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Aims: To describe the process of breastfeeding relationships among stay‐at‐home mother and infant dyads at 1, 3, 5 and 6 months. Design: A longitudinal qualitative online survey design was used. Methods: Data were obtained at 1, 3, 5 and 6 months from 26 breastfeeding mothers who stayed home with their infants and directly breastfed at least once a day for the first 6 months between June 2022 and August 2023. Mothers' written responses to 3 open‐ended questions were analysed to assess breastfeeding experiences at home, thoughts/comments while directly breastfeeding and breastfeeding concerns/problems and strategies they used. Based on grounded theory, inductive content analysis was used to analyse the data. Trustworthiness of results was established by coding to consensus, formal peer debriefing and maintaining an audit trail. Results: 'Breastfeeding Relationships at Home,' the core construct, was identified and organized the process of breastfeeding relationships into 5 domains: (1) mothers' emotional well‐being while breastfeeding, (2) infant‐led feeding, (3) alternatives to breastfeeding, (4) evaluation of breastfeeding and (5) changes in breastfeeding as infants grow older. Conclusion: Breastfeeding is not simply about feeding breast milk but also involves nurturing and developing a relationship between mother and infant. Across the domains, mutual responsiveness, a central element of the breastfeeding relationship was clear. Mothers who were committed to breastfeeding with embedded infant suckling reached emotional well‐being in return for their engagement which has potential to reduce maternal stress and prevent postpartum depression. Impact: Findings from the current study add to nurses' knowledge about the relationship building process between stay‐at‐home mothers and their infants in the first 6 months of breastfeeding during the COVID‐19 pandemic. Nurses must remain sensitive to aid the development of breastfeeding relationships in the home environment to maximize mutual responsiveness. Patient or Public Contribution: No patients or public involved. [ABSTRACT FROM AUTHOR]

Objectives: This study examined the relationship among constructs of the Breastfeeding Relationship Scale and exclusive direct breastfeeding (EDBF) while controlling for covariates in US breastfeeding dyads in the first 3 months. Background: The Breastfeeding Relationship Scale was developed to measure mother-infant mutual responsiveness during breastfeeding in response to perceived insufficient milk, but there is no clear understanding about the relationships between the Breastfeeding Relationship Scale's constructs and EDBF. Methods: A cross-sectional design was used. The convenience sample of 589 directly breastfeeding mothers in the US whose infants were between 1 and 12 weeks of age were included for analysis using a structural equation model. Covariates for EDBF included mother's age, education, marital status, parity, prior breastfeeding experience, infant's age, weight, and sex. Results: Mother-Infant Breastfeeding Interaction and Breastfeeding Synchronicity were related (β = 0.33, p <.001), as were Breastfeeding Synchronicity and Perceived Adequate Milk Supply (β = 0.35, p <.001) and Mother-Infant Breastfeeding Interaction and Perceived Adequate Milk Supply (β = 0.08, p =.05). The relationship between Mother-Infant Breastfeeding Interaction and Breastfeeding Synchronicity with EDBF was fully mediated by Perceived Adequate Milk Supply, where the odds of EDBF was higher for mothers with higher scores on Perceived Adequate Milk Supply (OR = 1.61, p <.001) and prior breastfeeding experience (OR = 2.31, p =.006). Conclusions: Perceived Adequate Milk Supply and prior breastfeeding experience are major determinants of EDBF in the first 3 months. Breastfeeding Synchronicity can bolster Mother-Infant Breastfeeding Interaction and promote Perceived Adequate Milk. More attention should be paid to breastfeeding relationship to be the result of EDBF. [ABSTRACT FROM AUTHOR]

Aims: To apply videoconferencing as a new verification method prior to enrollment for an online survey‐based study. Design: A prospective‐observational, mixed methods, three group, repeated measures study involved recruiting a population‐based sample of breastfeeding mothers and infants (N = 81). Twenty‐seven mothers were recruited for each group: mothers returning to work outside of the home, mothers returning to work from home and mothers staying home with their infants full‐time. Methods: Data were collected at four time points, infant age 4, 12, 20 and 24 weeks, via online survey. Participating mothers received a $10 gift card for completing each survey. Social media, word of mouth and brochures promoted United States‐based recruitment nationwide. A publicly available direct link to the survey was initially provided to interested mothers. After the suspicion of online fraud, videoconferencing was instituted for self‐referrals and phone calls for professional referrals. Results: The survey was invaded by response fraud 3 weeks after the initial survey deployment. Out of 109 respondents who visited the survey site during that timeframe, only eight mothers (10%) were eligible (22 June 2022 to 14 July 2022). After recruitment modification, 313 individuals emailed the study team with 65 self‐referred mothers (80%) enrolled in the study via videoconferencing while eight mothers (10%) had a professional referral and enrolled via phone call (23 August 2022 to 30 March 2023). Conclusion: Providing a direct survey link, even with CAPTCHA‐protection, evoked fraudulent responses. Videoconferencing is an emerging verification method that can be readily applied to the enrollment of breastfeeding dyads for an online study. Impact: The emergence of fraudulent respondents and internet bots threatens data quality. This study addressed the strategy of videoconferencing as a new verification method for recruitment and enrollment of breastfeeding dyads. This knowledge can be applied by researchers to secure sample validity and data integrity. [ABSTRACT FROM AUTHOR]

Background and Purpose : The Breastfeeding Relationship Scale (BFRS) was developed to measure mother–infant mutual responsiveness during breastfeeding. The purpose of this study was to develop and test the psychometric properties of the BFRS. Methods : Construct validity of a 16-item three-factor model (Mother–Infant Breastfeeding Interaction, Perceived Adequate Milk Supply, and Breastfeeding Synchronicity) was assessed using confirmatory factor analysis (CFA) and reliability (Cronbach's alpha) across two independent samples. Results : CFA of the hypothesized three-factor model demonstrated good fit in both samples (comparative fit index >.90, root mean square error of approximation <.06, square root mean residual <.061). Cronbach's alpha for the constructs ranged between.73 and.83. Conclusion : The BFRS is a valid measure of breastfeeding relations between mother and infant. Reliability was acceptable for all constructs in both samples. [ABSTRACT FROM AUTHOR]

Perceived insufficient milk (PIM) is the primary reason for breastfeeding discontinuation globally. This study evaluated the short-term impact of mother–infant interactions through home interventions designed to overcome PIM as a result of the infant’s behavior, delivered to 14 dyads of breastfeeding mothers and their full-term singleton infants. A single group, three-occasion prepost design was used. Mother–infant interactions were measured by the Nursing Child Assessment Feeding Scale (NCAFS) at 6, 13, and 27 days postpartum. There were significantly increased mother–infant interactions during intervention. Specifically, significant growth over the intervention occurred for mother’s sensitivity to cues, cognitive growth fostering, infant’s clarity of cues, and responsiveness to caregiver. The NCAFS total score was also significantly improved. Although modifications are required, the three home intervention sessions showed promise in improving mother–infant interactions during breastfeeding. Further investigation using a randomized experimental design is warranted. [ABSTRACT FROM AUTHOR]