Attitudes toward a novel breastfeeding-mediated drug and nutrient delivery system: A qualitative study

The objective of this study was to determine the attitudes and impressions of breastfeeding mothers and healthcare practitioners towards a device concept integrating breastfeeding with infant drug and nutrient administration. This was an exploratory qualitative study involving 20 breastfeeding mothers and 6 healthcare practitioners from the Suffolk and Middlesex County areas of Massachusetts, USA each individually interviewed. Interview transcription of the semi-structured interviews by an independent service began during data collection, and data coding into major themes continued until and after data saturation was reached. Repeated medication delivery with a reusable product was highlighted as a potential use case for the device concept; ease of use and cleaning as well as cost, familiarity with the method, and infant response were identified as critical considerations. Participants questioned device suitability with liquid formulations (as opposed to non-liquid), while potential advantages over alternative medication delivery technology like oral syringes were identified, including a more "natural" feeling. Most participants had prior knowledge of, or personal experience with, devices like commercially available nipple shields. Attitudes towards the NSDS were not determined by experience with nipple shields, however. The participants' prior exposure to nipple shields is in contrast to related studies in Kenya and South Africa where commercial nipple shields were not widely known and where specific concerns surrounding potential community stigma to an unknown device were raised by participants.