The impact of the LactApp m-Health tool on breastfeeding self-efficacy: a mixed methods study among Filipino mothers.

Purpose: Breastfeeding self-efficacy is essential for successful breastfeeding, and mobile health applications offer a promising approach for increasing maternal confidence. This study investigated the impact of LactApp (LactApp Women's Health) on breastfeeding self-efficacy among Filipino mothers and explored their experiences and perceptions of the app as a support tool.

Methods: A sequential explanatory mixed-methods design was utilized. The quantitative phase employed a single-group pre- and post-test design with 280 Filipino mothers who used LactApp for 3 months, measuring changes in breastfeeding self-efficacy. Because the data were not normally distributed, the Wilcoxon signed-rank test was conducted. The qualitative phase involved semi-structured interviews with 30 mothers, which were analyzed using thematic analysis. Integration of quantitative and qualitative findings was achieved through a joint display.

Results: Quantitative analysis demonstrated a significant improvement in breastfeeding self-efficacy, with median scores increasing from 49 to 61 (Z=-3.20, p<0.001) and reduced score variability. The largest improvements occurred among mothers aged 21 to 30 years and multiparous women. Qualitative findings corroborated these results, with mothers describing increased confidence, improved breastfeeding techniques, and solutions to challenges such as low milk supply. However, some participants, particularly those with limited educational backgrounds, experienced difficulties, indicating ongoing challenges related to digital access and app usability.

Conclusion: LactApp improved breastfeeding self-efficacy among Filipino mothers, especially those with prior breastfeeding experience. The culturally relevant content and user-friendly design supported maternal confidence. To expand reach and impact, future interventions should address barriers to app use, especially for digitally underserved groups, and explore integration with traditional breastfeeding support systems.