Spanish version of the mHealth app usability questionnaire (MAUQ) and adaptation to breastfeeding support apps.

INTRODUCTION: Mobile applications (apps) are increasingly used during pregnancy, postpartum and lactation. To ensure the utility and usability of breastfeeding support apps, they need to be evaluated using a reliable scale specific to mHealth apps and breastfeeding users. OBJECTIVE: To translate the original the mHealth App Usability Questionnaire (MAUQ) questionnaire into Spanish and to adapt it to breastfeeding support apps environment. MATERIALS AND METHODS: The questionnaire was translated by one high English proficiency translator and was back translated. The items of the questionnaire were modified for Spanish readers and for breastfeeding users. The modified questionnaire was assessed for content validity with a panel of 5 experts and 12 users and the modified kappa statistic was used to determine the interrater agreement among the raters. The reliability of the questionnaire was assessed in a mobile application for breastfeeding support (LactApp) by 202 users. The structure of the questionnaire was validated using exploratory factor analysis. RESULTS: All items of the questionnaire were relevant, clear or comprehensible with content validity index values higher than 0.79. The modified kappa agreement for each item of the modified MAUQ (m-MAUQ) proved an excellent agreement (κ = 0.9-1.0). Factor analysis of the m-MAUQ showed four subscales. The internal consistency of the complete questionnaire was high (Cronbach α = 0.89). CONCLUSIONS: The Spanish and modified MAUQ demonstrated high reliability and validity and it might be used to evaluate the usability, utility and acceptability of mHealth apps aiming to support lactating women.

Impact of COVID-19 Pandemic in Breastfeeding Consultations on LactApp, an m-Health Solution for Breastfeeding Support.

Introduction: Breastfeeding is an unquestionable right of mothers and their children; however, it is not a one-woman job. For breastfeeding to succeed, women must have access to appropriate support and guidance. The COVID-19 pandemic and subsequent restriction measures and lockdown to reduce community spread of the disease have negatively impacted breastfeeding support from health services and thus, in mothers' breastfeeding experiences. Objective: The present study aims at evaluating the impact of the COVID-19 pandemic on breastfeeding consultations in LactApp (a mobile application [app] for m-Health focused on breastfeeding support, www.lactapp.com) during the COVID-19 pandemic. Materials and Methods: We conducted an observational, descriptive, and retrospective study with LactApp data recorded between July 2018 and March 2021, including 9,151,456 queries classified in 48 topics among 137,327 active users. We used the Interrupted time series model to evaluate the increase of the number of queries consulted and active users due to the COVID-19 pandemic. Wilcoxon test was used to study the increase of certain topics due to the COVID-19 pandemic. Results: LactApp active users increased by 12,092 users (p < 0.001) during the COVID-19 outbreak and confinement and queries consulted in LactApp also significantly increased by 10,899 queries per month after the pandemic outbreak. The breastfeeding topics that significantly increased are those related to growth spurts, breastfeeding stages, breastfeeding technique, breast pain and mastitis, problems with infants not gaining weight correctly, hypogalactia, increased milk demand, and relactation. These findings are important to understand the potential of online tools when face-to-face professional support is unavailable. Conclusions: Critical issues in breastfeeding establishment were highly consulted and significantly increased in the app during the pandemic. We believe that LactApp was a useful tool for breastfeeding support when women could not obtain appropriate support elsewhere. LactApp might be considered a powerful tool to identify critical issues of breastfeeding and trends in an automatized manner.

Telelactation with a Mobile App: User Profile and Most Common Queries.

Background: Mobile applications related to health issues are currently expanding. Different uses of new technologies have produced positive results regarding breastfeeding support. Breastfeeding applications are increasing. Objective: We conducted a descriptive analysis of a mobile application for breastfeeding (LactApp) to study the user profile and the most frequent queries. Materials and Methods: This was a retrospective, comparative, and descriptive ecological time-series study of LactApp from 2016 to 2019. Google Analytics and the app itself were used for data collection. The data were analyzed in Excel, and for the time series, Prais-Winsten autoregressions were applied based on the Durbin-Watson method in Stata. Results: A total of 115,830 users and 71,780 infants were registered in the application. A total of 1.91% of these users obtained the medical version. The application was used for both queries and surveys and for users to interact through chat. A total of 30.17% of the responses were related with "baby's sleep" (8.94%), 8.91% were related to "preservation of milk," 6.16% were related to "breastfeeding crisis," and 6.15% were related to "physiological evolution of breastfeeding," all with an increasing trend. Conclusion: LactApp is a resource for breastfeeding that is widely downloaded and used by a substantial number of individuals. The most recurring topics were baby's sleep, milk extraction and preservation, breastfeeding crisis and physiological evolution of breastfeeding.

Description of an mHealth tool for breastfeeding support: LactApp. Analysis of how lactating mothers seek support at critical breastfeeding points and according to their infant's age.

Interventions in mHealth have had positive effects on establishing and maintaining breastfeeding, but we still do not know what content women consult when downloading a breastfeeding mobile application. We conducted an observational, descriptive, and retrospective study using the data recorded by LactApp in 2019. The most frequently consulted topics were those related to breastfeeding technique, infant sleep, human milk management and storage, breastfeeding myths, breastfeeding stages, complementary feeding, infant care, and returning to work. Our study results suggest that LactApp's support seems to develop with mothers' needs according to their infant's development stage. The first breastfeeding days include more physiological answers. Between 15 days and 3 months, mothers look for support in topics like breastfeeding crisis/complications and returning to work. At 3 months to 1 year, answers are related to complementary feeding and weaning. When the user's infant is 1 year of age, mothers seek support for weaning, weaning management, and tandem breastfeeding.

Sobre las reflexiones de la lactancia materna desde el feminismo / On the reflections of breastfeeding from the feminist perspective

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