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Meta-Analysis
. 2022 Apr;18(2):e13296.
doi: 10.1111/mcn.13296. Epub 2021 Dec 29.

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

Anna Gavine  1 , Joyce Marshall  2 , Phyll Buchanan  3 , Joan Cameron  1 , Agnes Leger  3 , Sam Ross  4 , Amal Murad  5 , Alison McFadden  1
Affiliations
Meta-Analysis

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

Anna Gavine et al. Matern Child Nutr. 2022 Apr.

Abstract

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. To determine if breastfeeding support provided remotely is an effective method of support. A systematic review and meta-analysis were conducted. 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, 95% CI: 0.74, 1.64), 3 months (RR: 0.89, 95% CI: 0.71, 1.11), or 6 months (RR: 0.91, 95% CI: 0.81, 1.03) or the number of women stopping exclusive breastfeeding at 4-8 weeks (RR: 0.86, 95% CI: 0.70, 1.07) or 6 months (RR: 0.93, 95% CI: 0.85, 1.0). There was substantial heterogeneity of interventions in terms of mode of delivery, intensity, and providers. 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.

Keywords: breast feeding; counselling; lactation; meta-analysis; online social support; systematic review; telemedicine.

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Conflict of interest statement

The authors declare that there are no conflict of interests.

Figures

Figure 1
Figure 1
Preferred reporting items for systematic reviews and meta‐analysis flow diagram detailing study selection
Figure 2
Figure 2
Forest plot of comparison: Remote support versus standard care/control, outcome: Stopping exclusive breastfeeding at 4–8 weeks
Figure 3
Figure 3
Forest plot of comparison: Remote support versus standard care/control, outcome: Stopping any breastfeeding at 4–8 weeks
Figure 4
Figure 4
Forest plot of comparison: Remote support versus standard care/control, outcome: Stopping exclusive breastfeeding at 3 months
Figure 5
Figure 5
Forest plot of comparison: Remote support versus standard care/control, outcome: Stopping any breastfeeding at 3 months
Figure 6
Figure 6
Forest plot of comparison: Remote support versus standard care/control, outcome: Stopping exclusive breastfeeding at 6 months
Figure 7
Figure 7
Forest plot of comparison: Remote support versus standard care/control, outcome: Stopping exclusive breastfeeding at 6 months
See this image and copyright information in PMC

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