JMIR Publications

ABSTRACT

Background:

Breastfeeding in preterm infants is disrupted by several factors, thus requiring donated breast milk. Although human milk banks (HMB) become allies in reducing premature infant mortality, the number of donors is insufficient to meet the demand due to knowledge, individual, and sociocultural barriers, among others, that influence the willingness to donate. Mobile health apps can help address some of these barriers. However, few apps have been properly tested. We developed and evaluated a mobile app to promote human milk donation among breastfeeding women.

Objective:

This paper aimed to determine the effect of a mobile app, AmamantApp, on knowledge, attitudes, and practices of human milk donation among breastfeeding women in Lima, Peru.

Methods:

A mixed methods study design was conducted. The quantitative component included a randomized controlled trial involving 112 breastfeeding mothers enrolled in a mother and child hospital. The intervention group (n=54) received education on human milk donation via a mobile app, and the control group (n=58) received printed educational material. Knowledge, attitudes, and practices (KAP) were assessed with a KAP questionnaire before and after the 60-day intervention. The development of the mobile intervention was based on the Human Centered Design approach. Additionally, the qualitative component based on a phenomenological design was conducted through 17 in-depth interviews and one focus group to explore individual, social, and systemic barriers to the practice of human milk donation.

Results:

This study found no differences in sociodemographic characteristics between breastfeeding mothers in the intervention and control groups. A total of 78 mothers completed the study (n=37 in the intervention group; n=41 in the control group). The analyses revealed significant differences between the groups in knowledge scores (MD [mean difference]: 0.94 points, P=.04). No differences were observed in attitudes or practices towards human milk donation. Qualitative findings highlighted individual barriers, specifically a lack of time and social barriers related to working conditions. Systemic barriers were also identified, including the cost of laboratory tests required for donors, the limited number of collection points and HMB, and limited information, follow-up and motivation on human milk donation by health staff.

Conclusions:

AmamantApp improved knowledge about human milk donation among breastfeeding women participants. Individual, social, and systemic barriers were identified that limited this practice in the intervention group, which could be addressed to encourage donation practices. The use of technological resources such as AmamantApp has great potential to positively influence the promotion of favorable attitudes towards human milk donation. Accordingly, it is suggested that decision-makers in the health sector incorporate it into the planning and implementation of educational activities aimed at promoting human milk donation.