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Qualitative Research Designs

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• Published: 22 July 2024

The breastfeeding experience of women with multiple pregnancies: a meta-synthesis of qualitative studies

• Ruxue Bai 1 ,
• Yifan Cheng 1 ,
• Siyu Shan 1 ,
• Xinmiao Zhao 1 ,
• Jun Wei 1 &
• Chunling Xia 1  

BMC Pregnancy and Childbirth volume  24 , Article number:  492 ( 2024 ) Cite this article

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The experiences and challenges associated with breastfeeding multiple births can be considerably more complex than those of singletons. Multiple births refer to the delivery of more than one offspring in a single birth event. Emphasizing the needs and experiences of mothers with multiple births during breastfeeding can enable healthcare providers to design targeted interventions that enhance breastfeeding rates. However, existing breastfeeding and health education resources and practices do not fully meet the needs of women who breastfeed multiples. This review aimed to review and synthesize qualitative studies on the breastfeeding experiences of women with multiple births.

A systematic search was conducted in 10 electronic databases for papers published from the inception of the database to March 2024. The Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research was utilized to evaluate the methodological quality of the studies included. The thematic synthesis method of Thomas and Harden was employed to integrate and analyze the included literature to derive new categories and conclusions.

Eight studies met the inclusion criteria and quality assessment criteria for this study. Through the integration of their results, four themes were identified: the choice and willingness to breastfeed multiple births; the challenges of breastfeeding multiple births; stage management and individualised adaptation of breastfeeding; and the experience of support.

Throughout the feeding process from pregnancy to the postpartum period, mothers with multiple births often have predominantly negative experiences with breastfeeding. Consequently, hospitals should create a multidisciplinary follow-up team comprising obstetrics, neonatology, psychology, and community services to offer specialized and personalized support to these women at various stages.

Systematic review registration

[ https://www.crd.york.ac.uk/PROSPERO/ ], identifier [PROSPERO 2024 CRD42024520348].

Peer Review reports

Introduction

Over the past three decades, the global incidence of multiple pregnancies has significantly increased due to delayed childbearing, advancements in assisted reproductive technologies, and the use of ovulation-inducing drugs [ 1 ]. In Italy, the rate of twin pregnancy increased from 1.28% in 2015 to 2.48% in 2020 [ 2 ], and in the United States, it surged by 70% from 1980 to 2019 [ 3 , 4 ]. Similarly, in China, the incidence of multiple pregnancies grew by 60% between 2009 and 2019 [ 1 ]. Multiple pregnancies are categorized as high risk, with 60% of twins being born prematurely before 37 weeks and 75% of triplet pregnancies born before 35 weeks [ 5 ], significantly increasing the risk of adverse neonatal outcomes.

Exclusive breastfeeding is deemed the optimal feeding method for newborns, particularly beneficial for the development of premature infants [ 6 ]. The American Academy of Pediatrics strongly recommends exclusive breastfeeding for the first six months, highlighting its effectiveness in reducing the risk of various health issues in premature infants, including sepsis, necrotizing enterocolitis, severe retinopathy of prematurity, metabolic syndrome, long-term growth retardation, and neurodevelopmental disorders [ 7 ]. However, international studies from countries such as Japan [ 8 , 9 ], Italy [ 2 ], Indonesia [ 10 ], South Korea [ 11 ], Sweden [ 12 ], China [ 13 ], and those with high breastfeeding rates such as Ghana [ 14 , 15 ] revealed that exclusive breastfeeding rates among women with multiple births consistently lag behind those of women with single births at all measured intervals. Specifically, exclusive breastfeeding rates at six months were less than 17%, significantly below the World Health Organization’s target of 50% [ 16 ]. Therefore, enhancing the breastfeeding rates among women with multiple births is crucial.

Research indicates that the low breastfeeding rates among women with multiple births are attributable to factors related to mothers, newborns, and support systems. Breastfeeding self-efficacy is a critical determinant of exclusive breastfeeding rates in this group [ 10 , 17 ]. High self-efficacy signifies that mothers possess confidence and proficiency in breastfeeding multiple infants and are proactive in addressing challenges during the feeding process. The perception of insufficient milk supply is the predominant reason for cessation of breastfeeding among these women, with many doubting their ability to produce adequate milk for multiple infants [ 2 , 15 , 18 ]. In contrast, studies have shown that oxytocin levels in mothers of twins are double those in mothers of singletons, leading to doubled milk production. By six months postpartum, these mothers can produce between one to two kilograms of milk daily, sufficient for the needs of two infants [ 19 ]. The primary complication associated with multiple births is preterm delivery, which often results in the separation of mother and infant. This separation complicates the initiation of critical early breastfeeding practices, including immediate sucking, skin-to-skin contact, and early milk production. Furthermore, the persistent immature feeding behaviors of preterm infants—characterized by weak sucking, lethargy, and poor tolerance—continue to challenge breastfeeding efforts post-discharge, contributing to a lower rate of exclusive breastfeeding among mothers of multiples [ 20 ]. Comprehensive medical [ 21 ], family [ 2 ], and social support [ 15 ] are essential to enhance breastfeeding rates among women with multiple births.

As the number of infants increases, the complexities and challenges of infant care, particularly breastfeeding, intensify with multiple births. It requires greater physical strength, belief in breastfeeding and support systems from the mother [ 2 ]. After encountering numerous challenges, mothers are more likely to cease breastfeeding [ 20 ]. A deep understanding of the breastfeeding experiences and needs of women with multiple births can enable healthcare professionals and breastfeeding specialists to identify issues early and offer personalized support services, thereby enhancing breastfeeding rates and duration [ 22 ]. There are already qualitative studies on the real experiences of breastfeeding among women with multiple births, but a single qualitative study cannot fully reflect all experiences of this group. There is still a lack of integration of relevant research results. This study adopts a meta-synthesis approach to consolidate qualitative research in this area, aiming to provide a more comprehensive and profound insight into the real experiences of breastfeeding among women with multiple births. This approach serves as the foundation for developing targeted interventions, relevant social support, and psychological care in the future.

This systematic review was registered prospectively with the International Prospective Register of Systematic Reviews (PROSPERO) with registration number CRD42024520348. The Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) checklist (Supplementary Table 1) was used to report the process and results of synthesis and enhance transparency [ 23 ].

Search strategy

We conducted comprehensive searches across ten widely-used Chinese and English databases, including the China Biomedical Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP Database, PubMed, Web of Science, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Joanna Briggs Institute (JBI) Evidence-Based Healthcare Center Database, and PsycINFO, to collate qualitative studies on breastfeeding among mothers with multiple births. The search covered the period from the inception of each database to March 2024. We employed both MeSH descriptors and free-text terms, and systematically reviewed the reference lists of the included studies to ensure a thorough literature search. The search terms included: “pregnancy” “twins” “multiple births” “higher order pregnanc*” “breastfeeding” “breastfeed*” “breast-feed*” “experience” “need*” “feeling” “qualitative research” “qualitative study” “ground theory” “interview*” “focus groups” “phenomenon” “ethnography”. The search strategy for PubMed is detailed in Table  1 .

Inclusion and exclusion criteria

We applied the PICOS framework, as recommended by the Joanna Briggs Institute (JBI) Evidence-Based Healthcare Center [ 24 ], to establish the inclusion and exclusion criteria for the studies. The inclusion criteria were as follows: (1) Population: women with multiple gestations, including twins, triplets, and higher-order multiples; (2) Interest of phenomena: the experiences, feelings, and needs of these women concerning breastfeeding multiple infants; (3) Context: the specific settings such as hospital wards, outpatient departments, or the homes of the pregnant women; (4) Study design: qualitative research, including various qualitative research literature using descriptive analysis, phenomenology, grounded theory, ethnography, the qualitative part of mixed research and so on. The exclusion criteria were as follows: (1) literature not published in Chinese or English; (2) literature for which the full text is not available; (3) literature that has been published multiple times. (4) the literature quality evaluation grade is C.

Literature selection and data extraction

All search records were imported into the reference management software NoteExpress, and duplicate records were removed by the principal investigator (BRX). Two researchers (BRX and SSY), who had undergone systematic training in evidence-based practice methods, independently conducted literature searches using the specified terms. They then rigorously applied the inclusion and exclusion criteria to screen the literature. This involved a meticulous review of the titles and abstracts for preliminary screening to discard irrelevant studies. Subsequently, we conducted a full-text review to finalize the selection of included studies. Any disagreements were resolved through discussion or by consulting a third researcher (CYF).

The data extraction process included the first author’s name, publication date, country, qualitative research method, research subject, phenomenon of interest, and key findings.

Quality appraisal

Two researchers (BRX and SSY) worked independently using the Joanna Briggs Critical Assessment tool for Methodological Quality Assessment [ 24 ], which is widely applicable to the evaluation of qualitative research. The evaluation content consisted of 10 items, each of which is evaluated as “yes”, “no”, “unclear”, or “not applicable”. The quality of the literature is divided into A, B, and C levels. If all the standards are fully met, the possibility of bias is the smallest, and the quality level is “A”. If some of the above standards are met, the possibility of bias is moderate, and the quality level is “B”. If none of the above standards are met, the possibility of bias is the greatest, and the quality level is “C”. In the event of any disagreements, a third researcher (CYF) will be responsible for making a joint decision.

Translation

During the data analysis process, two researchers translated the results and discussion sections of the Chinese literature into English, compared their translations, and negotiated the most appropriate version. After that, the two researchers then translated the English back into Chinese, compared the back-translated content with the original Chinese text, and discussed and resolved any disagreements. Based on the discussion results, the English translation was revised. Where cultural concepts could not be translated, native English speakers were consulted for translation advice, but this was not encountered during the translation of this paper. All researchers were staff in the field of obstetrics and were proficient in English.

Data synthesis

The data was synthesized using Thomas and Harden’s thematic synthesis methods [ 25 ]. A thematic synthesis was used to interpret multiple findings and develop analytical themes enhancing understanding [ 26 ]. the development of analytical themes that enhance understanding. Initially, two researchers (BRX and SSY) imported all relevant content from the “Results” and “Conclusions” sections of the included studies into NVivo11. They then coded the findings line by line based on their meaning and content. These codes were systematically analyzed and organized to identify similarities and differences, which were grouped into related areas to form descriptive themes. Analytical themes were subsequently developed inductively by synthesizing the study findings and elucidating their meanings. Discrepancies were deliberated upon by two researchers and, where necessary, a third researcher (ZXM) was consulted to resolve any contradictions.

Literature search

We first obtained a preliminary total of 2,330 studies through database search and reference literature review. Then, using NoteExpress software, 248 duplicate studies were excluded. By reviewing the titles and abstracts, we then preliminarily selected 24 articles for full-text analysis. Following this, based on the inclusion and exclusion criteria, we further narrowed down the selection to 8 articles for quality evaluation. The process and results of the literature screening are depicted in Fig.  1 .

Quality assessment

Table 2 summarizes the quality assessment results of the eight identified studies. The majority of these studies described the phenomenon of interest, the typical participants, and the methods of data collection and analysis. Only two studies explicitly described the cultural or theoretical background of the researchers. Four studies addressed the researchers’ influence on the research process, such as through quality control measures, but failed to discuss the impact of the research on the researchers themselves. Only two studies did not explicitly state ethical approval or list the ethical approval number. Ultimately, two studies were assigned a grade A, six received a grade B, and all eight studies were included in the analysis.

Flow diagram of the search strategy and results

Characteristics of included studies

Eight studies were included after article screening and quality assessment. The studies were conducted in 6 countries; Canada ( n  = 2), Turkey ( n  = 2), New Zealand, Iceland, Ghana, and China. The methodologies used in the studies were 3 phenomenological studies [ 22 , 27 , 28 ], 1 ethnography study [ 29 ], 2 mixed studies [ 15 , 30 ], and 2 qualitative studies with unspecified methodologies [ 31 , 32 ]. A total of 122 multiparous pregnant women were included in the studies and the main method of data collection was interviews, both semi-structured and narrative; one study used observational methods. Data collection was postpartum in seven studies, and only one was collected antenatally [ 29 ]. Table  3  provides a detailed description of the included studies.

The breastfeeding experiences of mothers of multiples

After repeated reading, analysis, and comparison by the researchers, a total of 67 quotes were extracted, similar quotes were classified and combined into 11 categories, and further integrated into 4 integrated results.

Synthesized finding 1: The drive for breastfeeding

Breastfeeding is widely regarded as the best way to feed a newborn, providing numerous benefits for both the physical and psychological development of the infant and the mother [ 33 , 34 ]. Breastfeeding is conventionally regarded as integral to ‘good mother‘ [ 29 ]. Several mothers of multiple births in the study noted that breastfeeding provided them with a sense of wellbeing and fulfillment, fostering intimate connection and enhancing their sense of maternal identity [ 27 ]. “I think breastfeeding provides such a bond. Breastfeeding reinforces bonding.” [ 27 ] Moreover, some mothers described breastfeeding as a ‘miracle’ and viewed it as a privileged experience [ 27 ]. “I believe that breastfeeding is a sacred thing. It is something really miraculous. As soon as the baby is born, s/he is looking for it, s/he finds it and sucks it.” [ 27 ] Consequently, these mothers often purchased breastfeeding equipment early on, illustrating their anticipation of breastfeeding [ 28 ]. “I bought a twin breastfeeding pillow and tried simultaneous breastfeeding but I couldn’t succeed.the babies were too small.” [ 28 ] The significance that multiple birth mothers attribute to breastfeeding helps sustain their determination to breastfeed despite challenges. “I think being a mother of twins is really a great privilege. It is also very difficult! This means we are very strong. what a blessing!” [ 27 ].

Synthesized finding 2: The challenges of breastfeeding multiple births

The second theme of the study examines the complex array of challenges encountered by multiparous women in the process of breastfeeding. These challenges encompass a range of physical and psychological obstacles, conflicts arising from balancing work responsibilities with breastfeeding commitments, and concerns related to the care of the newborn. These challenges affect the duration of breastfeeding and may even lead mothers to decide to stop breastfeeding.

Physical burden

The feeding duration for multiple births is significantly longer than that for single births. Prolonged feeding and caring for multiple births impose substantial physical strain, including symptoms such as lower back pain, insomnia, fatigue, and breast and nipple pain [ 22 , 27 , 28 , 30 ]. “I was in bed, and I had a catheter and could not walk or talk. I was sort of out of it for about two days after birth, and I could not see my children ” [ 30 ]“My nipples were cracked” [ 28 ]. In addition, mothers of multiple births with older children have to juggle older children and multiple newborns, making breastfeeding multiple births overwhelming. “After the cases where I broke in tears, I got up immediately and told myself that I have to be strong, I have to do it, I have to accomplish it. In the end, they’re my children.” [ 27 ].

Thus, for women with multiple births, the physical exhaustion following a caesarean section conflicts with the physical and energetic demands of breastfeeding multiples, leading to significant maternal stress. Additionally, the frequency of suckling sessions for multiple breastfeeding infants increases substantially compared to single births, elevating the risk of breast and nipple pain.

Psychological burden

Some interviewees also talked about their psychological pressure, such as overwhelm, anxiety, guilt, disappointment and depression [ 22 , 27 , 28 , 30 ]. Some mothers feel confused and overwhelmed about breastfeeding multiple babies after the birth of newborns or when hospitalized newborns return home because of the complexity of breastfeeding and the physical challenge of feeding multiple babies [ 30 ]. Even some women gave up breastfeeding: “Although I know breastfeeding is good, when I really face two children, I feel that my mind is empty, and I always feel afraid that they will be hungry, so I just feed milk powder. ” [ 22 ]. However, parturients with low milk supply regretted that they could not extablish exclusive breastfeeding [ 30 ]. However, mothers with experience in breastfeeding consider successful breastfeeding experience to be very important for subsequent breastfeeding of twins [ 32 ].

Therefore, some women find breastfeeding burdensome and want to return to their normal routine and family relationships. “Then, I thought, ‘This is starting to be a burden’ it cannot overshadow the time spent with the family and other things I want to do. ” [ 30 ].

There are also some mothers who consider their own mother’s identity, so they can remind themselves to be strong in the face of poor physical and psychological conditions [ 27 , 31 ]. “After the cases where I broke in tears, I got up immediately and told myself that I have to be strong, I have to do it, I have to accomplish it. In the end, they’re my children. ” [ 27 ].

In most studies, multiple birth mothers have negative emotional experiences of breastfeeding, with some women viewing breastfeeding as a “burden” and longing to return to normal life, while others choose to continue breastfeeding and view it as a “problem” to be overcome.

The burden of immature feeding patterns

The incidence of premature birth in multiple births is higher than that in single births, and newborns who can be discharged with the mother are mostly late preterm or early term infants, with weak sucking ability and prone to sleepiness. The mother believes that breastfeeding is time-consuming and difficult, requiring more patience. “You know they sucked a little and then just went to sleep; they were so tired.” [ 30 ]; “The oldest is less than 4 catties and will not breastfeed after discharge” [ 22 ]. As a result of the infants’ immature feeding pattern, breastfeeding becomes complicated, leading to a loss of confidence in breastfeeding among multiple birth mothers.

Multiple births are fed more frequently than single births, and unfortunately the immature feeding patterns of newborns make them more difficult to feed, and the challenge of “making it harder” adds to the negative feelings of multiple births.

The burden of work-breastfeeding conflict

Similar to single-child mothers, the mothers’ jobs are also important factors affecting the choice of multiple-child mothers to continue breastfeeding. Balancing work and breastfeeding is a challenging issue for mothers. “Because I have to go to work, I really can’t help but give up.” [ 22 ]. “My work is so involving and I need to make money hence my inability to let them suckle much.” [ 15 ].

Following a series of physical and psychological challenges, the end of maternity leave, and conflicts between work and breastfeeding can make work an ‘opportunity’ or ‘turning point’ for weaning.

Synthesized finding 3: Stage management and individualised adaptation of breastfeeding

The third theme was stage management and individualised adaptation of breastfeeding, and this study demonstrated that mothers with multiples have different coping strategies in the early and mature stages of the breastfeeding process.

Coping strategies in the early stages of feeding

In the early stages of breastfeeding, the management of breastfeeding in mothers of multiples is characterized by “prudent” feeding and efforts to increase lactation [ 30 ]. Mothers of multiples with separated babies or preterm infants also frequently use equipment to establish lactation or actively go to the hospital to deliver milk [ 22 , 30 ]. “Prudent feeding” involves strict adherence to standardized intervals between feeds, precise measurements of milk volume, monitoring weight gain and loss, tracking baby excretions, and scheduling nappy changes. “We rented a scale that we placed on this table and weighed them. We wrote down how much they weighed and, of course, calculated how much they needed in addition to breastfeeding. After four days, we felt this was insane.” [ 30 ]. Mothers of multiples may often manage their milk supply tightly in the early stages [ 27 , 29 , 30 ], using a breastpump to empty the breasts after breastfeeding and managing inadequate milk supply by changing breasts or dividing the milk equally [ 28 , 29 , 30 ]. “After every feeding for many weeks after birth, I used the breast pump to get more milk.” [ 30 ] “There was more milk on the right side.the fatty baby (3,000 g) was sucking that side; the other one was 2,650 g. I thought that was unjust.thus, I interchanged the breasts.” [ 28 ] Mother-infant separation or immature feeding patterns increase the likelihood of using breast pumps, hand milking, or nipple shields to stimulate milk production.

Multiple birth mothers face particular challenges in the early stages of feeding, and their commitment to breastfeeding their babies is further reflected in their thorough feeding programmes and use of equipment to maintain lactation.

Adaptation shifts during feeding maturation

After mastering the early and complex breastfeeding management and the maturation of infant feeding patterns, some mothers became skilled in breastfeeding techniques and developed individualized feeding routines based on each infant’s needs and feeding bond [ 30 ]. However, some mothers experienced fatigue with breastfeeding, gradually stopped pumping, and began accepting formula feeds after breastfeeding. This eventually led to the cessation of breastfeeding due to decreased milk production [ 30 ]. “During the second month, I quit pumping. I just had enough and found it easier to just breast- and bottle feed. Pumping interrupted my sleep at night and just everything. We had three weeks where it was going fine, but suddenly, there was no milk.” [ 30 ].

Most mothers can find an individual way to breastfeed during the breastfeeding maturation period, although some may experience a decrease in milk supply and eventually stop breastfeeding.

Synthesized finding 4: The experience of supports

Multiple birth mothers receive support for breastfeeding from family, friends, socia, medical, and information, but these supports don’t exactly promote breastfeeding for multiple births. The following section discusses women’s experiences of receiving this support.

Family support

As the number of babies increases, the time spent on breastfeeding and other infant care tasks also increases. Therefore, women with twins or triplets often express the need for more family support to help them complete breastfeeding successfully [ 27 , 30 , 32 ]. Spouses or family members assisting in preparing formula, taking care of other infants, and providing emotional support during feeding allow mothers to spend more time on extended breastfeeding and find it meaningful. However, as the husband returns to work, this support diminishes, and the demanding task of caring for multiple infants leaves the mother fatigued and unable to continue breastfeeding [ 30 ]. “We could not have done this without my parents. My mother sat by their [the twins] side while they slept so we could take a nap” [ 30 ]. Differences in childcare beliefs between mothers and their family members can create discord within the family unit [ 27 ]. “. It would be better if the helper were closer to my mind set. I got angry because my mother-in-law was very involved. I asked her to stay out of it.because I want to make my own decisions” [ 27 ].

Some mothers of multiples also seek support and help from friends and experienced “elders” in the local area [ 15 , 30 ]. “My friend who lives close by sometimes dropped by during lunchtime. She, of course, got coffee, but she also fed them [solids] and gave them a bottle [laughs]. It somehow turned into this: If someone comes, then he or she is handed the bottle.” [ 30 ].

Mothers of multiple births require direct or indirect breastfeeding support from their social networks, including family and friends, to ensure they have the time and energy to breastfeed.

Social support

A New Zealand study mentions that the government provides 240 h of non-means-tested family support services over 12 months for families with children under five and then twins [ 32 ]. And these family support services are domestic services such as cleaning, cooking and laundry [ 35 ]. Additionally, twin mothers can benefit from the establishment of relevant social service groups or peer support groups, which can offer emotional and other forms of breastfeeding support. Mothers of multiples believe that the situation of feeding multiple children is different from that of single-child mothers, so they are eager to make friends with other multiple-child mothers to obtain peer support [ 29 ]. “And I’ve had some of them say, ‘Look, I have a girlfriend who had twins, this is her phone number’.” [ 29 ].

Social support from government organizations, social service groups, and peer support groups is essential for helping mothers of multiple births maintain breastfeeding.

Medical support

Professional medical support as a part of social support is very important for the success and duration of breastfeeding for mothers of multiple children. All participants in the study believed that receiving prenatal training from medical professionals was helpful for achieving breastfeeding. Additionally, they required sufficient medical support following discharge [ 28 ]. Mothers who are separated from their babies often face difficulties and doubts in breastfeeding due to lack of experience with multiple infants and not receiving professional breastfeeding guidance. As a result, they require more continuous medical support [ 31 ]. “Two babies were born prematurely and transferred to pediatrics. After returning home, the baby did not eat (breast milk) at all, but the eldest learned it as soon as possible, so only one was breastfeeding.” [ 31 ]. In two studies, respondents had a contradictory psychological state of worrying about disturbing medical staff but also desiring continuous medical services [ 28 , 31 ]. “They just answered me as I questioned.they didn’t give information on their own.” [ 28 ]. However, the unprofessional feeding support and unencouraging feeding attitude of medical staff can also indirectly lead to multiple women not being able to achieve exclusive breastfeeding [ 27 ].

In terms of medical support for breastfeeding, multiple birth mothers expect professional antenatal education, continuity of medical support, proactive medical care and positive attitudes towards breastfeeding.

Information support

Most studies have mentioned the need for information support during various stages of breastfeeding, as well as the problems encountered in seeking information support [ 15 , 22 , 29 , 30 , 31 ]. This study will be presented from four perspectives: the source, characteristics, content, and dissemination form of information.

Regarding the source of information, compared to feeding guidance from community workers, mothers trust the feeding knowledge provided by hospital medical staff more. “After returning home, I had engorged breasts, so I hired a lactation consultant, but the effect was not good. When community workers visited, I was more willing to believe in your guidance.” [ 22 ]. However, some mothers did not receive information about breastfeeding multiple children, so they turned to the internet, friends or “elders” around them for help [ 30 ].

In terms of the characteristics of information, some mothers of multiple children believe that their feeding experiences are different from those of single-child mothers and that each mother and baby is unique. However, the feeding information provided in prenatal classes and by medical staff is not targeted at multiple births, and medical staff do not provide personalized guidance for each mother. “I said, ‘I know that probably everyone, everyone else was expecting one but’ I said, ‘can you cover twins a little bit for me? ’” [ 29 ].

In terms of the content of information, mothers of multiple children usually hope to get a detailed explanation of a range of topics, including the benefits of breastfeeding, the possibility of breastfeeding multiple children, how to breastfeed two infants at the same time, how to balance rest with breastfeeding, how family members can support mothers of multiple children in breastfeeding, and how to increase milk production [ 29 , 30 ]. “I’m worried about one getting up, and then you just nurse them and feed them and then you fall asleep and then the other one’s getting up, and then it’s like you’d be so tired.” [ 29 ].

One study mentioned that mothers of multiple children prefer to receive information through written promotional brochures as a medium. “Instructions should start during pregnancy. an illustrated booklet would be very good” [ 28 ].

Mothers of multiple births who sought information about breastfeeding rated their experiences with various information sources, personalisation, content, and media support. They expressed a preference for personalised information from health professionals regarding breastfeeding multiples. Additionally, they found an easily accessible illustrated booklet to be an effective medium for information support.

This study comprehensively describes the real experiences and diverse needs of women with multiple births concerning breastfeeding throughout the perinatal period and at all stages of the future implementation of feeding, including four aspects: willingness to breastfeed, multiple challenges in the implementation of breastfeeding multiple births, stage management and individualised adaptation of breastfeeding, and the evaluation of support received.

Breastfeeding intention reflects the attitudes and beliefs of multiparous mothers toward breastfeeding. A positive intention facilitates their active pursuit of breastfeeding information and the establishment of related behaviors, thereby enhancing both the duration and quality of breastfeeding. A study has shown that antenatal intention to breastfeed is a predictor of six-month breastfeeding rates in pregnancies with twins [ 14 ]. Our study revealed that while the majority of multiparous mothers demonstrated a strong inclination to breastfeed, a subset remained ambivalent. The findings suggest that professional prenatal education significantly boosts breastfeeding intentions [ 36 ]. Accordingly, medical staff should not only encourage a positive breastfeeding disposition but also respect individual preferences, providing tailored information to those without an initial intention to breastfeed [ 37 ]. The Queensland Organization Breastfeeding Guidelines 2023 [ 37 ] recommend that healthcare providers assess barriers to breastfeeding at delivery, offer detailed guidance on infant feeding practices at subsequent deliveries, and collaborate with mothers to formulate and document comprehensive breastfeeding plans. Additionally, multiparous mothers are consulted about their previous breastfeeding experiences; if negative, strategies to address these issues are discussed [ 37 ].

Women with multiple births, as evidenced in five studies, frequently report fatigue and strain during breastfeeding [ 22 , 27 , 28 , 30 , 31 ]. Postpartum, woman’s recovery will be affected by physical and psychological factors, such as a weakened postpartum state, frequent breastfeeding and sleep deprivation. Common complaints among women with multiple births include lower back pain, fatigue, sleep deprivation, nipple soreness, anxiety, and increased incidences of crying, leading to adverse attitudes toward breastfeeding. Furthermore, research indicates that multiple births correlate with diminished postnatal mental health compared to single births [ 5 ], and negative emotional states can further decrease lactation and milk supply [ 38 ]. To mitigate these challenges, medical and mental health professionals should prioritize multiparous mothers for follow-up visits. These should focus on educating them about the stress-relieving benefits of oxytocin released during breastfeeding, acknowledging and addressing their physical and psychological hardships, and providing strategies to prevent and manage physical discomfort. This approach aims to bolster their confidence and promote successful breastfeeding [ 38 , 39 ].

Compared with full-term infants, infants from multiple pregnancies often experience developmental challenges such as inadequate sucking, lethargy, and poor feeding tolerance, which complicate breastfeeding [ 40 ]. These challenges can diminish the self-confidence of multiparous women and exacerbate anxiety and other negative emotions [ 22 ]. Furthermore, current antenatal breastfeeding promotion primarily addresses term and singleton births, lacking detailed guidance for multiple births. A meta-analysis demonstrated that breastfeeding interventions grounded in the Theory of Planned Behavior or the Theory of Breastfeeding Self-Efficacy significantly enhance breastfeeding rates and durations [ 41 ]. Medical professionals should therefore implement evidence based grounded in psychological theory programs, offering tailored breastfeeding guidance that addresses the specific behaviors of the newborn and the physiological condition of the mother. This guidance should include techniques for assessing effective suckling, measuring actual breastfeeding amounts, scheduling feedings, and incorporating breastfeeding enhancements such as breastmilk fortifiers. For complex cases, prompt referral to breastfeeding specialists or certified lactation consultants is crucial.

Research analyzing mothers with multiple births who breastfed beyond 12 months indicates that those with partner and family support experienced longer breastfeeding durations compared to their unsupported counterparts [ 42 ]. Thus, robust family and social support plays a critical role in promoting successful breastfeeding among women with multiple births. Emotional, parenting, and household support from partners or family members significantly enhance the ability of mothers with multiple births to allocate more time to breastfeeding. Such support also promotes adequate rest and relaxation, which facilitates oxytocin secretion and reduces the risk of insufficient milk production. The Breastfeeding Co-Parenting Theoretical Framework [ 43 ] underscores the importance of partner or co-parent involvement in breastfeeding success and provides guidance on effective support strategies. The framework comprises five components, providing support ranging from the emotional to the practical dimensions. In the emotional dimension, examples include co-parents’ willingness to participate in breastfeeding, offering encouragement and praise to mothers of multiples, and addressing challenges faced during childcare and feeding in a positive manner. In the practical dimension, support includes providing breastfeeding-related information, necessary feeding equipment, and ensuring a fair distribution of daily childcare and household chores. This equitable distribution allows mothers of multiples to have the time and energy needed for breastfeeding. Consequently, healthcare professionals should discuss parenting styles with mothers of multiples and their families during the antenatal and postnatal periods, actively coordinating breastfeeding and emotional support based on this framework. This approach highlights how critical co-parenting support is to the longevity and success of breastfeeding. Currently, healthcare workers lack adequate knowledge about breastfeeding multiples, revealing a significant gap between medical practice and optimal multiple breastfeeding support. This gap hinders healthcare workers from effectively delivering personalized breastfeeding assistance to mothers of multiples. Addressing this gap requires enhancing the training and education of medical personnel to improve their competence and professionalism in breastfeeding support.

The New Zealand Government’s non-means-tested domestic support for families with multiple births can help families with multiple births to focus more on breastfeeding and parenting, and increase breastfeeding rates [ 32 ]. Currently, non-profit organizations such as The Multiple Births Foundation, Twins Trust, and Twins & Multiple Births Association offer some free social services to these mothers. Healthcare professionals should provide specific information and counseling about these resources when assisting families with multiple, thereby enhancing their access to social support.

Excellent medical support for breastfeeding is multifaceted. Healthcare workers must possess a comprehensive understanding of multiple birth breastfeeding to effectively assist mothers in selecting and initiating appropriate infant feeding practices, as well as in addressing subsequent issues [ 44 ]. It is essential for healthcare professionals to exhibit commendable personal qualities, respect the feeding choices of women with multiples, affirm their decisions confidently, and offer guidance on suitable methods [ 37 ]. Moreover, clinical staff require advanced communication skills to engage with mothers using acceptable and effective methods [ 37 ]. Additionally, it is crucial for healthcare workers to develop and implement feasible, evidence-based breastfeeding intervention programs specifically tailored for multiple births [ 45 ]. Such programs should leverage distance learning [ 46 ], peer education [ 47 ], and visual aids like graphic booklets or videos [ 48 ] to enhance breastfeeding rates among mothers of multiples.

In the UK, health visitors offer support advice and guidance to families with children under five. However, families with multiple births often find that the generalized support from health visitors fails to address the complexities of breastfeeding multiples [ 49 ]. The Elizabeth Bryan Centre for Multiple Births advocates for providing families with health visitors who have specialized training in multiple births [ 50 ]. The health visitor service, which facilitates the transition from hospital to home, is crucial. In countries lacking such services, hospitals should establish multidisciplinary follow-up teams to ensure continuity of care for families with multiple and support breastfeeding mothers. Therefore, both health visitors and medical follow-up team members need to pursue systematic education on multiple breastfeeding, such as studying specialized guidelines [ 51 ], to offer scientifically sound, authoritative, and customized support for managing breastfeeding in multiple births and assisting mothers through all stages of breastfeeding.

Strengths and limitations

This study constitutes the first systematic review of qualitative research synthesis concerning breastfeeding among women with multiple births, offering significant clinical relevance. We meticulously recorded the outcomes of the original studies, and through the aggregation and analysis of codes, were able to effectively mitigate content bias. In addition, all members of this study had undergone systematic evidence-based training, which enabled them to professionally review and assess the quality of the literature. Moreover, during the process of the study, the research members kept in touch with each other to discuss and analyse the results, which effectively improved the credibility of the whole study. The literature included in this study involved countries with both high and low rates of breastfeeding, so the findings may have a wider application. We have included suggestions for improving care in Table  4 .

However, the study also has several limitations. The results of the meta-synthesis were influenced by the limited number of qualitative studies on the subject of breastfeeding in multiple births—specifically, eight studies—of which six were rated Grade B and only two were Grade A for high quality. In addition, this study did not include qualitative articles with the theme of real-life experiences of parenting in women with multiple births, which also affected the comprehensiveness of the results to a certain extent, considering that descriptions of breastfeeding might be mentioned in their studies.

This study employs a meta-synthesis approach to examine the experiences and needs of women breastfeeding twins or higher-order multiples, aiming to offer targeted recommendations. The findings suggest that these women generally report negative experiences and encounter numerous challenges. Consequently, it is advised that hospitals establish multidisciplinary follow-up teams involving obstetrics, neonatology, and community care for these women. These teams should develop interventions based on theoretical frameworks to support breastfeeding in multiple-birth scenarios. Furthermore, families with multiple births should be treated as educational units to ensure continuous, personalized care that includes promoting feeding information before delivery, providing guidance after delivery, and monitoring breastfeeding post-discharge.

Future relevant interventional trials and multicentre cohort studies on breastfeeding multiples are needed to assess the contribution of different interventions to multiple breastfeeding rates and to inform subsequent guideline development by specialist in breastfeeding for multiple births.

Data availability

No datasets were generated or analysed during the current study.

Tang W, Zou L. Trends and characteristics of multiple births in Baoan Shenzhen: a retrospective study over a decade. Front Public Health. 2022;10:1025867.

Article   PubMed   PubMed Central   Google Scholar  

Quitadamo PA, Comegna L, Palumbo G, Copetti M, Lurdo P, Zambianco F et al. Feeding Twins with Human Milk and Factors Associated with its duration: a qualitative and quantitative study in Southern Italy. Nutrients. 2021; 13(9).

Martin JA, Hamilton BE, Osterman M, Driscoll AK, Births. Final data for 2019. Natl Vital Stat Rep. 2021;70(2):1–51.

PubMed   Google Scholar  

Multifetal Gestations. Twin, Triplet, and higher-Order Multifetal pregnancies: ACOG Practice Bulletin, Number 231. Obstet Gynecol. 2021;137(6):e145–62.

Article   Google Scholar  

Fenwick N, Chorley A. Twin and higher-order pregnancy – patient Voice. In: Khalil L, Lopriore, editor. Twin and higher-order pregnancies. Cham: Springer International Publishing; 2021. pp. 425–35.

Chapter   Google Scholar  

Merter OS, Altay N. Effect of feeding fresh or frozen breast milk on the gut microbiota of premature infants: a prospective observational study. Biol Res Nurs. 2024;26(1):78–90.

Article   PubMed   CAS   Google Scholar  

Section OB, Eidelman AI, Schanler RJ, Johnston M, Landers S, Noble L, et al. Breastfeeding and the use of human milk. Pediatrics. 2012;129(3):e827–41.

Yokoyama Y, Wada S, Sugimoto M, Katayama M, Saito M, Sono J. Breastfeeding rates among singletons, twins and triplets in Japan: a population-based study. Twin Res Hum Genet. 2006;9(2):298–302.

Article   PubMed   Google Scholar  

Ooki S. The effect of an increase in the rate of multiple births on low-birth-weight and preterm deliveries during 1975–2008. J Epidemiol. 2010;20(6):480–8.

Anjarwati N, Waluyanti FT, Rachmawati IN. Exclusive breastfeeding for Twin babies and its influencing factors: a study in East Java, Indonesia. Compr Child Adolesc Nurs. 2019;42(sup1):261–6.

Shim JI, Kang SJ. Impact of Breastfeeding Knowledge, attitude, and barriers on breastfeeding practice among Twin mothers. Korean J Women Healt. 2017;23 2:89–98.

Ostlund A, Nordstrom M, Dykes F, Flacking R. Breastfeeding in preterm and term twins–maternal factors associated with early cessation: a population-based study. J Hum Lact. 2010;26(3):235–41.

Wang S, Li M, Xiang X, Guo X, Peng C, Wang D, et al. Analysis on the current situation of twin breastfeeding and its influencing factors. Med. 2023;102(38):e35161.

Odei JA. Factors Associated with Exclusive Breastfeeding of Ghanaian Twins. Ghana: University of Ghana; 2013.

Google Scholar  

Tahiru R, Agbozo F, Garti H, Abubakari A. Exclusive Breastfeeding and Associated Factors among Mothers with Twins in the Tamale Metropolis. Int J Pediatr. 2020; 2020:5605437.

World Health Organization. Breastfeeding. https://www.who.int/health-topics/breastfeeding#tab=tab_3

Ceylan S, Şahin S. Comparison of breastfeeding self-efficacy and breastfeeding success of obese and normal-weight mothers in the early period. Afr Health Sci. 2020;20:2022–31.

Cinar N, Kose D, Alvur M, Dogu O. Mothers’ attitudes toward Feeding Twin babies in the First Six months of life: a sample from Sakarya, Turkey. Iran J Pediatr. 2016;26(5):e5413.

Bartick M, Reinhold A. The burden of suboptimal breastfeeding in the United States: a pediatric cost analysis. Pediatrics. 2010;125(5):e1048–56.

Mikami F, Francisco R, Rodrigues A, Hernandez WR, Zugaib M, de Lourdes BM. Breastfeeding twins: factors related to Weaning. J Hum Lact. 2018;34(4):749–59.

Huaijie Y, Tao W, Xiaoyun L, Wenfei Z, Xiaoyu Y. [The current situation investigation and analysis about breastfeeding of twins]. Hebei Med. 2019;41(3):463–5.

Huaijie Y, Qiong D, Wenhua L, Aihua C, Lu H, Liqiong Z, et al. [A qualitative study of the breastfeeding experiences and needs of twin mothers]. Chin Nurs Manag. 2015;15(09):1051–4.

Tong A, Flemming K, Mcinnes E, Oliver S, Craig J. Enhancing transparency in reporting the synthesis of qualitative research: ENTREQ. BMC Med Res Methodol. 2012;12:181.

Lockwood C, Munn Z, Porritt K. Qualitative research synthesis: methodological guidance for systematic reviewers utilizing meta-aggregation. JBI Evid Implement. 2015; 13(3).

Thomas J, Harden A. Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Med Res Methodol. 2008;8:45.

Foyston Z, Higgins L, Smith DM, Wittkowski A. Parents’ experiences of life after medicalised conception: a thematic meta-synthesis of the qualitative literature. Bmc Pregnancy Child. 2023;23(1):520.

Article   CAS   Google Scholar  

Kocabey Z, Karakoç A. Breastfeeding experience of mothers with multiple babies: a phenomenological study. Clin Exp Health Sci. 2022;12(1):18–25.

Cinar ND, Alvur TM, Kose D, Nemut T. Breastfeeding twins: a qualitative study. J Health Popul Nutr. 2013;31(4):504–9.

PubMed   PubMed Central   Google Scholar  

Mckenzie PJ. The seeking of baby-feeding information by Canadian women pregnant with twins. Midwifery. 2006;22(3):218–27.

Jonsdottir RB, Flacking R, Jonsdottir H. Breastfeeding initiation, duration, and experiences of mothers of late preterm twins: a mixed-methods study. Int Breastfeed J. 2022;17(1):68.

Leonard LG. Breastfeeding higher order multiples: enhancing support during the postpartum hospitalization period. J Hum Lact: Official J Int Lactation Consultant Association. 2002;18(4):386–92.

Mcgovern T. The challenges of breastfeeding twins. Kai Tiaki Nurs New Z. 2014;20(11):26–44.

Li R, Ware J, Chen A, Nelson JM, Kmet JM, Parks SE et al. Breastfeeding and post-perinatal infant deaths in the United States, a national prospective cohort analysis. Lancet Reg Health Am. 2022; 5.

Yuen M, Hall OJ, Masters GA, Nephew BC, Carr C, Leung K, et al. The effects of breastfeeding on maternal Mental Health: a systematic review. J Womens Health (Larchmt). 2022;31(6):787–807.

Government Assistance. Multiples NZ. https://multiples.org.nz/government-assistance/

Menekse D, Çinar N. The Effect of Breastfeeding Education Provided to pregnant women who expect twins on their breastfeeding intention. Online Türk Sağlık Bilimleri Dergisi. 2022;7:4.

Queensland Clinical Guidelines. Establishing breastfeeding. Queensland Health. 2021. http://www.health.qld.gov.au/qcg

Nagel EM, Howland MA, Pando C, Stang J, Mason SM, Fields DA, et al. Maternal psychological distress and lactation and breastfeeding outcomes: a narrative review. Clin Ther. 2022;44(2):215–27.

Henshaw EJ. Breastfeeding and Postpartum Depression: A Review of relationships and potential mechanisms. Curr Psychiatry Rep. 2023;25(12):803–8.

Russell S, Russell N. Breastfeeding Twins and multiples. In: Khalil L, Lopriore, editor. Twin and higher-order pregnancies. Cham: Springer International Publishing; 2021. pp. 355–62.

Chipojola R, Chiu HY, Huda MH, Lin YM, Kuo SY. Effectiveness of theory-based educational interventions on breastfeeding self-efficacy and exclusive breastfeeding: a systematic review and meta-analysis. Int J Nurs Stud. 2020;109:103675.

Monvillers S, Tchaconas A, Li R, Adesman A, Keim SA. Characteristics of and sources of support for women who Breastfed multiples for more than 12 months. Breastfeed Med. 2020;15(4):213–23.

Abbass-Dick J, Dennis CL. Breast-feeding Coparenting Framework: a New Framework to improve breast-feeding duration and exclusivity. Fam Community Health. 2017;40(1):28–31.

Wallenborn JT, Lu J, Perera RA, Wheeler DC, Masho SW. The impact of the Professional qualifications of the prenatal care provider on Breastfeeding Duration. Breastfeed Med. 2018;13(2):106–11.

Whitford HM, Wallis SK, Dowswell T, West HM, Renfrew MJ. Breastfeeding education and support for women with twins or higher order multiples. Cochrane Database Syst Rev. 2017;2(2):CD012003.

Moukarzel S, Caduff A, Rehm M, Del FM, Perez-Escamilla R, Daly AJ. Breastfeeding Communication Strategies, challenges and opportunities in the Twitter-Verse: perspectives of influencers and Social Network Analysis. Int J Environ Res Public Health. 2021; 18(12).

Rodriguez-Gallego I, Leon-Larios F, Corrales-Gutierrez I, Gonzalez-Sanz JD. Impact and Effectiveness of Group Strategies for Supporting Breastfeeding after birth: a systematic review. Int J Environ Res Public Health. 2021; 18(5).

Novianty N, Syarif S, Ahmad M. Influence of breast milk education media on increasing knowledge about breast milk: literature review. Gac Sanit. 2021;35(Suppl 2):S268–70.

Turville N, Alamad L, Denton J, Cook R, Harvey M. Supporting multiple birth families: perceptions and experiences of health visitors. Public Health Nurs. 2022;39(1):229–37.

Turville N, Alamad L, Denton J, Harvey M. Supporting multiple birth families; establishing an evidence base to inform Health Visitor Practice. Twin Res Hum Genet. 2021;24(6):392.

Foundation MB. Guidance for health professionals on feeding twins, triplets and higher order multiples. Multiple Births Foundation; 2015.

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Acknowledgements

We would like to thank the Ministry of Science and Technology of the People’s Republic of China for the funding support provided to this research.

This study was supported by the scientific research project of the Ministry of Science and Technology of the People’s Republic of China (2023YFC2705903). The funder had no role in the study design, themes analysis and extraction process, results interpretation, or manuscript preparation.

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Ruxue Bai, Yifan Cheng, Siyu Shan, Xinmiao Zhao, Jun Wei & Chunling Xia

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Bai, R., Cheng, Y., Shan, S. et al. The breastfeeding experience of women with multiple pregnancies: a meta-synthesis of qualitative studies. BMC Pregnancy Childbirth 24 , 492 (2024). https://doi.org/10.1186/s12884-024-06697-4

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Student experiences in agile stand-up meetings

SAM Advanced Management Journal

ISSN : 2996-6078

Article publication date: 16 July 2024

Issue publication date: 30 July 2024

This purpose of this descriptive case study is to examine students’ experience engaging in stand-up meetings during the team project for the application development course in their Management Information Systems (MIS) program. Although the body of research on agile stand-up meetings is growing, there is little research on the experience of students who are engaging in stand-up meetings. The majority of research focuses on business professionals instead of students.

Design/methodology/approach

This study uses a mixed methods approach to collect data by anonymously surveying students. This exploratory study is a prelude to implementing a larger-scale investigation of student perceptions of stand-up meetings. The research was conducted using a mixed methods approach that used a survey instrument with both open-ended and closed-ended questions to gather students’ perceptions. The qualitative data was analyzed using a thematic coding approach.

The results of this study demonstrate that students’ experiences with stand-up meetings are overwhelmingly positive, with students describing how stand-up meetings helped them communicate and collaborate with their team and solve problems together as a team. The majority of students in this study reported that participating in stand-up meetings helped them overcome roadblocks.

Research limitations/implications

The main limitation of this descriptive case study is the sample size, since only one section of the course was available during the spring semester for the survey. Consequently, the findings may not be broadly generalizable to other contexts. An additional limitation is that the sample was obtained from a school primarily serving nontraditional adult students from underserved groups. One other limitation of this study is that the course surveyed was a synchronous online section with a limited amount of time for class sessions.

Practical implications

This case study should serve as a starting point for faculty, particularly information systems faculty, who are seeking to incorporate stand-up meetings into their courses. The benefits that students cited were clear. As one student stated, stand-up “allows us to vet through our work, help build interpersonal relationships and strengthen our skills.” The larger impact and contribution of this research is that encourages faculty to adopt the practice of stand-up meetings to enhance students’ communication, collaboration and problem solving.

Social implications

Incorporating stand-up meetings into coursework benefits students by fostering collaboration, communication and problem-solving. The results of this study demonstrate that students’ experiences with stand-up meetings are overwhelmingly positive, with students describing how stand-up meetings helped them communicate and collaborate with their team and solve problems together as a team. The majority of students in this study reported that participating in stand-up meetings helped them overcome roadblocks.

Originality/value

This descriptive case study examines students’ experience engaging in stand-up meetings during the team project for the application development course in their MIS program. Although the body of research on agile stand-up meetings is growing, there is little research on the experience of students who are engaging in stand-up meetings. The majority of research focuses on business professionals instead of students.

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Lebens, M.C. and Munmun, M. (2024), "Student experiences in agile stand-up meetings", SAM Advanced Management Journal , Vol. 89 No. 1, pp. 23-38. https://doi.org/10.1108/SAMAMJ-05-2024-0013

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Stand-up meetings are a popular practice embraced by Agile business teams ( Rigby et al. , 2016 ). In the academic environment, the practice of stand-up meetings allows the professor to identify common areas where students need guidance and encourages students to pair together to troubleshoot issues ( D’Souza and Rodrigues, 2015 ). Stand-up meetings foster collaboration, which in turn nurtures respect and trust in the classroom ( Hulshult and Krehbiel, 2019 ).

This descriptive case study examines students’ experience engaging in stand-up meetings during the team project for the application development course in their Management Information Systems (MIS) program. Although the body of research on Agile stand-up meetings is growing, there is little research on the experience of students who are engaging in stand-up meetings. The majority of research focuses on business professionals instead of students.

This study uses a mixed methods approach to collect data by anonymously surveying students. This exploratory study is a prelude to implementing a larger-scale investigation of student perceptions of stand-up meetings. The research was conducted using a mixed methods approach that employed a survey instrument with both open-ended and closed-ended questions to gather students’ perceptions. The qualitative data was analyzed using a thematic coding approach. The site of the research is a federally designated minority-serving University in the USA, where 75% of students are Pell-grant eligible, 57.6% are low-income, and the majority of students are people of color ( Whelan, 2019 ; Wolfston, 2020 ). The results of this study will be applied to refine the course curriculum and survey instrument prior to a longitudinal study examining the use of stand-up meetings across multiple semesters. The broad impact of this research is to encourage faculty to adopt the agile practice of stand-up meetings to foster communication, collaboration and problem-solving in their coursework.

This literature review examines the principles of agile methodology, including the practice of stand-up meetings as one of the methodology’s rituals. The practice of integrating stand-up meetings into the agile college classroom is discussed. Finally, the curriculum for a course that uses stand-up meetings is presented, including pedagogical artifacts, to help faculty integrate this practice into their own coursework.

Agile methodology

The implementation of Agile methodology transformed the software industry more significantly than any other innovation in the last 30 years ( Šalgovičová and Klinčeková, 2020 ). Agile approaches are now becoming more and more popular across a wide range of industries and roles, including in the C-suite (D. Rigby et al. , 2020 ). Agile incorporates new values, principles, practices and advantages to offer a radical alternative to command-and-control-style management ( Alsaqqa et al. , 2020 ). Within Agile, there are several frameworks of the methodology, with Scrum, Kanban and Lean Development as the most prominent Agile frameworks ( Denisovna et al. , 2020 ). These agile frameworks were developed to help teams deliver projects on time, within budget, and with a high level of quality in an unpredictable business environment ( Parsons et al. , 2007 ; Sandsto and Reme-Ness, 2021 ).

Businesses that incorporate the Agile methodology and embrace its practices discover that they can adjust to changes more quickly. A study of toy manufacturer LEGO Group’s transition to Agile found a major impact of the model is a quicker response to change ( Sommer, 2019 ). One major benefit is the capability to quickly change focus, adapt operations and reassess the approach for business processes ( Schmitt and Hörner, 2021 ). The new style of working with an Agile mindset brings efficiency, drives innovation and creates positive employee experiences ( Koi-Akrofi et al. , 2019 ).

The most popular Agile framework is Scrum, which is an iterative framework, meaning project teams break down tasks into small blocks of time called iterations ( Hron and Obwegeser, 2022 ). The fundamentals of Scrum are straightforward. Organizations create and empower a small team of three to nine full-time employees to take on an opportunity (D. K. Rigby et al. , 2016 ). This cross-functional team contains employees with all of the abilities required to complete the project tasks. The team is completely responsible for all aspects of the project and manages itself (D. K. Rigby et al. , 2016 ). Scrum is distinguished by its adaptability and holistic viewpoint. The methodology is intended to provide substantial value quickly ( Alami and Krancher, 2022 ). The practices of Scrum ensure communication transparency, foster a culture of collective responsibility and promote continuous progress ( Šalgovičová and Klinčeková, 2020 ). One of the Scrum practices used specifically to increase communication, collaboration and progress is holding stand-up meetings.

Stand-up meetings

A recent study of Agile implementation in 20 different organizations found that one of the most commonly embraced Agile practices is stand-up meetings, and another study found that the majority of teams who use Agile methods conduct stand-up meetings ( Julian et al. , 2019 ; Stray et al. , 2017 ). During stand-up meetings, the team members literally stand in a circle and provide three updates: their most recently finished task, their next task and their roadblocks to progress ( Stray et al. , 2017 ). The reason team members stand is to keep the meeting short.

Stand-up meetings have been found to improve communication between team members and increase collaboration by fostering trust ( Hummel et al. , 2015 ; Sandsto and Reme-Ness, 2021 ; Žužek et al. , 2020 ). Stand-up meetings also allow team members to solve problems. During stand-up meetings, team members report their roadblocks to getting their tasks done, which allows the team to triage problems and help each other to finish their tasks ( Morandini et al. , 2021 ). The benefits of enhanced communication, collaboration and problem-solving have contributed to making stand-up meetings one of the most widely embraced Agile practices. While stand-up meetings began as a practice on software development teams, they are now being embraced by all different types of teams, including student project teams in the classroom.

Integrating stand-up meetings into the classroom

With the popularity of stand-up meetings soaring as an industry practice, it is important for higher education to keep up with this trend. Students in computing must be prepared to enter a job market where Agile and stand-up meetings are the norm ( Sharp and Lang, 2018 ). Much of college instruction is still lecture-based and teacher-centered, which does not prepare students to enter the professional workplace, where communication, collaboration and problem-solving are critical to success ( D’Souza and Rodrigues, 2015 ). Students report that if they are learning communication and collaboration skills at all, it is almost an afterthought outside of the classroom, as a part of internships and extracurricular activities ( Matusovich et al. , 2012 ). This problem can be solved by integrating stand-up meetings into the college classroom to foster student communication, collaboration and problem-solving ( Devedžić and Milenković, 2011 ; Kessler and Dykman, 2007 ). At the same time, students learn a popular Agile practice that broadens their business skills.

While research into integrating stand-up meetings in the college classroom is still emerging, promising studies have already been published. A four-year study of upper-division computer science students found students improved their communication skills through stand-up meetings, particularly in planning and discussing their work, and collaborated more often to solve problems in their code ( Monett, 2013 ). A longitudinal 10-year study on teaching Agile practices found integrating stand-up meetings into the classroom fostered values of openness, respect and courage ( Martin et al. , 2017 ). Another study measured the success of incorporating Agile practices, including stand-up meetings, into an online information technology course ( Hulshult and Krehbiel, 2019 ). Students were polled at the end of the course, and the results show that agile improved their learning and raised the quality of their final project ( Hulshult and Krehbiel, 2019 ).

A case study of integrating Agile into student capstone projects found that while teaching Agile practices is challenging, it is worthwhile because it enriches students’ software development experience ( Lu and DeClue, 2013 ). Three studies on integrating the Agile practice of prototyping, using low-code tools and robotic process automation, show students feel the Agile skills they gained are valuable for the job market ( Lebens, 2021 ; Lebens et al. , 2023 ; Lebens and Finnegan, 2021 ). The authors of one study on integrating agile into the classroom concluded that agile practices “should be used in any college course requiring collaboration, group projects, or problem solving,” based on how practices such as stand-up meetings foster communication between students ( May, 2016 ).

With the rising popularity of the Agile methodology, integrating Agile practices such as stand-up meetings can help to prepare students for the cutting-edge business environment. Although faculty face the challenge of reworking the curriculum to integrate stand-up meetings into the classroom, there is growing evidence that stand-up meetings benefit students. Stand-up meetings have the potential to foster better communication, collaboration and problem-solving among student teams, which in turn positively impacts the student experience in the classroom.

Course structure

The researchers chose to implement stand-up meetings as a part of a larger group of Agile practices within a software development course. The course that is the focus of this study is an introductory application development course that is part of the information systems (IS) core curriculum. MIS students are required to take this course as a part of their degree requirements. Although the course is an upper-division course, there are no prerequisite programming, math or logic courses, so the curriculum is structured as an introductory programming course.

The course is taught online with weekly synchronous class sessions in a 16-week semester format. In the first half of the course, students learn the basic structures of the Python programming language, including variables, operators, conditional statements, repetition statements (loops), data structures, command-line input/output (I/O) and file I/O. After eight weeks, they take a practical midterm exam, which requires them to build an application that uses the basic structures of the Python language. Students who pass the midterm exam progress on to a team project to develop an application of their own design. Students complete several lessons on Agile methodology practices, including stand-up meetings, so that they are prepared to use the Agile methodology with their project team. During the project, the student teams engage in two development sprints, and they are required to hold stand-up meetings during their sprints.

Pedagogical artifacts

The assignment instructions for stand-up meetings are included in this section to serve as a curricular support for faculty seeking to use stand-up meetings in their own courses. In addition to discussing the instructions in class, students also prepare for stand-up meetings by engaging in a short interactive online module with videos and lecture on stand-up meetings and by reading the classic article “Daily Stand Up Meeting” by Don Wells, one of the pioneers of the Agile methodology eXtreme Programming ( Wells, 1999 ). They also take a short quiz to measure their knowledge after completing the interactive module and reading the article.

Assignment Instructions for Stand-Up Meetings:

Schedule a time in Zoom to meet with your team for the stand-up meeting during the sprint;

Invite your professor to the meeting so she can see that the meeting has been scheduled;

Participate in the stand-up meeting;

Directions on how to record a meeting in Zoom;

What task did you just finish?

What is your next task?

What are your roadblocks?

Upload a Word document containing the link to your video in the Sprint-Stand-Up Meeting assignment dropbox. (Source: figure created by authors)

Methodology

This descriptive case study is intended to serve as a condensed study performed with students in a single section of an online application development course before implementing a large-scale longitudinal investigation of students’ experiences with stand-up meetings over several sections of the course. The goal of this descriptive case study is to determine if the students experiences with stand-up meetings are positive enough to necessitate expanding this approach to a large number of sections of the course, as well as possibly expanding the approach to other courses in the IS department. The aim of this descriptive study is to encapsulate, in the students’ own words, their experiences with stand-up meetings. The research method chosen for this study is an anonymous survey consisting of open- and closed-ended questions to collect both qualitative and quantitative data. The mixed methods approach was chosen for this descriptive case study because it provides a theoretical perspective at a greater level than straight Likert-scale questions would provide.

Prior to conducting the research, a research proposal was submitted to the Institutional Review Board (IRB) at the researchers’ home institution, and the IRB was approved by the research board. Before answering the survey questions, the student respondents read and voluntarily agreed to a consent form describing the way the data would be used as well as the minimal risks involved. During one of the weekly online class sessions for the course, student respondents were given 10 minutes to complete the survey if they chose to participate. Students who did not want to take the survey were given the alternative of taking a short break instead of participating in the survey. Students were not offered course credit or extra credit for participating.

Research setting and participants

For this study, stand-up meetings were introduced in the spring 2022 semester in one section of an undergraduate upper-division application development course. The student population in the course consisted of juniors and seniors who were MIS majors. The application development course is required for MIS majors. The sample consisted of 28 nontraditional upper-division undergraduates enrolled in an online synchronous section. In total, 19 students elected to take part in the study out of the 28 students who were extended the opportunity to participate.

The site for this study is an urban, mid-size, public university where the average student is 29 years old. The University is a federally designated minority-serving institution, meaning the majority of students are students of color. 75% of the students at the university are Pell grant eligible, and 57.6% reside in lower-income households ( Whelan, 2019 ; Wolfston, 2020 ).

Q1: Participating in stand-up meetings helped me get to know my classmates better.

[Likert Scale: Strongly Agree, Agree, Neither Agree nor Disagree, Disagree, Strongly Disagree]

Q2: Participating in stand-up meetings helps students collaborate with each other.

Q3: As a result of sharing roadblocks during stand-up, students helped each other to overcome their roadblocks.

Q4: Participating in stand-up meetings in class is a valuable experience.

Q5: What are the benefits of stand-up meetings?

[Open-Ended]

Q6: What are the drawbacks to stand-up meetings?

Students completed the survey during an online synchronous class session on April 25, 2022. The survey was conducted during the final week of the course, after students had finished participating in stand-up meetings as a part of the course activities. The data was downloaded from Qualtrics and then exported into an Excel spreadsheet format to perform the analysis.

The quantitative data results were tallied to determine the most common responses to each of the closed-ended questions. These questions used a Likert rating scale to present a set of options that covered a range from strongly agreeing to strongly disagreeing with the researchers’ statements on stand-up meetings. The five-point scale allowed the researchers to analyze the level of agreement to gauge students’ experiences with stand-up meetings.

To investigate the students’ open-ended comments on their experiences with stand-up meetings, an inductive coding approach was chosen for the analysis of the qualitative data. This approach was selected due to its ability to allow the data to guide the formation of codes and themes, rather than imposing preconceived categories on the data.

The process began with a thorough exploration of the data, during which the researchers studied the responses to the survey questions. This study allowed them to gain a deep understanding of the content and context of the responses. Following this, the practice of qualitative data coding was used to create and assign codes that categorized these responses.

The coding process was iterative, with the researchers going back and forth between the data and the emerging codes. This ensured that the codes were grounded in the data and accurately represented the respondents’ experiences. The researchers also maintained a coding diary, which documented the development of the codes and provided a rationale for their creation. This diary served as an analytical pathway, linking the raw data to the final themes.

Once the codes were created and assigned, an inductive coding analysis was performed on the qualitative data. This involved looking for patterns and relationships between the codes and then grouping similar codes together to form themes. These themes represented the most frequent and significant ideas present in the data.

Throughout the analysis, the researchers were mindful of their own potential biases and took steps to address them. They engaged in reflexivity, regularly reflecting on their own beliefs, values and experiences and how these might influence the analysis. They also sought feedback from other researchers in the field of information systems (IS) to challenge their interpretations and ensure the validity of the findings. The goal of this analysis process was to establish the plausibility of the study findings, despite the small sample size typical of qualitative case studies.

The participation rate for the survey was fairly high, with 19 of the 28 students in the sample joining in the study. 63% of the students strongly agreed or somewhat agreed that participating in stand-up meetings helped them get to know their classmates better, as shown in Figure 1 . 79% of students strongly or somewhat agreed that participating in stand-up meetings helps students collaborate with each other, as shown in Figure 2 .

As shown in Figure 3 , 79% of the students strongly agreed or somewhat agreed that as a result of sharing roadblocks during stand-up, students helped each other to overcome their roadblocks. 84% of students strongly agreed or somewhat agreed that participating in stand-up meetings in class is a valuable experience, as shown in Figure 4 .

The researchers used an inductive coding analysis to scrutinize the data from survey questions 5 and 6. The researchers opted for this method as it allows the data to shape the formation of codes and themes instead of forcing preconceived categories onto the data. The initial step involved a comprehensive review of the students’ responses, enabling the researchers to gain a deep understanding of the content. Subsequently, codes were developed based on these responses. The coding process was cyclical, with the researchers continuously revisiting the data and the evolving codes. This ensured that the codes were firmly rooted in the data and accurately depicted the students’ experiences.

During the inductive coding analysis, the researchers identified several common categories, which are described in Tables 1 and 2 . The respondent IDs in Tables 1 and 2 correspond to the full text of the responses that is included in the Appendix of this paper. The categories presented in Tables 1 and 2 were not predetermined but emerged organically from the data as a part of the inductive coding analysis. Responses with similarities were grouped into these categories, facilitating the identification of recurring themes. These themes encapsulated the most critical ideas in the data.

In response to question 5, “What are the benefits of stand-up meetings?,” common themes that emerged are that stand-up meetings foster communication, collaboration and problem-solving. The most common theme is that stand-up meetings improved communication among team members, with eight out of the 19 responses to question 5 describing communication as a benefit of holding stand-up meetings. Other common themes in response to question 5 were how stand-up meetings helped team members fix problems and understand what each other was accomplishing in terms of completing project tasks.

Question 6 asked “What are the drawbacks to stand-up meetings?” The only drawback that was mentioned more than once in the responses was that it was difficult to find a time when all team members were available for their stand-up meeting. The remaining drawbacks cited were limited to a single response each, leaving finding available time for stand-up as the only common theme for question 6.

Students’ experiences with stand-up meetings were overwhelmingly positive in this case study. 84% of students strongly agreed or somewhat agreed that participating in stand-up meetings in class is a valuable experience, as shown in Figure 3 . Students expressed far more positive than negative perceptions of stand-up meetings in their responses to the survey questions.

The majority of students felt that participating in stand-up meetings helped them get to know their classmates better. This finding was consistent with the literature showing that stand-up meetings foster communication between team members. The majority of students responding to the survey also felt that participating in stand-up meetings helps students collaborate with each other. This finding was also consistent with the literature showing that stand-up meetings facilitate collaboration within project teams.

While the students’ responses to the Likert scale survey questions demonstrated students felt positively about the stand-up meeting experience, the majority of the students’ responses to the open-ended questions also highlighted positive sentiment toward stand-up meetings. The student’s open-ended responses are cited in this section using the Respondent ID (RID), which corresponds to the full text of the students’ responses in the Appendix. The students’ open-ended responses to the qualitative portion of the survey highlighted the benefits of communication and collaboration during stand-up meetings.

One student mentioned that a benefit of stand-up meetings is that the students “all got the chance to talk and get to know each other better” (RID 16). Another student described how stand-up meetings encouraged teamwork in their response: “Personally, i[ sic ] think wherever there is collaboration and teamwork, the outcome is great” (RID 17). Students mentioned that stand-up meetings “allow for everyone to get on the same page quickly” and “make sure everyone was on the same page in different stages of the project” (RID 18, 15). The comradery encouraged by stand-up meetings was evident in another student’s response to the benefits of stand-up meetings, “I thought it was nice to hear where some of my peers were also struggling. Not in any sort of a bad way, it is just insightful to hear what hangs people up” (RID 15). This student’s experience highlights how stand-up meetings can help students engage by learning that they are not the only person in the class struggling with a particular concept or task. In a similar vein, another student described the primary benefit of stand-up meetings as “reaching out for help and others will have an opportunity to help the teammate that is in need” (RID 10). Clearly, this student experienced positive collaboration with their classmates as a result of participating in stand-up meetings, which is consistent with the findings in the literature that stand-up meetings foster collaboration.

In addition to positive experiences with communication and collaboration as a result of stand-up meetings, students also overwhelmingly agreed that stand-up meetings facilitated problem-solving. As shown in Figure 3 , 79% of the students agreed that as a result of sharing roadblocks during stand-up, students helped each other to overcome their roadblocks. In addition, several students mentioned problem-solving as a benefit to stand-up meetings in the open-ended responses to question 5. One student described how stand-up meetings “encourage all participants to efficiently explain the problems going on within the project” (RID 18). Another student explained how stand-up meetings helped their team solve problems: “We knew when someone was struggling with something and could offer clarification/help before ‘crunch time’” (RID 15). Communication, collaboration and problem-solving were clearly positive aspects of the students’ experiences with stand-up meetings, which reinforces earlier findings in the literature.

While students’ experiences with stand-up meetings were mainly positive, there were some drawbacks as well. The most common drawback that students described was finding time to meet together. This is not surprising, since they were attending an online course section. The course was scheduled with only one hour of synchronous class meeting time per week, so students needed to schedule the stand-up meetings with their teams outside of class time. One student mentioned that it is “hard to find the right time for every member to meet up” (RID 10). Another student wrote that “it is difficult to coordinate a time that consistently works for everyone’s schedule, leaving people who aren’t able to make the meeting out of the loop” (RID 3).

One approach faculty could take to help find a consistent time for stand-up meetings is to schedule meetings as a part of the regular class session time. If this is not possible, such as in asynchronous online courses or courses with limited seat time, the faculty member could provide students with a polling tool to help with scheduling. Popular polling tools such as Doodle, Microsoft Bookings and Poll Everywhere allow a meeting organizer to specify several possible meeting times. Team members can then respond to the poll to indicate which meeting times work well with their schedule.

Although difficulty finding a common meeting time was by far the most prevalent drawback students cited, there were a few other drawbacks to stand-up meetings mentioned by individual students. One student described how meetings “felt tedious,” which another said “sometimes group members didn’t have much to report” (RID 11, 15). Faculty could emphasize the importance of being prepared and of keeping the meeting moving quickly by modeling a stand-up meeting in class, so students experience an example of a successful meeting before they move into scheduling their own stand-up meetings with their teams. If the course does not allow for an in-class meeting because it is an asynchronous online course, faculty could provide a video of a successful stand-up meeting to model best practices.

Another student pointed out that “stand-up meetings are not great for initial meetings where longer planning is needed or may be required. In our group, our first half of the semester was ‘waterfall’ based, as it required more planning for the initial development. Once we transitioned to the sprints, the stand-up meetings fit better and aided the work we were completing” (RID 19). When faculty are planning out the course timeline, they may want to consider including longer planning meetings at the beginning of the project to allow teams to develop the requirements and user stories for the project. Then, after the initial planning is finished, students could transition to stand-up meetings for their development sprints.

Limitations and future research

The main limitation of this descriptive case study is the sample size, since only one section of the course was available during the spring semester for the survey. Consequently, the findings may not be broadly generalizable to other contexts. The researchers recognize that the limited sample restricts the ability to draw larger conclusions. To address this, they plan to repeat the study across multiple semesters, collecting longitudinal data on students’ experiences with stand-up meetings to enhance the study’s robustness.

An additional limitation is that the sample was obtained from a school primarily serving nontraditional adult students from underserved groups. The university’s unique demographic composition warrants attention. It is a federally designated minority-serving institution where the majority of students are students of color, are eligible for Pell grants and reside in lower-income households. While this specificity provides rich insights into the stand-up meeting experiences of nontraditional adult learners, it also introduces limitations. The experiences of students from other backgrounds or age groups may differ significantly. A future area of research is repeating this study with traditional university students to see how traditional students’ experiences with stand-up meetings differ from the experiences of the students in this study. Investigating differences in stand-up meeting dynamics between these two groups will contribute to a more nuanced understanding of using agile practices in the college classroom.

One other limitation of this study is that the course surveyed was a synchronous online section with a limited amount of time for class sessions. Students in asynchronous online course sections and face-to-face course sections may report different experiences with stand-up meetings. For example, in a face-to-face course, stand-up meetings could be held in person as a part of the normal class period, which may encourage a higher level of participation. In summary, while this study sheds light on stand-up meeting practices, the researchers acknowledge these limitations and remain committed to refining their understanding through ongoing research on agile practices in the college classroom.

This case study should serve as a starting point for faculty, particularly information systems faculty, who are seeking to incorporate stand-up meetings into their courses. The benefits that students cited were clear. As one student stated, stand-up “allows us to vet through our work, help build interpersonal relationships and strengthen our skills.” The larger impact and contribution of this research is that it encourages faculty to adopt the practice of stand-up meetings to enhance students’ communication, collaboration and problem solving.

Survey question 1

Survey question 2

Survey question 3

Survey question 4

Inductive coding analysis results for survey question 5: benefits of stand-up meetings