The neonatal nurse: advocating for breastfeeding mothers

Accurate information and support from healthcare professionals as well as respect for parental choice are all factors which contribute to effective breastfeeding in the neonatal unit; with this in mind, Colm Darby and Sharon Nurse discuss the potential problems in expressing breast milk and the interventions which might be effective in avoiding them. Advocacy is an inherent part of neonatal nurses' role whilst caring for sick, vulnerable babies. Colm Darby is a male neonatal nurse working in a predominantly female environment and passionately believes in supporting and advocating for mothers who want to provide breast milk for their babies. In this article, CoIm uses Borton's model of reflection to discuss how he acted as an effective advocate for such a mother.

Predominance of genetic monogamy by females in a hammerhead shark, Sphyrna tiburo: Implications for shark conservation.

There is growing interest in the mating systems of sharks and their relatives (Class Chondrichthyes) because these ancient fishes occupy a key position in vertebrate phylogeny and are increasingly in need of conservation due to widespread overexploitation. Based on precious few genetic and field observational studies, current speculation is that polyandrous mating strategies and multiple paternity may be common in sharks as they are in most other vertebrates. Here, we test this hypothesis by examining the genetic mating system of the bonnethead shark, Sphyrna tiburo, using microsatellite DNA profiling of 22 litters (22 mothers, 188 embryos genotyped at four polymorphic loci) obtained from multiple locations along the west coast of Florida. Contrary to expectations based on the ability of female S. tiburo to store sperm, the social nature of this species and the 100% multiple paternity observed in two other coastal shark species, over 81% of sampled bonnethead females produced litters sired by a single male (i.e. genetic monogamy). When multiple paternity occurred in S. tiburo, there was an indication of increased incidence in larger mothers with bigger litters. Our data suggest that sharks may exhibit complex genetic mating systems with a high degree of interspecific variability, and as a result some species may be more susceptible to loss of genetic variation in the face of escalating fishing pressure. Based on these findings, we suggest that knowledge of elasmobranch mating systems should be an important component of conservation and management programmes for these heavily exploited species.

Correlates of reproductive success in a population of nine-banded armadillos: a preliminary report.

We used microsatellite DNA markers to identify the putative parents of 69 litters of nine-banded armadillos (Dasypus novemcinctus) over 4 years. Male and female parents did not differ in any measure of body size in comparisons with nonparents. However, males observed paired with a female were significantly larger than unpaired males, although paired females were the same size as unpaired females. Females categorized as possibly lactating were significantly larger than females that were either definitely lactating or definitely not lactating. There was no evidence of assortative mating: body-size measurements of mothers were not significantly correlated with those of fathers. Nine-banded armadillos give birth to litters of genetically identical quadruplets. Mothers (but not fathers) of female litters were significantly larger than mothers of male litters, and maternal (but not paternal) body size was positively correlated with the number of surviving young within years, but not cumulatively. There were no differences in dates of birth between male and female litters, nor were there any significant relationships between birth date and maternal body size. Body size of either parent was not correlated with the body sizes of their offspring. Cumulative and yearly reproductive success did not differ between reproductively successful males and females. Average reproductive success (which included apparently unsuccessful individuals) also did not differ between males and females. The majority of adults in the population apparently failed to produce any surviving offspring, and even those that did usually did so in only 1 of the 4 years. This low reproductive success is unexpected, given the rapid and successful range extension of this species throughout the southeastern United States in this century.

Symbolic violence and the neighbourhood: young working class girls' attitudes to education in Belfast

This article focuses on the experiences of 7-8 year old working-class girls in Belfast, Northern Ireland and their attitudes towards education. It shows how their emerging identities tend to emphasize relationships, marriage and motherhood at the expense of a concern with education and future careers. The article suggests that one important factor that can help explain this is the influence of the local neighbourhood. In drawing upon Bourdieu's concepts of symbolic violence and habitus and Elias' notion of figuration, the article shows how the local neighbourhood represents the parameters of the girls' social worlds. It provides the context within which the girls tend to focus on social relations within their community and particularly on family relationships, marriage and children. It also provides the context within which the girls tend to develop strong interdependent relationships with their mothers that also tend to encourage and reinforce the girls' particular gendered identities. The article concludes by arguing that there is a need for more research on working-class girls and education to look beyond the school to incorporate, more fully, an understanding of the influence of the family and local neighbourhood on their attitudes towards education and their future career aspirations.

The quality of parenting of individuals who had failed to thrive as children

Parenting behaviour is determined by a range of factors including personality, psychopathology, values, social support, child characteristics and socio-cultural influences. It has also been suggested that an individual's style of child-rearing is influenced by the style of parenting that they experienced as children. The relationships between children who fail-to-thrive and their parents are often characterized by interactional difficulties. Previous research using retrospective accounts suggested that mothers of children who fail-to-thrive for non-organic reasons themselves showed high levels of abuse, neglect, and deprivation during their childhoods. However, to date no one has investigated prospectively what kinds of parents failure-to-thrive individuals become. This paper examines the parenting experiences of individuals who had received psychosocial intervention for their non-organic failure-to-thrive as children over 20 years ago. Results suggest that where initial intervention failed to bring about long-term changes in family interactional patterns, there was a greater incidence of failure-to-thrive in the next generation. These families were characterized by dissatisfaction with the child, high levels of stress associated with the parenting role, and low levels of social support. However, where the family environment in the original study had changed substantially, the former clients' outcomes were more positive with their own children. These parents tended to find interaction with their children more rewarding, had good support networks and low levels of stress. The characteristics of particular cases are discussed in detail to illustrate differences between these two groups of individuals.

'A Job in Politics is not for Woman': Analysing Barriers to Women's Political Representation in CEE

This article discusses women’s political representation in Central and Eastern Europe in the fifteen years after the fall of the Berlin Wall and the adoption of liberal democratic political systems in the region. It highlights the deepseated gender stereotypes that define women primarily as wives and mothers, with electoral politics seen as an appropriate activity for men, but less so for women. The article explores the ways in which conservative attitudes on gender roles hinders the supply of, and demand for, women in the politics of Central and Eastern Europe. It also discusses the manner in which the internalisation of traditional gender norms affects women’s parliamentary behaviour, as few champion women’s rights in the legislatures of the region. The article also finds that links between women MPs and women’s organisations are weak and fragmented, making coalition-building around agendas for women’s rights problematic.

A longitudinal study of infant feeding and obesity throughout the life course

Background: The Centers for Disease Control and Prevention and the US Department of Health and Human Services promote breastfeeding as a strategy for reducing childhood overweight. We evaluated the relation between infant feeding and the development of overweight and obesity throughout life course. Methods: We investigated the association between infant feeding and obesity among 35 526 participants in the Nurses' Health Study II who were followed prospectively from 1989 to 2001. Mothers of participants provided information by mailed questionnaires on the duration of breast- and bottle-feeding, as well as the type of milk or milk substitute in the bottle. Information on body shape at ages 5 and 10, weight at age 18, current weight between 1989 and 2001, and height was reported by the participants. Results: The duration of breastfeeding, including exclusive breastfeeding, was not related to being overweight (25 body mass index (BMI)

Unlinked vital events in census-based longitudinal studies can bias subsequent analysis

Objective: To examine the potential biases arising from the nonlinkage of census records and vital events in longitudinal studies.
Study Design and Setting: A total of 56,396 deaths of residents of Northern Ireland in the 4 years after the 2001 Census were linked to the 2001 Census records. The characteristics of matched and nonmatched death records were compared using multivariate logistic regression. Subject attributes were as recorded on the death certificate.
Results: In total, 3,392 (6.0%) deaths could not be linked to a census record. Linkage rates were lowest in young adults, males, the unmarried, people living in communal establishments, or living in areas that were more deprived or had recorded low census enumeration. For those aged less than 65 years at census, this linkage would exclude from analysis 20.2% of suicides and 19.7% of deaths by external causes.
Conclusion: The nonlinkage of census and death records is a combination of nonenumeration at census and deficient information about the deceased recorded at the time of death. Unmatched individuals may have been more disadvantaged or socially isolated, and analysis based on the linked data set may therefore show some bias and perhaps understate true social gradients.

Maternal mental health and non-organic failure to thrive.

This study reports on the first phase of a large-scale, longitudinal, multidisciplinary community study examining the growth, learning and development of young children with a particular focus on failure to thrive without organic cause. However, the group identified in this study may be better described as weight faltering. This paper examines the psychological data collected using the Parenting Stress Index, Rosenberg Self-Esteem and the General Health Questionnaire in relation to child growth. There were no significant differences between the mothers of the weight faltering and control children in terms of parenting stress, maternal depression, maternal perceptions of their parenting competence or maternal self-esteem. Maternal sensitivity to comments about child size, regardless of direction, had a negative impact on mood.

Handling uncertainty in a medical study of dietary intake during pregnancy

This paper is concerned with handling uncertainty as part of the analysis of data from a medical study. The study is investigating connections between the birth weight of babies and the dietary intake of their mothers. Bayesian belief networks were used in the analysis. Their perceived benefits include (i) an ability to represent the evidence emerging from the evolving study, dealing effectively with the inherent uncertainty involved; (ii) providing a way of representing evidence graphically to facilitate analysis and communication with clinicians; (iii) helping in the exploration of the data to reveal undiscovered knowledge; and (iv) providing a means of developing an expert system application.

Parent-offspring conflict and motivational control of brooding in an amphipod (Crustacea)

Models of parent - offspring conflict concerning levels of caregiving centre on conflict resolution by offspring control, compromise or offspring 'honest signalling' that parents use to maximize their own fitness. Recent empirical studies on motivational control of parental feeding of offspring are interpreted as supporting the latter model. Here, we examine parental care in an amphipod, Crangonyx pseudogracilis, which directs care to embryos in a brood pouch. Embryo removal and transplantation elucidated causal factors that determine levels of caregiving. In the short-term, females with all embryos removed reduced care activities, but partial embryo removal did not affect caregiving, evidence of 'unshared' parental care. In the long-term, females with all embryos removed ceased care. Thus, females have a maternal state that is maintained by stimuli from offspring. Transplantation of early/late stage embryos among females originally carrying early/late stage embryos revealed that stimuli from embryos indicate their age-dependent needs, but only modify caregiving within the constraints of a changing endogenous maternal state. Thus, we demonstrate that mothers and offspring share motivational control of care. However, we highlight the inappropriate use of motivational data in reaching conclusions about the resolution of parent - offspring conflict.

The energetics of lactation in cooperatively breeding meerkats Suricata suricatta

Species may become obligate cooperative breeders when parents are unable to raise their offspring unassisted. We measured the daily energy expenditure of mothers, helpers and offspring during peak lactation in cooperatively breeding meerkats Suricata suricatta using the doubly labelled water technique. Lactating mothers expended more energy per day than allo-lactating subordinate females, non-lactating females or suckling offspring. Metabolizable energy intakes of lactating mothers were calculated from isotope-based estimates of offspring milk energy intake, and were not significantly different from the previously suggested maximal limit for mammals. Allo-lactating females were the only category of animals that lost weight during the period of study, probably because they spent more time babysitting than non-lactating females. Daily energy expenditure (DEE) of lactating mothers increased with litter size but decreased with the number of helpers. Calculations show that for every 10 helpers, even in the absence of allo-lactators, mothers are able to reduce their DEE during peak lactation by an amount equivalent to the energy cost of one pup. These results indicate that helpers have beneficial energetic consequences for lactating mothers in an obligate cooperatively breeding mammal.

Energetics and litter size variation in domestic dog Canis familiaris breeds of two sizes

We measured resting metabolic rate (RMR), daily energy expenditure (DEE) and metabolisable energy intake (MEI) in two breeds of dog during peak lactation to test whether litter size differences were a likely consequence of allometric variation in energetics. RMR of Labrador retrievers (30 kg, n = 12) and miniature Schnauzers (6 kg, n = 4) averaged 3437 and 1062 kJ/day, respectively. DEE of Labradors (n = 6) and Schnauzers (n = 4) averaged 9808 and 2619 kJ/day, respectively. MEI of Labradors (n = 12) was 22448 kJ/day and of Schnauzers (a = 7) was 5382 kJ/day. DEE of Labrador pups (2.13 kg, n = 19) was 974 kJ/day and Schnauzers (0.89 kg, n = 7) were 490 kJ/day. Although Labradors had higher MEIs than Schnauzers during peak lactation, there was no difference in mass-specific energy expenditure between the two breeds. Hence, it is unlikely that litter size variation is a likely consequence of differences in maternal energy expenditure. Individual offspring were relatively more costly for mothers of the smaller breed to produce. Therefore, litter size variations were consistent with the expectation that smaller offspring should be more costly for mothers, but not that smaller mothers should per se invest more resources in reproduction. (C) 2001 Elsevier Science Inc. All rights reserved.

Vitamin D deficiency and insufficiency in pregnant women: a longitudinal study.

Maternal vitamin D insufficiency is associated with childhood rickets and longer-term problems including schizophrenia and type 1 diabetes. Whilst maternal vitamin D insufficiency is common in mothers with highly pigmented skin, little is known about vitamin D status of Caucasian pregnant women. The aim was to investigate vitamin D status in healthy Caucasian pregnant women and a group of age-matched non-pregnant controls living at 54–55°N. In a longitudinal study, plasma 25-hydroxyvitamin D (25(OH)D) was assessed in ninety-nine pregnant women at 12, 20 and 35 weeks of gestation, and in thirty-eight non-pregnant women sampled concurrently. Plasma 25(OH)D concentrations were lower in pregnant women compared to non-pregnant women (P < 0·0001). Of the pregnant women, 35, 44 and 16 % were classified as vitamin D deficient (25(OH)D < 25 nmol/l), and 96, 96 and 75 % were classified as vitamin D insufficient (25(OH)D < 50 nmol/l) at 12, 20 and 35 weeks gestation, respectively. Vitamin D status was higher in pregnant women who reported taking multivitamin supplements at 12 (P < 0·0001), 20 (P = 0·001) and 35 (P = 0·001) weeks gestation than in non-supplement users. Vitamin D insufficiency is evident in pregnant women living at 54–55°N. Women reporting use of vitamin D-containing supplements had higher vitamin D status, however, vitamin D insufficiency was still evident even in the face of supplement use. Given the potential consequences of hypovitaminosis D on health outcomes, vitamin D supplementation, perhaps at higher doses than currently available, is needed to improve maternal vitamin D nutriture.