A project
Presented by
Candida Darling
of
Liverpool Hope University
in fulfilment of part of the examination requirement for
Degree of Bachelor of Science
of the
Liverpool Hope University
April 2009
A quantitative study examining maternal infant feeding methods in relation to: Emotional Intelligence, Narcissistic Trait and Social Support.
Candida Darling 06010546
DECLARATION OF ORIGINALITY
I declare that this is an original study based on my own work
and that I have not submitted it for any other course or degree.
Signature ---------------------
Contents Page
Abstract Page 5
List of tables Page 6
Acknowledgements Page 7
Introduction: Pages 8-18
The importance of breastfeeding Page 8
Current explanations for deficiency of breastfeeding. Pages 9-10
Emotional intelligence. Pages10-13
Narcissistic trait pages 13-16
Social support pages16-17
Methods: pages17-22
Participants page 17
Design pages 17-18
Materials: pages 18-22
Infant feeding efficacy questionnaire page 18
Social support questionnaire page 19
Schutte Self Report Emotional Intelligence Test (SSEIT) Page 19-20
Narcissistic Personality Inventory (NPI) Page 20-21
Control variables Page 22
Procedure Page 22
Results Pages 23-26
Discussion : Pages 27-34
Emotional intelligence Pages 28-29
Narcissistic trait Pages 29-30
Social Support. Pages 30-31
Limitations and future directions. Page 32
Suggestions for further studies: Pages 32-34
References (by alphabetical order of surnames) Pages 34-39
Appendix
Abstract.
Maternal infant feeding choice, trait Emotional Intelligence (EI), Narcissistic Trait (NT) and Social Support were investigated using an adaptation of established measures.
Emotional Intelligence, it is suggested, is recognising feelings and applying them rationally and appropriately. Regarding NT, it is usual human development to invest energy in one’s self and develop one’s own image into healthy narcissism; Narcissistic Trait is considered normal and on a continuum, although some facets of this trait are more adaptive than others.
Social Support, characterised by function and value of social relationship, has been found to influence maternal infant feeding choice in previous studies, thus it was investigated along with psychological measures in this study.
A web-based approach was used via an online survey provider; the online questionnaire combined 4 validated measures. Seventy-five participants, whose mean age was 34 years, were grouped according to feeding method: thirty-three bottle feeders and forty-two breastfeeders.
The main proposition of this research was that it was expected that a high EI score would correlate to breastfeeding one-tailed; that there would be a significant difference between the two groups regarding NT score, two- tailed; and that Social Support would mediate.
Participants in both groups scored similarly: for Social Support bottle feeders (M=10.54) breastfeeders (M=11.50); for EI ( 128.51 and 128.50 ) and for NT (10.33 and 11.76) respectively. There were no significant differences for any of the predictor variables p>.005.
Although, using direct binominal logistic regression, results were found to be significant for control variables: socioeconomic status (SES) and planned pregnancy (PP):
SES, (b=-1.62, s.e.=.623,Wald. 6.82 Exp.B=.19, p=.009), and PP, (b=101,s.e.=.561,Wald,2.24Exp.B=2.74,p=0.07)
List of tables
Table 1: Means and Standard deviations for SS, EI and NT. Page 23
Table 2: Narcissistic Trait Facets separated. Page 24
Table 3: Grouping of SES, Planned and Unplanned pregnancy according to feeding choice. Page 24
Figure 1. Frequency chart showing similarities in NT results for individual questions. Page 24
Figure 2: Depiction of Similarity of Emotional Intelligence scores. Page 25
Table 4: Logistic regression showing SS, EI and NT. Page 25
Acknowledgements
I would like to thank all the people that made it possible for me to undertake this research.
Firstly, thank you to my supervisor Minna Lyons, for her guidance and support throughout this study and for her understanding when I changed the direction of my area of interest for suggesting we separate the facets of Narcissistic Trait and for enduring my boisterous interruptions. Thank you, Minna.
I would like to give my sincere thanks to Dr. Margaret Coffey and Dr.Anne Coufopoulos, who were instrumental in my undertaking research into breastfeeding and who have supported and encouraged me throughout my degree. You kept me going more than you know.
I would also like to thank Martin Guest who was there for me throughout this research, with patience and understanding far beyond the call of duty and I would like to give a huge thank you to Val Walsh, my dyslexia tutor, who pushed me on when I wanted to give up.
I would like to thank the people who helped with my research, my participants; the women who took time to complete my surveys and all my friends who encouraged people to participate.
My biggest thank you is to my family: I would like to say a huge and heartfelt thank you to my three children; Loui, James and Ysabella, for enduring my moods and being accommodating, understanding and really helpful throughout my studies> I missed you guys and I love you more.
Finally thank you Jesus for giving me the strength to continue through all the struggles.
1.Introduction
Evidence proves that breastfeeding has a key function in the nation’s public health, as it positively affects infant and ultimately adult health (Furber & Thompson, 2006).
Approaching infant feeding from a psychology background, the main emphasis of this study was to understand and explore several psychological determinants of infant feeding choice. Established measures of human personality, specifically Emotional Intelligence (EI) and Narcissistic Trait (NT) were used to investigate this topic (Austin, Saklofske,Huang,& McKenney, 2004; Foster & Campbell , 2007), along with measures of other factors which are recognized as affecting infant feeding choice, namely: Social Support (SS), Socioeconomic Status (SES) and whether the pregnancy was planned (Bailey, Pain, & Aarvold, 2004). At this juncture it is useful to explain the importance of breastfeeding and to examine previously published literature on this topic; later Emotional Intelligence and Narcissistic Trait will be considered.
1.1 The importance of breastfeeding.
Breastfeeding prevents disease in both infant and mother by bolstering the immune system and preventing auto-immune response; for example, breast milk protects against: allergies, asthma, arthritis, coeliac disease, Crohn's disease, diabetes, sudden infant death syndrome, ulcerative colitis, and obesity (Department of Health , 2005). Breastfeeding protects a mother from health problems, such as ovarian cancer, breast cancer, and osteoporosis and urinary tract infections (ibid). Finally breastfeeding impacts psychological well being for the mother, as it helps with mother-infant bonding, produces the hormone oxytocin, which in turn increases calmness, self-esteem, and confidence (Dyson, Renfrew, McFadden, McCormick, Herbert, & Thomas, 2006; Wagner,Wagner, Ebeling, Gleaton- Chatman, Cohen, & Hulsey, 2006). Government recommends that infants should be solely breastfed, with no supplementary feeding for the first 6 months and that weaning should not take place before 6 months. However, the current breastfeeding rates are low, at 40-43%, and have not increased despite attempts to promote breastfeeding for over 10 years (Department of Health , 2005; Furber & Thompson, 2006).
1.2 Current explanations for deficiency of Breastfeeding.
There are several reasons reported for this lack of increase in breastfeeding, according to varying bio-psychosocial explanations, for example, maternal education. Breastfeeding rates are lowest among those who left school at 16 or less (Wagner,Wagner, Ebeling, Gleaton-Chatman, Cohen, & Hulsey, 2006); And socioeconomic status of mother (and partner): –breastfeeding rates become lower for lower socio economic groups (Tzuriel & Weller, 1986).
It is asserted that women complain breastfeeding takes too long, or is tiring or painful and baby cannot be fed by others, therefore mother’s role is more demanding if breastfeeding (Swanson & Power , 2005; Wagner,Wagner, Ebeling, Gleaton- Chatman, Cohen, & Hulsey, 2006). Finally, it is suggested that the media’s portrayal of bottle-feeding as the norm, and increased media portrayal of women’s breasts as symbols of sexuality, imply breastfeeding is not conducive to a woman’s sexuality or self esteem (Roth, 2006; Renshaw, Godfrey & Marshall, 2007).
Across the literature reviewed, there was little comparing personality traits to infant feeding choice, although there were a small number of studies relating breastfeeding to self belief and efficacy (Bick,D. Macarther,C. & Lancashire, R., 1998; Campbell, 2002; Dennis, Hodnett, Gallop & Chalmers, 2002). These studies assert that efficacy regarding infant feeding could be improved upon; however, the main findings indicate peer support to be the most effective method of improving breastfeeding rates (ibid). Attitudes of partner, mother and peer group, social support provided by woman’s partner, family and friends (Dennis, Hodnett, Gallop & Chalmers, 2002) are proven to affect feeding methods (ibid). This will be discussed in more detail later.
Wagner,Wagner, Ebeling, Gleaton-Chatman, Cohen, & Hulsey (2006) tested 87 women within 24 hours of giving birth, using the Neuroticism Extraversion Openness Personality Inventory Revised (NEO-PI-R). They found that bottle-feeding and breastfeeding participants differed on three personality domains: Agreeableness (Breastfeeding 48.5 vs Bottle-feeding 41.5, P = .001) Extraversion (53.3vs. 46.9, P = .002), and Openness (51.6 vs 46.2, P = .008). These findings were similar to those of Orlansky (1949). However, this research could not be supported by recent analysis; in fact the authors profess there are:
few studies that exist in the literature (regarding personality differences in maternal feeding choice) and those that do suggest differences by utilising traditional psychoanalytic interpretation, such as acceptance of the feminine role, comfort with physical contact, and sexuality (Wagner,Wagner, Ebeling, Gleaton- Chatman, Cohen, & Hulsey, pp.17;2006).
Most of the previous investigations used by these authors compared personality literature with infant feeding literature and thus extrapolating a hypothesis, as is to be the case with this research. Therefore, this literature review will now concentrate on Emotional Intelligence,
Narcissistic Trait and finally Social Support.
1.3 Emotional Intelligence.
EI is described as an aptitude to recognise the meanings of emotions and their associations and to reason and resolve problems rooted in this emotion (Goleman, 1996; Mayer, Caruso, and Salovey, 1999;Petrides, & Furnham, 2000). It could be extrapolated from the literature that a mother’s decision to initiate and continue breastfeeding may be impacted by her level of Emotional Intelligence; For instance, perhaps a feeling of overwhelming responsibility and tiredness, experienced if an individual is a breastfeeder(which could be expected according to the literature) (Wagner,Wagner, Ebeling, Gleaton- Chatman, Cohen, & Hulsey, 2006), contrasted with the ability to reason through this emotion and to discern that the importance of breastfeeding outweighs the effect of these feelings which will pass. This could be considered a decision of high Emotional Intelligence. Conversely, it could be suggested that low Emotional Intelligence may cause an individual to put their comfort before the needs of a dependant infant (Haslam, 2007). But according to Salovey (2005), one of the difficulties with Emotional Intelligence is that, not only is it a relatively recent construct, interest from both lay and scientific communities has caused behaviours and characteristics of individuals to be classified as EI, when in fact these behaviours have little if anything to do with EI (Schulze & Roberts, 2005); for example, traits such as task persistence, good character, morality and optimism, or emotions such as optimism and zeal (Salovey & Grewal, 2005). It is therefore important to explain what EI is and how EI was measured for this research, later discussing its limitations within the scope of this investigation.
In psychology, emotion as a topic has diverged until recently between physiology and psychology; but psychological literature now accepts the term “emotional intelligence,” and it has been given a persuasive equal status with cognitive intelligence (Goleman, 1998;Haslam, 2007). There are two main fields of EI: Abilty EI, which asserts that EI can be enhanced and individuals can be trained to possess improved EI (Goleman, 1998; Schulze & Roberts, 2005). This accords with Goleman et al, Epstein (1999) defines EI is an intellectual ability that can be learned and improved upon, although he concedes, and it is agreed universally, that like IQ one is genetically predisposed to an amount of EI (Epstein, 1999;Haslam, 2007). Trait EI suggests EI is an attribute, is concrete and innate (Petrides, & Furnham, 2000); its key protagonists assert that a distinction needs to be made between ability and the innate EI (Salovey & Grewal, 2005).
Grounding the current study in the literature, it is Emotional Intelligence Goleman (1998) maintains, that leads to success in business and politics, suggesting that high EI transfers into the ability to lead and manage effectively, represented as a “meta-ability”. Goleman also submits that EI transfers into other areas of life and can be useful in comprehensive situations. He proposes, for example, that the ability to motivate and endure in the face of disappointment;to regulate one's moods; and keep distress from swamping the ability to think is as useful for parents as it is for managers (ibid). Although Guastello & Guastello ( 2003) connect the concept of EI to parenthood more specifically, they discovered mothers scored higher in EI than fathers. Unfortunately in this case, the presence of higher IQ could have been a confounding factor (Guastello & Guastello, 2003). Nevertheless, similar results were attained by Harrod and Scheer (2005) from research with adolescents, and in EI scores related to SES, it was discovered that females had higher EI scores and that these were significantly correlated to mothers’ education level at p>.001, r=.58 a positive correlation of 58% (ibid). Furthermore, Petrides & Furnham (2000) found women to have slightly higher self-reported EI and when this was measured the self -estimation correlated significantly with the EI score achieved, with men estimating lower and achieving lower EI (ibid). Lay person perception and certainly perpetuated by the media, is of women being more in touch with their emotions and with superior skill in using them to sustain successful relationships (Mayer & Salovey, 1997). Even so, as previously explained, Emotional Intelligence is not the same as sensitivity; it is how one uses these perceptions that indicate Emotional Intelligence (ibid). Sensitivity is about perceiving and having feelings; Emotional Intelligence it is asserted (and agreed by most predominant researchers in the field) is acknowledging these feeling and applying them rationally and appropriately (Bailie & Ekermans, 2006). This report concentrates on Emotional Intelligence as a trait; this perspective on EI involves learning who we are as individuals and accordingly accepting the disparity between an emotional trait, or disposition, as distinct from an emotional state, the temporary experience of the emotion (Bailie & Ekermans, 2006). The Schutte Self Report Emotional Intelligence Test (SSEIT) is considered best to measure trait EI, although the SSEIT does not exhaustively cover trait EI (Gardner, & Qualter, 2009), it assesses trait-based aspects of EI, which are estimated as evaluating four facets: Managing Own Emotions, Managing Others’ Emotions, Emotion Perception and Utilisation of Emotion (ibid).
Having discussed EI, accepting a trait-based model, has established it as not necessarily a trait that women and in this case mothers, would have in abundance, although it is expected that women would have a relatively high EI score (Petrides, & Furnham, 2000; Austin, Saklofske,Huang,& McKenney, 2004). While acknowledging research which has shown there to be differences due to education level (Bailie & Ekermans, 2006), this study aims to investigate differences in EI level between primparous mothers, an issue not investigated according to current literature reviewed. this study will use a trait EI measure, which is evaluated for its reliability and practical utility; and the Schutte Self Report Emotional Intelligence Test (SSEIT) (Austin, Saklofske,Huang,& McKenney, 2004). It is feasible that mothers who breastfeed will have a higher EI score for various reasons. For example, high EI expects an individual to control impulses and delay gratification (Salovey & Grewal, 2005); , continue breastfeeding despite to the desire to give up because of discomfort, due to the expected deferred reward of a healthier infant or as discussed above, the importance of breastfeeding prevailing over the effect of immediate emotions and an individual putting their comfort subordinate to the needs of a dependant infant. This of course can be highly contested, as a balance of well being between mother and child does need to be accounted for, and as explained, EI is not to be mistaken for morality or task persistence (Schulze & Roberts, 2005). Along these lines Austin, Farrelly, Black, & Moore (2007) undertook research contrasting EI with Machiavellianism (Mach). It is argued that EI is not necessarily a concept that serves society’s best interest, as it is reliant upon the ethical circumstances in which it is used(ibid). In fact, a disproportionate amount of EI to morality could cause harmful as well as constructive outcomes. They assert that an individual with high EI could use this ability to comprehend and control the emotions of others, specifically to influence others’ behaviours to support their own interests. Although the research did not prove this to be the case, Mach was found to be negatively correlated with self-report and performance EI (Austin, Farrelly, Blacka, & Moorea, 2007), and therefore warrants further investigation. Furthermore it was found that productive narcissism correlates with EI and that productive narcissism could be helpful for interpersonal goals on some levels, although narcissists are typically not comfortable with their own emotions (Maccoby, 2000; Harrison & Clough, 2006). Corresponding with this, the present study investigates EI and also Narcissistic Trait (NT) in relation to infant feeding choice. NT will therefore be discussed before the full hypothesis is made.
1.4 Narcissistic Trait.
Narcissism is often regarded in part as an intense concern for an individual’s appearance. This is reflected in the narcissist’s preoccupation with good looks, and desire to be the centre
of attention (Freud, 1974; Davis, Claridge, & Cerullo, 1997 ). Thus, individuals high in Narcissistic Trait, who are reported to have an uninhibited sexual manner, exhibitionist tendencies and provocative, attention-grabbing behaviours (ibid) are possibly unlikely to consider breastfeeding a positive addition to their self-image. In fact, it is possible that having spent time and money on their appearance, they may be loathe to wear clothes that encourage breastfeeding, or breastfeed, as this could prevent them from wearing their usual attire (Vazire, S. Naumann,L. Rentfrow, P.& Gosling,S., 2008; Foster & Campbell , 2007). On the other hand, it is also stated that narcissists may try to attract attention by wearing flamboyant or revealing clothes, for exampleby showing cleavage. Thus an opportunity to reveal breasts while feeding (with a morally understandable reason) may supply (consciously or unconsciously) the narcissist’s passion for attention and approval (ibid). Narcissists’ desire to have status also influences their behaviour (Foster & Campbell, 2005), and it could be argued that to breastfeed is to have complete control and responsibility of an infant’s feeding, and this may nourish the narcissist’s feelings of importance and power (ibid). Although the literature could explain both scenarios succinctly, it is first important to establish what Narcissistic Trait is; how it differs from psychopathological narcissism; and how it was calculated for this study.
The exact meaning of narcissism varies slightly from one theorist to another. However, central to the theory is that it is generally part of normal development to invest energy in one’s self and develop one’s own image into healthy narcissism (Cervone & Pervin, 2008; Foster & Campbell , 2007). A healthy individual can respond to its own needs and respond to the needs of others; narcissistic displays of self can be channelled into art or writing or even work. The pathological narcissist, by contrast, displays itself with a grandiose sense of importance and preoccupation with unlimited success, power and entitlement (Tanchotsrinon, Maneesria & Campbell, 2007). A lack of empathy distinguishes narcissistic pathology from the degree of narcissistic trait which is considered normal (Cain, Pinkus, & Ansell, 2008), as does a profound desire to seek admiration. For example, where an individual considered normal seeks caring partners, an individual high in narcissism seeks a partner who will admire them and bolster their grandiose sense of self (Foster & Campbell, 2005). This is in agreement with Freud (1934): Narcissism, he states, is an extreme exaggeration of a normal set of affairs. He suggests it is a biological instinct, which is then shaped by childhood; this could then be exaggerated into pathological narcissism: the need to be loved more than to love (Freud, 1974a). Following this theory, Miller & Campbell (2008) studied college students and their parents, using a measure of pathological narcissism, namely Narcissistic Personality Disorder (NPD) and a measure of Narcissistic Trait (NT). They found small to moderate correlations between the Narcissistic Personality Inventory (NPI) and a self-reported Personality Diagnostic Questionnaire-4 (DSM-IV NPD),(Miller & Campbell, 2008). As alluded to, this assertion that narcissism is on a continuum has a long history; for example, Freud(1933) states that neurosis/psychopathologies are fixed and enduring over long periods of life; where external behaviours may be cured by psychoanalysis, the psychological rigidity in a narcissist leads to it being labelled biological and deemed determinate (Freud, 1974).
It is the description of phenotypic narcissism as an external behaviour that this study is interested in, NT on a normal scale measured by the NPI (Cain, Pinkus, & Ansell,2008). Having given an overview of narcissism and as this research is interested in exploring maladaptive narcissistic trait, the NPI will be discussed in relation to its constructs and how this may relate to infant feeding.
The NPI is the most extensively accepted and used measure of the construct Narcissism in non-clinical populations (Kubarych, Deary, & Austin, 2004). It has been evaluated using Cronbach’s alpha, used in tandem with other measures, and is established as having four- and seven-factor models of the trait (Foster & Campbell , 2007; Miller & Campbell, 2008). Emmons (1987) executed a principal components analysis with oblique rotation on the 54-item NPI. This factor analysis was used to uncover the concealed dimensions of the variables, thus reducing the attribute narcissism from a larger number of variables (for example, a seven point scale) to a smaller number of factors (Fabrigar, Wegener, MacCallum, & Strahan, 1999). In this manner, four sub-scales were discovered, which are labelled: Leadership/Authority (LA), Superiority/Arrogance (SA), Self-Absorption/Self-Admiration (SS) and Exploitiveness/ Entitlement (Emmons, 1987). Finally, a 40 item forced choice questionnaire was produced (Raskin, & Terry, 1988).
Leadership and authority is espoused to be the most adaptive form of NT, producing leaders in industry, for example Andrew Carnegie, politics; Franklin Delano Roosevelt and ethics; it is considered that Mahatma Ghandi had high leadership and authority aspects of narcissistic trait (Maccoby, 2000). These ‘engineers of society’, it is suggested, access new technologies and efficiently use them to force progress and social change (Harrison & Clough, 2006). Thus it can be fairly asserted that some aspects of NT are highly desirable. Despite that, the three remaining sub-scales developed by Raskin and Terry (1988) allude to the maladaptive and pathological narcissism described by researchers for nearly a century (Cervone & Pervin, 2008). These are discussed below:
Superiority/Arrogance (SA), highly correlated to mood variability and overt insistence that an individual knows more than others, could cause them to make decisions and behave in ways that go against proven knowledge and wisdom of professionals (Freud, 1974a), for example insisting bottle feeding is just as healthy as breastfeeding (Bailey, Pain, & Aarvold, 2004; Foster & Campbell, 2005). Self-Absorption/Self-Admiration (SS), as mentioned above, can cause an individual to seek out approval and admiration, to fuel a grandiose sense of importance, thus concentrating on appearance above all (Davis, Claridge, & Cerullo, 1997; Foster & Campbell, 2005), again clearly indicating its roots in pathological narcissism. Finally, the proven most maladaptive form of narcissistic trait is Exploitiveness/Entitlement (Kubarych,Deary, & Austin, 2004), which is considered to be largely associated with maladaptive behaviours and psychopathology, and correlates significantly with Machiavellianism, low emotional and cognitive empathy, low self-esteem (ibid); and manifested in a preoccupation with unlimited success, power and entitlement, to the detriment of all others (Tanchotsrinon, Maneesria & Campbell, 2007). Globally, the maladaptive aspects were found to correlate highly with unethical decision-making. This again supports the notion that maternal feeding choice would be affected by maladaptive aspects of narcissism (Antes, Brown, Murphy, Waples, Mumford, Connelly, & Devenport, 2007).
Individuals who scored high on the NPI appeared to gain most advantage from the perception of available social support during times of elevated stress (Rhodewalt, & Morf, 1995). Also, people with high emotional intelligence are indicated as reacting most positively from peer support at all times, although particularly in times of emotional upheaval (Harrison & Clough, 2006; Renshaw, Godfrey & Marshall, 2007). It could therefore be suggested that social support has a considerable influence on these entrenched personality traits, which makes it important for this study to address social support.
1.5 Social Support(SS)
Social Support refers to the purpose and value of social relationships, and occurs through an interactive process. It can be related to philanthropy, a sense of obligation, and the perception of reciprocity, such as perceived availability of help (Tones & Tilford, 2001; Dennis, Hodnett, Gallop & Chalmers, 2002). It is recognised that the relationship between social support and health is well established (Bennet,& Murphy,1998). Moreover, those who score high on extraversion and conscientiousness traits are reported to be more likely to resist impulses to withdraw from relationships, thus increasing social support over time (Cukrowicz & Franzese, 2008) and accumulating more satisfying interactions and greater perceived social support over time (Cukrowicz & Franzese, 2008). Thus SS increases SS. Concurring with this assertion, Tong et.al.(2004) found satisfaction with Social Support increased with Agreeableness, Extraversion, and Openness scores on the NEO-I-PR, although these personality traits contributed independently to number of Social Support conveyed (Tong et al, 2004).
Furthermore, after factoring out personality and socioeconomic variables, Social Support and Emotional Intelligence were found to have an equal effect on predicted well-being scores (Gallagher & Vella-Brodrick, 2008). The authors suggest that either EI or SS are to be acknowledged as predictors of perceived well-being, and that as SS is considered to promote well-being by manipulating cognitions, emotions and behaviours in a manner that encourages positive affect (Gallagher & Vella-Brodrick, 2008), an individual who has high Emotional Intelligence may be expected to have a similarly high level of well-being, although not the same level of perceived SS, due to the similarities encountered in their research (ibid). It is therefore suggested for the purposes of this study that EI may act as a moderator in the relationship between SS and maternal infant feeding.
With regards to Social Support, the situation with Narcissistic Trait is complicated. An individual high in Narcissistic Trait relates to the social world in deeply different ways than individuals considered normal (Sedikides et al, 2005; Tanchotsrinon, Maneesria & Campbell, 2007). Narcissists may report equivalent levels of Social Support but they differ from others in expressing the quality of that support. That is, narcissists believe that there are an exaggerated number of persons who think highly of them (Sedikides et al, 2005). However, as explained, it is expected that NT will have a significant effect on maternal infant feeding choice, so it is hoped that perceived SS will mediate rather than negate this effect.
Specific to the research in hand as mentioned, evidence was found to suggest partner support had an influence on maternal infant feeding choice (Ryan, A.,1997; Dennis,. Hodnett, Gallop. & Chalmers, 2002; Dennis, 2003; Dyson, Renfrew, & McFadden, 2006), although some research suggests peers and mothers have an affect (ibid; Swanson V, & Power KG. 2005). Thus both partner, mother and peer support were investigated.
Drawing from the variables discussed, Emotional Intelligence, Narcissistic Trait, and Social Support, it is the intention of this research to explore the interaction between personality traits and Social Support, and the effect these have on maternal infant feeding choice. It is expected that higher EI scores will be found in the breastfeeding group one tailed; that NT will have a significant effect; the hypothesis is two-tailed in this instance. A partner being supportive and a mother or peers who encourage breastfeeding would make it more likely that an individual would breastfeed themselves; again high Social Support indicating breast feeding, one tailed.
2. Methods
2.1 Participants
Subjects were recruited online to ensure ability to access a computer. Participants were a group of primiparous women (N= 98) aged between 18-45 (M= 33.9, SD)
Recruited via targeted Snowball sampling (N=76) using social networking sites 81.9%; a further 19.1% were recruited by a self-selected sample via online parenting chat rooms.
2.2 Design
The study was between participants design; the dependant variable (DV) was method of infant feeding. Primaparous participants were divided into two groups according whether they breast or bottlefed their infants for the first 6-26 weeks of their infant’s life. Emotional Intelligence (EI), Narcissistic Trait (NT) and Social Support (SS) were the independent variables.
2.3 Materials
A web-based approach was used via an online survey provider, Survey Monkey (2008); a questionnaire was designed, combining 4 validated questionnaires, explained below and see (Appendix 2). This was then posted on social networking sites and parenting websites (Appendix 3) with a post on the sites advertising: ‘Mums survey on infant feeding; click here!’
2.3.1 Infant feeding efficacy questionnaire (Dennis, 2003)
Method of infant feeding was measured using an adaptation of the breastfeeding efficacy questionnaire (Dennis,2003). Questions were asked regarding form of infant feeding in 4 categories, according to the method of infant feeding in hospital and at home until 26 weeks (Appendix 2). Categories breast and bottle feeding were used in the study as it was deemed more appropriate for the research; although data was collected on supplementary feeding, termed ‘both’, this was considered breast feeding, in order to cater for women who supplemented feeding, yet continued breastfeeding daily, as this research was primarily interested in the personality tenets of infant feeding, rather than the health benefits. However, it is usual in feeding research to only include sole breastfeeders for health reasons (Ryan, 1997; Swanson & Power, 2005).
Reliability and validity:
The reliability and validity of this questionnaire has been tested in hospitals and administered via the postal service (Ryan, 1997, Dennis, 2003), thus it would be expected to be as reliable using online method.
Social Support (SS)
Social Support questions were developed from research by: Hannon,Willis, Sharla Bishop-Townsend, Martinez, & Scrimshaw, 2000; Dennis, Hodnett, Gallop, & Chalmers, 2002 (see Appendix 2). Participants endorsed the answer that they agreed with on a Lickert scale; and were scored in the following manner: Partner scored support elicited marks out of 10, for example:
Regarding my choice of infant feeding method, my partner was:
Very supportive (10)
Supportive (8)
Neither supportive or unsupportive (6)
A little supportive (4)
Not at all supportive (2)
Questions were also asked regarding support they received from friends and their own mother, for example:
My mother encouraged me to breastfeed yes/ no
My friends encouraged me to breastfeed yes/ no
These questions were awarded 1 for yes and 0 for no. Highest possible score 16, lowest 2, with high score indicating high SS.
Reliability and validity:
This questionnaire was developed from scales used in previous established research studies by Baranowski, Bee, & Rassin, et al, (1983); Ryan(1997) and Dennis, Hodnett, Gallop, & Chalmers (2002), and was deemed an effective way of measuring social support on all facets in these studies (ibid).
2.3.2 Emotional Intelligence questionnaire (Schutte et al, 1997)
Emotional Intelligence was measured using a 33-item scale; the Schutte Self Report Emotional Intelligence Test (SSEIT) (Schutte, Malouff, Hall, Haggerty, Cooper, Golden, et al 1998). Participants were asked to answer on a 5 point Lickert scale, achieving 5 points for strongly agree, 4 for agree, 3 for neither agree nor disagree, 2 for disagree and 1 for strongly disagree, apart from when items were reversed scored; thus the highest score possible = 165,lowest = 0, with high scores reporting high EI, see (Appendix 2). Items 5, 28 and 33 were reversed scored (Austin, Saklofske, Huang, & McKenney,2004).
Example questions as follows:
1) I know when to speak about my personal problems to others.
10) I expect good things to happen.
15) I am aware of the non-verbal messages I send to others.
Reliability and validity:
The EI test used has been tested for reliability and validity in studies by Schutte, Malouff, Hall, Haggerty, Cooper, Golden, et al (1998); Saklofske, Austin& Minski (2003); Austin, Saklofske, Huang, & McKenney (2004). The self-report questionnaire was developed as a measure to assess the extent to which people can understand and control the emotions of themselves and those of other people, although, the use of self-report measures are contested and discussed widely, and often compared unfavourably with ability measures (Bailie & Ekermans, 2006). Nonetheless, as a self-report measure its correlation with other methods of measuring EI has been tested and found reliable (Schulze & Roberts, 2005). It has also been claimed that this measure does not have enough reversed scored items (Austin, Saklofske, Huang,& McKenney, 2004) and is too short. Fortunately, its reliability has been established in peer-reviewed studies and it is considered that sufficient items are reversed scored, yet not so many as to confuse participants (Saklofske, Austin, & Minski, 2003; Schulze & Roberts, 2005). Also its brevity may be influential in retention of participants, particularly for example when used in an online study (as in this case), where the data collection is reliant on participants self regulating their retention, with no encouragement from a researcher.
2.3.3. Narcissistic Personality Inventory (NPI) (Raskin, & Terry,1988)
Narcissism was measured using a modified version of the Narcissistic Personality Inventory (NPI) (ibid). This 40 item inventory has 4 subscales; Leadership/Authority, Self Absorption (S/S), Superiority and Arrogance (S/A) and Exploitiveness/Entitlement (E/E) (del Rosario, & White, 2005). This questionnaire was further reduced for the current research, by removing the questions concerning leadership and authority. There are reasonable psychological explanations for this reduction; primarily as this research is focusing on the maladaptive forms of narcissism, it was prudent to ensure these were readily available. In research undertaken by Watson & Biderman(1993), partialing out the more adaptive form of NT led to the unhealthy and obviously pathological forms being enhanced in statistical analysis (Watson & Biderman, 1993). Therefore this research could expect to show NT as having a high negative correlation to EI, when removing the more adaptive variance of the trait (Austin, Farrelly, Black, & Moore, 2007). Also from a practical perspective, this research was to be performed with no researcher present, and it was sensible to try and keep the questionnaire as brief as possible, so 13 items were removed.
Therefore this study reduced the inventory to 27 questions, excluding the L/A aspect of Narcissistic Trait, which is considered adaptive, thus concentrating on the maladaptive aspects of narcissism (del Rosario, & White, 2005) as discussed in full above. The facets of Narcissistic Trait measured were: Self Absorption (S/S), Superiority and Arrogance (S/A) and Exploitiveness/Entitlement (E/E) according to Ruskin and Hall (1988) and Davis, Claridge, & Cerullo (1997) (see Appendix 2).
Participants read a battery of 27 statements. They then indicated whether they agreed or disagreed with the statements regarding how they felt about themselves. There were 11 questions scrutinising Self Absorption; 8 questions measuring Superiority/Arrogance (S.A) and a further 8 questions measuring Exploitiveness/Entitlement (E.E).
Participants scored 1 for agree and 0 for disagree, thus a highest possible score = 27, lowest = 0, with high scores indicating high Narcissistic Trait. Items were grouped and analysed for specific facets of Narcissistic Trait and an overall score was calculated for each individual.
Examples of questions are as follows:
Self Absorption (S.S) for example:
2) I am an extraordinary person
Superiority/Arrogance (S.A): for instance:
14) I can read people like a book.
Exploitiveness/Entitlement (E.E) for example:
22) I am envious of other people’s good fortune.
The reliability and validity of this scale has been established in a number of studies, for example (Raskin, & Terry, 1988; Davis, Claridge, & Cerullo, 1997; Foster & Campbell , 2007), although no studies have used the NPI in relation to infant feeding.
2.3.5.Control variables
2 control variables were also measured. Literature shows that two of the most stable predictors of breastfeeding are high socioeconomic status (SES) (Tzuriel & Weller 1986; Baranowski Bee, Rassin, Richardson, Brown, Guenther & Nader; 1983; Ryan, 1997;Dennis, Hodnett, Gallop, & Chalmers, 2002) and the pregnancy being planned. In Wagner, Wagner, Ebeling, Gleaton- Chatman, Cohen, & Hulsey (2006), it was hypothesised that this study should show these factors to be explicitly related to infant feeding method if the sample was typical, and that these factors could be accounted for when reviewing the results.
Socioeconomic status was calculated using a combination of two of the most reliable measures of SES: education level and income bracket (Chapman, 2007). This method was deemed most appropriate as it measured participants’ SES, not family members, thereby specifically preventing the potential problem of the SES of a partner interfering with the strength of the data. Also, the effect of planned or unplanned pregnancy was measured again to see if the sample was typical (Dyson, Renfrew, & McFadden, 2006) and ensuring the effect of a planned pregnancy did not override the effect of NI or EI, thus confounding the data(see Appendix 2 for complete survey and Appendix 4 for results of all computations).
3. Procedure:
Participants were invited to take part in an online survey, via a banner posted on social networking sites:; ‘Mums survey on infant feeding: click here!’ (Appendix 3). Participants had to click on the link, for example: ‘http://www.surveymonkey.com/s.aspx?sm=t34bxBpCPxapMp1wjFFfuQ_3d_3d’
This link brought participants to participant information and consent, where they agreed to this study; they then filled in demographic data and continued into the questionnaire (Appendix 2). Participants had to click on the answer that best suited their response, according to clear instructions. The survey automatically moved on and changes were not allowed to be made to a section once it had been completed; a debriefing statement (Appendix 2) completed the survey and finally the survey linked the participant to a blog: ‘thoughts on infant feeding’ where they were able to leave their opinions on the survey and were offered the option of contacting the researcher in order to further debrief and have any questions answered. Data was then collected from Survey Monkey in the form of a spreadsheet, transferred to SPSS and analysed using an independent sample t-test and binary logistic regression.
3.Results:
3.1. Descriptives.
Although the original number of participants was n=98 with 23 withdrawing consent at the NT stage of the questionnaire, the final response rate was 75.5%. (N=75). Initially the participants were 85% breastfeeders; this gradually reduced at 2 weeks to 73% and finally 53%. With participants placed as n=33 bottle feeder, n=42 breast feeder.
26% of participants were from Facebook; 26.6% were known to the researcher; 27% were from a snowball from these people; 2.1% from a parenting blog; 17% from parenting sites (Appendix 3).
The mean age was 33.9 years, SD, 8.7 years. 44 pregnancies were planned, 31 were unplanned; 52 participants had a household income of <£19,000, 22 had a household income of > £19,000. (Appendix 4). Table 1 presents the measures of central tendency and dispersion, for all variables used in the analyses.
Table 1: Means and Standard deviations for SS,EI and NI.
| Measure | Bottle feeding group N=33 | Breastfeeding group N=42 | Total: N=75 |
| Social Support | M=10.54 SD,3.81 | M=11.50 SD,4.21 | M= 11.08 sd,4.04 |
| Narcissistic Trait | M=10.33 SD,5.86 | M=11.76 SD,5.21 | M= 11.13, sd 5.51 |
| Emotional Intelligence | M=128.51 SD,12.20 | M=128.50 SD,16.82 | M= 128.50, sd 14.87 |
Separating the facets of narcissistic trait scrutinising: Self Absorption/Self Admiration; Superiority/Arrogance (S.A; Exploitiveness/Entitlement (E.E). The means and standard deviations were similar. 20 individuals failed to complete E/E questions and all 75
participants scored identically on the S/A questions, although different answers were chosen over the 9 questions and all women scored 6. (See appendix 5 for data collected, with demographic data removed).
Fig.1. Frequency chart showing similarities in NT results for individual questions.
Table 2: NT Facets separated
| Measure | Bottle feeding group N=33 | Breastfeeding group N=42 | Total: N=75 |
| Self Absorption/Self Admiration | M=6 SD,0 | M=6 SD,0 | M= 6 SD,0 |
| Superiority/arrogance | M=3.29 SD,2.36 | M=3.76 SD,2.55 | M=3.52 SD,2.45 |
| Exploitiveness/Entitlement | M=2.01 SD,1,75 | M=2.57 SD, 2.61 | M=2.45 SD,2.18 |
Table 3: Grouping of SES, Planned and Unplanned Pregnancy according to feeding choice:
| | Breast feeder | Bottle feeder |
| High SES | 32 | 20 |
| Low SES | 10 | 12 |
| Planned Pregnancy | 30 | 14 |
| Unplanned Pregnancy | 12 | 19 |
3.2.t-test:
It was hypothesised that there would be a difference between the SS, EI and NI scores of 2 groups of mothers: breastfeeders and bottle feeders. The period analysed was first 6-26 weeks of an infant’s life.
The hypothesis was two tailed, to test this hypothesis, an independent samples t test was conducted as Levene’s test was insignificant, p>.05, showing the distribution of means was adequate to run such a test. A Bonferroni correction was administered, as there were multiple dependant variables.
Social support.
As can be seen from the table 1 above, bottle feeders scored (M=10.54,SD=3.81), Breast feeders scored (M=11.50,SD,4.21). This difference was non-significant t (73)=-1.01, p >.05, with a small effect size r=.23 .
Again participants in both groups scored similarly for Emotional Intelligence. Bottle feeders scored (M=128.51, SD=12.20), Breast feeders scored (M=128.50, SD,16.82). This difference was non-significant t (73)=.004, p >.05; with no effect size r=.0.00.
Narcissistic Trait.
Ultimately, results were almost parallel for NI: Bottle feeders scored (M=,10.33SD=5.86), Breastfeeders scored (M=11.76,SD,5.20). This difference was non-significant t (73)=-1.116, p >.05; with a small effect size r=2.5.
Figure 2: Depiction of Similarity of Emotional Intelligence scores. 
3.3. Binary Logistic regression:
Finally, direct binary logistic regression was performed; the data were originally collected to establish the impact of a number of factors affecting a mother’s chosen method of infant feeding. The (DV) in this case was (breast or bottle feeding ) in weeks 6-26 of an infant’s life. The model contained 3 independent variables: Social Support (SS), EmotionalIntelligence (EI) and Narcissistic Trait (NI) and 2 control variables: Socioeconomic status (SES) and planned or unplanned pregnancy (PP/UP).
The full model containing all 5 factors was statistically non-significant for Social Support, Emotional Intelligence and Narcissistic Trait; X 2=2.282,p=.516 ,df,3. The model as a whole explained 3% (Cox and Snell R2) and 4% (Nagerlkerke R2) of the variance in feeding methods, and correctly classified 63% of the cases. Probability cannot be ruled out as Exp (B) values >1 for Upper C.I. Thus it was proven that the null hypothesis was true, with less than 5% of differences in infant feeding choice being related to personality factors, EI or NI, or Social Support. The results were no higher than probability or chance. Table 2 shows that no predictor variables provided a significant fit for the model. For all results see (Appendix 4).
| Table 4: Logistic regression showing SS, EI and NT. | |||||||||
| Variable | B | S.E | Wald | df | Sig. | Exp (B) | 95%C.I Exp(B) |
| ||
| SS | -.059 | .06 | 1 | 1 | .904 | .94 | .84 | 1.05 |
| |
| EI | .002 | .02 | .013 | 1 | .172 | 1 | .97 | 1.04 |
| |
| NI | -.048 | .04 | 1.22 | 1 | .994 | .95 | .875 | 1.04 |
| |
However, significance was shown for control variables; thus the sample of women was similar to other mothers studied. Logistic regression showed SES (specifically the education facet) was a significant predictor, because SES, (b=-1.62, s.e.=.623,Wald. 6.82 Exp.B=.19, p=.009) and status of pregnancy because PP,(b=101,s.e.=.561,Wald,2.24Exp.B=2.74,p=0.07)
(see Appendix 4 for full results).
3.4
A small amount of qualitative data was collected on the blog at the end of the questionnaire: these responses will be discussed.
4.1. Discussion
It was apparent from this research that there were no significant differences in the scores attained in all categories by the groups; thus the null hypotheses must be accepted in this case: breastfeeders and bottle feeders are similar in Emotional Intelligence, Narcissistic Trait and Social Support. However, there were significant differences found in the control variables p=.009 for education level of mother and p=0.07 for PP with more mothers who planned their pregnancies breastfeeding. The results show reasonable confidence intervals for the data, showing the sample to be acceptable and a true representation of the population statistically, and factors that have been associated with maternal infant feeding choice in the past, namely mother’s education level and whether or not the pregnancy was planned also show the sample was adequate and usual according to previous research (Bailey, Pain, & Aarvold, 2004; Campbell, 2002); although no difference was found for Social Support which has been proven to affect maternal infant feeding choice (Dennis, et al, 2002; Hoddinot,et al, 2006).
4.2 EI.
EI as discussed is a much contested subject which correlates highly with IQ (Bastian, Burns, & Nettelbeck, 2005; Haslam, 2007). Furthermore, Guastello, & Guastello( 2003) found that mothers had higher EI scores than fathers, so it could be suggested that, as all the participants in this study scored similarly for EI, it is because generally mothers have relatively high EI and that the parameters of infant care do not necessarily accept breastfeeding as a priority due to entrenched values and norms in society regarding infant feeding (Furber & Thompson, 2006; Dungy et al, 2008). In addition, as explained, EI does not necessarily ensure moral decisions will be made (Austin, et al 2007), therefore it is not crucial regarding infant feeding choice, as this may or may not be considered a moral decision (Gardner & Qualter 2009). As discussed, media portrayals of breastfeeding are rare (Henderson,et al, 2000) and the issue of addressing the negative view mothers have toward breastfeeding in some demographics is both global and historical (Brown,et al, 1960; Baranowski, et al , 1983; Department of Health , 2005; World Health Organization, 2008); consequently it is possible the subject of breastfeeding is a socio-cultural rather than psychological one.
Also as asserted, EI correlates to IQ ( Arteche,Chamorro-Premuzic, Furnham, & Crump, 2008) and this study proved that education level does significantly affect infant feeding choice b=-1.62, s.e.=.623,Wald. 6.82 Exp.B=.19, p=.009. It could be submitted that, as education levels are rising, for example with the introduction of better availability for post-16 funded education, and as university rates are growing (Department for Children, Schools and Families, 2009), educating women who possess high EI and potentially higher IQ on the benefits of breastfeeding (in school for example), may lead to a longitudinal change in the values of infant feeding choice. Supporting this assertion Harrod& Scheer (2005) found EI scores related to education: it was discovered that females had higher EI scores and that these were significantly correlated to mothers’ education level at p>.001, r=.58 a positive correlation of 58%, thus suggesting again that educating women globally may have a positive effect on potentially not naturally assumed correlates, such as infant feeding. Therefore, even though EI does not have an immediate effect on infant feeding, education which does affect infant feeding may be influenced by EI by association, although EI does not affect infant feeding choice. This concurs with Trinidad, Unger, Chou, & Johnson (2004), who suggest individuals with high EI might have improved likelihood of benefitting from social influence prevention programs, in this case smoking. They go on to claim that as smoking prevention programs develop, taking EI into account may lead to increased effectiveness, therefore in the case of infant feeding, this supports further society-based education and peer involvement programs (Trinidad,et al 2004).
EI was found to positively correlate with agreeableness on the NEO-PI-R. Significant links between overall EI and Agreeableness, Extraversion, Openness and Conscientiousness (all positive) and Neuroticism (negative) were found ( Arteche et al 2008). Again, this alludes to EI as a potential mediator regarding infant feeding , in addition, as mentioned, breastfeeding mothers scored higher on Agreeableness, Extraversion and Openness (Wagner et al 2006), therefore perhaps the method of data collection for this study was flawed. This will be discussed later.
4.3 NT
The results obtained regarding NT where non-significant, with both groups scoring less than 1 point difference , bottle feeders mean score 10.33 and breast feeders mean score 11.76. However, the results gathered do have some interesting anomalies, for example: there was no standard deviation in the score for Self-Absorbency and Self Admiration M=6 SD,0, which shows that these women have more in common than could be expected by chance. There must be a significant reason for this, perhaps motherhood itself, or again the method of data collection; perhaps the sample was unusual. It would be interesting to investigate this in a further study with women of same age and status, only grouped by whether or not they were mothers. This idea would concur with studies on mothers in the past, where it was found motherhood itself was loaded with values of both a social and psychological nature (Renshaw, Godfrey & Marshall, 2007). As a consequence, it could be asserted that motherhood mediated thoroughly enough to at least encourage a change in response style to the questionnaire. This would be in agreement with Costa & McCrae (2007), who maintain that individuals will reply with what they consider a socially desirable response (SDR) to questions asked by researchers. As explained, 23 participants withdrew from the study upon reading the NT questions, and a further 20 failed to answer questions to do with the most maladaptive form of NT; E/E. If this is to do with ineffectual response style, this could also account for the further anomalies regarding the NPI responses; perhaps participants could not answer the questions as they did not know what was expected of them, yet answered similarly to the questions which they could ascertain a ‘correct’ response or SDR. This is an opinion promoted by Kurtz,Tarquini, & Iobst ( 2008) and corresponds to with Austin et al, (2007)
who suggested that high EI could cause an individual to act in a way that is not entirely truthful, due to the ability to understand others’ emotions and therefore cater to them. Although they could not prove their hypothesis in the research they undertook, they recommend that further research needs to be carried out (ibid). Similarly, the dichotomous, forced choice style of the NPI could exacerbate SDR and cause individuals to drop out or not respond. Kubarych et al (2004) suggest that a resolution to this would be to allow the dichotomous statements to serve as anchors on a Likert scale, though this would only exacerbate SDR and make the NPI (a validated) measure more unsuccessful (Emmons, 1987; Foster & Campbell , 2007).
Finally (and not without some scepticism), Freud, on discussing narcissism, suggested:
“There are biological facts (regarding parenthood); the individual is an organism whose satisfaction is gained via an innate drive to reproduce itself, maintaining a portion of itself to virtual immortality. The biological organism is a short-lived appendage to this mortality” (Freud, p.462,1974).
It could therefore be proposed that the similar NPI scores for the women were due to their shared narcissism in reproducing; yet as they have reasonable EI and as 30% did not answer the E/E questions, it can only be hypothesised that NT was not measured efficiently in this study.
4.4 Social Support.
The social support response was surprisingly similar for both groups, with M=10.54 for bottle feeders and M=11.50 for breast feeders. As mentioned, SS is a proven mediator regarding infant feeding (Baranowski,et al 1983; Dennis, et al, 2002), however, these studies discussed ‘instigated peer support’ as a method to induce breastfeeding, for example peer coaching and peer intervention (Hannon, et al, 2000). The effect Social Support had on choosing to breastfeed could actually have been negated in this case; for example the women may have found their partners, mothers and peers supportive in their decision to choose not to breast feed, as was the case in a Glasgow study (Dungy et al 2008); and perhaps these women were not entirely encouraged by medical professionals, something that was not addressed in this research, although it was later discovered via the data collected on the blog, for example:
Mother of two now 41:
“My eldest daughter is now 16 and I breastfed her totally until 7 months. Then when I returned to work I fed her before and after work until she was approx 10 months old… My 2nd daughter was a terrible feeder - wouldn't latch on properly and used to 'snack' as the health visitor said. I only managed to feed her for 6 months before she went onto Formula… I found when I was having the problems with my 2nd daughter, the general consensus from outsiders was I should give up; this included the healthcare people and my doctor too. If she had been my 1st child I would have given up much sooner than I did - it was only because I had done it before that I decided to keep trying” Mother 34 (see Appendix 4).
This response from professionals, although against the official line, is found in other studies (Dyson, et al, 2006; Furber & Thompson, 2006). Similarly, Social Support was reported anecdotally as having a profound influence:
“My daughter I fed for 2 years. I feel that my whole family supported me and it was a very natural process - as a consequence my babies are strong, robust little creatures who have had only 3 lots of anti-biotics between them - son is nearly 7 - daughter is nearly 5” Mother aged 41
Comparable to studies in both the U.S.A. and the U.K Hannon, et al (2000) and Bailey et al ( 2004) found an entrenched traditon of bottle feeding was espoused. The blog contained the following:
“I felt a bit bad not breastfeeding, but no one I knew breastfed and I (my mum) had not breastfed me, so I knew my little girl would be fine on the Formula. I was and I am very healthy.” Mother aged 32 (see Appendix 4).
Finally, regarding Social Support and the fact that it is important for bottle feeding also, a mother explained:
I could not breastfeed I did not want to, I see my boobs as mine really and for my husband, not for feeding babies. No one in my family has ever breastfed and my 4 kids are fine in fact (******) is top of all the classes at school and they say it makes you clever! Mother aged 28 .
This agrees with Zimmerman & Guttman N. (2001), who state that educating that ‘breast is best’ is not enough. An individual needs to see breastfeeding in action and experience peers breastfeeding, in order feel comfortable with breastfeeding. This research also showed that a negative response to breastfeeding was possible; women who only experienced a stranger breastfeeding expressed this was a negative influence (Zimmerman DR, & Guttman N., 2001) (Hoddinot,Chalmers & Roisin, 2006). Therefore, although the present study accurately measured perceived support, perhaps it was the nature of the support that caused the results to be so analogous.
4.5 Limitations and future directions.
One limitation is using a web-based approach: the sample was self-selected; therefore the participants may have been skewed toward women who had similar personality traits, for example, women who are happy to volunteer an opinion (Shepherd, Power & Harden, 1998).
Another of the limitations of this study was it failed to ask about intention to breastfeed. In fact almost all individuals embarked on breastfeeding initially, with 85% of participants breastfeeding in hospital and 82% for the first 6 weeks (see appendix 5). This could explain the similarities in the data collected for all of the variables (Department of Health , 2005).
4.6 Suggestions for further studies:
In future it would be interesting to undertake this research at a hospital or a mother and baby clinic with a random sample. Further supporting this suggestion, Shepherd, Power & Harden (1998) found different non-response rates. When assessing the breast and bottle feeders, they found bottle feeders were more likely to non-respond, thus the data in this study may have been skewed toward individuals who may have breastfed if it were not for physical restrictions (Bailey, Pain, & Aarvold, 2004). Following on from this assumption, it would be important to have an equal number of participants who intend to bottle feed as breastfeed, and perhaps conduct the study longitudinally, to discover if certain personality traits could be associated with perseverance to breastfeed; particularly if the participants were briefed on the positive reasons to breastfeed before taking part in the study, as although it is on the agenda and there are NICE guidelines (Campbell, 2002; Dyson, et al 2006), in practice it seems the message is not being relayed (Furber & Thompson, 2006).
Moreover, as all the women scored similarly, perhaps it would be interesting to undertake further research on mothers using the NPI, and the SSEIT (Emmons, 1987; Austin, Saklofske, Huang,& McKenney, 2004), but with an incentive to complete, with no mention of infant feeding and with a completely anonymous researcher to see if indeed motherhood is a narcissistic endeavour as Freud suggests (Freud, 1974).
Finally, a qualitative study regarding the reasons why women chose the infant feeding method they did, may be interesting and locate the problem more succinctly in both psychological and sociological terms: perhaps first with a questionnaire, asking what they knew regarding the advantages of breastfeeding, as although the Department of Health is exhorting the health reasons for breastfeeding and have suggested this is one of their chief targets, there seems little incentive for women on a low income or welfare benefits to breastfeed (Devlin, & Parkin, 2003; Department of Health , 2005;). For example, a nursing bra costs between £8-£24, breast pads are £5 for 30. This is a costly endeavour compared to infant formula, which is free if you are on income support. There is to date no extra financial help available to encourage breastfeeding, other than fruit and vegetable tokens, which are for all mothers of under 5s; no extra is available for breastfeeding mothers whose dietary requirements supersede normal intake (Dyson, et al, 2006).
Ultimately, as it has been suggested, education alone on the advantages of breastfeeding is ineffectual (Henderson, 2000; Hoddinot,et al 2006). Therefore, to change the present situation, research of both a quantitative and qualitative nature needs to be undertaken, in order to unearth the biopsychosocial barriers to breastfeeding, and fiscal policy needs to address the possibility of financial support for the woman of limited means, who chooses to breastfeed.
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