Feasibility and Effectiveness of Telelactation Among Rural Breastfeeding Women

Lori Uscher-Pines, Bonnie Ghosh-Dastidar, Debra L. Bogen, Kristin N. Ray, Jill R. Demirci, Ateev Mehrotra, Kandice A. Kapinos

Research output: Contribution to journalArticle

Abstract

Objective: To evaluate the feasibility and impact of telelactation via personal electronic devices on breastfeeding duration and exclusivity among rural women. Methods: The Tele-MILC trial, a pragmatic, parallel design trial, recruited 203 women during their postpartum hospitalization in a critical access hospital in Pennsylvania and randomized them to receive telelactation (n = 102) or usual care (n = 101). We used intent-to-treat (ITT) and instrumental variable (IV) approaches to analyze study data for the 187 participants who completed follow-up. The primary outcomes were any breastfeeding and exclusive breastfeeding at 12 weeks postpartum. Results: Among participants in the telelactation arm, 50% (47/94) reported participating in video calls. At 12 weeks, 71% of participants in the telelactation arm versus 68% of control participants were breastfeeding in the ITT model (3% difference, P =.73), whereas 73% of participants in the telelactation arm versus 68% of control participants were breastfeeding in the IV model (5% difference, P =.74). Among participants who were still breastfeeding at 12 weeks, 51% participants in the telelactation arm were breastfeeding exclusively versus 46% of control participants in the ITT model (5% difference, P =.47), whereas 56% of participants in the telelactation arm were breastfeeding exclusively versus 45% of control participants in the IV model (11% difference, P =.48). In all models, participants in the telelactation arm were breastfeeding at higher rates; however, differences were not statistically significant. Conclusions: This trial demonstrated that telelactation can be implemented with a rural underserved population. Though this trial was not powered to detect differences in breastfeeding duration and exclusivity, and none were observed, telelactation remains a promising approach for further investigation. ClinicalTrials.gov Identifier: NCT02870413.

Original languageEnglish (US)
Pages (from-to)652-659
Number of pages8
JournalAcademic Pediatrics
Volume20
Issue number5
DOIs
StatePublished - Jul 2020
Externally publishedYes

Keywords

  • breastfeeding
  • lactation
  • rural health
  • telehealth
  • telelactation
  • telemedicine

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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  • Cite this

    Uscher-Pines, L., Ghosh-Dastidar, B., Bogen, D. L., Ray, K. N., Demirci, J. R., Mehrotra, A., & Kapinos, K. A. (2020). Feasibility and Effectiveness of Telelactation Among Rural Breastfeeding Women. Academic Pediatrics, 20(5), 652-659. https://doi.org/10.1016/j.acap.2019.10.008