Web-Based Interventions Support Breastfeeding Women

The findings of a systematic review demonstrated the efficacy of internet-based e-technologies on breastfeeding outcomes.

In fact, the results from Alaa Almohanna, MSc, and colleagues highlighted the ability for healthcare professionals to use such technologies to promote, educate, and support women who breastfeed.

Almohanna and the team of investigators scoured 8 electronic databases to identify potential studies. They used peer-reviewed studies, including quantitative and quality research, mixed methods, descriptive studies, randomized controlled trials, and quasi-experimental design trials with or without blinding. What’s more, the team included papers examining interventions employing technologies requiring internet access and aimed at addressing any breastfeeding outcome.

Participants of the studies were healthy pregnant or postnatal women—primiparous or multiparous—who intended to breastfeed. When searching for studies, the team included the key terms: nursing, breast-feed, breast-feeding, breast feeding, breast milk, and lactation, and computers, telehealth, computer-mediated, and mobile application.

The investigators screened all titles and abstracts of the papers. After the examination, 17 studies fully met the inclusion criteria and were appraised for quality by 2 investigators. There was 1 study excluded after the appraisal, bringing the total to 16 studies.

The 16 included studies involved 4018 participants from 8 different countries. All of the studies reported >1 breastfeeding outcome.

Among 11 web-based interventions combining education and support focus, 8 showed improvements in breastfeeding outcomes. For example, in 1 study, investigators evaluated breastfeeding knowledge in an experimental study where there was a significant difference in breastfeeding knowledge level between the intervention and control groups in the post-test results (P <.001). There were no differences in the pretest knowledge level. What’s more, the study found that exclusive breastfeeding rates were statistically higher at 3-5 days and at 2, 4, and 6 weeks in the intervention group compared with the control group (48.3%, 45%, 31.7%, and 26.7% vs 38.3%, 20%, 20%, and 20%, respectively).

A web-based breastfeeding intervention with an interactive and asynchronous online discussion board was also found useful for motivating intervention mothers to breastfeed for longer periods of time. In 1 study, using online support and discussion forums was associated with higher exclusive breastfeeding rates at 6 months among women who lived in remote areas (n=10; 5.9% vs .6%; P=.01).

Such interventions—those combining educational activities with web-based personalized support through discussion forums&mdash;were the most effective way to improve breastfeeding outcomes and long-term exclusive breastfeeding rates. Conversely, monitoring and breastfeeding trackers were the least effective ways to improve such outcomes.

The results of 1 study relayed >77% of mothers who used a portal to record their daily breastfeeding data and get notifications, reported infant feedings >8 times per day and reported that the system motivated them to keep breastfeeding. But 70% of mothers stated breastfeeding data entry was not time-consuming yet reported monitoring did not substitute face-to-face consultation with a lactation consultant.

Mothers found interventions with personalized feedback and tailored information to be motivational and led to positive breastfeeding outcomes. The strategies pointed toward the need for informed, highly interactive, and tailored-designed breastfeeding interventions employing e-technologies. Web-based platforms were deemed the most dominant and effective mode of delivering such information.

Additional studies are needed to explore both the effectiveness and usability of interventions that have theory-based system designs that could incorporate encouragement and discussion opportunities from credible social and professional sources.

The study, “Effectiveness of Internet-Based Electronic Technology Interventions on Breastfeeding Outcomes: Systematic Review,” was published online in the Journal of Internet Medical Research.