Virtual Reality to Improve Breastfeeding Outcomes: A Systematic Review and Meta-Analysis

Background: Breastfeeding enhances infant and maternal health, but global breastfeeding rates remain suboptimal. Virtual reality (VR) emerges as a promising tool for breastfeeding education. The objective of this review was to assess the effectiveness of VR-based interventions on breastfeeding outcomes in pregnant and postpartum women. Methods: PubMed, Embase, Web of Science, Scopus, and CENTRAL were searched until 10 January 2026, for randomized controlled trials (RCTs) and quasi-experimental studies comparing VR-based interventions (immersive simulations, 360° videos, or head-mounted displays) with standard care or non-VR comparators in pregnant or postpartum women. Primary outcomes included breastfeeding self-efficacy, motivation, and breastfeeding technique (LATCH score). Secondary outcomes included exclusive breastfeeding rates, milk production, and maternal anxiety. Risk of bias was assessed using the RoB 2.0 and ROBINS-I tools for RCTs and non-RCTs, respectively. A random-effects meta-analysis was conducted, with results reported as mean differences (MD) or risk ratios (RR), along with 95% confidence intervals (CIs). Certainty of the evidence was assessed using the GRADE approach. Results: Five studies (4 RCTs and 1 quasi-experimental; n = 344) were included. VR improved prenatal breastfeeding self-efficacy (2 studies, MD: 13.93; 95% CI: 10.96-16.90), motivation (1 study, MD: 2.88; 95% CI: 1.66-4.10), and LATCH score (1 study, MD: 1.72; 95% CI: 1.37-2.07), and reduced time to breastfeeding initiation (1 study, MD: -22.4 min; 95% CI: -29 to -15.9), the certainty of evidence was low to very low for these outcomes. No significant effects were observed for postnatal self-efficacy, exclusive breastfeeding, or maternal anxiety. Formal assessment of publication bias could not be done. The small sample sizes for most outcomes, heterogeneity, the open-label nature of the trials, and the subjective nature of the outcomes should be considered when interpreting these results. Conclusions: VR-based interventions may improve process outcomes, such as prenatal breastfeeding self-efficacy, motivation, breastfeeding technique, and early breastfeeding initiation; the certainty of evidence is low to very low. Evidence for clinically important outcomes, including exclusive breastfeeding and maternal anxiety, remains inconsistent. Larger, well-designed RCTs are warranted before these interventions can be considered in routine practice.