Authors :
Presenting Author: Abrar O. Al-faraj, MD – Boston University School of Medicine/Chobanian & Avedisian School of Medicine
Daliya Saadoon, NA – Boston University Chobanian & Avedisian School of Medicine
Trudy D. Pang, MD – Beth Israel Deaconess Medical Center/Harvard Medical School
Rationale:
To explore patients’ perceptions and experiences, as well as the facilitators and barriers to breastfeeding (BF) in women with epilepsy (WWE)Methods:
This exploratory qualitative study aims to recruit 10 WWE (assumed saturation point), aged 18 to 45, who are currently pregnant or were pregnant in the last 5 years. Exclusion criteria included women who developed epilepsy postpartum and those with cognitive difficulties that would limit interview participation. Participants were recruited from the Epilepsy Clinic at Boston Medical Center. Our study framework is informed by the theory of planned behavior. [1,2] A semi-structured interview guide was developed to explore the following areas: 1) general perception about BF, 2) BF safety while taking ASM, 3) facilitators to BF, 4) barriers to BF. Interviews were conducted via Zoom with verbatim transcription. Data were analyzed using thematic analyses using the following steps:1) review of both video and interview transcripts for accuracy and data de-identification, 2) data organization and familiarization, 3) inductive open coding followed by paragraph-by-paragraph coding, 4) generation of common themes using aggregate codes.Results:
Three participants have completed interviews and the data analyzed thus far have generated the following codes: BF benefits, BF as a social norm, doing what is best, concerns about negative ASM effects in the baby, sleep deprivation, postpartum challenges, BF in WWE guidance, and resources and support systems. From these, seven common themes were identified and grouped into the following three categories:
- Perceptions and attitudes toward BF among WWE:
- Breast milk provides the best nutrition for the baby and has psychological benefits
- BF is a social norm
- Concern about potential negative effects of ASM exposure on the baby
- Navigating postpartum period, BF, and epilepsy is challenging
- Lack of protocols to navigate BF and sleep deprivation
- Lack of adequate education about ASM safety
- - Successful BF requires strong medical and social support systems
Conclusions:
To our knowledge, this is the first patient-centered qualitative study to explore patients’ perspectives on breastfeeding, including potential facilitators and barriers, among WWE. Gaining a better understanding of these perspectives and needs may help clinicians in providing more effective counseling and support for BF in WWE.
Funding: Grinspoon Grant