Journal of Human Lactation

Please read the following materials, which apply to all manuscripts and include general policies and publications standards.

At the end of the general directions, there will be a list of manuscript types. These links will lead you to specific directions for the manuscript type that you are preparing.

There are no fees payable to submit or publish in this Journal. Open Access options are available - see section below.

JHL offers optional open access publishing via the Sage Choice programme and Open Access agreements, where authors can publish open access either discounted or free of charge depending on the agreement with Sage. Find out if your institution is participating by visiting Open Access Agreements at Sage. For more information on Open Access publishing options at Sage please visit Sage Open Access. For information on funding body compliance, and depositing your article in repositories, please visit Sage’s Author Archiving and Re-Use Guidelines and Publishing Policies.

JHL PUBLISHING POLICIES FOR ALL MANUSCRIPT SUBMISSIONS

As a member of the Committee on Publication Ethics (COPE), the Journal of Human Lactation follows their ethical guidance, as well as the ethical standards set forth by other recognized international publications standards.

Protection of Human Rights

 JHL only publishes research that has been conducted ethically. All researchers must state within their manuscripts that investigations were carried out using a high ethical standard. Evidence of protection of human subjects’ rights approved by an appropriately credentialed Institutional Review Board is required for all research manuscripts, with the exception of literature reviews (document in the Design sub-section of Methods section). The specifics about how informed consent was obtained should be described in the Data Collection section of the submitted manuscript. All experimental studies must conform to the Declaration of Helsinki (World Medical Association, 2001).

Authors are required to ensure the following guidelines are followed, as per the International Committee of Medical Journal Editors recommendations (Fees, 2015):

• Participants have a right to privacy, which should not be infringed upon without their informed consent.
• Identifying information, including participants’ names, initials, or hospital numbers should not be published in written descriptions, photographs, or pedigrees unless the information is essential for scientific purposes and the participant (or parent or guardian) has given written informed consent for publication. Informed consent in this situation requires that an identifiable participant be shown the manuscript and provide consent prior to submission.
• Identifying details should be omitted if they are not essential. Complete anonymity is difficult to achieve; therefore, informed consent should be obtained if there is any doubt. For example, masking the eye region in photographs of participants is inadequate protection of anonymity. If identifying characteristics are altered to protect anonymity (e.g., in genetic pedigrees), authors should provide assurance that alterations do not distort scientific meaning.

Peer review policy

All manuscripts are reviewed initially by the editors and only those papers that meet the scientific and editorial standards of the journal, as well as fit within the aims and scope of the journal are considered for publication. JHL operates a conventional double-anonymize peer review for all original research, original perspectives, and Insights into Policy and Practice manuscripts. During this process both the reviewers’ and authors’ names (as well as any other identifying information) are concealed. Other types of submissions (e.g., letters to the Editor, organizational news briefs, commentaries, book reviews, Lactation Newsmakers, and About Research features) are peer reviewed but not anonymized. Each research manuscript is reviewed by 2 or 3 peer reviewers and an Associate Editor during the manuscript review process. All manuscripts are reviewed as soon as possible, and an editorial decision is generally reached within eight weeks of submission. However, in some cases more than 8 weeks may be needed to ensure quality and rigor of a manuscript.

The Editor in Chief makes all final decisions about publication and has broad discretion in determining whether an article is an appropriate fit for the journal. Many manuscripts are declined with a very general statement of the rejection decision. These decisions are not eligible for appeal unless the author believes the decision to reject the manuscript was based on an error in the review of the article or that ethical misconduct occurred. In this case the author may appeal the decision by providing the Editor in Chief (jhleditorinchief@gmail.com) with a detailed written description of the error or ethical misconduct they believe occurred. If an author believes the decision regarding their manuscript was affected by a publication ethics breach, the author also may contact the publisher with a detailed written description of their concern, and information supporting the concern, at publication_ethics@sagepub.com.

JHL editors and staff are permitted to submit papers to the journal for consideration. In this scenario, the author-editor is excluded from all information about peer review and editorial decision-making processes. The peer review process remains double-anonymized, as it is for all authors.  The manuscript is processed entirely by other members of the editorial staff and the editor-author is notified of decisions in the same way as are all other authors. These manuscripts are held to the same standards and processes as are all other submissions. If accepted and published, these articles will have an Editor’s note confirming the above process was followed.

Plagiarism

“Plagiarism is the act of presenting the words, ideas, or images of another as one’s own” (APA, 2020, p. 21). Plagiarism in any form is a serious breach of ethical scholarship. All submitted manuscripts will be checked for plagiarism using a software program. For this reason, it is important that authors understand that when using the written words from other sources

they must use quotation marks with appropriate in-text citations per APA formatting, including page numbers.

To avoid plagiarism quotes shorter than 40 words must be included within the narrative with quotation marks; however, for quotes longer than 40 words indent and do not use quotation marks. Both types of quotes must have the appropriate in-text citation (author[s] name, publication year, page number[s]) per APA formatting.

Self-Plagiarism or text recycling is a form of plagiarism where an author re-presents their published previously words as new without appropriate citation (APA, 2020; COPE, n.d.). An exception to this would be words used by an author in their dissertation.

Authors will be informed of suspected cases of plagiarism within their submitted manuscripts and these cases will be investigated. In severe cases, JHL is duty bound to inform the author(s) institutional affiliations of the ethical breach in accordance with COPE guidance (COPE, 2013).

Authorship

The submitting author is responsible for listing the contributions of all authors at submission. All authors should agree to their individual contributions prior to submission. The JHL has strict authorship requirements in accordance with the International Committee of Medical Journal Editors’ (ICMJE, n.d.) recommendations and uses the Contributor Roles Taxonomy (CreDIT) system (Sage, 2021). Per these guidelines, to qualify as an author one must meet all the following:

• Responsibility for at least one of the following roles, as defined by the taxonomy: conceptualization, methodology, formal analysis or investigation.
• Actively involved in writing the manuscript, either in drafting the work or revising it critically for important intellectual content.
• Given final approval of the version to be published.
• Agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved (ICMJE, n.d.).

Manuscripts should be submitted for consideration only after all contributing authors give consent. When there is no data collection, analysis, or interpretation for the work (e.g., for an Editorial) the first criterion may be met by the roles “Conceptualization” or “Methodology”. During the submission process, the submitting author will be responsible for identifying the roles of all authors that qualify them for authorship. As a part of the CreDIT system, the roles identified for each author during submission will be published if the manuscript is accepted.

Any contributors who do not meet all four authorship criteria outlined by ICMJE should be listed in the Acknowledgements. Examples of those who might be acknowledged include a person who provided purely technical or writing assistance, or a department chair who provided only general support (CITE https://us.sagepub.com/en-us/nam/credit). JHL allows shared first authorship when applicable. Please designate the co-first authors within an Authors’ Note section just before the references.

Please note that AI chatbots, for example ChatGPT, should not be listed as authors. For more information see the policy on Use of ChatGPT and generative AI tools.

Funding acknowledgement

In compliance with ICMJE guidance (Fees, 2015), all authors are required to acknowledge any funding source on the title page at the time of submission. If the manuscript is accepted, this funding statement will be published as part of the paper in a separate heading after the body of the text and before the reference list.

The International Code of Marketing of Breast-milk Substitutes

JHL complies with the World Health Organization’s (1981) International Code of Marketing of Breast-milk Substitutes (IC) by not publishing research funded by non-International Code compliant organizations.

Disclosures and Declaration of Conflicting Interests

It is the editorial policy of JHL to require a statement of disclosure and a declaration of conflicting interests from all authors to be included on the title page at the time of submission. If the manuscript is accepted, this declaration will be published as part of the paper in a separate heading after the body of the text and before the reference list. A disclosure is any additional information that could be important to the reader and promote transparency. All relevant disclosures about relationships between authors need to be included (e.g., student and advisor relationships; consultancy).

JHL does not publish proprietary trademarks or names of products in published articles. When writing the disclosure and conflict statement, the information must be specific and include any financial relationship that any and all authors of the article have with any sponsoring organization and the for-profit interests the organization represents, and with any for-profit product discussed or implied in the text of the article. Any commercial or financial involvements that might represent an appearance of a conflict of interest, including the employment of the authors needs to be additionally disclosed to the editor to evaluate whether sufficient disclosure has been made within the statement provided.

If an author is unsure if something constitutes a conflict of interest or requires a disclosure, JHL strongly encourages authors to email the Editor in Chief (jhleditorinchief@gmail.com) to seek assistance. For more information, please visit the Sage Journal Author Gateway (https://us.sagepub.com/en-us/nam/journal-author-gateway).

Choosing Relevant and Rigorous References

• Articles referenced must be the most relevant about the topic. In most cases, JHL asks that references cited be no older than five years. Citations about methodology and theoretical frameworks and a few classic articles on the topic older than five years are acceptable. Please be aware that, in areas with rapidly growing or shifting knowledge bases, five years may be too long to ensure relevance and even more recent works would need to be cited.
• Predatory references: The Journal of Human Lactation will not knowingly publish references to articles in predatory journals. Please see https://journals.sagepub.com/topic/collections-jhl/jhl-1-jhl-policies/jhl for further information on this policy.
• Preprints: The Journal of Human Lactation has specific policies regarding the use and citation of preprint papers. Please see https://journals.sagepub.com/topic/collections-jhl/jhl-1-jhl-policies/jhl for full policy if your manuscript contains any preprints
• In-text referencing limits: When citing more than one reference within a single in-text citation, limit to only the most relevant (no more than three references).
• Excessive self-citation: Self-citation (i.e., authors citing their previous works in a manuscript) is sometimes necessary. However, according to international publishing standards unnecessary, or excessive self-citation is ethically questionable and should be avoided. Authors should take care in referencing their own work and only do so when it is the most relevant reference. JHL will consider instances of possible excessive self-citation on a case-by-case basis and may ask authors to remove or change references if they are deemed unnecessary or not adequately relevant.
• Use primary sources: References should always be to a primary source, the source closest to the origin of the information (e.g., original research, documents), rather than secondary sources of information (e.g., literature review articles, textbooks, blogs). Please contact the Editor in Chief with any questions (jhleditorinchief@gmail.com).
• Rigor of references: All references must be of appropriate scholarly rigor given the context of manuscript. The potential lack of rigor within non-peer reviewed sources often is not appropriate for scholarly manuscripts.

Bias in Research: The threat of bias is present throughout the research and writing process. There are many types of bias, and they manifest in different ways within studies. All manuscripts submitted should address pertinent types of bias and what measures were taken to minimize them throughout the study process. For more details on types of bias see (Haddaway & Macura, 2018; Luijenijk et al., 2020).

Language and Grammar

• All necessary non-English words should be italicized.
• Participants in research studies must be referred to as participants or respondents, never subjects.
• Metric measurement is required; equivalent measurements may be included in parentheses. In most cases, no more than two decimal places are needed.
• Use generic names for drugs or devices.
• Clearly define ‘breastfeeding’ using one of the standard definition systems (e. g., Labbok & Starling, 2012).
• Affect/effect: The JHL uses research definitions for these words, which differ from their common language meaning and their usual grammatical usage (Burke & Dodgson, 2017)
  • Affect: In statistical usage affect refers to test procedures that do not have direct and unqualified causal inferences.
  • Effect: It always refers to a direct and unqualified causal relationship (X and only X caused Y), except when referring to statistical procedures (e.g., effect size). 
• Sex vs. Gender: Gender and sex refer to different concepts and are not interchangeable.  https://journals.sagepub.com/topic/collections-jhl/jhl-1-jhl-policies/jhl.
  • Sex: Categories into which we sort people based on their physical and biological factors (e.g., genitalia and chromosomes). In most cases “Sex assigned at birth” or “assigned sex” are preferred to “sex” as they are more precise. (see assigned female/male at birth) (Bamberger & Farrow, 2021). Note that in most manuscripts submitted to the JHL, it is more accurate to refer to an infant’s sex than their gender.
  • Gender: A social construct with associated expectations and roles. Often in research, it is more accurate to use the term “gender identity”, which is a person’s internal sense of their gender (i.e., man, woman, another gender, or no gender) (Bamberger & Farrow, 2021).
• Use only past tense verbs when referring to completed work.
• The word data always requires a plural verb.
• APA: The JHL follows APA guidelines for language and grammar usage.
  • The JHL uses research definitions as outlined by the APA Journal Article Reporting Standards (JARS) glossary, which can be found here: https://apastyle.apa.org/jars/glossary.
  • Use APA notation for all statistical notation (APA, 2020, pg.178-186). Every time you report a percent or a frequency (n) – you must report both; every time you report an arithmetic mean (M) you must report the standard deviation (SD) in the APA format M (SD).
  • Use American English only for spelling, word use and punctuation (no slang, medical jargon, or obscure abbreviations or phrasing).

Table 1.

JHL’s Language Use Policy

Manuscript Types

Please click on the type of manuscript you are preparing. You will find the specific directions for that type of manuscript.

1. Quantitative Research
2. Qualitative Research
3. Literature Review
4. Insights into Practice and Policy
5. Case Study

Quantitative Research

• Word Limit. Quantitative Research papers have a word limit of 3500 words; however, exceptions may be made with the Editor in Chief’s prior approval (email: jhleditorinchief@gmail.com). Not included in the word count are abstract, title page, key messages, tables, figures, and references.
• Clinical Trial
  • Registration. We require authors to register their clinical trials at an appropriate registration database databases identified by the International Committee of Medical Journal Editors current lists 15 acceptable registries (e.g., the US ClinicalTrials.gov at https://clinicaltrials.gov, the WHO’s International Clinical Trials Registry Platform Search Portal at https://www.who.int/clinical-trials-registry-platform). Pilot studies or secondary analyses do not require registration; however, the parent study registration for all secondary analyses should be specified with the registration number in ScholarOne and in the required statement on the title page.
  • All randomized controlled trials submitted for publication should include a completed Consolidated Standards of Report Trials (CONSORT) diagram (https://www.equator-network.org/reporting-guidelines/consort).

Institutional Review Board (IRB): All quantitative research must have been reviewed by an IRB and either approved or deemed exempt. The name of the IRB, the date of review, and approval number must be in the manuscript within the Design Section. Documentation of IRB approval or exemption may be requested by the editorial staff at any point.

Critical Elements Required for Consideration

Submissions lacking any of the following cannot be considered by the JHL, as lacking these requirements cannot be rectified during the editing process.

• All randomized controlled trials must have been registered.
• All studies must have been reviewed by an IRB.
• The end of data collection must have been within the past five years.

Manuscript Components: Quantitative Research

 Ensure that submissions adhere to the structure presented below and contain all listed parts:

Keywords

Up to 10 keywords should be entered into ScholarOne during manuscript submission and not included in the main manuscript file. One keyword must be either lactation or breastfeeding and one must be the type of methodology used (e.g., case-control, randomized controlled trial etc.). During the submission process, authors will need to choose keywords from a preselected list of lactation specific keywords and from MeSH (US National Library of Medicine’s Medical Subject Headings) keywords. You can submit your abstract to MeSH on Demand, which will identify and provide a list of MeSH keywords appropriate for your manuscript. You can check to see if your selected keywords are MeSH terms on their website (https://www.ncbi.nlm.nih.gov/mesh/).

Title page

All submissions require that the title page be submitted separately. To ensure anonymize peer review, this is the only file that should include the authors’ names and any other identifying information. Requirements for the title page are in a slightly different format than APA:

• Complete manuscript title in APA formatting.
• Authors’ full names, academic degrees, and current affiliations (candidacy for a degree is not appropriate to list). Also list any previous affiliations that existed during the time the study was conducted, if different than current affiliation.
• Identify the corresponding author’s name, address, telephone number, and email address.
• Funding statement: All sources of funding including in kind contributions must be stated. (https://journals.sagepub.com/home/jhl).
• Disclosures and conflict of interest statement: Include any additional information that could be important to the reader and promote transparency. This includes relationships between authors (e.g., student and advisor relationships). (https://journals.sagepub.com/home/jhl).
• If this study or study protocol has been registered, provide registration information here.
• Acknowledgements: If applicable, limit acknowledgements to 50 words. It is appropriate to acknowledge those who have assisted in the production of the manuscript but do not meet full authorship criteria.
• List all other publications or prior reporting of any of the data used in the manuscript (APA, 2020).

Key Messages: Are a separate file

• Provide 3-4 bullet points written as one to two short sentences each without abbreviations containing the following information:
  • One statement about context of study describing the gap in the knowledge base that is the rationale for doing this study.
  • 1-2 statements about the core findings of the study.
  • One statement of the significance of the study (i.e., how does this research add to the existing knowledge base?)

Abstract

The structured abstract has a strict 250 words or less limit. No abbreviations should be used in the abstract, except for APA formatted statistical notations. Required bolded headings are:

• Background
• Research aim/question(s). Stated as aim(s) or question(s), not objectives, goals or purposes.
• Method: Begin with design statement. Sample information belongs here.
• Results: findings from the study
• Conclusion(s): General statements only, no results should be presented here.

Background

• Succinctly summarize the literature that is directly related to the study aims (s). This includes the gap in the literature addressed by the research aim(s). If these data have been used before report differences between this report and previous ones.
• Describe the theoretical or conceptual framework used for this study. The framework can be from the literature or original. Strongly consider including a diagram of your framework as a figure.
• Describe the significance of the study to the field of human lactation.
• End this section with the study aims using the exact same words as in the abstract. For RCT studies, please also include the hypotheses related to each study aim or question.

Method

The Method section is divided into the following six subsections; all must be present:

• Research Design
  • Start this sub-section with a statement of the research design using research terminology (e.g., prospective/retrospective, cross-sectional/longitudinal, observational, 2-group comparison, etc.) according to the APA JARS (Journal Article Reporting Standards) glossary.
  • Provide the rational for the design in the second sentence.
  • Include a statement about the Institutional Review Board (IRB) approval of your study in this section include the date and name of the IRB, as well as the approval number. You should anonymize the name of the Institutional Review Board during peer review.
• Setting and Relevant Context
  • This section is more comprehensive and a bit different than the conventional setting sections of quantitative research manuscripts.
  • The purpose of this sub-section is to inform our international readers about the socio-cultural and economic context of the study, along with how these affect breastfeeding. For example, how does the structure of the health care system benefit or disadvantage breastfeeding families. In this section authors should paint a picture of the geo-socio-cultural environment (e.g., socio-economic status of geographic area, cultural context of area), along with the breastfeeding landscape (average duration of breastfeeding, who breastfeeds and who does not, what resources are available to inform and provide care for breastfeeding mothers).
• Sample
  • Identify the target population and the sample (participants).
    • State the participant inclusion and exclusion criteria.
    • For a cohort study: Describe methods of follow-up.
    • For a case-control study—Give the sources and methods of case ascertainment and control selection with the rationale for the choice of cases and controls.
    • For matched cohort studies, give matching criteria and number of exposed and unexposed.
    • For a matched case-control study— provide matching criteria and the number of controls per case.
  • Provide sample information here (not in the results section), including method of sampling, sample size rationale (with description of power analysis, if applicable), and the final sample size.
  • Outline any compensation or payments made to participants.
  • Include a flow diagram (for cross-sectional, case-control, and cohort studies) to clarify how the sample was obtained and cite the figure in the text. All randomized control must include a Consolidated Standards of Report Trials (CONSORT) diagram (Elm et al., 2007; https://www.equator-network.org/reporting-guidelines/consort).
  • A statement about the adequacy of the sample size should end this section.
• Measurement
  • Clearly define each variable including all outcomes, exposures, predictors, potential confounders, and effect modifiers (if any), and how it has been measured. Also give diagnostic criteria, if applicable.
  • Report category boundaries when continuous variables are categorized.
  • Provide quality indicators for all instruments. Include the type of reliability and validity evaluated and steps taken to insure both. If statistical tests were conducted for reliability, include the specific values (Resources: Berndt, 2020; Wambach, 2018).
  • Describe efforts to address potential sources of bias.
  • If survey methods are used, provide enough information about these instruments to inform readers of the appropriateness of their use within your specific population. Add a copy of the questionnaires/surveys used to the Supplementary Materials in ScholarOne and reference it in the text.
• Data Collection
  • Start this section with the dates of data collection, include only relevant dates (e.g., periods of recruitment, exposure, follow-up, and data collection).
  • Second provide information about how informed consent was obtained, if applicable.
  • Describe in adequate detail who collected data and how.
  • Include how the participants confidentiality was maintained and how data were kept secure.
• Data Analysis
  • This section should start with the methods used to describe the baseline characteristics of the study sample.
  • Followed by individualized descriptions of how data were analysed for each research aim or question in the same order as stated in the background section.
  • Include a rationale and any relevant information about your decisions to group individual variables into composite variables, indices or scales and how these new constructs were evaluated.
  • The analysis plan should include rationale for selection of statistical tests or why the tests are appropriate to address both the study aim/question and the level of measurement.
  • When multivariate modelling is applied, the analysis plan should include a description of the modelling procedures, including how variables were entered and evaluated, the criteria used to control for confounding, and the criteria by which the final models shown in the results were determined.
  • Describe any methods used to examine subgroups and interactions.
  • Explain how missing data were addressed.
  • Describe any sensitivity analyses performed.

In most cases, 95% confidence intervals are preferred over the p-value for evaluating statistical significance. In the case of p-values, the analysis plan should state if values shown are one or two tailed.

Results

• For guidance on APA formatting for numbers and statistics see https://apastyle.apa.org/instructional-aids/numbers-statistics-guide.pdf or pp. 178-186 of the APA publication manual (7th ed).
• Structure this section according to each of the research aims. It is appropriate to summarize findings displayed in table(s) and/or highlight key findings.
• Summarize the characteristics of study participants (e.g., demographic, clinical, social) and information on exposures and potential confounders.
  • For a cohort study, report numbers of outcome events or summary measures over time.
  • For a case-control study, report numbers in each exposure category, or summary measures of exposure.
  • For a cross-sectional study, report numbers of outcome events or summary measures.
• Avoid repeating most findings displayed in tables.
• Every time you report a percent or a frequency (n) – you must report both; every time you report a mean (M) you need to also report the standard deviation (SD) as M(SD).
• The inclusion of p-values is unnecessary when 95% confidence intervals are presented.
• Presentation of the results from logistic regression, Poisson regression, or Cox regression should be the exponentiated parameter estimate or measure of effect (i.e., the odds ratio, incidence rate ratio, or hazard ratio) and corresponding 95% confidence interval rather than the parameter estimate. Indicators of the goodness of fit of the model (e.g., a model log likelihood ratio for logistic regression) should be included. Give unadjusted estimates and, if applicable, confounder-adjusted estimates. Make clear which confounders were adjusted for and why they were included.
• Randomized controlled trials must report all important harms or unintended effects in each group (for specific guidance see: https://www.equator-network.org/reporting-guidelines/consort-harms/).
• Report other analyses performed (e.g., analyses of subgroups, interactions, and sensitivity analyses).

Discussion

• Avoid redundancy. Do not restate or repeat results in this section.
• Provide alternative possible explanations for the current findings, including possible biases.
• Identify and integrate areas in which further study should be done throughout the section.
• Include possible reasons for study findings and strengths of study.
• Do not overstate generalizability of findings.
• Describe how the results of this study compare with the most relevant previous studies.

Limitations

• Describe study limitations due to design, measurement, implementation, data analysis and context of the study.
• Describe how bias may have influenced the study
• Include a statement regarding any limitations of the generalizability of your findings.
• Do not include study strengths, which should only be presented in the Discussion section.

Conclusions

• Summarize the results and the discussion with several general statements.
• This section should only be one paragraph.

Click here for directions regarding References, Tables and Figures

Qualitative Research

• Word Limit. Qualitative Research papers have a word limit of 4000 words; however, exceptions may be made with the Editor in Chief’s prior approval (email: jhleditorinchief@gmail.com). Not included in the word count are abstract, title page, key messages, tables, figures, and references.

Institutional Review Board: All studies must have been reviewed by an IRB and either approved or deemed exempt. The name of the IRB, the date of review, and approval number must be in the manuscript where indicated by the directions below. Documentation of IRB approval or exemption may be requested by the editorial staff at any point.

Critical Elements Required in Qualitative Manuscripts

Submissions lacking any of the following elements cannot be considered for publication in JHL because the lack these required elements cannot be rectified during the editing process.

• For U.S. Researchers: An institutional review board must have approved the study protocol or determined that the study was exempt from full committee review, after an administrative review of an exempt status application, or was determined to be “not human subjects [participants] research” by the investigators and their IRB. Refer to relevant federal guidelines (National Institutes of Health, 2020).

For international researchers: An institutional review board (IRB) must have approved the study protocol following national or international guidelines.

• The end of data collection must have been within the past five years.
• Demographic data about participants must have been collected, analysed and presented in the manuscript.

Manuscript Components: Qualitative Research

Ensure that submissions adhere to the structure presented below and contain all listed parts.

Keywords

Up to 10 keywords should be entered into ScholarOne during manuscript submission and not included in the main manuscript file. One keyword must be either lactation or breastfeeding and one must be the type of methodology used (e.g., grounded theory, phenomenology, ethnographic, etc.). During the submission process, authors will need to choose keywords from a preselected list of lactation specific keywords and from MeSH (US National Library of Medicine’s Medical Subject Headings) keywords. You can submit your abstract to MeSH on Demand, which will identify and provide a list of MeSH keywords appropriate for your manuscript. You can check to see if your selected keywords are MeSH terms on their website. (https://www.ncbi.nlm.nih.gov/mesh/).

Title Page

All submissions require that the title page be submitted separately. To ensure anonymize peer review, this is the only file that should include the authors’ names and any other identifying information. Requirements for the title page are in a slightly different format than APA:

• Complete manuscript title in APA title formatting.
• Authors’ full names, academic degrees, and current affiliations (candidacy for a degree is not appropriate to list). Also list any previous affiliations that existed during the time the study was conducted if different than current affiliation.
• Identify the corresponding author’s name, address, telephone number, and email address.
• Funding statement: All sources of funding including in kind contributions must be stated. (https://journals.sagepub.com/home/jhl).
• Disclosures and conflict of interest statement: Include any additional information that could be important to the reader and promote transparency. This includes relationships between authors (e.g., student and advisor relationships). (https://journals.sagepub.com/home/jhl).
• Study Registration: If this study or study protocol has been registered, provide registration information here.
• Acknowledgements: If applicable, limit acknowledgements to 50 words. It is appropriate to acknowledge those who have assisted in the production of the manuscript but do not meet full authorship criteria.
• List all other publications or prior reporting of any of the data used in the manuscript (APA, 2020).

Abstract

The structured abstract has a strict 250 words or less limit. No abbreviations should be used in the abstract except for APA formatted statistical notations. Required bolded headings are:

• Background
• Research aim(s)/question(s). Stated as aim(s) or question(s), not objectives, goals or purposes.
• Method: Begin with design statement. Sample information belongs here.
• Results: Include findings from the study.
• Conclusion(s): Use general statements only; no results should be presented here.

Key Messages: Are a separate file

• Provide 3-4 bullet points written as one to two short sentences, each without abbreviations, containing the following information:
  • one statement about context of study describing the gap in the knowledge base that is the rationale for doing this study.
  • one to two statements about the core findings of the study; and
  • one statement of the significance of the study (i.e., How does this research add to the existing knowledge base?).

Background

• Succinctly summarize the literature that is directly related to the study aims(s) or question(s). This includes the gap in the literature addressed by the research aim(s) or question(s). If these data have been used before report differences between this report and previous ones.
• Describe the theoretical or conceptual framework used for this study as appropriate (Leeming, 2018).
• Describe the significance of the study to the field of human lactation.
• End this section with the study aim(s) or question(s) using the exact same words as in the abstract.

Method

The Method section is divided into the following subsections: All must be present in this order:

• Design
  • Start this sub-section with a statement of the research design using research terminology according to the APA JARS (Journal Article Reporting Standards) glossary. Identify the type of qualitative design being used (Dodgson, 2017).
  • Provide the rational for the design in the second sentence.
  • Include a statement about the Institutional Review Board (IRB) approval of your study in this section including the date and name of the IRB as well as approval number. You should anonymize the name of the Institutional Review Board during peer review.
• Setting and Relevant Context
  • In qualitative research the context in which the study was conducted influences everything. Be sure to adequately address this section.
  • The purpose of this sub-section is to inform our international readers about the socio-cultural and economic context of the study, along with how these influence breastfeeding. In this section authors should paint a picture of the geo-socio-cultural environment, along with the breastfeeding landscape (e.g., average duration of breastfeeding, who breastfeeds and who does not, what resources are available to inform and provide care for breastfeeding parents).
• Sample
  • Identify the target population and the sample (participants), including all inclusion and exclusion criteria.
  • Describe the participant recruitment process. Describe the study aims as conveyed to participants if different than written in the manuscript.
  • Provide sample information here (not in the results section), including sampling method, sample size rationale, and the final sample size (Gill, 2020).
  • Outline any compensation or payments made to participants.
  • A statement about the adequacy of the sample size should end this section.
• Data Collection
  • Start this section with the dates of data collection; include only relevant dates, periods of recruitment, initial data collection, and follow-up, if applicable.
  • Second, provide information about how informed consent was obtained.
  • Describe in detail who collected data and their qualifications.
  • The interview guide and demographic questions should be added to supplemental material in ScholarOne.
  • Describe in detail how data were collected. Include relevant contextual information like length of interviews, location, and extensiveness of engagement.
  • Describe how reflexivity was managed during data collection, including identifying the relevant characteristics of the research team members who might have influenced the interview process or the data analysis (Dodgson, 2019).
  • Include how the participants’ confidentiality was maintained and how data were kept secure.
• Data Analysis
  • This section should start with how the baseline characteristics of the study sample were analysed.
  • Next include individualized descriptions of how data were analysed for each research aim or question in the same order as stated in the Background section.
  • Provide enough detail about who analysed the data and exactly what method was used. Cite the source(s) for the method used.
  • Reference the required Data Analysis Structure table in this section. This table must include details of the coding/thematic analysis structure with definitions for each code/theme/category. Do not put quotes in this table; they belong in the text.
  • Trustworthiness should be addressed in this section (Lincoln & Guba, 1985; Sandelowski, 1993).

Results

• Start this section with demographic information, with the header ‘Characteristics of the Sample’.
• Use APA formatting for all quotes (https://apastyle.apa.org/style-grammar-guidelines/citations/quoting-participants).
• Structure this section according to each of the research aims. It is appropriate to summarize findings displayed in table(s) and/or highlight key findings.
• Avoid repeating most findings displayed in tables.

Discussion

• Avoid redundancy. Do not restate or repeat results in this section.
• Provide alternative possible explanations for the current findings and possible sources of bias.
• Identify and integrate areas in which further study should be done throughout the section.
• Include possible reasons for study findings and strengths of study.
• Describe how the results of this study compare with the most relevant previous studies.

Limitations

• Describe study limitations due to design, implementation, data analysis and context of the study.
• Do not include study strengths in this section.
• Address the potential for researcher bias and possible bias in the methodology used.

Conclusions

• Summarize the results and the discussion with several general statements.
• This section should only be one paragraph.

Click here for directions regarding References, Tables and Figures

Literature Review

• Word Limit. Quantitative Research papers have a word limit of 3500 words; however, exceptions may be made with the Editor in Chief’s prior approval (email: jhleditorinchief@gmail.com). Not included in the word count are abstract, title page, key messages, tables, figures, and references.

Critical components required for consideration

• JHL requires a minimum of 4 databases to be searched for a literature review, one of which is the Cochrane Database of Systematic Reviews.
• The articles reviewed must be the most recent and relevant and must include all articles that meet the requirements for inclusion published up to six months before submission.
• One of the standard literature review methodologies should be used (if using an alternative method query the Editor in Chief).

Manuscript components: Literature Review

 Ensure that submissions adhere to the structure presented below and contain all listed parts:

Keywords

Up to 10 keywords should be entered into ScholarOne during manuscript submission and not included in the main manuscript file. One keyword must be either lactation or breastfeeding and one must be the type of literature review conducted. During the submission process, authors will need to choose keywords from a preselected list of lactation specific keywords and from MeSH (US National Library of Medicine’s Medical Subject Headings) keywords. You can submit your abstract to MeSH on Demand, which will identify and provide a list of MeSH keywords appropriate for your manuscript. You can check to see if your selected keywords are MeSH terms on their website (https://www.ncbi.nlm.nih.gov/mesh/).

Title Page

All submissions require that the title page be submitted separately. To ensure anonymize peer review, this is the only file that should include the authors’ names and any other identifying information. Requirements for the title page are in a slightly different format than APA:

• Complete manuscript title in APA formatting.
• Authors’ full names, academic degrees, and current affiliations (candidacy for a degree is not appropriate to list). Also list any previous affiliations that existed during the time the study was conducted if different than current affiliation.
• Identify the corresponding author’s name, address, telephone number, and email address.
• Funding statement: All sources of funding including in kind contributions must be stated. (https://journals.sagepub.com/home/jhl).
• Disclosures and conflict of interest statement: Include any additional information that could be important to the reader and promote transparency. This includes relationships between authors (e.g., student and advisor relationships, consultancies). (https://journals.sagepub.com/home/jhl).
• If the literature review has been registered provide the site, date and number here. If accepted for publication, this information will be published after the abstract.
• Acknowledgements: If applicable, limit acknowledgements to 50 words. It is appropriate to acknowledge those who have assisted in the production of the manuscript but do not meet full authorship criteria.
• List all other publications or prior reporting of any of the data used in the manuscript (APA, 2020).

Abstract

The structured abstract has a strict 250 words or less limit. No Abbreviations should be used in the abstract except for APA formatted statistical notations. Required bolded headings are:

• Background
• Research aim. Stated as aim(s) or question(s), not objectives, goals or purposes.
• Method: Begin with design statement and include sample information.
• Results
• Conclusion(s): General statements only, no results should be presented here.

Key Messages: Are a separate file

• Provide 3-4 bullet points written as one to two short sentences each without abbreviations containing the following information:
  • One statement about context of review describing the importance of the topic (i.e., the rationale for doing this review).
  • 1-2 statements about the core findings of the review.
  • One statement of the significance of the review (i.e., what does this review say about the existing knowledge base?).

Background

• Provide background rational for the importance of the topic reviewed.
• Describe the theoretical or conceptual framework used for the investigation.
• Include pertinent non-research articles and documents here.
• End this section with the study aims or questions using the exact same words as in the abstract.

Method

The Method section is divided into the following six subsections; all must be present and in this order:

• Design
  • Indicate if a review protocol exists, and, if available, provide registration information, including protocol registration number.
  • Start this subsection with a design statement describing the type (methodology) of review conducted.
  • Provide the rational for choosing the type of review conducted in the second sentence.
• Sample: Defining the Articles Reviewed
  • Identify the sample selection inclusion and exclusion criteria, providing rationales for each. Describe the process of selecting studies, in meta-analyses indicate how many people or automated processes reviewed articles and if they worked independently.
  • The articles reviewed must be the most recent and relevant and must include articles published up to six months before submission.
  • State final sample size here.
  • A figure of a PRISMA diagram is required for this manuscript type and must be referenced in this section of the text. See the figure section below for further details.
• Data collection: The Search Strategy and Process
  • Start this section with the dates of the inclusion period of the articles reviewed and the date last searched.
  • Identify which databases were searched and the search terms used JHL requires a minimum of 4 databases to be searched, one of which must be the Cochrane Database of Systematic Reviews (https://www.cochranelibrary.com)
  • For meta-analysis indicate if study authors were contacted to identify missing data or additional studies.
  • Add to supplementary materials a full electronic search strategy for all databases searched, including any limits used, so that they could be repeated.
• Measurement
  • Clearly identify and define all variables. Indicate if any assumptions and simplifications were made when defining variables.
  • Collect demographic information about the publishing journals, year of publication, research teams, country of origin and institution of review articles.
  • Describe the process used to extract the data from the chosen articles (e.g., piloted forms, independently, in duplicate).
  • Describe processes (if any) for obtaining and confirming data from investigators.
  • Describe how the variables have been categorized for analysis, including a rationale and any relevant information about your decisions to group individual variables and how these new constructs were evaluated.
  • Describe the methods used to organize the data (e.g., matrices)
  • Describe how data were summarized.
• Data Analysis
  • This section should start with the methods used to describe the baseline characteristics of the sample (e.g., demographic information about the publishing journals).
  • Two data summary tables are required. Both tables should follow the general directions for all tables including being uploaded as separate files during submission and reference in the text in this section. See examples for more information. 
    • Table 1: Include each study’s 1st author, date of publication, study aim/question, sample (brief description and N), and design (using research terms). Include citations for each of these studies.
    • Table 2: Include each study’s 1st author and date of publication, variables measured, instruments used to measure each variable, and reliability and validity of each instrument.
  • Internal methodological congruence for each study reviewed must be determined and reported. Internal methodological congruence refers to the unity and consistence between study aim, research design, measurement, and analysis.
  • Define how potential bias was evaluated. This includes all types of cultural, institutional, and systemic bias (e.g., methodological, economic, environmental, gender, racial).
  • For meta-analysis:
    • Describe the method used for assessing risk of bias of individual studies including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.
    • State the principal summary measures (e.g., risk ratio, difference in means)
    • Describe the methods of handling data and combining results of studies, if done, including measures of consistency (e.g., I2) for each meta-analysis.
    • Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).
    • Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were prespecified.

Results

• For guidance on APA formatting for numbers and statistics see https://apastyle.apa.org/instructional-aids/numbers-statistics-guide.pdf or pg. 178-186 of the APA publication manual 7th ed.
• Avoid repeating most findings displayed in tables.
• For meta-analysis:
  • Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at each stage, ideally with a flow diagram.
  • For each study, present characteristics for which data were extracted (e.g., study size, (population, intervention, control, outcomes, and study type (PICOS), follow-up period) and provide the citations.
  • Present data on risk of bias of each study and, if available, any outcome-level assessment.
  • For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group; and (b) effect estimates and confidence intervals, ideally with a forest plot.
  • Present results of each meta-analysis done, including confidence intervals and measures of consistency.
  • Present results of any assessment of risk of bias across studies.
  • Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression

Discussion

• Avoid redundancy. Do not restate or repeat results in this section.
• Summarize what is known and unknown about your topic as a result of your critical analysis of the literature.
• Identify study design and other methodological issues seen across the reviewed studies.
• Identify and integrate areas for which further study is needed throughout the section.
• Discuss the limitations of the body of literature reviewed, include the methodology, bias and topics within this body of literature, include areas/topics/approaches that were missing.

Limitations

• Describe the limitations of your literature review (not the studies reviewed) due to design, measurement, implementation, and context of the study, include how bias might have influenced your results.

Conclusions

• Summarize the results and the discussion with several general statements.
• This section should only be one paragraph.

Click here for directions regarding References, Tables and Figures

 Insights into Practice and Policy

An Insight into Practice and Policy manuscript focuses on an innovative clinical practice or a policy analysis of interest to lactation educators, clinicians, researchers, and public health professionals. It is NOT the purpose of this manuscript type to report research.

• Word Limit. Insights into Practice and Policy papers have a word limit of 2500 words; however, exceptions may be made with the Editor in Chief’s prior approval (email: jhleditorinchief@gmail.com). Not included in the word count are title page, key messages, tables, figures, and references.

Manuscript Components: Insights into Practice and Policy

 Ensure that submissions adhere to the structure presented below and contain all listed parts:

Keywords

Up to 10 keywords should be entered into ScholarOne during manuscript submission and not included in the main manuscript file. One keyword must be either lactation or breastfeeding. During the submission process, authors will need to choose keywords from a preselected list of lactation specific keywords and from MeSH (US National Library of Medicine’s Medical Subject Headings) keywords. You can submit your abstract to MeSH on Demand, which will identify and provide a list of MeSH keywords appropriate for your manuscript. You can check to see if your selected keywords are MeSH terms on their website (https://www.ncbi.nlm.nih.gov/mesh/).

Title Page

All submissions require that the title page be submitted separately. To ensure anonymize peer review, this is the only file that should include the authors’ names and any other identifying information. Requirements for the title page are in a slightly different format than APA:

• Complete manuscript title in APA formatting.
• Authors’ full names, academic degrees, and current affiliations (candidacy for a degree is not appropriate to list). Also list any previous affiliations that existed during the time the study was conducted if different than current affiliation.
• Identify the corresponding author’s name, address, telephone number, and email address.
• Funding statement: All sources of funding including in kind contributions must be stated. (https://journals.sagepub.com/home/jhl).
• Disclosures and conflict of interest statement: Include any additional information that could be important to the reader and promote transparency. This includes relationships between authors (e.g., student and advisor relationships, consultancies). (https://journals.sagepub.com/home/jhl).
• Acknowledgements: If applicable, limit acknowledgements to 50 words. It is appropriate to acknowledge those who have assisted in the production of the manuscript but do not meet full authorship criteria.

Key Messages: Are a separate file

• Provide 3-4 bullet points written as one to two short sentences each without abbreviations containing the following information:
  • One statement about the context of this paper describing the gap in the knowledge base or issue the authors seek to address.
  • One or two statements about the clinical innovations or policy analysis presented in the paper.
  • One statement describing the significance of what this paper adds to the field.

Background

• Provide the gap in the current body of knowledge that is addressed in this paper.
• Provide the significance of this clinical innovation or policy.
• End this section with a concise purpose statement.

The Clinical Innovation or Policy

• Provide enough detail for readers to understand the innovation and your rationale for developing/creating the perspective.
• Include the advantages and limitations of your approach.
• Briefly describe what research could be done to test, describe or better understand what you have presented.

Conclusion

• Provide a concluding summary no longer than one paragraph.

Click here for directions regarding References, Tables and Figures

Case Study

• Word Limit. Case Studies have a word limit of 2000 words; however, exceptions may be made with the Editor in Chief’s prior approval. If a case series is presented, please contact the Editor and Chief for a word limit (email: jhleditorinchief@gmail.com). Not included in the word count are abstract, title page, tables, figures, and references.

Protection of Human Subjects

Institutional Review Board: IRB approval is not required for case studies. However, if IRB approval was sought then the name of the IRB, the date of review, and approval number must be in the manuscript where indicated by the directions below. Documentation of IRB approval or exemption may be requested by the editorial staff at any point.

• Patient Consent is required for case studies: Adequate documentation of participant consent must be obtained. Participants must consent to participation and approve of the manuscript as submitted. This consent must remain with the author(s); however, it can be requested by the JHL Editor in Chief at any time.

Critical Elements Required for Consideration

Submissions lacking any of the following cannot be considered by the JHL as lacking these requirements cannot be rectified during the editing process.

• Participant consent to submit the case study must have been acquired.
• The case participant must have read and approved of the submitted case study.

Manuscript Components: Case Study

 Ensure that submissions adhere to the structure presented below and contain all listed parts:

Keywords

Up to 10 keywords should be entered into ScholarOne during manuscript submission and not included in the main manuscript file. Keywords must include either lactation or breastfeeding, case study, and diagnoses or interventions used in the case report During the submission process, authors will need to choose keywords from a preselected list of lactation specific keywords and from MeSH (US National Library of Medicine’s Medical Subject Headings) keywords. You can submit your abstract to MeSH on Demand (https://meshb.nlm.nih.gov/MeSHonDemand), which will identify and provide a list of MeSH keywords appropriate for your manuscript. You can check to see if your selected keywords are MeSH terms on their website. (https://www.ncbi.nlm.nih.gov/mesh/)

Title page

All submissions require that the title page be submitted separately. To ensure anonymize peer review, this is the only file that should include the authors’ names and any other identifying information. Requirements for the title page are in a slightly different format than APA:

• Complete manuscript title in APA formatting
• Authors’ full names, academic degrees, and current affiliations (candidacy for a degree is not appropriate to list). Also list any previous affiliations that existed during the time the study was conducted if different than current affiliation.
• Identify the corresponding author’s name, address, telephone number, and email address.
• Funding statement: All sources of funding including in kind contributions must be stated. (https://journals.sagepub.com/home/jhl).
• Disclosures and conflict of interest statement: Include any additional information that could be important to the reader and promote transparency. This includes relationships between authors (e.g., student and advisor relationships, provider and patient). (https://journals.sagepub.com/home/jhl). In the event the case study participant is also an author on the case study, this must be disclosed.
• Acknowledgements: If applicable, limit acknowledgements to 50 words. It is appropriate to acknowledge those who have assisted in the production of the manuscript but do not meet full authorship criteria.
• List all other publications or prior reporting of the data used in the manuscript (APA, 2020).

Abstract

The structured abstract has a strict 250 words or less limit. No abbreviations should be used in the abstract except for APA formatted statistical notations. Required bolded headings, which summarize the same section of the manuscript are:

• Introduction – What is unique about this case and why is it important within the socio- cultural context of the participant and family?
• Main issue – Important clinical findings and major lactation issue
• Management – The actions taken and outcomes
• Conclusion – What are one or more “take-away” messages?

Introduction

• Start with a brief summary as to why this case is unique in the lactation literature using current evidence.
• Socio-cultural context should be clearly described.
• End this section with a statement that clearly states that the person(s) discussed in this case has given written consent for publication of this case and has read and approved of the case as submitted. If IRB approval was sought than include date and name of the IRB as well as approval number. You should anonymize the name of the Institutional Review Board during peer review.

History and Observational Assessment

• Start this section with de-identified demographic and other relevant historical and observational information.
• Describe main concerns and presenting signs and symptoms of the breastfeeding family.
• Relevant past intervention(s) and their outcomes should be outlined.
• End this section with a summary paragraph of the evaluation of the history and observational assessment.

Management

• Diagnostic testing and challenges should be in this section, if applicable.
• Describe types of interventions with specific time frames and rationales, including any referrals or consultations.
• Describe any changes made to the original management with their rationales.
• Describe all follow-up actions taken.
• Reference the timeline table/figure in this section. For more details about the timeline, see section below.

Outcome(s)

• Clinician and client assessment of outcomes belong in this section. It is appropriate to use quotes, as needed.
• Describe the extent to which the participant followed and tolerated the management plan.
• Describe any adverse outcomes and unanticipated events.

Discussion

• This section should be a critical analysis of the process and outcomes of the management.
• Explain how the case could be relevant to the current body of lactation literature.
• Discuss both the strengths and weaknesses of the management approach.
• Main ‘Take-away’ lesson(s) learned.
• Provide rationale for any of your conclusions.
• Take care not to infer generalizability.

Directions for References, Tables, and Figures

References

• All in-text citations and the reference list must be formatted according to the APA Manual of Style (7th edition; 2020). For more information see https://apastyle.apa.org/style-grammar-guidelines/references/examples.
• Only citations in the text may appear in the reference list.
• References in languages other than English should contain the paper name and journal name in the original language followed by the English translation in brackets.
  • Format: Author names. (Year of Publication). Title in original language [English translation of title]. Name of Journal in original language [English translation of journal name]. Volume number (Issue number), page range. DOI
  • Example: Domínguez-Rodríguez, I., Prieto-Cabras, V., & Barraca-Mairal, J. (2017). Un estudio de caso de trastorno adaptativo con ansiedad por situación de sobrecarga laboral [Adaptive disorder with work overload anxiety: A case study]. Clínica y Salud [Clinical and Health], 28 (3) 139-146. https//:doi.org/10.1016/j.clysa.2017.05.003

Tables

• For formatting all table types, please see APA site (https://apastyle.apa.org/style-grammar-guidelines/tables-figures/tables)
• Every table must be understandable separate and apart from the text. This means that all the information a reader needs to understand the table must be on the table (e.g., title, table, notes).
• Each table must be submitted as a separate .DOC or .DOCX document.
• Each table can display only one type of statistic (i.e., do not put means (SD) in the same table as frequency distributions).
• For comparison tables the test statistic value must be included within a separate column.
• All missing values must appear in the APA formatted foot note only (e. g., Missing value: Age = 3; education = 2).
• In a footnote explain any “other” designations in the tables.
• JHL exceptions to APA table formatting are:
  • Include n (%) in the same column not in 2 separate columns.
  • Designation of the sample size (N=XXX) belongs after the table title not in the footnote

Photographs/Figures

• Photographs/figures must be provided in their original format: .JPG, .TIF, .EPS. Please ensure that figures are at least 300x300 dpi.
• Titles and legends should be on the same page as the photographs and figures and follow APA (2020) formatting.
• If photographs of people are included, please identify them in the caption with approval. Authors must have on file consent to take and publish all photographs submitted (See Audio-visual Likeness Release Form on Sage website [https://www.sagepub.com/sites/default/files/upm-binaries/50296_Audio_Video_Visual_Likeness_Release_Form_Sage_owned.pdf]), and attribution must be given in the legend for any that are not explicitly by the author.

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