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Zhang Y, Fu J, Lai J, Deng S, Guo Z, Zhong C, Tang J, Cao W, Wu Y. Reporting of Ethical Considerations in Qualitative Research Utilizing Social Media Data on Public Health Care: Scoping Review. J Med Internet Res 2024; 26:e51496. [PMID: 38758590 PMCID: PMC11143395 DOI: 10.2196/51496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/29/2023] [Accepted: 04/16/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND The internet community has become a significant source for researchers to conduct qualitative studies analyzing users' views, attitudes, and experiences about public health. However, few studies have assessed the ethical issues in qualitative research using social media data. OBJECTIVE This study aims to review the reportage of ethical considerations in qualitative research utilizing social media data on public health care. METHODS We performed a scoping review of studies mining text from internet communities and published in peer-reviewed journals from 2010 to May 31, 2023. These studies, limited to the English language, were retrieved to evaluate the rates of reporting ethical approval, informed consent, and privacy issues. We searched 5 databases, that is, PubMed, Web of Science, CINAHL, Cochrane, and Embase. Gray literature was supplemented from Google Scholar and OpenGrey websites. Studies using qualitative methods mining text from the internet community focusing on health care topics were deemed eligible. Data extraction was performed using a standardized data extraction spreadsheet. Findings were reported using PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. RESULTS After 4674 titles, abstracts, and full texts were screened, 108 studies on mining text from the internet community were included. Nearly half of the studies were published in the United States, with more studies from 2019 to 2022. Only 59.3% (64/108) of the studies sought ethical approval, 45.3% (49/108) mentioned informed consent, and only 12.9% (14/108) of the studies explicitly obtained informed consent. Approximately 86% (12/14) of the studies that reported informed consent obtained digital informed consent from participants/administrators, while 14% (2/14) did not describe the method used to obtain informed consent. Notably, 70.3% (76/108) of the studies contained users' written content or posts: 68% (52/76) contained verbatim quotes, while 32% (24/76) paraphrased the quotes to prevent traceability. However, 16% (4/24) of the studies that paraphrased the quotes did not report the paraphrasing methods. Moreover, 18.5% (20/108) of the studies used aggregated data analysis to protect users' privacy. Furthermore, the rates of reporting ethical approval were different between different countries (P=.02) and between papers that contained users' written content (both direct and paraphrased quotes) and papers that did not contain users' written content (P<.001). CONCLUSIONS Our scoping review demonstrates that the reporting of ethical considerations is widely neglected in qualitative research studies using social media data; such studies should be more cautious in citing user quotes to maintain user privacy. Further, our review reveals the need for detailed information on the precautions of obtaining informed consent and paraphrasing to reduce the potential bias. A national consensus of ethical considerations such as ethical approval, informed consent, and privacy issues is needed for qualitative research of health care using social media data of internet communities.
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Affiliation(s)
- Yujie Zhang
- Nanfang Hospital, Southern Medical University, Guangzhou, China
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Jiaqi Fu
- Nanfang Hospital, Southern Medical University, Guangzhou, China
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Jie Lai
- Nanfang Hospital, Southern Medical University, Guangzhou, China
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Shisi Deng
- Nanfang Hospital, Southern Medical University, Guangzhou, China
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Zihan Guo
- Nanfang Hospital, Southern Medical University, Guangzhou, China
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Chuhan Zhong
- Nanfang Hospital, Southern Medical University, Guangzhou, China
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Jianyao Tang
- Nanfang Hospital, Southern Medical University, Guangzhou, China
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Wenqiong Cao
- Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yanni Wu
- Nanfang Hospital, Southern Medical University, Guangzhou, China
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Huang EY, Hairston TK, Walsh J, Ballard ME, Boss EF, Jenks CM. Evaluation of Parental Perspectives and Concerns about Pediatric Cochlear Implantation: A Social Media Analysis. Otol Neurotol 2023; 44:e715-e721. [PMID: 37758320 DOI: 10.1097/mao.0000000000004024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
OBJECTIVE Parents often experience uncertainty during decision-making for their child's cochlear implantation (CI) surgery, and online forums provide insight on parental opinions that might not be expressed in clinic. This study aims to evaluate parental perspectives and concerns about pediatric CI using social media analysis. STUDY DESIGN Qualitative study. SETTING Three online forums involving parental posts about pediatric CI. INTERVENTION/METHODS Forums were queried using keywords (e.g., "cochlear implant") to gather all U.S. parent-initiated posts about pediatric CI from 2006 to 2021. Thematic content analysis was performed to classify posts by overarching domain, themes, and subthemes. Posts were reviewed for thematic synthesis and double coded. Descriptive statistics were calculated for each theme by unique users. RESULTS A total of 79 posts by 41 unique users were analyzed. Themes relating to decision for CI included facilitators, inhibitors, resources, and feelings. Parents posted about lack of benefit from hearing aids promoting decision for CI and high cost as an inhibitor. Some expressed concern about making a major decision for a minor. Parents often mentioned their child's healthcare providers and social media as resources. CONCLUSION Through social media posts, parental priorities and concerns for decision-making of CI surgery were identified. Findings may guide discussions between physicians and parents and facilitate shared decision-making about CI.
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Affiliation(s)
- Emily Y Huang
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Tai K Hairston
- Johns Hopkins University School of Medicine, Department of Pediatrics, Baltimore, Maryland
| | - Jonathan Walsh
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Megan E Ballard
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Emily F Boss
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Carolyn M Jenks
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Hubbard L, Reis P, Neil J. Beliefs and Decision-Making of First-Time Mothers Planning to Use a Breast Pump. J Perinat Educ 2023; 32:202-212. [PMID: 37974663 PMCID: PMC10637317 DOI: 10.1891/jpe-2022-0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 08/01/2022] [Indexed: 11/19/2023] Open
Abstract
Beliefs and decision-making processes associated with breast pump use in first-time mothers providing human milk to healthy, term newborns soon after birth are explored in this qualitative, descriptive study. Eight women participated in an individual semistructured interview in a community hospital in the southeastern United States. Guided by the theory of planned behavior, conventional content analysis about prenatal and early postpartum beliefs of planning and utilizing breast pumps yielded themes of Resource Gathering, Intention Refining, and Behavior Navigating. An understanding of these beliefs gives insight into ways health professionals can increase collaboration with expectant and new mothers about the selection and safe use of breast pumps, resource availability at various stages, and infant-feeding goals.
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Affiliation(s)
- Lori Hubbard
- Correspondence regarding this article should be directed to Lori Hubbard, PhD, RN, IBCLC. E-mail:
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Fu J, Li C, Zhou C, Li W, Lai J, Deng S, Zhang Y, Guo Z, Wu Y. Methods for Analyzing the Contents of Social Media for Health Care: Scoping Review. J Med Internet Res 2023; 25:e43349. [PMID: 37358900 DOI: 10.2196/43349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 05/28/2023] [Accepted: 05/30/2023] [Indexed: 06/27/2023] Open
Abstract
BACKGROUND Given the rapid development of social media, effective extraction and analysis of the contents of social media for health care have attracted widespread attention from health care providers. As far as we know, most of the reviews focus on the application of social media, and there is a lack of reviews that integrate the methods for analyzing social media information for health care. OBJECTIVE This scoping review aims to answer the following 4 questions: (1) What types of research have been used to investigate social media for health care, (2) what methods have been used to analyze the existing health information on social media, (3) what indicators should be applied to collect and evaluate the characteristics of methods for analyzing the contents of social media for health care, and (4) what are the current problems and development directions of methods used to analyze the contents of social media for health care? METHODS A scoping review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted. We searched PubMed, the Web of Science, EMBASE, the Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Library for the period from 2010 to May 2023 for primary studies focusing on social media and health care. Two independent reviewers screened eligible studies against inclusion criteria. A narrative synthesis of the included studies was conducted. RESULTS Of 16,161 identified citations, 134 (0.8%) studies were included in this review. These included 67 (50.0%) qualitative designs, 43 (32.1%) quantitative designs, and 24 (17.9%) mixed methods designs. The applied research methods were classified based on the following aspects: (1) manual analysis methods (content analysis methodology, grounded theory, ethnography, classification analysis, thematic analysis, and scoring tables) and computer-aided analysis methods (latent Dirichlet allocation, support vector machine, probabilistic clustering, image analysis, topic modeling, sentiment analysis, and other natural language processing technologies), (2) categories of research contents, and (3) health care areas (health practice, health services, and health education). CONCLUSIONS Based on an extensive literature review, we investigated the methods for analyzing the contents of social media for health care to determine the main applications, differences, trends, and existing problems. We also discussed the implications for the future. Traditional content analysis is still the mainstream method for analyzing social media content, and future research may be combined with big data research. With the progress of computers, mobile phones, smartwatches, and other smart devices, social media information sources will become more diversified. Future research can combine new sources, such as pictures, videos, and physiological signals, with online social networking to adapt to the development trend of the internet. More medical information talents need to be trained in the future to better solve the problem of network information analysis. Overall, this scoping review can be useful for a large audience that includes researchers entering the field.
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Affiliation(s)
- Jiaqi Fu
- Nanfang Hospital, Southern Medical University, Guangzhou, China
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Chaixiu Li
- Nanfang Hospital, Southern Medical University, Guangzhou, China
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Chunlan Zhou
- Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Wenji Li
- Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jie Lai
- Nanfang Hospital, Southern Medical University, Guangzhou, China
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Shisi Deng
- Nanfang Hospital, Southern Medical University, Guangzhou, China
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Yujie Zhang
- Nanfang Hospital, Southern Medical University, Guangzhou, China
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Zihan Guo
- Nanfang Hospital, Southern Medical University, Guangzhou, China
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Yanni Wu
- Nanfang Hospital, Southern Medical University, Guangzhou, China
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Quinn EA, Sobonya S, Palmquist AE. Maternal perceptions of human milk expression output: An experimental design using photographs of milk. Soc Sci Med 2023; 324:115871. [PMID: 37023658 DOI: 10.1016/j.socscimed.2023.115871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 01/20/2023] [Accepted: 03/26/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND The widespread use of breast pumps in the United States is a recent phenomenon that is reshaping how individuals understand and perceive lactation. In the 1990s, adequacy of milk supply was primarily measured indirectly by infant weight gain and/or diapers; now >95% of all lactating persons in the United States use breast pumps and are seeing their milk regularly. How seeing milk impacts the perception of lactation sufficiency is an important area of research. Research aim/question: To understand personal and intersubjective influences of seeing expressed human milk on perceptions of milk supply among participants who express milk for their infants. METHODS We surveyed 805 lactating participants from the United States about their pumping practices using an online survey. Participants described pumping practices, milk output, and beliefs. They were then randomized to view one of three photographs of expressed milk (<2 oz, 4 oz, >6oz) and asked to imagine they had just pumped that amount and provide a written response; this created 4 exposure groups (2 increase and 2 decrease) and a control group (no difference). RESULTS Participants randomized to a higher volume reported more positive feelings and used the terms "good", "great", and "accomplished" to describe emotional responses to output. Participants randomized to lower milk volumes reported more feelings of "bad" or "depressed." A subset of participants reported feeling "annoyed" about small volumes of milk. CONCLUSIONS Participants in this study were very conscious of the volume of milk pumped each session; both increases and decreases were associated with emotional responses that could contribute to decisions about pumping practices, perceived milk supply, and lactation duration.
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Fan HSL, Fong DYT, Lok KYW, Tarrant M. A Qualitative Exploration of the Reasons for Expressed Human Milk Feeding Informed by the Breastfeeding Self-Efficacy Theory. J Hum Lact 2023; 39:146-156. [PMID: 35414281 DOI: 10.1177/08903344221084629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND There is an increasing prevalence of expressed human milk feeding. The reasons for expressed human milk feeding of healthy term infants may differ from those for preterm infants. The process of adopting expressed human milk feeding for healthy full-term infants has not been well-described in the existing literature. RESEARCH AIM To describe the reasons for, and antecedents to, expressed human milk feeding among Chinese women who used a high proportion of expressed human milk for feeding. METHODS A descriptive, prospective cross-sectional qualitative design was used. Participants (N = 25) who used a high proportion of expressed human milk feeding were recruited from a larger perspective cohort study in two public hospitals in Hong Kong. Semi-structured, in-depth, one-to-one interviews were conducted 2017-2018. Data collection and thematic analysis were guided by the Breastfeeding Self-Efficacy Theory. RESULTS The authors conducted thematic analysis and identified six core themes: (1) perceived maternal roles; (2) breastfeeding role models; (3) negative feedback from social networks; (4) negative direct breastfeeding experiences; (5) expressed human milk feeding as a solution to a problem; and (6) advice from health care professionals to express human milk. These themes were consistent with the four antecedents of the Breastfeeding Self-Efficacy Theory (e.g., physiological and affective state, vicarious experiences, performance accomplishments, and verbal persuasion). CONCLUSIONS The main reason for participants to feed expressed human milk was experiencing difficulties with direct breastfeeding. Expressed human milk feeding was used as an immediate solution for breastfeeding problems. Strengthening breastfeeding support in the early postpartum period may decrease the perceived need for human milk expression.
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Affiliation(s)
- Heidi Sze Lok Fan
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR
| | - Kris Yuet Wan Lok
- School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong SAR
| | - Marie Tarrant
- School of Nursing, Faculty of Health and Social Development, University of British Columbia, Kelowna, BC, Canada
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Rosenbaum KA. Exclusive breastmilk pumping: A concept analysis. Nurs Forum 2022; 57:946-953. [PMID: 35716155 PMCID: PMC9546173 DOI: 10.1111/nuf.12766] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/24/2022] [Accepted: 06/02/2022] [Indexed: 01/04/2023]
Abstract
Aim To analyze and examine the concept of exclusive breast pumping (EP). Background Breastmilk is the ideal nutrition for infants, yet when breastfeeding is unsuccessful, parents resort to informal breastmilk sharing, artificial formula feeding, or EP. A growing proportion of families exclusively pump yet they often receive guidance from social media rather than healthcare providers because healthcare providers are uninformed about this feeding method. Data Source Cumulative Index of Nursing and Allied Health Literature, PubMed, and Google Scholar databases were searched using the following keywords: human milk express*, breast express*, breast milk express, breastmilk express*, exclusive pump, exclusive breast pumping, and exclusive expression. Review Methods Concept analysis design using Walker and Avant's method. Results Three defining attributes of (1) absence of direct breastfeeding, (2) breastmilk expression, (3) and an enduring infant feeding pattern of feeding expressed breastmilk only via a bottle were identified. All three attributes are required to confirm the presence of the concept of exclusive pumping. Definitions, antecedents, consequences, and empirical referents are described. Model and contrary cases are discussed. Conclusion This exclusive pumping concept analysis allows for consistency in terminology in practice and research. EP is a feeding method which can increase the proportion of infants who are fed breastmilk and may reduce the risks that arise from artificial formula feeding.
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Zizzo G, Rumbold AR, Grzeskowiak LE. "Fear of stopping" vs "wanting to get off the medication": exploring women's experiences of using domperidone as a galactagogue - a qualitative study. Int Breastfeed J 2021; 16:92. [PMID: 34886887 PMCID: PMC8656031 DOI: 10.1186/s13006-021-00438-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 11/16/2021] [Indexed: 11/10/2022] Open
Abstract
Background Domperidone is the most frequently prescribed medicine used to increase breast milk supply. There is considerable controversy surrounding the use of domperidone in lactation, due to limited evidence about efficacy and concerns about rare but life-threatening side-effects. Despite this, in many high-income settings such as Australia, use of domperidone among breastfeeding mothers appears to be increasing. The aim of this paper was to explore women’s experiences of using domperidone during breastfeeding. Methods Semi-structured interviews were conducted in 2019 with 15 women in Australia who reported using domperidone as a galactagogue during breastfeeding. Interviews were recorded, transcribed and analysed thematically. Results Women reported a wide variety of practices concerning the timing of initiation of domperidone use, including prophylactic use, as well as the dose and duration of use. Prolonged periods of use and unsupervised dosing were commonly reported, these practices were sometimes associated with a fear of the consequences of stopping, insufficient provision of information about the drug or feeling dismissed by health professionals. Some women indicated that when doctors refused to prescribe domperidone they responded by doctor shopping and seeking anecdotal information about benefits and risks online, leading to unsupervised practices. Women often reported high expectations surrounding the effectiveness of domperidone, and most used the medication in conjunction with food/herbal galactagogues and non-galactagogue support. Positive outcomes following domperidone use included having greater confidence in breastfeeding and pride at achieving breastfeeding goals. Conclusions This study identified a variety of practices concerning domperidone use, including potentially unsafe practices, linked in some cases to inconsistent advice from health professionals and a reliance on online, anecdotal information sources. These findings emphasise the urgent need for development of clinical practice guidelines and a greater focus on translating existing evidence concerning domperidone into clinical practice, including clinical support that is tailored to women’s needs.
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Affiliation(s)
- Gabriella Zizzo
- Faculty of Health and Medical Science, The University of Adelaide, Adelaide, Australia
| | - Alice R Rumbold
- Faculty of Health and Medical Science, The University of Adelaide, Adelaide, Australia.,SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Luke E Grzeskowiak
- Faculty of Health and Medical Science, The University of Adelaide, Adelaide, Australia. .,SAHMRI Women and Kids, South Australian Health and Medical Research Institute, Adelaide, Australia. .,Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, Australia. .,SA Pharmacy, SA Health, Adelaide, Australia.
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Kochis S, Keet C, Claus LE, Hairston T, Links AR, Boss EF. Caregiver perceptions and attitudes associated with oral immunotherapy on social media. Allergy Asthma Proc 2021; 42:432-438. [PMID: 34474713 DOI: 10.2500/aap.2021.42.210050] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background: Caregiver values and preferences with regard to oral immunotherapy (OIT) for treatment of food allergies are not widely reported. Understanding caregiver perspectives is integral to establishing shared decision-making in the treatment of food allergy. Objective: We aimed to understand caregiver opinions that may influence caregivers in their decisions about OIT through social media. Methods: We searched a popular parenting web site for posts related to OIT from December 2008 to September 2019. We applied a Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework to review posts for inclusion, performed thematic content analysis to determine common themes, and calculated frequencies for each theme and subtheme. Posts and comments were included if they contained discussions about OIT for immunoglobulin E-mediated food allergy and were excluded if they were duplicates, comments from an original post from the original user, or comments on a nonrelevant original post. Results: Of 1300 posts and comments retrieved, 174 were included (13%). Most were excluded because they did not directly address OIT for food allergy. Relevant posts could fall into multiple themes and were categorized under three main themes: attitudes (n = 128, "I am scared to do OIT but scared not to!"), logistics (n = 168, "We will be doing this once LO [little one] is a little older"), and questions (n = 32, "How does it work?"). Conclusion: Caregivers communicate with each other through social media, expressing attitudes, logistics, and questions about OIT. Understanding these lay perspectives may help guide clinicians in counseling and engage caregivers in decision-making.
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Affiliation(s)
- Suzanne Kochis
- From the Division of Allergy/Immunology, Children's National Hospital, Washington, DC
| | - Corinne Keet
- Department of Pediatrics, Johns Hopkins School of Medicine, and
| | - Lauren E. Claus
- Department of Otolaryngology, Johns Hopkins School of Medicine, Baltimore, MD
| | - Tai Hairston
- Department of Pediatrics, Johns Hopkins School of Medicine, and
| | - Annie R. Links
- Department of Otolaryngology, Johns Hopkins School of Medicine, Baltimore, MD
| | - Emily F. Boss
- Department of Otolaryngology, Johns Hopkins School of Medicine, Baltimore, MD
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Zizzo G, Amir LH, Moore V, Grzeskowiak LE, Rumbold AR. The risk-risk trade-offs: Understanding factors that influence women's decision to use substances to boost breast milk supply. PLoS One 2021; 16:e0249599. [PMID: 33939738 PMCID: PMC8092651 DOI: 10.1371/journal.pone.0249599] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 03/20/2021] [Indexed: 12/21/2022] Open
Abstract
Galactagogues are foods, herbs or medications thought to support or increase breast milk supply. The use of galactagogues during lactation is becoming increasingly common despite limited evidence regarding effectiveness and safety, and no definitive recommendations for use in clinical practice. The aim of this study is to explore factors influencing women's decisions to use galactagogues during lactation. Twenty-two semi-structured interviews were conducted in October and November 2019 (over the telephone or in person) with participants located in most Australian states and territories, including metro and regional areas. Interviews were audio-recorded, transcribed verbatim and thematically analysed using NVivo. Analysis revealed that following a concern about breast milk supply, the decision to use galactagogues was influenced by three core and interrelated domains: access to and quality of breastfeeding support, maternal agency and determination to provide breast milk. Women revealed many problematic experiences with health care professionals that left them feeling dismissed and confused due to provision of inconsistent and insufficient information that was sometimes at odds with their desire to provide breast milk. In this instance, some women turned to galactagogues to regain agency. A range of broader dimensions influencing decision-making also emerged. These were separated into categories that emphasise distinctions relating to breast milk supply, which included: maternal emotional wellbeing, social norms and pressures, concerns about infant development, maternal physical health and lactation history, as well as those relating specifically to galactagogue use, including: desire for a guaranteed/urgent response, risk-risk trade-off, acceptance and trust, and accessibility and cost. In understanding the complexity of decision-making concerning these substances, we identify opportunities to improve breastfeeding counselling and support. We recommend that support be individually tailored to manage conflicting information, adopt communication styles that encourage trust and processes that enable shared decision-making to enhance or restore maternal agency. There is also considerable need to address evidence gaps regarding the effectiveness and safety of commonly used galactagogues, so that women can be appropriately counselled about potential benefits and harms.
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Affiliation(s)
- Gabriella Zizzo
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- * E-mail:
| | - Lisa H. Amir
- Judith Lumley Centre, La Trobe University | Royal Women’s Hospital, Parkville, Victoria, Australia
| | - Vivienne Moore
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Luke E. Grzeskowiak
- Faculty of Health and Medical Sciences, The University of Adelaide, South Australia | Women and Kids, South Australian Health and Medical Research Institute, South Australia, Australia
| | - Alice R. Rumbold
- Women and Kids, South Australian Health and Medical Research Institute, South Australia, Australia
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Castro-Blanco KA, Marks RM, Geraghty SR, Felice JP, Rasmussen KM. Information Available Online That Answers Common Questions About Breast Pumping: A Scoping Review. Breastfeed Med 2020; 15:689-697. [PMID: 32845741 DOI: 10.1089/bfm.2020.0177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: In light of the widespread use of breast milk pumping, or, "pumping," mothers are seeking clear, adequate breast pumping guidelines. We aimed at characterizing the information in web pages that mothers might find online when searching for answers related to breast pumping. Materials and Methods: We used Google to search for answers to 10 questions about pumping that mothers might ask. This search used Boolean search. We screened the first three pages of search results for each computer Google search. Each eligible hit (web pages) was evaluated for accuracy, readability, and credibility of its source. Results: Our search strategy produced 241 hits eligible for analysis. The majority of these contained accurate, readable information and were authored by credible sources. The proportion of eligible hits from questions that had a quantifiable (numeric) answer, (e.g., number of days that refrigerated milk remains safe for consumption) differed significantly (p = 0.024) from searches that did not. Search inquiries related to milk supply adequacy produced a disproportionately high number of inaccurate hits. Conclusion: Our findings indicate that accurate and credible information about breast pumping is accessible on the internet. However, practitioners should be aware that inaccurate information is present among mothers' likely hits. Our findings also underscore the fact that there are aspects of breast pumping that do not yet have guidelines available, and that these areas warrant further research. In addition, there is a need for guidelines that reflect the individual nature of the experience of breast pumping.
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Affiliation(s)
| | - Rachel M Marks
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
| | - Sheela R Geraghty
- Division of General & Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Division of Epidemiology and Biostatistics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Julia P Felice
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
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Ávila-Ortiz MN, Castro-Sánchez AE, Martínez-González EA, Núñez-Rocha GM, Zambrano-Moreno A. Factors associated with abandoning exclusive breastfeeding in Mexican mothers at two private hospitals. Int Breastfeed J 2020; 15:73. [PMID: 32814577 PMCID: PMC7436974 DOI: 10.1186/s13006-020-00316-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 08/10/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Exclusive breastfeeding (EBF) has multiple benefits for both the child and the mother; however, there is little data regarding the reason why Mexican mothers with a high socio-economic level abandon EBF before 6 months, and there is limited information about the practice of breastfeeding in private hospitals. The objective was to identify the factors associated with the cessation of exclusive breastfeeding in Mexican mothers at two private hospitals. METHODS A cross-sectional study was conducted with 218 upper-class mothers selected according to their place of residence by geographic location, socio-economic level, and pediatric consultations cost. They were over 18 years old and with children aged 6 to 24 months. Data were collected between July and November 2016 by face to face interview using a structured questionnaire while the mothers waited for the pediatric postnatal care consultation in two private hospitals in northeastern Mexico. Exclusive breastfeeding was measured according to World Health Organization (WHO) recommendations, which consist of providing only breast milk for the first 6 months of life. Chi-squared tests and multivariate logistic regression were performed. RESULTS Mean maternal age was 31.4 years (SD of 4.4) and most of the participants had an undergraduate education, were married, and worked outside the home. The prevalence of exclusive breastfeeding at 6 months was 28%. Upper-class working mothers are less likely to continue breastfeeding. There was a negative association with employment (AOR 13.69; 95% CI 1.59, 111.11), bottle use in the first 6 months (AOR 7.93; 95% CI 3.07, 20.48), and a low level of knowledge (AOR 2.18; 95% CI 1.04, 4.56). After 6 months, only 61 mothers (28%) maintained exclusive breastfeeding. CONCLUSIONS Knowledge level, bottle use, and employment are associated with premature cessation of EBF in Mexican upper-class mothers, attending two private hospitals. There was a high percentage of breastfeeding cessation in the sample. It is necessary to reinforce a strategy that coordinates the action of the different laws, regulations and programs affecting the exclusive breastfeeding practice, in order to adequately promote breastfeeding and support mothers in both public and private sectors.
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Affiliation(s)
- María Natividad Ávila-Ortiz
- Autonomous University of Nuevo Leon, Faculty of Public Health and Nutrition, Calle Eduardo Aguirre Pequeño y Yuriria, s/n Col. Mitras Centro, C.P. 64460, Monterrey, Nuevo León, Mexico.
| | - Ana Elisa Castro-Sánchez
- Autonomous University of Nuevo Leon, Faculty of Public Health and Nutrition, Calle Eduardo Aguirre Pequeño y Yuriria, s/n Col. Mitras Centro, C.P. 64460, Monterrey, Nuevo León, Mexico
| | - Elizabeth Andrea Martínez-González
- Autonomous University of Nuevo Leon, Faculty of Public Health and Nutrition, Calle Eduardo Aguirre Pequeño y Yuriria, s/n Col. Mitras Centro, C.P. 64460, Monterrey, Nuevo León, Mexico
| | - Georgina Mayela Núñez-Rocha
- Autonomous University of Nuevo Leon, Faculty of Public Health and Nutrition, Calle Eduardo Aguirre Pequeño y Yuriria, s/n Col. Mitras Centro, C.P. 64460, Monterrey, Nuevo León, Mexico
| | - Adriana Zambrano-Moreno
- Autonomous University of Nuevo Leon, Faculty of Public Health and Nutrition, Calle Eduardo Aguirre Pequeño y Yuriria, s/n Col. Mitras Centro, C.P. 64460, Monterrey, Nuevo León, Mexico
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Ray S, Hairston TK, Giorgi M, Links AR, Boss EF, Walsh J. Speaking in Tongues: What Parents Really Think About Tongue-Tie Surgery for Their Infants. Clin Pediatr (Phila) 2020; 59:236-244. [PMID: 31875407 DOI: 10.1177/0009922819896583] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
We evaluate maternal perspectives of frenotomy for ankyloglossia in newborns. We searched highly frequented forums like babycenter.com for comments related to frenotomy posted from 2012 to 2017. We applied modified grounded theory, reviewed posts for thematic synthesis, and calculated frequencies for each theme. High decisional conflict, low discussion of surgical complications, and an overall moderate positive experience were noted. Mothers posted about breastfeeding issues (n = 227, 74.7%) and overall experience (n = 229, 75.3%). Posts related to breastfeeding include discomfort ("I can no longer physically take the pain"; n = 93, 30.6%). Parents posted frequently about a satisfactory outcome ("It was so worth it to improve our nursing relationship"; n = 133, 43.8%), but dissatisfactory outcome ("I'm still having problems latching and am pumping. It's brutal"; n = 31) was present in 10.2%. These results aid in understanding parental thoughts of frenotomy. Physicians can use these self-reported maternal perspectives on frenotomy to guide counseling and improve shared decision making for parents.
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Affiliation(s)
- Shagnik Ray
- Johns Hopkins University, Baltimore, MD, USA
| | | | - Mark Giorgi
- Morehouse School of Medicine, Atlanta, GA, USA
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Lebron CN, St George SM, Eckembrecher DG, Alvarez LM. "Am I doing this wrong?" Breastfeeding mothers' use of an online forum. MATERNAL AND CHILD NUTRITION 2019; 16:e12890. [PMID: 31568669 PMCID: PMC6937377 DOI: 10.1111/mcn.12890] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 08/27/2019] [Accepted: 08/29/2019] [Indexed: 01/06/2023]
Abstract
As mothers seek out information around breastfeeding, many are turning to online message boards, listservs, or social media for advice. Babycenter.com, a parenting website with widespread use, hosts a Breastfeeding Support and Help community forum with over 140,000 users and more than one million conversation threads. The purpose of this study is to examine this online support forum to understand the information seeking and sharing practices of its users. We extracted a total of 258 original posts and 1,445 corresponding comments from Babycenter.com's breastfeeding forum posted over a 10-day period. Using content analysis, we coded the posts into 15 categories reflective of the types of information users were seeking. We then randomly selected 45 conversation threads across the most popular categories to further understand how users were sharing information. The most popular breastfeeding topics for which users sought out information included feeding challenges, supply issues, feeding schedule and duration, pumping, physical health, excretion issues, storing milk, nipple issues, and general breastfeeding questions. Participants elicited information from others using interviewing questions and built consensus around issues by agreeing with previous posts. They shared their knowledge and personal breastfeeding experiences and also provided encouragement to continue breastfeeding and overcome challenges. Online support forums are actively being used by breastfeeding mothers seeking information from others with similar experiences. This presents an important resource for breastfeeding mothers and may, therefore, be an important component of future breastfeeding interventions.
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Affiliation(s)
- Cynthia N Lebron
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Sara M St George
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Daphne G Eckembrecher
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Lucia M Alvarez
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
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