Feasibility, acceptability, and preliminary impact of mHealth supported breastfeeding peer counselor intervention in rural India

Exclusive breastfeeding (EBF) is an important public health intervention for child health and survival. WHO recommends EBF for the first 6 months of life to achieve optimal growth, development and health.

Despite the benefits of and recommendations for EBF, India witnesses a low rate of EBF. An intervention with a peer support system may help in improving breastfeeding behaviors of mothers in India as Peer counseling depends on local community women who have successfully breastfed, acquired training in breastfeeding education, and worked with their peers to improve breastfeeding outcomes. Yet there is insufficient evidence that community-level peer counseling interventions significantly improve EBF rates in India.

Another program, like one that utilizes mobile health (mHealth) platforms, may also be beneficial for increasing EBF. The advancement in technology has increased the availability and accessibility of mHealth, including health-related education and counseling, and telemedicine services delivered via phone or computer applications. Evidence indicates that implementing mHealth-supported community programs is feasible and can improve other behaviors of Indian mothers, including the uptake of health services among pregnant and breastfeeding women with HIV.

A recent study by Short VL. et al. evaluated the feasibility of a mHealth-supported breastfeeding peer counselor intervention executed in rural India and the preliminary impact of the intervention on maternal breastfeeding behaviors, including EBF.

The enrolled participants received either the intervention plus usual care (n = 110) or usual care alone (n = 112). The intervention group received 9 in-home visits during and after pregnancy from peer counselors who provided education about and support for EBF and other optimal infant feeding practices and were assisted with a mHealth tool. While the control group received routine prenatal and postnatal health education. Progress notes and surveys assessed the feasibility and logistic regression models performed between-group comparisons of optimal infant feeding outcomes, including EBF for 6 months.

The intervention was delivered as planned, carried over the study period, and showed high acceptability ratings. Statistically significant differences were found in all outcomes between groups. Further, the intervention group showed a significantly higher likelihood of EBF at 6 months compared to the control group.

Thus, integration of mHealth with community-based peer counselors to educate women about EBF is feasible and acceptable in rural India, with the benefit of impacting maternal breastfeeding behaviors.

Short VL, Bellad RM, Kelly PJ., et al. Feasibility, acceptability, and preliminary impact of an mHealth supported breastfeeding peer counselor intervention in rural India. International Journal of Obstetrics and Gynecology. 2022;156(1): 48-54. https://doi.org/10.1002/ijgo.13599