OBJECTIVES: The purpose of this study was to determine whether breast-feeding has a dose-related protective effect against illness and whether it confers special health benefits to poor infants. METHODS: The association between breast-feeding dose and illnesses in the first 6 months of life was analyzed with generalized estimating equations regression for 7092 infants from the National Maternal and Infant Health Survey. Breast-feeding dose (ratio of breast-feedings to other feedings) was categorized as full, most, equal, less, or no breast-feeding. RESULTS: Compared with no breast-feeding, full breast-feeding infants had lower odds ratios of diarrhea, cough or wheeze, and vomiting and lower mean ratios of illness months and sick baby medical visits. Most breast-feeding infants had lower odds ratios of diarrhea and cough or wheeze, and equal breast-feeding infants had lower odds ratios of cough or wheeze. Full, most, and equal breast-feeding infants without siblings had lower odds ratios of ear infections and certain other illnesses, but those with siblings did not. Less breast-feeding infants had no reduced odds ratios of illness. Findings did not vary by income. CONCLUSIONS: Full breast-feeding was associated with the lowest illness rates. Minimal (less) breast-feeding was not protective. Breast-feeding conferred similar health benefits in all economic groups.

This qualitative study asked low income mothers about their experiences of breastfeeding care in the health system and about integrating breastfeeding into their daily lives. Focus group interviews were conducted with urban and rural nursing mothers who participated in the WIC Program and were supported by breastfeeding peer counselors. Mothers said that helpful breastfeeding care providers knew correct information, established supportive personal relationships, referred women to breastfeeding specialists for problems, showed enthusiasm for nursing, and facilitated breastfeeding through concrete actions during the prenatal, intrapartum, and postpartum periods. Unhelpful providers missed opportunities to discuss breastfeeding, gave misinformation, encouraged formula supplementation, provided perfunctory or routine breastfeeding care, and were hard to contact when problems arose. Women valued their breastfeeding peer counselors for responding promptly to distress calls, making home visits, being knowledgeable about breastfeeding, providing hands-on assistance, and acting personal and caring. Incorporating breastfeeding into daily activities was a challenge for many mothers. Ambivalence about the physical bond of nursing, personal modesty, and getting on with life at home, work, or school were identified as important issues. Listening to the thoughts and experiences of low income nursing mothers can help health workers to provide more culturally sensitive, effective breastfeeding care to this population.

The current study investigated the use of ice massage of the acupressure energy meridian point large intestine 4 (LI4) to reduce labor pain during contractions. LI4 is located on the medial midpoint of the first metacarpal, within 3 to 4 mm of the web of skin between the thumb and forefinger. A one‐group, pretest, posttest design was chosen, which used 100‐mm Visual Analog Scales (VAS) and the McGill Pain Questionnaire (MPQ) ranked numerically and verbally to measure pain levels; the pretest served as the control. Study participants were Hispanic and white Medicaid recipients who received prenatal care at a women's clinic staffed by certified nurse‐midwives and obstetricians. Participants noted a pain reduction mean on the VAS of 28.22 mm on the left hand and 11.93 mm on the right hand. The postdelivery ranked MPQ dropped from number 3 (distressing) to number 2 (discomforting). The study results suggest that ice massage is a safe, noninvasive, nonpharmacological method of reducing labor pain.