mHealth interventions to improve self efficacy and exclusive breastfeeding: a scoping review
The exclusive breastfeeding rate in developed and developing countries is low, and is significantly affected by maternal breastfeeding self-efficacy. Mobile health (mHealth, using mobile devices to carry out public health interventions) may help increase self-efficacy and exclusive breastfeeding. The aim of this study was to explore the existing literature on mHealth interventions to increase self-efficacy and exclusive breastfeeding.
This scoping review included an electronic search of PubMed, Science Direct, ProQuest, Google Scholar and IJSR. Randomised controlled trials and quasi-experimental studies published in English between 2014 and 2023 about breastfeeding self-efficacy and exclusive breastfeeding were screened for eligibility.
Overall, 12 studies were included. Thematic analysis showed that primary interventions were delivered using smartphone applications such as WhatsApp, Telegram or video, and most participants were women with infants of normal birth weight.
Delivering breastfeeding education using mHealth may increase self-efficacy and exclusive breastfeeding. Further research is needed to assess the effects of mHealth on breastfeeding self-efficacy and exclusive breastfeeding among women with infants who have health conditions, such as those born preterm or of low birth weight.
Optimal breastfeeding practice is essential and could reduce the under-5 mortality rate (World Health Organization (WHO), 2021). Breastfeeding is reported to be the ‘highest impact intervention’ potentially capable of preventing up to 823 000 child deaths annually, particularly in low- and middle-income countries (Rollins et al, 2016). Breast milk is considered the best source of nutrition for most infants. Nevertheless, the average global rate of exclusive breastfeeding between 2015 and 2020 was approximately 44% (WHO, 2021).
Several factors are known to influence exclusive breastfeeding, including maternal age, race, marital status, multiparity and socioeconomic factors (Pineda, 2011). Women may experience barriers to early breastfeeding initiation as a result of an infant's health condition (Dian Isti Anggraini, 2016), sore nipples (Delvina et al, 2022) or returning to work (Asrina et al, 2022). Women may also believe that the infant does not like breastmilk (Wu et al, 2020) or experience difficulties transitioning from expressing breast milk to breastfeeding. They may be concerned that their infant will contract a maternal illness or experience perceived or actual breast milk supply deficiencies. Pacifier use (Mamemoto et al, 2013), separation from the infant (Oliveira and Valle Volkmer, 2021) and low breastfeeding self-efficacy (Siqueira et al, 2023) are also known to play a role in exclusive breastfeeding rates.
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