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 I² 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.