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      Feasibility and acceptability of a text message intervention used as an adjunct tool by WIC breastfeeding peer counsellors: The LATCH pilot

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          Abstract

          Breastfeeding rates among mothers in the Supplemental Nutrition Program for Women, Infants, and Children (WIC) are lower than for other mothers in the United States. The objective of this study was to test the acceptability and feasibility of the Lactation Advice thru Texting Can Help intervention. Mothers were enrolled at 18–30 weeks gestation from two WIC breastfeeding peer counselling (PC) programmes if they intended to breastfeed and had unlimited text messaging, more than fifth‐grade literacy level, and fluency in English or Spanish. Participants were randomized to the control arm (PC support without texting) or the intervention arm (PC support with texting). The two‐way texting intervention provided breastfeeding education and support from peer counsellors. Primary outcomes included early post‐partum (PP) contact and exclusive breastfeeding (EBF) rates at 2 weeks PP. Feasibility outcomes included text messaging engagement and mother's satisfaction with texting platform. Fifty‐eight women were enrolled, 52 of whom were available for intention‐to‐treat analysis ( n  = 30 texting, n  = 22 control). Contact between mothers and PCs within 48 hr of delivery was greater in the texting group (86.6% vs. 27.3%, p  < .001). EBF rates at 2 weeks PP among participants in the texting intervention was 50% versus 31.8% in the control arm ( p  = .197). Intervention group mothers tended to be more likely to meet their breastfeeding goals ( p  = .06). Participants were highly satisfied with the Lactation Advice thru Texting Can Help intervention, and findings suggest that it may improve early post‐delivery contact and increase EBF rates among mothers enrolled in WIC who receive PC. A large, multicentre trial is feasible and warranted.

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          Effect of short message service on infant feeding practice: findings from a community-based study in Shanghai, China.

          Appropriate infant feeding practices have the potential for long-term health effects. However, research findings on improving early infant feeding practices are limited. The wide use of mobile phone short message service (SMS) provides new opportunities for health promotion and services. To assess the effect of an SMS intervention on infant feeding practices. Quasiexperimental design with follow-up measures scheduled at 4, 6, and 12 months at 4 community health centers in Shanghai, China. Two community health centers represented the intervention group, and 2 other community health centers represented the control group. In total, 582 expectant mothers were recruited during the first trimester. Expectant mothers were eligible to participate if they owned a mobile phone, were first-time mothers, conceived a singleton fetus, were older than 20 years and less than 13 weeks' gestation, had completed at least a compulsory junior high school education, and had no illness that limited breastfeeding after childbirth. Mothers in the intervention group received weekly SMS messages about infant feeding from the third trimester to 12 months' post partum. The primary outcome was the duration of exclusive breastfeeding (EBF). Survival analysis was used to compare the duration of EBF between the intervention group and the control group. Compared with the control group, the intervention group had a significantly longer median duration of EBF at 6 months (11.41 [95% CI, 10.25-12.57] vs 8.87 [95% CI, 7.84-9.89] weeks). The hazard ratio for stopping EBF in the intervention group was 0.80 (95% CI, 0.66-0.97). The intervention resulted in a significantly higher rate of EBF at 6 months (adjusted odds ratio, 2.67 [95% CI, 1.45-4.91]) and a significantly lower rate of the introduction of solid foods before 4 months (adjusted odds ratio, 0.27 [95% CI, 0.08-0.94]). An SMS intervention may be effective in promoting EBF, delaying the introduction of solid foods, increasing awareness of the World Health Organization breastfeeding guidelines, and improving knowledge of appropriate infant feeding practices for new mothers.
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            Breastfeeding concerns at 3 and 7 days postpartum and feeding status at 2 months.

            We characterized breastfeeding concerns from open-text maternal responses and determined their association with stopping breastfeeding by 60 days (stopping breastfeeding) and feeding any formula between 30 and 60 days (formula use).
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              Interest of pregnant women in the use of SMS (short message service) text messages for the improvement of perinatal and postnatal care

              Background Mobile health (mHealth) is emerging as a useful tool to improve healthcare access especially in the developing world, where limited access to health services is linked to poor antenatal care, and maternal and perinatal mortality. The objective of this study is to 1) understand pregnant women’s access and usage of cell phones and 2) survey the health information needs and interests in a population attending public hospitals and health centers of two cities in Argentina. This information is not available and it is the basis to develop a strategy for improving maternal care via cell phones. Methods Questionnaires were verbally administered to pregnant women who were attending an antenatal care visit in community health centers and public hospitals in Rosario, Santa Fe and Mercedes, Corrientes. Participants were 18 years of age or older and had previously given birth. The data obtained was qualitative and analyzed using SPSS version 18. Results A total of 147 pregnant women meeting inclusion criteria (Rosario: 63; Mercedes: 84) were approached and verbally consented to participate. The average age was 29.5 years, most lived in urban areas (89%) with a mean travel time of 43.4 minutes required to get to the health center and 57.3 minutes to get the hospital. Ninety-six percent of women (n = 140) responded that they would like to receive text messages and cell phone calls with information regarding prenatal care, although the topics and period of time to receive information varied greatly. Conclusions Considering the vast majority of the interviewed women had access to and were interested in receiving text messages and calls with educational information regarding pregnancy and infant health, pregnant women in Argentina could benefit from such an mHealth program. The low access to Internet suggests it is not an option for this population; however, this cannot be assumed as representative of the country’s situation. To retain active participation, other forms of health communication, such as a 2-way text message systems or toll-free numbers, could be considered in the future. Cost of use and implementing these options should be studied.
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                Author and article information

                Journal
                Maternal & Child Nutrition
                Matern Child Nutr
                Wiley
                17408695
                January 2018
                January 2018
                August 01 2017
                : 14
                : 1
                : e12488
                Affiliations
                [1 ]Chinle Comprehensive Health Care Facility; Indian Health Services; Chinle Arizona USA
                [2 ]National Clinician Scholars Program, Robert Wood Johnson Foundation Clinical Scholars Program; Yale University School of Medicine; New Haven Connecticut USA
                [3 ]Breastfeeding Heritage and Pride Program; Yale New Haven Hospital; New Haven Connecticut USA
                [4 ]Connecticut WIC Program, Community, Family and Health Equity Section; State of Connecticut Department of Public Health; Hartford Connecticut USA
                [5 ]Harvard Medical School; Boston Massachusetts USA
                [6 ]Perelman School of Medicine; University of Pennsylvania; Philadelphia Pennsylvania USA
                [7 ]Graduate School of Nursing; University of Massachusetts; Worcester Massachusetts USA
                [8 ]Yale School of Public Health; New Haven Connecticut USA
                Article
                10.1111/mcn.12488
                6866153
                28766913
                51ab612f-17aa-4a16-ae9b-0dcfefda513a
                © 2017

                http://doi.wiley.com/10.1002/tdm_license_1.1

                http://onlinelibrary.wiley.com/termsAndConditions#vor

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