| Summary: | Breastfeeding significantly impacts on the health of the population; however, few babies are breastfed for more than a few weeks. Nine out of ten women who stop breastfeeding early say they stopped before they intended to. The most common reasons given for premature breastfeeding cessation can be resolved given proper instruction and support. However, women have consistently identified a lack of breastfeeding knowledge in their communities, and a mainly inadequate support service from health care professionals. The potential of the internet to instruct, support and motivate women to breastfeed has been reported in recent research, and may be one approach to more effectively supporting women who wish to breastfeed for a longer period of time. Online health seeking behaviour is particularly prevalent amongst pregnant women and approximately three out of ten new mothers are turning to the internet for breastfeeding support. The online environment offers a diverse range of breastfeeding resources but little is known about this phenomenon. The literature in the area is sparse and supports the need for further research. The aim of this study was to understand women's experience of using the internet to support breastfeeding. A mixed methods approach was selected and this incorporated a triangulated exploratory sequential design beginning with a tentative concept analysis to identify antecedents, attributes and consequences of online breastfeeding support. Following ethical approval, these tentative components were tested in the second phase of the study through unobtrusive observation of an online discussion forum. Subsequent analysis of online interactions between 510 individuals over a three month period, alongside an additional nine month tracking period to ascertain consequences, provided further clarity about this phenomenon. This resulted in crystallisation of an evolving concept that was validated and further developed in the third phase through online interviews with twelve women who had previously sought or offered breastfeeding support online. This research offers a conceptual model which suggests that online breastfeeding support is a sophisticated, effective mother to mother breastfeeding support system where women can choose to adopt the role of observer, seeker or supporter at various stages of their breastfeeding experience. New information has been obtained about specific types of breastfeeding support sought online, and how more experienced mothers work together in this virtual environment to co-construct menus of tailored support for those seeking help. The key component identified in this naturally occurring phenomenon of online breastfeeding support, is that it is self perpetuating - based on the generalised reciprocity of mothers who return with experiential knowledge and a willingness to reciprocate the support they received. These findings have implications for breastfeeding support strategies which should consider promotion of online resources found to be effective by breastfeeding women as well as incorporation of this sustainable woman centred model in future developments of online breastfeeding support. This study has made a number of recommendations relating to theory, practice, technology and research including consideration of further testing of this model.
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