Introduction: Due to the implied health benefits for mother and baby, breastfeeding has become a key public health issue. Literature reviewed highlighted the ‘medical’ and ‘natural’ mother discourse which surrounds motherhood and impacts on women’s decisions to breastfeed. Whilst the emotional and physical strains of a difficult experience have been explored, it is unclear how these experiences impact on women’s identities as mothers and in what ways women are able to narrate and share their embodied experiences. Methods: Seven first time mothers who described themselves as having had a difficult breastfeeding experience were interviewed to gather data pertaining to how mothers construct narratives of breastfeeding and the impact of these narratives on their identity as mothers. An interest in both socio-political discourse and embodiment theory derived from the literature review led to the use of visual methods in eliciting narratives and the employment of a critical narrative analysis in exploring the data gathered. Findings: The participants’ narratives drew from ‘medical’ and ‘natural’ mother discourses and were found to constrain subjective experience and leave participants with feelings of guilt, frustration and loss. A prevailing assumption that unruly, excessive bodies must be controlled by a rational ‘mind’ led to the body becoming a site for control and resistance for participants as they attempted to conform to norms of motherhood and breastfeeding. Discussion: Results identified the ways in which women as mothers can see their subjective experiences diminished and their voices silenced due to a lack of available discourse and entrenched ideologies surrounding the ‘good’ mother. It is suggested that adopting a social justice agenda within therapeutic practice might prevent the internalisation of oppressive discourse which can lead to mothers’ psychological distress. Moreover, it is suggested that exploring the body in therapy might resist a mind/body dualism and lead to increasingly compassionate and accepting relationships with our bodies; in turn increasing awareness of subjective experience.

Rates of child behaviour problems are increasing both in the UK and globally. Numerous risk factors for the development of child behaviour problems have been identified but a key risk factor is dysfunctional parenting practices. Parenting programmes are the most effective treatment for child behaviour problems, however barriers to treatment prevent some families, particularly disadvantaged families, from accessing programmes delivered in a group format. Individually delivered programmes eliminate some of the barriers associated with group-based programmes and may be more accessible and therefore appropriate for disadvantaged families (Chapter 1). The Enhancing Parenting Skills (EPaS) 2014 programme is an individually delivered behavioural parenting intervention for parents of young children with behaviour problems. This thesis reports on the first rigorous evaluation of the EPaS 2014 programme. Chapter two gives an overview of the origins and background of the EPaS 2014 programme followed by the first study, a systematic review of the evidence for individually delivered parenting intervention for parents of young children displaying behaviour problems (Chapter 3). Chapter four is the published protocol for the main evaluation study providing details of the methodology. Chapter five describes the baseline characteristics of a sample of families recruited for the main study. Children had high levels of co-occurring hyperactivity symptoms and parents were generally low educated, unemployed, living in poverty and had high levels of depressive symptoms. The next two chapters report the findings of the evaluation study. The EPaS 2014 programme was effective in reducing levels of child behaviour problems, especially for families who completed the intervention (Chapter 6) and feedback from health visitors was positive with all reporting they would continue to use the methods taught (Chapter 7). The final chapter of the thesis provides a summary of the research findings and discusses their implications, limitations, and future directions (Chapter 8).

Background: In the UK, mothers under 20 are the group least likely to breastfeed. Recent public health interventions to promote breastfeeding in the under 20s have met with limited success. Suggested factors include cultural constructions of normative behaviour, environmental and practical barriers, and a lack of professional and community support. However, less is known about the journey through infant feeding and the interrelation of the various influences on the experiences of young mothers. Methods: Ethnographic interviews and participant observation were used to explore the lived experience of ten young mothers aged 16-18 and their babies, from pregnancy to weaning. The data were analysed using Thematic Network Analysis and the emerging themes developed into a coherent description of the influences on infant feeding practices and why these influences seem to lead to formula feeding. Results: The influences were found to relate to three broad thematic areas: the immediate context and the importance of family relationships; the external context of public spaces (which could include the public areas of the home) and the themes of the babies and the milk. Discussion: Theories of the interplay of practical experiences of the young mothers with moral discourses of good motherhood were developed. Using the Ricœurdian theory of the narrative of the self (ipse identity) the work of becoming a mother and making feeding decisions in a morally charged environment are explicated. This approach has begun to reframe the discourse on health research on the public health approach to breastfeeding to encompass and integrate personal identities and social relationships with cultural norms of infant feeding. Conclusions: The findings gave new insights into both why breastfeeding rates are low in this group and why existing interventions have not significantly changed behaviour. The need for a consideration of the social, cultural and moral meanings of infant feeding to young mothers has been highlighted. Practical suggestions for supporting young mothers who wish to breastfeed have also been developed from these research findings.

Background Previous research has found that a third of women attributed their postnatal distress to breastfeeding difficulties. Further to this, other studies have found that women experience feelings of failure, guilt and shame when they have difficulties feeding their infants. This research aims to add to the understanding of how women view the impact of breastfeeding on their emotional wellbeing by exploring their lived experiences. Method A qualitative methodology was utilised to conduct this research. An Interpretative Phenomenological Analysis approach was used to analyse data from six participant interviews with first time mothers with experiences of breastfeeding their infant. Results Three overall superordinate themes were identified from the data that were shared across the participants. These included “nature’s way: the maternal self”, “expectations versus realities of breastfeeding” and “overcoming difficulties.” Within these, nine subordinate themes were also outlined and discussed. Conclusions The overall conclusions drawn from the interpreted experiences of the participants who took part in this study are comparable with existing research in the field of breastfeeding experience. This includes the experience that women feel a desire to breastfeed their babies so as to fulfil their perceptions of what it is to be a good mother. This can be source of significant emotional distress if breastfeeding is not possible or is difficult. There is also a perception that information provided by health professionals around infant feeding is inadequate and mis-timed. Future research into other factors such as healthcare policy and implementation of information given is needed to help guide support for breastfeeding and nonbreastfeeding mothers.

Differences in the experiences of 24 fathers of premature children in comparison to 24 fathers of children born at term, and to 24 mothers of premature children were investigated with regard to perceptions of their children's vulnerability to health problems, child temperament and parenting stress. It was hypothesised that (1) fathers of children born prematurely would perceive their currently healthy children to be more vulnerable than fathers of full term children; (2) fathers of children born prematurely would perceive their currently healthy children to be less vulnerable than mothers of the same children; and (3) paternal perceptions of vulnerability regarding their children born prematurely would be related to paternal perception of child temperament and paternal parenting stress. The results showed no differences between perceptions of vulnerability of fathers of children born prematurely and fathers of children born at term, although significantly more fathers of premature children felt the need to take special care of their children. There were no differences between paternal and maternal perceptions of vulnerability of children born prematurely. There was a relationship between paternal perceptions of vulnerability, parenting stress and perceptions of negative mood in their children. Qualitative information illustrated the impact of premature birth on fathers. The results were interpreted in relation to (1) the Vulnerable Child Syndrome (Green & Solnit, 1964) which suggests that premature birth may contribute to disturbances in the parent-child relationship; and (2) the transactional model of child development, which suggests that parental perceptions, child temperament and parental stress are interdependent, and that paternal beliefs and anxieties modify and mediate maternal behaviour (Sameroff & Chandler, 1975, Parke & Anderson, 1987). Identified areas for future research include larger scale research which attempts to disentangle the complex interaction of predisposing factors which contribute to the Vulnerable Child Syndrome. Clinical implications of the study are discussed including recognition of the impact of premature birth on both parents, and the importance of messages given by medical professionals. Neonatal services are encouraged to cater for the needs of fathers, and expanded support/clinical services are recommended.

No description available.

There is a dearth of research on aspects of child rearing and parent-child relationships in Asian families living in Britain. The literature indicates that there are variations in child-rearing practices that are informed by values and socialisation goals. Models of parenting provide framework for understanding parenting in different cultures, however, none specifically relate to Asian parenting in Britain. The effect of ethnic minority status on parenting and the acculturation process are important influential factors. This study explored Asian Hindu mothers' views regarding child-rearing practices and socialisation goals in an attempt to understand parenting in a cultural context. Grounded theory method was employed to structure and analyse the interview data, in order to generate a conceptual framework that accounted for this process. The findings generated a core theme, which encapsulated the mothers' perception of parenting, in terms of 'responsible nurturing'. This relates to the mother's responsibility in preparing the child for life. A process was identified in which perceived threats work to undermine the mother's confidence in her role and also affect the course of the preparation for life. Balancing strategies, such as cultural propagation and seeking help, are employed by the mother in order to set the process of preparation for life back on course. The mother first weighs up the intervening factors that act to hinder or facilitate the use of balancing. These factors include the mother's sense of cultural belonging, family trustworthiness and child characteristics. This study had clinical implications for the way in which parenting in Asian Hindu families is understood and identifies an active parenting model which may be used to guide assessment and intervention with Asian families who experience parenting difficulties. These findings are placed in a cultural context and are related to the literature on ethnic minority parenting.

This study deconstructed the nurturing child rearing strategies used by a group of ‘Trinidadian’ middle class parents and early childhood professionals to alter punitive intergenerational child rearing practices, and emphasised the significant contribution warm and responsive parent-child relationships made to children’s developmental outcomes. Framed within a postcolonial context, this thesis claims the main task of parenthood is to coach, mentor, and provide a pathway for future generations. The transference of punitive intergenerational parenting practices was examined to understand the significance of these practices and its effects on parent’s ability to develop warm and responsive relationships with their children. Interviews and focus groups with ten sets of parents examined the strategies they used to build a responsive parent-child relationship. The study also investigated the professional practices of four early childhood professionals in supporting parents through the emotional journey of developing intimate relationships with their children. The main findings of the research indicates that the parents and early childhood professionals used nurturing and sensitive child rearing practices, supported by a collaborative partnership to help them alter historical, political and socio-economic challenges within the ‘Trinbagonian’ society which contributed to the transference of punitive intergenerational parenting practices. This research contributes to the literature on nurturing and sensitive child rearing practices in Trinidad and Tobago, by highlighting the specific strategies used by my study participants, which are worthy of consideration in the wider domain to facilitate nurturing parent-child relationships, and contribute to beneficial developmental outcomes for children, their families, and the society.

Background: Despite breastfeeding providing maximum health benefits to mother and baby, many women in the UK do not breastfeed, or do so briefly. Using tenets of ethnography, this study aimed to explore the everyday experiences of first time breastfeeding mothers in the early weeks following birth. Methods: Using a camcorder, five mothers captured their real-time experiences in a video diary, until they perceived their infant feeding was established. A multi-dimensional approach involving thematic analysis was developed to ensure that both the audio and visual elements of the data were analysed. Findings: Three themes, significant to mothers were identified. First, how the camcorder empowered mothers to record their experiences ‘24/7’, providing audiovisual insights into the socio-cultural context and embodied nature of breastfeeding. Embodying the camcorder enabled mothers to offload their thoughts, feelings and experiences in real-time, revealing an emotional rollercoaster. The second theme showed how the video diary provided a platform for mothers to work out how to survive their ‘state of flux’ with their breastfeeding baby. Deep personal reflection involved identity work and plans to get back to ‘normal’. The third theme highlighted the complex nature of support including what mothers experienced when they felt under medicalised surveillance by the healthcare team, nurtured, influenced or undermined by family and friends, and when they sought information for themselves. Conclusions: For the first time, this thesis reports on the ‘unique presence of being there’ to observe mothers’ real-time everyday experiences of breastfeeding as recorded in their video diaries. It reveals the unique therapeutic role of the camcorder, the evolving nature of mothers’ identities in the first few weeks after birth, the impact of commercialisation on breastfeeding and the negative impact of medicalised surveillance when healthcare workers scrutinised rather than supported breastfeeding mothers. Recommendations are made for practice, education, policy and further research.

The research investigated 60 parents with conduct disordered children (49 were female and 11 male, 45 had partners and 15 were lone parents, 7 attended with their partners). Forty nine parents joined one of two parent training programmes, in order to compare and contrast effectiveness and to identify essential or core therapeutic variables. Six groups were measured against a non-treatment control group (n=11). Three groups (n=27) used the Fun and Families programme (Neville, King and Beak, 1995) whilst a further three (n=22) completed the WINNING programme (Dangel and Polster, 1988). Additionally, a sample of parents (n=35) attended an ongoing Parent Support Group in order to further evaluate the impact on the maintenance and generalisation of change. Qualitative and quantitative measures were used to evaluate group process, consumer satisfaction, attitudinal shift and child behaviour change (Eyberg Child Behaviour Inventory; Eyberg, 1980). Parental reporting was cross checked through direct observation tests administered within the natural home setting. Parents were followed-up at two weeks, three months, nine months and two years. Outcomes demonstrated there was no major significant difference between the two groupwork programmes; providing evidence that Group Leaders can achieve just as effective results by teaching intervention skills (WINNING programme) without the need for group members to carry out their own assessment (Fun and Families programme). Both programmes received significantly high consumer satisfaction ratings. Those parents who attended parent training reported significantly less child conduct problems when compared against the Control Group. Over time though (two years) there was no overall evidence to indicate a significant maintenance effect. Levels of self-efficacy and positive regard towards children did improve significantly as well as the quality of parent-child interaction; matched by a reduction in observed child behaviour problems within the home. The Control Group failed to achieve such improvements. There was no quantitative confirmation of the hypotheses that parental involvement with an ongoing support group facilitated the maintenance and generalisation of change over time and settings.