Mother-infant interaction in low-income families.

PURPOSE: To describe interaction patterns of low-income mothers and infants and to compare the study sample to a larger, diverse sample from a national database. STUDY DESIGN AND METHOD: Data from 156 mothers with infants under 12 months of age were identified from the first wave of a longitudinal evaluation of an early childhood intervention program. Trained data collectors using the NCAST Teaching Scale conducted observations in the home. Differences among the study sample on selected demographic characteristics were calculated. Comparisons between the study sample and a sample of similar mothers from the NCAST database were performed. RESULTS: The study sample as a whole was most like a low-education adolescent comparison group, and least like a high-education adult comparison group. They scored significantly lower on most scales of the NCAST Teaching Scale than a NCAST database sample of educated adults. About 40% of the dyads had scores below the NCAST 10th percentile cutoff, with a higher percent of mothers having lower scores than infants. CLINICAL IMPLICATIONS: Nurses should routinely assess parent-child interaction in all high-risk, disadvantaged families with very young children. Nurses can help mothers understand and capitalize on their infants' capacity to interact, particularly in early months of life. Future research should include changes in interaction patterns over time and exploration of factors that may have an impact on parent-child interactions.

An ecological approach to breastfeeding.

PURPOSE: Current numbers of breast-feeding mothers are well below Healthy People 2010 goals of 75% in the early postpartum period, 50% at 6 months, and 25% at 1 year. A promising line of research is the use of an ecological model for breastfeeding that includes factors traditionally examined in breastfeeding (mother/infant and family) as well as mesosystem and exosystem sources of influence on families (healthcare delivery system, community, and societal/cultural). STUDY DESIGN AND METHODS: A telephone survey was conducted with 95 primiparous, postpartum women using closed and open-ended items. Content analysis was used with the transcribed comments from these telephone interviews, to test the fit of a preexisting ecological model for breastfeeding. RESULTS: The comments of postpartum women provided a rich source of information about the many mother-infant, family, healthcare delivery system, community, and societal/cultural factors that influence breastfeeding. These all fit the ecological breast-feeding model proposed. CLINICAL IMPLICATIONS: Efforts to improve rates of breastfeeding in this country to meet year 2010 goals must consider the many contextual factors that influence feeding. Interventions to promote breastfeeding should exceed the individual level, and occur at many layers simultaneously. The ecological model provides direction for the multiple interventions needed to increase rates and duration of breastfeeding.

Making nursing models relevant for the practising nurse.

For thousands of years the goal of nursing has been to provide nurturing 'care' in a manner which assists individuals or groups of people to reach an optimal level of health. This defines the uniqueness of nursing, ie the care by the nurse versus the 'cure' of the physician. The motivation of providing nurturing care is the same today for the critical care nurse in a modern intensive care unit as it was for the parent in a cave.