The Impact of a Daily Smartphone-based Communication Among Postpartum Women on Breastfeeding Rates
Condition: Breast Feeding, Exclusive; Post Partum Depression
MeSH terms: Depression, Postpartum; Depression
Study type: Interventional

Summary: 
      We will aim to study the impact of introducing a smartphone-based daily feedback and
      communication platform between postpartum women delivering at our institute and a
      multidisciplinary breastfeeding-support team (obstetricians, neonatologists, midwives,
      lactation consultants, nurses, and psychologist) on breastfeeding rates.
    

Detailed description: 
      Our study will aim to introduce a smartphone-based daily feedback and communication platform
      between postpartum women delivering at our institute and a multidisciplinary
      breastfeeding-support team. This team will include: an obstetrician specialized in
      maternal-fetal medicine, a general obstetrician, two certified midwives, two certified
      lactation-consultants, a neonatologist, and a psychologist. Our vision and hypothesis for the
      current study- is that an intimate personalized daily communication and feedback platform
      between each woman and the support team will improve the rates of initiation of lactation and
      of full/partial lactation at various time points postpartum.

      Geographic area - A university affiliated hospital in southern Tel-Aviv that serves a
      population of over 500,000 people. Our annual delivery volume is 5000 deliveries with a 22%
      CS rate. The population is heterogeneous and consists of a high rate of women with
      intermediate-low income as well as a population of refugees from Africa (mostly Eritrea),
      both populations still have a very high rate of smartphone owners based on our previous
      experience.

      Methods- Prospective, single-center randomized controlled trial. Eligibility will be limited
      to women expressing wish to breastfeed, with singleton gestations, delivering > 37 weeks with
      no other maternal/neonatal significant morbidities.

      Study design and group assignment -Women meeting inclusion criteria who own a smartphone will
      be approached for recruitment on postpartum day 1. After obtaining a written informed
      consent, patients will be randomly assigned either to the intervention group (smartphone
      group) or to the control group in a 1:1 ratio. A blocked randomization scheme will be created
      using a computer-generated list of random numbers.

      The routine prenatal care provided by our institute includes lactation consulting during the
      48-72 hour postpartum hospitalization. Patients allocated to the control group will receive
      the aforementioned care. Patients assigned to the smartphone group will receive our standard
      care, and in addition will have an application installed to their smartphones. This
      application will be in Hebrew language, simple to use, and specifically designed to the needs
      of the current study.

      All patients will receive a demonstration regarding the use of the application from one of
      our research coordinators, in addition to a detailed information brochure.

      the patient will receive via email an individualized feedback from our team regarding her
      lactation. This feedback could include: reassurance and positive feedback and lactation tips
      in attempt to optimize specific obstacles. In addition, patients will be encouraged to use
      the platform to ask questions and receive immediate answers regarding any aspect lactation.

      Primary outcome- Lactation at 3 months postpartum Secondary outcomes Full/partial lactation
      at 2 weeks, 4 weeks, 6 weeks, 3 months, and 6 months and a variety of outcomes regarding
      neonatal health, maternal health, emotional status and satisfaction.
    

Intervention name(s): Smartphone based communication
Intervention type(s): Other
Intervention description(s): Each patient will document each evening her lactation performance during the day, and the App will generate a daily report transmitted by email every evening to our computerized research database. Every evening the patient will receive via email an individualized feedback from our team regarding her lactation. This feedback could include: reassurance and positive feedback and lactation tips in attempt to optimize specific obstacles.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: randomized control trial
Masking: None (Open Label)
Primary purpose: Supportive Care