Development of a Nursing Sports Bra for Physically Active Breastfeeding Women Through User-Centered Design

Abstract

Postpartum women who wish to engage in physical activity and breastfeed their children are at greater risk for breast soreness due to increased breast volume and sensitivity associated with breastfeeding. An apparel product that supports both good breastfeeding practices and physical activity has the potential to improve the health of both mother and child. The purpose of this research was to understand the design requirements of physically active breastfeeding women for a sports bra design. The researchers applied user-centered methods to develop a nursing sports bra prototype based on data from a focus group. The researchers created a two-layer bra concept to improve breast support and provide the convenience of nursing. Through wear trials, participants found the prototype to be successful in providing breast support with the added advantage of being able to nurse a child, resulting in a novel bra concept that addresses many needs of active breastfeeding women.

Keywords

functional design user-centered design nursing bra sport clothing

Researchers have found that women with children under the age of 6 engaged in fewer minutes of physical activity per week than those without children (Adamo, Langlois, Brett, & Colley, 2012). Furthermore, women who wish to engage in physical activity and who are breastfeeding are at greater risk for breast pain and soreness due to increased breast volume and sensitivity associated with breastfeeding (Goldberg, 2007; Neifert et al., 1990). Many physically active mothers are unable to acquire comfortable, supportive, functional nursing bras that can be worn during exercise (Costantakos & Watkins, 1982). Ramifications from the inability to locate a supportive sports bra, suitable for nursing women, can manifest in breast pain, which can lead to a reduction in or elimination of exercising (Adamo et al., 2012). The dearth of products on the current market offers a unique challenge for designers to develop nursing sports bras that make it easy to manage both breastfeeding and physical activity, which will have positive contributions to the improved health of both mother and child.

Some researchers in the apparel field have approached improving nursing bras and sports bras separately (Costantakos & Watkins, 1982; Lawson & Lorentzen, 1990; Wakefield-Scurr, 2012; Yip & Yu, 2006). However, to the best of the authors’ knowledge, there is no research effort in the current literature, to date, in developing a hybrid nursing/sports bra for breastfeeding women. The physical bodily changes, such as increased breast weight and volume, have been reported to cause critical pain in breastfeeding women by stretching the tissues attached to the breasts (Yip & Yu, 2006). Excessive movement experienced during exercise can exacerbate the pain. As breasts increase in size, breasts move around more, and the overall bra performance decreases (Lawson & Lorentzen, 1990; McGhee, Steele, Zealey, & Takacs, 2013). Therefore, the same bras used by women before breastfeeding are expectedly not adequate for breastfeeding women postdelivery.

Given the pain that breastfeeding women experience and the lack of nursing sports bras available on the market, there is a need for a bra that eases physical pain during exercise and reduces the burden of breastfeeding for women. Bras created explicitly for physically active breastfeeding mothers should combine design features of both sports bras and nursing bras. In general, nursing mothers have great difficulty finding products that meet their needs because the products available do not adequately alleviate breast pain and do not support an active lifestyle (Gordon, 2015). Therefore, the purpose of this research was to understand the needs of and develop a nursing sports bra for physically active breastfeeding women, through a user-centered design (UCD) framework (The International Organization for Standardization, 1999). In this study, UCD is used as a framework to systematically guide the design and evaluation processes of the nursing sports bra prototype, whereby breastfeeding women are involved as central figures in the design process. A limited number of apparel researchers have used UCD as a named framework (Hall & Lobo, 2015; Park & Quevedo, 2008; Watkins & Dunne, 2015). This research was conducted in partnership with BF (pseudonym), a maternity athletic apparel manufacturer headquartered in the Western region of the United States. BF participated in the entire UCD process as an industry collaborator and provided access to potential consumers to work with the research team. At the time when the research partnership was sought, BF had five full-time employees and wholesaled maternity athletic apparel through retailers and direct to consumers through their website. Their target consumers were pre- and postpartum women aged 25–37 who lived active lifestyles. BF agreed to participate in this project because they had observed a void in the market for a bra that could accommodate the needs of breastfeeding women who wished to participate in physical activities postdelivery. However, they viewed a nursing sports bra as a high-risk product because of the complexities of the users’ needs associated with the product. BF’s only source of user feedback was through consumers’ posts on the company’s website and feedback given to sales representatives by retailers.

Review of Literature

UCD

To ensure the “proposed” nursing sports bra satisfied the needs of potential end users and produced a quality product appealing to BF’s target market, we used UCD as the framework to guide the design process. UCD is a design framework in which the needs, desires, and limitations of end users of a product or service are considered at each stage of the design process (Sanders, 2002). There are five general stages of the UCD framework: (a) specify the context of use by identifying the people who will use the product and what they will use it for, (b) determine business requirements or user goals for the product to be successful, (c) create design solutions drawing on the experiences and knowledge of users, (d) evaluate potential design solutions through usability testing with actual users, and (e) assess whether the system satisfies the users’ requirements (The International Organization for Standardization, 1999). In this research, the second UCD stage was simplified to only address user goals and did not include business requirements. The main difference between a UCD approach and other product design paradigms is that UCD attempts to optimize the product based on users’ needs and desires, rather than attempting to force the users to change their behavior to accommodate the product (Usability.gov , 2016).

Researchers such as DeJonge (1984) have long emphasized the importance of understanding user needs in a design process. Because technical clothing should enhance human performance, Watkins and Dunne (2015) stress that the human user should be at the center of all design activities. In typical functional clothing projects, UCD methods are used to frame the users’ exact needs in the front end of the apparel product development process through various modes of data collection, such as questionnaires, interviews, and focus groups. Then designers interpret users’ observable needs through the assessment of anthropometric fit and subjective comfort via wear trials to ground conceptual product ideas in the user’s real-life experiences (Scariot, Heemann, & Padovani, 2012). Data are gathered directly from users via these methods, which are fundamentally different from data captured for market research or sales data. Data gathered directly from users through the UCD framework provide fundamental information about how users interact with the product, how the product fits into their lives, and how the product matches their cultural values (Beyer & Holtzblatt, 1998). Although many apparel researchers have used methods that involve users in the design process, only a few have utilized UCD as a named framework (Hall & Lobo, 2015; Park & Quevedo, 2008). In their recently published textbook, Watkins and Dunne (2015) feature UCD as the framework that guides all of the functional clothing design examples throughout the text. The value of applying a named framework, such as UCD, is that consistent use of a theory can guide multiple research attempts that together can further explain, describe, provide order, advance knowledge, and guide research about a particular phenomena (Bubolz, 1991). In this study, the researchers apply UCD as a formal framework and evaluate the value of UCD for functional apparel products.

Physical Breast Changes During Pregnancy and Breastfeeding

Women will start breastfeeding their newborn within 1–2 hr of delivery (Livoti & Topp, 2009). Between 2 and 15 days after birth, the milk volume will increase, and the breasts will become heavier, fuller, and firmer as the mature milk “comes in” (Goldberg, 2007; Livoti & Topp, 2009; Meek & Yu, 2011). In a study of 271 postpartum women, the majority of women (n = 143, 53%) experienced approximately one bra cup size increase, and 26% (n = 72) experienced increases of more than one bra cup size (Neifert et al., 1990). Breast size will fluctuate throughout the day with milk volume changes before and after each feeding (Costantakos & Watkins, 1982). Because the breasts do not contain any muscles and are supported primarily by the skin and thin ligaments, lactating breasts need additional support to sustain extra breast weight (Costantakos & Watkins, 1982).

Pain Associated With Breastfeeding

Breast changes in response to nursing can cause breasts to become very sensitive and feel uncomfortable (Costantakos & Watkins, 1982). Breast pain is the main contributor for women to stop breastfeeding (Schwartz et al., 2002). Women may experience tenderness down the sides of the breasts, pins and needles sensations, breast engorgement, obstructed milk ducts, chapped nipples, and mastitis, all of which are painful medical conditions experienced by some breastfeeding mothers. Obstructed milk ducts and chapped nipples are two ailments that can be aggravated by clothing. For example, wearing a tight-fitting bra (especially one with underwire) that places pressure on one area of the breast can cause obstructed milk ducts (Goldberg, 2007). Breastfeeding mothers may also experience chapped or cracked areola tissue due to improper latching, so any fabric that touches the skin should be very soft and nonabrasive (Meek & Yu, 2011). Milk letdown is an involuntary action. Women wear nursing pads inside their bras to control leaking and catch excess fluid. Gordon (2015) reported that all of the women in her study (8 of 8) had to wear nursing pads at some point while breastfeeding to catch leaking milk. Nursing pads, if made from nonbreathable or absorbent materials that keep the nipple wet for prolonged periods of time, can lead to candidiasis, a fungal infection that causes inflamed nipples as well as radiating pain from the axilla (Goldberg, 2007).

Moreover, it is important to note that women’s choice to continue to breastfeed can be affected by social psychological influences. In the U.S. culture, the functioning lactating breast is viewed as “abnormal” and lactation as a temporary oddity (Mulford, 2008). Clothing items play a significant role for mothers to feel comfortable breastfeeding around other people (Mulford, 2008). Because breastfeeding is a complicated endeavor, it is important that apparel products do not contribute to negative experiences (Gordon, 2015).

Impact of Physical Activity on Breast Tissue

Physical activity is hard on breasts, whether they are lactating or not (Burnett, White, & Scurr, 2015; Hess, 2013; McGhee et al., 2013). Researchers found that breasts move in a complicated figure-eight pattern (McGhee et al., 2013). In 1 hr of moderate jogging, a pair of breasts can complete the figure-eight pattern several thousand times, and as breasts get bigger, they accelerate quicker, move faster, and bounce higher than smaller breasts (Hess, 2013). During vigorous physical activity, such as jogging, breasts move from top to bottom an average of 3.94 inches (McGhee et al., 2013). Larger breasted women with greater breast mass are more likely to experience excessive breast movement while exercising (Burnett et al., 2015).

Breast tissue movement is associated with breast pain (Burnett et al., 2015) and can include breast tenderness, sharp pain, burning pain, or a feeling of tightness in the breast tissue (Burnett et al., 2015; Mayo Clinic Staff, 2016b). Women had significantly higher breast pain during vigorous physical activity when compared to moderate physical activity, and 24% of the women in the study (n = 239) reduced physical activity to manage breast pain resulting from exercise (Burnett et al., 2015). Thus, some women may temporarily postpone or altogether stop physical activity if breast pain is not reduced (Burnett et al., 2015).

Physical Activity Postpartum

Women with healthy births are encouraged to take part in gentle exercises like walking and stretching a few days after giving birth (Mayo Clinic Staff, 2016a). Moderate to vigorous physical activity can resume around 6 weeks postpartum, with a doctor’s permission (Goldberg, 2007). Regular exercise after pregnancy can offer many benefits to mothers, including promoting weight loss, improving cardiovascular fitness, strengthening abdominal muscles, boosting energy levels, relieving stress, promoting better sleep, and providing a social support community (Mayo Clinic Staff, 2016a; Meek & Yu, 2011). Exercise does not have any major adverse effects on breast-milk production (Mayo Clinic Staff, 2016a).

Managing Pain Associated With Exercise and Breastfeeding Through Bra Design

A key to reducing breast pain and maintaining optimal comfort related to physical activity and breastfeeding is a supportive sports bra. The primary purpose of a sports bra is to provide support by controlling excessive breast motion, reducing breast pain, and regulating body heat and moisture transfer during high-impact physical activities (Yip & Yu, 2006). There are two main approaches to sports bra designs: compression and encapsulation. Compression sports bras are designed to press the breasts tightly against the body to minimize movement, whereas encapsulation sports bra enclose each breast with separate fabric panels but still provide a degree of compression (Yip & Yu, 2006).

In sports bras, a well-fitted bra will have a wide band at the base of the bra and wide straps which remain flat to evenly distribute the pressure of the bra on the body (Costantakos & Watkins, 1982; Wakefield-Scurr, 2012). Nearly 80% of the breast support comes from the bra band (Costantakos & Watkins, 1982; Wakefield-Scurr, 2012). Strap placement is important to distribute the load generated by breast bounce during physical activity (Bowles et al., 2000). As breast mass increases, a larger load is placed on the straps, causing excessive pressure on the wearer’s shoulder (Bowles et al., 2000).

Well-designed nursing bras should provide support without adding excessive pressure on the breasts. Costantakos and Watkins (1982) achieved significant reductions in pressure by increasing the width of the shoulder straps to 1-in. (2.54 cm) and inserting a 2-in. (5.08 cm) elastic strip at the end of the regular bra straps. A nursing bra should not apply localized pressure to the breast and cause plugged ducts (Costantakos & Watkins, 1982; Goldberg, 2007; Gordon, 2015). It should be easy to use for breastfeeding (Bye & Gordon, 2013; McKinney & Ghalachyan, 2013), and it should accommodate constantly changing breast sizes (Goldberg, 2007; Gordon, 2015) and cover the nipple and breast completely (Gordon, 2015). Fabrics used in the design should be breathable and nonabrasive (Goldberg, 2007; Gordon, 2015). Overall, the product should interface well with nursing accessories such as nursing pads and look aesthetically pleasing (Bye & Gordon, 2013; Goldberg, 2007; Gordon, 2015).

Research Gaps and Questions

Sports bras created explicitly for physically active breastfeeding mothers should combine design features of both sports bras and nursing bras. Nearly all apparel researchers who addressed this topic found there is a significant need for improved breastfeeding products (Bye & Gordon, 2013; Costantakos & Watkins, 1982; Gordon, 2015; McKinney & Ghalachyan, 2013), yet few solutions exist. As dicussed, to address these gaps in the literature, we used the UCD framework to develop research questions, where each research question relates to a stage of UCD.

Research Question 1: What is the context of use of a nursing sports bra?

Research Question 2: What design requirements must be met for a nursing sports bra to meet users’ physical activity and breastfeeding goals?

Research Question 3: What design features should be included in a nursing sports bra to be successful with users in this target market?

Research Question 4: To what extent was the nursing sports bra prototype successful in meeting users’ needs with users in this target market?

Research Question 5: What is the value of a UCD process as perceived by the users and by the company?

Method

As illustrated in Figure 1, the research was completed in five stages following the UCD framework.

Figure 1.

Research procedure, data collection points, and user-centered design (UCD) stages. *Participant provided data through an exit survey. **Participants were individually interviewed.

Stage 1: Specify Context of Use

We recruited study participants from an “information-rich” pool of users through a homogeneous purposeful sampling procedure (Patton, 1987). Participation was sought through direct e-mails from the researchers, using BF’s customer database of 541 individual e-mails. The inclusion criteria were women who were 18 years and older, were currently breastfeeding, were actively involved in high-impact sports activities, and had no history of injury at the time of the study. Thirteen women expressed interest in participating in the study, eight of whom qualified based on the inclusion criteria. The sample size of eight end users (N = 8) was justified in that focus groups (Stage 1) and wear trials (Stage 4) of this nature typically involve 8–15 participants (Visser, Stappers, van der Lugt, & Sanders, 2005). BF’s company members (n = 5) were invited to participate in focus groups (Stage 1) and participant reflection (Stage 5). The profiles of the end user participants and company members are summarized in Table 1.

Table 1.

Demographic Information of Research Participants.

				Participate in Stage 1	Participate in Stage 2	Participate in Stage 4	Participate in Stage 5
Participant Code	Age	Occupation	Group	Initiation	Focus Group	Wear Trials	Exit Survey or Interview
100	30	Physician	User	X	X	X	X^a
101	33	Marketing	User	X	X	X	X^a
102	29	Chemical Engineer	User	X	X	—	—
103	37	Physical Therapist	User	X	X	X	X^a
104	34	Compliance Lawyer	User	X	X	—	—
105	38	Accountant	User	X	X	X	X^a
106	37	Prenatal Chiropractor	User	X	X	—	—
107	34	Wellness Coordinator	User	X	X	X	X^b
200	37	CEO	BF Employee	—	X	—	X^b
201	34	Logistics	BF Employee	—	—	—	X^b
202	39	Marketing	BF Employee	—	—	—	X^b
203	41	Marketing	BF Employee	—	—	—	X^b
204	23	Sales	BF Employee	—	—	—	X^b

Note. X = participation in the stage; — = no participation in that stage.

^aParticipant provided data through an exit survey. ^bParticipants were individually interviewed.

The first author called each interested participant to review the study goals and set up the focus group meeting. On the day of the focus group, each study participant signed an informed consent form and filled out a survey used to gather demographic information. The survey included questions regarding intended duration of breastfeeding, physical activity levels, and breast soreness. The researchers held the focus group at the company’s headquarters, and it lasted approximately 90 min, using an institutional review board–approved semistructured interview protocol. The purpose of the focus group was to specify the use context of nursing sports bra products, define user needs, and define design requirements. During the focus group, the researchers asked a series of questions regarding their current problems, needs, and strategies to accommodate increased breast discomfort due to breastfeeding while remaining physically active.

Stage 2: Determine Goals for Success

The focus group was audio-recorded, transcribed verbatim, and analyzed using template analysis (King, 2004). Template analysis is a qualitative analysis method where templates of a priori codes are developed to thematically organize and analyze qualitative data (King, 2004). An initial template was prepared based on the literature, and it was modified as the researchers analyzed the data. The focus group data informed the development of a nursing sports bra.

Stage 3: Create Design Solution

Next, the first author created technical sketches of three concepts and presented them to the CEO of the company where she selected one concept that she believed would be appropriate for their logistical and manufacturing constraints. Two fitting samples were created to test the order of operations and construction methods as well as to assess the fit of the bra using a dress form. Body measurements were collected from each participant, and patterns were drafted for the prototype bras. The researchers produced one prototype bra for each of the wear trial participants, which allowed simultaneous wear trials by multiple participants. All of the prototypes were assessed for any quality defects before being mailed to each participant.

Stage 4: Evaluate Design Solution

The purpose of the wear trials was to analyze key concepts that became salient in the focus group. The wear trial protocol asked participants to complete a series of five wear trials in actual use environments over a 2-week period (Whitehead, 1996). Participants selected their favorite bra from their existing wardrobe that they typically wore while exercising to provide a measure of comparison to the nursing sports bra prototype (Whitehead, 1996). Participants wore the prototype bra for three trials and their favorite bra for two trials during their usual exercise routines. For the wear trials, the participants received the prototype bra, instructions for wear trials, a hard copy of a wear trial journal to collect data for each wear testing, and a prepaid envelope to return the prototype bra and journal after completion of the wear trials. Upon receiving the completed packet of materials from the wear trial participant, the researchers e-mailed each participant a digital US$ 50 gift card to BF’s website . The researchers captured quantitative data from the wear trial journals for each of the five tests using 7-point Likert-type scales. The prototype bra and favorite bra were evaluated on the following variables, identified from the focus group: support, fit, physical comfort, aesthetics, arm mobility, donning/doffing, fabric breathability, and ease of nursing. The type of activity and intensity was recorded in the journal to understand the context of use.

Stage 5: Assess the System

Upon completion of the wear trials, the participants reflected on the UCD process they just experienced through an exit survey. A copy of the survey was included as part of the initial packet of materials and mailed back to the researchers in a self-addressed and stamped envelope. The survey gathered both text and quantitative data regarding the user’s perceptions of working with BF, the importance for BF to use a UCD framework in the future, and the ability of the UCD process to develop a product which met their needs. The researchers also individually interviewed the five BF employees to understand their attitude about bringing users into the design process, assess whether it was an effective strategy to develop an apparel product, and gain insight into the benefits and limitations of adopting the UCD framework in a real-life clothing business. Each interview was audio-recorded, transcribed verbatim, and analyzed using template analysis (King, 2004).

Results

Results of Stage 1: Specify Context of Use

All users (N = 8) were postpartum women, Caucasian, between the ages of 30 and 38, who had earned a bachelor’s degree or higher and had an average combined family income above the U.S. median household income, which was $53,657/year (U.S. Census Bureau, 2014). Six of eight participants had one child at the time of the study, and two women had two children. The women reported how long they anticipated breastfeeding their current child, with estimations including 6 months or less (25%), 7–12 months (38%), 13–18 months (25%), and up to 24 months (13%). All participants stated an increase in at least one alphanumeric size (the size system predominantly used in sports bras). The participants waited for 4–5 weeks postdelivery to return to exercising. All women reported a decrease in physical activity level after giving birth, going from participating in high-impact activities on average 4 times per week to an average of 3 times per week. Seven of eight participants reported no breast soreness during or after exercise when they are not lactating. When lactating, five of eight participants experience breast pain during or after exercise. Seven of eight women shared that breastfeeding had negatively influenced their participation in exercise.

Results of Stage 2: Determine Goals for Success

The researchers observed four thematic codes in the focus group data, including breast support, compression within limits, convenient to use, and design features.

Breast support

The most important issue for participants was breast support (Gordon, 2015; McKinney & Ghalachyan, 2013).¹ The participants indicated that they had not been able to find a sports bra or nursing bra on the market that had good breast support that alleviated breast discomfort. Because they were unable to find a bra with adequate support, they all reported making compromises in their physical activities to manage pain. A participant (ID 100) explained, “I have to plan runs around feeding because it is more comfortable to go after feedings.” Another participant (ID 102) explained, “I have two high-impact, maximum support bras which are what I wore pre-pregnancy and they were fine. But they are not fine on their own for running right now, and it has been frustrating.” The women reported strategies to reduce breast tissue movements, such as wearing two regular sports bras or a sports bra over a nursing bra for increased support and greater convenience of nursing. They explained that when they get home from working out, they could take off the outer sports bra to nurse.

Compression within limits

Participants believed that if a bra could reduce breast tissue movement, their breasts would be less tender after exercising. However, the women wanted as little compression as possible due to skin-level ailments like chafed nipples (Costantakos & Watkins, 1982; Goldberg, 2007; Gordon, 2015). As a participant (ID 103) explained, “I was having really sorer nipples there for a while, so anything that binds the nipples is not okay, and anything up against the nipples has to be really comfortable.” They preferred nonabrasive fabrics with some stretch qualities to nonstretch fabrics. Some narrated that they were reluctant to wear bras (for any activity) with underwire because they tended to cause plugged milk ducts (Goldberg, 2007; Gordon, 2015).

Convenient to use

The participants specified design and usability features in a nursing sports bra that could enhance their breastfeeding experience. They stated the bra needed to be convenient to use and fit into women’s busy lifestyles (Bye & Gordon, 2013; Gordon, 2015; McKinney & Ghalachyan, 2013). A participant (ID 104) explained, “When I get up in the morning I put on my exercise gear, and then I nurse my baby, hang out, eat some breakfast, and then I work out, and nurse him again right after. I don’t have time to change clothes.” All users agreed that the bra concept should be easy to undo the clasp and start nursing with one hand (Gordon, 2015; Livoti & Topp, 2009; Meek & Yu, 2011). Additionally, the bra has to accommodate pumping as part of their daily routines, and it is sometimes done on the go, as the following account described: “Depending on the day I will actually pump in the car” (ID 101).

Design features

The participants preferred bras that closed with a hook-and-eye closure to bras that pull over the head for ease of donning and doffing, especially when sweaty or when breasts are tender (Mayo Clinic Staff, 2016a, 2016b). All users requested adjustable straps and stretch fabric to help with variations in breast size (Meek & Yu, 2011). They wanted wide straps because they thought it would distribute the weight of the breasts across more surface area of the shoulder. The users wanted a way to incorporate nursing pads into the structure of the bra; as one participant reported, “For the first three months I was leaking all the time, so having the option to have the pad but to also take [the pads] out would be huge [because it would] increase the longevity of the bra” (ID 100). The wearer could place a removable molded bra cup in the same pocket when nursing pads were no longer necessary, providing a level of modesty and coverage of erect nipples, which is a common occurrence for women who exercise, and a more frequent problem for women while breastfeeding (Livoti & Topp, 2009). They thought performance fabrics would play a significant role in satisfying their physical comfort needs because, as the participants explained, the fabric should wick not only sweat but also excess milk away from the skin. In addition, the material needs to be quick-drying (Costantakos & Watkins, 1982; Gordon, 2015). Fabric that is “soft like cotton” was preferred to accommodate skin-level pain associated with breastfeeding (ID 106). Users agreed that no seams should go across the chest because of potential discomfort (Gordon, 2015). The cut of the bra should adequately cover the entire breast to reduce the chance that the edge of the cup could cause chafing (Gordon, 2015). As the participants noted, if seams were not placed correctly, they could cut into their skin. All participants expressed a desire to feel attractive while wearing the bra because they had to wear garments that made them feel “ugly” and “ridiculous” during pregnancy (IDs 100 and 104). They expressed wanting their bras to be pretty, so they can feel beautiful while their body experiences dramatic changes postdelivery (Costantakos & Watkins, 1982; Gordon, 2015).

Results of Stage 3: Create Design Solution

The results of the focus group analysis informed the product development. The researchers tried to address as many user needs, ideas, and suggestions as possible in the bra prototype (Figure 2), which incorporated a two-layer system, whereby a surplice-style bralette as an encapsulation-style bra was sewn under a compression-style outer layer to improve breast support, reduce breast tissue movement, and provide the convenience of nursing. This particular design idea was inspired by Participant 102, saying that she often wore two sports bras or a sports bra over a nursing bra to provide additional support and convenience. The surplice design is typical in nursing bras because the mother can move the fabric out of the way to nurse (Gordon, 2015). Two-part nursing clips that are easy to open with one hand were used on the outer layer, so that the wearer could lower one or both sides of the outer layer to access the surplice bra underneath (Meek & Yu, 2011).

Figure 2.

On left are photos of the nursing sports bra prototype showing (clockwise) the front, inner bralette, inside-out view of the bra cup details, and back with the straps crossed into the racer back orientation. The illustration on the right is a technical sketch of the final design including all modifications which was sent by the company to their overseas factory to create new prototypes.

A high-modulus brushed polyester/Lycra® blend with a moisture transfer finish was used for the outer shell, and a moisture-wicking two-way stretch 80% nylon, 20% spandex micromesh fabric was used for the interior surplice bra for breathability (Costantakos & Watkins, 1982; Gordon, 2015). The researchers used two layers of fabric for the outer shell, between which a pocket was created to hold either nursing pads or removable bra cups, based on discussion with the focus group participants. There are two seams on the outside shell, which are necessary to keep the removable nursing pads in place, but the seams do not cross over the bust (Gordon, 2015). The bra was cut with broad side-smoothing wings to lay smooth over the back, and additional length was added at center front for full coverage based on the request of the focus group participants. A 1.5-in. (3.81 cm)-wide hook and eye closure with three hooks and three eye adjustments was used for the closure at the center back. The straps were 1 in. (2.54 cm) wide and slightly padded by sewing a 1/16-in. (0.16 cm)-thick polyester laminate foam between two layers of shell fabric (Bowles, Steele, & Munro, 2012; Costantakos & Watkins, 1982). The strap lengths are adjustable by Velcro to accommodate variations in breast size as discussed by focus group participants. Wearers of the bra can cross the straps in the back into a racer back orientation to reduce pressure strain at the shoulders by moving the breast mass toward the center bodyline (Yip & Yu, 2006). The prototype design also featured added mesh trims and a visually favored plum-colored fabric to make the bra look feminine (Moran, 1999).

Results of Stage 4: Evaluate Design Solution

We invited all focus group participants to participate in the wear trials; however, only five of eight users actually participated. Participants 102, 104, and 106 did not finish the wear trials and follow-up survey because they could no longer commit their time to the research project. Five participants tested the prototype bra and their favorite bra 34 times, with 18 trials of the sports bra prototype and 16 trials of their favorite bras, which exceeded the minimum test requirements given to the participants. A plurality of the favorite bras worn by participants in this research were traditional sports bras (44%), followed by nursing bras (22%) and other bras (10%), which may have been a nursing sports bra or a combination of two bras. Participants took part in high-impact activities 46% of the time and medium- to low-impact activities 37% of the time. In 17% of the entries, the participants did not indicate an activity level. Examples of high-impact activities were running, running with a stroller, and playing soccer games, whereas medium-low-impact activities were walking and hiking. Through a comparison of the mean scores, the researchers found (Table 2) that the prototype bra outperformed the participant’s favorite bra on the variables of support, physical comfort, aesthetics, and fabric breathability. However, the prototype was poorly rated for ease of nursing, fit, donning and doffing, and arm mobility. The text data, in the form of written comments in the wear trial journals, show that when nursing pads or bra cups were inside the pockets designed to hold them, they made it difficult to fold and keep down the outer shell while nursing. Participants found the interior surplice bralette to be too large and not easy to pull to the side for nursing. They also reported that the bra straps were set too far apart across the shoulders, affecting garment fit. The participants addressed this issue by crossing the straps into the racer back position, which improved fit but negatively influenced donning and doffing and ease of nursing. Although the prototype bra had a back closure, the participants may have found the clasp difficult to manage behind the back due to the number of hooks.

Table 2.

Wear Trial Mean Scores of Prototype and Favorite Bras.

Wear Trial Mean Scores of Prototype Bra by Participant (SDs in Parentheses)									Wear Trial Comments
Participant Code	Support	Ease of Nursing	Fit	Donn/Doff	Physical Comfort	Aesthetics	Arm Mobility	Breathability	Wear Trial Comments
100	6.00 (0.00)	1.00 (0.00)	3.33 (0.58)	1.00 (0.00)	5.00 (0.00)	2.67 (0.58)	4.67 (0.58)	5.00 (0.00)	“It is hard to take off because of the straps. Inside panels are too big making it difficult to nurse.”
101	1.00 (0.00)	4.00 (0.00)	1.00 (0.00)	7.00 (0.00)	6.00 (0.00)	5.00 (0.00)	7.00 (0.00)	6.50 (0.71)	“The straps are set too far apart and fall off my shoulders. While comfortable otherwise, the bra did not provide enough support.”
103	7.00 (0.00)	7.00 (0.00)	6.20 (0.48)	6.20 (0.48)	7.00 (0.00)	7.00 (0.00)	6.80 (0.47)	7.00 (0.00)	“The product I got in the mail seemed to have everything we moms discussed wanting in a nursing/sports bra.”
105	7.00 (0.00)	5.75 (0.50)	6.20 (0.48)	5.80 (0.48)	6.40 (0.59)	5.20 (0.48)	6.00 (0.00)	5.80 (0.84)	“I love this bra! It offers support, opens for nursing at the top, is comfortable and breathable, and has adjustable shoulder straps.”
113	6.00 (0.00)	3.33 (0.58)	4.67 (0.58)	2.33 (0.58)	6.00 (0.00)	4.67 (0.58)	4.00 (1.00)	6.00 (0.00)	“The bra was very comfortable to run in with good support. The padding offers good ‘coverage’ especially after nursing, but is bulky.”

The bra design was modified based on the results from the wear trials in the following ways (Figure 2): (a) bra straps were moved closer to the center body line; (b) the armhole depth was decreased for better coverage at the side, and the center front length was further increased; (c) the size of the interior surplice bralette was reduced to make it easier to nurse, and the amount of crossover at the center front was reduced; (d) the surplice fabric was changed to a polyester spandex jersey knit, which was mechanically brushed to give it a soft texture; (e) an elastic portion was added to the back of the straps; and (f) the center back closure was revised to two rows of hooks and eyes. The final design was handed over to BF who continued the product development process with their overseas factory.

Results of Stage 5: Assess the System

The wear trial participants (n = 5) thought the research process was an enjoyable experience (M = 5.80, SD = 0.447 on a 7-point Likert-type scale) because they could see their needs manifest in a tangible product. One participant (ID 105) explained, “We discussed what we liked or didn’t like about current offerings, what we needed, and in a few weeks, a proto was created and sent out for trial. This prototype incorporated our suggestions.” The participants thought the methods used in this study were effective in addressing their needs (M = 5.80, SD = 0.837); however, they thought the product developed through following the UCD framework was only somewhat successful in meeting their needs (M = 4.60, SD = 2.510). Although the bra was not perfect, the participants believed it was important that BF continues to work with users in their design and development process (M = 6.00, SD = 0.707).

Overall, the general feeling among the company members was that the bra concept met the user’s needs. A participant (ID 201) explained, “Our target market’s needs were very well defined and needs of the market were addressed within the test feedback.” The company members thought that the bra concept met users’ needs more adequately than the users who tested the prototype in wear trials. This finding reveals a disconnection between how company members and users perceived how well the UCD framework was used to create a product that met their needs. This disconnect exposes an important issue about the product development process. If users had not tested the product concept, the company members may have approved the bra concept for production, missing valuable insights that could only come from the users.

The company members viewed working with users as incredibly important, as the CEO of the company member explained: “This is how we can receive fresh, honest input, and ideas. Working with users allows us to see a variety of viewpoints in a collaborative environment that is open and one which encourages creativity and honesty” (ID 200). The company members, especially in marketing, expressed enthusiasm about engaging in “dynamic communication” (ID 202) with users. All five company members saw the UCD process as an improvement in efficiency over their current design process, especially since, as the logistic manager of the company explained (ID 201), “before the study, the lack of organization in the product development process was challenging and inefficient.” They perceived other benefits of a UCD process as providing tools and methods to gather another aspect of the market to create a needed product for their target market. The company member in marketing (ID 202) described that the perceived challenges of a UCD process were “balancing contradictory feedback” from users, finding enough users to participate, and additional costs associated with monetary incentives. Although these difficulties should not be overlooked, the company members overall had a positive outlook on the UCD process as a viable strategy to translate user needs into a product.

Conclusion

To achieve the goal of identifying users’ needs and implementing the findings to drive the development of a nursing sports bra for physically breastfeeding women, the researchers implemented the UCD framework. Specifically, the researchers followed five steps: specify context of use, determine goals for success, create a design solution, evaluate the design solution, and assess the system. A nursing sports bra prototype was developed based on the results collected from the focus group (Stage 1) and wear trials (Stage 4). The focus group data showed that bras available on the market do not meet the needs of athletic breastfeeding women who participate in high-impact activities. Breastfeeding women desired breast support and reduced tissue movement due to the size and volume changes of their breasts postpregnancy. In the wear trials, the researchers found the prototype bra outperformed the participant’s favorite bra on breast support, where the two-layer encapsulating surplice and compressive outer shell design was successful in providing support for the wearer. Ease of nursing, fit, and donning and doffing were not as highly rated for the prototype bra as they were for the participant’s favorite bra.

Although further refinements were necessary, the bra concept developed in this research was novel and addressed many needs of active breastfeeding women. The study participants representing the product’s potential users were able to give first-person data, experiences, and observations about their requirements in a nursing sports bra. The researchers found the study participants generally enjoyed the UCD process and saw the potential for a UCD framework to develop products that meet their needs by incorporating actual end users into the design process. The company members viewed the UCD framework as valuable, with benefits such as fresh perspectives from users, honest input, new ideas, and a variety of viewpoints by incorporating multiple users. However, they mentioned additional costs and balancing multiple voices as limitations to using a UCD process.

This study contributes to the limited body of research regarding the needs of active breastfeeding women for nursing sports bras. This research has important practical implications for bra manufacturers, providing research on physically active nursing women, for whom there is a gap in products available on the market. Industry professionals may gain design insights on the success or failure of particular design features tested in this study from first-person experiences. The product developed through this research may increase the chances of mothers maintaining a regular exercise and breastfeeding routine, benefiting the health of both the mother and the baby.

UCD provides a sequential flow of information that follows the natural progression of the product development process, and it is valuable in providing researchers and practitioners with methods to gather rich data (Sanders & Stappers, 2008; Usability.gov , 2016; Watkins & Dunne, 2015) that can be used to inform the apparel product development process. Following a UCD process, a prototype bra was used in this study to test decisions made at the design level that were either approved or disproved through user testing. The results of the wear trials provided insight into designers on the main and minor unmet needs of the users that would be addressed in future changes and implementations of the prototype, resulting in a theoretically better product than designers could produce by not using the UCD framework. Therefore, the findings suggest that the UCD framework could go beyond traditional apparel design methods because it not only requires the designer to foresee how users are likely to use a product but also test the legitimacy of their assumptions through real-world product evaluations with actual users. Future research in refining the UCD process may address consumer product reviews as a starting point of design creation to develop a list of user evaluation criteria, which could then be addressed in focus groups (Fiore, 2008; McKinney & Shin, 2016). Moreover, industry professionals may also consider adopting the UCD framework in their product development process because this research documented benefits of the flexible design approach based on the perspectives of not only the industry partners but also the potential users of the product.

As with most research, this study had limitations that researchers should address in future studies. The main limitations of this study were sample size and the bra-fitting process. Eight participants started the focus groups, but only five completed the entire research procedure. Future researchers should confirm findings from this study with a more robust sample. A limitation of the product development process was that the researchers did not fit the bras on a live person to understand some of the fit issues that negatively influenced the study findings before sending them out for wear trials. Based on the results of this research, another prototype and wear trial should be conducted to refine the product before production. Future researchers may utilize digital or analog tools such as 3-D body scanning to collect anthropometric data from users to develop better-fitting patterns. The 3-D body scanning would provide quantitative measurements of breast size changes within participants both during pregnancy and during breastfeeding. Changes in breast volume data could inform the development of bra cups and straps that could address this unique need.

Footnotes

Acknowledgments

The authors would like to thank Jung Ha-Brookshire and the anonymous reviewers for their recommendations and thoughtful insights.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Note

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