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Parent-targeted digital health interventions increase the odds of exclusive breastfeeding with an odds ratio of 2.58Digital tools help parents increase exclusive breastfeeding for infants

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Key Takeaway
Consider DHIs as a promising tool to increase exclusive breastfeeding odds (OR 2.58), though evidence certainty is low.

This systematic review and meta-analysis evaluated the impact of parent-targeted digital health interventions (DHIs) on various breastfeeding outcomes. The scope included mHealth, eHealth, and telehealth platforms designed to support parents of children younger than 5 years of age. The analysis synthesized data from 46 studies across 18 diverse countries, involving a total population of 33,785 participants. The primary objective was to determine the efficacy of these digital tools in improving exclusive breastfeeding (EBF), any breastfeeding, and overall breastfeeding duration.

The interventions analyzed were categorized as digital health interventions (DHIs). These included mobile health (mHealth) applications, electronic health (eHealth) platforms, and telehealth services. The study did not report a specific comparator group for these interventions in the meta-analysis. The primary outcomes focused on three distinct metrics: exclusive breastfeeding (EBF), any breastfeeding, and total breastfeeding duration.

Regarding the primary outcome of exclusive breastfeeding (EBF), the meta-analysis reported that DHIs significantly improve the odds of EBF. This finding was based on a sample of 11,601 participants, yielding an odds ratio of 2.58 (95% CI 1.91 to 3.50; I2=83%). The evidence for this specific outcome is characterized by low certainty due to substantial heterogeneity and varying risk of bias across the included studies. For the outcome of any breastfeeding, which involved 8,991 participants, no significant effect was observed (odds ratio 1.09; 95% CI 0.90 to 1.31; I2=19%). In contrast, results for breastfeeding duration were more consistent. Based on data from 716 participants, DHIs may improve breastfeeding duration with a standardized mean difference of 0.48 (95% CI 0.29 to 0.67; I2=0%). The certainty of evidence for this outcome was rated as moderate.

Secondary outcomes included breastfeeding self-efficacy, cost-effectiveness, and safety profiles. Regarding safety and tolerability, adverse events were scarcely reported in the source data, and no serious adverse events or discontinuation rates were provided. These findings suggest that while DHIs are generally well-tolerated, the volume of data regarding specific side effects is limited.

When compared to previous clinical perspectives on breastfeeding support, these results highlight a specific advantage for digital platforms in promoting exclusive breastfeeding rather than just any form of breastfeeding. However, the high heterogeneity (I2=83%) in EBF results suggests that the effectiveness of DHIs may vary significantly depending on the specific platform or delivery method used. The study identified several significant methodological limitations. A total of 41 out of 46 studies were noted to have some concerns or a high risk of bias. Additionally, there is potential publication bias and limited evidence for certain secondary outcomes like cost-effectiveness. The large variation in EBF results suggests that the diversity of digital platforms may lead to inconsistent clinical outcomes.

Clinically, these results suggest that DHIs represent a promising strategy for improving key breastfeeding indicators, specifically exclusive breastfeeding and duration. Practitioners can consider integrating mHealth or telehealth components into postnatal care to support these goals. However, clinicians should note that the evidence for EBF is of low certainty due to study heterogeneity. Future research is needed to standardize DHI protocols and provide clearer data on cost-effectiveness and specific adverse events to better inform clinical decision-making.

For many new parents, the journey of breastfeeding can feel overwhelming. Navigating the demands of a newborn while trying to maintain exclusive breastfeeding—where a baby receives only breast milk for the first six months—can be a significant challenge. Because of these hurdles, many families look for reliable ways to get support and information quickly. This research looks at how digital tools, such as mobile phone apps (mHealth), online platforms (eHealth), and remote consultations (telehealth), can help parents feel more confident and successful in their breastfeeding journeys.

To understand the impact of these technologies, researchers conducted a large-scale review of 46 different studies involving over 33,000 parents across 18 countries. The goal was to see if digital interventions could actually change outcomes for infants under the age of five. By looking at such a large and diverse group of participants, the researchers aimed to find clear patterns in how technology affects breastfeeding habits.

The results showed that these digital tools were particularly effective at increasing the odds of exclusive breastfeeding. Specifically, parents who used these digital programs were much more likely to successfully breastfeed their infants exclusively compared to those who did not have such support. Additionally, the data suggested that these digital interventions could help mothers and fathers extend the total duration of breastfeeding. While the tools did not significantly change the overall rates of 'any' breastfeeding, they showed a clear and positive impact on the specific goal of exclusive breastfeeding.

In terms of safety, the study found very few reported problems or side effects associated with using these digital platforms. This suggests that these tools are generally safe and well-tolerated by parents seeking guidance. However, it is important to keep some context in mind. The researchers noted that because the original studies they reviewed varied so much in quality, the certainty of the evidence for exclusive breastfeeding was considered low. There were also many different types of digital programs used, which makes it hard to say exactly which specific app or method works best.

What does this mean for you right now? While one study cannot change medical advice, it highlights that technology is a promising way to reach parents. Digital tools can provide the immediate, accessible support that many families need to feel confident in their choices. If you are looking for ways to support your breastfeeding journey, these digital resources could be a helpful addition to your care team's recommendations.

What this means for you:
Digital tools like apps and telehealth can significantly improve exclusive breastfeeding rates for infants under five.

Study Details

Study typeMeta analysis
Sample sizen = 33,785
EvidenceLevel 1
Follow-up60.0 mo
PublishedJul 2026
View Original Abstract ↓
BACKGROUND: Global breastfeeding rates remain below recommended levels. Parent-targeted digital health interventions (DHIs), including mobile health (mHealth) and eHealth strategies, offer a scalable way to support breastfeeding, but their effectiveness remains uncertain. OBJECTIVE: The aim of this study is to explore the effectiveness of parent-targeted DHIs for improving breastfeeding outcomes. METHODS: In total, 7 databases were searched on December 9, 2025, for randomized controlled trials (RCTs) involving parents of children younger than 5 years of age. Eligible interventions aimed to promote breastfeeding and were primarily delivered via digital mediums. Primary outcomes of interest included exclusive breastfeeding (EBF), any breastfeeding, and breastfeeding duration. Secondary outcomes included breastfeeding self-efficacy, cost-effectiveness, and adverse events. Random effects meta-analyses were conducted in accordance with Cochrane methods, and results were reported following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool, and certainty of evidence was graded using the Grading of Recommendations Assessment, Development, and Evaluation approach. RESULTS: In total, 46 (39 RCTs and 7 cluster RCTs) studies, including 33,785 participants from 18 diverse countries, were included. A total of 25 of the interventions focused on mHealth strategies, 8 were delivered via computer-based eHealth, 4 by telehealth, and 9 were delivered by eHealth or mHealth combined with telehealth. Risk of bias was indicated with "some concerns" or "high risk" for 41 (89%) studies. Pooled results indicated that DHIs can significantly improve the odds of EBF (odds ratio 2.58, 95% CI 1.91-3.50; I2=83%; 39 trials, 11,601 participants); however, considerable heterogeneity was present, and certainty of evidence was very low. Pooled results indicated with moderate certainty that DHIs may improve breastfeeding duration (standardized mean difference 0.48, 95% CI 0.29-0.67; I2=0%; 7 trials, 716 participants). Results suggest that DHIs have no effect on the odds of any breastfeeding (odds ratio 1.09, 95% CI 0.90-1.31; I2=19%; 21 trials, 8991 participants), but the certainty of evidence is very low. Cost or cost-effectiveness and adverse events were scarcely reported. CONCLUSIONS: This review provides a comprehensive synthesis of global evidence exploring the impacts of parent-targeted DHIs on breastfeeding outcomes, spanning diverse cultural and health system contexts. Our results suggest that parent-targeted DHIs represent a promising strategy for improving key breastfeeding indicators, such as EBF and breastfeeding duration with very low to moderate certainty, as current evidence is limited by variable risk of bias, potential publication bias, and substantial heterogeneity. DHIs could have a complementary role as part of the health care and support provided to parents during the first 2000 days. Future trials should seek to minimize possible biases as well as capture key scale-up outcomes to justify embedding such innovations within existing health systems and structures.
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