Beth Baldwin Tigges

Management strategies for promoting successful breastfeeding.

Clinicians can promote a successful breastfeeding experience by providing support, anticipatory guidance and practical information. This article presents the components of early follow-up and guidelines for assessment. Management strategies for common problems are discussed, such as nipple soreness, cracked nipples, plugged ducts and mastitis, insufficient infant weight gain, perceived inadequacy of milk supply, breast-milk jaundice, sexual adjustment and failure at breastfeeding. Breastfeeding guidelines for employed mothers and adoptive mothers are indicated.

Psychometric properties of the Social Comparison Motives Scale.

This article describes the 19-item Social Comparison Motive Scale [SCMS], a measure of adolescents’ motives for social comparison related to pregnancy. Dimensions and items were developed based on adolescent focus groups. The instrument was reviewed for content validity, pilot tested, and administered to 431 adolescents aged 14–18 years. Principal axis factor analysis with oblique rotation supported five dimensions. Convergent and discriminant validity were demonstrated by moderate correlations (r = .50) between the SCMS and the Iowa–Netherlands Comparison Orientation Measure and low correlations (r = .15) between the SCMS and the Rosenberg Self-Esteem Scale. Cronbach’s alphas were .91 overall and .71 to .85 for the subscales. The SCMS demonstrated reliability and validity as a measure of adolescents’ motives for comparing themselves with others about pregnancy.

Infant formulas: practical answers for common questions.

The pediatric health care provider is often faced with myriad decisions related to the use of infant formula. This article compares human milk to cows milk. It addresses the composition, classification, and use of some of the most common infant formulas manufactured for use with the term infant in the outpatient setting. Common clinical situations are discussed, including the role for low-iron, goats milk, and follow-up formulas, and formula use for the infant with diarrhea, colic, and atopic disease. The article highlights the poor quality of research and the lack of definitive answers available to the clinician when managing the infant with atopic disease. It concludes with a review of practical aspects of infant formula feeding for use in client education and management, including guidelines for formula preparation, calculating necessary formula intake, frequency, and quantity of infant feedings, and provisions of the WIC program.

Teen pregnancy and parenting: a qualitative study into attitudes and behaviours of teenaged long-term Hispanics in New Mexico

Introduction: Teen pregnancy in Hispanic youth is a poorly understood phenomenon with numerous and overlapping sociocultural influences. Hispanics have had the highest teen pregnancy rates in the United States since 1995 and pregnancy rates that have declined much more slowly when compared to every other ethnic group. Literature investigating long-term Hispanic youth of the United States and the factors influencing their decision-making processes and sexual behaviours is limited. Purpose: This study aimed to explore and describe attitudes and behaviours related to teen pregnancy and parenting in Hispanic female teens from long-term families in New Mexico, whose primary language was English and who have experienced pregnancy and motherhood in the 12 months prior to participation. Methods: This was a focused-ethnographic qualitative study conducted in areas of New Mexico with high rates of teen pregnancy and where the population is majority Hispanic with long-term residency. Data were collected in interviews with 10 adolescent mothers and 10 adults, and through participant observation. Data were analysed inductively through immersion and crystallisation. Results: Key findings of the study include chaos/instability characterising the homes of youth, low levels of communication related to reproductive issues, disappointment expressed by families and community in response to teen pregnancy and community goals for the future. Conclusions: The study results will aid in increasing the knowledge base related to long-term Hispanic youth and the many sociocultural factors affecting their sexual decisions and behaviours.

Acute otitis media and pneumococcal resistance: making judicious management decisions.

The emergence of drug-resistant Streptococcus pneumoniae (DRSP) has implications for the primary care provider who treats acute otitis media (AOM) in children. AOM must be carefully distinguished from otitis media with effusion (OME). Antibiotic treatment for AOM is recommended because of the low rate of spontaneous resolution of S. pneumoniae infection and the risk of suppurative complications, particularly in young children. Amoxicillin continues to be the first drug of choice. Children for whom the first course of antibiotics fails should be treated with amoxicillin-clavulanate, cefuroxime axetil, or ceftriaxone. Trimethoprim-sulfamethoxazole, the macrolides, and most of the cephalosporins have limited effectiveness against DRSP and should no longer have a major role in AOM treatment. OME need not be treated with antibiotics unless the effusion has been present for 3 to 4 months. Tympanostomy tubes are an effective treatment for both chronic OME and recurrent AOM. Given the significant increase of DRSP during the past decade, clinicians must minimize antibiotic use and, when antibiotics are required, make judicious clinical decisions.