Abstract

The World Health Organization and the United Nations International Children's Emergency Fund recommend breastfeeding as the sole nutritional source for infants in the first six months after birth. However, breastfeeding rates amongst new mothers have declined alongside the evident gaps in breastfeeding literacy. According to Bloom’s Taxonomy, there are three domains of learning: cognitive, affective, and psychomotor. Yet, the educational breastfeeding resources available to parents concentrate primarily on the cognitive and affective domains, although the act of breastfeeding requires all three. The purpose of this study is to gather the perceptions of stakeholders (mothers) to develop a breastfeeding micro-credential (MC) course that targets all three learning domains. This work will follow the Design-Based Research (DBR) framework which comprises four phases: design, test, evaluate, and reflect. This work focused on the design phase, which was split into two stages where the first stage utilized Delphi rounds to gather stakeholders' (i.e., mothers) perceptions regarding the agreeability of topics from a previously developed eHealth breastfeeding resource (breastfeedinginfo.ca) that should be included in the MC. The second stage will focus on the development of the MC itself. The first stage was completed through an online questionnaire sent to 11 mothers. Participants were asked to rank nine breastfeeding topics from the eHealth resource from most to least important for inclusion in the MC. A consensus was determined to be reached when the topics achieved a minimum of 65% agreeability. Qualitative data was gathered by means of open-ended questions in the Delphi rounds regarding additional topics they would want to be included in the MC, as well as what components of the MC would be most beneficial. A total of two Delphi rounds were performed, with one week to complete each round. Round one curated the four highest topics, along with their agreeability: the baby latches (89%), breastfeeding positions (74%), signs of effective breastfeeding (69%) and feeding sessions (68%), reaching over 65% agreeability to move on to Delphi round two. Based on stakeholders’ responses to the open-ended question in round one, four new topics were generated to be added to the questionnaire for round two. The new topics were: 1) dealing with multiple and premature babies, 2) sore nipples, 3) the effect of a mother's nutrition on breastfeeding, and 4) teething, solids, and weaning. In the second Delphi round, participants were asked to rank the top four topics curated from round one against the four new topics, resulting in a new top four, along with their agreeability: the baby latches (97%), breastfeeding positions (74%), feeding sessions (61%), signs of effective breastfeeding (56%). Lastly, participants were given a multiple-select question regarding what features they believed would be most beneficial to include in the MC. The top two features, along with their agreeability, were informative videos (82%) and discussion boards (73%). The results from this stage will inform the project's second stage, the development of a MC which adheres to Bloom's Taxonomy, which will focus on the topic: the baby latches.