Effect of Educational Program on Maternal Breastfeeding Self-Efficacy: A Randomized Controlled Trial

Breastfeeding contributes to the reduction of infant mortality. Educational programs have been employed to strengthen maternal breastfeeding self-efficacy. This study aimed to evaluate the effect of a combined educational intervention on maternal breastfeeding self-efficacy.

A clinical trial was conducted with 152 postpartum women from a public maternity hospital in Fortaleza, Brazil, between February and November 2019. Participants were randomized in blocks into an intervention group and a comparison group that received conventional care. The intervention group received serial album "Eu Posso Amamentar o Meu Filho" (I Can Breastfeed My Child) and brief motivational interview in addition to routine care. Data collection occurred at the maternity hospital and via telephone follow-up at 15, 30, 60, 90, 120, and 180 days, using a sociodemographic and obstetric questionnaire, the Brazilian version of the Breastfeeding Self-Efficacy Scale - Short Form, and a feeding pattern form. Data were analyzed using SPSS version 20.0, employing Chi-square tests, independent t-tests, and repeated measures analysis. A significance level of less than 0.05 was considered.

The intervention group showed higher mean scores in breastfeeding self-efficacy than the comparison group at 15 (P<0.001), 30 (P<0.001), 60 (P<0.001), and 90 days (P=0.015). In the comparison group, the means across the time points did not show a statistically significant difference (P=0.087), but in the intervention group, there was a statistically significant difference (P<0.001). Regarding exclusive breastfeeding, the mean score of self-efficacy in the intervention group was higher the than comparison group to 60 days (P<0.001).

The combined educational intervention increased breastfeeding self-efficacy, and its effects lasted for up to 90 days postpartum.Trial Registration Number: U1111-1251-1052.