On this webpage are summary findings and links to independent academic evaluations of Baby Buddy.

To see an overview of data on uptake, usage and feedback of Baby Buddy, including on how the app is disproportionately used by families who experience inequalities, please click here.

Using Baby Buddy as a digital intervention targeting diet and physical activity in pregnancy

Development Study (Rhodes A, Pimprikar A, Baum A, Smith AD, Llewellyn CH)

The aim of this study was to create a theory-based intervention within Baby Buddy to empower, encourage, and support expectant parents to develop healthier dietary and physical activity (PA) habits for pregnancy and parenthood.

  • The intervention’s development process was guided by the Behaviour Change Wheel, with the person-based approach used to create and test its design. Three stages of qualitative research with pregnant and recently pregnant parents guided the intervention design. 
  • Study 1 confirmed the appeal and relevance of the intervention concept and its novel approach of including partners. The identified themes underpinned the development of the intervention design. Iterative feedback from study 2, in conjunction with patient and public involvement and engagement and expert contributor input, helped refine the intervention design and ensure its relevance and appeal to a diverse target user group. Study 3 highlighted functionality, content, and design issues with the app prototype and identified ways of improving the user experience.
  • This study illustrates the value of combining a theoretical method for intervention development with the person-based approach to create a theory-based intervention that is also user-friendly, appealing, and engaging for its target audience. Further research is needed to evaluate the effectiveness of the intervention in improving diet, PA, and weight management in pregnancy.

The full study can be accessed here.

Baby Buddy App for Breastfeeding and Behaviour Change

Retrospective Study of the App Using the Behaviour Change Wheel (Musgrave LM, Baum A, Perera N, Homer CS, Gordon A. 2021 April. JMIR Mhealth Uhealth)

This study aimed to retrospectively examine the development of Baby Buddy by applying the Behaviour Change Wheel (BCW) framework to understand how it might increase breastfeeding self-efficacy, knowledge, and confidence.

  • A three-stage process evaluation used triangulation methods and formalized tools to gain an understanding of the potential mechanisms and behaviours used in apps that are needed to improve breastfeeding rates in the UK.
  • The study found Baby Buddy to be a well-designed platform that could be used to change breastfeeding behaviours in the following ways:
    • Best Beginnings had defined breastfeeding as a key behaviour requiring support and demonstrated a thorough understanding of the context.
    • Best Beginnings had used intervention and policy functions to address the barriers and enablers of breastfeeding and incorporated several behaviour change techniques that could assist women with decision making around breastfeeding (eg, information about health consequences and credible sources) and possibly affect attitudes and self-efficacy.
    • Of the 39 videos in the app, 19 (49%) addressed physical capabilities related to breastfeeding and demonstrated positive breastfeeding behaviours

The full study can be accessed here.

Experiences, Attitudes, and Needs of Users of a Pregnancy and Parenting App (Baby Buddy) During the COVID-19 Pandemic

Mixed Methods Study (Rhodes, A., Kheireddine, S., & Smith, A. D.; 2020. JMIR mHealth and uHealth)

A mixed methods study on the experiences, attitudes and needs of Baby Buddy app users during the Covid pandemic took place by Alexandra Rhodes et al (2020). The study consisted of a web-based survey with 436 expectant and new parents with 32 telephone interviews with the same cohort. 

  • A significant proportion of parents reported increased level of anxiety on pregnancy and birth (88.5%) with 58% concerned with their emotional and mental health.
  • The qualitative interviews echoed these findings with many interviewees’ feelings isolated, disregarded and overwhelmed.
  • 97% of the respondents reported that the Baby Buddy was supporting them and that it is increasingly more relevant given the lack of face-to-face support from healthcare providers.

You may access the published study here.

Self Care Project

Impact on parents using 'Just One Norfolk' website and the Baby Buddy app (Eastern AHSN commissioned University of Essex to undertake this evaluation, 2020)

An evaluation of a project using the Just One Norfolk website and the Baby Buddy app to promote self-care amongst parents found that:

  • Parents using the website and Baby Buddy showed improvements in self-care (measured by the Patient Activation Measure)
  • The average activation score increased by 3.8 points for parents using the website: this increase was not statistically significant
  • The average self-care score increased by 5.6 points for parents using the Baby Buddy app. This increase was statistically significant (p<0.01)
  • Study limitations such as a small sample size and lack of control conditions means that these findings should be interpreted with caution.

Full report here

The North of England Study

Impact of parenting resources on breastfeeding, parenting confidence and relationships (Crossland et al., 2019)

An evaluation of the Best Beginnings' resources (the Baby Buddy app, Baby Express magazine and from Bump to Breastfeeding DVD) found that:

  • Baby Buddy significantly improves mother to infant bonding 
  • Women using the Best Beginnings resources at two of the sites reported higher rates of breastfeeding, although this was not statistically significant.
  • The resources were felt to have helped increase knowledge, build confidence and support relationship-building.

Full report here.

Smartphone applications available to pregnant women in the United Kingdom

An assessment of nutritional information (Bland et al., December 2019, Maternal and Child Nutrition) 

This review identified 29 pregnancy-related apps available to UK women and assessed nutritional information in line with national recommendations. They found that:

  • Several apps conveyed inappropriate information for pregnancy
  • There was a need for the integration of both evidence‐based nutritional information during app development and for increased regulatory oversight to ensure that nutritional content is accurate before it is available for widespread use
  • Only two apps, one being Baby Buddy (and the other a commercial app with adverts), fulfilled all accountability criteria and contained no inaccurate information.

Full report here.

The North of England Study

Embedding supportive parenting resources into maternity and early years care pathways: a mixed methods evaluation (Crossland et al., July 2019, BMC Pregnancy and Childbirth)

An evaluation of Best Beginnings approach to embedding resources into local care pathways found that:

  • Women and health professionals held positive views of the resources
  • The resources were particularly seen as a beneficial aid for families
  • Embedding models are necessary to successfully introduce digital resources into maternity and early years pathways

Full report here.

The Bumps and BaBies Longitudinal Study (BaBBLeS)

A multi-site cohort study of first-time mothers to evaluate the effectiveness of the Baby Buddy app (Deave et al., 2019)

This study exploring the impact of the Baby Buddy app on parenting self-efficacy and wellbeing found that:

  • No impact on parental self-efficacy using the validated tool (TOPSE)
  • At 1 week, 1 month and at 3 months post-birth
    • Baby Buddy users were 12% more likely to report in any breastfeeding
    • And 9% more likely to report exclusive breastfeeding
  • At 1 month post-birth, Baby Buddy users were 17.1% more likely to report breastfeeding and this was statistically significant
  • Baby Buddy app users felt they had less social support than non-users, suggesting that the app appeals more to those most in need.

Read more here.

Small Wonders E-Learning for Health – a case study of collaboration

Back in 2012 we launched the Small Wonders DVD and associated Change Programme in over 100 neonatal units across the UK. The programme was designed to support parents of premature and sick babies to be at the heart of their babies’ care and drive positive change towards family-centred care in neonatal units across the UK. An independent academic evaluation was undertaken to evaluate the impact of the Small Wonders Change Programme on staff knowledge and attitudes, parental knowledge and experience and preterm feeding outcomes in two neonatal units in the UK. The researchers  (Yoxall et al., 2016, Archives of Disease in Childhood) found:

  • Statistically significant improvements in staff knowledge and confidence in supporting preterm breastfeeding and family-centred care
  • There were several significant improvements in the information received by parents, infant feeding intentions and practices 
  • Of mothers who watched the Small Wonders DVD, 78.9% rated it as either ‘very helpful’ or ‘helpful’. All fathers rated it as either ‘helpful’ or ‘very helpful’. 
  • Significantly more mothers were giving their babies breast milk at six weeks post-discharge
  • The proportion of babies receiving breast milk at discharge increased from 42.4% to 49.0% (p = 0.02).
  • The number of days that babies were given breast milk, as a proportion of days the babies were given any milk increased from 57.2% to 62.8% (p < 0.0001). 

All the Small Wonders films are now freely available within the Baby Buddy app and on the Baby Buddy website 

The Baby Buddy app: Tackling inequalities in breastfeeding in the UK using a cultural lens

(Perera & Papain, pending publication) An exploratory study of the uptake of Baby Buddy app and its impact on breastfeeding found that: 

  • The second most searched term within the app is Breastfeeding
  • 98% of pregnant and new mums said that the app is helping them feel more confident to take care of their baby
  • 24.7% of Baby Buddy users are from minority ethnic groups
  • Ethnicity alone was not a determinant of breastfeeding status
  • First language and occupation is a stronger determinant of breastfeeding status

An evaluation of Baby Buddy m-health intervention with a focus on the Guys and St. Thomas' Trust pilot embedding site (Canterbury Christ Church University, June 2016)

The study compared Baby Buddy user data and survey responses from the Guys and St. Thomas' site to national data gathered between 2014 and 2016 and found that:

  • Women both nationally and in at the site, viewed Baby Buddy favourable in terms of it being easy-to-use, fun, interesting and with content that is easy to understand.

Midwives remain the single biggest source of information about Baby Buddy.