title: Efficacy of e-technologies in improving breastfeeding outcomes among perinatal women: a meta-analysis.
abstract: A growing line of research has highlighted that e-technologies may play a promising role in improving breastfeeding outcomes. The objective of this review was to synthesise the best of available evidence by conducting a meta-analysis to evaluate whether e-technologies have had any effect in improving breastfeeding outcomes among perinatal women. The review was conducted using nine electronic databases to search for English-language research studies from 2007 to 2014. A 'risk of bias' table was used to assess methodological quality. Meta-analysis was performed with the RevMan software. The Q test and I(2) test was used to assess the heterogeneity. The test of overall effect was assessed using z-statistics at P < 0.05. Of 1842 studies identified through electronic searches and reference lists, 16 experimental studies were selected after applying the inclusion and exclusion criteria. Half of the selected studies had a low risk of bias, from which a total of 5505 women in six countries in these studies were included. Meta-analyses revealed that e-technologies significantly improved exclusive breastfeeding initiation (z = 6.90, P < 0.00001), exclusive breastfeeding at 4 weeks (z = 2.12, P = 0.03) and 6 months (z = 3.2, P = 0.001), breastfeeding attitude (z = 3.01, P = 0.003) and breastfeeding knowledge (z = 4.54, P = < 0.00001) in subgroup analyses. This review provides support for the development of web-based, texting messaging, compact disc read-only memory, electronic prompts and interactive computer agent interventions for promoting and supporting breastfeeding.
authors.affiliation: Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Ying
authors.initials: Y
authors.lastname: Lau
authors.affiliation: Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Tha P
authors.initials: TP
authors.lastname: Htun
authors.affiliation: Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Wai S W
authors.initials: WS
authors.lastname: Tam
authors.affiliation: Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Piyanee
authors.initials: P
authors.lastname: Klainin-Yobas
mesh_terms: D001942:Breast Feeding; D016251:CD-ROM; D005260:Female; D006266:Health Education / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D018743:Perinatal Care; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic; D017216:Telemedicine; D060145:Text Messaging
keywords: breastfeeding; e-technology; meta-analysis; perinatal women