An exploration of breastfeeding, infant nutrition and development: A qualitative blog analysis
2. Research Question
What are the common concerns mothers who blog with regards to infant nutrition and development?
According to the World Health Organization (WHO) (2018), mothers should breastfeed exclusively for the first six months of a child’s life. Within this period a child receives energy and nutrients that promote cognitive development (WHO, 2018). In the United Kingdom, breastfeeding rates are significantly lower than the rest of the world, reasons being that there is a lack of support for new mothers, a need to establish a routine for their child and stigma between breastfeeding and using infant formula. A survey conducted by Public Health England (PHE) (2017) revealed that mothers’ breastfeeding after two months had decreased by 40 percent, but it also revealed the common barriers most new mothers were facing (PHE, 2017). There are numerous long-running campaigns that use the slogan “breast is best” and how it has health benefits for a new born baby (British Pregnancy Advisory Service (BPAS), 2015). Nonetheless, a mother’s decision to breastfeed is highly personal and she should receive support and guidance on the choices she makes and the alternatives that are available (Crisp, 2014). It is suggested that breast milk contains bioactive agents that can aid digestion and boost the immune system and can particularly protect against obesity and diabetes (Martin, Ling and Blackburn, 2016).
4. A Review of the Literature / Context
Published research over the last ten-fifteen years examine breastfeeding, infant formula and how they can contribute to child development. Themes have emerged from published articles that highlight the debate of breastfeeding vs formula, the benefits and barriers to both of those and how they can affect development.
Theme 1: Breastfeeding
Human breast milk contains fats, proteins, vitamins and mineral that are essential for infants, and it is also abundant in antibodies as this allows new born babies to develop an immunity to gastrointestinal infections (Martin, Ling and Blackburn, 2016). In an article by Hunt and Thomson (2016), many developed countries including the UK do not meet the global recommendations for breastfeeding, even though there were interventions in place to promote peer support for women (Hunt and Thomson, 2016). Results from semi-structured interviews conducted by Jardine, McLellan and Dombrowski (2017), revealed nineteen woman that had participated and that six women had maintained breastfeeding between the antenatal and postnatal interviews, from the four women that had stopped, three had begun giving formula and 1 woman had commenced with mixed feeding. Other women in the study had experienced difficulties and discomfort and some were advised to attempt mixed feeding and then progressing to infant formula almost instantly (Jardine, McLellan and Dombrowski 2017). Their findings suggested that mothers who has discontinued with breastfeeding initially had the intent to breastfeed prior to giving birth, however, they had experienced difficulties. Furthermore, their study adds that many women do have challenges with regards to breastfeeding, but individual support systems should be in place to support all women (Jardine, McLellan and Dombrowski 2017).
Theme 2: Infant formula
For many new mothers in the UK, receiving adequate hours of sleep is essential to achieve some normalcy in their lives. There is debate about how often a baby should feed within a day, so most women decide to use infant formula to assess the quantity of their baby’s feed. They also argue that women who breastfeed are likely to have an infant demanding more feeds during the night, thus, increasing their tiredness. Women also face the reality of having to introduce formula much earlier by family members, which contradict the recommendations by WHO (Rudzik and Ball, 2015). New guidelines for women who choose to use infant formula has been published by the Royal College of Nursing, cited on the Nursing Times (Nursing Times, 2016), stating that professionals should provide support to mothers on the decisions they make with regards to using infant formula. Trained professionals should be trained with the skills and knowledge of the use of infant formula, including different formulas that can be used by mothers (Nursing Times, 2016).
5. Aims and objectives
To explore the common concerns of mothers breastfeeding, regarding infant nutrition and development.
My objectives are to:
– To gain an insight into breastfeeding and the use of infant formula.
– To understand the stigma mothers face when deciding to breastfeed or use infant formula.
– To analyse the health benefits of breastfeeding and/or using infant formula for child development.
6. Ethical Considerations
Research such as this one that will be conducted pose a number of challenges when using the Internet, as privacy of an individual and confidentiality are not as they clear as they normally would be. Whereas, in an interview for example, subjects would be made aware of the research being carried out, their rights to participate or withdraw, and on some occasions they may sign a disclaimer form should they decide to withdraw at any moment (Bell, 2010, pp.45-46). With concerns to blog analysis, the extent of contacting all of the bloggers on various websites would be difficult and time consuming. Furthermore, there would be great difficulty in acquiring contact information as they are not generally available. The text from the blogs can be seen as public, because indirect consent has been given by the owners of the blogs. When research being conducted progresses, there is the likelihood of stepping outside the bounds of information being collected. So, a general standard of ethics is to be observed, whereby “permissions obtained, confidentiality maintained, identities protected” (Denscombe, 2007, pp.128-9).
Within this study, the aims and objectives of this research project will be explained to blog administrators, briefly followed by a description of how their information will be used and interpreted. Moreover, there will be an explanation of anonymity and confidentiality. Also, as detailed and personal experiences of individuals will be used, names, addresses and other personal information will be kept anonymous and not be used within the study. Lastly, bloggers will be contacted if their detailed accounts were to be used within the project.
A phenomenological qualitative approach will be used within the study to explore the understanding and experiences of various individuals. Phenomenology is concerned with the experiences and interpretations of individuals in the world and how other people view them. Due to the nature of qualitative methodology, it is often referred to as ‘unspecific’ and ‘difficult to replicate’, however, those views are now beginning to diminish (Pope and Mays, 2006, p.1). Furthermore, as qualitative research is concerned with understanding how people attach meanings of the social world – it can also be referred to as interpretative research (Pope and Mays, 2006, p.3).
· Study design
This research project will primarily focus on personal experiences from mothers who breastfeed, either short term or long term and if they seek alternatives, but also if breastfeeding or infant formula has an impact on child development. Key phrases such as “breastfeeding and infant nutrition UK”, “blogs on breastfeeding vs. infant formula” and “breastfeeding, nutrition and development” will be inputted into Google. The data from the blogs will be read thoroughly, so that the criteria mentioned previously are met. Furthermore, blog entries will be organised based upon how recent and relevant they are, but if they contain a detailed and generic overview of the subject matter. Although the key focus would be to identify blog entries from the last 10 years, it is crucial to note how infant feeding has transformed in the last 50 years. There is a greater awareness of the benefits of infant nutrition and how this may affect development, so blog entries that are exclusively concerned with this will be analysed in more depth. As themes will begin to develop from the data, they will be categorised and then catalogued on Microsoft Word where they are converted into text format.
As mentioned previously, blogs published in the UK will be used, because the UK has one the lowest rates of breastfeeding globally. Also, blogs that highlight two or more key aspects of the research topic will be used as this allows for connections to be made. Lastly blogs that are easily accessible and do not require a login and password will be selected, as this reduces the time to analyse any data significantly.
Blog entries that contain written accounts by other people will not be selected, this is due to information being changed.
– Recruitment of Subjects/ Participants
Once ethical approval has been authorised by my supervisor the recruitment process can begin. On Google search engine queries such as “breastfeeding vs infant formula”, “infant feeding and development” will be used to identify the blogs. 8 – 10 results may appear on Google, but 2 or 3 blogs may outline themes that were mentioned in the literature review. The selection will be specific as it is essential to meet the aim and objectives mentioned previously, but only suitable blogs will be accessed and included. Lastly, with qualitative methodology a large sample size will not be necessary, so a minimum of 4 blogs will be used.
8. Anticipated Research Outcomes
By the end of the research project the outcomes are to gain a deeper understanding of the perceptions that mothers have with regards to breastfeeding and/or the use of infant formula. Also, to analyse the health benefits of breastfeeding and/or infant formula on how they impact on child development. Lastly, the possibility of the research project being published.
A rigorous literature review will be carried out, this is because all proposals gather information from previous literature and this allows for gaps in the subject to be identified. Another strength is that blogs contain detailed accounts of experiences and emotions of bloggers, so blog analysis can be used as a qualitative methodology.
As a junior researcher, there is the likelihood of errors occurring.