What barriers and facilitators to self-management are experienced by mothers who wish to breastfeed but require concurrent pharmacotherapy in the first two years postpartum? A mixed-methods systematic review protocol.
Bibliographic record
Abstract
Background Breastfeeding is the recommended method of infant feeding. The postpartum period can be a challenging time for women who experience illness requiring pharmacotherapy. However, breastfeeding women may use medication less frequently than their counterparts who are not breastfeeding. Some women report the need for pharmacotherapy as a reason for earlier than desired breastfeeding cessation. The experiences of women in relation to self-management of medication use and breastfeeding are poorly understood. Aim The aim of this systematic review is to explore the barriers and facilitators to self-management for women who wish to breastfeed but require concurrent pharmacotherapy in the first two years postpartum, using mixed-methods and a systems-based theoretical framework. Methods Systematic searches will be performed using six electronic bibliographic databases. Dual independent selection, data extraction and quality assessment of studies will be carried out. A convergent integrated approach to data synthesis will be used. The System Engineering Initiative for Patient Safety (SEIPS) model will be used as a theoretical framework to guide data synthesis. Input and collaboration from public and patient involvement (PPI) contributors will be sought throughout. Conclusion Enhancing understanding of mothers’ self-management experiences when they wish to breastfeed and take medication is arguably key to improving maternal and child health and quality of life. The proposed review will synthesise the available data regarding the barriers and facilitators to self-management for women who face the need for concurrent pharmacotherapy and breastfeeding. In doing so, important supports and unmet needs of this cohort will be revealed. PROSPERO registration number CRD420251000918. Amendments to this protocol will be uploaded as revision notes to any platforms where the protocol was published.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.093 | 0.115 |
| Meta-epidemiology (narrow) | 0.003 | 0.004 |
| Meta-epidemiology (broad) | 0.014 | 0.013 |
| Bibliometrics | 0.014 | 0.012 |
| Science and technology studies | 0.003 | 0.003 |
| Scholarly communication | 0.006 | 0.007 |
| Open science | 0.004 | 0.005 |
| Research integrity | 0.006 | 0.004 |
| Insufficient payload (model declined to judge) | 0.039 | 0.004 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".