Virtual Health Interventions to Improve Breastfeeding: A Systematic Review.

CONTEXT: Use of virtual health interventions has increased rapidly, with growing evidence evaluating virtual breastfeeding support. However, the effectiveness of different types of virtual breastfeeding interventions remains unclear. OBJECTIVE: To examine the effects of various types of virtual breastfeeding interventions on breastfeeding duration and exclusivity. DATA SOURCE: We systematically searched PubMed, CINAHL, EMBASE, PsycINFO, Cochrane Library, and clinical trial registries (ClinicalTrials.gov and WHO International Clinical Trials Registry Platform) up to January 2025. STUDY SELECTION: Randomized controlled trials evaluating synchronous virtual breastfeeding interventions delivered by health care providers were included. DATA EXTRACTION: Data on study design, place of origin, participant characteristics, sample size, outcomes of interest, and study outcomes were extracted. RESULTS: A total of 58 studies were included, and 62 interventions were examined. Among them, 32 (51.6%) interventions effectively prolonged breastfeeding duration. Although virtual breastfeeding interventions were effective in extending any and exclusive breastfeeding durations, the interventions that combined in-person and virtual breastfeeding interventions showed more substantial effects in enhancing breastfeeding duration and exclusivity. Several types of interventions improved breastfeeding outcomes, including proactive and reactive telephone support, videoconferencing, and multiple forms of virtual support. LIMITATIONS: Generalizability is limited as the majority of the reviewed studies were conducted in high-income countries. CONCLUSION: Virtual breastfeeding interventions effectively prolong any breastfeeding and exclusive breastfeeding. As digital health technologies continue to evolve, it is important to understand parents' need for virtual breastfeeding support and enhance the integration of virtual support provision in clinical settings to meet the diverse needs of parents.