Women and Birth
Volume 23, Issue 2 , Pages 74-80, June 2010

‘I only give advice if I am asked’: Examining the grandmother's potential to influence infant feeding decisions and parenting practices of new mothers

  • Judy Reid

      Affiliations

    • School of Nursing and Midwifery, University of Western Sydney (UWS), Australia
    • Sydney South West Area Health Service, Australia
    • Corresponding Author InformationCorresponding author at: Campbelltown Campus, Bld. 7, School of Nursing and Midwifery, College of Health and Science, University of Western Sydney, Locked Bag 1797, Penrith, South DC 1797, NSW, Australia. Tel.: +61 46203325/0400201484; fax: +61 46254252.
    • ,
  • Virginia Schmied

      Affiliations

    • School of Nursing and Midwifery, University of Western Sydney (UWS), Australia
    • ,
  • Barbara Beale

      Affiliations

    • School of Nursing and Midwifery, University of Western Sydney (UWS), Australia

Received 10 November 2009; received in revised form 3 December 2009; accepted 7 December 2009.

Article Outline

Summary 

Background

Australia has high breastfeeding initiation rates however, at 3 and 6 months exclusive breastfeeding rates fall below global recommendations. Research suggests significant others in a woman's life can influence infant feeding decisions and practices but how and why they do so needs investigation.

Research question

This study explored grandmothers’ perceptions of their role in supporting new families and examined the potential for grandmothers to influence infant feeding decisions and parenting practices of new mothers in an area of Sydney, Australia, with low breastfeeding maintenance rates.

Participants and method

A qualitative, descriptive study was conducted in South Western Sydney, Australia. Eleven grandmothers participated in one to one interviews and three of these also participated in a group discussion.

Results

Analysis revealed three themes: ‘Presence’; ‘Position’; and ‘Power versus Preservation’ which provide insight into the complexity of the grandmother–new mother relationship and describe the potential influence that grandmothers may have on infant feeding and parenting.

Discussion and conclusion

The findings highlight challenges and dilemmas faced by grandmothers in their supportive role for the new mother in her breastfeeding and early parenting experience and the difficulties grandmothers face in balancing potential risks and rewards in their interactions with the new family.

Keywords: Breastfeeding, Grandmothers, Parenting practices, Social support, Family relations

 

Back to Article Outline

Background 

Exclusive breastfeeding for a minimum of six months is recommended globally to achieve significant health benefits for mothers and babies.[1], [2], [3], [4] In Australia, recent analysis of data from the longitudinal study of Australia's children,5 found the breastfeeding initiation rate among the mothers of 5000 infants was 92%. However, exclusive breastfeeding rates declined significantly each month thereafter. This is particularly so in disadvantaged groups where the difference in breastfeeding rates, compared to those of the most advantaged groups, is widening, potentially compounding the disadvantage for these infants.6 New South Wales (NSW) statistics demonstrate a similar trend with introduction of complementary feedings resulting in only 17.5% of infants being exclusively breastfed until 6 months of age.7

Research suggests that significant others such as a woman's partner and her mother or mother-in-law are influential in decisions and practices about infant feeding, but precisely how and why this happens, needs investigation.[8], [9] A study of the perceptions of Swedish women about support from partners and grandmothers highlighted the importance of a woman's social network, including grandmothers, in determining a woman's ability to cope with breastfeeding.10 Williams11 analysed social support for the new family and found that grandmothers and new mothers have different understandings about what is supportive. Other studies have found that extended family, particularly the maternal grandmother, exerts the most influence on the early introduction of solids and other practices which are counter-productive to exclusive breastfeeding[8], [12] and is very important in influencing the infant decision-making of teen mothers.[13], [14], [15] In addition, Meyerink and Marquis16 identified the grandmother as being particularly influential for low income women, noting that initiation of breastfeeding was positively associated with the mother having been breastfed herself and breastfeeding at one month was more likely among women who have close relatives who breastfed. Women themselves report that emotional support for breastfeeding is crucial, including a sense of being cared for.[17], [18], [19] This demonstrates the need to understand the grandmother's role in providing support for new mothers particularly in regard to achieving a positive breastfeeding experience. The purpose of this study was to explore the role of grandmothers in supporting new families and to examine their potential to influence the infant-feeding decisions of new mothers in an area of Sydney, Australia, that has low breastfeeding maintenance rates.

Back to Article Outline

Methods and participants 

This qualitative, descriptive study collected data using face-to-face interviews and one focus group. Data were analysed using thematic analysis. The study was conducted in the Macarthur area in southwest Sydney, NSW. This area comprises three local government areas and is a known area of socio-economic disadvantage with a high proportion of single-parent households, a higher proportion of births to women under 20, a higher infant mortality rate and the second lowest area of breastfeeding initiation in NSW, Australia.20

Eleven grandmothers were recruited to this study over a three-month period from May to August 2008. A range of recruitment strategies were used. One participant responded to an advertisement placed in the local paper; one to a flyer that was posted a community venue and one to a direct appeal for participants at a community venue. A further eight grandmothers were recruited via purposive snowballing,

Data were collected through semi-structured face-to-face interviews by author one. In addition to being interviewed, 3 of the 11 grandmothers also participated in a focus group. Interviews and the focus group were digitally recorded with the consent of the participants. Interviews were planned for a time and place convenient to the grandmother and each interview lasted between 45 and 90min. Key prompts were used to encourage participants to talk freely about their views about breastfeeding, their experiences with feeding their own children and the relationship they have with the new mother. Specific questions included: Tell me about your experience of feeding your children when they were babies? What do you think influences mothers’ decisions now about infant feeding? How are you helping your daughter/daughter in law? What do you believe is most helpful in supporting new mothers to breastfeed?

The focus group discussion was designed to explain the grandmothers’ perceptions of community attitudes towards breastfeeding. For example, group participants were asked ‘In this community what are the general views towards breastfeeding? And how does this influence the decisions that new mothers make? The focus group discussion lasted 90min and was facilitated by authors one and three—one facilitator guided the discussion using key prompts and the other took notes of key points made by the group to present to participants on completion of the session to confirm interpretation.

Data were transcribed verbatim and responses from each participant were initially categorised according to the topics discussed in the interviews for example grandmothers’ personal experience of infant feeding, views on contemporary feeding and parenting practices. These data were then examined in more depth. The first author listened to the recordings and all authors read the transcribed data. Data were coded (using Keywords: and phrases) and themes emerged that reflected the participant's perception of their role as well as indicating the potential that they had to influence infant feeding decisions.

Ethics approval was provided by the University of Western Sydney (UWS) Human Research Ethics Committee and the study was conducted within the guidelines of the National Health and Medical Research Council (NHMRC) in Australia. All participants gave written, informed consent in this project.

Back to Article Outline

Results 

Participants included four paternal grandmothers and seven maternal grandmothers. The new baby was the first grandchild for four participants. For nine of the new mothers this was their first baby (or babies—one mother had twins). For nine participants either the grandmother or new mother lived in the Macarthur region, the other two participants worked in the area but neither they nor their family lived there (see Table 1).

Table 1. Demographic data and comparisons of grandmother/new mother feeding decisions. MGM=maternal grandmother; PGM=paternal grandmother; B/F=breastfeeding; A/F=artificial feeding; CW=coping well; JM=just managing; S=struggling.
GrandmotherNew mum
RelationshipNo. childrenNo. grandchildrenAge first childMethod of feedingMethod of feedingAgeMarital statusAge of childBaby numberFinancial status
PGM very close5521All B/F > 6 monthsB/F for 11 weeks23Upcoming in 3 months11 weeks1stCW
PGM close3225B/F 12–15 monthsB/F26Married 12 months9 weeks1stCW
PGM very supportive2224B/F 6 weeksB/F few days only27Married12 months2ndJM
PGM close2124B/F few days only first. A/F secondB/F24Married4 months1stJM
MGM closer4126B/F −12 monthsB/F27Married13 weeks1stJM-CW
MGM very good3525B/F first week child 1 and 3 then A/FTried B/F with first but she would not latch so straight to bottle33Married6 months3rdJM
MGM fairly close BUT…3123B/F 4 months, 5 months, 8 monthsB/F 4 months30Marriedl0 months1stCW
MGM good4+26+316B/F for 3 monthsB/F 12 months38Together 8 yrs. Getting married soon12 months1stCW
MGM good better than before36−121B/F first week child 1 and 2 then A/FA/F25Single Mum10 months1stS-JM
MGM great2130B/F >12 monthsB/F >12 months31Married2 years1stCW
MGM great2424B/F 4 months, 1o monthsB/F >12 months33Married14 months (twins)1stCW

Three central themes emerged from the data analysis: ‘Presence’ ‘Position’ ‘Power versus Preservation’. These themes reflect the perception and experience that grandmothers have of their support for new mothers and the potential they have to influence infant feeding and early parenting decisions. They are not completely separate from one another but rather are layers of understanding of the relationships that grandmothers have with new mothers. Within each theme underpinning issues, actions or relationships critical to understanding the theme were identified.

Presence: “Just to be supportive and do whatever I can to help….” 

The grandmothers in this study were very positive about providing support to the new mother and wanted to be available to help:

“My mother helped me a great deal when I had my children so I wanted to do the same thing for my kids when they started to have their children”

“Well helping them like to have a little time to do some things for themselves sometimes and just give them a break”.

Remembering the challenges of being a new mother themselves assisted the grandmothers’ understanding of the support needs of the new mother and underpinned their sense of ‘being present’ for them. However, grandmothers also talked about a process of emotional adjustment to the new role of being a grandmother and revealed that in order to ‘be available’ they have to juggle many competing obligations, roles and responsibilities (for example, care and support responsibilities for elderly parents). Grandmothers therefore felt the need to sometimes place boundaries on their availability:

“Sometimes she forgets…and I’d ring up and say, what time are you bringing A? I’m not bringing him, I’m on holidays. Oh thanks for telling me. One day I said to D (son), she needs to let me know so we can both work in together”

“…and then grandchildren. It's just been one roller coaster. Like a merry go round it just continues”

Significantly, grandmothers felt they had to directly help with breastfeeding because the mothers did not get the help they needed from midwives and other health professionals. Time pressures on staff and conflicting advice were noted by grandmothers as impacting on the breastfeeding experience of the new mother. Responses indicated that grandmothers recognised the need to ‘be there’ and fill the void created by this lack of support:

“I felt that she (midwife) needed to talk to her more about what to expect… but she was not shown how to breastfeed when the baby was born. I showed her how to do it”

“…the midwife didn’t visit for about a week and half and she was having a bit of trouble actually feeding him. I was a bit cross. I mean she (new mother) was very forgiving and said oh she's busy… But that doesn’t help a new mum.”

Some noted a difference in priorities for today's parents that the grandmothers perceived as creating a need for more direct support and help from them:

“…we have to help the kids a lot more, I think, because of the expenses in life. Things are so much more expensive and I think the kids want more.”

The need to return to work was identified as directly impacting breastfeeding and as another factor that increased the grandmother's role in directly caring for the grandchild:

“I think today there's a lot more mothers having to go back to work earlier. So rather than have to go through the trauma of breastfeeding and then changing them to the bottle so that they can go to work, that decision is almost taken out of their hands, that they just go straight to the bottle because that's one less hassle they’re going to have to worry about”

Position: “Like they’ve got to learn to do it themselves and learn to cope… But if she asks me for help, I’m there” 

Position refers to where the grandmother is placed in the new mother's network of support and the capacity this creates for her to be valued as a person with expertise and experience within that network (and thereby influence decisions). Responses in this theme indicated that grandmothers consider what type of relationship they want to have with the new mother and vice versa. Even though grandmothers may position themselves as being accessible for advice and support they did not want to be too intrusive:

“I don’t like to be too much in their faces or telling them things, I figure they have their own little journeys and discoveries that they have to make too about how they want to raise their own child. But if they ask me, that's fair enough, I figure I can tell them what I think”

Another explained her reasons for not interfering:

“…because of the length of time that's been between my experience of breast feeding and what is the new normal for new mums”.

Grandmothers noted that contemporary mothers were more independent in their decision-making and when seeking advice, were more likely to consult friends, rather than themselves or even health professionals:

“I think a lot of the younger people now do have a pre-planned or pre-conceived idea as to what they want to do”

Responses in this theme also exposed a real or perceived difference in being the maternal or paternal grandmother. One grandmother expressed this as

“Yes, if it was a daughter I think they would probably say, mum, what will I do? Whereas I’m only the mother-in-law, with your own daughter they probably ring you and say do you want to go out for lunch and stuff like that. Whereas with your daughter-in-law it's not the same”

Participating grandmothers also identified the input the other grandmother might have and how they balanced that input with their own advice:

“She (new mother) introduced solids late… and I just reaffirmed yes, because her mother in law was telling her different things”.

This could be sometimes challenging, particularly for paternal grandmothers:

“… there were a couple of times where I got called at two o’clock in the morning, could I come down and help because she's getting all upset? So I’d do that. But then it was but don’t tell J's mum…because she might get upset that they’ve called me as opposed to calling her”.

Power versus Preservation: “No. I stay out, I’m just the grandmother”

Being a presence in the new family's life and being positioned as having experience or expertise does not necessarily determine the grandmother's capacity to influence the decisions of new mothers. Grandmothers in this study were aware that stating their own views carried a risk in terms of potentially jeopardising their relationship with the new family. In other words, if they exercise the ‘power’ they have from the other levels of interaction they may not be able to ‘preserve’ a good relationship with the new mother. Responses in this theme indicated that grandmothers were evaluating the possible effect of their interactions with the new mother. For example, grandmothers found that giving unsolicited advice was not always viable. As one explained: “Yeah, oh good luck trying to tell them what to do”. In terms of being an influence one grandmother commented: “Maybe I’ve had some influence but a lot of it you know, she's decided what she wants to do anyway”.

Even though grandmothers believed they were not influential responses revealed strategies that grandmothers used to make certain choices seem more acceptable:

“I don’t think I have strong influences, because I give them a choice. I just sort of encourage what are ‘good’ ideas, think about the ideas and you make your decision.”

Holding back had its potential limits as explained by one participant:

“…I wouldn’t be saying you should do this or you should do that. Never… if they were doing something that I felt was really wrong they’re not looking after those children properly, then I might say something”.

Some grandmothers identified specific examples of when they bit their tongue:

“But I couldn’t say, you know. I really felt that he should have been in the cot. She's really making a rod for her own back, because he doesn’t sleep through the night properly anymore”

When caring directly for their grandchild, attempts to follow the mother's wishes were sometimes abandoned if the grandmother thought it was not best for the baby. One grandmother described the dilemma of being asked to adhere to an unrealistic feeding schedule that she knew would either result in the baby being left to scream until the next bottle (of expressed breastmilk) or her feeding the baby as needed and then lying to cover herself for not doing as asked. The grandmother was relieved when the mother realised herself that the plan did not match the baby's needs:

“So that lasted for two days, so I was pleased. I said, yeah, I thought it was a little bit magical to think that he was going to go up to six hours. I said even we can’t get to six hours”

Helping the new mum to realise that their expectations about the baby's behaviour were unrealistic was also noted by another grandmother:

“Yes, he was unsettled through the day. But like you put up with unsettledness through the day if they’re sleeping well at night and you can get a good night's sleep”

Not being valued as a person with experience or expertise seemed to carry an emotional toll for some:

“But I couldn’t sway them to what I thought. So I just had to really keep right out of it because it was like I didn’t know anything at all…within about two days of being down there, I was probably in tears… they wanted to do it their way”.

For some the new baby had provided an opportunity to improve a previously strained relationship:

“Things are a lot better since she's had the baby or in fact when she found out she was pregnant…Before that it was very up in the air. But we’re getting on great now”

However, responses that grandmothers gave to specific questions about their views of current recommendations for infant feeding and parenting practices highlight the potential power that grandmothers may still hold in influencing mothers. For example, one grandmother attempted (unsuccessfully) to persuade the new mother to introduce solids early:

“At six weeks I said put a bit of cereal in the bottle. She said no. I said why not…I says don’t go by what your friends have said, you can’t start solids until the four months, you can’t do this until the – I said bugger that. I said that's old wive's… I said what do you think? She wants more, give her more, give her solids”.

Participants also revealed personal views about the use of dummies/pacifiers, letting babies cry, and demand feeding that in some cases seemed to be based more on the grandmothers own parenting experience rather than an understanding of what might be important for the baby and the continuation of breastfeeding.

Focus group participants talked about current community attitudes towards breastfeeding and identified that breasts are seen as having more of a sexual function today. They believe that breastfeeding in public is still not widely supported and that young women have concerns that breasts “would be saggy” as a result of breastfeeding.

Back to Article Outline

Discussion 

This study explored the relationships that grandmothers have with new mothers in order to understand the potential influence that grandmothers may have on infant feeding and related parenting practices. The study findings provide insight into the complexity of the grandmother–new mother relationship and the difficulties grandmothers face balancing potential risks and rewards when interacting with the new family. The results also reveal that simply having a viewpoint or wanting to be involved, does not mean that a grandmother is able to influence decisions. The grandmothers’ observation that today's new mothers were more independent in their thinking and decision-making raises the question of ‘how much input is the grandmother allowed to have?’

In fast-changing urban environments, similar to this study setting, new mothers may rely more on horizontal transmission of information (from peers, professionals and the media) rather than from elders who are less likely to be seen as authorities for child rearing.21 While new mothers may listen to the grandmother, there is some evidence that mothers will check the grandmothers’ advice with another source that they consider credible before following it.22 In addition, the reality that grandmothers in this study were all juggling many competing roles and obligations could potentially limit their capacity to participate in child care and ‘be available’ to the new mother. Therefore it is possible, that in some cases, the new mother defers to others for help and advice in order to avoid being another burden on the grandmother.

In a study of social support for new mothers Williams11 described the notion of ‘being there’ as a complex concept. The study findings highlighted the difficulties those providing support experience because what is considered acceptable or helpful by new mothers is open to interpretation and changes according to how the mother is feeling or coping. The inability of new mothers to accurately convey their support needs can compromise the good intentions of those around them and potentially hinder the support that is provided.23

“Unsolicited advice” has been identified by new mothers themselves as a criticism of their parenting efforts that contributes to undermining their confidence and self-view as a mother.11 The grandmothers in this study admitted they were often “biting their tongues” although the true motivation for this was unclear. The desire to not be too intrusive and to allow parents to “find their own way” could be related to the understanding that good parenting on their part means allowing their children to be independent adults.24 If their children are self-reliant and competent as parents this then validates the grandparents own parenting as successful.

Interestingly, Mason et al.,24 found that grandmothers were more focussed on interactions with the grandchildren to influence upbringing whereas grandfathers were focussed on interactions with the parents and giving them advice. This reinforces the findings of Lamm et al.,21 which showed that grandmothers will acquiesce to the new mother's viewpoint in order to avoid jeopardising sustained, rewarding contact with the grandchild. This appears to be a considerable dilemma for grandmothers as they negotiate the fine line between the desire to not interfere and the need to speak up or intervene in circumstances where they believe the well-being of their grandchild could be compromised.24

Another consideration is that the new mother usually has the input of more than one set of grandparents and this potentially creates another level of difficulty in the relationship. The mother–daughter bond can be strong25 and even when the relationship with their daughter has previously been shaky, having a baby tends to bring mother and daughter closer[26], [27]; conversely new mothers appear to experience more tension with their mother-in-laws.27 Even when a good relationship does develop the paternal grandmother may be mindful of not compromising the mother–daughter relationship or, as revealed by one paternal grandmother in this study, be requested to keep her involvement secret to avoid the maternal grandmother finding out and any negative impact that may have for the new mother. The result in either situation may be a significant increase in ambivalence and the associated emotional toll for paternal grandmothers24 and may explain why maternal grandmothers report a unique level of emotional fulfilment.27

Ironically, despite the grandmothers believing that they were not imposing their views, some of their responses validate findings from Lavender's study of new mothers and their families that they may be “overtly or covertly undermining the mother's breastfeeding experience”.28 Even without them directly stating a view, the new mother may be aware of non-verbal signals and cues that the grandmother (or even other significant persons give) that indicate an opinion regarding decisions and choices that she is making and because it is not discussed openly the mother is left to make her own interpretation of what is expected or what is best. However, in many cases, the grandmothers’ self-reported intervention apparently saved the new mother from abandoning breastfeeding and was considered necessary due to lack of support from health professionals. The issues regarding professional support, particularly conflicting advice; observed by the grandmothers in this study, have been reported in other studies.[17], [22], [29] Midwives have identified that they want a greater understanding of how to support breastfeeding women and that increased workloads deny them the time and opportunity to give better support and to access research that would inform the support.30

The results of this study extend beyond the notion of ‘being helpful, updating my knowledge and learning together’ as outlined in the study of grandmothers by Grassley and Eschiti8 to highlight the potentially precarious nature of the grandmother/new mother relationship. Using focus groups, their qualitative study ascertained thirty-five participant's views of breastfeeding experiences, knowledge and concerns. The importance of being helpful and updating my knowledge are recognised by grandmothers in both studies as key elements of being supportive to new mothers who are breastfeeding. However, as this study reveals, the process of ‘learning together’ could be hampered by relationship issues if they are not recognised and resolved.

This study is limited by sample size and the homogeneity of the participants. Grandmothers who were positive about their role as grandparents and breastfeeding were more likely to respond to recruitment initiatives. Grandmothers, particularly maternal grandmothers, are considered important in regards to decision-making particularly for teen mothers[13], [14], [15] and since this is a relevant area of concern in the Macarthur region,20 future studies need to develop strategies to ensure recruitment that reflects the diverse population in the area particularly those who are socio-economically disadvantaged.

Back to Article Outline

Conclusions and implications for practice 

The results of this study are consistent with findings that grandmothers are an important part of the support network for new mothers and can potentially be an influencing factor in terms of their breastfeeding and parenting decisions. It demonstrates a need for health professionals to recognise the challenges and dilemmas faced by grandmothers in trying to be supportive for the new mother in her breastfeeding and early parenting experience. Given that grandmothers are often highly motivated to help the new mother, particularly in ways that achieve the best outcomes for their grandchild, it might be helpful to include grandmothers in parenting education sessions which would allow their expertise and experience to be acknowledged while at the same time ensuring that they are aware of current recommendations for the care of infants.8 Indeed, perhaps the concept of ‘learning together’ should be extended to include all participants in the post-natal experience (midwives, new mothers, their significant others and the wider community) to ensure consistent, evidence-based strategies are implemented by all to foster breastfeeding success. Such a “multi-layered approach” to breastfeeding support is in line with recommendations by Lavender et al.28

Because having a supportive relationship with their own mothers is positively associated with new mothers feeling more competent as parents31 and lowered grandmother self-esteem has been associated with new mother depression26; it is essential to understand how grandmothers cope with role strain and conflict and what factors are enhancing for their self-esteem and the grandmother/new mother relationship. Further research into the complexity of the grandmother/new mother relationship that includes the new mother's perspective is needed to allow greater understanding of the way in which new mothers give meaning to all the verbal and non-verbal messages they receive and how they validate and use the information and advice that is available explicitly and implicitly to them.

Back to Article Outline

Acknowledgement 

Funding for this project was provided by the School of Nursing and Midwifery (University of Western Sydney), Australia.

Back to Article Outline

References 

  1. Chiarella M, Lau C. First report on the models of care project, N.D.o. Health Editor. Better Health Care-Publications Warehouse; 2006;
  2. Kruse L, Denk CE, Feldman-Winter L, Mojta Rotondo F. Comparing sociodemographic and hospital influences on breastfeeding initiation. Birth. 2005;32(2):81–85
  3. National Health and Medical Research Council . National Health and Medical Research Council strategic plan 2003–2006. 2003;
  4. WHO and UNICEF . Global strategy for infant feeding & young child feeding. Geneva: WHO and UNICEF; 2003;
  5. Australian Institute of Family Studies . Growing up in Australia: the longitudinal study of Australian children 2006–07 annual report 2008. Melbourne: Commonwealth of Australia; 2008;
  6. Amir L, Donath S. Socioeconomic status and rates of breastfeeding in Australia: evidence from three recent national health surveys. MJA. 2008;189(5):254–256
  7. Centre for Epidemiology and Research . Report on child health from the NSW population health survey 2005–2006. Sydney: NSW Department of Health; 2008;
  8. Grassley JS, Eschiti VS. Two generations learning together: facilitating grandmothers’ support of breastfeeding. International Journal of Childbirth Education. 2007;22(3):23–26
  9. Aubel J, Toure I, Diagne M. Senegalese grandmothers promote improved maternal and child nutrition practices: the guardians of tradition are not averse to change. Social Science & Medicine. 2004;59(5):945–959
  10. Ekstrom A, Widstrom A, Nissen E. Breastfeeding support from partners and grandmothers: perceptions of Swedish women. Birth: Issues in Perinatal Care. 2003;30(4):261–266
  11. Williams P. What is social support? A grounded theory of social interaction in the context of the new family. Adelaide: Department of Public Health, University of Adelaide; 2005;p. 266
  12. Monti D. Nutrition news, Can my six-week-old eat Thanksgiving dinner? Early introduction of solids to infants. International Journal of Childbirth Education. 2005;20(4):31–33
  13. Eshbaugh EM. Potential positive and negative consequences of coresidence for teen mothers and their children in adult-supervised households. Journal of Child and Family Studies. 2008;17(1):98–108
  14. Persad MD, Mensinger JL. Maternal breastfeeding attitudes: association with breastfeeding intent and socio-demographics among urban primiparas. Journal of Community Health. 2008;33(2):53–60
  15. Shanok AF, Miller L. Stepping up to motherhood among inner-city teens. Psychology of Women Quarterly. 2007;31(3):252–261
  16. Meyerink RO, Marquis GS. Breastfeeding initiation and duration among low-income women in Alabama: the importance of personal and familial experiences in making infant-feeding choices. Journal of Human Lactation. 2002;18(1):38–45
  17. Dykes F. Breastfeeding in hospital: mothers midwives and the production line. London: Routledge; 2006;
  18. Sheehan A. Complex decisions: deconstructing best: a grounded theory study of infant feeding decisions in the first six weeks post-birth. Sydney: University of Technology; 2006;
  19. Hauck Y, Inurita . Constructing compatibility: managing breastfeeding and weaning from women's perspective. Qualitative Health Research. 2002;12.(1):
  20. Sydney South West Area Health Service . A health profile of Sydney South West. Sydney: Sydney South West Area Health Service; 2005;
  21. Lamm B, Keller H, Yovsi RD, Chaudhary N. Grandmaternal and maternal ethnotheories about early child care. Journal of Family Psychology. 2008;22(1):80–88
  22. Hauck YL, Irurita VF. Incompatible expectations: the dilemma of breastfeeding mothers. Health Care for Women International. 2003;24(1):62–78
  23. Lavender T, McFadden C, Baker L. Breastfeeding and family life. Maternal & Child Nutrition. 2006;2(3):145–155
  24. Mason J, May V, Clarke L. Ambivalence and the paradoxes of grandparenting. Sociological Review. 2007;55(4):687–706
  25. Shrier DK, Tompsett M, Shrier LA. Adult mother–daughter relationships: a review of the theoretical and research literature. Journal of the American Academy of Psychoanalysis & Dynamic Psychiatry. 2004;32(1):91–115
  26. Sadler LS, Clemmens DA. Ambivalent grandmothers raising teen daughters and their babies. Journal of Family Nursing. 2004;10(2):211–231
  27. Somary K, Stricker G. Becoming a grandparent: a longitudinal study of expectations and early experiences as a function of sex and lineage. Gerontologist. 1998;38(1):53–61
  28. Lavender T, Thompson S, Wood L. Supporting teenage mothers with breastfeeding guardians. British Journal of Midwifery. 2005;13(6):354–359
  29. Dykes F, Moran VH, Burt S, Edwards J. Adolescent mothers and breastfeeding: experiences and support needs—an exploratory study. Journal of Human Lactation. 2003;19(4):391–401
  30. Reid J, O’Reilly R, Beale B, Gillies D, Connell T. Research priorities of NSW midwives. Women and Birth. 2007;20(2):57–63
  31. Oberlander SE, Black MM, Starr RH. African American adolescent mothers and grandmothers: a multigenerational approach to parenting. American Journal of Community Psychology. 2007;39(1–2):37–46

PII: S1871-5192(09)00089-4

doi:10.1016/j.wombi.2009.12.001

Women and Birth
Volume 23, Issue 2 , Pages 74-80, June 2010

Article Tools