A Technological Approach to Improved Breastfeeding Rates and Self-Efficacy: A Randomized Controlled Pilot Study

Background: Breastfeeding confers significant maternal and infant benefits; however, breastfeeding rates remain suboptimal in the United States. A parent’s decision to breastfeed is influenced by non-modifiable and modifiable factors, including breastfeeding knowledge and self-efficacy. There is a positive correlation between high maternal self-efficacy and breastfeeding duration. Parents increasingly rely on technology for health information. Research Aim: To determine if a smartphone application affected maternal self-efficacy and breastfeeding exclusivity rates. Method: This study was a randomized, controlled pilot study examining the effect of an educational program, included in a smartphone application, on breastfeeding self-efficacy (assessed in postpartum Week 1 and Weeks 4–6) and breastfeeding rates (assessed in postpartum Weeks 4–6). Forty participants were recruited using block randomization to intervention (17 of 20 completed the study) and usual care (19 of 20 completed the study) groups. To examine the pre-test/post-test difference in the Breastfeeding Self-Efficacy Scale – Short Form total scores, a change in score (post-intervention minus pre-intervention) was calculated for each parent. Result: The intervention group (phone application and usual care) showed greater change in self-efficacy scores ( M = 7.6, SD = 7.8) compared to the control group (usual care; M = 1.2, SD = 3.7, p = .001). The rate of exclusive breastfeeding was nearly twice as high in the intervention group as in the control group, but did not reach statistical significance ( p = .093). Conclusion: The investigators found enhanced breastfeeding self-efficacy and breastfeeding rates among postpartum women receiving a smartphone educational program in the first 6 weeks postpartum. Further studies on smartphone interventions will develop our understanding of this technology in improving breastfeeding rates.