Objective
This study evaluates the impact of telelactation (video breastfeeding support visits) on breastfeeding satisfaction and the likelihood of breastfeeding another child. Breastfeeding satisfaction is a key person-centered outcome and indicator of breastfeeding success and is associated with a longer duration of breastfeeding.

Methods
This randomized controlled trial randomized pregnant individuals to receive a telelactation app (intervention group) or an infant care e-book (control group). The main outcome measured was self-reported breastfeeding satisfaction at 24 weeks postpartum, while a secondary outcome assessed the likelihood of breastfeeding another child. We estimated unadjusted and adjusted linear regression models for the effect of telelactation on breastfeeding satisfaction and logistic regression models for the effect of telelactation on the likelihood of breastfeeding another child. We also examined whether the effects of telelactation differed by breastfeeding problems experienced.

Results
Results indicated that telelactation significantly improved breastfeeding satisfaction scores by 0.53 points (confidence interval (CI): [0.04,1.04], P = 0.04) and increased the likelihood of participants being very likely to breastfeed another child by 7% (risk ratio = 1.07 [CI: {1.01, 1.14}, P = 0.02]; adjusted risk ratio = 1.07 [CI: {1.01, 1.14}, P = 0.03]). We found no significant differences in outcomes based on race or ethnicity. Further analysis highlighted that telelactation was particularly beneficial for participants experiencing common newborn/premature feeding issues.

Conclusions
Telelactation can enhance breastfeeding experiences and satisfaction, with implications for public health strategies targeting new parents.