Online participatory intervention to promote and support exclusive breastfeeding: Randomized clinical trial

Abstract

The support offered to mothers after hospital discharge can be decisive in maintaining exclusive breastfeeding during the first 6 months post-partum. The objective of this study was to assess the impact on the duration of exclusive breastfeeding of a participatory intervention using an online social network. A randomized clinical trial was performed involving 251 mother-child pairings in a university hospital in the Northeast of Brazil, 123 of which assigned to the intervention group and 128 to the control group. After hospital discharge, the intervention group was followed through a closed group of an online social network, where weekly posters were published on topics related to breastfeeding and an active communication was established with the mothers. The groups were interviewed monthly over the phone until the child reached 6 months of age. The duration of exclusive breastfeeding was calculated through survival analysis, and the effect of the intervention was estimated through the Cox regression model. The exclusive breastfeeding frequencies were higher in the intervention group in all follow-up months, reaching 33.3% in the sixth month versus 8.3% in the control group. The median exclusive breastfeeding duration was 149 days (95% CI [129.6, 168.4]) in the intervention group and 86 days (95% CI [64.9, 107.1]) in the control group (P < 0.0001). The proportional risk of early interruption of exclusive breastfeeding was 0.38 (95% CI [0.28, 0.51], P < 0.0001). This intervention had a positive impact on the duration and frequency of exclusive breastfeeding.

Inserção de um grupo virtual na rede social de apoio ao aleitamento materno exclusivo de mulheres após a alta hospitalar

“…A potencialidade dessa estratégia virtual no cenário brasileiro foi sistematizada em um estudo inovador realizado por Silva e colaboradores, cujo cenário de intervenção foi o grupo virtual Projeto Amamenta Mamãe. Os pesquisadores realizaram um ensaio clínico randomizado e identificaram que essa prática on-line impactou positivamente na frequência e na duração do aleitamento materno exclusivo 34 .…”

“Am I doing this wrong?” Breastfeeding mothers' use of an online forum

“…As Tonsaker, Bartlett, and Trpkov () pointed out, “patients might trust misleading information or might make important health decisions based on sensationalised or emotionally charged stories that are not relevant to their health context,” and breastfeeding may be considered an emotionally charged issue (Raju, ). A recent study attempted to address this concern by providing a healthcare provider mediated social network group using Facebook (Cavalcanti, Cabral, de Toledo Vianna, & Osório, ). The intervention group was provided with weekly education topics relevant to the process of breastfeeding and questions raised were answered by the research group, and members were invited and encouraged to discuss their concerns and share their experiences.…”

An integrative review on mothers' experiences of online breastfeeding peer support: Motivations, attributes and effects

“…Nine were qualitative (Alianmoghaddam et al, 2019;Black et al, 2020;Bridges, 2016;Clapton-Caputo et al, 2020;Jackson & Hallam, 2020;Niela-Vilén et al, 2015;Regan & Brown, 2019;Skelton et al, 2018), and two were mixed methods (Herron et al, 2015;Skelton et al, 2020). The remaining three were quantitative studies, of which two were randomized controlled trials (RCTs) (Cavalcanti et al, 2019;Niela-Vilén et al, 2016) and one was a cross-sectional survey . The participants in seven studies were breastfeeding mothers with no specification (Alianmoghaddam et al, 2019;Bridges, 2016;Cavalcanti et al, 2019;Herron et al, 2015;Regan & Brown, 2019;Skelton et al, 2018Skelton et al, , 2020).…”

“…The remaining three were quantitative studies, of which two were randomized controlled trials (RCTs) (Cavalcanti et al, 2019;Niela-Vilén et al, 2016) and one was a cross-sectional survey . The participants in seven studies were breastfeeding mothers with no specification (Alianmoghaddam et al, 2019;Bridges, 2016;Cavalcanti et al, 2019;Herron et al, 2015;Regan & Brown, 2019;Skelton et al, 2018Skelton et al, , 2020). In the other seven studies, the participants were from specific groups of breastfeeding mothers, including primiparous mothers, mothers with preterm infants, primiparous African American mothers, mothers who exclusively expressed breast milk and ones who continued breastfeeding over 12 months of the child's age (Black et al, 2020;Clapton-Caputo et al, 2020;Jackson & Hallam, 2020;Niela-Vilén et al, 2015;Niela-Vilén et al, 2016;.…”

“…In the other seven studies, the participants were from specific groups of breastfeeding mothers, including primiparous mothers, mothers with preterm infants, primiparous African American mothers, mothers who exclusively expressed breast milk and ones who continued breastfeeding over 12 months of the child's age (Black et al, 2020;Clapton-Caputo et al, 2020;Jackson & Hallam, 2020;Niela-Vilén et al, 2015;Niela-Vilén et al, 2016;. The breastfeeding peer support groups in 10 studies were exclusively on Facebook (Black et al, 2020;Bridges, 2016;Cavalcanti et al, 2019;Clapton-Caputo et al, 2020;Niela-Vilén et al, 2015;Niela-Vilén et al, 2016;Skelton et al, 2018Skelton et al, , 2020. The groups in the remaining four studies were from forums in parenting websites or unspecified social media groups (Alianmoghaddam et al, 2019;Herron et al, 2015;Jackson & Hallam, 2020;Regan & Brown, 2019).…”