Book review: Merrill D. Smith, Cultural Encyclopedia of the Breast

Book Review: Merrill D. Smith, Cultural Encyclopedia of the Breast (Lanham, Boulder, New York, London: Rownan and Littlefield, 2014), pp. xi + 288. ISBN 978-0-7591-2331-

FLUORESCENT PROBE INVESTIGATIONS OF MICROENVIRONMENTS OF ANALYTICAL INTEREST (REVERSED-PHASE, POLYETHYLENIMINE, POLARIZATION)

Fluorescent probes were applied to investigate three systems. Reverse phase chromatographic surfaces were studied using ion pairs. Variables were cation reagent structure and concentration, bonded phase (methyl, octyl, octadecyl, and phenyl), and solvent (water or methanol). Emission wavelength shifts for the anionic polarity probe, ANS, (8-anilino-napthalene-1-sulfonate) reflect the nature and extent of lipophilic interactions. Tetramethylammonium promoted ANS penetration into surface structure. Tetrabutylammonium overcame aqueous surface alkyl aggregation, which greatly enhanced ANS-surface interaction of C18. For the other phases at high cation concentrations there was lipophilic interaction between ANS and cation. High concentrations of small cations excluded ANS from the surface, as did all levels of trimethylmyristylamine cation. Methanol solvation reduced lipophilic interactions with alkyl surfaces. Pi-pi interactions were important with the phenyl surface. Results are consistent with the ion interaction retention model for ion pairing chromatography, which is based on double layer formation on a dynamic surface. Polyelectrolyte-counterion binding strength and proximity were studied using a three component system: metals bound to polyethylenimine (PEI) and pyrenesulfonate counterion probes. Metals altered rates of excited state processes and defined binding environment. Variables were net charge on metal and probe and metal-amine complex properties. Cu(II)-PEI efficiently and selectively quenched probes. Ground state dimerization in Zn(II)-PEI implied territorial binding involving lipophilic interactions with PEI and between probes was important. Quenching and excimer formation in Ag(I)-PEI were due to more than net charge since protonated sites did not alter emission. Fluorescence polarization was used to detect intramolecular energy transfer between equivalent fluorophors in crown ethers, metal complexes, and simple organic molecules. Energy transfer randomizes the transition moment of emission relative to that of excitation, thereby decreasing polarization. In dilute glycerol solutions intermolecular depolarization is eliminated. A simple model based on Forster energy transfer theory was developed to distinguish molecules with different numbers of fluorophors and to obtain average angles between fluorophors, based on the extent of polarization differences

Developing and producing a focused conference poster

This fourth article in the Writing for Publication series aims to provide guidance on developing and producing a poster presentation for a conference. Most academic conferences offer opportunities for health professionals to present their work as an oral presentation or a poster; an earlier paper in this series discussed the submission of abstracts to conference organisers for consideration. Planning, preparing and producing a poster presentation requires different skills from those used when giving an oral presentation. These are examined in this paper by outlining what is meant by a poster presentation, and discussing key issues to consider when planning and producing a poster, and when presenting it at a conference

Digital times: Disseminating your work and networking

This fifth and final article in the Writing for Publication series aims to provide guidance on disseminating your work and increasing professional networks through the use of social media. We will outline a range of different ways in which nurses can write about their research via blogs, and use Twitter to both grow their professional networks, and disseminate their work. Increasingly, health professionals are using social media and online resources to communicate with each other; advantages include connecting with interested others worldwide, and being able to access an audience far beyond that which could be accessed locally or via conferences

Contested moral landscapes: Negotiating breastfeeding stigma in breastmilk sharing, nighttime breastfeeding, and long-term breastfeeding in the U.S. and the U.K

Recent public health breastfeeding promotion efforts have galvanized media debates about breastfeeding in wealthy, Euro-American settings. A growing body of research demonstrates that while breastfeeding is increasingly viewed as important for health, mothers continue to face significant structural and cultural barriers. Concerns have been raised about the moralizing aspects of breastfeeding promotion and its detrimental effects on those who do not breastfeed. Far less, however, is known about the moral experiences of those who pursue breastfeeding. This study draws together research on breastmilk sharing (2012–2016) and nighttime breastfeeding from the U.S. (2006–2009), and long-term breastfeeding from the U.K. (2008–2009) from three ethnographic projects to address this gap. Comparative analysis of these cases reveals that while breastfeeding is considered ideal infant nutrition, aspects of its practice continue to evoke physical and moral danger, even when these practices are implemented to facilitate breastfeeding. Breastmilk sharing to maintain exclusive breastmilk feeding, nighttime breastfeeding and bedsharing to facilitate breastfeeding, and breastfeeding beyond the accepted duration are considered unnecessary, unhealthy, harmful or even deadly. The sexual connotations of breastfeeding enhance the morally threatening qualities of these practices. The cessation of these “problematic” breastfeeding practices and their replacement with formula-feeding or other foods is viewed as a way to restore the normative social and moral order. Mothers manage the stigmatization of these breastfeeding practices through secrecy and avoidance of health professionals and others who might judge them, often leading to social isolation. Our findings highlight the divide between perceptions of the ideal of breastfeeding and its actual practice and point to the contested moral status of breastfeeding in the U.S. and the U.K. Further comparative ethnographic research is needed to illuminate the lived social and moral experiences of breastfeeding, and inform initiatives to normalize and support its practice without stigmatizing parents who do not breastfeed

Breastfeeding in South Gloucestershire: Mothers' early experiences of infant feeding

Executive SummaryIntroduction• This research about mothers’ early experiences of infant feeding was developed following discussions about South Gloucestershire’s public health priorities for breastfeeding; current services supporting breastfeeding; and relatively low breastfeeding continuation rates.Background and context• Breastfeeding is recognised as the optimal way to feed infants from birth and exclusive breastfeeding is recommended until about six months of age, with the introduction of complementary feeding when babies are developmentally ready, usually around six months. • The support, promotion and protection of breastfeeding is a national and local priority. In 2014/15, initiation of breastfeeding in South Gloucestershire, was 77.1% while continuation was 47.8%. The Joint Strategic Needs Assessment in 2016, highlighted the need to obtain the views of mothers on their experience of support for breastfeeding. Research question• The research question was: What are the experiences of mothers (with a focus on support) in South Gloucestershire in relation to infant feeding in the first 6-8 weeks? Methods• The research design adopted a purposive sampling strategy, based on criteria sampling, with mothers that had; experience of breastfeeding in the first 6-8 weeks of their baby’s life, a baby up to 6 months of age and were engaged with a Children’s Centre. We recruited mothers who met all three criteria. • Support for the research was obtained from Midwifery, Health Visiting and Children’s Centres managers. Baby and Me groups were visited to invite participation; 53 mothers expressed an interest and 24 mothers selected randomly were interviewed. An information sheet, consent form and interview schedule were developed.• NVivo was used to support data management and analysis in which themes were identified. Data protection requirements were adhered to throughout the research. The research had ethical approval from both South Gloucestershire Council and the University of the West of England. The findingsFindings from this project suggest that there are three ‘critical stages’ in supporting a mother to breastfeed and in her experience of breastfeeding; within these the main themes emerging from this research are discussed: • Support before birth: o Preparation antenatally for breastfeeding does not prepare women for the reality.o Many mothers would have liked information about expressing milk and bottle-feeding before they become mothers. • Support around the time of the birth:o In hospital, after the birth, some mothers receive conflicting messages and don’t always feel supported.o Birth experience can influence early experiences of breastfeeding.• Support once at home:o On return home, Health Visitors are generally perceived as supportive although contact can be minimal.o Breastfeeding support groups suit some women but are not available when needed.o Family, friends and other networks are a key source of support and advice for many motherso Many women seek support from other sources including online groups and apps although telephone helplines were not much used.Recommendations A number of recommendations are made; these are mainly directed towards South Gloucestershire Council but are also of relevance to the wider partnership of health and community and voluntary sector agencies. Recommendations concern the promotion and protection of breastfeeding; the mental and emotional health and wellbeing of women; consistent evidence-based personal and timely support; mothers awareness of differing professional roles; evaluation of breastfeeding groups and; consistent approach to signposting women to websites, apps and social media; and quality assurance of resources and workforce development

An exploration of the experiences of mothers who breastfeed long-term: What are the issues and why does it matter?

Background: The World Health Organization (WHO) promotes breastfeeding for 2 years and beyond. Despite this, only 25% of women in the United Kingdom are breastfeeding at all by 6 months postpartum, with a minority of women breastfeeding beyond the first year. Those who do often report feeling ridiculed or alienated in their choice. Here, the aim was to examine the experiences of women who chose to breastfeed longer term and to seek insight into the ways they felt breastfeeding could be normalized past infancy. Subjects and Methods: The study combined two qualitative datasets that explored maternal attitudes and experiences toward longer-term breastfeeding. In Study 1 a combination of methods was used, including interviews, to explore the challenges, attitudes, and experiences faced by women who had breastfed for over 6 months postpartum. In Study 2, 1,319 mothers who were pregnant or had an infant 0-2 years old completed an open-ended questionnaire exploring their attitudes toward longer-term breastfeeding. Results: Mothers who had experience of longer-term breastfeeding described how they faced negative attitudes and criticism from others, including the perceptions that longer-term breastfeeding was comical, bizarre, and pointless. Mothers discussed ways in which longer-term breastfeeding could be normalized rather than promoted, targeting health professionals and society instead of encouraging mothers themselves. Key ideas included greater visual representation, increasing knowledge and removing stigma. Conclusions: Longer-term breastfeeding needs to be normalized to increase acceptance and in turn reduce the negative attitudes that mothers often face despite following WHO guidance. Greater support is needed from health professionals and in health policy. © Mary Ann Liebert, Inc

“Work with us… to make it more accessible”. What women with intellectual disabilities want from infant-feeding health resources: An exploratory study

BackgroundMore women with intellectual disabilities are becoming mothers but fewer are known to breastfeed compared with other women. Women with intellectual disabilities are entitled to accessible antenatal and infant feeding information, yet are rarely asked for their views on available resources. This article reports on the final stage of a UK project exploring how women with intellectual disabilities are supported to make infant feeding decisions. The wider project includes a scoping review and interviews with healthcare professionals, here we focus on the voices of the women themselves.MethodsFour women with an intellectual disability participated in a focus group where they were asked to give their views on the accessibility of currently available infant feeding resources and on alternative representations of infant feeding. All were interested in women’s health issues, including infant feeding. Photo-elicitation was used to gather views on videos, bespoke ‘Easy Read’ material and several alternative representations of infant feeding. A transcription of the discussion was thematically analysed whilst a critical visual analysis was undertaken of the women’s preferred images/resources. The study took place in Bristol, UK, during 2022.ResultsTwo themes were identified from the group discussion: ‘The desire for choice’ and ‘How easy is ‘Easy Read’?’ The desire for choice was expressed in terms through agreements and disagreements about preferred imagery, differing tastes, and reasons for these preferences. We identified a challenge to ‘Easy Read’ as a default standard and concerns that some forms of ‘Easy Read’ can confuse rather than inform. Critical visual analysis identified the importance of the story and social setting of the preferred infant feeding image.ConclusionsFindings suggest a need for a suite of resources, avoiding the one-size-fits-all approach, including people with an intellectual disability at every stage of the design and production process. Resources should recognise and embrace differences in terms of understanding, visual literacy and cultural taste, as well as being freely available to support women with intellectual disabilities to make informed infant feeding decisions. An accessible film was co-produced, to disseminate the findings from all three stages of the completed project