{"title":"The effectiveness of real-time telelactation intervention on breastfeeding outcomes among employed mothers: a systematic review and meta-analysis.","authors":"Tippawan Iamchareon, Wantana Maneesriwongul","doi":"10.1186/s12884-025-07440-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The global exclusive breastfeeding (EBF) rate during the first six months is < 50%. This rate is particularly low among employed mothers, who may face obstacles in accessing in-person lactation services. Given that telelactation services can increase EBF rates, we conducted this study to assess the effects of real-time telelactation services (vs. usual lactation services) on breastfeeding outcomes among employed mothers.</p><p><strong>Methods: </strong>The Preferred Reporting Items for Systematic Reviews Meta-Analyses guidelines were followed. Studies published between 2012 and 2023 were identified from the Academic Search Ultimate, Cochrane, CINAHL Complete, Embase, ProQuest, SAGE journals, ScienceDirect, Scopus, Springer Link, Google Scholar, and Thai Journal Online databases. Randomized controlled trials and quasi-experimental studies that met the inclusion criteria were included. The JBI critical appraisal tool was used to assess the studies selected for the systematic review. Categorical data were analyzed using relative risk (RR) with 95% confidence intervals (CIs) and a random-effects model.</p><p><strong>Results: </strong>Of the 18 studies selected for the review, 13 were included in the meta-analysis with a total of 4,564 participants. Of these, 3,582 were employed mothers. We identified three types of real-time telelactation services based on the activities of the provider and client: proactive, reactive, and mixed services. The results showed that real-time telelactation services had a statistically significant positive effect on the EBF rate during the first six months compared to usual care (Relative risk (RR): 1.31, 95% Confidence interval (CI) [1.10, 1.54]; p = 0.002). Proactive and mixed services significantly enhanced the rate of EBF (RR: 1.59, 95% CI [1.23, 2.05]; p = 0.0004 and RR: 1.38, 95% CI [1.01, 1.87]; p = 0.04, respectively). Reactive services did not significantly affect the EBF rate during the first six months compared to usual care (RR: 0.98, 95% CI [0.93, 1.04]; p = 0.54).</p><p><strong>Conclusions: </strong>Real-time telelactation services delivered by lactation/trained professionals in a proactive or combined proactive/reactive manner (i.e., via scheduled appointments and on demand) were the most effective. These service models should be considered by lactation service providers and healthcare policymakers seeking to increase EBF among the majority of participants who were employed mothers.</p><p><strong>Review registration: </strong>This review has been registered in the International Prospective Register of Systematic Reviews (PROSPERO) (ID: CRD42023429900).</p>","PeriodicalId":9033,"journal":{"name":"BMC Pregnancy and Childbirth","volume":"25 1","pages":"341"},"PeriodicalIF":2.8000,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934809/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Pregnancy and Childbirth","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12884-025-07440-3","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: The global exclusive breastfeeding (EBF) rate during the first six months is < 50%. This rate is particularly low among employed mothers, who may face obstacles in accessing in-person lactation services. Given that telelactation services can increase EBF rates, we conducted this study to assess the effects of real-time telelactation services (vs. usual lactation services) on breastfeeding outcomes among employed mothers.
Methods: The Preferred Reporting Items for Systematic Reviews Meta-Analyses guidelines were followed. Studies published between 2012 and 2023 were identified from the Academic Search Ultimate, Cochrane, CINAHL Complete, Embase, ProQuest, SAGE journals, ScienceDirect, Scopus, Springer Link, Google Scholar, and Thai Journal Online databases. Randomized controlled trials and quasi-experimental studies that met the inclusion criteria were included. The JBI critical appraisal tool was used to assess the studies selected for the systematic review. Categorical data were analyzed using relative risk (RR) with 95% confidence intervals (CIs) and a random-effects model.
Results: Of the 18 studies selected for the review, 13 were included in the meta-analysis with a total of 4,564 participants. Of these, 3,582 were employed mothers. We identified three types of real-time telelactation services based on the activities of the provider and client: proactive, reactive, and mixed services. The results showed that real-time telelactation services had a statistically significant positive effect on the EBF rate during the first six months compared to usual care (Relative risk (RR): 1.31, 95% Confidence interval (CI) [1.10, 1.54]; p = 0.002). Proactive and mixed services significantly enhanced the rate of EBF (RR: 1.59, 95% CI [1.23, 2.05]; p = 0.0004 and RR: 1.38, 95% CI [1.01, 1.87]; p = 0.04, respectively). Reactive services did not significantly affect the EBF rate during the first six months compared to usual care (RR: 0.98, 95% CI [0.93, 1.04]; p = 0.54).
Conclusions: Real-time telelactation services delivered by lactation/trained professionals in a proactive or combined proactive/reactive manner (i.e., via scheduled appointments and on demand) were the most effective. These service models should be considered by lactation service providers and healthcare policymakers seeking to increase EBF among the majority of participants who were employed mothers.
Review registration: This review has been registered in the International Prospective Register of Systematic Reviews (PROSPERO) (ID: CRD42023429900).
期刊介绍:
BMC Pregnancy & Childbirth is an open access, peer-reviewed journal that considers articles on all aspects of pregnancy and childbirth. The journal welcomes submissions on the biomedical aspects of pregnancy, breastfeeding, labor, maternal health, maternity care, trends and sociological aspects of pregnancy and childbirth.