Meaning-making of breast milk donation among women experiencing perinatal loss: a netnographic study of a public forum

Although the scientific literature has increasingly adopted a more positive perspective on breast milk donation among women experiencing perinatal loss, there is still insufficient attention paid to the process of meaning-making and the influencing factors involved in breast milk donation. A netnographic study was conducted from August to November 2024, during which four Reddit forums were observed and reflective field notes were documented. Twelve posts, with 907 online comments, were analyzed, leading to 14 comprehensive case studies from some Western, economically developed settings. Observational data and reflective field notes were analyzed through thematic analysis. Based on the 14 cases observed in the online forum, three themes were identified: Uncertainty of meaning: push; Regulation of meaning: moderating forces; Certainty of meaning: pull. The “push” refers to the factors that contribute to “the uncertainty of meaning” in breast milk donation, while the “pull” represents the positive forces that promote “the certainty of meaning.” It is important to highlight that the “moderating force” refers to the mediating factors that influence the push-pull dynamics, playing a key role in balancing the forces of push and pull. A “push-pull” model for meaning-making in breast milk donation among women experiencing perinatal loss was developed, with “push-pull of meaning-making” as the overarching metaphor. We explored the process of meaning-making surrounding breast milk donation among women experiencing perinatal loss from a positive perspective. Based on the 14 cases observed in the online forum, we identified the liminal state of meaning-making surrounding breast milk donation and analyzed the unique factors associated with the transition from the “push” phase to the “pull” phase. The model generated in this study provides a systematic perspective for understanding women experiencing perinatal loss who are preparing for or participating in breast milk donation. In the future, further consideration should be given to the timing of interventions for breast milk donation among women experiencing perinatal loss, and advance care planning for breast milk donation in perinatal palliative care should be developed.