{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:44:37Z","timestamp":1792788277756,"version":"4.5.0"},"reference-count":52,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,2,19]],"date-time":"2024-02-19T00:00:00Z","timestamp":1708300800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,2,19]],"date-time":"2024-02-19T00:00:00Z","timestamp":1708300800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"DkIT Summer Undergraduate Research Programme"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int Breastfeed J"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite concerted efforts by policy developers, health professionals and lay groups, breastfeeding rates in Ireland remain one of the lowest in world, with 63.6% of mothers initiating breastfeeding at birth, dropping to 37.6% of mothers breastfeeding exclusively on hospital discharge. Nipple trauma and difficulties with baby latching are major contributors to the introduction of formula and discontinuation of breastfeeding. Research shows laid-back breastfeeding (LBBF) significantly reduces breast problems such as sore and cracked nipples, engorgement, and mastitis as well as facilitating a better latch. Although the benefits of LBBF are well documented, this position does not seem to be routinely suggested to mothers as an option when establishing breastfeeding. This study aims to determine midwives\u2019 and student midwives\u2019 knowledge, attitudes, and practices of using laid-back breastfeeding in Ireland.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>A cross-sectional descriptive survey distributed to midwives and student midwives in three maternity hospitals in Ireland and two online midwifery groups based in the Republic of Ireland, during June, July, and August 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Two hundred and fifty-three valid responses were received from nine maternity units. Most participants (81.4%) were aware of laid-back breastfeeding. However, only 6.8% of respondents cited it as the position they most frequently use. Over one-third (38.34%) had never used this position with mothers. Those more likely to suggest LBBF had personal experience of it, were lactation consultants or working towards qualification, or had participated in specific education about LBBF. Barriers included lack of education, confidence, time, and experience. Further issues related to work culture, a tendency to continue using more familiar positions and concerns about mothers\u2019 anatomy and mothers\u2019 unfamiliarity with LBBF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although there was a high level of awareness of laid-back breastfeeding among midwives and student midwives, there are challenges preventing its use in practice. Education specifically related to using LBBF in practice is required to overcome the barriers identified. A greater understanding of mothers\u2019 and babies\u2019 intrinsic feeding capacities may give midwives more confidence to recommend this method as a first choice, potentially leading to more successful breastfeeding establishment and maintenance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13006-024-00619-y","type":"journal-article","created":{"date-parts":[[2024,2,19]],"date-time":"2024-02-19T11:03:18Z","timestamp":1708340598000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Laid-back breastfeeding: knowledge, attitudes and practices of midwives and student midwives in Ireland"],"prefix":"10.1186","volume":"19","author":[{"given":"Margaret","family":"McGuigan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Larkin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,19]]},"reference":[{"key":"619_CR1","unstructured":"National Women and Infants Health Programme. Irish Maternity Indicator System: National Report 2022; 2023."},{"issue":"11","key":"619_CR2","doi-asserted-by":"publisher","first-page":"762","DOI":"10.12968\/bjom.2020.28.11.762","volume":"28","author":"D McGuinness","year":"2020","unstructured":"McGuinness D, Paul G, Murtagh R, O\u2019Hagan L. A service evaluation of a hospital-based specialist postnatal breastfeeding clinic. Br J Midwifery. 2020;28(11):762\u20137.","journal-title":"Br J Midwifery"},{"key":"619_CR3","volume-title":"Breastfeeding Uncovered","author":"A Brown","year":"2021","unstructured":"Brown A. Breastfeeding Uncovered. 2nd ed. London: Pinter & Martin Ltd.; 2021.","edition":"2"},{"key":"619_CR4","doi-asserted-by":"publisher","first-page":"10","DOI":"10.3390\/ijerph121012247","volume":"12","author":"JC Kent","year":"2015","unstructured":"Kent JC, Ashton E, Hardwick CM, Rowan MK, Chia ES, Fairclough KA, et al. Nipple pain in breastfeeding mothers: Incidence, causes and treatments. Int J Environ Res Public Health. 2015;12:10.","journal-title":"Int J Environ Res Public Health"},{"key":"619_CR5","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1016\/j.midw.2013.01.008","volume":"30","author":"P Leahy-Warren","year":"2014","unstructured":"Leahy-Warren P, Mulcahy H, Phelan A, Corcoran P. Factors influencing initiation and duration of breast feeding in Ireland. Midwifery. 2014;30:345\u201352.","journal-title":"Midwifery"},{"issue":"7","key":"619_CR6","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1016\/j.earlhumdev.2007.12.003","volume":"84","author":"SD Colson","year":"2008","unstructured":"Colson SD, Meek JH, Hawdon JM. Optimal positions for the release of primitive neonatal reflexes stimulating breastfeeding. Early Hum Dev. 2008;84(7):441\u20139.","journal-title":"Early Hum Dev"},{"key":"619_CR7","volume-title":"Biological Nurturing: Instinctual Breastfeeding","author":"S Colson","year":"2019","unstructured":"Colson S. Biological Nurturing: Instinctual Breastfeeding. 2nd ed. London: Pinter & Martin Ltd.; 2019.","edition":"2"},{"key":"619_CR8","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1186\/s13006-020-00261-4","volume":"15","author":"M Milinco","year":"2020","unstructured":"Milinco M, Travan L, Cattaneo A, Knowles A, Sola MV, Causin E, et al. Effectiveness of biological nurturing on early breastfeeding problems: A randomized controlled trial. Int Breastfeed J. 2020;15:21.","journal-title":"Int Breastfeed J"},{"key":"619_CR9","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1186\/s12884-021-03714-8","volume":"21","author":"Z Wang","year":"2021","unstructured":"Wang Z, Liu Q, Min L, Mao X. The effectiveness of the laid-back position on lactation-related nipple problems and comfort: a meta-analysis. BMC Pregnancy Childbirth. 2021;21:248.","journal-title":"BMC Pregnancy Childbirth"},{"key":"619_CR10","volume-title":"The Womanly Art of Breastfeeding","author":"D Wiessinger","year":"2010","unstructured":"Wiessinger D, West D, Pitman T. The Womanly Art of Breastfeeding. 8th ed. New York: La Leche League International; 2010.","edition":"8"},{"key":"619_CR11","volume-title":"Guidelines for OLCHC Staff Caring for Mothers Breastfeeding their Sick Infants in Our Lady\u2019s Children\u2019s Hospital Crumlin","author":"E Harris","year":"2018","unstructured":"Harris E. Guidelines for OLCHC Staff Caring for Mothers Breastfeeding their Sick Infants in Our Lady\u2019s Children\u2019s Hospital Crumlin. 2018."},{"key":"619_CR12","unstructured":"The Breastfeeding Committee for Canada. BFI 20-Hour Course\u202f: Clinical Practice Options. Toronto, Ontario; 2018."},{"key":"619_CR13","volume-title":"Breastfeeding Answers; A Guide for Helping Families","author":"N Mohrbacher","year":"2020","unstructured":"Mohrbacher N. Breastfeeding Answers; A Guide for Helping Families. 2nd ed. Arlington Heights, IL: Nancy Mohrbacher Solutions, Inc.; 2020.","edition":"2"},{"key":"619_CR14","volume-title":"Breastfeeding Answers Made Simple; A Guide for Helping Mothers","author":"N Mohrbacher","year":"2010","unstructured":"Mohrbacher N. Breastfeeding Answers Made Simple; A Guide for Helping Mothers. Amarillo, TX: Hale Publishing, L.P; 2010."},{"key":"619_CR15","unstructured":"Colson S. Biological Nurturing: The laid-back breastfeeding revolution. Midwifery Today. 2012; Spring:9\u201312."},{"key":"619_CR16","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1891\/215805310807011882","volume":"1","author":"S Colson","year":"2010","unstructured":"Colson S. What happens to breastfeeding when mothers lie back? Clin Lact. 2010;1:9\u201312.","journal-title":"Clin Lact"},{"issue":"2","key":"619_CR17","first-page":"7","volume":"25","author":"J Batacan","year":"2010","unstructured":"Batacan J. A new approach: Biological nurturing and laid-back breastfeeding. Int J Childbirth Educ. 2010;25(2):7\u20139.","journal-title":"Int J Childbirth Educ"},{"key":"619_CR18","unstructured":"Marmet C, Shell E. Therapeutic positioning for breastfeeding. In: Supporting Sucking Skills in Breastfeeding Infants. 3rd ed. Burlington, MA: Jones & Bartlett Learning; 2017. p. 399\u2013416."},{"key":"619_CR19","unstructured":"Okuyucu K. Musculoskeletal disorders in midwives: prevalance, impact and contributory factors [doctoral thesis]. Loughborough University. Loughborough University; 2019."},{"key":"619_CR20","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1016\/j.midw.2012.02.003","volume":"29","author":"MH Long","year":"2013","unstructured":"Long MH, Johnston V, Bogossian FE. Helping women but hurting ourselves? Neck and upper back musculoskeletal symptoms in a cohort of Australian Midwives. Midwifery. 2013;29:359\u201367.","journal-title":"Midwifery"},{"issue":"3","key":"619_CR21","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1177\/0890334411413097","volume":"27","author":"RC Tarrant","year":"2011","unstructured":"Tarrant RC, Younger KM, Sheridan-Pereira M, Kearney JM. Factors associated with duration of breastfeeding in Ireland: Potential areas for improvement. J Hum Lact. 2011;27(3):262\u201371.","journal-title":"J Hum Lact"},{"key":"619_CR22","doi-asserted-by":"crossref","unstructured":"Murphy R, Foley C, Verling AM, O\u2019Carroll T, Flynn R, Rohde D. Women\u2019s experiences of initiating feeding shortly after birth in Ireland: a secondary analysis of quantitative and qualitative data from the National Maternity Experience Survey. Midwifery. 2022;107.","DOI":"10.1016\/j.midw.2022.103263"},{"key":"619_CR23","doi-asserted-by":"publisher","first-page":"1097","DOI":"10.1111\/j.1365-2702.2011.03975.x","volume":"21","author":"H Mulcahy","year":"2011","unstructured":"Mulcahy H, Phelan A, Corcoran P, Leahy-Warren P. Examining the breastfeeding support resources of the public health nursing services in Ireland. J Clin Nurs. 2011;21:1097\u2013108.","journal-title":"J Clin Nurs"},{"key":"619_CR24","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.midw.2019.08.001","volume":"78","author":"E McCarthy Quinn","year":"2019","unstructured":"McCarthy Quinn E, Gallagher L, de Vries J. A qualitative exploration of breastfeeding support groups in Ireland from the women\u2019s perspectives. Midwifery. 2019;78:71\u20137.","journal-title":"Midwifery"},{"key":"619_CR25","volume-title":"Practice Standards for Midwives","author":"Nursing and Midwifery Board of Ireland","year":"2022","unstructured":"Nursing and Midwifery Board of Ireland. Practice Standards for Midwives. Ireland: Dublin; 2022."},{"key":"619_CR26","volume-title":"The National Maternity Strategy 2016\u20132026","author":"Department of Health","year":"2016","unstructured":"Department of Health. The National Maternity Strategy 2016\u20132026. 2016."},{"key":"619_CR27","unstructured":"Health Service Executive. Breastfeeding in a Healthy Ireland. Health Service Breastfeeding Action Plan 2016\u20132021. 2016."},{"key":"619_CR28","unstructured":"IBM Corporation IBM. IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY; 2019."},{"key":"619_CR29","volume-title":"SPSS Survival Manual","author":"J Pallant","year":"2007","unstructured":"Pallant J. SPSS Survival Manual. 3rd ed. Berkshire, UK: McGraw-Hill; 2007.","edition":"3"},{"key":"619_CR30","doi-asserted-by":"crossref","unstructured":"Spencer RL, Stephenson J, Thomas C. \u201cOne of those things the student is left to do \u201d. Student midwives\u2019 experience of infant feeding education. A phenomenological study. Nurse Educ Pract. 2022;63.","DOI":"10.1016\/j.nepr.2022.103416"},{"key":"619_CR31","volume-title":"Myles Textbook for Midwives","author":"JE Marshall","year":"2020","unstructured":"Marshall JE, Raynor MD. Myles Textbook for Midwives. 17th ed. London: Elsevier Ltd.; 2020.","edition":"17"},{"key":"619_CR32","volume-title":"Successful Breastfeeding","author":"Royal College of Midwives","year":"1991","unstructured":"Royal College of Midwives. Successful Breastfeeding. 2nd ed. London: Churchill Livingstone; 1991.","edition":"2"},{"key":"619_CR33","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1016\/j.wombi.2016.01.002","volume":"29","author":"R Thompson","year":"2016","unstructured":"Thompson R, Kruske S, Barclay L, Linden K, Gao Y, Kildea S. Potential predictors of nipple trauma from an in-home breastfeeding programme: a cross-sectional study. Women Birth. 2016;29:336\u201344.","journal-title":"Women Birth"},{"issue":"11","key":"619_CR34","doi-asserted-by":"publisher","first-page":"724","DOI":"10.12968\/bjom.2018.26.11.724","volume":"26","author":"RL Spencer","year":"2018","unstructured":"Spencer RL, Fraser DM. \u201cYou\u2019re kinda passing a test\u201d: a phenomenological study of women\u2019s experiences of breastfeeding. Br J Midwifery. 2018;26(11):724\u201330.","journal-title":"Br J Midwifery"},{"key":"619_CR35","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/s13006-023-00551-7","volume":"18","author":"A Chambers","year":"2023","unstructured":"Chambers A, Emmott EH, Myers S, Page AE. Emotional and informational social support from health visitors and breastfeeding outcomes in the UK. Int Breastfeed J. 2023;18:14.","journal-title":"Int Breastfeed J"},{"issue":"10","key":"619_CR36","doi-asserted-by":"publisher","first-page":"2266","DOI":"10.3390\/nu11102266","volume":"11","author":"ML Gianni","year":"2019","unstructured":"Gianni ML, Bettinelli ME, Manfra P, Sorrentino G, Bezze E, Plevani L, et al. Breastfeeding difficulties and risk for early breastfeeding cessation. Nutrients. 2019;11(10):2266.","journal-title":"Nutrients"},{"issue":"6","key":"619_CR37","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1097\/NMC.0000000000000566","volume":"44","author":"AH Morrison","year":"2019","unstructured":"Morrison AH, Gentry R, Anderson J. Mothers reasons for early breastfeeding cessation. Am J Matern Nurs. 2019;44(6):325\u201330.","journal-title":"Am J Matern Nurs"},{"key":"619_CR38","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1002\/cad.20168","volume":"153","author":"P Kim","year":"2016","unstructured":"Kim P. Human maternal brain plasticity: adaptation to parenting. New Dir Child Adolesc Dev. 2016;153:47\u201358.","journal-title":"New Dir Child Adolesc Dev"},{"issue":"1","key":"619_CR39","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1891\/RTNP-2022-0073","volume":"37","author":"AM Nelson","year":"2023","unstructured":"Nelson AM. A quasi-realist synthesis investigating professional breastfeeding support failure. Res Theory Nurs Pract. 2023;37(1):59\u201379.","journal-title":"Res Theory Nurs Pract"},{"key":"619_CR40","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.midw.2019.04.004","volume":"75","author":"AM Taylor","year":"2019","unstructured":"Taylor AM, Van TE, Ryan KM, Alexander J. 'Scrutinised, judged and sabotaged\u2019: a qualitative video diary study of first-time breastfeeding mothers. Midwifery. 2019;75:16\u201323.","journal-title":"Midwifery"},{"key":"619_CR41","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1111\/mcn.12148","volume":"11","author":"G Thomson","year":"2015","unstructured":"Thomson G, Ebisch-burton K, Flacking R. Shame if you do \u2013 shame if you don\u2019t: women\u2019s experiences of infant feeding. Matern Child Nutr. 2015;11:33\u201346.","journal-title":"Matern Child Nutr"},{"key":"619_CR42","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1111\/j.1523-536X.2011.00509.x","volume":"39","author":"M Redshaw","year":"2012","unstructured":"Redshaw M, Henderson J. Learning the hard way: expectations and experiences of infant feeding support. Birth. 2012;39:21\u20139.","journal-title":"Birth"},{"key":"619_CR43","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1186\/1746-4358-5-20","volume":"5","author":"CA B\u00e4ckstr\u00f6m","year":"2010","unstructured":"B\u00e4ckstr\u00f6m CA, HertfeltWahn EI, Ekstr\u00f6m AC. Two sides of breastfeeding support: experiences of women and midwives. Int Breastfeed J. 2010;5:20.","journal-title":"Int Breastfeed J"},{"key":"619_CR44","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1746-4358-8-1","volume":"8","author":"KE Svensson","year":"2013","unstructured":"Svensson KE, Velandia MI, Matthiesen AST, Welles-Nystr\u00f6m BL, Widstr\u00f6m AME. Effects of mother-infant skin-to-skin contact on severe latch-on problems in older infants: a randomized trial. Int Breastfeed J. 2013;8:1.","journal-title":"Int Breastfeed J"},{"key":"619_CR45","first-page":"757","volume-title":"Mayes\u2019 Midwifery","author":"F Entwistle","year":"2017","unstructured":"Entwistle F. Infant Feeding and Relationship Building. In: MacDonald S, Johnson G, editors. Mayes\u2019 Midwifery. 15th ed. London: Elsiver; 2017. p. 757\u201388.","edition":"15"},{"key":"619_CR46","first-page":"670","volume-title":"Myles Textbook for Midwives","author":"H McIntyre","year":"2020","unstructured":"McIntyre H, Marshall JE. Optimal Infant Feeding. In: Marshall J, Raynor M, editors. Myles Textbook for Midwives. 17th ed. London: Elsiver Limited; 2020. p. 670\u2013714.","edition":"17"},{"issue":"12","key":"619_CR47","doi-asserted-by":"publisher","first-page":"683","DOI":"10.12968\/bjom.2021.29.12.683","volume":"29","author":"J Doherty","year":"2021","unstructured":"Doherty J, Brosnan M, Sheehy L. Changes in care in the fourth trimester in Ireland: 2010\u20132020. Br J Midwifery. 2021;29(12):683\u201391.","journal-title":"Br J Midwifery"},{"issue":"5","key":"619_CR48","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1016\/j.wombi.2020.09.001","volume":"34","author":"EC Newnham","year":"2021","unstructured":"Newnham EC, Moran PS, Begley CM, Carroll M, Daly D. Comparison of labour and birth outcomes between nulliparous women prospective cohort study. Women Birth. 2021;34(5):435\u201341.","journal-title":"Women Birth"},{"key":"619_CR49","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1016\/j.wombi.2015.09.005","volume":"29","author":"J Chaplin","year":"2016","unstructured":"Chaplin J, Kelly J, Kildea S. Maternal perceptions of breastfeeding difficulty after caesarean section with regional anaesthesia: a qualitative study. Women Birth. 2016;29:144\u201352.","journal-title":"Women Birth"},{"key":"619_CR50","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/j.midw.2017.10.013","volume":"57","author":"ME Edwards","year":"2018","unstructured":"Edwards ME, Jepson RG, McInnes RJ. Breastfeeding initiation: an in-depth qualitative analysis of the perspectives of women and midwives using Social Cognitive Theory. Midwifery. 2018;57:8\u201317.","journal-title":"Midwifery"},{"key":"619_CR51","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1016\/j.midw.2015.03.006","volume":"31","author":"L Hunter","year":"2015","unstructured":"Hunter L, Magill-Cuerden J, McCourt C. \u201cOh no, no, no, we haven\u2019t got time to be doing that\u201d: Challenges encountered introducing a breast-feeding support intervention on a postnatal ward. Midwifery. 2015;31:798\u2013804.","journal-title":"Midwifery"},{"issue":"3","key":"619_CR52","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1108\/MRR-02-2013-0027","volume":"37","author":"J Rowley","year":"2014","unstructured":"Rowley J. Designing and using research questionnaires. Manag Res Rev. 2014;37(3):308\u201330.","journal-title":"Manag Res Rev"}],"container-title":["International Breastfeeding Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13006-024-00619-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13006-024-00619-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13006-024-00619-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,19]],"date-time":"2024-02-19T11:05:50Z","timestamp":1708340750000},"score":1,"resource":{"primary":{"URL":"https:\/\/internationalbreastfeedingjournal.biomedcentral.com\/articles\/10.1186\/s13006-024-00619-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,19]]},"references-count":52,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["619"],"URL":"https:\/\/doi.org\/10.1186\/s13006-024-00619-y","relation":{},"ISSN":["1746-4358"],"issn-type":[{"value":"1746-4358","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,19]]},"assertion":[{"value":"10 July 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 February 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 February 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical approval was granted by the Dundalk Institute of Technology Research Ethics Committee (24\/06\/2021). The Health Service Executive (HSE) and participating hospitals also granted ethical approval through their local research ethics committees (REC-21\u2013025, 24\/06\/2021) and (REC-2021\u2013015, 09\/07\/2021). Individual hospitals have not been identified for reasons of confidentiality.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"13"}}