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The risk-risk trade-offs: Understanding factors that influence women’s decision to use substances to boost breast milk supply

Galactagogues are foods, herbs or medications thought to support or increase breast milk supply. The use of galactagogues during lactation is becoming increasingly common despite limited evidence regarding effectiveness and safety, and no definitive recommendations for use in clinical practice. The...

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Autores principales: Zizzo, Gabriella, Amir, Lisa H., Moore, Vivienne, Grzeskowiak, Luke E., Rumbold, Alice R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8092651/
https://www.ncbi.nlm.nih.gov/pubmed/33939738
http://dx.doi.org/10.1371/journal.pone.0249599
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author Zizzo, Gabriella
Amir, Lisa H.
Moore, Vivienne
Grzeskowiak, Luke E.
Rumbold, Alice R.
author_facet Zizzo, Gabriella
Amir, Lisa H.
Moore, Vivienne
Grzeskowiak, Luke E.
Rumbold, Alice R.
author_sort Zizzo, Gabriella
collection PubMed
description Galactagogues are foods, herbs or medications thought to support or increase breast milk supply. The use of galactagogues during lactation is becoming increasingly common despite limited evidence regarding effectiveness and safety, and no definitive recommendations for use in clinical practice. The aim of this study is to explore factors influencing women’s decisions to use galactagogues during lactation. Twenty-two semi-structured interviews were conducted in October and November 2019 (over the telephone or in person) with participants located in most Australian states and territories, including metro and regional areas. Interviews were audio-recorded, transcribed verbatim and thematically analysed using NVivo. Analysis revealed that following a concern about breast milk supply, the decision to use galactagogues was influenced by three core and interrelated domains: access to and quality of breastfeeding support, maternal agency and determination to provide breast milk. Women revealed many problematic experiences with health care professionals that left them feeling dismissed and confused due to provision of inconsistent and insufficient information that was sometimes at odds with their desire to provide breast milk. In this instance, some women turned to galactagogues to regain agency. A range of broader dimensions influencing decision-making also emerged. These were separated into categories that emphasise distinctions relating to breast milk supply, which included: maternal emotional wellbeing, social norms and pressures, concerns about infant development, maternal physical health and lactation history, as well as those relating specifically to galactagogue use, including: desire for a guaranteed/urgent response, risk-risk trade-off, acceptance and trust, and accessibility and cost. In understanding the complexity of decision-making concerning these substances, we identify opportunities to improve breastfeeding counselling and support. We recommend that support be individually tailored to manage conflicting information, adopt communication styles that encourage trust and processes that enable shared decision-making to enhance or restore maternal agency. There is also considerable need to address evidence gaps regarding the effectiveness and safety of commonly used galactagogues, so that women can be appropriately counselled about potential benefits and harms.
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spelling pubmed-80926512021-05-07 The risk-risk trade-offs: Understanding factors that influence women’s decision to use substances to boost breast milk supply Zizzo, Gabriella Amir, Lisa H. Moore, Vivienne Grzeskowiak, Luke E. Rumbold, Alice R. PLoS One Research Article Galactagogues are foods, herbs or medications thought to support or increase breast milk supply. The use of galactagogues during lactation is becoming increasingly common despite limited evidence regarding effectiveness and safety, and no definitive recommendations for use in clinical practice. The aim of this study is to explore factors influencing women’s decisions to use galactagogues during lactation. Twenty-two semi-structured interviews were conducted in October and November 2019 (over the telephone or in person) with participants located in most Australian states and territories, including metro and regional areas. Interviews were audio-recorded, transcribed verbatim and thematically analysed using NVivo. Analysis revealed that following a concern about breast milk supply, the decision to use galactagogues was influenced by three core and interrelated domains: access to and quality of breastfeeding support, maternal agency and determination to provide breast milk. Women revealed many problematic experiences with health care professionals that left them feeling dismissed and confused due to provision of inconsistent and insufficient information that was sometimes at odds with their desire to provide breast milk. In this instance, some women turned to galactagogues to regain agency. A range of broader dimensions influencing decision-making also emerged. These were separated into categories that emphasise distinctions relating to breast milk supply, which included: maternal emotional wellbeing, social norms and pressures, concerns about infant development, maternal physical health and lactation history, as well as those relating specifically to galactagogue use, including: desire for a guaranteed/urgent response, risk-risk trade-off, acceptance and trust, and accessibility and cost. In understanding the complexity of decision-making concerning these substances, we identify opportunities to improve breastfeeding counselling and support. We recommend that support be individually tailored to manage conflicting information, adopt communication styles that encourage trust and processes that enable shared decision-making to enhance or restore maternal agency. There is also considerable need to address evidence gaps regarding the effectiveness and safety of commonly used galactagogues, so that women can be appropriately counselled about potential benefits and harms. Public Library of Science 2021-05-03 /pmc/articles/PMC8092651/ /pubmed/33939738 http://dx.doi.org/10.1371/journal.pone.0249599 Text en © 2021 Zizzo et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Zizzo, Gabriella
Amir, Lisa H.
Moore, Vivienne
Grzeskowiak, Luke E.
Rumbold, Alice R.
The risk-risk trade-offs: Understanding factors that influence women’s decision to use substances to boost breast milk supply
title The risk-risk trade-offs: Understanding factors that influence women’s decision to use substances to boost breast milk supply
title_full The risk-risk trade-offs: Understanding factors that influence women’s decision to use substances to boost breast milk supply
title_fullStr The risk-risk trade-offs: Understanding factors that influence women’s decision to use substances to boost breast milk supply
title_full_unstemmed The risk-risk trade-offs: Understanding factors that influence women’s decision to use substances to boost breast milk supply
title_short The risk-risk trade-offs: Understanding factors that influence women’s decision to use substances to boost breast milk supply
title_sort risk-risk trade-offs: understanding factors that influence women’s decision to use substances to boost breast milk supply
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8092651/
https://www.ncbi.nlm.nih.gov/pubmed/33939738
http://dx.doi.org/10.1371/journal.pone.0249599
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