Mobile applications for promoting and supporting breastfeeding: Systematic review and meta‐analysis

Abstract Breastfeeding practices require improvement. We performed a systematic review of randomised controlled trials (RCTs) and analytic observational studies to assess effects of mobile applications (apps) aiming to support and promote breastfeeding targeting pregnant women, mothers of infants or...

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Main Authors: Monika Ziebart, Michael Kammermeier, Berthold Koletzko, Bernadeta Patro‐Golab
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Maternal and Child Nutrition
Subjects:
Online Access:https://doi.org/10.1111/mcn.13733
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author Monika Ziebart
Michael Kammermeier
Berthold Koletzko
Bernadeta Patro‐Golab
author_facet Monika Ziebart
Michael Kammermeier
Berthold Koletzko
Bernadeta Patro‐Golab
author_sort Monika Ziebart
collection DOAJ
description Abstract Breastfeeding practices require improvement. We performed a systematic review of randomised controlled trials (RCTs) and analytic observational studies to assess effects of mobile applications (apps) aiming to support and promote breastfeeding targeting pregnant women, mothers of infants or their partners, on breastfeeding outcomes. We searched MEDLINE, EMBASE, Cochrane CENTRAL and Association of Computing Machinery Digital Library from 1 July 2008 to 29 November 2022, with lack of coverage of the most recent period before publication date being a limitation of this review. We performed meta‐analyses of findings from RCTs on primary outcomes, namely early breastfeeding initiation, exclusive and any breastfeeding rates. Joanna Briggs Institute tools were used for risk of bias assessment. Six RCTs, one quasi‐experimental and two cohort studies, mainly from high‐income countries, were included. Most studies focused on maternal app usage starting from pregnancy. One study targeted fathers as app‐users. Population characteristics, such as parity or delivery mode, apps scope of content and applied active components varied between studies. Main methodological limitations of studies were baseline differences between groups and lack of blinding. Compared to controls, app usage tended to increase the odds of exclusive breastfeeding. This nonsignificant effect was most pronounced at 1–1.5 months (n = 1294, odds ratio 1.45 (95% Confidence Interval, CI 0.83, 2.54), with considerable heterogeneity between studies [I2 77%]), but less so at 3 and 6 months post‐partum. The odds of early breastfeeding initiation, any breastfeeding at all time points were similar among groups. However, two cohort studies reported increased odds of exclusive and/or any breastfeeding at different time points. In conclusion, evidence is insufficient to show sustained beneficial effects of breastfeeding promotion and support through mobile apps on breastfeeding rates.
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spelling doaj-art-ce2f0cd9c2f94d408875ae577483595f2024-12-17T09:57:23ZengWileyMaternal and Child Nutrition1740-86951740-87092025-01-01211n/an/a10.1111/mcn.13733Mobile applications for promoting and supporting breastfeeding: Systematic review and meta‐analysisMonika Ziebart0Michael Kammermeier1Berthold Koletzko2Bernadeta Patro‐Golab3Stiftung Kindergesundheit, c/o Dr. von Hauner Children's Hospital, LMU University Hospital Munich GermanyDepartment of Pediatrics, Division of Metabolic and Nutritional Medicine Dr. von Hauner Children's Hospital, University Hospital, LMU Munich Munich GermanyStiftung Kindergesundheit, c/o Dr. von Hauner Children's Hospital, LMU University Hospital Munich GermanyStiftung Kindergesundheit, c/o Dr. von Hauner Children's Hospital, LMU University Hospital Munich GermanyAbstract Breastfeeding practices require improvement. We performed a systematic review of randomised controlled trials (RCTs) and analytic observational studies to assess effects of mobile applications (apps) aiming to support and promote breastfeeding targeting pregnant women, mothers of infants or their partners, on breastfeeding outcomes. We searched MEDLINE, EMBASE, Cochrane CENTRAL and Association of Computing Machinery Digital Library from 1 July 2008 to 29 November 2022, with lack of coverage of the most recent period before publication date being a limitation of this review. We performed meta‐analyses of findings from RCTs on primary outcomes, namely early breastfeeding initiation, exclusive and any breastfeeding rates. Joanna Briggs Institute tools were used for risk of bias assessment. Six RCTs, one quasi‐experimental and two cohort studies, mainly from high‐income countries, were included. Most studies focused on maternal app usage starting from pregnancy. One study targeted fathers as app‐users. Population characteristics, such as parity or delivery mode, apps scope of content and applied active components varied between studies. Main methodological limitations of studies were baseline differences between groups and lack of blinding. Compared to controls, app usage tended to increase the odds of exclusive breastfeeding. This nonsignificant effect was most pronounced at 1–1.5 months (n = 1294, odds ratio 1.45 (95% Confidence Interval, CI 0.83, 2.54), with considerable heterogeneity between studies [I2 77%]), but less so at 3 and 6 months post‐partum. The odds of early breastfeeding initiation, any breastfeeding at all time points were similar among groups. However, two cohort studies reported increased odds of exclusive and/or any breastfeeding at different time points. In conclusion, evidence is insufficient to show sustained beneficial effects of breastfeeding promotion and support through mobile apps on breastfeeding rates.https://doi.org/10.1111/mcn.13733breastfeedinginfant nutritionlactationmHealthmobile applicationsystematic review
spellingShingle Monika Ziebart
Michael Kammermeier
Berthold Koletzko
Bernadeta Patro‐Golab
Mobile applications for promoting and supporting breastfeeding: Systematic review and meta‐analysis
Maternal and Child Nutrition
breastfeeding
infant nutrition
lactation
mHealth
mobile application
systematic review
title Mobile applications for promoting and supporting breastfeeding: Systematic review and meta‐analysis
title_full Mobile applications for promoting and supporting breastfeeding: Systematic review and meta‐analysis
title_fullStr Mobile applications for promoting and supporting breastfeeding: Systematic review and meta‐analysis
title_full_unstemmed Mobile applications for promoting and supporting breastfeeding: Systematic review and meta‐analysis
title_short Mobile applications for promoting and supporting breastfeeding: Systematic review and meta‐analysis
title_sort mobile applications for promoting and supporting breastfeeding systematic review and meta analysis
topic breastfeeding
infant nutrition
lactation
mHealth
mobile application
systematic review
url https://doi.org/10.1111/mcn.13733
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AT michaelkammermeier mobileapplicationsforpromotingandsupportingbreastfeedingsystematicreviewandmetaanalysis
AT bertholdkoletzko mobileapplicationsforpromotingandsupportingbreastfeedingsystematicreviewandmetaanalysis
AT bernadetapatrogolab mobileapplicationsforpromotingandsupportingbreastfeedingsystematicreviewandmetaanalysis