Evidence map›Paper›PMID 42521671›Full record

SynthesisJournal of medical Internet research2026

Effects of Digital Health Interventions on Breastfeeding Rates, Self-Efficacy, and Knowledge: Systematic Review and Meta-Analysis.

Jiahe Sun, Yu Wang, Shuang Hu, Yajie Ding, Congshan Pu, Danni Song, Jiaai Xia, Chunjian Shan

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Journal of medical Internet research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Jiahe Sun *School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China.ORCID https://orcid.org/0009-0002-6811-3098
Yu Wang *School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China.ORCID https://orcid.org/0009-0001-6927-3563
Shuang HuSchool of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China.ORCID https://orcid.org/0009-0002-2676-7245
Yajie DingDepartment of Obstetrics, Women's Hospital of Nanjing Medical University (Nanjing Women and Children's Healthcare Hospital), Nanjing, Jiangsu, China.ORCID https://orcid.org/0009-0005-0358-7286
Congshan PuDepartment of Obstetrics, Women's Hospital of Nanjing Medical University (Nanjing Women and Children's Healthcare Hospital), Nanjing, Jiangsu, China.ORCID https://orcid.org/0009-0005-4090-9221
Danni SongDepartment of Obstetrics, Women's Hospital of Nanjing Medical University (Nanjing Women and Children's Healthcare Hospital), Nanjing, Jiangsu, China.ORCID https://orcid.org/0000-0002-9742-762X
Jiaai XiaDepartment of Obstetrics, Women's Hospital of Nanjing Medical University (Nanjing Women and Children's Healthcare Hospital), Nanjing, Jiangsu, China.ORCID https://orcid.org/0009-0006-6838-2967
Chunjian ShanSchool of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China.ORCID https://orcid.org/0000-0002-8553-2350

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe current global status of breastfeeding is marked by both progress and challenges. Digital health interventions (DHIs) have emerged as a promising strategy for improving breastfeeding practices, yet evidence regarding their impact on breastfeeding outcomes remains limited.

objectiveThis study aimed to evaluate the impact of DHIs on breastfeeding practices and outcomes.

methodsFollowing PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched PubMed, Web of Science, the Cochrane Library, Embase, CINAHL, Scopus, IEEE Xplore, and gray literature databases, from inception to April 2026. We included randomized controlled trials (RCTs) and quasi‑experimental studies that enrolled pregnant women or lactating mothers using DHIs vs standard care, waiting lists, or placebo. Outcomes were exclusive breastfeeding (EBF) rates, self‑efficacy, and knowledge. Studies recruiting mothers with infectious diseases or severe substance use disorders, non‑English publications, unavailable full texts or data, animal studies, letters, conference proceedings, and studies rated as "high risk" were excluded. Study quality was evaluated using the Cochrane Risk of Bias Tool version 2 and the Risk of Bias in Nonrandomized Studies of Interventions tool. Evidence certainty was assessed using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation). We performed the analysis using Review Manager (version 5.4) and R software (version 4.6.0), estimated using the Hartung-Knapp-Sidik-Jonkman random-effects model.

resultsA total of 52 studies involving 11,704 participants were included. DHIs improved EBF rates (at <3 months: relative risk [RR] 1.33, 95% CI 1.18-1.50, 95% prediction interval [PI] 0.85-2.08; P<.001; I

conclusionsDHIs show promise for improving EBF rates and breastfeeding self-efficacy. Compared with previous reviews, this review provides a more comprehensive evaluation of DHIs and identifies potential effect modifiers through subgroup analyses, offering updated evidence for digital breastfeeding support. However, moderate risk of bias, substantial heterogeneity, wide 95% PI, and low to moderate GRADE certainty warrant cautious interpretation. Further high-quality studies are needed to confirm effectiveness and optimize implementation of DHIs in clinical practice.

trial registrationPROSPERO CRD420251233352; https://www.crd.york.ac.uk/PROSPERO/view/CRD420251233352.

Indexed as

Breast FeedingHealth Knowledge, Attitudes, PracticeSelf EfficacyDigital HealthFemaleHumansPregnancybreastfeedingDHIsdigital health interventionsdigital interventionseHealthmaternal healthmeta-analysismHealthsystematic review

Identifiers

PMID42521671
PMCPMC13519512

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.