{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T18:46:39Z","timestamp":1783709199291,"version":"3.55.0"},"reference-count":39,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T00:00:00Z","timestamp":1738800000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100012400","name":"Sigma Theta Tau International","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012400","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Advanced Nursing"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Many frontline essential working mothers returned to work outside of the home after maternity leave during the COVID\u201019 pandemic. The purpose of this study is to describe the changes in breastfeeding relationships.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A longitudinal descriptive qualitative design was used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Four open\u2010ended questions were asked to explore breastfeeding experiences at home, mothers' thoughts and feelings during direct breastfeeding, strategies to solve their breastfeeding problems, and workplace breastfeeding support. Data were collected by an online survey at 1, 3, 5 and 6\u2009months between June 2022 and August 2023. Data were analysed using inductive content analysis from 21 mothers in the United States who were directly breastfeeding at least once a day for the first 6\u2009months. The trustworthiness of study results involved coding by consensus, peer debriefing, and maintenance of an audit trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The core construct, \u201cChanges in Breastfeeding Relationships When Frontline Essential Working Mothers Return to Work Outside of the Home\u201d explained mothers' experience in four domains: (1) Breastfeeding changes, (2) Changes in sleep arrangements, (3) Social support to continue breastfeeding, and (4) Physical and emotional distress of mothers and infants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Unrestricted direct breastfeeding upon reunion through the night along with co\u2010sleeping was the strategy mothers used to restore breastfeeding relationships with their infants and continue direct breastfeeding. Scheduled feeding and solitary sleep resulted in less direct breastfeeding, had negative consequences such as low milk supply, slow infant weight gain, and maternal distress.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>Even though frontline essential working mothers persevered with the complexities of their work during the COVID\u201019 pandemic, findings highlight challenges mothers faced with their breastfeeding experience. Nurses need to discuss with mothers expected challenges of less frequent direct breastfeeding along with emotional tolls while being separated from their infant and strategies to develop sustainable breastfeeding relationships and continuation of direct breastfeeding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contributions<\/jats:title>\n                    <jats:p>None.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jan.16793","type":"journal-article","created":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T03:35:27Z","timestamp":1738812927000},"page":"6709-6721","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Changes in Breastfeeding Relationships When Frontline Essential Working Mothers Return to Work During the\n                    <scp>COVID<\/scp>\n                    \u201019 Pandemic: A Longitudinal Qualitative Online Study"],"prefix":"10.1111","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7689-4774","authenticated-orcid":false,"given":"Natsuko K.","family":"Wood","sequence":"first","affiliation":[{"name":"Washington State University College of Nursing  Spokane Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen R.","family":"Helfrich\u2010Miller","sequence":"additional","affiliation":[{"name":"Rehabilitation Specialists, Inc.  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,6]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884\u2010021\u201004304\u20104"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2022.1081028"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.13088"},{"key":"e_1_2_15_5_1","unstructured":"Centers for Disease Control and Prevention (CDC).2022.\u201c2022 Breastfeeding Report Card.\u201dhttps:\/\/www.cdc.gov\/breastfeeding\/data\/reportcard.htm."},{"key":"e_1_2_15_6_1","unstructured":"Centers for Disease Control and Prevention (CDC).2023.\u201cEnd of the Federal COVID\u201019 Public Health Emergency (PHE) Declaration.\u201dhttps:\/\/archive.cdc.gov\/www_cdc_gov\/coronavirus\/2019\u2010ncov\/your\u2010health\/end\u2010of\u2010phe.html#:~:text=The%20federal%20COVID%2D19%20PHE ended%20on%20May%2011%2C%202023."},{"key":"e_1_2_15_7_1","unstructured":"Centers for Disease Control and Prevention (CDC).2024a.\u201cCOVID\u201019 and Breastfeeding.\u201dhttps:\/\/www.cdc.gov\/breastfeeding\u2010special\u2010circumstances\/hcp\/illnesses\u2010conditions\/covid\u201019.html."},{"key":"e_1_2_15_8_1","unstructured":"Centers for Disease Control and Prevention (CDC).2024b.\u201c5 Tips for Returning to Work and Breastfeeding.\u201dhttps:\/\/www.cdc.gov\/breastfeeding\/features\/returning\u2010to\u2010work\u2010and\u2010breastfeeding.html."},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/jmwh.13243"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12872"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102648.2007.04569.x"},{"key":"e_1_2_15_12_1","volume-title":"The Discovery of Grounded Theory: Strategies for Qualitative Research","author":"Glaser B. 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