Introduction
Methods
Study design
Recruitment
Data collection
Mothers (N = 16) | Grandmothers (N = 29) | |
---|---|---|
Age in years, mean (range) | 31.2 (25-40) | 55.9 (42-77) |
Education level, n (%) | ||
Low | 2 (12.4) | 17 (58.6) |
Middle | 7 (43.8) | 11 (37.9) |
High | 7 (43.8) | 0 (0) |
Unknown | 0 (0) | 1 (3.5) |
Employment status, n (%) | ||
Employed | 10 (22.2) | 6 (20.7) |
Unemployed | 6 (77.8) | 23 (79.3) |
Living with, n (%) | ||
Extended family | 5 (31.3) | 3 (10.3) |
Nuclear family | 11 (68.7) | 26 (89.7) |
Age of infant in months, mean (range) | 21.9 (3-36) | 22.1 (0-48) |
Age categories of infants, n (%) | ||
0-6 months | 1 (5.6) | 4 (8.2) |
6-12 months | 4 (22.2) | 11 (22.5) |
12-24 months | 4 (22.2) | 13 (26.5) |
24-36 months | 9 (50.0) | 13 (26.5) |
36-48 months | 0 (0) | 8 (16.3) |
Data analysis
Consent and ethical considerations
Results
The support and cogent advice of grandmothers and the wider social community during the first 1000 days is self-evident and often rooted in socio-cultural beliefs and practices
“In our [social community, ed.] everybody has the right to voice an opinion about the care of the baby. [ …] Everybody interferes.” (I-M6).
“In our [social community, ed.] you don’t need to ask for advice: advice is given.” (I-M11).
“Take your mother’s advice seriously, because it contains invaluable things that you cannot get from a gynaecologist, a midwife or a child health centre and it’s all for the good of your child. So listen to us, because we too know a little bit about these things.” (I-GM-15).
“The role of grandparents … I think the role of grandparents with regard to our children and family … I couldn’t do without them. We couldn’t do without them. My mother-in-law often sends us meals … not all the time but often. Very often, and that’s so nice.” (I-M15).
“Yes, but they kept going on and on about it, and that made it difficult because they kept repeating it. [ …] I kept saying, ‘OK, OK’ but they just kept on going. [ …] You just don’t have the energy to keep telling them the same thing. You’ve just had a baby, so you’re tired, you are still recovering.” (I-M12).
“Yes, in our culture it’s a case of: the bigger the baby, the better. Being fat is a sign of prosperity. That’s something from back in the old days.” (I-M9).
“In the eyes of us Turks, if a child is too thin that’s because it’s not well-fed or well cared for. I think that’s why we think a chubby baby is a baby that’s well looked after. So we say: ‘Oh, that mother takes good care of her baby, she is well fed.’ That’s how we see it. I know it isn’t really true, but everyone thinks a chubby baby is much cuter.” (I-GM11).
“It’s about making sure the children eat well, so that if they get sick, they won’t immediately lose weight. My daughter doesn’t want them to eat too much, but I want them to eat a bit more.” (I-GM18).
“But they [the grandparents, ed.] want to raise the child the Turkish way, and give them everything they want so they don’t cry.” (I-M6).
“For example, when we are in a shop or a grocery store we buy everything the children want to stop them crying. We buy it so that the child won’t cry, otherwise we feel like everyone is staring at us.” (I-GM8).
“When they’re at grandma’s, things can be different or less strict. It should be fun, and it’s up to the parents to apply their own rules at home. He only comes to my house twice a week, so I can do whatever I want. And I think I have the right to spoil him.” (FG-GM1).
“He [father-in-law, ed.] kept challenging me. And if I looked at him as if to say, ‘No, I don’t want that. He needs to eat first. He’s a one-year-old baby, he doesn’t need a chocolate bar or any of those sweets. He doesn’t need them.’ [ …] When they come to visit they all bring sweets, and when we go to see them there are always sweets around. And when I see my father-in-law giving him sweets, I say: ‘No papa, later’. And he says ‘Just one?’ And it usually ends up being two or three.”(I-M15).
Grandmothers and the wider social community actively encourage mothers to breastfeed
“With my first child I felt like: if I don’t breastfeed it means that I’m an inferior mother. Everybody around me was saying: ‘Yes, you really need to breastfeed’. [ …] You just feel that pressure, it’s like you have to breastfeed.” (I-M7).
“I said to her, ‘Breastfeed and your child will be strong.’ And she said ‘I can’t because of my job and I’m not able to express milk.’ That’s why her child is so thin.” (I-GM5).
“I gave that advice, because milk production increases when you consume sweet things. They say things like fruit syrup or compote are also good. And they also tell you to eat a lot of fruit so that your child will be sweet and beautiful.” (I-GM14).
“If the child is crying, he is probably still hungry. Just give him an extra bottle, it can’t hurt.” (IGM9).
“That was a difficult thing in our culture. To keep on hearing, ‘Yes, but why did you stop breastfeeding so early?’ It’s like you’re being handed a burden of shame. Not that I was ashamed of it, but it’s as if that’s being imposed on you: ‘How come you only breastfed for six weeks? You should be ashamed of yourself. Why is she being bottle-fed?’ [ …] My uncle’s wife also made a remark along the lines of ‘Hey, why aren’t you breastfeeding anymore?’” (I-M4).
Grandmothers often deviate from their grandchildren’s daily routine when they are babysitting
“In the beginning I typed and printed out a schedule which I gave [her, ed.]: ‘This is the schedule, please keep to it as much as possible.’ So I think that played a part, so she knows: ‘OK, she really wants her child to have a specific routine. I’d better not deviate from it too much.’ She does, of course, but not too much.” (I-M6).
“If I compare it with some children the same age in Turkey, for example, they eat everything. Those children are already eating cheese at 9 months. My grandchild doesn’t eat that yet. Why? ‘Because there’s salt in it.’ I understand, but it also makes me sad and sometimes I end up having words with my daughter about it.” (I-GM7).
“My son doesn’t want to give his son raw meat such as salami, sausage etc. He doesn’t do it himself and I know he doesn’t want me to do it, but I pretend I don’t know. [ …] When the parents aren’t around, I just give it to them and explain that it only happens when their parents are not around.” (FG2-GM1).
“It really is non-stop food all day with grandpa and grandma [laughs]. It just doesn’t stop, you know [ …]. So every half hour they get a banana, a yoghurt or something or... It just never stops. It is eating continuously throughout the day. That’s pretty much how it goes.” (I-M10).
“No, none of the parents on either side do that. Full is full, and if she doesn’t want to eat, then they stop. They don’t try to force her.” (I-M13).
“I was quite strict the first year, especially when he was younger. Also about the kind of food he was allowed, supplementary foods and how many bottle-feeds he got. Because at the moment, he’s on the verge of being overweight. For the first year or 18 months, I think, I put everything he was allowed to eat that day in his bag, so I really controlled what he was allowed to eat and how much.” (I-M8).
“He always sleeps at the same time. And I said, ‘Don’t rock him, don’t rock him.’ She really had to unlearn that, get used to it. I said: ‘Let him cry for a bit, it’s OK. Just for ten minutes and if he keeps crying, then you can pick him up, you know.’” (I-R15).
“For example, I would like to rock her on my legs or rock her to sleep on my lap and I’m afraid to leave her alone, but her mother is the exact opposite. She tells me to put her to bed and close the door. I feel sorry for the child when it cries, but that’s how she wants it.” (I-GM2).
The communication between mothers and grandmothers about differences of opinion regarding health-related practices is perceived as complicated
“If she said anything about what I’m doing with the baby [ …], I’d be really disappointed. That would be a bit … ungrateful.” (FG3-GM2).
“She doesn’t have the right to say anything about it. And if she doesn’t like it then she should quit her job, stay at home and look after the baby herself.” (FG1-GM5).
“To my own family I could maybe speak up more, to my direct family. But I am not going to tell my in-laws, ‘Thanks for the well-meaning advice, guys, but give it a rest will you …? ’ you know?”(I-R4).
“I am very lucky with my mother-in law, she is someone who is open to new information. And often, in Turkish culture, people are not open to criticism, especially from a daughter-in-law, you know. People take it the wrong way and then it goes from being positive feedback to negative criticism. That’s how it comes across. And that’s what I’m trying to say: it’s not often you meet a mother-in-law like that, one to whom you can really say, ‘I’d kind of like things done this way because of such and such.’” (I-M15).
“With my mother-in-law it was a case of... We really had to say a couple of times, ‘Look, we don’t want to be questioned about breastfeeding,’ but she kept on asking. And so I asked my husband, ‘Can you please tell her sometimes too?’ And he did. So yes, I can’t say that she stopped right away, but there came a point when she understood that I really didn’t appreciate it.” (I-M1).
“I look at my own son and see that he bathes my grandchild, takes my grandchild to school, even though he works and his wife doesn’t. I think the new generation of fathers are very attentive and involved. And that means he also becomes someone to talk to about his children. In the past, fathers were invisible.” (FG2-GM1).
“With my second child I was a bit older, more mature. More experienced as well. You’re no longer a child who is afraid to hold a baby or feed it or something. You’re more mature, you’ve been through it once already. And you think: ‘No, I’m going to do what feels good for me and my child.’ And so you feel much more confident in saying: ‘No, she doesn’t want a drink … period!’” (I-M7).