Assessing the Feasibility and Effectiveness of Two Prenatal Breastfeeding Intervention Apps in Promoting Postpartum In-Hospital Exclusive Breastfeeding

Abstract

Purpose: To test the feasibility and possible effects of two iPad®-based breastfeeding interventions for expectant minority women and evaluate (1) the intervention effect on exclusive breastfeeding (EBF) intention, (2) intervention acceptability and satisfaction, and (3) follow-up rates of in-hospital EBF. Materials and Methods: This was a longitudinal survey study with follow-up chart review. Expectant women who completed clinically required breastfeeding education were eligible and were assigned to one of the following interventions by nonrandomized block design: the champion intervention utilized a free commercially available app to identify a supportive breastfeeding champion and the positive messaging intervention offered breastfeeding information in a question-answer format. Medical records were reviewed postpartum for in-hospital feeding choice. Data were analyzed using percentages, frequencies, chi-squared analyses, and McNemar's test. Results: We enrolled 243 publicly insured predominantly African American women: 132 and 111 completed the champion and positive messaging interventions, respectively. Thirty-two of 40 champion participants (80.03%) intended EBF and did in-hospital EBF; 39/86 champion participants (45.3%) not intending EBF did in-hospital EBF (p < 0.0001 for change). Similarly, 30/36 positive messaging participants (83.3%) intended EBF and did in-hospital EBF; 36/67 positive messaging participants (53.7%) not intending EBF did in-hospital EBF (p < 0.0001 for change). Conclusions: In this pilot of two brief, iPad-based prenatal interventions designed to promote in-hospital EBF among minority women, interventions were feasible and a statistically significant change in the proportion of women who intended (prenatally) and then chose (postpartum) EBF was noted. Additional controlled trials are needed to demonstrate the effectiveness of this approach.