Effects of Different Digital Interventions on Breastfeeding Outcomes: A Systematic Review and Network Meta-analysis

Abstract Context Breastfeeding has significant benefits for maternal and infant health; however, the global exclusive breastfeeding rate remains low. Objective Digital interventions have shown potential in improving breastfeeding rates. This study aims to evaluate and identify the most effective digital interventions through a network meta-analysis. Data Sources We systematically searched 9 databases from their inception to August 2024. Data Extraction Two reviewers independently screened the studies according to the predefined inclusion and exclusion criteria. Any discrepancies or ambiguities during the screening process were resolved through group discussion. Data were extracted independently by 2 reviewers based on the guidelines outlined in the Cochrane Handbook. Data Analysis A total of 30 studies were included in this analysis (27 randomized controlled trials and 3 quasi-experimental studies), encompassing 9348 participants. The analysis revealed that, during the 0–3-month postpartum period, interventions such as non-breastfeeding applications, breastfeeding applications, and proactive calls significantly increased exclusive breastfeeding rates. For the 4–6-month postpartum period, the combination of proactive calls and one-way breastfeeding text messages (single sender) was the most effective, outperforming standalone proactive calls, movies, and usual care. The cumulative ranking curve indicated that the combination of proactive calls and one-way breastfeeding text messages (single sender) was the optimal choice for promoting exclusive breastfeeding during both the 0–3-month and 4–6-month postpartum periods. Conclusion Digital interventions significantly improved exclusive breastfeeding rates during the 0–6-month postpartum period, with the combination of proactive calls and one-way breastfeeding text messages (single sender) proving to be the most effective. Future research should explore the combination and adaptability of different interventions to optimize breastfeeding support strategies. Systematic Review Registration PROSPERO no. CRD42024571963.