Woman Infant Research Articles

Determinants of breastfeeding practices: An analysis of the Sri Lanka Demographic and Health Survey 2006–2007

Identification of factors that predict a woman's infant feeding choice is important for breastfeeding promotion programmes. We analysed a subsample of children under 2 years of age from the most recent Sri Lanka Demographic and Health Survey (SLDHS) to assess breastfeeding practices and factors associated with suboptimal practices. SLDHS 2006-2007 used a stratified two-stage cluster sample of ever-married women aged 15-49 years. Breastfeeding indicators were estimated for the last-born children (n = 2735). Selected indicators were examined against independent variables through cross-tabulations and multivariate analyses. Of the sample, 83.3% initiated breastfeeding within 1 h of birth. Continuation rates declined from 92.6% in first year to 83.5% in second year. Exclusive breastfeeding (EBF) rate under 6 months of age was 75.8%, with median duration being 4.8 months. Delayed initiation of breastfeeding was associated with low birthweight [odds ratio (OR) = 2.24] and caesarean delivery (OR = 3.30), but less likely among female infants (OR = 0.75), mothers from 'estate' sector (OR = 0.61) or richer wealth quintile (OR = 0.60). Non-EBF was associated with children from urban areas (OR = 1.72) and estate sector (OR = 4.48) and absence of post-natal visits by a public health midwife (OR = 1.89). A child was at risk for not currently breastfeeding if born in a private hospital (OR = 3.73), delivered by caesarean section (OR = 1.46) or lived in urban areas (OR = 2.80) or estate sector (OR = 3.23). Those living in estates (OR = 11.4) and not receiving post-natal home visits (OR = 2.62) were more likely to discontinue breastfeeding by 1 year. Breastfeeding indicators in Sri Lanka were higher compared with many countries and determined by socio-economic and health care system factors.

Complex decisions: theorizing women’s infant feeding decisions in the first 6 weeks after birth

This paper is a report of a grounded theory study of woman's infant feeding experiences and decisions in the first 6 weeks after birth. Breastfeeding is considered the optimum method of infant feeding. Studies have identified numerous factors associated with infant feeding decisions. What remains unexplored are the mechanisms by which socio-demographic, biomedical and psychosocial factors influence infant feeding decisions. Research highlights the need for further investigation of the experiences and decision-making processes of both breastfeeding and formula-feeding women. A constructionist grounded theory approach to data collection and analysis was used. Data for this study were collected and analysed between 2003 and 2004. Further data, collected in a previous study in 2000, were theoretically sampled and analysed in 2005. In-depth interviews with 37 women from various socio-demographic areas in New South Wales, Australia provided data. The core category was 'deconstructing best'. 'Deconstructing best' was the infant feeding decision-making process in the first 6 weeks after birth. The process of 'deconstructing best' involved seven phases: planning, expecting, realizing, questioning, getting on with it, defending and qualifying. Four main categories -'it's really best to breastfeed', 'it's the unknown', 'it's not the only thing going on', and 'everybody's best is different'- comprised the context within which deconstructing best occurred. Woman's infant feeding decisions cannot be viewed in isolation from other post-natal experiences and needs. Infant feeding decisions will only be understood and appropriately supported when they are seen in relation to the circumstances of a woman's life, her immediate sociocultural context and individual experience.

Temporal Changes in the Determinants of Breastfeeding Initiation

Regular identification of factors that predict a woman's infant feeding choice is important so that breastfeeding promotion interventions can be targeted at those women least likely to breastfeed. The objective of this study was to compare determinants of breastfeeding at discharge from hospital in 2002/2003 with those reported for 1992/1993. Women participating in two longitudinal infant feeding studies in Perth, Australia, completed a baseline questionnaire just before, or shortly after, discharge from hospital. Data collected included infant feeding method and socio-demographic, biomedical, and psychosocial factors known, or suspected, to be related to the initiation of breastfeeding. Multivariate logistic regression was used to identify independent predictors of "any" and "exclusive" breastfeeding at hospital discharge in both studies. Although maternal age, level of education, and family income were independent predictors of breastfeeding at hospital discharge in the first study, no association was found between these factors and breastfeeding at hospital discharge in the second study. In both studies, a woman who perceived her husband to prefer breastfeeding was significantly more likely to leave hospital breastfeeding, and to be exclusively breastfeeding, than a woman who perceived her husband to prefer formula feeding. The strongest predictor in both studies for a woman to not be exclusively breastfeeding at hospital discharge was having an infant who had been admitted to the special care nursery after delivery. Given the importance of psychosocial factors to breastfeeding initiation, interventions that aim to increase breastfeeding initiation rates should be targeted on the basis of parental attitudes to breastfeeding rather than on sociodemographic factors. Similarly, interventions that aim to increase exclusive breastfeeding should address biomedical factors that hinder a woman's ability to establish exclusive breastfeeding.

Maternal Compassion in the Thought of René Girard, Emil Fackenheim, and Emmanuel Levinas

MATERNAL COMPASSION IN THE THOUGHT OF RENÉ GIRARD, EMIL FACKENHEIM, AND EMMANUEL LÉVINAS Ann W. Astell Purdue University l;ike empathy, compassion is a word that seldom occurs in the /writings of René Girard,' who prefers to answer to Martin Heidegger's "anxiety" [Die Sorge] before death by speaking instead of a "concern for victims" [le souci des victims].2 Maternal corn-passion does enter Girardian analysis directly, however, in his discussion ofthe biblical good harlot, a compassionate mother whom Girard calls "the most perfect figura Christi that can be imagined" (1978, 241). In this paper I focus on the neglected theme of maternal compassion in the writings of Girard, letting them enter into conversation, first, with Emil Fackenheim's reflections on the plight and actions of Jewish mothers during the Holocaust and, second, with themes sounded in the philosophy of Emmanuel Lévinas. I argue that maternal compassion is actually central to Girard's understanding of the unveiling of the victimage mechanism, because it sees goodness in the very life of every potential victim, regardless ofwhat that person has done or is capable ofdoing, simply because he or she exists, has a face. The "innocence" of every victim is reducible to the innocence of the infant, because an infant within a sacrificial system can substitute for every other possible victim. The infant and, even more, the unborn bring us back to the very origins of life, to the Creator. There 1 On empathy and Girard, see my "Saintly Mimesis, Contagion, and Empathy." " See James William's comment on this topic in René Girard, ISee Satan Fall Like Lightning (177, note 4). The locus classicus for Martin Heidegger's "anxiety" is his Being and Time, sections 39-42. 16Ann W. Astell is, as Plato asserts and Lévinas reminds us, a "Good beyond being" that, on a transcendent plane, constitutes the "innocence" ofevery human being that lives, protesting against any one's murder. To illustrate the triangulation of desire, the rivalry of doubles, the mimetic crisis, and its possible outcome in victimage, René Girard turns to the famous biblical story ofthe judgment of Solomon in 3 Kings 3:16-28. In that story two women, two harlots, approach the king, each claiming to be the mother ofa single, living infant, over whom they are fighting. "The symmetry is obvious," Girard writes, "and it represents the very essence of human conflict" (1978, 238). Unable to determine the truth ofthe case on the basis of their conflicting testimonies, the wise king tests them by proposinga sacrificial solution that parodies distributivejustice. He decides to cut the baby in half, giving each woman an equal share, the symmetrical division ofthe victim mirroring the symmetry between the litigants. "The Latin word decidere," Girard notes, "mean etymologicalIy to divide by the sacrificial knife, to cut the throat of a victim" (1978, 238). The proposed sacrifice is averted because its horrific promise of an equal apportionment of parts of the baby's body—a sameness that would confirm the two as doubles—reveals a significant difference between the two women. According to the usual reading of the passage, one of the mothers, having (either deliberately or accidentally) killed her own baby by smothering him, lacks any genuine love for the other woman's infant. As Girard explains, "The only thing that counts for her ispossessing what the other onepossesses. In the last resort, she is ready to accept being deprived ofthe child as long as her opponent is deprived of it in the same way.... All that counts is her fascination with her hated model and rival" (1978, 239). The other woman, however, filled with yearning for the life ofthe child to whom she has given birth, reveals herself to be its true mother by renouncing her maternal rights in a passionate plea: "I beseech thee, my lord, give her the child alive, and do not kill it" (3 Kings 3:26). Commenting on the passage, Girard characterizes the values of the false mother as sacrificial, those ofthe good mother as anti-sacrificial. With reference to the child whose fate hangs in the balance, the distinction is clear enough. The true mother begs for the baby...

Rhnull Red Cells and Pregnancy

The haemoglobin, haematocrit and osmotic fragility red cell values in a South African white woman with Rhnull cells and the corresponding haematological syndrome were shown to vary only minimally during her third pregnancy. This occurred in spite of the precautionary donation by her of two units of her blood at 20 and 27 weeks of pregnancy for storage in liquid nitrogen. Although there was fear to the contrary, the woman's infant was found at birth to be suffering only mildly from haemolytic disease of the newborn due to the anti-Rh29 antibodies present in her plasma.