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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Breastfeeding.

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Strategy. Social Media-Based Support

Approach. Use social media platforms to provide breastfeeding support

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Overview. With millennial women having a significant presence online, making internet-based sources of breastfeeding support is a potentially far-reaching, cost-effective, and convenient innovation. Social media platforms (e.g., Facebook, YouTube, Twitter, LinkedIn, Pinterest, Tumblr, and Instagram) are internet-based applications that enable the creation and exchange of user-generated content that may provide an avenue of social support for breastfeeding. Research indicates that social media-based breastfeeding support groups can increase self-efficacy[1] and have a direct effect on breastfeeding confidence, knowledge, and attitudes[2,3] as well as rates of exclusive breastfeeding.[4,5]

Evidence. Emerging Evidence. Strategies with this rating typically trend positive and have good potential to work. They often have a growing body of recent, but limited research that documents effects. However, further study is needed to confirm effects, determine which types of health behaviors and conditions these interventions address, and gauge effectiveness across different population groups. (Clarifying Note: The WWFH database calls this "mixed evidence").

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source. (Read more about understanding evidence ratings).

Source. Peer-Reviewed Literature

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Health and Health Behaviors/Behavior Change. This strategy improves individuals' physical and mental health and their adoption of healthy behaviors (e.g., healthy eating, physical activity).
  • Environmental Health. This strategy improves the impact of physical, chemical, and biological factors in the environment on health.
  • Utilization. This strategy improves the extent to which individuals and communities use available healthcare services.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Health Teaching (Education and Promotion) (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Population/Systems-Focused

Examples from the Field. Access descriptions of ESMs that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort ("What/how much did we do?")

PROCESS MEASURES:

  • Number of social media accounts or pages created to provide breastfeeding support and education. (Measures platform presence)
  • Number of followers, likes, or subscribers to the breastfeeding support social media accounts. (Assesses audience reach)
  • Number of posts, videos, or articles shared on the breastfeeding support social media platforms. (Evaluates content generation)

OUTCOME MEASURES:

  • Total number of engagements (e.g., likes, comments, shares) with the breastfeeding support content on social media. (Captures audience engagement)
  • Number of women who reported receiving helpful breastfeeding information and support through social media. (Measures perceived support)
  • Number of women who connected with lactation experts or peer supporters through the breastfeeding support social media platforms. (Assesses network building)

Quadrant 2:
Measuring Quality of Effort ("How well did we do it?")

PROCESS MEASURES:

  • Percent of social media content that was evidence-based, accurate, and aligned with current breastfeeding guidelines. (Measures content quality)
  • Percent of user inquiries or comments on social media that received a timely and appropriate response from a lactation expert or moderator. (Evaluates responsiveness)
  • Percent of social media posts that included calls to action, such as setting breastfeeding goals or seeking professional support when needed. (Assesses engagement tactics)

OUTCOME MEASURES:

  • Percent of women who reported increased breastfeeding confidence and self-efficacy after engaging with the social media-based support. (Measures empowerment)
  • Percent of women who reported that the social media-based support helped them overcome breastfeeding challenges and continue breastfeeding. (Captures problem-solving effectiveness)
  • Percent of women who exclusively breastfed their infants at 3 and 6 months postpartum while actively participating in the social media-based support. (Assesses breastfeeding outcomes)

Quadrant 3:
Measuring Quantity of Effect ("Is anyone better off?")

PROCESS MEASURES:

  • Number of collaborations or partnerships formed with influencers, bloggers, or organizations to amplify the reach and impact of the breastfeeding support social media content. (Measures network amplification)
  • Number of social media campaigns or challenges launched to promote breastfeeding awareness, knowledge, and peer support. (Assesses proactive outreach)
  • Number of offline events or meetups organized to foster in-person connections and support among breastfeeding women who interact on social media. (Evaluates online-offline integration)

OUTCOME MEASURES:

  • Number of women who reported that the social media-based support helped them feel less isolated and more connected to a supportive breastfeeding community. (Captures social connectedness)
  • Number of user-generated content pieces (e.g., testimonials, photos, videos) shared on social media to inspire and support other breastfeeding women. (Measures peer inspiration)
  • Number of healthcare providers or organizations that reported using the breastfeeding support social media content as a resource for their patients or clients. (Assesses system integration)

Quadrant 4:
Measuring Quality of Effect ("How are they better off?")

PROCESS MEASURES:

  • - Percent of social media followers or participants from diverse racial, ethnic, and socioeconomic backgrounds. (Measures demographic diversity)
  • - Percent of social media content and interactions that were culturally sensitive, inclusive, and available in multiple languages. (Evaluates cultural competence)
  • - Percent of social media-based support initiatives that were co-designed or led by women from underserved or marginalized communities. (Assesses community ownership)

OUTCOME MEASURES:

  • - Percent reduction in breastfeeding disparities between women who actively participated in the social media-based support and those who did not, stratified by race, ethnicity, and income. (Measures equity impact)
  • - Percent of women from communities with historically low breastfeeding rates who reported increased breastfeeding initiation, duration, and exclusivity after engaging with the social media-based support. (Captures progress in underserved areas)
  • - Percent increase in public awareness, acceptance, and support for breastfeeding as a result of the collective impact of breastfeeding-focused social media initiatives. (Assesses societal shift)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

1 Black, R., McLaughlin, M., & Giles, M. (2020). Women's experience of social media breastfeeding support and its impact on extended breastfeeding success: A social cognitive perspective. British journal of health psychology, 25(3), 754-771.

2 Morse, H., & Brown, A. (2021). Accessing local support online: Mothers' experiences of local Breastfeeding Support Facebook groups. Maternal & child nutrition, 17(4), e13227.

3 Moukarzel, S., Rehm, M., & Daly, A. J. (2020). Breastfeeding promotion on Twitter: A social network and content analysis approach. Maternal & child nutrition, 16(4), e13053.

4 Wilson, J. C. (2020). Using Social Media for Breastfeeding Support. Nursing for Women's Health, 24(5), 332-343.

5 Cavalcanti, D. S., Cabral, C. S., de Toledo Vianna, R. P., & Osório, M. M. (2019). Online participatory intervention to promote and support exclusive breastfeeding: Randomized clinical trial. Maternal & child nutrition, 15(3), e12806.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.