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Background There is wide variation in the duration of breastfeeding across Europe which may in part be due to the between-country differences in mothers' and societal attitudes towards breastfeeding in public. The objective of this study was to quantify and compare the maternal attitudes to, and practice of, breastfeeding in public in four European centers and investigate the association with duration of breastfeeding. Methods Participants ( n = 389) were mothers recruited from maternity wards of hospitals in Glasgow (Scotland), Stockholm (Sweden), Granada (Spain), and Reggio-Emilia (Italy). Results Among those who had breastfed, Scottish (adjOR 0.25 [95% CI 0.12-0.50]) and Italian mothers (adjOR 0.30 [95% CI 0.14-0.63]) were significantly less likely than Swedish mothers to have ever breastfed in public. Mothers who had a negative attitude toward breastfeeding in public were less likely to have ever breastfed in public (adjOR 0.05 [95% CI 0.02-0.17]), and those who had never breastfed in public were in turn more likely to discontinue breastfeeding earlier. Conclusions Perceived social norms may exert a stronger influence on breastfeeding outcomes than a woman's breastfeeding attitudes and knowledge. Differences between European countries in the duration of breastfeeding may be explained in part by differences in societal attitudes to breastfeeding in public. [ABSTRACT FROM AUTHOR]

Background: Lactational mastitis is a painful, debilitating condition that if inappropriately managed, may lead women to discontinue breastfeeding prematurely. The aim of this paper is to report the incidence of mastitis in the first six months postpartum in a Scottish population, its impact on breastfeeding duration and to describe the type and appropriateness of the support and management received by affected women from health professionals. Methods: A longitudinal study of 420 breastfeeding women was undertaken in Glasgow in 2004/ 05. Participants were recruited and completed a baseline questionnaire before discharge from hospital. Cases of mastitis were reported either directly to the researchers or were detected during regular follow-up telephone interviews at weeks 3, 8, 18 and 26. Women experiencing mastitis provided further information of their symptoms and the management and advice they received from health professionals. Results: In total, 74 women (18%) experienced at least one episode of mastitis. More than one half of initial episodes (53%) occurred within the first four weeks postpartum. One in ten women (6/57) were inappropriately advised to either stop breastfeeding from the affected breast or to discontinue breastfeeding altogether. Conclusion: Approximately one in six women is likely to experience one or more episodes of mastitis whilst breastfeeding. A small but clinically important proportion of women continue to receive inappropriate management advice from health professionals which, if followed, could lead them to unnecessarily deprive their infants prematurely of the known nutritional and immunological benefits of breast milk. [ABSTRACT FROM AUTHOR]

Against a backdrop of new arrangements for representing children's interests in England, this paper examines the role of 'safeguarders' in Scottish children's hearings. Safeguarders may be appointed by children's hearings and sheriffs when it is in the child's interests to do so. Recent research conducted by the authors revealed that the performance of most safeguarders is very well regarded. However, the arrangements for recruitment, training, monitoring and support are highly variable and often limited. The independence of safeguarders is widely supported. Certain aspects of the organization of the service and of the processes for allocating individual safeguarders to particular cases raise questions about consistency and independence. [ABSTRACT FROM AUTHOR]

A 6-month intervention study with a quasi-experimental design was conducted to evaluate the effectiveness of an Internet-based, stepwise, tailored-feedback intervention promoting four key components of the Mediterranean diet. Fifty-three (intervention group) and nineteen (control group) healthy females were recruited from the Universities of Glasgow and Glasgow Caledonian, Scotland, respectively. Participants in the intervention group received tailored dietary and psychosocial feedback and Internet nutrition education over a 6-month period, while participants in the control group were provided with minimal dietary feedback and general healthy-eating brochures. Internet education was provided via an innovative Mediterranean Eating Website. Dietary changes were assessed with 7 d estimated food diaries at baseline and 6 months, and data were analysed to calculate the Mediterranean Diet Score, a composite score based on the consumption of eight components of the traditional Mediterranean diet. The 'intention-to-treat' analyses showed that, at 6 months, participants in the intervention group had significantly increased their intake of vegetables, fruits and legumes, as well as the MUFA:saturated fatty acid ratio in their diet, and had significantly increased plasma HDL-cholesterol levels and a reduced ratio of total:HDL-cholesterol. Participants in the control group increased their intake of legumes but showed no other favourable significant changes compared with baseline. This Internet-based, tailored-feedback intervention promoting components of the Mediterranean diet holds promise in encouraging a greater consumption of plant foods, as well as increasing monounsaturated fat and decreasing saturated fat in the Scottish diet; it also shows that the Mediterranean diet can be adopted by healthy individuals in northern European countries.

Background: A woman chooses to breastfeed for many reasons. Recent research, however, suggests that parental attitudes toward breastfeeding are stronger predictors of infant feeding choice than commonly cited sociodemographic factors. The objective of the current study was to compare the infant feeding attitudes of expectant couples, and to determine to what degree their individual attitudes during early pregnancy were predictive of the method of infant feeding at discharge from hospital., Methods: A convenience sample of pregnant women (gestational age 8-12 weeks), who were attending maternity clinics in Glasgow, Scotland, in 2000, completed the 17-item Iowa Infant Feeding Attitude Scale (IIFAS), together with their partners., Results: The IIFAS was completed by 108 expectant couples. At discharge from hospital 49.1 percent of women were exclusively breastfeeding, and 50.9 percent were exclusively formula-feeding. A woman's total infant feeding attitude score was significantly correlated with her partner's score(r = 0.67, p < 0.001). There was no difference in the infant feeding attitudes of formula-feeding couples(p = 0.987), but breastfeeding women tended to be more supportive of breastfeeding than their partners(p = 0.022). Maternal, but not paternal, infant feeding attitude was a significant predictor of the choice of feeding method (OR = 1.16 95% CI = 1.09-1.24)., Conclusions: Infant feeding attitudes tended to be shared by expectant couples. Maternal infant feeding attitude was a better predictor of feeding choice than were demographic factors. Paternal attitudes were not found to be independently associated with feeding choice. Identification of women with neutral infant feeding attitudes using the IIFAS may be an effective way of targeting interventions at those women who are most likely to be receptive to such programs.

Background: Research has indicated that parental attitudes are strong predictors of choice of infant feeding. Identification and understanding of the infant feeding attitudes of mothers and their social networks should be an early step in the design and implementation of breastfeeding interventions., Aim: To compare the infant feeding attitudes of parents of breastfed infants with those of parents of formula fed infants., Methods: A survey was carried out with a convenience sample of pregnant women (gestational age 8-12 weeks) attending three maternity clinics in Scotland in 2000. Expectant mothers and their partners (n = 108 couples) completed the 17 item Iowa Infant Feeding Attitude Scale. Demographic information was collected by face-to-face interview and the method of feeding at discharge from hospital was obtained from medical records., Results: Parents of breastfed infants had more positive attitudes towards breastfeeding than parents of formula fed infants, and were more knowledgeable about the health benefits and nutritional superiority of breastfeeding. Fathers of both breastfed and formula fed infants were more likely than their partners to disapprove of women breastfeeding in public. Parents considered their chosen method of feeding to be the more convenient alternative. Mothers of formula fed infants were more likely to think that women who occasionally drink alcohol should not breastfeed., Conclusion: Parents of formula fed infants had several misconceptions about breastfeeding. Use of the Iowa Infant Feeding Attitude Scale could help health professionals identify and address these in infant feeding discussions in the early antenatal period. Efforts should be made to include fathers in these infant-feeding discussions.

Focus group interviews were used to explore the breastfeeding attitudes and experiences of a group of low-income Scottish women who were breastfeeding in an environment where bottle-feeding was the cultural norm. The majority of women interviewed had no prior exposure to breastfeeding and received little or no support or advice for breastfeeding from family or friends. All women were participants in a breastfeeding peer-support project, and for most the peer volunteers represented their only source of support and guidance, outside of that provided by health professionals. Women often went to great lengths to avoid having to breastfeed in public, and the majority preferred to breastfeed away from the public gaze. Despite reported increases in breastfeeding rates, bottle-feeding remains the cultural norm in the more deprived areas of Glasgow. Those women who do breastfeed in these areas demonstrate a high level of commitment to breastfeeding that sets them apart from their social peers.