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. 2020 Jul;20(5):652-659.
doi: 10.1016/j.acap.2019.10.008. Epub 2019 Oct 16.

Feasibility and Effectiveness of Telelactation Among Rural Breastfeeding Women

Lori Uscher-Pines  1 , Bonnie Ghosh-Dastidar  2 , Debra L Bogen  3 , Kristin N Ray  3 , Jill R Demirci  4 , Ateev Mehrotra  5 , Kandice A Kapinos  2
Affiliations

Feasibility and Effectiveness of Telelactation Among Rural Breastfeeding Women

Lori Uscher-Pines et al. Acad Pediatr. 2020 Jul.

Abstract

Objective: To evaluate the feasibility and impact of telelactation via personal electronic devices on breastfeeding duration and exclusivity among rural women.

Methods: The Tele-MILC trial, a pragmatic, parallel design trial, recruited 203 women during their postpartum hospitalization in a critical access hospital in Pennsylvania and randomized them to receive telelactation (n = 102) or usual care (n = 101). We used intent-to-treat (ITT) and instrumental variable (IV) approaches to analyze study data for the 187 participants who completed follow-up. The primary outcomes were any breastfeeding and exclusive breastfeeding at 12 weeks postpartum.

Results: Among participants in the telelactation arm, 50% (47/94) reported participating in video calls. At 12 weeks, 71% of participants in the telelactation arm versus 68% of control participants were breastfeeding in the ITT model (3% difference, P = .73), whereas 73% of participants in the telelactation arm versus 68% of control participants were breastfeeding in the IV model (5% difference, P = .74). Among participants who were still breastfeeding at 12 weeks, 51% participants in the telelactation arm were breastfeeding exclusively versus 46% of control participants in the ITT model (5% difference, P = .47), whereas 56% of participants in the telelactation arm were breastfeeding exclusively versus 45% of control participants in the IV model (11% difference, P = .48). In all models, participants in the telelactation arm were breastfeeding at higher rates; however, differences were not statistically significant.

Conclusions: This trial demonstrated that telelactation can be implemented with a rural underserved population. Though this trial was not powered to detect differences in breastfeeding duration and exclusivity, and none were observed, telelactation remains a promising approach for further investigation. ClinicalTrials.gov Identifier: NCT02870413.

Keywords: breastfeeding; lactation; rural health; telehealth; telelactation; telemedicine.

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