The Proverbial Bourdieu: Habitus and the Politics of Representation in the Ethnography of Kabylia

Since the 1970s, anthropologists have been centrally concerned with the relationship of ethnographic representation to political and historical context. Interestingly, the work of Pierre Bourdieu has largely escaped such contextualization, despite the significance of Bourdieu's ideas to anthropological theorizing. Today, many of Bourdieu's central concepts float free from the context out of which they arose—the Kabyle region of Algeria. This article addresses this omission by reading Bourdieu's early works against each other to reconstitute aspects of his methodology and fieldwork. Focusing on his choice to represent the Kabyles of his early work in prose, and those in his later work via proverbs, I suggest that key premises of Bourdieu's theory may not be supported by historical and ethnographic evidence. I consider how Bourdieu's position as a young social scientist grappling with ethnographic responsibilities in colonial wartime led him to privilege his interlocutors' accounts in some studies while expunging them from others. [Keywords: Bourdieu, represented speech, literacy, Algeria, Berbers]     

A qualitative study of the promotion of exclusive breastfeeding by health professionals in Niamey, Niger

Infant feeding by HIV-infected mothers has been a major global public health dilemma and a highly controversial matter. The controversy is reflected in the different sets of WHO infant feeding guidelines that have been issued over the last two decades. This thematic series, 'Infant feeding and HIV: lessons learnt and ways ahead' highlights the multiple challenges that HIV-infected women, infant feeding counsellors and health systems have encountered trying to translate and implement the shifting infant feeding recommendations in different local contexts in sub-Saharan Africa. As a background for the papers making up the series, this editorial reviews the changes in the guidelines in view of the roll out of prevention of mother to child transmission (PMTCT) programmes in sub-Saharan Africa between 2001 and 2010.     

Ways ahead: protecting, promoting and supporting breastfeeding in the context of HIV

The HIV epidemic coupled with the assumed benefits of infant formula for the children of all HIV-infected mothers have in complex ways changed public ideas about infant feeding and represents a threat to well established breastfeeding practices. In the wake of the confusion that postnatal prevention of mother to child transmission of HIV (PMTCT) interventions have created among HIV-infected mothers, infant feeding counsellors and the public at large, it is time to reinstate the principles of the Innocenti Declaration to protect, promote and support breastfeeding in the context of HIV. The challenge that lies ahead is a search for ways to restore the trust in breastfeeding as the normal and safest way to feed an infant. This requires continued research as well as concerted advocacy and action.     

“Can breast feeding help you in later life? Evidence from German military heights in the early 20th century”

Considerable literature exists on the benefits of breast feeding on the health and survival of infants and young children, but there is less on the effects on later life outcomes. One such measure of health and well-being that has received attention in the historical literature is terminal adult stature. Information on height is rather widely available; however, it is much more difficult to obtain data on breast feeding. One country that does have such information is Imperial Germany (1871-1919). A number of physicians and local health officials collected information on the incidence and duration of breast feeding early in the 20th century, particularly because of concern about the unusually high infant mortality rates in parts of Germany. Hallie Kintner has surveyed the published results of these studies. The information on the prevalence of breast feeding for the period 1903/10 has been inputed into a database of demographic and economic variables for the counties (Regierungsbezirke) of Germany (1850-1939). There are also published data on heights of military recruits from the Imperial German military forces in 1906. These can be linked to areas in the database and related to breast feeding practices and infant mortality both contemporaneously and approximately 20 years previous to 1906. Results indicate a significant effect of infant feeding practices on later life outcomes operating through infant health conditions, proxied by the infant mortality rate.     

WHO accused of stifling debate about infant feeding

International specialists in infant feeding expressed concern that the policy of WHO of establishing partnerships with private industry has gone too far, with the result that debate about the infant food industry's role in marketing breast milk substitutes is being stifled. Specialists, who want the WHO to recommend exclusive breast-feeding to babies up to 6 months, claim that at a recent joint meeting on infant feeding they were prevented from discussing the issue. In addition, some papers intended for the meeting were edited so that they were less critical to the infant food industry. Although 20 of the 28 consultants signed a statement saying that scientific evidence was now sufficient to warrant changing of the current WHO recommendation on the introduction of complementary feeding from age 4-6 months to about 6 months, no discussion was allowed. In response, a spokesman for the WHO stated that the current recommendation of WHO on the duration of exclusive breast-feeding was excluded in the discussion because of the WHO?s research that is under way in this connection. As far as the alleged censorship of the background papers is concerned, he explained that WHO documents have to conform to a high standard of scientific objectivity and balance. Lastly, WHO cited that the food industry continues to play an important and constructive role in relation to infant feeding.     

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 body build and composition of Samoan children: Relationships to infant feeding patterns and infant weight-for-length status

The relationships between infant feeding patterns, infant weight status, and subsequent growth are not yet firmly established. This study attempts to address these topics among Samoan children. The study population consists of 1,186 children born between October 1974 and September 1976 who were subsequently seen in the Well Baby Clinic in American Samoa. On the basis of the clinic records the children were categorized into feeding groups (breast vs. bottle) and weight-for-length groups (<25th percentile or >75th percentile of National Center for Health Statistics (NCHS) standards). A survey of 74 of these children was conducted in 1982. The average age of the children was 6.6 years. Twenty anthropometric measurements were taken and divided into three groups: skeletal, adipose, and mixed. Multiple analysis of variance was used on each of the groups of measurements to assess effects of infant feeding and weight-for-length. This analysis demonstrated significant relationships between infant weight-for-length and childhood skeletal size (heavy infants are larger children); between infant feeding patterns and childhood adiposity (bottle-fed children are fatter); and between both infant patterns and the mixed measurements (heavy and bottle-fed infants are heavier children with larger circumferences). The relationship between infant weight-for-length and skeletal size may be a continuation of infant patterns of high musculoskeletal weight in heavy infants. The relationship between infant feeding and childhood fatness was not affected by family income.     

Bottle feeding and the sudden infant death syndrome.

OBJECTIVE--To determine whether the risk of the sudden infant death syndrome is increased in bottle fed babies. DESIGN--Population based case-control study matching for age and time. SUBJECTS--All babies aged 1 week to 1 year dying of sudden infant death syndrome during November 1987 to April 1989 or February 1990 to June 1991 and two live controls. SETTING--Avon and north Somerset. MAIN OUTCOME MEASURES--Breast or bottle feeding, sleeping position, maternal smoking, parental employment, and length of gestation. RESULTS--Compared with being fully breast fed, the crude odds ratio for sudden infant death in fully bottle fed babies was 3.1 and for mixed breast and bottle fed babies 1.5. These odds ratios fell to 1.8 (95% confidence interval 0.7 to 4.8) and 1.2 (0.5 to 2.7) respectively after maternal smoking, parental employment, preterm gestation, and sleeping position had been adjusted for. Sleeping position partly masked the effect of being bottle fed on sudden infant death as breast fed babies were more likely to have slept prone than bottle fed babies. CONCLUSIONS--Bottle feeding is not a significant independent risk factor for the sudden infant death syndrome. Patterns of maternal smoking, preterm gestation, and parental employment status account for most of the apparent association with bottle feeding.     

The protective effect of breast feeding in relation to sudden infant death syndrome (SIDS): II. The effect of human milk and infant formula preparations on binding of Clostridium perfringens to epithelial cells

Breast feeding is known to protect an infant against gastrointestinal pathogens and epidemiological studies indicate that compared to breast fed infants, formula fed infants are at a greater risk of dying from sudden infant death syndrome (SIDS). Many SIDS infants have symptoms of gastrointestinal infections prior to death and one gastrointestinal pathogen associated with SIDS is Clostridium perfringens. Studies have found that a significantly higher number of formula fed SIDS infants have C perfringens and its enterotoxin in their faeces compared to breast fed infants. The aim of the study was to compare the effects of human milk and infant formula on binding of C perfringens to epithelial cells. Two protocols were used to assess the effect of human milk and infant formula to inhibit binding of C perfringens to epithelial cells. Binding was assessed by flow cytometry. For the in vivo protocol which more closely represents interactions on the mucosal surface, breast milk enhanced bacterial binding but infant formula caused inhibition of binding; however for the in vitro method, both human milk and infant formula resulted in consistent enhancement of binding. Flow cytometry studies indicated that enhancement of binding was due to the formation of bacterial aggregates. Lewis(a) and Lewis(b) antigens, found in both breast milk and infant formula, inhibited C. perfringens binding in a dose dependent manner. The Lewis(a) and Lewis(b) antigens in human milk and infant formula can inhibit C. perfringens binding to epithelial cells. While infant formula reduced binding of C. perfringens to epithelial cells in the experiments carried out with the in vivo protocol, the protective effects of breast feeding in relation to colonisation with C. perfringens are more likely to be due to formation of bacterial aggregates. These findings have implications for improving infant formula preparations.     

Pressuring and restrictive feeding styles influence infant feeding and size among a low‐income African‐American sample

Objective:

The prevalence of overweight among infants and toddlers has increased dramatically in the past three decades, highlighting the importance of identifying factors contributing to early excess weight gain, particularly in high‐risk groups. Parental feeding styles and the attitudes and behaviors that characterize parental approaches to maintaining or modifying children's eating behavior are an important behavioral component shaping early obesity risk.

Design and Methods:

Using longitudinal data from the Infant Care and Risk of Obesity Study, a cohort study of 217 African‐American mother‐infant pairs with feeding styles, dietary recalls, and anthropometry collected from 3 to 18 months of infant age, we examined the relationship between feeding styles, infant diet, and weight‐for‐age and sum of skinfolds.

Results:

Longitudinal mixed models indicated that higher pressuring and indulgent feeding style scores were positively associated with greater infant energy intake, reduced odds of breastfeeding, and higher levels of age‐inappropriate feeding of liquids and solids, whereas restrictive feeding styles were associated with lower energy intake, higher odds of breastfeeding, and reduced odds of inappropriate feeding. Pressuring and restriction were also oppositely related to infant size with pressuring associated with lower infant weight‐for‐age and restriction with higher weight‐for‐age and sum of skinfolds. Infant size also predicted maternal feeding styles in subsequent visits indicating that the relationship between size and feeding styles is likely bidirectional.

Conclusion:

Our results suggest that the degree to which parents are pressuring or restrictive during feeding shapes the early feeding environment and, consequently, may be an important environmental factor in the development of obesity.     

Representing infant feeding: content analysis of British media portrayals of bottle feeding and breast feeding

ObjectiveTo examine how breast feeding and bottle feeding are represented by the British media.DesignContent analysis.Subjects Television programmes and newspaper articles that made reference to infant feeding during March 1999.SettingUK mass media.ResultsOverall, 235 references to infant feeding were identified in the television sample and 38 in the newspaper sample. Bottle feeding was shown more often than breast feeding and was presented as less problematic. Bottle feeding was associated with “ordinary” families whereas breast feeding was associated with middle class or celebrity women. The health risks of formula milk and the health benefits of breast feeding were rarely mentioned.ConclusionsThe media rarely present positive information on breast feeding, even though this feeding practice is associated with the most health benefits. Health professionals and policy makers should be aware of patterns in media coverage and the cultural background within which women make decisions about infant feeding.     

Gendered Endings: Narratives of Male and Female Suicides in the South African Lowveld

Durkheim's classical theory of suicide rates being a negative index of social solidarity downplays the salience of gendered concerns in suicide. But gendered inequalities have had a negative impact: worldwide significantly more men than women perpetrate fatal suicides. Drawing on narratives of 52 fatal suicides in Bushbuckridge, South Africa, this article suggests that Bourdieu's concepts of 'symbolic violence' and 'masculine domination' provide a more appropriate framework for understanding this paradox. I show that the thwarting of investments in dominant masculine positions have been the major precursor to suicides by men. Men tended to take their own lives as a means of escape. By contrast, women perpetrated suicide to protest against the miserable consequences of being dominated by men. However, contra the assumption of Bourdieu's concept of 'habitus', the narrators of suicide stories did reflect critically upon gender constructs.     

人工哺育期腹泻婴猴奇异变形杆菌的分离与鉴定

目的对一株人工哺育期引发恒河猴婴猴腹泻的奇异变形杆菌进行了鉴定,为实验猕猴疾病检测、鉴别诊断提供参考依据。方法通过培养特性、菌落形态、染色、生化试验和血清学诊断鉴别等检查,对分离菌株进行初步鉴定,同时,对分离菌株进行致病性试验及药敏试验。结果通过表型生物学特性鉴定,并结合血清学诊断鉴别方法,确证该分离菌株为奇异变形杆菌,应用药敏试验筛选出了高度敏感的抗菌药,控制了该病的继续发生,致病性试验证明,该分离菌株对小白鼠有高致病性。结论分离到的奇异变形杆菌是导致本次婴猴腹泻死亡的病原菌,该菌为条件致病菌,对实验猕猴和研究人员均有潜在的危害,尽管该菌不是国家标准要求排除的病原菌,但该菌引发的传染病将对动物实验造成严重影响,故应引起高度重视。     

Translating global recommendations on HIV and infant feeding to the local context: the development of culturally sensitive counselling tools in the Kilimanjaro Region, Tanzania

Background

This paper describes the process used to develop an integrated set of culturally sensitive, evidence-based counselling tools (job aids) by using qualitative participatory research. The aim of the intervention was to contribute to improving infant feeding counselling services for HIV positive women in the Kilimanjaro Region of Tanzania.

Methods

Formative research using a combination of qualitative methods preceded the development of the intervention and mapped existing practices, perceptions and attitudes towards HIV and infant feeding (HIV/IF) among mothers, counsellors and community members. Intervention Mapping (IM) protocol guided the development of the overall intervention strategy. Theories of behaviour change, a review of the international HIV/IF guidelines and formative research findings contributed to the definition of performance and learning objectives. Key communication messages and colourful graphic illustrations related to infant feeding in the context of HIV were then developed and/or adapted from existing generic materials. Draft materials were field tested with intended audiences and subjected to stakeholder technical review.

Results

An integrated set of infant feeding counselling tools, referred to as 'job aids', was developed and included brochures on feeding methods that were found to be socially and culturally acceptable, a Question and Answer Guide for counsellors, a counselling card on the risk of transmission of HIV, and an infant feeding toolbox for demonstration. Each brochure describes the steps to ensure safer infant feeding using simple language and images based on local ideas and resources. The brochures are meant to serve as both a reference material during infant feeding counselling in the ongoing prevention of mother to child transmission (pMTCT) of HIV programme and as take home material for the mother.

Conclusion

The study underscores the importance of formative research and a systematic theory based approach to developing an intervention aimed at improving counselling and changing customary feeding practices. The identification of perceived barriers and facilitators for change contributed to developing the key counselling messages and graphics, reflecting the socio-economic reality, cultural beliefs and norms of mothers and their significant others.     

Qualitative evidence syntheses of attitudes and preferences to inform guidelines on infant feeding in the context of Ebola Virus Disease (EVD) transmission risk

BackgroundBreast-feeding holds considerable potential to reduce infant mortality. Feeding choices, already complex, take on additional complexity against a backdrop of the risk of transmissible Ebola Virus. This review describes the factors that influence infant feeding and attitudes of pregnant women, mothers, family members and health practitioners, policy makers and providers (midwives) concerning infant feeding when there is a risk of Mother-to-Child (MTC) transmission of Ebola Virus Disease (EVD).MethodologyA systematic review of qualitative studies identified through rigorous searches of thirteen online databases and additional citation searches of included studies was undertaken. Search terms included breast-feeding, breast-feeding, infant feeding; Ebola; and qualitative, interview(s) and findings. Independent extraction of data by two reviewers using predefined extraction forms. Studies were assessed using the CASP Qualitative checklist.Principal findings5219 references were screened. 38 references related specifically to Ebola, and five papers met the inclusion criteria with data gathered from two settings: Guinea and Sierra Leone. The EVD outbreak had a significant impact on beliefs, attitudes, and resources to support infant feeding practices negatively affecting the nutritional status of children. The evidence from these studies highlight the need for guidance and appropriate psychosocial support need to be available to mothers who display symptoms and become infected and to front-line staff who are giving advice. Communities need to be engaged because stigma and fear may hinder uptake of appropriate interventions. The EVD outbreak caused multi-level system disruption akin to that seen following a natural disaster, meaning that logistics and coordination are critical and need adequate resourcing. Food production and distribution, and malnutrition screening are also disrupted and thereby compounding compromised nutritional status. The limited number of relevant studies highlights the need for further primary research, particularly in translation of messages to local settings.ConclusionsAn EVD outbreak causes multi-level disruption that negatively impacts infant feeding and child care practices. Negative impacts have multiple causes and successful planning for Ebola outbreaks requires that nutrition of infants and young children is a priority. Lessons from the Ebola pandemic have wider applicability to other pandemic contexts including Covid-19.     

Costs of Promoting Exclusive Breastfeeding at Community Level in Three Sites in South Africa

Background

Community-based peer support has been shown to be effective in improving exclusive breastfeeding rates in a variety of settings.

Methods

We conducted a cost analysis of a community cluster randomised-controlled trial (Promise-EBF), aimed at promoting exclusive infant feeding in three sites in South Africa. The costs were considered from the perspective of health service providers. Peer supporters in this trial visited women to support exclusive infant feeding, once antenatally and four times postpartum.

Results

The total economic cost of the Promise-EBF intervention was US$393 656, with average costs per woman and per visit of US$228 and US$52, respectively. The average costs per woman and visit in an operational ‘non research’ scenario were US$137 and US$32 per woman and visit, respectively. Investing in the promotion of exclusive infant feeding requires substantial financial commitment from policy makers. Extending the tasks of multi-skilled community health workers (CHWs) to include promoting exclusive infant feeding is a potential option for reducing these costs. In order to avoid efficiency losses, we recommend that the time requirements for delivering the promotion of exclusive infant feeding are considered when integrating it within the existing activities of CHWs.

Discussion

This paper focuses on interventions for exclusive infant feeding, but its findings more generally illustrate the importance of documenting and quantifying factors that affect the feasibility and sustainability of community-based interventions, which are receiving increased focus in low income settings.     

Inappropriate infant feeding practices of HIV-positive mothers attending PMTCT services in Oromia regional state,Ethiopia: a cross-sectional study

Background

Inappropriate infant feeding affects the probability of mother-to-child transmission of HIV and HIV-free survival of infants. However, in Ethiopia limited evidence exists regarding the infant feeding practice of mothers who are HIV-positive. The aim of this study was to determine the prevalence and predictors of inappropriate infant feeding among HIV-positive mothers attending the prevention of mother-to-child transmission (PMTCT) service in Adama and Bushoftu towns, Oromia, central Ethiopia.

Methods

A cross-sectional study was conducted in ten PMTCT service providing health facilities in the towns; 283 mother-infant pairs were enrolled. Appropriate infant feeding practice was defined as exclusive breastfeeding in the first six months of age. Logistic regression was employed to analyze the data and the outputs are presented using adjusted odds ratio (AOR) with 95% confidence intervals (CI).

Results

One hundred thirty of the infants were aged below six months, 103 between 6 and 11 months and 50 were older than 12 months. The prevalence of inappropriate infant feeding was 14.5% (95% CI 10.6, 18.7). About 6.3% and 8.3% practiced exclusive replacement feeding and mixed feeding respectively, in the first six months. Only 1.8% ever expressed their breast milk to feed their baby and none practiced wet nursing. Among 38 mothers who already discontinued breastfeeding 52.6% did so before 12 months of age. Mothers who were HIV-positive and had received antenatal (AOR?=?0.05: 0.01, 0.30) and postnatal visits (AOR?=?0.18: 0.04, 0.81); received infant feeding counseling (AOR?=?0.18: 0.06, 0.55); and disclosed their HIV status to their partners (AOR?=?0.28: 0.12, 0.63), showed a reduction of practicing inappropriate infant feeding. Mothers having breast problems (AOR?=?4.89: 1.54, 15.60) and infants with mouth ulcers (AOR?=?6.41: 2.07, 19.85) were more likely to practice inappropriate feeding.

Conclusion

Prompt management of breast complaints in mothers and mouth ulcer in infants; and provision of nutrition counseling to HIV-positive mothers, especially during antenatal and postnatal care, may help to improve the infant feeding practices for HIV exposed infants.

     

Factors affecting intention to breastfeed among Syrian and Jordanian mothers: a comparative cross-sectional study

Background

Breastfeeding remains normative and vital for child survival in the developing world. However, knowledge of the risk of Human Immunodeficiency Virus (HIV) transmission through breastfeeding has brought to attention the controversy of whether breastfeeding can be safely practiced by HIV positive mothers. Prevention of mother to child transmission (PMTCT) programs provide prevention services to HIV positive mothers including infant feeding counseling based on international guidelines. This study aimed at exploring infant feeding choices and how breastfeeding and the risk of HIV transmission through breastfeeding was interpreted among HIV positive mothers and their counselors in PMTCT programs in Addis Ababa, Ethiopia.

Methods

The study was conducted in the PMTCT clinics in two governmental hospitals in Addis Ababa, Ethiopia, using qualitative interviews and participant observation. Twenty two HIV positive mothers and ten health professionals working in PMTCT clinics were interviewed.

Results

The study revealed that HIV positive mothers have developed an immense fear of breast milk which is out of proportion compared to the evidence of risk of transmission documented. The fear is expressed through avoidance of breastfeeding or, if no other choice is available, through an intense unease with the breastfeeding situation, and through expressions of sin, guilt, blame and regret. Health professionals working in the PMTCT programs seemed to largely share the fear of HIV positive mother's breast milk, and their anxiety was reflected in the counseling services they provided. Formula feeding was the preferred infant feeding method, and was chosen also by HIV positive women who had to beg in the streets for survival.

Conclusions

The fear of breast milk that seems to have developed among counselors and HIV positive mothers in the wake of the HIV epidemic may challenge a well established breastfeeding culture and calls for public health action. Based on strong evidence of the risks when infants are not exclusively breastfed, there is a great need to protect breastfeeding from pressures of replacement feeding and to promote exclusive breastfeeding as the best infant feeding option for HIV positive and HIV negative mothers alike.     

Incident of intense aggression by chimpanzees against an infant from another group in Mahale Mountains National Park,Tanzania

We document here an unusual case of intense aggression against an infant male from another group by chimpanzees (Pan troglodytes schweinfurthii) of the Mahale Mountains National Park, in Tanzania. Adult males of the study group collectively attacked an unknown male infant. Although an unknown female, probably the mother, tried to retrieve him, the infant was seriously injured and most likely died. During this incident, the unknown female attacked and injured two researchers. After the aggressive encounter, it was found that six of the nine adult males in the study group were wounded. Attacking the extragroup male infant may have the effect of weakening the future power of the neighboring group, leading to better access to resources and enhanced safety in the future for the study group.     

母婴间菌群传递的研究进展

肠道菌群的结构对婴儿肠道系统发育及免疫系统构建具有重要的影响,研究表明最初的婴儿肠道菌群在母亲子宫内就已经存在并受分娩方式和喂养方式的影响。本研究从母亲怀孕、分娩、喂养三个阶段综述母婴间的菌群传递,为母婴间菌群传递机制及婴儿肠道菌群对其免疫系统构建的影响提供一定的理论依据。