Smartphone-based counseling and support platform and the effect on postpartum lactation: a randomized controlled trial

Hadas Miremberg; Karen Yirmiya; Shiran Rona; Noa Gonen; Or Marom; Alona Pohol; Michal Kovo; Jacob Bar; Eran Weiner

doi:10.1016/j.ajogmf.2021.100543

Smartphone-based counseling and support platform and the effect on postpartum lactation: a randomized controlled trial

Am J Obstet Gynecol MFM. 2022 Mar;4(2):100543. doi: 10.1016/j.ajogmf.2021.100543. Epub 2021 Dec 4.

Authors

Hadas Miremberg¹, Karen Yirmiya², Shiran Rona³, Noa Gonen⁴, Or Marom⁵, Alona Pohol⁵, Michal Kovo⁵, Jacob Bar⁴, Eran Weiner⁴

Affiliations

¹ Department of Obstetrics and Gynecology, The Edith Wolfson Medical Center, Holon, Israel; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel. Electronic address: dasile2@gmail.com.
² Department of Psychology, Bar-Ilan University, Ramat Gan, Israel; Interdisciplinary Center, Herzliya, Israel.
³ Department of Obstetrics and Gynecology, The Edith Wolfson Medical Center, Holon, Israel.
⁴ Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
⁵ Department of Obstetrics and Gynecology, The Edith Wolfson Medical Center, Holon, Israel; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.

PMID: 34871782
DOI: 10.1016/j.ajogmf.2021.100543

Abstract

Background: Human milk lactation provides health benefits for both the mother and infant. Patients commonly report stopping breastfeeding sooner than they planned. Interventions with proper accessible counseling and support to the mother can potentially increase lactation rates and duration.

Objective: This study aimed to investigate the impact of introducing a smartphone-based daily feedback and counseling platform between women after delivery and a multidisciplinary lactation support team on lactation rates and various maternal and neonatal outcomes. Counseling was provided via a specifically developed application from a multidisciplinary team (obstetricians, nurses, lactation counselors, and psychologist) in an attempt to assist and counsel to maintain lactation.

Study design: This was a prospective, single-center, randomized controlled trial. Women planning to lactate were recruited at postpartum day 1 and were randomized to (1) routine lactation counseling and support (control group) or (2) additional daily detailed counseling and feedback on lactation from the team via the application (App group). The primary outcome was partial or full lactation at 3 months after delivery. The secondary outcomes included lactation at additional time points up to 6 months after delivery. The study was adequately powered to detect a 15% difference in the primary outcome.

Results: A total of 197 patients were recruited, 97 in the App group and 100 in the control group. The 2 groups did not differ in any background or delivery characteristics. The App group showed higher rates of lactation 6 weeks after delivery (96.9% vs 82.0%; P<.001) and 3 months after delivery (81.4% vs 69.0%; P=.049) than the control group. Patients in the App group reported excellent satisfaction from the use of the application and their overall postnatal care.

Conclusion: Our study has provided further information on the growing efficacy of technology platforms in obstetrical care. The introduction of a smartphone-based daily feedback and counseling platform between postpartum patients and a multidisciplinary lactation support team increased the lactation rates after delivery with excellent patient satisfaction.

Trial registration: ClinicalTrials.gov NCT04135612.

Keywords: breastfeeding; lactation; multidisciplinary counseling; postpartum; telemedicine.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Breast Feeding*
Counseling
Female
Humans
Infant
Infant, Newborn
Lactation
Postpartum Period
Prospective Studies
Smartphone*

Associated data

ClinicalTrials.gov/NCT04135612