Household food insecurity is negatively associated with achievement of prenatal intentions to feed only breast milk in the first six months postpartum.

Background: Household food insecurity (HFI) has been associated with suboptimal breastfeeding practices. Postpartum factors reported by caregivers include stressful life circumstances and maternal diet quality concerns. It is unknown whether prenatal breast milk feeding intentions, a well-established predictor of breastfeeding outcomes, differ by HFI status. We explored associations between HFI and prenatal intentions to feed any and only breast milk in the first 6 months postpartum, and achievement of these intentions. Methods: We utilized data from self-identified biological mothers with children 6-12 months of age who responded to a retrospective, cross-sectional online infant feeding survey conducted in Nova Scotia, Canada. HFI (yes/no) was assessed using the Household Food Security Survey Module. Prenatal intentions to feed any and only breast milk were assessed based on responses to five options for infant milk feeding plans. Achievement of intentions was assessed by breast milk and formula feeding practices in the first 6 months. Multivariable logistic regressions were conducted, adjusting for maternal socio-demographics. Results: Among 459 respondents, 28% reported HFI; 88% intended to feed any breast milk and 77% intended to feed only breast milk, with no difference by HFI status. Of those intending to feed any breast milk, 99% succeeded, precluding further analysis. Among mothers who intended to provide only breast milk, only 51% achieved their intention, with lower odds among those with HFI (aOR 0.54, 95% CI 0.29-0.98). Conclusion: HFI was not associated with intentions for feeding breast milk in the first 6 months postpartum, but mothers with HFI were less likely to achieve their intention to provide only breast milk. Further research is needed to understand the underlying reasons for this and to guide intervention designs to address HFI and help mothers reach their breastfeeding goals.

When work came home: Formation of feeling rules in the context of a pandemic.

The shift of middle-class jobs to home settings, which occurred as a result of COVID-19 health measures that also closed schools and daycares, introduced dynamic changes to everyday life. We investigate these changes drawing on data from our study in which participants in Nova Scotia, Canada, who were working at home due to the pandemic, wrote journal entries in response to weekly prompts. Participants not only documented changes to their routines and challenges of managing work and parenting simultaneously and in the same physical space, but also reflected on their conflicted emotions about life during the pandemic and their vision for life as things return to "normal." Their narratives prompt us to consider these experiences and emotions in relation to Arlie Hochschild's scholarship on feeling rules, emotion work, and gender and work more broadly. We find that from our participants' struggle to meet existing expectations on activities and emotion while simultaneously managing new sets of protocols and feeling rules what emerges is a resistance to norms of busyness, productivity, and exhaustion.

Qualitative Research Studies Online: Using Prompted Weekly Journal Entries During the COVID-19 Pandemic.

Solicited journal entries are a qualitative research method with a fairly strong tradition in sociological research and particularly in qualitative health research. However, the practices and strengths associated with solicited journal entries have not been explored as frequently or comprehensively as more conventional qualitative research methods, such as interviews. During the COVID-19 pandemic we carried out two online studies employing solicited written journal entries and photos. One study focused on pregnancy and health care experiences during the pandemic and the other on everyday life while working from home due to public health restrictions. Here, we discuss solicited online journal entries as a qualitative method and reflect on the strengths and challenges we encountered, including those related to using the online survey tool LimeSurvey for a qualitative diary-based study. The richness of data and the ability to solicit participants' contemporaneous reflections over the course of a set length of time, the ability to reach people across time zones and in multiple places, and the ability to adapt prompts in a quickly changing research context are major strengths of online journaling. The level of commitment required by participants, the potential for attrition, the need for literacy and technology access, and the large amount of data from each participant are potential limitations for researchers to consider.

Breastfeeding experiences among mothers living with food insecurity in high resource, Western countries: a qualitative systematic review protocol.

OBJECTIVE: The objectives of this review are to identify, appraise, and synthesize the qualitative evidence on the breastfeeding experiences of mothers living with food insecurity in high-resource, Western countries. INTRODUCTION: Breastfeeding and food insecurity are inter-related health issues. Globally, breastfeeding augments food security at individual, household, and community levels, but a growing body of evidence from high-resourced countries also suggests that a mother's breastfeeding practice may be negatively impacted by the additional experience of food insecurity. This protocol outlines a systematic approach to understanding the experiences of breastfeeding from the perspective of mothers living with food insecurity. Findings will provide much-needed evidence toward guiding policies and practices that support mothers to breastfeed. INCLUSION CRITERIA: The review will consider studies that explore the breastfeeding experiences of mothers aged 18 years and older who self-identify, or are classified using a screening tool, as food insecure. Papers that will be included in this review will consider all qualitative methodologies and will be limited to studies from countries identified as being within the United Nations classification of Western European and Other States Group (WEOG). METHODS: The authors will conduct a three-step search process across both published and gray literature to identify relevant studies for inclusion. A preliminary search using the PubMed database was undertaken in January 2020. Studies published in English from 1981 to 2020 will be included. The recommended JBI methodology for qualitative systematic review for study selection, critical appraisal, data extraction, and data synthesis will be followed. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42020183652.

The cost and affordability of growing and feeding a baby in Nova Scotia.

OBJECTIVE: This paper examines the affordability of a basic nutritious diet for low-income families in Nova Scotia over three developmental periods (pregnancy, perinatal, early infancy) using economic simulations that include food costing and secondary data. METHODS: The cost of a nutritious food basket was determined from a random sample of grocery stores in Nova Scotia (n = 21), along with the cost of infant formula (n = 29) and prenatal vitamins and vitamin D drops (n = 15), from randomly selected pharmacies. The monthly funds remaining to purchase a basic nutritious diet were calculated for several household scenarios, after deducting essential living expenses from net incomes. Each scenario included either a pregnant woman or a breastfed or formula-fed infant at 3 months, and either Income Assistance, Federal Maternity Benefits based on minimum wage employment, or a $15/h wage. RESULTS: Income Assistance and Federal Maternity Benefits, based on minimum wage, were inadequate to purchase a basic nutritious diet during pregnancy or in early infancy whether breastfeeding or formula feeding. All household scenarios faced significant potential monthly deficits if they were to purchase a basic nutritious diet. CONCLUSION: Minimum wage and income security programs are inadequate for the purchase of a basic nutritious diet throughout the prenatal, perinatal, and early infancy periods in Nova Scotia, emphasizing risk of food insecurity as a critical issue for young families facing income constraints. Adequate maternity protection is required to support access to food and nutrition essential for maternal and infant health.

Relation between household food insecurity and breastfeeding in Canada.

BACKGROUND: Qualitative studies have suggested that food insecurity adversely affects infant feeding practices. We aimed to determine how household food insecurity relates to breastfeeding initiation, duration of exclusive breastfeeding and vitamin D supplementation of breastfed infants in Canada. METHODS: We studied 10 450 women who had completed the Maternal Experiences - Breastfeeding Module and the Household Food Security Survey Module of the Canadian Community Health Survey (2005-2014) and who had given birth in the year of or year before their interview. We used multivariable Cox proportional hazards models and logistic regression to examine the relation between food insecurity and infant feeding practices, adjusting for sociodemographic characteristics, maternal mood disorders and diabetes mellitus. RESULTS: Overall, 17% of the women reported household food insecurity, of whom 8.6% had moderate food insecurity and 2.9% had severe food insecurity (weighted percentages). After adjustment for sociodemographic factors, women with food insecurity were no less likely than others to initiate breastfeeding or provide vitamin D supplementation to their infants. Half of the women with food insecurity ceased exclusive breastfeeding by 2 months, whereas most of those with food security persisted with breastfeeding for 4 months or more. Relative to women with food security, those with marginal, moderate and severe food insecurity had significantly lower odds of exclusive breastfeeding to 4 months, but only women with moderate food insecurity had lower odds of exclusive breastfeeding to 6 months, independent of sociodemographic characteristics (odds ratio 0.60, 95% confidence interval 0.39-0.92). Adjustment for maternal mood disorder or diabetes slightly attenuated these relationships. INTERPRETATION: Mothers caring for infants in food-insecure households attempted to follow infant feeding recommendations, but were less able than women with food security to sustain exclusive breastfeeding. Our findings highlight the need for more effective interventions to support food-insecure families with newborns.

Comparative Depletion of Sulfamethazine in Bob Veal, Fancy Veal, and Replacement Calves.

The Code of Federal Regulations provides for the use of sulfamethazine (SM) boluses in cattle, a tolerance of 0.1 ppm for SM in meat, and a 10-day withdrawal. Bob veal, fancy veal, and replacement calves were dosed with SM as provided in the regulations and the rate of depletion of SM and, where practicable, N4-acetylsulfamethazine and desaminosulfamethazine were measured in liver, kidney, and diaphragm muscle by gas chromatography. SM concentrations reached lower maximum levels and depleted faster in the tissues of replacement calves than in bob veal and fancy veal calves. Average SM levels on d 5 of withdrawal in liver, kidney, and diaphragm were about 1 ppm in fancy veal, above 2 ppm in bob veal, and below 0.1 ppm in replacement veal. Two of the d 14 and two of the d 10 withdrawal fancy veal livers contained more than 0.10 ppm of SM. A 10-d withdrawal period may not be long enough for bob and fancy veal calves that have been dosed according to the drug label.