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

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Background. The internet is widely used by women to guide infant-feeding decisions and practice, but there is no clearunderstanding of women’s self-directed use of the internet to support breastfeeding.Aim. To conceptualise online breastfeeding support.Methods. With ethical approval, a mixed methods triangulated study was undertaken based on a concept analysis that usedan eight-step framework. The study was designed in three phases – Phase 1: a concept analysis to identify components ofonline breastfeeding support; Phase 2: testing of tentative components arising from the concept analysis through observationof 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 practicehad antecedents of: a breastfeeding goal; a breastfeeding query or interest in discussion/debate; inadequate face-to-face supportor seeks additional/optional support; willingness to seek and offer support online. Attributes manifested as a tailored menu ofsupport or enablement of debate by more experienced others, in an accessible, responsive, optionally anonymous environmentsustained by indirect reciprocity. Confirmed consequences were: reconstruction of breastfeeding experience; impact onbreastfeeding outcomes and other aspects of parenting; becoming expert and enabling face-to-face support. Together, thesecomponents constitute an authentic presence of support created by a global community of breastfeeding women.Conclusion. To our knowledge, this study is unique and has potential to impact on strategies targeting maternal and childhealth at a national and international level. The study provides new theoretical knowledge about women’s behaviour and usageof online support to enable them to achieve desired breastfeeding goal(s). This study provides empirical evidence of ‘womangenerated’,sustainable, online breastfeeding support and opens the doors for targeted public health research investment.
Original languageEnglish
Pages (from-to)76-83
JournalEvidence Based Midwifery
Issue number3
Early online date5 Feb 2017
Publication statusE-pub ahead of print - 5 Feb 2017


  • Key words: Breastfeeding
  • support
  • online
  • mixed methods
  • concept analysis
  • antecedents
  • attributes
  • consequences
  • indirect
  • reciprocity
  • evidence-based midwifery

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