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Militant Lactivism?
Following networks of mothers in London and Paris, the author profiles the narratives of women who breastfeed their children to full term, typically a period of several years, as part of an 'attachment parenting' philosophy. These mothers talk about their decision to continue breastfeeding as 'the natural thing to do': 'evolutionarily appropriate', 'scientifically best' and 'what feels right in their hearts'. Through a theoretical focus on knowledge claims and accountability, the author frames these accounts within a wider context of 'intensive parenting', arguing that parenting practices – infant feeding in particular – have become a highly moralized affair for mothers, practices which they feel are a critical aspect of their 'identity work'. The book investigates why, how and with what implications some of these mothers describe themselves as 'militant lactivists' and reflects on wider parenting culture in the UK and France. Discussing gender, feminism and activism, this study contributes to kinship and family studies by exploring how relatedness is enacted in conjunction to constructions of the self.
eBook
Is Breast Best?
pWhy has breastfeeding re-asserted itself over the last twenty years, and why are the government, the scientific and medical communities, and so many mothers so invested in the idea? In Is Breast Best? Joan B. Wolf challenges the widespread belief that breastfeeding is medically superior to bottle-feeding. Despite the fact that breastfeeding has become the ultimate expression of maternal dedication, Wolf writes, the conviction that breastfeeding provides babies unique health benefits and that formula feeding is a risky substitute is unsubstantiated by the evidence. In accessible prose, Wolf argues that a public obsession with health and what she calls “total motherhood” has made breastfeeding a cause célèbre, and that public discussions of breastfeeding say more about infatuation with personal responsibility and perfect mothering in America than they do about the concrete benefits of the breast. Parsing the rhetoric of expert advice, including the recent National Breastfeeding Awareness Campaign, and rigorously questioning the scientific evidence, Is Breast Best? uncovers a path by which a mother can feel informed and confident about how best to feed her thriving infant—whether flourishing by breast or by bottle./p
eBook
Effectiveness of targeting fathers for breastfeeding promotion: systematic review and meta-analysis
Background
Further research gaps exist in relation to the promotion of breastfeeding. Robust scientific evidence obtained by a meta-analysis would provide objectively summarized data while enabling the assessment of consistency of findings. This review includes the first documented meta-analysis done on the effectiveness of targeting fathers for promoting breastfeeding (BF). Assessments have been done for a primary outcome and for six more secondary outcomes.
Methods
PubMed, EMBASE, Google Scholar, CENTRAL databases and unpublished researches were searched. Selections of randomized-controlled trials and quasi-experimental studies were done in three rounds. Heterogeneity and potential publication bias were assessed. Eight studies were included in meta-analysis and others in narrative synthesis of the outcomes. Pooling was done with the Mental- Haenszel method using risk ratio (RR). Summary-of-Findings table was composed by Review-Manager (version 5.3) and GRADEproGDT applications. Subsequent sensitivity analysis was done.
Results
Selected eight interventional studies included 1852 families. Exclusive BF at six months was significantly higher (RR = 2.04, CI = 1.58–2.65) in the intervention groups. The RR at 4 months was 1.52 (CI = 1.14 to 2.03). Risk of full-formula-feeding (RR = 0.69, CI = 0.52–0.93) and the occurrence of lactation-related problems were lower in the intervention groups (RR = 0.24, CI = 0.10–0.57). More likelihood of rendering support in BF-related issues was seen in intervention groups (RR = 1.43, CI = 1.22–1.68). Increase of maternal knowledge and favorable attitudes on BF were higher in the intervention groups (
P
≤; 0.001). The quality of evidence according to GRADE was “low” (for one outcome), “moderate” (for four outcomes), and “high” (for two outcomes).
Conclusions
Targeting fathers in promotion of BF has provided favorable results for all seven outcomes with satisfactory quality of evidence.
This review was registered in the PROSPERO-registry (ID: 2017-CRD42017076163) prior to its commencement.
Journal Article
The womanly art of breastfeeding
A guide for expectant and new mothers on breastfeeding thier baby.
Book
Knowledge, attitudes, and practices of breastfeeding among women visiting primary healthcare clinics on the island of Abu Dhabi, United Arab Emirates
Background
The World Health Organization recommends continued breastfeeding up to 2 years of age or beyond. This study assessed breastfeeding knowledge, attitudes, and practices among women residing on the island of Abu Dhabi and identified associated factors.
Methods
We conducted a cross-sectional study using a self-administered questionnaire among mothers visiting primary healthcare clinics in Abu Dhabi between November 2014 and 2015. Participants were women aged at least 18 years who had at least one child aged 2 years or younger at the time of the study. Breastfeeding knowledge, attitudes, and practices were assessed on the basis of experience with last child. Selected questions were used to develop a scaled scoring system to categorize these aspects as good, fair, or poor. Exclusive breastfeeding is defined as the act of feeding infants only breast milk since birth, without providing water, formula, or other liquid supplements.
Results
The participants were 344 women. Exclusive breastfeeding for 6 months was reported by only 46 (16.9%, 95% CI 0.10, 0.17,
n
= 272). 79 (28.7%,
n
= 275) of the participants were breastfeeding and planning to continue after the child was ≥24 months. Multivariate logistic regression analysis revealed that the following factors were associated with exclusive breastfeeding: mothers with female children (adjusted OR [AOR] 2.42; 95% CI 1.18, 4.97) and better breastfeeding knowledge scores (AOR 1.25; 95% CI 1.04, 1.50). The following factors were associated with less likelihood of exclusively breastfeeding: working mothers (AOR 0.29; 95% CI 0.12, 0.72), living with relatives (AOR 0.21; 95% CI 0.05, 0.81), no past exclusive breastfeeding experience (AOR 0.23; 95% CI 0.09, 0.58) and being offered readymade liquid formula in hospital (AOR 0.33; 95% CI 0.15, 0.72). The most common reason for stopping breastfeeding was insufficient breast milk production (68/89, 76%), and the most common work related reason was inadequate maternity leave (24/89, 15%).
Conclusion
Although breastfeeding knowledge was generally good, breastfeeding practice was still suboptimal. Modifiable factors found to predict exclusive breastfeeding included breastfeeding knowledge and mothers’ employment status.
Journal Article
Breastfeeding at the workplace: a systematic review of interventions to improve workplace environments to facilitate breastfeeding among working women
Background
Breastfeeding can be affected by maternal employment. This is important considering that in 2019, 47.1% of women globally participated in the labor force. The aim of this study was to review workplace interventions to promote, protect and support breastfeeding practices among working mothers globally.
Methods
A systematic review was conducted following the guidance of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Observational, experimental and qualitative peer-reviewed studies in English and Spanish, published between 2008 and 2019 were included. The review focused on working women who were pregnant, breastfeeding or who recently had a child, and women’s working environments. The outcomes of interest included breastfeeding intentions, initiation, exclusivity and duration, confidence in breastfeeding or breastmilk extraction, and perceived support at workplace. Quality was assessed according to National Institute for Health and Care Excellence (NICE) checklist for systematic reviews. It was registered on PROSPERO (#140624).
Results
Data was extracted from 28 quantitative and 9 qualitative studies. The most common interventions were designated spaces for breastfeeding or breastmilk extraction (
n
= 24), and the support from co-workers (
n
= 20). The least common interventions were providing breast pumps (
n
= 4) and giving mothers the flexibility to work from home (
n
= 3). Studies explored how interventions affected different breastfeeding outcomes including breastfeeding duration, breastfeeding exclusivity, confidence in breastmilk expression, and breastfeeding support. The evidence suggests that workplace interventions help increase the duration of breastfeeding and prevent early introduction of breastmilk substitutes. Having a lactation space, breastmilk extraction breaks, and organizational policies are key strategies. However, to achieve equitable working conditions for breastfeeding mothers, organizational and interpersonal changes need to occur as well.
Conclusions
The systematic review revealed that interventions at the workplace are important in protecting, promoting and supporting breastfeeding among working mothers. To achieve equitable work environments and fair nutritional opportunities for infants of working mothers, interventions should focus at the three ecological layers – individual, interpersonal, and organizational. The quality of studies can be improved. There is a need for studies assessing impacts of workplace interventions on infant feeding practices, mothers’ self-esteem and outcomes such productivity and abstentionism.
Journal Article