Increasing prevalence of breast-feeding.

Two studies were performed to gauge the prevalence of and attitudes towards breast-feeding. Mothers delivered in one month in 1975 and in one month in 1977 were sent a questionnaire one month later to determine whether they were breast-feeding their babies; those that were received a second questionnaire at three months. The prevalence of breast-feeding increased significantly between 1975 and 1977, and in both periods primiparas were more likely to breast-feed than multiparas. A survey of mothers'' intentions to breast-feed showed that there were no significant racial differences, but that 82% of women in social classes I and II intended to breast-feed compared with 54% in classes IV and V. These results show that, although the level of breast-feeding was high in 1975, a campaign directed at mothers, doctors, midwives, and health visitors did increase the prevalence of breast-feeding.     

Infant-feeding practices among immigrants in Glasgow.

Two hundred and six Asian, 99 African, 99 Chinese, and 102 Scottish children from 172 families were studied to ascertain infant-feeding practices. After arriving in the United Kingdom most of the immigrant mothers had not wished to breast-feed their babies because of wrong information or misconceptions about British infant-feeding practices. The Asians had largely adopted British habits of introducing solid foods to their babies'' diets, but the habits of the African and Chinese mothers in this respect had changed little. Furthermore, many of the African and Chinese children had received no vitamin preparation. The survey showed that all mothers resident in Britain urgently need advice on some aspects of infant feeding.     

MILK LET-DOWN—The Use of Intranasal Oxytocin for Nursing Mothers

A study was carried out to determine whether intranasal spraying with a solution of oxytocin was an effective way to increase flow of milk in mothers who wished to breast-feed their babies.A hundred such women were given the drug intramuscularly for two days before they were to begin nursing. Then administration by that means was discontinued and 50 of the hundred were given oxytocin nasal spray kits for use at home. In general the patients receiving the spray kits were those who were apprehensive about sufficient lactation, those who had had previous difficulty and those who had flat, inverted or tender nipples.Results were not much different between the 50 women who used the spray and the 50 controls, but since the former group included the “difficult” cases, some benefit may be attributed to the aerosol therapy. Ninety per cent of those who used it said they would be willing to use it again.     

Further decline of breast-feeding.

In a personal survey, by structured interview, we have investigated some of the factors which led 100 healthy mothers (63 primiparae) to decide to breast-feed their healthy babies, and 100 comparable mothers (43 primiparae) to decide to bottle-feed. Past experience (either personal or that of their family and friends) was of considerable but not overriding importance, and the decisions were apparently made surprisingly early in most cases. But much more effective educational approaches are needed, perhaps starting in the schools, and concentrated in the antenatal clinic, to allow mothers to reach the right decision for themselves and their babies. The reasons for early cessation of breast-feeding were also investigated, and suggested that those mothers opting for breast-feeding need better technical information and support.     

Health service support of breast feeding--are we practising what we preach?

OBJECTIVE--To ascertain the attitudes of health professionals and breast feeding mothers to breast feeding and their views on current practice. DESIGN--Questionnaire to all midwives and health visitors and to breast feeding mothers in Newcastle upon Tyne. SETTING--Maternity units and community in Newcastle upon Tyne. SUBJECTS--127 hospital midwives, 23 community midwives, 63 health visitors, and 50 first time breast feeding mothers. RESULTS--Optimum practice guidelines were not followed. 30 (60%) mothers said they were separated from their babies on the first night after birth. 82 (42%) professionals said that breast fed babies were frequently given water to drink. 28 (56%) babies in the mothers survey had received food or water other than breast milk; 19 of these had been given water. Professionals expressed mainly positive attitudes towards breast feeding in general but less positive attitudes to specific issues such as the beneficial effects on child health and the value of voluntary organisations in breast feeding promotion and management. CONCLUSIONS--Although many health workers are in favour of breast feeding there is conflict among the professions working most closely with breast feeding mothers. Good breast feeding support requires closer attention to monitoring hospital practices and continued training on good lactation management.     

Is there a link between cot death and child abuse?

Forty five babies delivered in Oxford obstetric units who subsequently died unexpectedly in infancy were compared with 134 controls matched for maternal age, social class, parity, and year of birth to see whether five factors identified in an earlier study as predictive of subsequent child abuse would also predict the sudden infant death syndrome. Epidemiological findings had suggested certain similarities between the two events. In contrast with babies who were abused, four of the five factors did not distinguish between babies who died suddenly and unexpectedly and their controls, but there was a slight increase in the proportion of mothers of babies who died suddenly and unexpectedly for whom nursing staff thought that support and advice on feeding the baby were needed. Factors predictive of child abuse did not predict sudden infant death in this study.     

Influence of cultural and environmental factors on breast-feeding.

A study was undertaken at hôpital Sainte-Justine, Montreal, to determine the factors that influence the choice of feeding method for infants and the duration of breast-feeding. The factors that most clearly distinguished the mothers who breast-fed were lifestyle, education and conditioning to the parental role; those who nursed successfully for a long time were well motivated, well educated, supported by their family, especially the husband, and the La Leche League, and were of an economic status such that it was not necessary for them to return to work soon after delivery. Although the breast-fed babies were more fussy, they were healthier and received fewer drugs.     

When and why are babies weaned?

A prospective study was designed to investigate the weaning practices of 50 primiparous mothers whose babies were born between September 1976 and March 1978. The question whether the age of weaning influenced growth from birth to 6 months was also considered. The mothers and babies were seen in hospital and then at a follow-up clinic at 1, 2, 3, and 6 months. Details were taken of feeding practices, and measurements made of the babies'' weight, length, and subscapular and triceps skinfold thicknesses. Seventeen infants who were breastfed received their first solid food at a mean age of 13.8 weeks, compared with 8.3 weeks for the 33 bottle-fed infants. Most (38) mothers weaned because they though their babies were hungry (crying after a feed or demanding more frequent feeds, or both). The age of weaning did not influence weight gain, growth in length, or change in skinfold thicknesses. The results suggest that the "4-month rule" for weaning is unrealistic. The decision to wean should be based more on the mother''s interpretation of her baby''s needs than on age alone.     

Prevalence and duration of breast-feeding in Manitoba.

The rate of breast-feeding in the first 3 months post partum was studied in a group of 456 mothers. At 3 months 58% had been or still were breast-feeding their infants. The mothers who breast-fed were older, had a higher level of education, had a higher socioeconomic status, and were more likely to live on farms or in small towns, to have attended prenatal education classes and to have previously breast-feds. There were no significant differences between the method of feeding and the sex or birthweight of the infant, the maternal weight/height ratio or the participation of the father in the prenatal education classes. At 1 month 45% of the infants, at 2 months 35% and at 3 months 28% were being breast-fed. Public programs to promote breast-feeding as normal, beneficial and satisfying to both mother and infant are necessary so that more mothers will attempt to breast-feed their infants. Support for continuance of breast-feeding is needed in the hospital as well as in the home and the community.     

Mothers' experiences of induction

Mothers of a random sample of 2182 legitimate live births were interviewed about their experiences of pregnancy, labour, and delivery. Of these, 24% reported that their labours were induced, and data about this from a subsample of mothers tallied with information obtained through the doctors in charge in 88% of cases. All but 3% of the mothers who were induced perceived some medical reason for the induction. The proportion of inductions in the 24 study areas ranged from 6% to 39%. A relatively small proportion of labours in “teaching” hospitals, small hospitals with less than 100 beds, and GP maternity hospitals were induced, but a comparatively high proportion of private patients had an induction. There was no clear association between induction and the mother''s age or parity. Despite being given more pain relief, those who were induced reported similar intensities of pain during the first and second stages of labour to those whose labour started spontaneously; they also reported that they had “bad pains” for a similar period. The period they had contractions was shorter for the induced than for those starting spontaneously, and the intensity of pain at delivery was rated somewhat less by those who were induced.There was no difference between induced babies and others in the proportion who were held by their mothers immediately after their birth. Two-fifths of the mothers who were induced would have liked more information about induction; and a similar proportion said they had not discussed induction with a doctor, midwife, or nurse during their pregnancy. Only 17% of the mothers who had an induction said they would prefer to be induced if they had another baby. This contrasts with 63% of those who had epidural analgesia who would opt for the same procedure next time, while 83% of those who had had a baby in hospital, and 91% of those having had a home birth, would want their next baby in the same type of place.     

Influence of maternal obesity on subcutaneous fat in the newborn.

Skinfold thickness measurements were made at biceps, triceps, subscapular, and suprailiac sites on both sides on 265 full-term newborn infants. The mothers were classified as thin (25), normal (179), or obese (61) on the basis of their triceps skinfold thicknesses. At all skinfold sites the babies of the obese mothers were significantly fatter than the babies of normal mothers, and the babies of the normal mothers were significantly fatter than those of the thin mothers. There was a highly significant positive correlation between maternal triceps thickness and the baby''s sum of skinfold thicknesses. Hypertension was common during the pregnancies of the obese mothers and was associated with a significant reduction in the babies'' skinfold thicknesses. When each of the 61 obese mothers were matched for parity, blood pressure, and smoking habit with 61 non-obese mothers the babies of the obese mothers still had significantly greater skinfold thicknesses than the babies of non-obese mothers.     

Social relationships of nulliparous young adult females beyond the ordinary age of the first birth in a free-ranging troop of Japanese macaques (Macaca fuscata)

We describe the social relationships of young adult female Japanese macaques (Macaca fuscata) in a free-ranging troop in Arashiyama, Kyoto, Japan, who remained nulliparous beyond the ordinary age of first birth because of contraceptive administration. We observed 12 young nulliparous adult females (6–9 years old) for 270 h and 10 min from 2 February to 5 October 2010. The majority maintained close relationships with their mothers through proximity and grooming, whereas a few had very infrequent social interactions with their mothers. Most had asymmetrical grooming relationships; the grooming they received from unrelated adult females was less than the grooming they gave. Young adult females who had less frequent interactions with their mothers by either proximity or grooming received more grooming from a larger number of unrelated adult females than did those who had more frequent social interactions with their mothers. These results indicate that most young adult females who remained nulliparous beyond the ordinary age of first birth tended to maintain close relationships with their mothers, and their grooming relationships with unrelated adult females were inversely related to the degree of closeness with their mothers.     

Epidemic seasonal infertility — a hypothesis for the cause of seasonal variation of births

A hypothesis is proposed to explain the seasonality of births and its variations, that some unrecognized epidemic infertile factors have existed seasonally. In that case, certain women born in a particular low birth rate season must be those who survived these infertile factors in very early stage of their fetal lives. Then in later years, when they become pregnant, they may possibly be immune or different in their susceptibility to these infertile factors. Therefore, mothers born in a particular low birth rate season would tend to bear babies more frequently in that season than the others. To examine this hypothesis, birth records in 1930 of two maternity hospitals in Tokyo were investigated. These years were chosen for a period when seasonality of birth was most prominent in Japan. First babies were excluded to eliminate disturbances by season of marriages and other possible non-biological factors. The results show that among 1038 mothers born in a low birthrate season, May–July, 245 (23.6%) had babies in May–July, while the other mothers had significantly less babies (19.0%, 819/4302, P<0.001) in the same season. This may imply that seasonality of birth may have been influenced by some immunogenic infertile factors epidemic in a particular season.Presented at the Eight International Congress of Biometeorology, 9–14 September 1979, Shefayim, Israel     

Infant feeding practices: 1984-85 versus 1977-78.

In 1979 and 1980 the Canadian Paediatric Society''s Nutrition Committee published guidelines for professionals counselling mothers of infants on feeding practices. The practices in 1984-85 of mothers in Toronto were determined for comparison with the practices identified in a similar study conducted in Toronto and Montreal in 1977-78 to ascertain if practices had changed in favour of the recommendations. Between July 1984 and February 1985, 404 metropolitan Toronto mothers of infants were interviewed. Compared with the 1977-78 group of mothers, more of the 1984-85 mothers had chosen to breast-feed and fewer had stopped breast-feeding in the first month. As well, fewer of the 1984-85 infants had been fed unmodified cow''s milk in the first 6 months of life and introduced to solid foods before 4 months of age. We conclude that major changes in infant feeding practices had occurred since 1977-78 and that the 1984-85 practices corresponded closely to the infant feeding guidelines.     

Media and breastfeeding: Friend or foe?

This short essay examines infant formula marketing and information sources for their representation of "choice" in the infant feeding context, and finds that while providing information about breast and bottle feeding, infant formula manufacturers focus on mothers' feelings and intuition rather than knowledge in making decisions. In addition, the essay considers how "choice" operates in the history of reproductive rights, shifting the discourse from a rights-based set of arguments to one based on a consumerist mentality. Utilizing the work of historian Rickie Solinger and a 2007 paper for the National Bureau of Labor Statistics, I argue that the structure of market work, and not abstract maternal decision making, determine mothers' choices and practices concerning infant feeding. For true freedoms for mothers to be achieved, freedoms that would include greater social provisions for mothers, our culture will have to confront how structural constraints make breastfeeding difficult, as well as how the concept of choice divides mothers into those who make good choices and those who do not.     

The effect of divorce on infant mortality in a remote area of Bangladesh

The process of divorce is usually lengthy and hazardous, and can start quarrels that can lead to the abuse of women and their children. This study examines the effects of divorce on neonatal and postneonatal mortality of babies born before and after divorce in Teknaf, a remote area of Bangladesh. The longitudinal demographic surveillance system (DSS) followed 1,762 Muslim marriages in 1982-83 for 5 years to record divorce, deaths of spouse, emigration and births. It recorded 2,696 live births during the follow-up period, and their survival status during infancy. Logistic regression models were used to estimate the effect of divorce on neonatal and postneonatal mortality, controlling for maternal age at birth, parity, sex of the child and household economic status. The odds of neonatal and postneonatal deaths among babies born after divorce or less than 12 months before mothers were divorced were more than double the odds of those born to mothers of intact marriages. The odds of postneonatal deaths were two times higher among babies born more than 12 months before divorce happens than their peers. The high mortality of infants born before and after mothers were divorced may reflect how abusive marriage and divorce increase the vulnerability of women and children in rural Bangladesh. Divorce and abuse of women are difficult and intractable social and health problems that must be addressed.     

Is breast feeding possible after reduction mammaplasty?

The purpose of this study was (1) to evaluate the frequency of breast feeding in patients who had given birth following reduction mammaplasty using an inferiorly based pedicle flap and (2) to identify operative and nonoperative factors that may affect breast feeding following reduction mammaplasty. Seventy-three patients between the ages of 18 and 40 years were contacted and sent a standardized questionnaire. Data collected included age at pregnancy, duration of breast feeding, difficulties while breast feeding, and reasons for discontinuing breast feeding. A total of 20 patients of the 68 who responded had become pregnant following reduction mammaplasty. All 20 women lactated. Seven of these women (35 percent) went on to a breast-feed successfully, whereas 13 (65 percent) decided not to breast-feed or discontinued breast feeding for a variety of personal reasons.     

Extending lactational amenorrhoea in Manila: a successful breast-feeding education programme.

An experimental breast-feeding education programme conducted at the Philippine General Hospital in Manila demonstrated that women could be motivated to improve their breast-feeding practices and lengthen their period of lactational amenorrhoea in comparison to a control group. Mothers who participated in the programme breast-fed their babies more frequently, delayed the introduction of regular supplements, used fewer bottles and pacifiers and maintained night feeding longer than mothers who were not exposed to the positive breast-feeding messages. The programme was successful in lengthening the period of amenorrhoea among women with elementary, high school, or technical school education, but not among college-educated women. Different educational approaches may be necessary for women of different education levels.     

Constraints to exclusive breastfeeding practice among breastfeeding mothers in Southwest Nigeria: implications for scaling up

Background

The practice of exclusive breastfeeding is still low despite the associated benefits. Improving the uptake and appropriating the benefits will require an understanding of breastfeeding as an embodied experience within a social context. This study investigates breastfeeding practices and experiences of nursing mothers and the roles of grandmothers, as well as the work-related constraints affecting nurses in providing quality support for breastfeeding mothers in Southwest Nigeria.

Methods

Using a concurrent mixed method approach, a structured questionnaire was administered to 200 breastfeeding mothers. In-depth interviews were also held with breastfeeding mothers (11), nurses (10) and a focus group discussion session with grandmothers.

Results

Breastfeeding was perceived as essential to baby's health. It strengthens the physical and spiritual bond between mothers and their children. Exclusive breastfeeding was considered essential but demanding. Only a small proportion (19%) of the nursing mothers practiced exclusive breastfeeding. The survey showed the major constraints to exclusive breastfeeding to be: the perception that babies continued to be hungry after breastfeeding (29%); maternal health problems (26%); fear of babies becoming addicted to breast milk (26%); pressure from mother-in-law (25%); pains in the breast (25%); and the need to return to work (24%). In addition, the qualitative findings showed that significant others played dual roles with consequences on breastfeeding practices. The desire to practice exclusive breastfeeding was often compromised shortly after child delivery. Poor feeding, inadequate support from husband and conflicting positions from the significant others were dominant constraints. The nurses decried the effects of their workload on providing quality supports for nursing mothers.

Conclusion

Breastfeeding mothers are faced with multiple challenges as they strive to practice exclusive breastfeeding. Thus, scaling up of exclusive breastfeeding among mothers requires concerted efforts at the macro, meso and micro levels of the Nigerian society.     

Egg and cows' milk hypersensitivity in exclusively breast fed infants with eczema,and detection of egg protein in breast milk.

Forty nine eczematous infants who were still solely and exclusively breast fed and who had never received anything but breast milk were studied for evidence of sensitisation to foods. Thirty four similar infants without eczema formed a control group. The eczematous infants were divided into three groups according to clinical criteria: (1) definite atopic eczema; (2) possible atopic eczema; (3) atopic eczema unlikely. Twenty three infants showed cutaneous hypersensitivity to foods, usually egg and cows'' milk. Seven of 14 infants in group 1 and nine of 20 in group 2 were sensitised compared with four of 15 in group 3 and three of 34 controls (p less than 0.01). Ovalbumin was detected in breast milk from 14 of 19 mothers tested after ingestion of egg, the concentrations being the same for mothers feeding eczematous and normal infants. Breast fed babies developing eczema may be sensitised by foods eaten by their mothers.