Efficacy of e-technologies in improving breastfeeding outcomes among perinatal women: a meta-analysis

A growing line of research has highlighted that e-technologies may play a promising role in improving breastfeeding outcomes. The objective of this review was to synthesise the best of available evidence by conducting a meta-analysis to evaluate whether e-technologies have had any effect in improving breastfeeding outcomes among perinatal women. The review was conducted using nine electronic databases to search for English-language research studies from 2007 to 2014. A 'risk of bias' table was used to assess methodological quality. Meta-analysis was performed with the RevMan software. The Q test and I-2 test was used to assess the heterogeneity. The test of overall effect was assessed using z-statistics at P < 0.05. Of 1842 studies identified through electronic searches and reference lists, 16 experimental studies were selected after applying the inclusion and exclusion criteria. Half of the selected studies had a low risk of bias, from which a total of 5505 women in six countries in these studies were included. Meta-analyses revealed that e-technologies significantly improved exclusive breastfeeding initiation (z = 6.90, P < 0.00001), exclusive breastfeeding at 4 weeks (z = 2.12, P = 0.03) and 6 months (z = 3.2, P = 0.001), breastfeeding attitude (z = 3.01, P = 0.003) and breastfeeding knowledge (z = 4.54, P = < 0.00001) in subgroup analyses. This review provides support for the development of web-based, texting messaging, compact disc read-only memory, electronic prompts and interactive computer agent interventions for promoting and supporting breastfeeding.