Effects of an Online Theory-Based Educational Programme for Primiparous Women on Improving Breastfeeding-Related Outcomes: A Randomised Controlled Trial.

Participants were recruited by convenience sampling and were mostly low-risk first-time mothers with relatively high breastfeeding intention, so results may not apply to multiparous women, high-risk pregnancies, or mothers with low intention to breastfeed. Most participants were highly educated, employed, and had family support or income above HKD30,000, which may not represent all mothers. Mothers could attend other antenatal breastfeeding talks, and the analysis adjusted for this, but additional education may still confound the effect. Recruitment was mainly through online advertisements, which may miss some primiparous communities. Many mothers were excluded from breastfeeding initiation analysis, reducing statistical power for that outcome. Mothers knew which group they were in, and most outcomes were self-reported, so social desirability or response bias is possible. Infant hospitalisation was rare, so the study had little ability to detect a difference in infant morbidity. The 6-month exclusive breastfeeding result was not significant, and the confidence interval included no effect.

The authors declared no conflicts of interest. The paper does not report a funder.

Do not conclude that this programme improves exclusive breastfeeding at 6 months. The 6-month exclusive breastfeeding result was not significant (adjusted RR = 1.78, 95% CI 0.96-3.32, p = 0.068), and the study did not show a difference in infant hospitalisation or postnatal depression.