from each article. Coding decisions were reviewed weekly and differences were settled by consensus. Results: From pooling the results of 29 primary studies, we describe how a tenuous ground contributes to teen paternity and imperils young fathers' involvement with their children. In the best of circumstances, the ground begins to stabilize for teens who become involved parents despite significant challenges and hardships. Clinical Implications: Our results contribute to the visibility of teen fathers and the social disparities that imperil fathering. We provide clinical guidance for strengthening the ground for teen fathers and their families, recognizing that clinicians often encounter challenges such as interpersonal factors and sociocultural conditions that systematically erode fathers' ties to their children, partners, professional caregivers, and institutions.

Safety of Over-the-Counter Medications in Pregnancy Approximately 90% of pregnant women use medications while they are pregnant including both over-the-counter (OTC) and prescription medications. Some medications can pose a threat to the pregnant woman and fetus with 10% of all birth defects directly linked to medications taken during pregnancy. Many medications have documented safety for use during pregnancy, but research is limited due to ethical concerns of exposing the fetus to potential risks. Much of the information gleaned about safety in pregnancy is collected from registries, case studies and reports, animal studies, and outcomes management of pregnant women. Common OTC categories of readily accessible medications include antipyretics, analgesics, nonsteroidal anti-inflammatory drugs, nasal topicals, antihistamines, decongestants, expectorants, antacids, antidiarrheal, and topical dermatological medications. We review the safety categories for medications related to pregnancy and provide an overview of OTC medications a pregnant woman may consider for management of common conditions.

A Concept Analysis of Parental Uncertainty in Illness of an Infant Background: The concept of uncertainty in illness has been well described and applied to many different areas of nursing and other disciplines. Specifically, parental uncertainty in illness of an infant is a meaningful concept that has specific attributes and implications. A current concept analysis that considers the changing healthcare setting, historical conceptual inconsistencies, and a lack of information concerning parents of infants is needed. Purpose: To identify essential antecedents, attributes, and consequences of parental uncertainty in illness using Rodgers' Evolutionary Concept Analysis method. Methods: A literature search was conducted using PubMed, CINAHL, and PsycInfo. The following keywords were used in combination using the Boolean terms “AND” and “OR”: parental uncertainty; infants; parental uncertainty in illness; preterm infants; parent; uncertainty. Inclusion criteria: articles published between 2000 and 2017 and published in English. The search included 38 articles published from 2000 to 2017 with a specific focus on parental uncertainty in illness. Findings: Parental uncertainty in illness of an infant is a paradoxical, cognitive, and emotional experience in which there is an inability to create meaning and may cause disruption in parental role development. Implications for Practice: Nursing care of parents with ill infants and children must include sensitivity to parents' experiences of uncertainty in illness. Nurses are uniquely positioned to normalize parental uncertainty and facilitate healthy coping.

Care and Treatment Recommendations for Pregnant Women with Opioid Use Disorder Background: Recent data suggest a significant increase in use of opioids among pregnant women. In the United States, reported rates of neonatal abstinence syndrome increased from 1.5 per 1,000 to 6.0 per 1,000 live births from 2000 to 2013. Use of opioids, both pharmacologic and nonpharmacologic, during pregnancy exposes women and babies to increased risks of adverse health outcomes. Professional organizations recommend addressing the complex needs of women who use opioids during pregnancy. Objective: The purpose is to review the role of nurses in the prenatal setting caring for pregnant women with opioid use disorder. Methods: We conducted a literature search using the CINAHL, PubMed, and PsycInfo electronic databases through January 2018 to identify best practices for referring women to treatment from the prenatal care office. Search terms included “substance use disorder,” “pregnancy,” “prenatal care,” “referral,” and “referral pathway.” Results: From our search, 68 abstracts were identified as relevant for review. Eight articles were selected for the analysis based on our focus. The findings assisted in development of our recommendations for nurses. Clinical Implications: During prenatal care, nurses can screen for opioid use disorder, develop positive relationships, and refer to treatment. This care should be based on values-neutral strategies to promote healthy outcomes for pregnant women and their babies.

Women's Experiences with Tandem Breastfeeding Background: Choosing to breastfeed is a decision with far-reaching benefits; strengthened immune systems, all-encompassing nutrition, and fostering healthy attachment. For these and other reasons, some mothers are reluctant to wean their child due to a subsequent pregnancy. Mothers may breastfeed throughout their second pregnancy, give birth to their second child, and simultaneously breastfeed two children. This practice is known as tandem breastfeeding. Purpose: We explore the biological and emotional considerations of tandem breastfeeding and offer practical suggestions for nurses. Methods: Three mothers who engaged in tandem breastfeeding were identified and interviewed. Interviews were face-to-face or over the phone. One researcher conducted all interviews using the same questions that served as the foundation and guidance for the discussion-based interview. The interviews lasted 40 to 60 minutes and were audio recorded to minimize recall issues during data analysis. Results: Three mothers shared their tandem breastfeeding journeys, challenges faced, and overall perspectives. This was an opportunity for mothers to share feedback on how nurses provided education and care as well as suggestions for nursing care of future mothers who choose to tandem breastfeeding. Clinical Implications: Through research and case-series interviews, we developed implications for nursing practice. Nurses must be informed and supportive of mothers' decisions to tandem breastfeed.

Experiences of Women with Postpartum Depression Participating in a Support Group Led by Mental Health Providers Purpose: The purpose of this study was to explore experiences of women currently with or at high risk for developing postpartum depression (PPD) who were participating in a postpartum support group facilitated by mental health providers. Study Design and Methods: Using a qualitative design, women ≥18 years of age, who had given birth within the past 2 years, and who were currently attending, or had attended the PPD support group within the past year were invited to participate. The women provided demographic data and participated in a semistructured face-to-face interview. Data were analyzed using qualitative content analysis. Results: Seven women between 27 and 38 years of age participated. Most were married and college educated. At time of the interviews, participants were between 5 months and 2 years postpartum and all reported taking antidepressant medications for their symptoms. Qualitative content analysis revealed three overall themes: attendance, impact, and medication adherence, with associated subthemes. Clinical Implications: Women attending a PPD support group facilitated by mental health providers felt supported, were more likely to disclose their symptoms to other women in the same situation, and were able to share their feelings without fear of judgment. Having concerns about antidepressant medication addressed at each meeting promoted medication adherence. Nurses working with childbearing women should be aware of community support services available for women at risk for developing PPD.

Caring for Women with Obesity No abstract available

Increasing Popularity of Vaping among Adolescents No abstract available

Protecting Breastfeeding for Adolescents who Return to School No abstract available