Abstract
BackgroundSupporting women to initiate and continue breastfeeding is a global challenge. A range of breastfeeding interventions employing electronic technologies (e-technologies) are being developed, which offer different delivery modes and features over the internet; however, the impact of internet-based e-technologies on breastfeeding outcomes remains unclear.ObjectiveThis study aimed to identify the characteristics of current internet-based breastfeeding interventions employing e-technologies and investigate the effects of internet-based e-technologies on breastfeeding outcomes.MethodsA systematic search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in the following databases: Scopus, Web of Science, the Cochrane Database of Systematic Reviews, ScienceDirect, Google Scholar, the Association for Computing Machinery, SpringerLink, and Institute of Electrical and Electronics Engineers Xplore.ResultsThis systematic review included 16 studies published between 2007 and 2018, with 4018 women in 8 countries. The characteristics of the interventions were grouped based on (1) mode of delivery (web-based, mobile phone apps, and computer kiosk), (2) purpose of the interventions (education and support), and (3) key strategies (monitoring and breastfeeding tracking, personalization, online discussion forum, web-based consultation, and breastfeeding station locators). Combining educational activities with web-based personalized support through discussion forums appeared to be the most effective way to improve breastfeeding outcomes and long-term exclusive breastfeeding rates. Monitoring and breastfeeding trackers appeared to be the least effective ways.ConclusionsThis study demonstrated a variety of internet-based e-technologies that professionals can use to promote, educate, and support breastfeeding women. Future internet-based breastfeeding interventions employing e-technologies might consider improving interaction with mothers and personalizing the content of the proposed interventions.
Highlights
Breastfeeding provides survival, growth, and health benefits for infants and promotes positive maternal health outcomes [1]
This study demonstrated a variety of internet-based e-technologies that professionals can use to promote, educate, and support breastfeeding women
3 studies reported using a theoretical framework to inform the design of the intervention: the sustained breastfeeding framework based on predicting and changing behavior theory [40], Bandura’s [41] social cognitive theory [42], and Bandura’s [43] self-efficacy theory [44]
Summary
Breastfeeding provides survival, growth, and health benefits for infants and promotes positive maternal health outcomes [1]. In Australia, 96% of women initiate breastfeeding after birth, but the feeding practices significantly declined to only 15% to 25% at 6 months postnatally [4]. Breastfeeding education with support that starts from early pregnancy and continues to the late postnatal period was demonstrably one of the most effective interventions in long-term breastfeeding behavior [9]. Information and communications technology (ICT) may be suitable in transforming traditional education and support into a free and widely accessible mode of delivery [12,13]. Supporting women to initiate and continue breastfeeding is a global challenge. A range of breastfeeding interventions employing electronic technologies (e-technologies) are being developed, which offer different delivery modes and features over the internet; the impact of internet-based e-technologies on breastfeeding outcomes remains unclear
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