Evidence map›Paper›PMID 41276849›Full record

ArticleArchives of public health = Archives belges de sante publique2025

Impact of breastfeeding education with WhatsApp follow-up on infant feeding, growth, and health outcomes: a quasi-experimental study in Malaysia.

Halimah Jalil, Mei-Chan Chong, Muhammad Yazid Jalaludin, Li Ping Wong

Abstract read
In one paragraph

Article in Archives of public health = Archives belges de sante publique, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Halimah JalilDepartment of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia.
Mei-Chan ChongDepartment of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia.
Muhammad Yazid JalaludinDepartment of Paediatrics, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia. yazidjal@um.edu.my.
Li Ping WongCenter for Population Health (CePH), Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundExclusive breastfeeding (EBF) promotes optimal growth and health in infants. Despite national and global initiatives, EBF rates in Malaysia remain below the 70% target set for 2030. This study evaluated the impact of structured breastfeeding education supplemented with WhatsApp follow-up on infant feeding practices, growth, and health outcomes.

methodsA quasi-experimental study was conducted at six public health clinics in Gombak District, Selangor. Mothers of healthy-term infants were assigned to either an intervention group (structured education with WhatsApp follow-up) or a comparison group (routine care). A total of 500 mother-infant pairs were enrolled. Data on feeding practices, anthropometric indicators, length-for-age (LAZ), weight-for-age (WAZ), and weight-for-length z-scores (WLZ) and common illnesses, including upper respiratory tract infection (URTI), gastroenteritis (GE), contact dermatitis (CD), bowel disorders (BD), and other illnesses (OI), were collected at Months 1, 3, and 6. Analyses included descriptive statistics, linear mixed-effects models, and generalised logistic mixed models.

resultsOf the 602 mothers screened, 500 were enrolled across six purposively selected clinics, and 460 (220 in the comparison group and 240 in the intervention group) were included in the final analysis. Baseline maternal and infant characteristics were comparable between groups. EBF prevalence was initially higher in the comparison group but increased more significantly in the intervention group by Month 6. Although some baseline z-scores were negative, descriptive trends showed modest, non-significant improvements in LAZ, WAZ, and WLZ over time, indicating overall upward growth trajectories. Linear mixed-effects models confirmed significant time effects, but no group-by-time interactions were observed. Illness prevalence decreased with age, with significant reductions observed for GE and OI and a borderline improvement for URTI in the intervention group. Overall, the intervention improved EBF practices and selected morbidity outcomes but did not significantly alter growth trajectories.

conclusionsStructured breastfeeding education, combined with WhatsApp follow-up, effectively enhanced exclusive breastfeeding practices and reduced certain infant illnesses, but showed no significant short-term effects on growth. Longer-term follow-up is warranted to assess the sustained effects on growth and health.

Indexed as

Community healthExclusive breastfeedingHealth educationInfant growthInfant healthMalaysiaMHealth

Identifiers

PMID41276849
PMCPMC12752280

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.