Bedsharing among breastfeeding physicians: Results of a nationwide survey

Adetola F. Louis-Jacques; Melissa Bartick; Adeola Awomolo; Jiaqi Zhang; Lori Feldman-Winter; Stephanie A. Leonard; Joan Meek; Katrina B. Mitchell; Susan Crowe

doi:10.1371/journal.pone.0305625

Peer Review History

Original SubmissionJune 7, 2023
17 Jul 2023 Decision Letter - Linglin Xie, Editor PONE-D-23-16782Bedsharing among breastfeeding physicians: Results of a nationwide surveyPLOS ONE Dear Dr. Louis‐Jacques, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please submit your revised manuscript by Aug 31 2023 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. 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The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Dear Authors, you are come up with interesting title which creates a dilemma between d/t scholars. because some argue that bedsharing is important while others not. Additionally, your write up is smart however your paper have the following gaps:_ 1.Your summary doesn't contain introduction part which is not appropriate way 2.your objective is not SMART which is not measurable .The verb you use not measurable. 3.You only use 3 kye words which is below standard. 4.Your methodology didn't go with your objective because your objective is to understand and to investigate the reason why bedsharing is high or low which is qualitative data. your study design didn't go with survival model. where is your follow up time?? Also your sample size determination and procedure is not clear?? how you select 806 physician respondents or if you incorporate all physicians is there only 806 physicians in USA?? Think over?? Why you include only single birth only? 5.result: you didn't make model fitness test, multicollinearity test and other important components were not performed 6 . what will be your interpretation of your outcome variable is it low or high requires justification?? ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: Yes: Tamiru Alene,department of pediatrics and child health nursing,injibara univesity ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0305625.r001
Revision 1
19 Feb 2024 Author Response January 15, 2024 Manuscript Number: PONE-D-23-16782 Manuscript Title: Bedsharing among breastfeeding physicians: Results of a nationwide survey PLOS ONE Dear Dr. Linglin Xie, On behalf of my co-authors and myself, I would like to thank you and our reviewer for the prompt and thoughtful feedback on our manuscript. Attached, please find original comments and our responses. We are truly sorry for the delay in our response. Reviewer #1: Dear Authors, you are come up with interesting title which creates a dilemma between d/t scholars. because some argue that bedsharing is important while others not. Additionally, your write up is smart however your paper have the following gaps: 1. Your summary doesn't contain introduction part which is not appropriate way Authors Response: Thank you very much. We have included an introduction in the abstract. 2. your objective is not SMART which is not measurable. The verb you use not measurable. Authors Response: The objective in the abstract has been modified to be measurable. Thank you for this comment. 3. You only use 3 kye words which is below standard. Authors Response: Thank you, we have increased the number of key words to 5 - breast feeding, lactation, sleeping habits, postpartum period, physicians. 4. Methodology a. Your methodology didn't go with your objective because your objective is to understand and to investigate the reason why bedsharing is high or low which is qualitative data. your study design didn't go with survival model. where is your follow up time?? Authors Response: Studying the association between bedsharing and breastfeeding duration was one of the objectives. This outcome was a time-to-event variable with right censoring, so we elected to conduct time-to-event (survival) analysis. The follow-up time was the time from birth to the end of breastfeeding. Some participants were still breastfeeding when they took the survey, and these participants were censored. I can see why using a KM curve seems odd given that we did not follow a cohort of individuals, but rather surveyed responses at one time to determine "survival of breastfeeding" given bedsharing practice. The cross-sectional survey allowed retrospective data collection of time for a survival analysis. The reasons for bedsharing were collected in the survey not as qualitative data. This was a secondary objective and was reported in table 5 to better understand the reasons for bedsharing or not bedsharing. b. Also, your sample size determination and procedure is not clear?? how you select 806 physician respondents or if you incorporate all physicians is there only 806 physicians in USA?? Think over?? Authors Response: This is a cross sectional study design using a convenience sample of physicians who responded to the invitation to survey. We recruited as many participants as possible through 2 closed Facebook groups (Dr. MILK and Physician Moms Group) and Academy of Breastfeeding Medicine listserv. Recruitment was through social media platforms and by email listservs targeting breastfeeding physicians from October 2020 through July 2021. c. Why you include only single birth only? Authors Response: Multiples were excluded since that may confound the probability of breastfeeding continuation. 5.result: you didn't make model fitness test, multicollinearity test and other important components were not performed We used Cox proportional hazards modeling in analyses. It is recommended that most people in a time-to-event analysis have the event observed, and in this study 73.1% had ceased breastfeeding by the time of the survey. Cox proportional hazards models are semi-parametric models that are widely used for time-to-event analyses because they do not require modeling the baseline hazard. The primary assumption in Cox proportional hazards model is that the hazard is proportional between the two comparison groups over time. The proportionality assumption was tested by the Schoenfeld residual test with global p = 0.061 on complete data, and Schoenfeld residual scaled plot. Both results showed the proportionality assumption was not violated. We also assessed the proportionality assumption for each covariate and found that it was not violated." Table 1 Schoenfeld residual individual test result variable Individual p value bedsharing 0.596 race 0.861 ethnicity 0.955 Marital status 0.763 Trainee status 0.619 specialty 0.090 Birth year 2005 0.051 Depression 0.115 Figure 1 Scaled Schoenfeld residual plot (please see attached response document) We adjusted for medical specialty, trainee status, race, Hispanic ethnicity, self-reported postpartum depression, and infant birth year before or after 2005 in the Cox proportional hazards regression. We did not have reason to suspect multicollinearity between these confounders and these were categorical or binary variables. Cox proportional hazards models are not ordinary least squares models and the confounders being categorical precludes a calculation of variation inflation factors as quantitative assessments of collinearity test. 6 . what will be your interpretation of your outcome variable is it low or high requires justification?? Authors Response: Thank you very much for this comment. We have expanded on this in the first paragraph of our discussion section. Lines 249-253: “We found bedsharing was common among breastfeeding physicians consistent with our hypothesis, including physicians in specialties caring for women/mothers and/or infants. Also consistent with previous literature in the general population and our hypothesis, bedsharing is associated with longer duration of breastfeeding among physicians. There was a greater than 40% HR decrease for breastfeeding cessation.” One would expect physicians to be among the most compliant groups to follow the AAP guidelines, given their type of work in the healthcare sector, and the fact that many are expected to counsel on this guideline as part of their job. This finding demonstrates that the recommendations are not consistent with the lived experiences of the physicians in our sample. Attachments Attachment Submitted filename: Bedsharing Reviewers Comments and Responses.docx https://doi.org/10.1371/journal.pone.0305625.r002
4 Jun 2024 Decision Letter - Linglin Xie, Editor Bedsharing among breastfeeding physicians: Results of a nationwide survey PONE-D-23-16782R1 Dear Dr. Louis-Jacques, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice will be generated when your article is formally accepted. Please note, if your institution has a publishing partnership with PLOS and your article meets the relevant criteria, all or part of your publication costs will be covered. Please make sure your user information is up-to-date by logging into Editorial Manager at Editorial Manager® and clicking the ‘Update My Information' link at the top of the page. If you have any questions relating to publication charges, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Linglin Xie Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #2: All comments have been addressed ******** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #2: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #2: Yes ****** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #2: Yes ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #2: Yes ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #2: (No Response) ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #2: No ******** https://doi.org/10.1371/journal.pone.0305625.r003
Formally Accepted
23 Jul 2024 Acceptance Letter - Linglin Xie, Editor PONE-D-23-16782R1 PLOS ONE Dear Dr. Louis‐Jacques, I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now being handed over to our production team. At this stage, our production department will prepare your paper for publication. This includes ensuring the following: * All references, tables, and figures are properly cited * All relevant supporting information is included in the manuscript submission, * There are no issues that prevent the paper from being properly typeset If revisions are needed, the production department will contact you directly to resolve them. If no revisions are needed, you will receive an email when the publication date has been set. At this time, we do not offer pre-publication proofs to authors during production of the accepted work. Please keep in mind that we are working through a large volume of accepted articles, so please give us a few weeks to review your paper and let you know the next and final steps. Lastly, if your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. If we can help with anything else, please email us at customercare@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Linglin Xie Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0305625.r004

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