Infant feeding styles of West Indian women

Enhancing the sample diversity of snowball samples: Recommendations from a research project on anti-dam movements in Southeast Asia

Snowball sampling is a commonly employed sampling method in qualitative research; however, the diversity of samples generated via this method has repeatedly been questioned. Scholars have posited several anecdotally based recommendations for enhancing the diversity of snowball samples. In this study, we performed the first quantitative, medium-N analysis of snowball sampling to identify pathways to sample diversity, analysing 211 reach-outs conducted via snowball sampling, resulting in 81 interviews; these interviews were administered between April and August 2015 for a research project on anti-dam movements in Southeast Asia. Based upon this analysis, we were able to refine and enhance the previous recommendations (e.g., showcasing novel evidence on the value of multiple seeds or face-to-face interviews). This paper may thus be of particular interest to scholars employing or intending to employ snowball sampling.

Reasons for prolonged bottle-feeding and iron deficiency among Mexican-American toddlers: an ethnographic study

OBJECTIVE

Several studies have shown that prolonged bottle-feeding is associated with iron deficiency. Mexican-American toddlers are the racial/ethnic group at greatest risk for prolonged bottle-feeding and iron deficiency, yet no studies have examined reasons for prolonged bottle-feeding in Mexican-American toddlers. The objective of this study was to assess infant feeding beliefs, knowledge, and behaviors among Mexican-American parents.

METHODS

Ethnographic interviews were conducted of parents of Mexican-American toddlers 15 to 48 months old at 3 community sites. A 31-question moderator's guide addressed 4 domains: knowledge and cultural beliefs; sources of nutritional information; anticipatory guidance; and suggestions for ways to change infant feeding practices. Interviews were audiotaped, transcribed, and analyzed using grounded theory.

RESULTS

Thirty-nine parents were interviewed; the mean parental age was 29 years, and mean child age, 2.2 years. Parents cited convenience as a reason for prolonged bottle-feeding, and believed that they should give toddlers as much milk as they want. Many parents lacked essential knowledge regarding infant feeding practices and iron deficiency, including when to stop bottle-feeding, health problems caused by prolonged bottle-feeding, the quantity of milk to give a child >1 year old, and iron deficiency as a complication of prolonged bottle-feeding. Parents reported not receiving enough education from physicians, and they supported educational interventions on healthy infant feeding practices, including refrigerator magnet charts, videos, brochures, and teaching by physicians.

CONCLUSIONS

Parents of Mexican-American toddlers often are unaware of the adverse consequences of prolonged bottle-feeding and developmental problems associated with iron deficiency. Parents supported educational interventions, including videos, brochures, and refrigerator magnet charts on healthy infant feeding practices.

In-hospital formula supplementation of healthy breastfeeding newborns

The UNICEF/WHO Baby-Friendly Hospital Initiative suggests that breastfeeding activities in hospital are important to later breastfeeding. Understanding reasons for in-hospital supplementation may help to optimize the successful implementation of this initiative. The objective was to identify predictors of in-hospital initial formula supplementation of healthy, breastfeeding newborns. The authors analyzed 564 Canadian mother-infant pairs and interviewed nurses. Half of the study infants (47.9%) received formula in hospital; the median age at first supplementation was 8.4 hours. Risk for supplementation was affected by birth occurring between 7 PM and 9 AM (hazard ratio [HR] varied with time) and high maternal trait anxiety (HR=1.61, 95% confidence interval [CI]=1.01, 2.59). The following variables were protective against supplementation: planning to exclusively breastfeed (HR=0.46, 95% CI=0.33, 0.64), planning to breastfeed for >or=3 months (HR=0.56, 95% CI=0.37-0.86), childbirth education (HR=0.61, 95% CI=0.43, 0.86), mother born in Canada (HR=0.68, 95% CI=0.53, 0.87), completion of community college (HR=0.76, 95% CI=0.59, 0.98), male infant (HR=0.78, 95% CI=0.61, 0.99), and breastfeeding at delivery (HR varied with time). Nurses reported breastfeeding problems, infant behavior, and maternal fatigue as reasons for supplementing. Reassessing patterns of night feeds and encouraging breastfeeding at delivery may decrease supplementation. Trait anxiety reduction and the role of infant gender in supplementation merit further study.

The milk of human kindness: environmental and human interactions in a WIC clinic that influence infant-feeding decisions of Black women

In this ethnographic study, the author explores the context of Black women's infant-feeding decisions in an urban WIC clinic. Data were obtained from 319 people (130 Black women enrolled in WIC [BWEW], 189 relatives and friends) with close follow-up of 11 primiparous key informants during pregnancy and the first year postpartum. The major findings include (a) the WIC clinic environment set a positive tone for service, (b) WIC employees treated the women with caring and respect, (c) BWEW believed that WIC was a source of support in time of need, and (d) WIC influenced infant-feeding decisions. The availability of free formula facilitated bottle feeding, but personalized breast-feeding promotion with trusting relationships with WIC providers encouraged breast-feeding decisions for almost half of the key informants.

A discussion of chain referral as a method of sampling hard-to-reach populations

Nursing research often requires inquiry into sensitive topics that involve hidden or hard- to reach populations. However, identifying and sampling these populations for research purposes is often fraught with difficulties. Barriers include society's lack of tolerance of diverse groups, social stigma, concern for issues of confidentiality, and fear of exposure because of possible threats to security. Chain referral sampling techniques are proposed to minimize bias while maintaining privacy and confidentiality. Techniques of chain referral sampling are detailed for use in researching sensitive topics and hidden populations. When carefully planned and executed, this sampling design offers transcultural nurse researchers a reasonable method for accessing and studying special populations that are particularly hard-to-reach.

Explaining infant feeding style of low-income black women

Unstructured interviews were conducted with 10 low-income black women to explore infant feeding style. Formula-feeding with early introduction of cereal in the bottle was the most common pattern used by mothers in the first 3 months. By 6 months, formula-fed infants had a complex diet of a variety of foods. Half the women intended to breast-feed, but only one exclusively breast-fed. Beliefs about healthy infants and crying influenced feeding. There was a lack of knowledge about and support for breast-feeding in these women's environment. Support and advice about infant feeding from the health care system were uneven.