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Table 1 The basic characteristics of the included studies (n = 18)

From: The effectiveness of real-time telelactation intervention on breastfeeding outcomes among employed mothers: a systematic review and meta-analysis

1st author/year/

design/

Countries

Characteristics of Participants

n, Subjects in Intervention/

Control groups

(n, Working/

N total)

Telelactation Intervention

Outcomes

Services activities

Platforms

Providers

Usual care

Follow-up mode/period

BF outcomes

Amin, 2022 [46]

Quasi-experiment

Egypt

-Primiparous pregnant women

-Mean age: 23.89 ± 1.50

-Employed 88%

60/60

(106/120)

Scheduled online education via Zoom and on-demand consultation via WhatApp support during 2 months

Zoom and WhatsApp

Nurses

Not mentioned

-Interview at 1, and 3 months

1.BF knowledge

2. BF attitude

3. BFSE

Cauble, 2021[47]

RCTs

USA

-Primiparous pregnant and Postpartum women

-Mean age: 26.2 ± 4.3

-Employed 54%

19/22

(22/41)

Weekly support via telephone call during antenatal (6 sessions)

Acano Audio Conferencing System

IBCLCs

Plus, Usual care

-Email, REDCap survey

at 2 weeks,

2, 4, 6 months

1. ABF

2. EBF

Fan, 2022 [48]

RCTs

Hong Kong

-Primiparous pregnant women

-Mean age: 33.0 ± 4.3

-Employed 82%

18/15

(27/33)

Weekly support and consultation via WhatsApp calls and text messages for 6 months

WhatsApp

Trained peer support

Plus, Usual care

- Telephone F/U at 1, 2, 4, 6 months

1. ABF

2. EBF

3. BF attitude

4. BFSE

Forster, 2019 [49]

RCTs

Australia

-Primiparous postpartum women

-Mean age: 31.0 ± 5.0

-Employed 96.8%

501/515

(984/1,016)

BF support on days 4–6, then on days 10, weekly in the first 3 months, monthly in 3–6 months, via telephone call, and on mother’s demand support

Telephone

Trained peer volunteer counselors

Plus, Usual care

- Email survey and telephone interview at

6 months

1. ABF

2. EBF

Fu, 2014 [50]

RCTs

Hong Kong

-Primiparous postpartum women

-Mean age: 30.5 ± 4.5

-Employed 78.5%

255/257

(402/512)

In-hospital support during 24 h and weekly support via telephone call during 4 weeks postpartum

Telephone

Midwife or IBCLCs

Plus, Usual care

- Telephone F/U at 1, 2, 3 months

1. ABF

2. EBF

Iamchareon, 2020 [51]

Quasi-experiment

Thailand

-Primiparous postpartum women

-Mean age: 23.92 ± 4.05

-Employed 69%

80/77

(108/157)

Onsite providing BF information and practices with BF support via telephone call at 6 weeks, 3 and 6 months

Telephone

Trained nurses

Plus, Usual care

- Telephone F/U at 6 weeks,

3 and 6 months

1. EBF

2. BF knowledge

3. BF practices

Jiewtamai, 2020 [52]

Quasi-experiment

Thailand

- Postpartum women

-Mean age: 27.61 ± 5.75

-Employed 63.6%

33/33

(42/66)

Onsite providing BF information and practices with scheduled telephone follow up

Telephone

Nurses

Plus, usual care

-Telephone follow up at 6 months

1. BFSE

2. BF practices

Monsaeng, 2016 [53]

Quasi-experiment

Thailand

-Pregnant and postpartum women

-Age range: 20–30 y.

-Employed 76%

29/29

(44/58)

Onsite providing BF information and practices with consultation during service hours and extended hours via telephone Line App for on-demand consultation

Line App

Lactation nurses

Plus, Usual care

- Onsite visit at

1 week, 1, 2–4, and 6 months and telephone F/U at 4 weeks

1. EBF

2. BF knowledge

3. BF practices

Ogaji, 2021 [54]

RCTs

Nigeria

-Postpartum women

-Mean age:

> 30 years

-Employed 89%

67/64

(117/131)

- Weekly support in the first two weeks then monthly support via telephone call for 6 months and on mother’s demand call

Telephone

Pediatrician

Plus, Usual care

- Telephone F/U at 1, 2, 3, 4, 5 months and home visit at 6 months

1. EBF

Pengpit, 2022 [55]

Quasi-experiment

Thailand

- Postpartum women

-Mean age: 29.0 ± 4.72

-Employed 60%

30/30

(36/60)

Onsite providing BF information and practices with scheduled telephone follow up

Telephone

Nurses

Plus, usual care

- Telephone follow up and BF clinic visit at 2 weeks

1. BF knowledge

2. BF attitude

3. BF practices

Phaiboonbunpot, 2015 [56]

Quasi-experiment

Thailand

-Primiparous postpartum women

-Mean age: 22.8 ± 5.2

-Employed 60%

16/16

(19/32)

Onsite providing BF information and BF practices with scheduled telephone consultation and follow up

Telephone

Nurses

Not mentioned

- Telephone follow up at 2 weeks

1. BF knowledge

2. BF attitude

3. BF practices

Prasitwattanaseree,

2019 [57]

RCTs

Thailand

-Primiparous pregnant and postpartum women

-Mean age:

IG = 27.9 ± 4.6,

CG = 27.1 ± 4.7

-Employed 77%

41/42

(64/83)

Onsite providing BF information and practices in ANC with on days 7 support and then monthly support during 3–6 months via telephone call

Telephone

Trained nurses

Plus, Usual care

- Telephone F/U at 7 days, 1, 2, 3, 4, 5, 6 months

1. EBF

2. BFSE

3. BF practices

Puharic, 2020 [58]

RCTs

Croatia

-Primiparous pregnant and postpartum women

-Age range: 18–35 y.

-Employed 75%

129/123

(189/252)

BF Support in antenatal care, then monthly support during the first 3 months postpartum via telephone call

Telephone

Trained nurses

Not mentioned

- Telephone call record at 3, 6 months

1. ABF

2. EBF

3. BF attitude

4. BFSE

Ruenprot, 2023 [59]

Quasi-experiment

Thailand

-Primiparous pregnant and postpartum women

-Age range:

18–35 y.

-Employed 100%

30/30

(60/60)

Online consultation via telephone Line App in the third trimester, 24 h, 72 h, 1 week, and 1 month postpartum with an onsite home visit at 4–8 weeks postpartum

Line App

Trained nurses and peer volunteer

Plus, Usual care

- Home visit at 4–8 weeks and

- Telephone line app F/U at 6 months

1. EBF

2. BF knowledge

Seguranyes, 2014 [60]

RCTs

Spain

-Postpartum women

-Mean age:

IG = 31.22 ± 4.71,

CG = 31.13 ± 4.76

-Employed 78%

683/718

(1,093/1,401)

On-demand consultation on VDO or telephone call during service hours (8.0 am-8.0 pm)

ASSIR Skype and Hotline phone

Midwives

Plus, Usual care

- Onsite visit, online consulting record, and telephone F/U at 6 weeks

1. EBF

Simonetti, 2012 [61]

RCTs

Italy

-Primiparous postpartum women

-Mean age:

IG = 32.18 ± 3.80,

CG = 31.54 ± 3.81

-Employed 69%

55/59

(79/114)

Weekly support via telephone call during 6 weeks postpartum and on mothers’ demand calls

Telephone

Midwives

Plus, Usual care

- Telephone F/U at 1, 3, 5 months

1. EBF

Uscher-Pines, 2020 [62]

RCTs

USA

-Pregnant and postpartum women

-Mean age: 26.5 ± 5.11

-Employed 55.6%

94/93

(104/187)

On-demand VDO call with 24-hour access and unlimited requests

Pacify Health’s telelactation App

IBCLCs

Plus, Usual care

-Email online survey at 2 weeks, 1, 3 months

1. ABF

2. EBF

Wen, 2020 [63]

RCTs

Australia

-Pregnant and postpartum women

-Mean age: 32.5 ± 5.0

-Employed 62%

386/385

(478/771)

Every two months support via telephone call during the first 12 months postpartum

Telephone

Trained nurses

Not mentioned

- Telephone F/U at 6 months

1. ABF

2. EBF

  1. Note. ABF, Any breastfeeding–the infant receives breast milk, with or without complementary foods or liquids; ASSIR, Attention to Sexual and Reproductive Health program; BF, Breastfeeding; BFSE, Breastfeeding Self-efficacy; EBF, Exclusive breastfeeding–the infant receives only breast milk, no other foods, liquids, or water (except for medications, vitamin or mineral supplements); IBCLCs, International Board–Certified Lactation Consultations; Line App, Freeware app and service for instant messaging, video or voice calling and social networking which is a very popular communication application; Skype, a free software that lets people make video and voice calls, send messages, and share files on mobile devices, computers, or tablets; SMS, Short Message Service is a text messaging service component of most telephone, Internet and mobile device systems; WhatsApp, is an instant messaging and voice-over-Internet. It allows users to send text, voice, and video messages, make voice and video calls, and share photos, documents, users’ locations, and other content; Zoom, a communications platform that allows users to connect with video, audio, phone, and chat