Background:

The World Health Organization recommends lactation support to enhance the rates of exclusive breastfeeding. Access to in person lactation support may be limited due to scarcity of resources (e.g., healthcare professionals) and geography. Advances in technology have allowed lactation supports to be offered virtually through information and communication technologies (i.e., telephone, internet, and social media).

Research Aims:

To (1) critically review and (2) statistically analyze the effectiveness of virtual lactation support for postpartum mothers’ exclusive breastfeeding for up to 6 months.

Methods:

A systematic review and meta-analysis were conducted using PRISMA guidelines. Studies were included if they were (a) randomized controlled trials, (b) with a virtual lactation support intervention during the postpartum period, (c) reported on exclusive breastfeeding outcomes. Two reviewers independently assessed the risk of bias and extracted data. The prevalence of exclusive breastfeeding in each group and the total number of participants randomized for each group were entered into random-effects meta-analyses to calculate a pooled relative risk (RR) at three different time points (1, 4, and 6 months). The sample size was 19 randomized control trials.

Results:

Of the 19 studies, 16 (84.2%) were included in the meta-analysis (n = 5,254). Virtual lactation support was found to be effective at increasing exclusive breastfeeding at 1 month (RR, 1.21; 95% CI [1.09, 1.35]; p < .001) and 6 months (RR, 1.87; 95% CI [1.30, 2.68]; p < .001).

Conclusion:

In this meta-analysis of randomized controlled trials comparing virtual lactation support with other postnatal maternity care, virtual lactation support was associated with increasing exclusive breastfeeding rates at 1 month and 6 months postpartum.

The study protocol was registered (CRD42021256433) with PROSPERO

中文翻译：

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虚拟哺乳支持的有效性：系统评价和荟萃分析

背景：

世界卫生组织建议哺乳支持以提高纯母乳喂养率。由于资源（例如医疗保健专业人员）和地理位置的稀缺，获得亲自哺乳支持的机会可能会受到限制。技术进步允许通过信息和通信技术（即电话、互联网和社交媒体）虚拟提供哺乳支持。

研究目的：

(1) 严格审查和 (2) 统计分析虚拟哺乳支持对产后母亲纯母乳喂养长达 6 个月的有效性。

方法：

使用 PRISMA 指南进行了系统评价和荟萃分析。如果研究是（a）随机对照试验，（b）在产后进行虚拟哺乳支持干预，（c）报告纯母乳喂养结果，则纳入研究。两名审查员独立评估偏倚风险并提取数据。将每组纯母乳喂养的流行率和每组随机分配的参与者总数输入随机效应荟萃分析，以计算三个不同时间点（1、4 和 6 个月）的汇总相对风险 (RR) . 样本量为 19 项随机对照试验。

结果：

在 19 项研究中，16 项（84.2%）被纳入荟萃分析（n = 5,254）。发现虚拟哺乳支持可有效增加 1 个月（RR，1.21；95% CI [1.09, 1.35]； p < .001）和 6 个月（RR，1.87；95% CI [1.30, 2.68]）的纯母乳喂养; p < .001)。

结论：

在这项比较虚拟哺乳支持与其他产后产后护理的随机对照试验的荟萃分析中，虚拟哺乳支持与增加产后 1 个月和 6 个月的纯母乳喂养率相关。

研究方案已在 PROSPERO 注册 (CRD42021256433)