Telehealth lactation services improve breastfeeding duration, exclusivity for Black mothers

Key takeaways:

• Telelactation services improved breastfeeding duration and exclusivity for Black mothers.
• The strategy could help reduce disparities in breastfeeding rates.

Telelactation services significantly improved breastfeeding duration and exclusivity among Black mothers and showed promise in other populations, according to findings published in JAMA Network Open.

“Video breastfeeding support significantly improves breastfeeding rates among Black mothers,” Lori Uscher-Pines, PhD, MSc, senior policy researcher at RAND, told Healio. “The service shows promise in diverse populations overall, but it has the largest impact among Black women.”

Uscher-Pines and colleagues conducted a digital randomized clinical trial with 2,108 pregnant women (mean age, 29.61 years) who intended to breastfeed, recruited through pregnancy apps from July 2021 to December 2022. Researchers randomly assigned women to a treatment arm to receive free telelactation services (n = 1,052), which included access to a smartphone app with on-demand access to lactation consultations 24 hours daily via video chat, or the control arm (n = 1,056), which included an infant care e-book. Researchers followed the women through 24 weeks’ postpartum.

The primary outcomes were any breastfeeding or infant formula use at 24 weeks’ postpartum and time to breastfeeding cessation.

Overall, 32% of mothers identified as Black, 35.5% as Latino and 32.5% as other races/ethnicities. Almost half (48.8%) of mothers in the treatment arm used the telelactation services.

In the intention-to-treat analysis, 70.6% of mothers in the treatment arm and 66.8% in the control arm reported any breastfeeding and 46.9% and 44.1% reported exclusive breastfeeding at 24 weeks’ postpartum, respectively.

Researchers observed the most improvement in breastfeeding duration among Black mothers. At 24 weeks’ postpartum, 65.1% in the intervention arm reported any breastfeeding compared with 57.4% of controls (P = .045). Black women also demonstrated the most improvement in breastfeeding exclusivity, with more exclusivity reported in the treatment vs. the control arm (42.7% vs. 33.9%; P = .02).

“Telelactation could be used as a tool to address disparities in breastfeeding rates. Although the barriers to breastfeeding for minority mothers are complex, telelactation could be a key component of a comprehensive strategy to support breastfeeding parents,” Uscher-Pines told Healio. “For telelactation to deliver on its potential, it will be important to have policies that increase access.”

Uscher-Pines said it was surprising that about half of all mothers assigned to telelactation services used them, suggesting these services are feasible, acceptable and appealing to diverse parents.

“It will be important to study the effectiveness of different telelactation models and assess strategies to increase use of telelactation among mothers with less digital literacy and/or who don’t have access to broadband,” Uscher-Pines told Healio.

For more information:

Lori Uscher-Pines, PhD, MSc, can be reached at luscherp@rand.org.