Black Beastfeeding Support through Facebook

There are large racial disparities between women who initiate and continue breastfeeding. The purpose of this study is to help identify African American women's concerns about breastfeeding which are related to perceived low supply and perceived low production. Although studies have been done on breastfeeding initiation and continuation, much of the research is very new and also has yet to specifically address Black women and how they're breastfeeding experiences are supported through social media communities. The proposed research is informed by Rogers and Kincaid's social networking theory (1981). I will conduct a qualitative content analysis of all posts from 2016 through 2018, in the closed Facebook group, Breastfeeding Support Group for Black Moms.I will utilize the search tool to search for key phrases: "low production", "low supply", and "not enough".

There are significant racial and ethnic disparities in the initiation of breastfeeding. In 2016, the Center for Disease Control reported that White women initiate breastfeeding at a rate of 84.3%, and Hispanic women at 83%. In comparison, Black women initiate breastfeeding less often, at 66.3%. Because Black women are less likely to initiate breastfeeding, the risks for infant mortality, SIDS, and other childhood illnesses, are much higher (Center for Disease Control [CDC], 2016).

Despite the many benefits of breastfeeding, African American women continue to choose other modes of infant feeding, whether when their child is born, or after brestfeeding initiation. Two of the primary reasons found for hwy women discontinue breastfeeding or choose not to initiate are the lack of support and insufficient information on it. The research on breastfeeding in the 21st century is very new and steadily merging. However, there has not been research on the role of social media among support groups specifically for Black women.

The theory that will help to guide and inform this study is social networking theory (Rogers and Kincaid, 1981). Social networking theory explains how individuals, organizations, and groups interact and how those interactions influence behaviors and attitudes. I can use this theory to articulate closed groups on social media dedicated to support women who breastfeed, influences breastfeeding continuation.

Although women are motivated and encouraged to breastfeed, they lack support and education on breastfeeding, which leads to early discontinuation of breastfeeding (Keevash, Norman et al.,2018). Researchers concerned with the continuous decrease in breastfeeding rates, assert that the tradition of breastfeeding can be saved through breastfeeding advocates informing women and their families through social media (Jolynn 2012).

A 2018 study conducted an online ethnography using the American Breastfeeding Association Facebook page, to observe the use of closed Facebook groups as a means of women receiving breastfeeding support. When women become mothers, traditionally they find support during their parenting experience from their mothers or other close relatives. The "modern mother", however is utilizing online spaces to seek support from peers who are also online (Bridges,Howell, & Schmeid, 2018).

Given the disparity in breastfeeding initiation, and the relationship this rate has with infant mortality, it is important to focus on Black women specifically to understand how the rates can be improved. During pregnancy, Black women tend to choose an infant feeding method that suits their current support systems, lifestyles, and comfortability (Cricco-Lizza 2004).Positive partner influence and breastfeeding normalization, as well as community support and access to information are necessary for the improvement of African American women's likelihood to initiate breastfeeding (Hinson, Skinner et al., 2018). Furthermore, to normalize breastfeeding, mother- to mother dialogue will be required (Spencer, Wambach et al., 2015).

In 2016, an ethnographic study was conducted to understand the decision making process of African American women to exclusively breastfeed. An antepartum interview took place asking participants whether they would breastfeed or not, and during the postpartum period another interview took place to monitor if the participants followed through with that initial goal. Researchers found African American women's initiation and continuation of breastfeeding to be largely unsuccessful, and suggested including online networking as further research (Asiodu,Waters et al., 2016).

After reviewing the very new and emerging literature, it is clear that there is a need for more research on breastfeeding women and the support they receive that influence their continuation of their breastfeeding experience. It also has been communicated through some of the studies noted above, that research should be done by way of social networking sites

I chose this group due to its specific demographic of Black women members as well as the size of the group and the availability of access. There are a total of 98 groups on facebook dedicated to supporting breastfeeding women and/or their significant others. Of the 98 groups, Breastfeeding Support Group for Black Moms is the third largest group with 56,000 members. The members are all Black or biracial. The group is "closed" and in order to be granted membership you must be invited by someone who is already a member, and then approved based on the criteria that you are a Black woman who breastfeeds or is pregnant, and planning to breastfeed.

The unit of analysis for this qca will be the posts within the group about low milk production or low milk supply. Being that much of the present research on breastfeeding support through social media has been conducted this year, I will utilize all of the posts from the year 2016-2018 in an attempt to find themes within the current posts.

The primary documents of the research will be posts that have been posted on the main timeline of the Facebook page. I will locate the primary documents, the posts using the search tool within the group's page. I will search the following phrases which are related to low breastmilk supply; "low production", "low supply" and "not enough". The search tool will allow me to apply filters and find posts most specific to what I want to find.

In addition to the main timeline of the BMWBSG Facebook page, there is also a section dedicated to additional files related to breastfeeding. Many of these files address the concerns of the women on the page. They also provide links to articles that support the claims or arguments presented in the files. The files are usually either updated rules and regulations of the group or centered around more controversial topics that are likely to cause some contention among members.

All of the files are written or posted by Administration members. Some of these topics include inducing labor, exclusive pumping, or water for infants. All of the topics of course are framed in relation to the effects they may have on a woman's breastfeeding experience. These files will act as the secondary documents. They can assist me in forming the protocol. After reviewing some of the files already it has helped me to analyze the other post.

Furthermore, I am also considering using auxiliary documents to analyze supply concerns. In the group, several photos are posted, many of them which are infographics about breastfeeding. My auxiliary documents will consist of infographics posted as photos in the group that are related to breastmilk supply maintenance. This also will help me to be confident in the fact that there is indeed concern among women about breast milk supply.

Some of the items I want to assess about the primary documents in my protocol include: date the post was created, the number of words in the post, hashtags included in the posts, reactions and number of reactions to the posts, details about the breastfed child included in the posts, is this post asking for advice, sharing an experience, or giving advice. The same protocol will be completed for each posts. The protocol will help me to code the posts, that way research assistants will be able to easily understand the material.

This section is often labeled "Significance of the Study." In formal proposals for graduate study, the Discussion may be placed near the end of the Introduction. The Discussion focuses on the implications of the proposed study, such as how the study's results will affect future research, theory, counseling, policy, etc. Therefore, write this section with the focus on how the study's results will benefit others. Identify any weaknesses to the proposed study and why they were not addressed. Address how well the study will do in terms of internal and external validity, and discuss the implications of the study affecting practice, policy, and scholarly/future research. When the proposal is finished, be sure to include a reference list for all sources used at the end of the proposal.

References

1. Asiodu, I. V., Waters, C. M., Dailey, D. E., & Lyndon, A. (2017). Infant feeding decision-making and the influences of social support persons among first-time african american mothers. Maternal and Child Health Journal, 21(4), 863-872.
2. Bridges, N., Howell, G., & Schmied, V. (2018). Breastfeeding peer support on social networking sites. Breastfeeding Review, 26(2), 17-27.
3. Bridges, N., Howell, G., & Schmied, V. (2018). Exploring breastfeeding support on social media. International Breastfeeding Journal, 13(1), 1-9.
4. Centers for Disease Control and Prevention. (2016). Results: Breastfeeding Rates.
5. Cricco-Lizza, R. (2006). Black non-Hispanic mothers' perceptions about the promotion of infant feeding methods by nurses and physicians. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 35(2), 173–180.
6. Hinson, T. D., Skinner, A. C., Lich, K. H., & Spatz, D. L. (2018). Factors that influence breastfeeding initiation among african american women. Journal of Obstetric, Gynecologic & Neonatal Nursing, 47(3), 290-300.
7. Keevash, J., Norman, A., Forrest, H., & Mortimer, S. (2018). What influences women to stop or continue breastfeeding? A thematic analysis. British Journal of Midwifery, 26(10), 651-658.
8. Spencer, B., Wambach, K., & Domain, E. W. (2015). African american Women's breastfeeding experiences: Cultural, personal, and political voices. Qualitative Health Research, 25(7), 974-987.
9. Wolynn, T. (2012). Using social media to promote and support breastfeeding. Breastfeeding Medicine : The Official Journal of the Academy of Breastfeeding Medicine, 7(5), 364.

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