A qualitative study of expectations and experiences of women using a social media support group when exclusively expressing breastmilk to feed their infant

Background: Global recommendations are that mothers exclusively breastfeed their infants for the first six months of life to achieve optimal growth, development, and health outcomes. When infants are unable to feed at the breast, giving expressed breastmilk is the preferred alternative. Mothers who exclusively express breastmilk are poorly supported in mainstream healthcare, and are increasingly using social media groups for assistance. Aim: To understand the expectations and experiences of women who access social media groups when exclusively expressing breastmilk. Methods: A qualitative descriptive approach was used. Participants were recruited online using purposive sampling. The data was collected using semi-structured in-depth interviews with ten women. Audio data were transcribed and subjected to a thematic analysis. Findings: The first theme was expecting and experiencing emotional support; sub-themes include: coping with grief through emotional support and shared experiences; providing emotional support in the absence of in-person social support; providing emotional support through being non-judgemental; and the ability to access emotional support and engagement 24/7. The second theme was receiving information to manage exclusive expressing; sub-themes include: expression schedules and the let-down reflex; managing exclusive expression; and resolving lactation and breast-related issues. Discussion: Ajzen's ‘Theory of Planned Behaviour’ is used to better understand the women's expectations and experiences of belonging to an online peer support group while exclusive expressing. Conclusion: The study highlights the importance of both antenatal and postnatal education and support, the need for reliable information, and the impact of the inability to breastfeed on mothers’ emotional health.