Investigating interactive methods in remote chestfeeding support for lactation consulting professionals in Brazil

Abstract

ObjectiveLactation consultants (LCs) positively impact chestfeeding rates by providing in-person support to struggling parents. In Brazil, LCs are a scarce resource and in high demand, risking chestfeeding rates across many communities nationwide. The transition to remote consultations during the COVID-19 pandemic made LCs face several challenges to solve chestfeeding problems due to limited technical resources for management, communication, and diagnosis. This study investigates the main technological issues LCs have in remote consultations and what technology features are helpful for chestfeeding problem-solving in remote settings.MethodsThis paper implements qualitative investigation through a contextual study (n=10) and a participatory session (n=5) to determine stakeholders’ preferences for technology features in solving chestfeeding problems.FindingsThe contextual study with LCs in Brazil characterized (1) the current appropriation of technologies that help during consultations, (2) technology limitations that affect LCs’ decision-making, (3) challenges and benefits of remote consultations, and (4) cases that are easy and difficult to solve remotely. The participatory session brings LCs’ perceptions on (1) components for an effective remote evaluation, (2) preferred elements by professionals when providing remote feedback to parents, and (3) feelings about using technology resources for remote consultations.ConclusionFindings suggest that LCs adapted their methodologies for remote consultations, and the perceived benefits of this modality show interest in continuing to provide remote care as long as more integrative and nurturing applications are offered to their clients. We learned that fully remote lactation care might not be the main objective for overall populations in Brazil, but as a hybrid mode of care that benefits parents by having both modalities of consultations available to them. Finally, remote support helps reduce financial, geographic, and cultural barriers in lactation care. However, future research must identify how generalized solutions for remote lactation care can be, especially for different cultures and regions.

Augmenting Telepostpartum Care With Vision-Based Detection of Breastfeeding-Related Conditions: Algorithm Development and Validation

“…Remote lactation care presents challenges, including limited visibility during video calls, communication difficulties, and technical issues [18,40,41]. Despite challenges, remote care offers benefits, reducing the mother's sense of isolation, enabling faster feedback, and promoting effective communication and patient engagement for improved independent learning [17,18,22]. These benefits positively impact mothers' intentions in exclusive breastfeeding for up to six months and reduce the risk of breastfeeding cessation at three months by 25% [42].…”

“…LCs often conduct remote consultations from their workplaces, including personal offices, clinics, or hospitals, especially when they are also midwives with on-call responsibilities [37]. They provide consultations for patients who seek them pre-birth, post-birth, and in emergency cases where the mother is facing breastfeeding challenges [22]. Depending on the nature of the consultation, in-person or remote visits are chosen to meet the patient's specific needs.…”

“…Another issue is professional availability itself, as LCs often combine their practice with midwife nursing, splitting their time between prenatal visits, attending births, lactation consultations, and managing their patients, which can lead to professional exhaustion, burnout, and emotional stress [ 21 - 23 ]. Moreover, the predominantly independent practice of LCs outside the United States, without the support of clinics with sophisticated patient management and triage systems, further complicates their time management and patient organization [ 22 , 24 ].…”

“…Complementing tele-lactation services, patient triaging using information systems allow LCs to prioritize in-person visits for severe cases requiring physical assessment, while less critical cases can be handled remotely [ 25 , 26 ]. Prior research suggests that LCs would benefit from time-saving tools for efficient patient information delivery while focusing on mitigating prolonged interactions, helping alleviate the burden on these professionals with a load of patients [ 22 , 27 ]. As LCs often follow up with their patients up to weeks after birth to ensure positive breastfeeding outcomes, an easy-to-access system to monitor patient progress is essential for effective patient triage, facilitating consultation scheduling, holding remote consultations, or providing reassurance.…”

“…LCs, especially those who are also midwives, have limited time availability due to demanding schedules and receiving numerous remote messages from patients daily, some requiring higher priority attention [ 22 , 43 ]. Manually sorting through patient messages to determine priority can be time consuming and inconvenient for mothers with urgent needs.…”