From Obstetrics and Gynecology 82(1):156, July 1993.
This study assesses the widely held but previously untested hypothesis that the net weight of postpartum candy gifts from parents to delivery suite and postnatal ward staff is proportional to their neonates' birth weight. Midwives at Musgrove Park Hospital in Taunton, Somerset, United Kingdom were requested to record the details of all candy gifts received over a 6-month period in 1992. Only 39 candy gifts from 1491 deliveries were documented, with a mean net weight of 416 g. The coefficient of correlation between candy weight and birth weight was 0.1477 (P = 0.2). The basis for the association is multifactorial. Socioeconomic and prematurity-related factors were responsible for poor candy giving following low birth weight deliveries. In contrast, factors related to the etiology and psychology of obesity and diabetes were implicated in generous candy giving by the high birth weight population. (Obstet Gynecol 1993;82:156-8)
New parents in western civilizations traditionally demonstrate their gratitude to the providers of their intrapartum and postnatal care through the gift of confectionary. Deeply entrenched in obstetric and midwifery folklore, but previously untested, is the hypothesis that the weight of the candy gifts is proportional to birth weight. Data collected over 6 months in a busy regional maternity unit were analyzed to test this hypothesis.
The most popular assortment was a soft-cream collection weighing 454 g, which was presented on eight occasions (21%). The hospital charity shop reported brisk trade on this particular attractively packaged assortment. Soft-cream mixtures were given more commonly than hard and soft assortments, with an approximate dominance of 4:1; no all-hard-center assortments were recorded during the study. Amongst recipients, orange cream and almond marzipan were generally accepted as the most popular flavors, with strawberry and coffee soft-cream centers the least sought-after.
Regression analysis found an association between birth weight and net candy weight, with a linear correlation equation of y = 3349.9 + 0.52058x. The correlation coefficient of 0.1477 was not statistically significant (P = 0.2) (Figure 1).
Only two parents of infants weighing less than 2500 g gave any candy, and this is consistent with expectations. Smokers from low socioeconomic groups with small term infants are notoriously poor candy-givers. Conversely, parents of preterm infants are well known to be prolific candy-givers, but anxiety and concern for their newborn immediately after delivery frequently result in displacement of these substantial candy gifts to the neonatal intensive care staff. Gifts to delivery suite staff by these parents tend to consist of cookies rather than candy. This anecdotal observation demands urgent collaborative multi-center study because of its potential to further our understanding of prematurity.
Parents of average-size infants in this white, homogeneous, middle-class, semirural community traditionally endow hospital staff with soft-centered candy. The expectation of increasing candy weight with birth weight in this population is based on the trend of increasing birth weight with subsequent pregnancies, coinciding with improvement in the family's economic situation.
Parents of high birth weight infants are themselves frequently at the upper end of the adult population weight nomogram, and often achieve this status by consuming vast quantities of confectionary. The situations of diabetic and gestational diabetic mothers with macrosomic infants are unique and well explained. Insulin-dependent diabetics often have obsessions with soft-centered candy, holding it in high regard as a forbidden pleasure. Thus, many grateful diabetic mothers can think of no greater reward for the midwife or obstetrician who has just safely negotiated her macrosomic infant through a potentially hazardous perinatal experience than to present him or her with a large box of "soft-centers." The purchase of large candy boxes often contributes to the onset of the gestational diabetic condition, and the celebration of a gestational diabetic's return to normal glucose tolerance on the postnatal ward is likely to involve excessive candy consumption by the mothers, their families, and their midwives.
The small number of candy gifts recorded over the 6-month period fell short of pre-study expectations. A number of confounding factors are implicated. One of the two postnatal wards withdrew from data collection after several weeks, citing the burden of the additional workload generated by the study. However, rumor suggested that a black-market "soft-center" racket allegedly coordinated by the senior midwife on the ward suffered when all candy gifts were documented. Under-reporting on the other wards is also likely to have biased the study. The frequency of reports fell dramatically after rumor circulated through the hospital that the same data were to be used retrospectively to test the separate hypothesis that midwife waist measurement is directly proportional to the net weight of boxed candy received over a 6-month period.
Less-than-expected clumping of candy weight distribution provoked an extensive search of local candy retail outlets, confirming the suspicion that reported candy net weights did not correspond to the weight cited on commercial packaging. A midwife candy "sampling" error is believed to have occurred before candy weighing.
It is also likely that the true rate of candy gifts has fallen in recent years. One can only speculate on the role of the prolonged economic recession. Only 39 gifts from 1491 deliveries strongly supports recent calls to the government by midwifery and obstetric groups for inclusion in the new mother's maternity grant, with strict regulation and monitoring, to specifically provide for these essential purchases.
Figure 1. Correlation of Birth Weight (BW) and net weight of postpartum candy gifts (CHOCW).