Mobile device based educational support for breast feeding technique in multigravida mothers improved exclusive breast feeding practice during the COVID-19 pandemic -A facility based single-Blind, Parallel-Randomised, Controlled Trial.

COVID 19 pandemic disrupted the daily life for pregnant women, and maternity care services. During the lockdown, social isolation rendered one to one support difficult and there has been a rapid switch to the access of the support provided remotely including in the domains of breastfeeding support. We aimed to assess the breastfeeding behaviour following education through a video on breastfeeding techniques using smartphones. A facility-based randomized controlled trial enrolled 144 multigravida postnatal mothers in a community maternity centre. The Intervention group was educated antenatally with a video on breastfeeding techniques and shared to the mother's smartphone through "Whatsapp application". All mothers received education with ongoing public health programs. Breastfeeding self-confidence assessed by the breastfeeding self-efficacy scale short form (BSES-SF) and breast-feeding technique by Bristol breastfeeding assessment tool (BBAT) was assessed in both groups 24 -48 hours postpartum. Infant feeding practice was recorded telephonically at two, four and six months. BSES-SF scores improved in both groups post-intervention.There was no statistically significant difference in breastfeeding technique assessed by the BBAT, post intervention. In the intervention group, the exclusive breast-feeding (EBF) rates at the end of two, four, and six months were significantly higher and mothers were 2.64 times more likely to exclusively breastfeed. Video-based health education in the peripartum period and self-reinforcement through availability of educational material on their smartphones improved the EBF rate.