Engagement with Postpartum Text-Based Support Platform Is Not Associated with Breastfeeding Outcomes at 6 Weeks Postpartum

Abstract

Background:

Technology-based breastfeeding support interventions have shown mixed effectiveness. International studies have reported improved breastfeeding outcomes, whereas U.S.-based studies have demonstrated variable results.

Research Aim:

The aim of this study was to describe the association between engagement with a personalized text-based breastfeeding support platform and infant feeding outcomes.

Methods:

This secondary observational within-trial analysis used data from a randomized, controlled trial conducted at an urban tertiary care center (January 2020–January 2021). The parent trial compared usual care with an intervention consisting of weekly educational text messages plus on-demand personalized breastfeeding support. This analysis included only participants randomized to the intervention arm. The exposure of interest was participant engagement with the breastfeeding support platform. The primary outcome was breastfeeding exclusivity at 6 weeks postpartum, obtained through direct text report or medical record documentation. Secondary outcomes included additional infant feeding measures and parental mood assessment. Of 216 subjects in the randomized, controlled trial, 92 intervention-arm subjects were included.

Results:

Participants were 45.7% (n = 42) Black, 52.2% (n = 48) primiparous, and 58.7% (n = 54) with commercial insurance. Overall, 54.4% (n = 50) of participants submitted at least one breastfeeding question, most frequently during the first postpartum week. There was no difference in the primary outcome between those who queried the platform and those who did not (48% vs. 48.8%, p = .94). There were no differences in the secondary outcomes analyzed.

Conclusion:

Engagement with a personalized text-based breastfeeding support platform was not associated with improved breastfeeding outcomes at 6 weeks postpartum. Further research is needed to clarify how technology-based interventions can effectively support breastfeeding families.

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