Telelactation Via Mobile App: Perspectives of Rural Mothers, Their Care Providers, and Lactation Consultants

Background: Rural-urban disparities exist in breastfeeding rates and availability of lactation support. Direct-to-consumer (DTC) telelactation that uses two-way video through personal devices has the potential to increase access to international board-certified lactation consultants (IBCLCs) in rural settings that lack them. This study describes the feasibility and acceptability of DTC telelactation for rural mothers. Methods: We conducted semi-structured interviews among various stakeholders involved in a study exploring the impact of telelactation through mobile phone app in rural Pennsylvania. Interviewees included mother participants assigned to receive telelactation (n=17), IBCLCs employed by the telelactation vendor (n=7), and nurses (n=2) and physicians (n=1) caring for mother participants at the recruitment hospital. Thematic content analysis was used to analyze qualitative data. Results: Interviewees reported that telelactation was convenient and efficient, provided a needed service in rural areas lacking breastfeeding support services, and increased maternal breastfeeding confidence. Telelactation was noted to have several advantages over in-person and telephone-based support. Barriers to use included maternal reluctance to conduct video calls with an unknown provider, preference for community-based breastfeeding resources, and technical issues including limited WiFi in rural areas. Conclusions: Among rural women who experience inequitable access to qualified breastfeeding support resources, DTC telelactation appears to be an acceptable delivery model for lactation assistance.