Knowledge‑Attitude‑Practice breastfeeding-based model is associated with better outcomes: a retrospective comparative...

Sustaining exclusive breastfeeding remains challenging, and integrated antenatal education targeting knowledge, attitudes, and practical skills may improve outcomes.

This is a single-centre retrospective study. Women receiving conventional education (January-August 2024) were compared with women receiving a multicomponent knowledge, attitudes, and practices (KAP)-based breastfeeding education programme after its formal implementation (September 2024-June 2025). After 1:1 matching by maternal age, parity, and gestational age at enrolment, 640 women were included. Primary outcomes were KAP total score at 37-39 weeks of gestation and exclusive breastfeeding status at six months postpartum based on a structured 24-hour dietary recall; secondary outcomes included Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) score, early initiation, interim breastfeeding status, and lactation complications.

The matched cohort included 320 women per group. The multicomponent KAP-based programme group showed higher KAP scores (80.8 ± 5.6 vs 63.4 ± 6.9; p < .001), BSES-SF scores (58.2 ± 4.8 vs 48.6 ± 5.4; p < .001), and a higher prevalence of exclusive breastfeeding at six months based on 24-hour recall (55.9% vs 31.6%; p < .001). Early initiation was increased, while nipple pain, engorgement, and mastitis were reduced (all p < .01). Exposure to the multicomponent KAP-based programme was independently associated with exclusive breastfeeding status at six months based on 24-hour recall (aOR 2.84, 95% CI 1.98-4.07; p < .001).

Participation in a multicomponent KAP-based breastfeeding education programme was associated with better breastfeeding outcomes and fewer lactation complications. Multicentre studies are needed to confirm these findings.