Remote provision of breastfeeding support and education: systematic review and meta-analysis

Anna Gavine, Joyce L Marshall, Phyll Buchanan, Joan Cameron, Agnes Leger, Sam Ross, Amal Murad, Alison McFadden

Research output: Contribution to journalReview articlepeer-review

Abstract

Background
The Covid-19 pandemic has led to a substantial increase in remotely provided maternity care services, including breastfeeding support. It is therefore important to understand whether breastfeeding support provided remotely is an effective method of support.

Aim
To determine if breastfeeding support provided remotely is an effective method of support.

Methods
A systematic review and meta-analysis were conducted.

Results
Twenty-nine studies were included in the review and 26 contributed data to the meta-analysis. Remotely provided breastfeeding support significantly reduced the risk of women stopping exclusive breastfeeding at 3 months by 25% (risk ratio [RR] 0.75, 95% confidence interval [CI] 0.63, 0.90). There was no significant difference in the number of women stopping any breastfeeding at 4-8 weeks (RR 1.10, CI 0.74,1.64), 3 months (RR 0.89, CI 0.71,1.11) or 6 months (RR 0.91, CI 0.81,1.03) or the number of women stopping exclusive breastfeeding at 4-8 weeks (RR 0.86, CI 0.70,1.07) or 6 months (RR 0.93, CI 0.85, 1.0). There was substantial heterogeneity of interventions in terms of mode of delivery, intensity, and providers.

Conclusion
This demonstrates that remote interventions can be effective for improving exclusive breastfeeding at 3 months but the certainty of the evidence is low. Improvements in exclusive breastfeeding at 4-8 weeks and 6 months were only found when studies at high risk of bias were excluded. They are also less likely to be effective for improving any breastfeeding. Remote provision of breastfeeding support and education could be provided when it is not possible to provide face-to-face care.
Original languageEnglish
JournalMaternal and Child Nutrition
Publication statusAccepted/In press - 13 Oct 2021

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