Promoting breastfeeding through digital communication: a longitudinal randomized controlled trial

Area of Science:

• Public Health
• Behavioral Science
• Digital Health Interventions

Background:

• Exclusive breastfeeding is crucial for infant health but rates remain suboptimal.
• Digital interventions offer a scalable approach to support breastfeeding mothers.
• Existing strategies need enhancement to translate intentions into sustained behaviors.

Purpose of the Study:

• To evaluate the effectiveness of two resource-efficient digital communication interventions on breastfeeding duration.
• To test interventions based on the extended Theory of Planned Behavior (TPB) and practical skill-building messages.
• To explore the influence of self-objectification on breastfeeding behavior.

Main Methods:

• A longitudinal randomized controlled trial (RCT) with 467 pregnant women at 36 weeks gestation.
• Participants were randomized into TPB-based messages, practical tips, implementation intentions, or control groups (healthy eating/physical activity).
• Interventions were delivered via mobile phone messages, with follow-up until 5 months postpartum.

Main Results:

• The TPB-based intervention indirectly increased breastfeeding duration by enhancing self-efficacy and perceived behavioral control, leading to stronger intentions.
• Practical tips and implementation intentions interventions strengthened the intention-behavior relationship for full breastfeeding.
• Higher self-objectification was associated with reduced breastfeeding duration via lower maternal identification and intentions.

Conclusions:

• Resource-efficient digital communication interventions can empower mothers and promote exclusive breastfeeding.
• These interventions support the translation of breastfeeding intentions into sustained behaviors.
• Digital strategies represent a scalable method to improve breastfeeding outcomes.