'I'm glad my baby has weaned so I don't need to make that decision.' Understanding breastfeeding-related COVID-19 vaccine narratives on social media.

Issue Addressed: During the coronavirus disease 2019 (COVID-19) pandemic, the infodemic has been highly visible. Vaccine-related advice and evidence-based guidelines for breastfeeding women have lagged, and, at times have been contradictory and confusing. Breastfeeding is an important public health issue with long-lasting health benefits for infants and mothers. This online social listening study aimed to understand breastfeeding-related narratives on social media during the early stages of the Australian COVID-19 vaccine roll-out.

Methods: Public content about breastfeeding and COVID-19 vaccines from Facebook pages with Australian-based administrators were accessed via the CrowdTangle platform. All related content posted between 1 December 2020-31 December 2021 was included. Content (n = 29 567) was coded to an adapted vaccine narrative typology, and emergent themes were inductively identified.

Results: Most posts were promoting, sharing or discussing reliable information. However, the comments responding to these posts varied more widely. Several consistent questions, concerns, and information voids were evident, and misinformation and conflicting information contributed to confusion and challenges with decision-making.

Conclusions: These findings highlight the complexities associated with decision-making. Pregnant and breastfeeding women continue to be a priority group for vaccination, yet there were gaps in data, evidence and information. Incorporating social listening and infodemic management into public health work is important. SO WHAT?: Information voids, when identified early, can help inform public health messaging. Increasing social listening and infodemic training and skills in the health promotion workforce can help build future capacity and give insight into optimising public health communication and addressing misinformation.