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Maxwell C, Fleming V, Porcellato L. Why have a bottle when you can have draught? Exploring bottle refusal by breastfed babies. MATERNAL & CHILD NUTRITION 2023; 19:e13481. [PMID: 36737247 PMCID: PMC10019064 DOI: 10.1111/mcn.13481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 01/11/2023] [Accepted: 01/13/2023] [Indexed: 02/05/2023]
Abstract
Bottle refusal by breastfed babies is a scenario that has received surprisingly little attention in the literature, given the number of mothers who appear to be experiencing it globally and the subsequent negative impact it can have. In line with this, we undertook a study to explore mothers' views on why their breastfed baby refuses to bottle feed. A parallel, two-stage, exploratory qualitative design was employed using 30 semi-structured interviews and 597 online forum posts. Data were analysed using a thematic analysis, and a biopsychosocial model was applied resulting in four overarching themes being identified: 'Breastfeeding is the answer to everything….' 'Bottle feeding: an alien concept… 'Babies are individuals' and 'Find the right bottle and don't delay'. The psychological benefits of breastfeeding, not inherent in bottle feeding, appeared to underpin some mothers' views on their baby's refusal. Other mothers explained refusal as being down to a baby's biological expectation to be fed by the breast; therefore, bottle feeding was not a normal concept to them. A baby's individual personality and temperament were also suggested as contributing to the scenario and refusal was linked to babies disliking a certain brand of bottle and being introduced to it 'too late'. This study's findings point to a complex, multifactorial picture underpinning bottle refusal by breastfed babies, which transcends physical, psychological and biological concepts, and is influenced by socio-cultural norms surrounding infant feeding. Recognition of these contributing factors is needed to aid those supporting mothers experiencing the scenario and, importantly, to underpin mothers' decision-making around managing it.
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Affiliation(s)
- Clare Maxwell
- Department of Midwifery, Faculty of Health, School of Public and Allied HealthLiverpool John Moores UniversityLiverpoolUK
| | - Valerie Fleming
- Department of Midwifery, Faculty of Health, School of Public and Allied HealthLiverpool John Moores UniversityLiverpoolUK
| | - Lorna Porcellato
- Department of Midwifery, Faculty of Health, School of Public and Allied HealthLiverpool John Moores UniversityLiverpoolUK
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Davie P, Bick D, Silverio SA, Chilcot J. Easier, but not easy: Testing a grounded theory of breastfeeding experiences among women with larger birthweight infants. Psychol Health 2023; 38:167-189. [PMID: 34498534 DOI: 10.1080/08870446.2021.1956495] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Grounded Theory has previously been used to explore breastfeeding practices amongst average birthweight infants and these working hypotheses can be 'tested' in new contexts. A pre-existing Grounded Theory was applied to the context of women who gave birth to larger birthweight infants (≥4,000 g) to understand whether perceptions and practices of infant feeding were distinct. DESIGN A nested qualitative study analysed data from N = 10 women with a larger birthweight infant (≥4,000 g). Face-to-face, semi-structured interviews were audio-recorded and transcribed verbatim. Grounded Theory methodology was used to analyse data. RESULTS A pre-existing Grounded Theory of breastfeeding experiences derived from women with average birthweight infants did not hold true among women with larger birthweight infants. An alternative Grounded Theory was therefore proposed comprised of three discrete themes: Infant Ability to Breastfeed; Attenuating Maternal Concerns; and Reality of Breastfeeding. CONCLUSIONS Larger infant birthweight is potentially a protective factor against breastfeeding latch and lactation difficulties. It is associated with alleviating maternal concerns, helping to reduce disparities between expectations of breastfeeding and reality, but does not alleviate the demands breastfeeding places on women. Healthcare professionals help to attenuate women's concerns, however the support needs for women with larger birthweight infants may not differ from existing care recommendations.
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Affiliation(s)
- Philippa Davie
- Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, Guy's Hospital, King's College London, London, UK
| | - Debra Bick
- Clinical Trials in Maternal Health, Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
| | - Sergio A Silverio
- Department of Women and Children's Health, Faculty of Life Sciences and Medicine, St Thomas' Hospital, King's College London, London, UK.,Elizabeth Garrett Anderson Institute for Women's Health, Faculty of Population Health Sciences, School of Life and Medical Sciences, University College London, London, UK.,Department of Psychological Sciences, Institute of Life and Human Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
| | - Joseph Chilcot
- Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, Guy's Hospital, King's College London, London, UK
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Brødsgaard A, Andersen BL, Skaaning D, Petersen M. From Expressing Human Milk to Breastfeeding-An Essential Element in the Journey to Motherhood of Mothers of Prematurely Born Infants. Adv Neonatal Care 2022; 22:560-570. [PMID: 34923499 PMCID: PMC10519291 DOI: 10.1097/anc.0000000000000962] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Lactation and breastfeeding present an extraordinary challenge for mothers of prematurely born infants. PURPOSE To explore the significance of and the circumstances that affect lactation for mothers of premature infants. METHODS A qualitative exploratory study based on single, in-depth, semistructured interviews with 16 purposefully sampled mothers of premature infants admitted to the neonatal intensive care unit (NICU). Data were analyzed using content analysis. The study was reported according to Standards for Reporting Qualitative Research. FINDINGS The overall theme was "From expressing human milk to breastfeeding-an essential element in the journey to motherhood." The theme emerged from 3 categories: the birth preparation time has been interrupted; expressing human milk is essential for lactation; and the motherhood journey encompasses breastfeeding. The analysis also revealed that the categories were impacted by initiating, performing, and maintaining lactation and further influenced by inhibitors and promoters. IMPLICATIONS FOR PRACTICE The promoters for performing milk expression and breastfeeding should be stimulated and the inhibitors should be eliminated. The achievement of "zero separation" and mother-infant couplet care in the NICU would be beneficial. In order for mothers to maintain successful lactation, it is essential that they receive supportive around-the-clock access to health professionals with expertise in lactation and breastfeeding until exclusive breastfeeding is well established. IMPLICATIONS FOR RESEARCH The study highlights the need to investigate mother-infant as one entity rather than separately as mother and infant.
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Affiliation(s)
- Anne Brødsgaard
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Amager Hvidovre, Denmark (Drs Brødsgaard and Skaaning and Mss Andersen and Petersen); and Nursing and Health Care, Institute of Public Health, Aarhus University, Aarhus, Denmark (Dr Brødsgaard)
| | - Bente Lund Andersen
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Amager Hvidovre, Denmark (Drs Brødsgaard and Skaaning and Mss Andersen and Petersen); and Nursing and Health Care, Institute of Public Health, Aarhus University, Aarhus, Denmark (Dr Brødsgaard)
| | - Diana Skaaning
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Amager Hvidovre, Denmark (Drs Brødsgaard and Skaaning and Mss Andersen and Petersen); and Nursing and Health Care, Institute of Public Health, Aarhus University, Aarhus, Denmark (Dr Brødsgaard)
| | - Mette Petersen
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Amager Hvidovre, Denmark (Drs Brødsgaard and Skaaning and Mss Andersen and Petersen); and Nursing and Health Care, Institute of Public Health, Aarhus University, Aarhus, Denmark (Dr Brødsgaard)
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Maman R, Rand D, Avrech Bar M. A Scoping Review of the Maternal Role at Older Age; Perceptions and Occupations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19010492. [PMID: 35010752 PMCID: PMC8744541 DOI: 10.3390/ijerph19010492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/26/2021] [Accepted: 12/31/2021] [Indexed: 02/05/2023]
Abstract
Motherhood is a meaningful life role among adult women. Occupations within the maternal role of younger mothers have been well documented, but less is known regarding the maternal-role at older age. This review aimed to describe the occupations, activities, and perceptions that older women ascribe to their maternal role. In the future, this information may promote health and wellbeing of older women. A systematic search of peer reviewed articles, that included healthy, community-dwelling mothers, 60 years of age or older, was conducted. Maternal-role occupations and perceptions of older mothers were identified and classified according to the Occupational Therapy Practice Framework (OTPF). Fourteen articles, representing 3102 older mothers, were included. The identified occupations and activities within the maternal role were from two categories: Instrumental Activities of Daily Living (IADL) (such as assistance with daily chores) and social participation (such as sharing holiday rituals). Three themes reflecting maternal-role perceptions were identified: providing support; relationship with children; and motherhood as a never-ending role. Maternal occupations were identified in only a few articles and from only two categories, IADL and social participation. These findings together with the perception that motherhood is a ‘never-ending’ role suggests that further research is needed to better characterize the maternal role of older women from an occupational perspective.
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Peles C, Shloim N, Rudolf MCJ. "Over-preoccupation with healthy food is perceived as worship of the body": Food, culture and beliefs in Ultra-Orthodox Jewish families. Appetite 2021; 167:105621. [PMID: 34363899 DOI: 10.1016/j.appet.2021.105621] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 06/28/2021] [Accepted: 08/01/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Eating behaviours vary by culture and religion, and an understanding of attitudes and practices are essential for providing culturally competent nutritional guidance. The Ultra-orthodox Jewish community is characterized by poor diet, high rates of obesity, anemia and diabetes. This study aimed to acquire insights that could influence the promotion of healthier eating in the Ultra-orthodox and other closed religious communities, particularly regarding children's eating habits and the food they consume. METHODS In depth face-to-face recorded interviews were conducted with 20 information-rich participants: religious leaders, opinion leaders and education/health professionals from Gur and Chabad, two Ultra-orthodox Jewish religious communities in Israel. The focus was on exploring young family eating behaviours and perceived challenges to encouraging healthier nutrition in the community. Interviews were transcribed and thematic analysis employed using grounded theory. RESULTS Seven themes were identified with findings that had clear implications for the promotion of health at both the community and individual level. These included spiritual aspects of eating, deficits in knowledge and awareness, less relevance of kashrut than previously thought, the centrality of motherhood and family meals, the quality of food in educational institutions, the significance and sensitivity of Sabbath and festive meals and pragmatic considerations. DISCUSSION AND CONCLUSIONS By illuminating attitudes and behaviors, the study broadens and enhances our understanding of the Ultra-orthodox communities' perspectives on eating behaviours in the family. The findings have the potential to contribute to strengths-based health promotion for children's nutrition. Recommendations regarding culturally competent guidance and implications for other secluded religious communities are discussed.
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Affiliation(s)
- C Peles
- Department of Population Health, Azrieli Faculty of Medicine, Safed, Israel.
| | - N Shloim
- School of Healthcare, University of Leeds, UK.
| | - M C J Rudolf
- Department of Population Health, Azrieli Faculty of Medicine, Safed, Israel.
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Vazquez-Vazquez A, Dib S, Rougeaux E, Wells JC, Fewtrell MS. The impact of the Covid-19 lockdown on the experiences and feeding practices of new mothers in the UK: Preliminary data from the COVID-19 New Mum Study. Appetite 2021; 156:104985. [PMID: 33038477 PMCID: PMC7538871 DOI: 10.1016/j.appet.2020.104985] [Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/02/2020] [Accepted: 09/30/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND The COVID-19 New Mum Study is recording maternal experiences and infant feeding during the UK lockdown. This report from week 1 of the survey describes and compares the delivery and post-natal experiences of women who delivered before (BL) versus during (DL) the lockdown. METHODS Women living in the UK aged ≥18 years with an infant ≤12 months of age completed an anonymous online survey (https://is.gd/covid19newmumstudy). Information/links are shared via websites, social media and existing contacts. RESULTS From 27.5.20-3.6.20, 1365 women provided data (94% white, 95% married/with partner, 66% degree/higher qualification, 86% living in house; 1049 (77%) delivered BL and 316 (23%) DL. Delivery mode, skin-to-skin contact and breastfeeding initiation did not differ between groups. DL women had shorter hospital stays (p < 0.001). 39% reported changes to their birth plan. Reflecting younger infant age, 59% of DL infants were exclusively breast-fed/mixed fed versus 39% of BL (p < 0.05). 13% reported a change in feeding; often related to lack of breastfeeding support, especially with practical problems. Important sources of feeding support were the partner (60%), health professional (50%) and online groups (47%). 45% of DL women reported insufficient feeding support. Among BL women, 57% and 69% reported decreased feeding support and childcare, respectively. 40% BL/45% DL women reported insufficient support with their own health, 8%/9% contacted a mental health professional; 11% reported their mental health was affected. 9% highlighted lack of contact/support from family and distress that they had missed seeing the baby. CONCLUSION Lockdown has impacted maternal experiences, resulting in distress for many women. Our findings suggest the need for better infant feeding support, especially 'face-to-face' support for practical issues; and recognising and supporting mothers who are struggling with mental health challenges or other aspects of their health. The effectiveness of online versus face-to-face contact is currently uncertain, and requires further evaluation.
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Affiliation(s)
- A Vazquez-Vazquez
- Childhood Nutrition Research Group, Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, WC1N 1EH, UK.
| | - S Dib
- Childhood Nutrition Research Group, Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, WC1N 1EH, UK.
| | - E Rougeaux
- Childhood Nutrition Research Group, Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, WC1N 1EH, UK.
| | - J C Wells
- Childhood Nutrition Research Group, Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, WC1N 1EH, UK.
| | - M S Fewtrell
- Childhood Nutrition Research Group, Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, WC1N 1EH, UK.
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Davie P, Bick D, Chilcot J. The Beliefs About Breastfeeding Questionnaire (BAB-Q): A psychometric validation study. Br J Health Psychol 2020; 26:482-504. [PMID: 33340201 PMCID: PMC8247407 DOI: 10.1111/bjhp.12498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 08/19/2020] [Indexed: 11/27/2022]
Abstract
Objectives Questionnaires used to assess women’s beliefs as a predictor of breastfeeding behaviour are not theoretically informed or tested for psychometric validity and reliability. This study conducted a psychometric evaluation of the Beliefs About Breastfeeding Questionnaire (BAB‐Q). Design A two‐phase evaluation in an online cross‐sectional questionnaire study (N = 278) and cohort study sample (N = 264). A ten‐item questionnaire was proposed to assess women’s beliefs about the benefits and efforts of breastfeeding. Methods Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) assessed construct validity and reliability. Multivariate regression analyses assessed validity in predicting breastfeeding behaviour and experiences. Results EFA found a shortened 8‐item, 2‐factor model had good fit (χ2 = 23.3, df = 13, p < .040; CFI = .99, TLI = .99, RMSEA = .05), with significant factor loadings. Factor 1 (benefit beliefs) and factor 2 (effort beliefs) accounted for 47 and 19.4% of the explained variance and correlated moderately (r = −.40). CFA confirmed the solution in the cohort sample (χ2 = 49.6 df = 19, p < .010; CFI = .97, TLI = .96, and RMSEA = .078). Adjusted regression analyses found beliefs did not reliably predict infant feeding practices. Women’s beliefs significantly predicted the likelihood that women experienced breastfeeding as ‘much more’ positive and negative than they expected. Conclusions The eight‐item questionnaire showed good model fit with acceptable loadings, and good reliability for all subscales. The utility of the BAB‐Q at predicting breastfeeding behaviour remains unclear and unsupported by empirical evidence. Further assessments of the predictive validity of the questionnaire in longitudinal studies with diverse beliefs and infant feeding practices are required.
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Affiliation(s)
- Philippa Davie
- Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, Guy's Hospital, King's College London, UK
| | - Debra Bick
- Professor of Clinical Trials in Maternal Health, Warwick Medical School, Warwick Clinical Trials Unit, University of Warwick, UK.,Department of Women and Children's Health, Faculty of Life Sciences and Medicine, St Thomas' Hospital, King's College London, UK
| | - Joseph Chilcot
- Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, Guy's Hospital, King's College London, UK
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Dattilo AM, Carvalho RS, Feferbaum R, Forsyth S, Zhao A. Hidden Realities of Infant Feeding: Systematic Review of Qualitative Findings from Parents. Behav Sci (Basel) 2020; 10:E83. [PMID: 32349324 PMCID: PMC7287829 DOI: 10.3390/bs10050083] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 04/21/2020] [Accepted: 04/23/2020] [Indexed: 01/22/2023] Open
Abstract
A growing, global conversation, regarding realities and challenges that parents experience today is ever-present. To understand recent parent's attitudes, beliefs, and perceptions regarding infant feeding, we sought to systematically identify and synthesize original qualitative research findings. Following the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) framework, electronic databases were searched with a priori terms applied to title/abstract fields and limited to studies published in English from 2015 to 2019, inclusive. Study quality assessment was conducted using the Critical Appraisal Skills Programme (CASP) checklist, and thematic analyses performed. Of 73 studies meeting inclusion criteria, four major themes emerged. (1) Breastfeeding is best for an infant; (2) Distinct attitudes, beliefs, and perceptions of mothers that breastfeed, and those that could not or chose not to breastfeed, are evident; (3) Infant feeding behaviors are influenced by the socio-cultural environment of the family, and (4) Parent's expectations of education and support addressing personal infant feeding choices from health care providers are not always met. This systematic review, guided by constructs within behavioral models and theories, provides updated findings to help inform the development of nutrition education curricula and public policy programs. Results can be applied within scale-up nutrition and behavioral education interventions that support parents during infant feeding.
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Affiliation(s)
- Anne M. Dattilo
- Nestlé Nutrition, Avenue Nestle, 55 CH-1800 Vevey, Switzerland;
| | | | - Rubens Feferbaum
- Children’s Institute University of São Paulo, Rua Tremembé, São Paulo-SP 01256-010, Brazil;
| | - Stewart Forsyth
- School of Medicine, University of Dundee, Dundee DD5 1JG, UK;
| | - Ai Zhao
- School of Public Health, Peking University Health Science Center, Xueyuan Road No. 38., Beijing 100191, China;
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Shloim N, Lans O, Brown M, Mckelvie S, Cohen S, Cahill J. “Motherhood is like a roller coaster… lots of ups, then downs, something chaotic… “; UK & Israeli women’s experiences of motherhood 6-12 months postpartum. J Reprod Infant Psychol 2019; 38:523-545. [DOI: 10.1080/02646838.2019.1631448] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- N. Shloim
- Faculty of Medicine and health, School of Healthcare, University of Leeds, Leeds, UK
| | - O. Lans
- Social Work Department, Tel Hai Academic College, Upper Galilee, Israel
| | - M. Brown
- Faculty of Medicine and health, School of Healthcare, University of Leeds, Leeds, UK
| | - S. Mckelvie
- Faculty of Medicine and health, School of Healthcare, University of Leeds, Leeds, UK
| | - S. Cohen
- Faculty of Medicine and health, School of Healthcare, University of Leeds, Leeds, UK
| | - J. Cahill
- Faculty of Medicine and health, School of Healthcare, University of Leeds, Leeds, UK
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Berhane HY, Ekström EC, Jirström M, Berhane Y, Turner C, Alsanius BW, Trenholm J. Mixed blessings: A qualitative exploration of mothers' experience of child care and feeding in the rapidly urbanizing city of Addis Ababa, Ethiopia. PLoS One 2018; 13:e0207685. [PMID: 30458024 PMCID: PMC6245682 DOI: 10.1371/journal.pone.0207685] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 11/05/2018] [Indexed: 12/02/2022] Open
Abstract
Many studies have drawn attention to the vital role mothers have in safeguarding the health and nutritional wellbeing of their children. However, little is known about mothers’ experiences and the challenges they face in fulfilling this role in rapidly urbanizing cities in Africa. This study aims to explore child care and feeding practices of mothers with children under five years of age in Addis Ababa, Ethiopia. This qualitative study was conducted using a semi-structured interview guide. A total of thirty-six interviews were conducted with purposively selected participants. All interviews were audio recorded, transcribed verbatim and translated for analysis. We used a thematic analysis approach, which was guided by a resilience framework. The findings are presented as three major themes. 1) ‘Mixed blessings-balancing motherhood’s expectations’. While mothers identified positively with the social recognition and sense of fulfillment of being a ‘good mother’, they were ambivalent/torn about earning the necessary income from outside work and fulfilling their duties at home. 2) ‘Instabilities due to rampant urban sprawl’. While women expressed a keen desire to balance work and motherhood, the disintegrating social capital, due to large in-migration, market fluctuations and abrupt/forced resettlements to new housing units had left mothers without support for childcare, stressed and exhausted. 3) ‘Anchored by faith: a source of resilience to cope with adversities’. In the face of the multiple adversities, mothers cited their strong faith as their most reliable foundation for their resilience. In summary, the societal and environmental changes accompanying the rapid urbanization in low income settings makes combining child care and working outside the home very challenging for mothers. As a result they suffer from fatigue and feelings of isolation. Efforts to improve child feeding and care in urban low-income settings need to consider context appropriate strategies that support mothers with small children.
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Affiliation(s)
- Hanna Y. Berhane
- Department of Women’s and Children Health, International Maternal and Child Health, Uppsala University, Uppsala, Sweden
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
- * E-mail:
| | - Eva-Charlotte Ekström
- Department of Women’s and Children Health, International Maternal and Child Health, Uppsala University, Uppsala, Sweden
| | - Magnus Jirström
- Department of Human Geography, Lund University, Lund, Sweden
| | - Yemane Berhane
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Christopher Turner
- Department of Human Geography, Lund University, Lund, Sweden
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Beatrix W. Alsanius
- Department of Biosystems and Technology, Swedish University of Agricultural Sciences, Alnarp, Sweden
| | - Jill Trenholm
- Department of Women’s and Children Health, International Maternal and Child Health, Uppsala University, Uppsala, Sweden
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Shloim N, Rudolf M, Feltbower RG, Blundell-Birtill P, Hetherington MM. Israeli and British women's wellbeing and eating behaviours in pregnancy and postpartum. J Reprod Infant Psychol 2018; 37:123-138. [PMID: 30325661 DOI: 10.1080/02646838.2018.1529408] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVES The study had two main objectives: (a) track changes in self-esteem, eating behaviours and body satisfaction from early pregnancy to 24 months postpartum and (b) to compare changes by context (Israel vs. UK) and maternal body mass index (BMI). BACKGROUND High maternal BMI is associated with negative body image and restrained eating, which are experienced differently across cultures. METHODS 156 pregnant women were recruited from Israel and the UK. Seventy-three women were followed up every six months from early postpartum and until 24 months following birth. Women completed questionnaires assessing self-esteem (RSEQ), body image (BIS/BIDQ) and eating behaviours (DEBQ) and self-reported weights and heights so that BMI could be calculated. RESULTS Women with higher BMI had higher levels of self-esteem and were less satisfied with their body. Healthy-weight women were more likely to lose all of their retained pregnancy weight compared to overweight and obese women. Self-esteem, body image and eating behaviours remained stable from pregnancy until 24 months postpartum. No significant differences were found for any measure by context. CONCLUSION BMI was the strongest predictor of self-esteem and body dissatisfaction and a higher BMI predicted less weight loss postpartum.
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Affiliation(s)
- N Shloim
- a Institute of Medicine and health, School of Healthcare , University of Leeds , Leeds , UK
| | - McJ Rudolf
- b Faculty of Medicine in the Galil , Bar Ilan University , Safed , Israel
| | - R G Feltbower
- c Centre for Epidemiology and Biostatistics, Leeds Institute for Genetics Health and Therapeutics, School of Medicine , University of Leeds , Leeds , UK
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Shloim N, Shafiq I, Blundell-Birtill P, Hetherington MM. Infant hunger and satiety cues during the first two years of life: Developmental changes of within meal signalling. Appetite 2018; 128:303-310. [PMID: 29879451 DOI: 10.1016/j.appet.2018.05.144] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 05/23/2018] [Accepted: 05/25/2018] [Indexed: 12/11/2022]
Abstract
Overfeeding in infancy may lead to overweight and obesity in later childhood. Mothers are advised to "tune in" to their infant's hunger, appetite and satiation cues to prevent overfeeding. The present study aimed to 1) assess stability and change in infant hunger and satiety cues (first two years of life) taken at six monthly intervals; 2) track the expression of appetite cues during the course of a meal (beginning, middle and end). Thirty-eight women (mean age 35.3 + 3.7 years) participated in the study. Mothers were within a normal weight range (BMI = 22 + 3.3 kg/m2), most were married (N = 35; 95%) and for most this was not their first child. After an initial investigation (T1) follow-up visits took place every six months with filmed meals involving solid foods. A typical meal contained foods high in protein and carbohydrate plus cooked vegetables. Films were viewed and communication cues (engagement indicating appetite and disengagement indicating satiation) identified and recorded by appearance using the NCAST (Nursing Child Assessment Satellite Training). Coding included the frequency and time at which each cue appeared. Results showed that infants were more likely to communicate potent engagement cues such as babbling, mutual gaze and looking at mother with age. None of the disengagement cues showed any significant main effects of time of follow up. Most, not all, feeding cues were stable across the segment of the feed and did not show a simple linear change across the meal, rather this appeared to develop with age. Raising awareness of these cues with mothers may encourage more responsive and positive mealtime interactions.
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Affiliation(s)
- N Shloim
- University of Leeds, LS2 9JT, United Kingdom.
| | - I Shafiq
- University of Leeds, LS2 9JT, United Kingdom
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Harrison M, Hepworth J, Brodribb W. Navigating motherhood and maternal transitional infant feeding: Learnings for health professionals. Appetite 2017; 121:228-236. [PMID: 29155172 DOI: 10.1016/j.appet.2017.11.095] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 11/09/2017] [Accepted: 11/11/2017] [Indexed: 02/04/2023]
Abstract
Given the lifelong associations between infant diet and weight, understanding maternal transitional infant feeding decisions can assist efforts to establish healthy eating habits early in life. Feeding experiences were explored using semi-structured interviews with 15 first-time mothers who were selected based on their concerns about their infants' weight in an infant feeding survey. Thematic synthesis of the interview transcripts identified three main themes: (1) Expectations of a "responsible mother", (2) Trusting oneself and trust in others, and (3) From stress to successful feeding. Dominant social ideals of motherhood and infant behaviour influenced feeding practices, some of which are associated with obesity. Judgments of mothers' infant feeding practices and infant size alongside feeding and weight gain 'checklists' undermines maternal transitional feeding knowledge. Family-centred, non-judgmental guidance from peers, family members and health professionals would better support mothers to navigate the day-to-day reality of feeding and caring for an infant throughout the first year of life that is based on achievable personal goals rather than societal ideals.
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Affiliation(s)
- Michelle Harrison
- Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland, Australia.
| | - Julie Hepworth
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Australia
| | - Wendy Brodribb
- Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland, Australia
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14
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Maternal postpartum depressive symptoms predict delay in non-verbal communication in 14-month-old infants. Infant Behav Dev 2016; 46:33-45. [PMID: 27870989 DOI: 10.1016/j.infbeh.2016.11.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 11/05/2016] [Accepted: 11/05/2016] [Indexed: 11/21/2022]
Abstract
We investigated the potential relationship between maternal depressive symptoms during the postpartum period and non-verbal communication skills of infants at 14 months of age in a birth cohort study of 951 infants and assessed what factors may influence this association. Maternal depressive symptoms were measured using the Edinburgh Postnatal Depression Scale, and non-verbal communication skills were measured using the MacArthur-Bates Communicative Development Inventories, which include Early Gestures and Later Gestures domains. Infants whose mothers had a high level of depressive symptoms (13+ points) during both the first month postpartum and at 10 weeks were approximately 0.5 standard deviations below normal in Early Gestures scores and 0.5-0.7 standard deviations below normal in Later Gestures scores. These associations were independent of potential explanations, such as maternal depression/anxiety prior to birth, breastfeeding practices, and recent depressive symptoms among mothers. These findings indicate that infants whose mothers have postpartum depressive symptoms may be at increased risk of experiencing delay in non-verbal development.
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15
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Fallon A, Van der Putten D, Dring C, Moylett EH, Fealy G, Devane D. Baby-led compared with scheduled (or mixed) breastfeeding for successful breastfeeding. Cochrane Database Syst Rev 2016; 9:CD009067. [PMID: 27673478 PMCID: PMC6457764 DOI: 10.1002/14651858.cd009067.pub3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Baby-led breastfeeding is recommended as best practice in determining the frequency and duration of a breastfeed. An alternative approach is described as scheduled, where breastfeeding is timed and restricted in frequency and duration. It is necessary to review the evidence that supports current recommendations, so that women are provided with high-quality evidence to inform their feeding decisions. OBJECTIVES To evaluate the effects of baby-led compared with scheduled (or mixed) breastfeeding for successful breastfeeding, for healthy newborns. SEARCH METHODS We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (23 February 2016), CINAHL (1981 to 23 February 2016), EThOS, Index to Theses and ProQuest database and World Health Organization's 1998 evidence to support the 'Ten Steps' to successful breastfeeding (10 May 2016). SELECTION CRITERIA We planned to include randomised and quasi-randomised trials with randomisation at both the individual and cluster level. Studies presented in abstract form would have been eligible for inclusion if sufficient data were available. Studies using a cross-over design would not have been eligible for inclusion. DATA COLLECTION AND ANALYSIS Two review authors independently assessed for inclusion all potential studies we identified as a result of the search strategy. We would have resolved any disagreement through discussion or, if required, consulted a third review author, but this was not necessary. MAIN RESULTS No studies were identified that were eligible for inclusion in this review. AUTHORS' CONCLUSIONS This review demonstrates that there is no evidence from randomised controlled trials evaluating the effect of baby-led compared with scheduled (or mixed) breastfeeding for successful breastfeeding, for healthy newborns. It is recommended that no changes are made to current practice guidelines without undertaking robust research, to include many patterns of breastfeeding and not limited to baby-led and scheduled breastfeeding. Future exploratory research is needed on baby-led breastfeeding that takes the mother's perspective into consideration.
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Affiliation(s)
- Anne Fallon
- National University of Ireland GalwaySchool of Nursing and MidwiferyÁras MoyolaGalwayIreland
| | - Deirdre Van der Putten
- National University of Ireland GalwaySchool of Nursing and MidwiferyÁras MoyolaGalwayIreland
| | - Cindy Dring
- National University of Ireland GalwayHealth Promotion, Student ServicesGalwayIreland
| | - Edina H Moylett
- National University of Ireland GalwayDepartment of PaediatricsClinical Science InstituteGalwayIreland
| | - Gerard Fealy
- University College DublinNursing, Midwifery and Health SystemsBelfield CampusDublinIrelandDublin 4
| | - Declan Devane
- National University of Ireland GalwaySchool of Nursing and MidwiferyÁras MoyolaGalwayIreland
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