Evaluating the Effectiveness of mHealth Application Interventions to Promote Breastfeeding Amongst Pregnant Women and Postpartum Mothers: A Global Systematic Review and Meta-Analysis.

Despite global recommendations, less than 40% of infants ≤ 6 months are exclusively breastfed (EBF) reflecting socio-economic, cultural, and systemic barriers. Mobile health (mHealth) interventions (delivered through mobile phone applications to support medical/public health practices) have been developed to support breastfeeding, but their effectiveness remains unclear. In this systematic review we searched PubMed, Embase, CINAHL, Web of Science, and Cochrane Library from 1 January 2010 to 1 May 2025 for randomised controlled trials in English involving pregnant or postpartum women up to 1 year, assessing the effectiveness of any form of mHealth intervention aimed at the mother, excluding qualitative studies (PROSPERO: CRD420251032811). The main outcome was EBF ≤ 6 months; Secondary outcomes were EBF at later time points, overall breastfeeding duration and breastfeeding self-efficacy up to 12 months. Quantitative synthesis used Harvest plots, binomial calculations, and meta-analysis. Of 3102 retrieved records, 13 studies (3269 women) were included. Interventions typically combined mobile apps with text messaging or telelactation. Binomial calculations/harvest plots suggested strong evidence for improved breastfeeding self-efficacy, knowledge, and confidence, with less evidence for effects on initiation, exclusivity, and duration. Meta-analysis suggested increased breastfeeding self-efficacy (Hedges' g = 1.08, 95% CI 0.07-2.1, p = 0.04) but with high heterogeneity (I2 = 90.7%), reflecting diverse populations, intervention types, and contexts. Engagement was affected by maternal, socio-cultural, and structural factors, underscoring the need for tailored, accessible, context-sensitive interventions. mHealth interventions may improve breastfeeding self-efficacy, knowledge and confidence, particularly when incorporating interactive, personalised features such as real-time feedback or telelactation.