All things to all people? A scoping review of mobile phone apps that support breastfeeding

Background: The widespread availability of smartphones has given rise to the development of mobile health (mHealth) interventions, including breastfeeding support interventions delivered through smartphone apps. Aims: The aim of this scoping review was to identify articles that evaluated the use of mobile phone apps to deliver breastfeeding support. Methods: A search of BNI, CINAHL, MEDLINE and PsycINFO was undertaken in December 2022 and 880 records were identified. Through a systematic approach, two reviewers, 12 articles were identified that met the inclusion criteria and were included in the review synthesis. Results: The included articles were published between 2018-2022, with half originating from the USA. Study objectives focused on usability testing, impact evaluation, or a combination of these. Outcome measures focused on breastfeeding rates, breastfeeding confidence, usability and satisfaction. Breastfeeding support apps largely featured written educational material. Some apps contained links to other resources and some featured breastfeeding trackers. Studies tended to feature women with higher levels of education which can challenge the generalisability of the results. Most articles identified positive feedback regarding usability, but only two articles featured interventions that demonstrated significantly higher breastfeeding rates. Discussion: The role of intersectionality in breastfeeding is reflected on in relation to the preponderance of more educated participants in these studies. Whilst there are clear educational benefits to breastfeeding support apps, there is a risk that apps promote an individualistic focus to the detriment of structural breastfeeding barriers being addressed. Healthcare commissioners should consider how health inequalities can be tackled when considering mHealth breastfeeding interventions.