A smartphone application to support breastfeeding for new mothers in Vietnam

INTERVENTION: The trial will be conducted at Dong Anh General Hospital, Hanoi, Vietnam. The Vietnamese Breastfeeding (VBF) app is a theory‐based yet user‐friendly smartphone application developed to support breastfeeding, with specific focus at different postnatal stages. Its purpose is to provide support and knowledge that will empower new mothers to exclusively breastfeed their babies for six months. The app content is tailored to the context of breastfeeding in Vietnam, addressing known barriers such as prelacteal feeds and emphasising early initiation of breastfeeding after birth. The VBF app will support and educate mothers about the importance of exclusive breastfeeding, build confidence in breastfeeding (e.g. correct positioning, feeding on demand) and motivate them to continue breastfeeding, by providing evidence‐based information and reinforcing regular communication with health professionals to address any problem. All app materials will be culturally appropriate and sensitive to the needs of Vietnamese mothers. Each intervention participant will receive routine care and twice weekly SMS messages from baseline until childbirth. The text messages, adapted from those of Mobile Alliance for Maternal Action (United Nations Foundation 2015), contain advice on healthy lifestyle and nutrition (e.g. to avoid anaemia) during pregnancy, sanitation, early initiation of breastfeeding and vaccinations. Participants may also request a free call back from our hospital nurse to discuss any problem or complex issue. Within 24 hours of giving birth, mothers in the intervention group will be assisted by our trained nurses to install the VBF app and access it weekly for six months. To avoid potential contamination and information exchange with the controls, each intervention participant will be issued a unique non‐sharable access code for the download of VBF app to her personal smartphone. They will be briefly trained on use of the app functions and features, and enc CONDITION: caesarean section;breastfeeding; ; caesarean section ; breastfeeding Public Health ‐ Health promotion/education Reproductive Health and Childbirth ‐ Breast feeding PRIMARY OUTCOME: Any breastfeeding duration, as assessed by a self‐reported questionnaire (Duong, Lee, Binns 2005, Journal of Paediatrics & Child Health)[6 months postpartum] Exclusive breastfeeding duration, as assessed by a self‐reported questionnaire (Duong, Lee, Binns 2005, Journal of Paediatrics & Child Health)[6 months postpartum] SECONDARY OUTCOME: Any breastfeeding rates, as assessed by a self‐reported questionnaire (Duong, Lee, Binns 2005, Journal of Paediatrics & Child Health)[at 1, 3 and 6 months postpartum] Exclusive breastfeeding rates, as assessed by a self‐reported questionnaire (Duong, Lee, Binns 2005, Journal of Paediatrics & Child Health)[at 1, 3 and 6 months postpartum] Timing of introduction of solid foods, as assessed by a self‐reported questionnaire (Duong, Binns, Lee 2005, Acta Paediatrica)[at 3 and 6 months postpartum] INCLUSION CRITERIA: Pregnant women, at around 28 weeks of gestation, will be recruited at the hospital antenatal clinic. They will be eligible to participate if they: own a smartphone, aged over 18 years, have sufficient language skills (completed junior high school education) and carrying a singleton fetus.