The faces of breastfeeding support : a netnographic analysis of how breastfeeding mothers find support online

Abstract

Background: Breastfeeding is an important public health issue and is associated with reduced infant mortality and improved health outcomes for children and their mothers. Research indicates that although most women are aware of the importance of breastfeeding, they are often denied the opportunity to meet their breastfeeding goals due to a lack of consistent informational and emotional support. In recent times, there have been substantial changes to the way breastfeeding mothers seek and receive support in their mothering role. Many are finding their mothering community in online spaces, such as social networking sites (SNSs) like Facebook. Aim: The aim of this study was to explore the experiences of women seeking, receiving and giving breastfeeding support online, and the nature of that support. This study had the following objectives: 1) To identify the types of social support engaged in closed Facebook groups attached to the Australian Breastfeeding Association (ABA); 2) To advance understanding of the experiences of mothers using closed Facebook groups attached to the ABA and how these mothers find and share breastfeeding support and information; 3) To investigate the specific breastfeeding topics that women are researching via SNSs such as Facebook, and how breastfeeding peer supporters respond with informational and emotional support to queries about breastfeeding concerns on a SNS. Methods: Employing a netnographic (online ethnographic) research approach, data collection comprised of three steps: 1) Observation of 15 ABA closed Facebook groups for four weeks in mid-2013. 2) Online in-depth interviews (using Facebook “Chat” function) with administrators of three of these ABA closed Facebook groups in late 2013 and early 2014. 3) Online focus groups (utilising Facebook “Events” function) of groups of six to eight active participants from each of these three groups in late 2014. Findings: This study explored the frequency of posts of the two types of support (informational and emotional) and what types of responses these posts elicit. It was found that 36 percent were informational queries and 64 percent were a combination of informational and emotional. When sharing information from the wall posts, 40 percent were informational shares and 60 percent were a combination of informational and emotional. Support providers offered comments that matched the query and featured precision, timeliness, credibility and depth. The results indicate that the types of support-giving comments were significantly associated with the types of support-seeking posts (queries). The findings also indicated that the support from support providers matched the requests from support seekers, providing congruency and also relationality. A thematic analysis of the in-depth interview and focus group data identified the overarching theme was ‘support’, with four sub-themes that describe the nature of online breastfeeding support within the Facebook environment. These sub-themes are: ‘community’, ‘complementary’, ‘immediate’ and ‘information’. It was found that the SNSs provided support from the trusted community. It is immediate, it complements existing support or services that the ABA provide, and also provides practical and valuable information for its users. This study also explored the specific breastfeeding topics that women are investigating via SNSs such as Facebook. Of the 72 queries that were specific breastfeeding questions, 55 (76 percent) were categorised into the three topic areas of ‘breastfeeding management’, ‘breastfeeding and health’, and ‘breastfeeding and work’ which are all themes universally recognised as some of the most common reasons for the cessation of breastfeeding, and important areas for future study. The research also found that these types of SNSs facilitated by trained peer breastfeeding counsellors are more likely to facilitate an authentic presence and facilitative style, both recognised as the most effective components of breastfeeding support. Conclusion: These study findings have significant implications for peer support organisations and health professionals charged with the care of breastfeeding mothers and their families, and policy makers and international agencies with an interest in maternal and child health and nutrition. It is evident that social media has become a significant method of communication and social connection for the current generation of mothers. By designing social media tools and integrating the use of SNSs into the support mechanisms available to breastfeeding mothers, these organisations can provide cost-effective and socially relevant methods of connecting with and supporting breastfeeding mothers – now and into the future. Also, by providing a two-way symmetric dialogue through social media, that does not primarily focus on promoting the ABA and breastfeeding but rather providing support to its stakeholders, the ABA is able to provide an additional form of support that serves several important purposes. This study provides a lesson in opportunities that can be applied to any organisation aimed at providing not only peer support to mothers but peer support in general. Indeed, closed Facebook groups like those engaged by the ABA have led to public relations practice that has become more global, strategic, two-way and interactive, symmetrical or dialogical, and socially responsible.