Evaluating the Effectiveness of mHealth Application Interventions to Promote Breastfeeding Amongst Pregnant Women and Postpartum Mothers: A Global Systematic Review and Meta‐Analysis

ABSTRACT

Despite global recommendations, less than 40% of infants ≤ 6 months are exclusively breastfed (EBF) reflecting socio‐economic, cultural, and systemic barriers. Mobile health (mHealth) interventions (delivered through mobile phone applications to support medical/public health practices) have been developed to support breastfeeding, but their effectiveness remains unclear. In this systematic review we searched PubMed, Embase, CINAHL, Web of Science, and Cochrane Library from 1 January 2010 to 1 May 2025 for randomised controlled trials in English involving pregnant or postpartum women up to 1 year, assessing the effectiveness of any form of mHealth intervention aimed at the mother, excluding qualitative studies (PROSPERO: CRD420251032811). The main outcome was EBF ≤ 6 months; Secondary outcomes were EBF at later time points, overall breastfeeding duration and breastfeeding self‐efficacy up to 12 months. Quantitative synthesis used Harvest plots, binomial calculations, and meta‐analysis. Of 3102 retrieved records, 13 studies (3269 women) were included. Interventions typically combined mobile apps with text messaging or telelactation. Binomial calculations/harvest plots suggested strong evidence for improved breastfeeding self‐efficacy, knowledge, and confidence, with less evidence for effects on initiation, exclusivity, and duration. Meta‐analysis suggested increased breastfeeding self‐efficacy (Hedges′ g  = 1.08, 95% CI 0.07–2.1, p  = 0.04) but with high heterogeneity ( I ²  = 90.7%), reflecting diverse populations, intervention types, and contexts. Engagement was affected by maternal, socio‐cultural, and structural factors, underscoring the need for tailored, accessible, context‐sensitive interventions. mHealth interventions may improve breastfeeding self‐efficacy, knowledge and confidence, particularly when incorporating interactive, personalised features such as real‐time feedback or telelactation.