“What Is ‘Enough,’ and How Do I Make It?”: A Qualitative Examination of Questions Mothers Ask on Social Media About Pumping and Providing an Adequate Amount of Milk for Their Infants

Abstract

Background: Mothers commonly cite an inadequate milk ''supply'' as a reason for stopping human milk feeding. Further, pumping may affect mothers' understanding of their milk production. We aimed to characterize the questions mothers ask each other online related to the adequacy of the milk they pumped and provided to their infants. Materials and Methods: We conducted a secondary analysis of 543 posts containing questions related to pumping on an online discussion forum. These posts were provided by an open cohort of *25,000 women between 1 month before due date and 4.5 months postpartum. We used thematic analysis with Atlas.ti to analyze the posts. Results: Mothers commonly asked how many ounces they should be pumping and inquired about strategies to increase their pump output. They also wondered how many ounces or bottles of pumped milk they should provide to their infants or store for future use. Finally, mothers reported the inadequacy of the milk they were pumping or providing to their infants as potential reasons for stopping human milk feeding. Conclusion:Our findings suggest that mothers may benefit from additional guidance from health care providers on the limitations of using pumps to draw conclusions about their milk production, the current evidence related to the use of herbal galactagogues, and the importance of responsive infant feeding. These findings also highlight the need for future research into how pumping or using herbal galactagogues may affect mothers' actual or perceived milk production and how styles for providing pumped milk compare to styles for feeding directly at the breast.

Factors associated with abandoning exclusive breastfeeding in Mexican mothers at two private hospitals

“…In the current study, as in others [ 5 , 32 , 37 – 39 ], the mothers’ perception that they did not produce enough milk was related to the cessation of breastfeeding. Therefore, the cessation of breastfeeding was found to be related to the perceptions of mothers, potentially, it could be addressed with more information that emphasizes the difficulties that can occur at the beginning of breastfeeding [ 25 ].…”

“Am I doing this wrong?” Breastfeeding mothers' use of an online forum

“…More recently, a study conducted using http://Babycenter.com on pumping reported on the types of questions mothers posted to a discussion board. Researchers found that women were unsure of adequate amounts of milk, scheduling feedings, and were concerned about their supply (Yamada, Rasmussen, & Felice, ). These results, along with ours, are indicative of the lack of education around breastfeeding and the need for help to overcome the numerous challenges experienced.…”

“…Another way mothers in our study shared their experience was through providing instructions (i.e., explicit directives, advice to seek medical help). It is important to note that we did not evaluate the accuracy in the advice being given because often women suggested home remedies and herbal galactagogues, and because many have not been rigorously studied, they cannot be commented on one way or the other (Bazzano et al, ; Sim, Hattingh, Sherriff, & Tee, ; Yamada et al, ). Notably (and perhaps another reason women seem to be turning to one another on these issues), there are no existing national guidelines on most of these issues.…”

Speaking in Tongues: What Parents Really Think About Tongue-Tie Surgery for Their Infants

“…These sites were chosen due to their high user frequency and validation from breastfeeding literature. 33-35…”

“…These sites were chosen due to their high user frequency and validation from breastfeeding literature. [33][34][35] We searched every public forum post written between January 1, 2012, and December 31, 2017. Search terms were created by combining primary keywords indicating either diagnoses ("tongue-tie") or treatment ("frenotomy") with pediatric keywords ("infant") to narrow the search.…”