Milk, medicine and the other mother: understanding donor milk use in Scotland's Neonatal Intensive Care Units

牛奶、药物和另一个母亲：了解苏格兰新生儿重症监护病房捐赠母乳的使用情况

• 批准号: 2886081
• 金额: --
• 依托单位: University of Edinburgh
• 依托单位国家: 英国
• 项目类别: Studentship
• 财政年份: 2023
• 资助国家: 英国
• 起止时间: 2023 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=studentship-2886081
• 关键词: Milk; medicine; other; mother; understanding

When a mother donates her breastmilk to a milk bank it is referred to as a 'gift' for vulnerable neonates. Breastmilk offers gut protection and prevents the life-threatening disease necrotising enterocolitis (NEC) associated with formula milk use. When a new mother cannot produce sufficient amounts of breast milk, NICU medical professionals promote this gift of donor milk as life-saving 'medicine'. Mauss (1925) understood gifts as creating and maintaining social relations. Donor breast milk is the bodily fluid, given as gift, that highlights the porous borders of these social bodies. This PhD will offer a novel approach to breastmilk ethnography by following the flow of the milk from the private sphere of the donor mothers home, to milk bank, to recipient mother/infant dyad in NICU and explore the beliefs, practices and processes surrounding it. Building on anthropological theories of gift and commodity, donor milk will be explored as both and contribute to a more nuanced understanding of these key anthropological concepts. This PhD will explore the use of donor breast milk within Scotland's NICUs as the bodily fluid that permeates the boundaries of bodies and state, kinship and mothers, nutrition and medicine. This is a timely issue as milk donation has risen three-fold in Scottish NICUs, despite Scottish breastfeeding rates remaining some of the lowest in the world (UNICEF). This PhD will offer novel insight to Scottish reproductive ethnography. The overarching questions to be asked are:1. Milk as gift: why do mothers donate breast milk in Scotland? What does this involve?2. Milk as medicine: what are the beliefs, practices and processes in transforming donor milk to NHS medicine and commodity? What does donor milk mean to those involved in this process? 3. Milk and the other mother: What does it mean to receive donated breast milk within Scotland's NICUs? What does donor milk contribute to both donor and recipient mother's 'motherwork'?As a registered midwife in the NHS, I hold a unique and advantageous position to deliver this research in a familiar environment with existing connections as 'ethnographer at home'. Multiple sites of ethnographic work will be split into repetitive phases over the course of 12 months due to the requirement for donor milk to be used within 6 months (NICE, 2010). A multi-methods approach will utilise key anthropological research methods of participant observation, fieldwork notes, interviews and documentary analysis to triangulate and contextualise findings .Phase 1: participant observation and interviews with donor mothers across Scotland, exploring what it means to donate, if they think about who the milk goes to and how this fits around their own 'motherwork'. Women will also be invited to record pictures and sound recordings of their expressing practices to provide visual, sense based content to the findings during dissemination. Phase 2: Participant observation of transportation to the milk bank and storage, pasteurising and bacterial testing of the milk transforming to 'medicine'. Interviews with milk bank staff and volunteer couriers will build a picture of what donor milk means to them. Phase 3: located within the two identified NICU sites of Glasgow and Dundee, chosen for their high rates of social deprivation and ethnic diversity. Participant observation of NICU staff will understand the practices involved in storing, handling, administrating donor milk. Documentary analysis of policies, including errors in use, can reflect those being observed. Interviews with NICU staff, mothers and partners will contextualise this observed data and explore how it relates to their own mothering identity work in NICU. Finally, NICU parents will be invited during interview to help co-create an information guide for future parents in NICU to further contextualise findings and deliver a tangible outcome for dissemination.

当母亲将母乳捐赠给母乳库时，这被称为送给弱势新生儿的“礼物”。母乳可以保护肠道，并预防与使用配方奶相关的危及生命的疾病坏死性小肠结肠炎 (NEC)。当新妈妈无法产生足够的母乳时，新生儿重症监护病房的医疗专业人员会将捐赠母乳的这种礼物宣传为救生“药物”。 Mauss (1925) 将礼物理解为创造和维持社会关系。捐赠者的母乳是作为礼物赠送的体液，凸显了这些社会机构的多孔边界。该博士将提供一种新的母乳民族志研究方法，跟踪母乳从捐赠者母亲家中的私人空间流向母乳库，再流向新生儿重症监护病房的接受母亲/婴儿二人组，并探索围绕它的信念、实践和过程。基于礼物和商品的人类学理论，捐赠母乳将作为礼物和商品进行探索，并有助于更细致地理解这些关键的人类学概念。该博士将探索在苏格兰新生儿重症监护病房内使用捐赠母乳作为渗透身体和国家、亲属关系和母亲、营养和医学边界的体液。这是一个及时的问题，因为苏格兰新生儿重症监护室的母乳捐赠增加了三倍，尽管苏格兰的母乳喂养率仍然是世界上最低的（联合国儿童基金会）。该博士学位将为苏格兰生殖民族志提供新颖的见解。需要提出的首要问题是： 1．牛奶作为礼物：为什么苏格兰的母亲们要捐赠母乳？这涉及到什么？2.牛奶作为药物：将捐赠牛奶转化为 NHS 药物和商品的信念、实践和流程是什么？捐赠母乳对于参与这一过程的人员意味着什么？ 3. 牛奶和另一个母亲：在苏格兰新生儿重症监护室接受捐赠的母乳意味着什么？捐赠母乳对捐赠者和接受者母亲的“母业”有何贡献？作为 NHS 的注册助产士，我拥有独特且有利的地位，可以在熟悉的环境中以“家庭民族志学家”的现有联系开展这项研究。由于捐赠母乳要求在 6 个月内使用，多个地点的人种学工作将在 12 个月内分为多个重复阶段（NICE，2010）。多种方法将利用参与观察、实地考察记录、访谈和文献分析等关键人类学研究方法来三角测量和背景化研究结果。第一阶段：参与观察和采访苏格兰各地的捐赠母亲，探索捐赠的意义，如果她们考虑牛奶会流向谁，以及这与她们自己的“母亲的工作”有何关系。还将邀请妇女录制她们表达实践的图片和录音，以便在传播过程中为研究结果提供视觉、感官内容。第二阶段：参与者观察牛奶库的运输以及牛奶转化为“药物”的储存、巴氏灭菌和细菌检测。对母乳银行工作人员和志愿快递员的采访将了解捐赠母乳对他们意味着什么。第三阶段：位于格拉斯哥和邓迪这两个已确定的新生儿重症监护病房（NICU）地点，因其社会贫困率高和种族多样性而被选中。新生儿重症监护室工作人员的参与者观察将了解储存、处理和管理捐赠母乳所涉及的做法。对政策（包括使用错误）的记录分析可以反映所观察到的情况。对新生儿重症监护室工作人员、母亲和伴侣的采访将把这些观察到的数据置于背景中，并探讨它与他们自己在新生儿重症监护病房的母亲身份工作之间的关系。最后，新生儿重症监护病房 (NICU) 家长将在访谈中受邀帮助共同为新生儿重症监护病房 (NICU) 的未来家长制定信息指南，以进一步结合研究结果并提供切实的传播成果。