Background According to the Centers for Disease Control and Prevention, Hispanic breastfeeding mothers begin early formula supplementation at higher rates than other ethnic groups, which can lead to shorter breastfeeding duration and decreased exclusive breastfeeding. Acculturation, the process of adopting beliefs and behaviors of another culture, appears to influence breastfeeding practices of Hispanic women in the United States. Little is known about Mexican American mothers’ formula use and exclusive breastfeeding within the context of acculturation. Objective Our study identified perceived benefits and barriers to exclusive breastfeeding and levels of acculturation among Mexican American women living in a Midwestern city. Methods We used a qualitative descriptive design integrating Pender’s Health Promotion Model concepts. Individual interviews were conducted in English or Spanish (N = 21). The revised Acculturation Rating Scale for Mexican Americans was used to examine acculturation levels. Results Acculturation scores indicated that the majority (66%) of the sample was “very Mexican oriented.” Most women exclusively breastfed, with a few using early supplementation for “insufficient milk production.” Three themes emerged: (1) It is natural that a woman give life and also provide the best food for her baby; (2) Breastfeeding is ultimately a woman’s decision but is influenced by tradition, guidance, and encouragement; and (3) Breast milk is superior but life circumstances can challenge one’s ability to breastfeed. Conclusion Strong familial/cultural traditions supported and normalized breastfeeding. Barriers to exclusive breastfeeding were similar to breastfeeding women in general, in the United States. Findings support the need for culturally competent and individualized lactation care.

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Until recently, we in the health care field have been a bit "hearing impaired" about pain in children. Infant boys are circumcised, chest tubes are inserted in neonates, IVs are started, bloods are drawn, and spinal taps performed with no or inadequate analgesia. This occurs in spite of the availability of pain management strategies for most situations.We do, however, appear to be turning the corner. There are now several comprehensive reviews on pediatric pain management (1 -4) and two recent books published on this topic (5, 6 ) . In addition, the First International Symposium on Pediatric Pain was held in Seattle, Washington, July 22-24, 1988. It is important that we use this growing body of knowledge in our daily practice with children. Nurses are important advocates for children in the health care system and can work with medical and allied health colleagues to insure that children are provided needed pain relief.We are pleased to present this issue on pediatric pain assessment and management. The contributing authors were asked to approach their specific topics from a developmental perspective that acknowledges the complexities and unique aspects of pain assessment and management in children. They were also asked to stimulate interest in research on pediatric pain and offer practical suggestions for nurses who are attempting to help relieve pain and suffering in children. The authors have done an admirable job of meeting these requirements.Beginning with assessment, Ross and Ross describe available instruments for use in assessing pain in children. Eland discusses pharmacologic management of pain, as well as the nurse's role in advocacy for appropriate pain management. Patterson and Ware discuss how we can help children cope with painful medical procedures. Chronic pain associated with selected chronic diseases is addressed by Varni and Walco.