Effectiveness of Telemedicine-Based Intervention on Breastfeeding Self-Efficacy in Iranian Women: A Systematic Review and Meta-Analysis.

Background: Breastfeeding self-efficacy (BSE) is a modifiable factor that can enhance breastfeeding rates. Telemedicine constitutes safe and low-cost health services that can be developed for the interaction between professionals and clients. Therefore, this study aimed to review the effectiveness of telemedicine-based intervention on BSE in Iranian women.

Methods: This systematic and meta-analysis review was performed according to PRISMA guidelines. English databases including Web of Science, PubMed, Scopus, and Persian databases including SID, Magiran, and IranMedex was searched until Aug 1, 2023 to identify randomized control trials about telemedicine-based interventions on BSE in Iran. The search strategy was focused on terms and eligibility criteria. Data analysis was done using CMA V.2 software. The risk of bias in the included studies was assessed.

Results: Out of 385 articles, eight articles that met the inclusion criteria were included in the meta-analysis. The overall result demonstrated that telemedicine-based interventions have a positive impact on BSE compared with the control, especially in the long-term intervention (pooled SMD= 1.27; 95% CI= 1.01-1.53, P-value<0/001); heterogeneity (Cochrane's Q-value=51.94, P<0/001, I2=76.90%). In addition, twelve weeks of postpartum had more effect on BSE than the others. Also, breastfeeding intervention in the postpartum period was more effective compared with pregnancy. The publication bias among included studies was assessed by funnel plot.

Conclusion: This review could give insight to healthcare providers into the effect of telemedicine on BSE. Therefore, by strengthening BSE through telemedicine interventions, especially for women who do not have the conditions for face-to-face counseling, we can expect positive results.