Efficacy of three good things intervention for enhancing exclusive breastfeeding behaviors: a randomized controlled...

Emotional factors have been linked to breastfeeding behaviors, while evidence remains limited on the efficacy of positive psychology interventions in promoting breastfeeding. This study aims to evaluate the efficacy of "Three Good Things" intervention on breastfeeding.

A parallel, two-arm, single-blind randomized controlled trial was conducted in 2022 at a Women's Hospital in China. First-time pregnant women aged >18 years with 34-38 gestational weeks were included. Participants were stratified by family support for breastfeeding and randomly assigned to "Three Good Things" intervention group or "First Three Things" control group. The primary outcome was exclusive breastfeeding during postnatal hospitalization.

A total of 297 participants (141 in intervention and 156 in control group) completed the study. Intention-to-treat analysis using generalized linear models indicated no significant differences in emotional outcomes between two groups. Logistic regression analysis revealed comparable proportion of exclusive breastfeeding (16.3 % vs. 19.9 %, P = 0.43). Notably, higher levels of positive emotions were associated with higher breastfeeding behavior scores (β = 0.046, SE = 0.015, P = 0.002). Among individuals with high levels of positive emotions, higher scores on positive emotion were associated with an increased likelihood of exclusive breastfeeding.

While the "Three Good Things" intervention did not directly enhance exclusive breastfeeding behaviors, our findings suggested that higher level of positive emotions was associated with higher potential of exclusive breastfeeding and better breastfeeding practices.