"I Just Want to Do Everything Right:" Primiparous Women's Accounts of Early Breastfeeding via an App-Based Diary.
Jill Demirci, Erin Caplan, Nora Murray and 1 others
PMID 29276003WHAT IT FOUND
First-time mothers described early breastfeeding as pressure to show enough milk and rely on weight checks.
Diary entries showed exhaustion, conflicting support, and family help easing burden before confidence grew.
Key findings
01The overarching theme was seeking sustainability and validation, with subthemes of breaking point, lessening the burden, deference to external authority, blame and absolution, and tentative confidence.
02Women described surprise, uncertainty, frustration, and anxiety about infant satiety, pain with feedings, and frequent cluster feeding, especially during evening and overnight fatigue.
03Mothers' sense of breastfeeding success was tied to self-worth and external weight checks, and external validation carried more weight than their own observations.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was convenience-based and homogeneous: mostly non-Hispanic White, college-educated women from one hospital system who intended to breastfeed exclusively for at least two months. Only 35 of 61 enrolled women logged any diary entry, and diary use declined over the eight weeks, so later experiences were less represented. Participants had healthy singleton infants, owned smartphones, spoke English, and had no conditions expected to harm breastfeeding or milk supply, so findings may not apply to more medically complex or lower-resource postpartum patients. The study was descriptive and did not test an app, diary, or breastfeeding support intervention. The app's development or maintenance funding was not disclosed, although no formula company advertisements were visible to users. Women were encouraged to continue logging during follow-up calls, which may have influenced diary content.
Declared interests
Publication types indicate NIH extramural research support. Authors declared no conflicts of interest. The app developers gave permission for research use; funding for app development or maintenance was not disclosed, but no formula company advertisements were visible to users.
The easy way to misread this
Do not read the eight-week breastfeeding figures as evidence that the app or diary improved breastfeeding. The study did not test an intervention, and only a subset of enrolled women provided diary entries.