The Efficacy of Telephone-based Lactation Counseling: Literature Review

The research conducted by Tahir et al did not show conclusive evidence that telephone lactation counselling was effective at improving lactation rates at the fourth and sixth months postpartum. 1 However, there have been many studies and meta-analyses published in relation to lactation counselling and methods to improve the rate of exclusive breastfeeding rates since the paper was published. Recently, literature reviews have been conducted to determine the efficacy of enhancing healthcare and health education in relation to breastfeeding and as a health tool independently. In a world where communication technology is at the fingertips of almost everyone, including 90% of the population in developing countries, healthcare delivered through telephones or instant messaging seems practical.

A systematic review performed by Sondaal et al assessed the efficacy of mobile health (mHealth) in delivering maternal and neonatal care in low to middle income countries. 2 The widespread use of mobile phones and tablets in developing countries is a possible method of delivering health education to patients that may not be able to regularly attend clinics due to disability or distance. Sondaal et al claimed that mHealth techniques to improve at-home care may be beneficial for patients and healthcare professionals but further studies are recommended.

Another study conducted by Efrat et al sought out to examine the efficacy of telephone-based interventions delivered by lactation educators to lower-income Hispanic patients in the Unites States. In this randomised controlled trial, mothers were delegated to either a control group or an intervention group and data was collected at three days, one month, three months, and six months post-partum. According to this study, mothers that receive tele-health education from lactation professionals had improved quantity and duration of breastfeeding and were less likely to stop breastfeeding within the first six months post-partum. This study shows promise in the delivery of tele-health as a substitute for clinic or hospital visits for mothers to improve breastfeeding rates.

Another promising study for telephone-based interventions was conducted by Carlsen et al. This paper analyzed the efficacy of telephone counselling of obese mothers and concluded that telephone-based guidance does in fact increase the incidence and duration of exclusive breastfeeding rates. The promotion of breastfeeding is one of the most important health interventions that healthcare professionals can provide to new mothers. Along with mHealth and tele-health support, in-hospital and face-to-face breastfeeding counselling has shown to be beneficial for new mothers. For example, a systematic review performed by Haroon et al examined over one hundred papers. The results of the review showed that education methods, such as counselling during home visits and peer support groups increased the incidence of exclusive breast feeding and decreased rates of non-breastfeeding.

One meta-analysis conducted by Sinha et al showed similar results. In this paper, Sinha et al studied a multitude of papers on breastfeeding counselling delivered in a variety of settings, such as home or work environments. This paper concluded that early breastfeeding interventions in multiple settings increased rates of exclusive breastfeeding rates and that support should be provided to the nursing mother. 6 Most papers studied the breastfeeding rates after intervention only involving the mother. However, some studies analyzed the efficacy of delivering lactation education to expecting fathers. For example, when mothers and fathers are educated together about breastfeeding, the exclusive breastfeeding rates and paternal attachment to the neonate increases according to a study conducted by Özlüses et al. This result is clinically significant because it demonstrates that fathers have in influence on breastfeeding rates but it also touches on other important parent-child factors, such as attachment and bonding. In the time since the paper by Tahir et al was published, the scientific community has been busy conducting research and analyzing papers to find ways to increase exclusive breastfeeding rates and duration.

Healthcare professionals worldwide would benefit from this research because maternal and neonatal health is an important and universal medical topic. Additionally, according to Kornides et al, there are many factors that determine whether a mother decides to breastfeed or not, the most influential factor being knowledge. Thus by determining the best method for lactation counselling (and therefore increasing maternal prenatal knowledge of breastfeeding), whether it be telephone-based or in-person, exclusive breastfeeding rates can be increased in high, middle, or low income countries.