76 research outputs found
Typologies of postnatal support and breastfeeding at two months in the UK.
There is extensive evidence to suggest that social support improves breastfeeding outcomes. Building on this evidence-base, public health services and interventions aiming to improve breastfeeding rates have primarily targeted informational and emotional support to mothers, reflecting an individual behaviour-change approach. However, mothers exist within a wider social network, and the characteristics of their broader support networks may be an important predictor of breastfeeding outcomes. Here we explore the typologies of postnatal support for mothers in the UK; a population with one of the lowest breastfeeding rates in Europe. Using retrospective data from an online survey (data collection period December 2017 - February 2018), we carry out a latent class regression (n = 432) to identify "clusters" of postnatal support in our data. Mothers in our sample were most likely to report receiving practical and emotional support from partners and maternal grandmothers, and breastfeeding information from health professionals. We identify three distinct typologies of postnatal support: 1) Extensive support, where mothers received support from a wide range of supporters including partners, maternal grandmothers, friends and health professionals, but mothers were the only ones to feed the infant; 2) Family support, where mothers received support from partners and maternal grandmothers, including with infant feeding, but less likely to receive support from health professionals; and 3) Low support, where mothers primarily received support from partners. 94% of women with extensive support were predicted to be breastfeeding at two months, followed by 48% of mothers in the low support group, and 13% in the family support group. Our findings highlight the complexities of family support and its potential impact on breastfeeding, as well as the significance of professional support. Overall, our results hint at the potential value for health professionals to engage with wider family in order to achieve extensive support for mothers
Subjective environmental experiences and women’s breastfeeding journeys: a survival analysis using an online survey of UK mothers
Local physical and social environmental factors are important drivers of human health and behaviour. Environmental perception has been linked with both reproduction and parenting, but links between subjective environmental experiences and breastfeeding remain unclear. Using retrospective data from an online survey of UK mothers of children aged 0–24 months, Cox-Aalen survival models test whether negative subjective environmental experiences negatively correlated with any and exclusive breastfeeding (max n = 473). Matching predictions, hazards of stopping any breastfeeding were increased, albeit non-significantly, across the five environmental measures (HR: 1.05–1.26) Hazards for stopping exclusive breastfeeding were however (non-significantly) reduced (HR: 0.65–0.87). Score processes found no significant time-varying effects. However, estimated cumulative coefficient graphs showed that the first few weeks postpartum were most susceptible to environmental influences and that contrary to our predictions, mothers with worse subjective environmental experiences were less likely to stop breastfeeding at this time. In addition, the hazard of stopping exclusive breastfeeding declined over time for mothers who thought that littering was a problem. The predicted increased hazards of stopping breastfeeding were only evident in the later stages of any breastfeeding and only for mothers who reported littering as a problem or that people tended not to know each other. Perceived harsher physical and social environmental conditions are assumed to deter women from breastfeeding, but this may not always be the case. Women’s hazards of stopping breastfeeding change over time and there may be particular timepoints in their breastfeeding journeys where subjective environmental experiences play a rol
Who cares for women with children? Crossing the bridge between disciplines.
It has long been acknowledged that women with children require social support to promote their health and wellbeing, as well as that of their children. However, the dominant conceptualizations of support have been heavily influenced by Western family norms. The consequence, at best, has been to stifle our understanding of the nature and consequences of support for mothers and children. At worst, it has led to systematic discrimination negatively impacting maternal-child health. To fully engage with the complexities of social support, we must take multidisciplinary or interdisciplinary approaches spanning diverse cultural and geographical perspectives. However, multidisciplinary knowledge-processing can be challenging, and it is often unclear how different studies from different disciplines relate. To address this, we outline two epistemological frameworks-the scientific approach and Tinbergen's four questions-that can be useful tools in connecting research across disciplines. In this theme issue on 'Multidisciplinary perspectives on social support and maternal-child health', we attempt to foster multidisciplinary thinking by presenting work from a diverse range of disciplines, populations and cultures. Our hope is that these tools, along with papers in this issue, help to build a holistic understanding of social support and its consequences for mothers and their children. Overall, a multidisciplinary perspective points to how the responsibility of childrearing should not fall solely onto mothers. Indeed, this multidisciplinary issue demonstrates that successful childrearing is consistently an activity shared beyond the mother and the nuclear family: an insight that is crucial to harnessing the potential of social support to improve maternal-child health. This article is part of the theme issue 'Multidisciplinary perspectives on social support and maternal-child health'
Testing the buffering hypothesis: Breastfeeding problems, cessation, and social support in the UK.
OBJECTIVES: Physical breastfeeding problems can lead women to terminate breastfeeding earlier than planned. In high-income countries such as the UK, breastfeeding problems have been attributed to the cultural and individual "inexperience" of breastfeeding, ultimately leading to lower breastfeeding rates. Yet, cross-cultural evidence suggests breastfeeding problems still occur in contexts where breastfeeding is common, prolonged, and seen publicly. This suggests breastfeeding problems are not unusual and do not necessarily lead to breastfeeding cessation. As humans evolved to raise children cooperatively, what matters for breastfeeding continuation may be the availability of social support during the postnatal period. Here, we test the hypothesis that social support buffers mothers from the negative impact breastfeeding problems have on duration. METHODS: We run Cox models on a sample of 565 UK mothers who completed a retrospective online survey about infant feeding and social support in 2017-2018. RESULTS: Breastfeeding problems were important predictors of cessation; however, the direction of the effect was dependent on the problem type and type of support from a range of supporters. Helpful support for discomfort issues (blocked ducts, too much milk) was significantly associated with reduced hazards of cessation, as predicted. However, helpful support for reported milk insufficiency was assoicated with an increased hazard of cessation. CONCLUSIONS: Experiencing breastfeeding problems is the norm, but its impact may be mitigated via social support. Working from an interdisciplinary approach, our results highlight that a wide range of supporters who provide different types of support have potential to influence maternal breastfeeding experience
Wealth, health and inequality in Agta foragers
Background and objectivesThere is significant evidence from large-scale, industrial and post-industrial societies that greater income and wealth inequality is negatively associated with both population health and increasing health inequalities. However, whether such relationships are inevitable and should be expected to impact the health of small-scale societies as they become more market-integrated is less clear.MethodologyHere, using mixed-effect models, we explore the relationship between health, wealth, wealth inequality and health inequalities in a small-scale foraging population from the Philippines, the Agta.ResultsAcross 11 camps, we find small to moderate degrees of wealth inequality (maximal Gini Coefficient 0.44) which is highest in the most permanent camps, where individuals engage more heavily in the formal market. However, in both adults (n = 161) and children (n = 215), we find little evidence that either wealth or wealth inequality associates with ill health, except for one measure of nutritional condition—red blood cell count.Conclusions and implicationsWe interpret these results in the light of high levels of cooperation among the Agta which may buffer against the detrimental effects of wealth inequality documented in industrial and post-industrial societies. We observe little intergenerational wealth transmission, highlighting the fluid nature of wealth, and thus wealth inequality, particularly in mobile communities. The deterioration of nutritional status, as indicated by red blood cell counts, requires further investigation before concluding the Agta’s extensive cooperation networks may be beginning to breakdown in the face of increasing inequality
Post-marital residence patterns and the timing of reproduction: evidence from a matrilineal society
Humans exhibit a broad range of post-marital residence patterns and there is growing recognition that post-marital residence predicts women's reproductive success; however, the nature of the relationship is probably dependent on whether co-resident kin are cooperators or competitors. Here, we explore this relationship in a Tibetan population, where couples practice a mixture of post-marital residence patterns, co-residing in the same village with the wife's parents, the husband's parents or endogamously with both sets of parents. Using detailed demographic data from 17 villages we find that women who live with only their own parents have an earlier age at first birth (AFB) and age at last birth (ALB) than women who live with only their parents-in-law. Women who co-reside with both sets of parents have the earliest AFB and ALB. However, those with co-resident older siblings postponed reproduction, suggestive of competition-related delay. Shifts to earlier reproductive timing were also observed in relation to the imposition of family planning policies, in line with Fisherian expectations. Our study provides evidence of the costs and benefits to women's direct fitness of co-residing with different kin, against a backdrop of adaptive responses to cultural constraints on completed fertility
Why so many Agta boys? Explaining ‘extreme’ sex ratios in Philippine foragers
Abstract</jats:p
Intracellular \u3cem\u3eListeria monocytogenes\u3c/em\u3e Comprises a Minimal but Vital Fraction of the Intestinal Burden Following Foodborne Infection
Listeria monocytogenes is a highly adaptive bacterium that replicates as a free-living saprophyte in the environment as well as a facultative intracellular pathogen that causes invasive foodborne infections. The intracellular life cycle of L. monocytogenes is considered to be its primary virulence determinant during mammalian infection; however, the proportion of L. monocytogenes that is intracellular in vivo has not been studied extensively. In this report, we demonstrate that the majority of wild-type (strain EGDe) and mouse-adapted (InlAm-expressing) L. monocytogenes recovered from the mesenteric lymph nodes (MLN) was extracellular within the first few days after foodborne infection. In addition, significantly lower burdens of L. monocytogenes were recovered from the colon, spleen, and liver of gentamicin-treated mice than of control mice. This led us to investigate whether intracellular replication of L. monocytogenes was essential during the intestinal phase of infection. We found that lipoate protein ligase-deficient L. monocytogenes (ΔlplA1) mutants, which display impaired intracellular growth, were able to colonize the colon but did not persist efficiently and had a significant defect in spreading to the MLN, spleen, and liver. Together, these data indicate that the majority of the L. monocytogenes burden in the gastrointestinal tract is extracellular, but the small proportion of intracellular L. monocytogenes is essential for dissemination to the MLN and systemic organs
Wealth, health and inequality in Agta foragers
BACKGROUND AND OBJECTIVES: There is significant evidence from large-scale, industrial and post-industrial societies that greater income and wealth inequality is negatively associated with both population health and increasing health inequalities. However, whether such relationships are inevitable and should be expected to impact the health of small-scale societies as they become more market-integrated is less clear. METHODOLOGY: Here, using mixed-effect models, we explore the relationship between health, wealth, wealth inequality and health inequalities in a small-scale foraging population from the Philippines, the Agta. RESULTS: Across 11 camps, we find small to moderate degrees of wealth inequality (maximal Gini Coefficient 0.44) which is highest in the most permanent camps, where individuals engage more heavily in the formal market. However, in both adults (n = 161) and children (n = 215), we find little evidence that either wealth or wealth inequality associates with ill health, except for one measure of nutritional condition-red blood cell count. CONCLUSIONS AND IMPLICATIONS: We interpret these results in the light of high levels of cooperation among the Agta which may buffer against the detrimental effects of wealth inequality documented in industrial and post-industrial societies. We observe little intergenerational wealth transmission, highlighting the fluid nature of wealth, and thus wealth inequality, particularly in mobile communities. The deterioration of nutritional status, as indicated by red blood cell counts, requires further investigation before concluding the Agta's extensive cooperation networks may be beginning to breakdown in the face of increasing inequality
Post-marital residence patterns and the timing of reproduction: evidence from a matrilineal society
Humans exhibit a broad range of post-marital residence patterns and there is growing recognition that post-marital residence predicts women's reproductive success; however, the nature of the relationship is probably dependent on whether co-resident kin are cooperators or competitors. Here, we explore this relationship in a Tibetan population, where couples practice a mixture of post-marital residence patterns, co-residing in the same village with the wife's parents, the husband's parents or endogamously with both sets of parents. Using detailed demographic data from 17 villages we find that women who live with only their own parents have an earlier age at first birth (AFB) and age at last birth (ALB) than women who live with only their parents-in-law. Women who co-reside with both sets of parents have the earliest AFB and ALB. However, those with co-resident older siblings postponed reproduction, suggestive of competition-related delay. Shifts to earlier reproductive timing were also observed in relation to the imposition of family planning policies, in line with Fisherian expectations. Our study provides evidence of the costs and benefits to women's direct fitness of co-residing with different kin, against a backdrop of adaptive responses to cultural constraints on completed fertility
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