This study sought to provide a comprehensive picture of maternal conceptualization of Perceived Insufficient Milk (PIM) using qualitative methods (semistructured interviews, free lists, and rankings) in Mexico. Two hundred and seven first-time mothers of infants younger than 6 months and mothers-to-be who were (or intended to be) breastfeeding were interviewed in waiting areas at a hospital and a health clinic in Mexico City, Mexico, from September 2000 to January 2001. Pattern searching and triangulation of the 3 qualitative methods indicated that women viewed crying as the chief symptom of PIM. Maternal diet and liquid intake were cited as both the most salient causes and treatments for PIM. The main coping strategy in the event of PIM was formula feeding. These findings highlight the need for addressing maternal concerns in relation to PIM, especially regarding the role of crying as the initiator of the PIM cycle.

Purpose – The purpose of this paper is to report the outcome of an education and public health collaboration investigating the impact of adapted training to enhance teachers' potential role to promote child health and wellbeing. Design/methodology/approach – The study was conducted in three phases: a survey of the health education content in universities in initial teacher training courses; a longitudinal survey at the commencement and completion of courses to capture trainees' knowledge, skills and attitudes towards health and their role in health promotion; and mapping curriculum content against qualified teacher standards and public health competencies. Findings – Training about health varies largely between institutions. Trainees' knowledge levels remained low after training; ranked importance of key health topics – nutrition, alcohol, smoking, – decreased significantly; a majority thought that teachers and schools play an important role in health promotion, but significant increases were also noted in the minority who thought health promotion is not part of their remit (Phase 2). Originality/value – To the best of one's knowledge, similar work has not so far been reported. While teachers are in a prime position to influence child health, trainees require knowledge and skills to realise their public health potential.

Breastfeeding mothers often report perceived insufficient milk (PIM) believing their infant is crying too much, which leads to introducing formula and the early abandonment of breastfeeding. We sought to determine if infant crying was associated with reported PIM (yes/no) and number of problems associated with lactation (lactation problem score [LPS] 6‐point Likert scale) before formula introduction. Primiparous breastfeeding mothers were recruited at birth and visited at 1, 2 and 4 weeks. Among those fully breastfeeding at 1 week (N = 230), infant crying variables based on maternal reports were not associated with PIM at 1 week, but LPS was. However, a mother's expectation that her infant would cry more than other infants was associated with increased odds of reporting PIM at 2 and 4 weeks, as were delayed onset of lactation and previous LPS. At 1 week, crying variables (frequency, difficulty in soothing) were associated with LPS along with percent weight change. Delayed onset of lactation, infant care style, number of breastfeeds and previous LPS were longitudinally associated with change in LPS from 1 to 2 weeks and 2 to 4 weeks. Our data suggest that reported infant crying is associated with PIM and LPS in the first 4 weeks of life. Guidance on what to expect in crying behaviour and the impact of infant care style may be beneficial in reducing PIM and LPS in the first month.