Effect of a Novel Smartphone Application on Breastfeeding Rates Among Low-Income, First-Time Mothers Intending to Exclusively Breastfeed: Secondary Analysis of a Randomized Controlled Trial

Mother’s Milk Messaging™: trial evaluation of app and texting for breastfeeding support

“…A recent trial showed improvements and satisfaction like our study but no difference in breastfeeding rates in low-income mothers [ 43 ]. Unfortunately there were confounding circumstances because 50% of the participants reported formula feeding planned after enrollment and they were excluded from the analysis [ 43 ]. Health-system sponsored apps (e.g.…”

Perinatal support for breastfeeding using mHealth: A mixed methods feasibility study of the My Baby Now app

“…In line with our findings, a small pilot study of 29 women in rural Victoria (Wheaton et al, 2018) reported high acceptability and usefulness of a breastfeeding app, although impact on breastfeeding outcomes was not assessed. An RCT (Lewkowitz et al, 2021) among low‐income women in the United States found that a breastfeeding app provided in late pregnancy did not improve breastfeeding initiation or duration of exclusive breastfeeding at 6 months despite the app being perceived by participants as the best source of support. Likewise, the Milk Man app, which focused on engaging fathers to start conversations about breastfeeding, was an acceptable source of breastfeeding information and support (White et al, 2019) and generated breastfeeding conversations in half of all fathers; but did not find a measurable impact on their partners’ infant feeding decision and breastfeeding self‐efficacy, compared with a father focused antenatal breastfeeding class or usual antenatal parenting class (Scott et al, 2021).…”

Mobile Health Approaches to Breastfeeding

“…Other researchers developed their own apps to target specific barriers their research identified that prevented specific populations of women from continuing to breastfeed. For example, Wang et al 23 created an app to help Thai women overcome breastfeeding difficulties after hospital discharge, while the app created by Lewkowitz et al 22,29 contained on-demand videos on breastfeeding, infant care, and postpartum health that targeted specific challenges low-income women in St. Louis identified as preventing them from breastfeeding exclusively at hospital discharge. 30 Both studies employing commercially available apps demonstrated a significant increase among women exposed to app-based breastfeeding education compared with those unexposed, 21,24 whereas the only study employing a novel app did not produce any change in breastfeeding rates, when examined in primary 22 or secondary analyses.…”

“…30 Both studies employing commercially available apps demonstrated a significant increase among women exposed to app-based breastfeeding education compared with those unexposed, 21,24 whereas the only study employing a novel app did not produce any change in breastfeeding rates, when examined in primary 22 or secondary analyses. 29 The study by Wang et al 23 focused on usability and did not include breastfeeding outcomes. This may be because of study differences.…”

“…For example, the study by Wheaton et al 24 was conducted in rural Australia, which has a much higher baseline of exclusive breastfeeding at 6 months postpartum than in the United States, whereas the low-income American women who participated in the study by Farr et al 21 were required to complete formal breastfeeding education before study enrollment but those in the study by Lewkowitz et al were not. 22,29 Lastly, because the studies by Wheaton and colleagues and Farr and colleagues used commercially available technology interventions, 21,24 they could not determine whether the app was actually utilized by study participants. Indeed, the app used by Lewkowitz et al 22,29 contained an embedded tracker providing data on app usage, which demonstrated that participants had an overall low rate of app use during the study period.…”