Breast Feeding, Exclusive Breast Feeding, Maternal-Fetal Attachment, Primiparity
Conditions
Keywords
Breastfeeding Education, Hybrid Education, Primiparous Women, Antenatal Attachment, Breastfeeding Self-Efficacy, Mother-Infant Bonding
Brief summary
This randomized controlled study aims to examine the effect of individualized hybrid breastfeeding education provided during late pregnancy on antenatal attachment and breastfeeding behaviors among first-time mothers. Participants will be randomly assigned to either the intervention or control group. Women in the intervention group will receive individualized hybrid breastfeeding education beginning at the 36th week of pregnancy. The program includes a face-to-face individual breastfeeding education session at 36 weeks of pregnancy and a reinforcement and practice session at 38 weeks. Participants will also have access to personalized digital educational materials, short educational videos, and online consultation support. In the postpartum period, participants will receive an online support session during the first week after birth and a follow-up session through online communication or telephone at the sixth postpartum week. The control group will receive routine hospital education during pregnancy. After completion of the study, the same educational materials will be provided to the control group in accordance with ethical principles. Data will be collected using the Demographic Information Form, Breastfeeding Behavior Evaluation Form, Antenatal Attachment Inventory, and Breastfeeding Self-Efficacy Scale. Written informed consent will be obtained from all participants prior to enrollment.
Detailed description
Maternal emotional attachment to the fetus during pregnancy is an important factor influencing breastfeeding success and the quality of mother-infant interaction in the postpartum period. Higher levels of antenatal attachment have been associated with earlier initiation of breastfeeding and stronger emotional bonding with the infant after birth. Educational and psychosocial interventions during pregnancy may therefore play an important role in strengthening the maternal-infant relationship and improving breastfeeding outcomes. Breastfeeding is not only a nutritional practice but also a biological and psychosocial process that supports the development of secure attachment between mother and infant. Sustained breastfeeding contributes to maternal responsiveness and supports the infant's emotional security and development. First-time mothers often experience lower breastfeeding self-efficacy and may require additional professional guidance and support during the breastfeeding process. Educational interventions implemented during pregnancy can enhance maternal knowledge, confidence, and emotional readiness for breastfeeding. Hybrid educational models that combine face-to-face and online approaches may increase accessibility while accommodating the physical and time limitations experienced during late pregnancy. Personalized digital educational materials and online counseling can further support mothers by providing flexible access to breastfeeding information and professional guidance. However, studies examining individualized hybrid breastfeeding education programs initiated during the late stages of pregnancy for first-time mothers remain limited. Evaluating the effectiveness of such programs may contribute to improving antenatal attachment and promoting positive breastfeeding behaviors after birth. Therefore, the purpose of this randomized controlled study is to evaluate the effect of individualized hybrid breastfeeding education initiated during late pregnancy (approximately at the 36th week of gestation) on antenatal attachment and breastfeeding behaviors among primiparous women.
Interventions
BEHAVIORALIndividualized Hybrid Breastfeeding Education
Primiparous pregnant women in the intervention group will receive an individualized hybrid breastfeeding education program planned for late pregnancy. The education consists of a hybrid structure including face-to-face sessions and online educational materials. The content covers the importance of breastfeeding, breastfeeding techniques, common breastfeeding problems, approaches to support mother-infant attachment, and preparation for the postpartum breastfeeding process. The intervention will be provided in addition to standard prenatal care.
Sponsors
Emel GÜÇLÜ CİHAN
Kahramanmaras Sutcu Imam University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Masking description
This study is planned as an open-label trial. Since the intervention involves an educational program, both participants and implementers need to be aware of their assigned groups. Therefore, no blinding will be applied in this study.
Intervention model description
This study will use a parallel assignment model. Primiparous pregnant women will be randomly assigned to either the intervention group or the control group. The intervention group will receive individualized hybrid breastfeeding education during late pregnancy, while the control group will receive routine prenatal care. Participants will remain in their assigned group throughout the study period.
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 35 Years
Healthy volunteers
Yes
Inclusion criteria
Aged 18-35 years, At 36 weeks of gestation or later, Experiencing their first pregnancy (primiparous), Having a singleton pregnancy, Able to read and write in Turkish and capable of communication, Having access to a smartphone or the internet, Free from any physical or mental health problems that would prevent participation in the education, Willing to voluntarily participate in the study and provide written informed consent.
Exclusion criteria
Presence of chronic physical illness or pregnancy complications (e.g., preeclampsia, gestational diabetes), Multiple pregnancy, Gestation earlier than 36 weeks, Inability to actively participate in the education due to communication barriers or cognitive impairment, Lack of access to a smartphone or the internet, Failure to attend any stage of the educational program or voluntary withdrawal from the study, Refusal to participate in the study or failure to sign the informed consent form.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Antenatal Maternal Attachment | 36-38 weeks of pregnancy | The level of antenatal maternal attachment will be assessed using the Maternal Antenatal Attachment Scale (MAAS). The scale consists of 19 items rated on a 5-point Likert scale. Total scores range from 19 to 95, with higher scores indicating stronger antenatal maternal attachment. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Breastfeeding Self-Efficacy | At 1 and 6 weeks postpartum | Breastfeeding self-efficacy will be assessed using the Breastfeeding Self-Efficacy Scale (BSES). The scale consists of 33 items rated on a 5-point Likert scale. Total scores range from 33 to 165, with higher scores indicating greater breastfeeding self-efficacy. |
Countries
Turkey (Türkiye)
Contacts
CONTACTAsst. Prof.
PRINCIPAL_INVESTIGATORAsst. Prof.
Kahramanmaras Sutcu Imam University
Outcome results
None listed