JMIR Publications

ABSTRACT

Background:

The benefits of breastfeeding for both infants and mothers have been well recognized. However, the exclusive breastfeeding rate in China is quite low and decreasing which makes it urgent to explore effective ways to reverse the current downward trend. As mobile technologies have been rapidly developed, communication apps such as WeChat (one of the largest social networking platforms in China) are widely used and have the potential to improve health behaviors conveniently.

Objective:

This study aims to assess the effectiveness of using a WeChat account on improving breastfeeding practices.

Methods:

This two-arm randomized controlled trial was conducted among pregnant women from May 2019 to April 2020 in Huzhu County, Qinghai Province, China. Pregnant women were eligible to participate if they were aged at least 18 years, were 11-37 weeks pregnant, conceived a singleton fetus, had no known illness that limited breastfeeding after childbirth, used WeChat through their smartphone, and had access to the internet. A total of 344 pregnant women were recruited at the baseline, with 170 in the intervention group and 174 in the control group. Women in the intervention group received breastfeeding knowledge and promotion information through a WeChat official account weekly from their 3rd pregnancy month to 6 months postpartum. The primary outcome of exclusive and predominant breastfeeding rate was measured at 0-1 month, 2-3 months, and 4-5 months postpartum.

Results:

At the first two months postpartum, the exclusive breastfeeding rate was significantly higher in the intervention group than in the control group (81.1% vs 63.3%; OR 2.75, 95% CI, 1.58-4.78; P<.001). Similarly, mothers in the intervention group were more likely to provide breast milk predominantly (OR 2.77, 95% CI, 1.55-4.96; P<.001), and less likely to give dairy or dairy products to their children (OR 0.40, 95% CI, 0.21-0.75; P=.005). There was no statistically significant difference on exclusive breastfeeding rate at 2-3 months (P=.09) and 4-5 months postpartum follow-up (P=.27), even though more children in the intervention group were exclusively breastfed than the control group at the 2-3 months postpartum follow-up (73.0% vs 63.2%) and 4-5 months postpartum follow-up (46.3% vs 42.2%).

Conclusions:

This study is the first effort to promote exclusive breastfeeding through WeChat in China, which proved to be an effective way in promoting exclusive breastfeeding in early life. WeChat health education intervention strategy can be used as an addition to local breastfeeding promotion programmes. Clinical Trial: Chinese Clinical Trial Registry –ChiCTR1800017364, http://www.chictr.org.cn/showproj.aspx?proj=29325.