For a study, researchers sought to determine whether a platform for postpartum SMS messaging increased breastfeeding rates.
A control group that received weekly texts asking about baby feeding practices was contrasted with an intervention group that received instructional texts and tailored, text message-based breastfeeding assistance in a randomized controlled experiment. The main result was exclusive breastfeeding at 6 weeks after delivery. At 6 weeks after delivery, secondary outcomes included breastfeeding and formula supplementing. With a two-sided alpha of 5%, a sample size of 190 was intended to have 80% power to detect a 50% change in breastfeeding exclusivity from the baseline of 40%. Due to the fact that race was identified as an impact modifier, findings were summarized and compared to self-reported Black and non-Black races.
About 300 patients were enrolled between January 2020 and January 2021, and 216 were randomly assigned: 110 to the control group and 106 to the therapeutic group. Around 46.3% of the cohort were nulliparous, 45.4% had public insurance, and 52.8% were Black. There were no variations in the groups’ postpartum, delivery, or demographic characteristics. There was no difference in breastfeeding exclusivity by treatment group among the 185 patients (85.6%) for whom data were available for the primary outcome (intervention 48.4% vs. usual care 41.3%, P=.33). Black patients in the intervention arm had 2.6 times the chances of exclusively breastfeeding at 6 weeks postpartum compared with Black patients in the control arm (39.5% vs. 20.0%, odds ratio 2.62, 95% CI 1.04-6.59). The difference was seen when racial groups were stratified. Participation in the intervention arm resulted in a smaller Black-non-Black discrepancy in the primary outcome (20.0% vs. 66.7%, P<.001 in the usual care arm vs. 39.5% vs. 56.0%, P=.11 in the intervention arm). Other secondary outcomes showed no differences.
When compared to standard care, a text message-based communication platform was not linked to exclusive breastfeeding at six weeks postpartum.
