BackgroundBreastfeeding has many benefits for newborns, mothers, and the wider society. The World Health Organization recommends mothers to feed newborns exclusively with breastmilk for the first 6 months after birth, but breastfeeding rates in many countries fail to align with the recommendations because of various barriers. Breastfeeding success is associated with a number of determinants, such as self-efficacy, intention to breastfeed, and attitudes toward breastfeeding. Information and communication technology (ICT) has been leveraged to support breastfeeding by means of improving knowledge or providing practical supports in different maternal stages. Previous reviews have examined and summarized the effectiveness and credibility of interventions; however, no review has been done from a human-computer interaction perspective that is concerned with novel interaction techniques and the perspective of end users.ObjectiveThe objective of this review was to provide a comprehensive overview of existing digital interventions that support breastfeeding by investigating systems’ objective, technology design, validation process, and quality attributes, both in terms of clinical parameters as well as usability and user experience.MethodsA systematic search was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in the following libraries: PubMed, Science Direct, Association for Computing Machinery Digital Library (ACM Digital Library), and Institute of Electrical and Electronics Engineers Xplore (IEEE Xplore).ResultsA total of 35 papers discussing 30 interventions were included. The main goals of these interventions were organized into 4 categories: breastfeeding education (n=12), breastfeeding promotion (n=8), communication support (n=6), and daily practical support (n=4). Of the interventions, 13 target mothers in the postnatal period. Most interventions come in forms of client communication systems (n=18), which frequently leverage Web technologies, text message, and mobile apps to provide breastfeeding support. Systems predominantly focus on mothers; validation strategies were rather heterogeneous, with 12 user studies concerning usability and user experience and 18 clinical validation studies focusing on the effects of the interventions on breastfeeding determinants; 5 papers did not report results. Generally, straightforward systems (eg, communication tools or Web-based solutions) seem to be more effective than complex interventions (eg, games).ConclusionsExisting information and communication systems offer effective means of improving breastfeeding outcomes, but they do not address all relevant periods in parenthood (eg, the antenatal period) and often do not involve important stakeholders, such as partners. There is an opportunity to leverage more complex technical systems to open up avenues for the broader design of ICT to support breastfeeding; however, considering evaluation outcomes of existing support systems of higher complexity, such systems need to be...

Breastfeeding brings benefits for newborns and parents, but can be a challenging process. In this paper, we leverage a mixed-methods approach that builds on the Integrated Behavioural Model (IBM) to explore parents' perspectives toward breastfeeding along with their lived experiences, and examine the role of technology in this setting. Results of twelve semi-structured interviews and 175 online survey responses suggest generally positive attitudes toward breastfeeding and good theoretical knowledge. This is combined with a complex lived experience of breastfeeding where main challenges are situated in practical, emotional, and environmental/societal aspects, which are currently not sufficiently recognised by technology that seeks to support breastfeeding. Building upon our findings, we present points for reflection for the design of technology to support breastfeeding, focusing on the importance of drawing from the lived experience of parents, and ensuring that technology not only casts breastfeeding as an individual but also as a collective effort. CCS CONCEPTS• Human-centered computing → User models.

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Technology use in antenatal education is often basic and inadequately presents the emotional and practical challenges of breastfeeding. This work presents Virtual Feed, a Virtual Reality interactive breastfeeding simulation designed with parents and health care professionals to convey key aspects of breastfeeding and to explore the potential and limitation of interactive technology in eliciting intimacy in parent-child space. CCS CONCEPTS• Software and its engineering → Software prototyping.

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