Tapping into authentic presence: key components arising from a concept analysis of online breastfeeding support

Background:
The internet is widely used by women to guide infant-feeding decisions and practice, but there is no clear understanding of women’s self-directed use of the internet to support breastfeeding.
Aim:
The aim of this study was to conceptualise online breastfeeding support.
Methods:
With ethical approval, a mixed methods triangulated study was undertaken, based on a concept analysis that used an eight-step framework. The study was designed in three phases – Phase 1: a concept analysis to identify components of online breastfeeding support; Phase 2: testing of tentative components arising from the concept analysis through observation of breastfeeding-related online discussions (based on 126 threads containing 1230 messages generated by 510 individuals); Phase 3: confirmation of the resultant model through online interviews with 12 women.
Findings:
In total, 16 components of online breastfeeding support emerged indicating that women who engaged in this practice had antecedents of: a breastfeeding goal; a breastfeeding query or interest in discussion/debate; inadequate face-to-face support or seeks additional/optional support; willingness to seek and offer support online. Attributes manifested as a tailored menu of support, or enablement of debate by more experienced others, in an accessible, responsive, optionally anonymous environment sustained by indirect reciprocity. Confirmed consequences were: reconstruction of breastfeeding experience; impact on breastfeeding outcomes and other aspects of parenting; becoming expert and enabling face-to-face support. Together, these components constitute an authentic presence of support created by a global community of breastfeeding women.
Conclusion:
To the authors’ knowledge, this study is unique and has potential to impact on strategies targeting maternal and child health at a national and international level. It provides new theoretical knowledge about women’s behaviour and usage of online support to enable them to achieve desired breastfeeding goal(s). This study provides empirical evidence of ‘woman generated’, sustainable, online breastfeeding support and opens the doors for targeted public health research investment.