Information and Communication Systems to Tackle Barriers to Breastfeeding: Systematic Search and Review

Abstract

BackgroundBreastfeeding has many benefits for newborns, mothers, and the wider society. The World Health Organization recommends mothers to feed newborns exclusively with breastmilk for the first 6 months after birth, but breastfeeding rates in many countries fail to align with the recommendations because of various barriers. Breastfeeding success is associated with a number of determinants, such as self-efficacy, intention to breastfeed, and attitudes toward breastfeeding. Information and communication technology (ICT) has been leveraged to support breastfeeding by means of improving knowledge or providing practical supports in different maternal stages. Previous reviews have examined and summarized the effectiveness and credibility of interventions; however, no review has been done from a human-computer interaction perspective that is concerned with novel interaction techniques and the perspective of end users.ObjectiveThe objective of this review was to provide a comprehensive overview of existing digital interventions that support breastfeeding by investigating systems’ objective, technology design, validation process, and quality attributes, both in terms of clinical parameters as well as usability and user experience.MethodsA systematic search was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in the following libraries: PubMed, Science Direct, Association for Computing Machinery Digital Library (ACM Digital Library), and Institute of Electrical and Electronics Engineers Xplore (IEEE Xplore).ResultsA total of 35 papers discussing 30 interventions were included. The main goals of these interventions were organized into 4 categories: breastfeeding education (n=12), breastfeeding promotion (n=8), communication support (n=6), and daily practical support (n=4). Of the interventions, 13 target mothers in the postnatal period. Most interventions come in forms of client communication systems (n=18), which frequently leverage Web technologies, text message, and mobile apps to provide breastfeeding support. Systems predominantly focus on mothers; validation strategies were rather heterogeneous, with 12 user studies concerning usability and user experience and 18 clinical validation studies focusing on the effects of the interventions on breastfeeding determinants; 5 papers did not report results. Generally, straightforward systems (eg, communication tools or Web-based solutions) seem to be more effective than complex interventions (eg, games).ConclusionsExisting information and communication systems offer effective means of improving breastfeeding outcomes, but they do not address all relevant periods in parenthood (eg, the antenatal period) and often do not involve important stakeholders, such as partners. There is an opportunity to leverage more complex technical systems to open up avenues for the broader design of ICT to support breastfeeding; however, considering evaluation outcomes of existing support systems of higher complexity, such systems need to be...

Effect of a breastfeeding educational intervention: a randomized controlled trial

“…Other studies ( 17 - 25 ) that used technologies as health education strategies reinforce evidence of innovations in BF assistance, such as: use of educational games, electronic media, educational manuals, information booklets, video conferencing, and digital instant messaging. These practices showed to be effective in adherence and maintenance of breastfeeding supported by educational technologies based on greater interaction and protagonism of the participating women.…”

“…Other studies (17)(18)(19)(20)(21)(22)(23)(24)(25) that used technologies as health education strategies reinforce evidence of innovations in BF assistance, such as: use of educational games, electronic media, educational manuals, information booklets, video conferencing, and digital instant messaging.…”

Effectiveness of WeChat for Improving Exclusive Breastfeeding in Huzhu County China: Randomized Controlled Trial

“…It has been demonstrated that information and communication systems, such as web platform, mobile apps, and SMS can be used to promote, educate, and support breastfeeding women, and offer effective means of improving breastfeeding outcomes [ 33 , 34 ]. From 2010 to 2012, a study in Shanghai using SMS to promote breastfeeding found that weekly messages on infant feeding from the third trimester to 12 months postpartum could improve the exclusive breastfeeding rate at 6 months (OR 2.67) but not at 4 months [ 35 ].…”

Construção e validação de tecnologia educacional para promoção do aleitamento materno no período neonatal

“…It was also clarified that the level of knowledge of mothers can help them in several ways, such as avoiding physical discomfort and perceiving milk supply. 17 The judges also agreed that the messages were well organized, and the figures completed the meaning of the texts, besides being simple and expressive. Appropriate use of illustrations was sought in order to allow readability and understanding of the messages presented, which were proposed as a way to attract readers, awaken and maintain interest in reading, complement and reinforce the information provided by the health professional in relation to the BF process.…”

“…16 Therefore, research is needed to explore how ICT can be used to provide comprehensive support for BF. 17,18 Thus, it was aimed at building and validating Text and Figure Message Pack (TFMP) for the promotion of breastfeeding in the neonatal period.…”