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Impact of Digital Lactation Support on Breastfeeding Problem-Solving Practices among Nursing Mothers in Nigeria

Abstract

Breastfeeding is an important component of maternal and infant health, providing nutritional, immunological, developmental, and psychosocial benefits for infants while supporting maternal health. However, nursing mothers may experience breastfeeding difficulties such as poor positioning or attachment, breast or nipple pain, engorgement, perceived insufficient milk supply, blocked milk ducts, difficulties with expressing breast milk, and challenges associated with returning to work or school. In Nigeria, limited access to skilled lactation support, geographical barriers, time constraints, cost of professional services, and inadequate continuity of breastfeeding counselling may make it difficult for mothers to obtain timely assistance when breastfeeding problems arise. Digital lactation support, delivered through mobile applications, teleconsultations, messaging platforms, online educational resources, and other digital communication channels, provides an opportunity to extend breastfeeding guidance beyond conventional facility-based services. Against this background, this study investigates the impact of digital lactation support on breastfeeding problem-solving practices among nursing mothers in Nigeria. The study will be anchored on the Health Belief Model, Social Cognitive Theory, and Technology Acceptance Model. The Health Belief Model explains how mothers' perceptions of breastfeeding difficulties, perceived benefits of seeking appropriate support, perceived barriers, self-efficacy, and cues to action may influence their responses to breastfeeding problems. Social Cognitive Theory emphasizes observational learning, behavioural modelling, self-efficacy, reinforcement, and social support in developing effective breastfeeding problem-solving behaviours. The Technology Acceptance Model explains how perceived usefulness and perceived ease of use may influence mothers' acceptance and utilization of digital lactation-support services. Collectively, these theoretical perspectives provide a suitable framework for explaining how digital lactation support may influence breastfeeding problem-solving practices among nursing mothers in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise nursing mothers aged 18 years and above with infants aged 0–24 months residing in selected urban, semi-urban, and rural communities across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, local government areas, communities, healthcare facilities, workplaces where appropriate, and eligible nursing mothers. Digital lactation support will be assessed using indicators such as access to digital lactation-support platforms, frequency and duration of use, teleconsultation, mobile-app use, messaging support, online educational materials, video demonstrations, virtual counselling sessions, response time to breastfeeding concerns, access to trained lactation or healthcare professionals, follow-up communication, personalized guidance, and referral to appropriate healthcare services. Breastfeeding problem-solving practices will be assessed using indicators such as appropriate recognition of breastfeeding difficulties, correct positioning and attachment, appropriate management of breast or nipple pain, engorgement management, response to perceived low milk supply, appropriate expression of breast milk, management of blocked ducts, recognition of symptoms requiring professional assessment, avoidance of harmful self-treatment, appropriate use of recommended breastfeeding techniques, timely consultation with qualified healthcare providers, and continued breastfeeding where appropriate. Data will be collected using structured questionnaires, breastfeeding problem-solving practice assessment tools, digital-support utilization records where available and voluntarily provided, breastfeeding diaries, scenario-based questions, and pre-test and post-test assessments where a quasi-experimental intervention is adopted. Descriptive statistics will be used to summarize mothers' demographic and socioeconomic characteristics, breastfeeding experiences, types of breastfeeding difficulties encountered, sources of breastfeeding information, digital access, and problem-solving practices. Inferential statistical techniques, including chi-square tests, paired and independent t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the impact of digital lactation support on breastfeeding problem-solving practices. Where a quasi-experimental design is adopted, problem-solving practice scores before and after introduction of digital lactation support may be compared with those of a comparison group to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that digital lactation support has a significant positive impact on breastfeeding problem-solving practices among nursing mothers in Nigeria. Mothers who receive timely, evidence-based, and professionally guided digital lactation support are expected to demonstrate better ability to recognize breastfeeding difficulties and apply appropriate strategies than mothers without comparable access to digital support. Digital platforms may improve access to practical demonstrations, individualized counselling, reminders, follow-up guidance, and rapid responses to breastfeeding concerns. They may also reduce geographical and time barriers to professional lactation assistance, particularly for mothers living far from specialized services or balancing breastfeeding with work and other responsibilities. Digital support may encourage mothers to seek professional assessment when symptoms persist or indicate a possible medical problem rather than relying on misinformation or potentially harmful self-treatment. However, limited internet connectivity, data costs, digital literacy, smartphone access, privacy concerns, misinformation, variable quality of online lactation advice, and limited availability of trained lactation professionals may reduce the effectiveness of digital support alone. The study therefore expects accessible, evidence-based, privacy-conscious, user-friendly, and professionally supervised digital lactation support to contribute significantly to improved breastfeeding problem-solving practices among nursing mothers in Nigeria. The study is expected to contribute to the literature on digital lactation support, breastfeeding, maternal and child health, digital health, breastfeeding problem-solving, lactation counselling, telehealth, mobile health, health education, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, hospitals, primary healthcare centres, maternity facilities, breastfeeding-support programmes, lactation consultants, nurses, midwives, digital-health developers, community health workers, development partners, and policymakers regarding strategies for strengthening breastfeeding support. The study will also provide evidence-based recommendations for integrating digital lactation support into maternal and child health services, strengthening tele-lactation and mobile breastfeeding counselling, improving access to qualified lactation professionals, developing reliable digital breastfeeding resources, protecting mothers' privacy, strengthening referral systems for complex breastfeeding problems, and developing sustainable hybrid digital and facility-based breastfeeding-support programmes across Nigeria.

Keywords: Digital lactation support, breastfeeding problem-solving practices, nursing mothers, breastfeeding, lactation support, digital health, telehealth, mobile health, maternal and child health, breastfeeding counselling, Nigeria, public health.