Breastfeeding
Conditions
Keywords
Breastfeeding, Breastfeeding education, Health literacy, Breastfeeding self-efficacy, Postpartum education, paternal support
Brief summary
This study aims to evaluate the effects of a comprehensive breastfeeding education program based on a health literacy development strategy on maternal and paternal breastfeeding self-efficacy, fathers' breastfeeding support, parental health literacy, and breastfeeding outcomes. The sustainability of breastfeeding depends not only on maternal knowledge and skills but also on social support mechanisms and parents' ability to access, understand, evaluate, and use health-related information. Fathers play a crucial role in supporting breastfeeding, yet studies incorporating both fathers and health literacy-based educational strategies remain limited. Therefore, this randomized controlled trial was designed to determine whether a structured breastfeeding education program delivered to both mothers and fathers, in addition to routine postpartum care, improves maternal and paternal breastfeeding self-efficacy, fathers' breastfeeding support, parental health literacy, and breastfeeding outcomes. This study sought to answer the following questions: 1. Does breastfeeding education based on a health literacy development strategy affect parents' breastfeeding self-efficacy? 2. Does breastfeeding education based on a health literacy development strategy affect fathers' breastfeeding support? 3. Does breastfeeding education based on a health literacy development strategy affect breastfeeding outcomes? If so, what is the nature of this effect? 4. Does breastfeeding education based on a health literacy development strategy affect the health literacy levels of mothers and fathers?
Detailed description
Based on this background, the present randomized controlled trial was designed to evaluate the effects of a structured, health literacy-oriented breastfeeding education program delivered to both mothers and fathers in addition to routine postpartum care. The study aimed to determine whether this comprehensive intervention improved maternal and paternal breastfeeding self-efficacy, increased fathers' breastfeeding support, enhanced parental health literacy, and positively influenced breastfeeding outcomes, including exclusive breastfeeding, bottle or teat use, breastfeeding frequency, breastfeeding duration, formula use, the frequency of breastfeeding problems, and breastfeeding success.
Interventions
Breastfeeding is initiated by nurses or midwives in the hospital within the first hour after birth at most. General information about breastfeeding and breastfeeding is given to the patient for approximately 10 minutes. Afterwards, care is provided in the form of answering the patient's questions, if any.
OTHERExperimental
In this study, a breastfeeding education program was prepared based on the "Integrated Health Literacy Model" that combines the processes of accessing, understanding, appraising, and applying health information. The intervention consisted of a 25-30 minute face-to-face education given by the researcher in the hospital within the first 24 hours after birth. At the end of the training, written material was presented and directions were provided to reliable online resources. In order to support the intervention, telephone counseling was provided in the first week after birth and the La Leche League Turkey article "Breastfeeding Myths" was shared via WhatsApp. On the 15th day, a telephone call was made again to evaluate current experiences and send short support messages. In the first month, information was provided about the TEMAS Association's article "Breastfeeding Volunteer, Mothers Have Something to Say" and the "Tuesday Swings" support activities.
Sponsors
Nigde Omer Halisdemir University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Outcomes Assessor)
Masking description
Participants and care providers were not masked due to the nature of the educational intervention. The outcome assessor was blinded to participant group allocation.
Intervention model description
Participants were randomly assigned to either a health literacy-based breastfeeding education group or a routine postpartum care group. The two groups were followed in parallel from baseline until the postpartum 6-8-week assessment.
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
* Mothers and fathers aged 18-65 years * Parents of a healthy term infant * Parents able to read and speak Turkish * Mothers and fathers without hearing or visual impairment * Mother without a medical contraindication to breastfeeding * Parents with access to the internet * Parents willing to participate voluntarily * Parents living together * Parents able to receive postpartum education
Exclusion criteria
* Separation of the mother and infant due to admission to intensive care * Maternal use of medications contraindicating breastfeeding * Loss of internet access during the study period * Discontinuation of breastfeeding due to maternal or infant medical conditions * Inability to complete follow-up (e.g., relocation, death, or loss to follow-up)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Health literacy level | Baseline and postpartum 6-8 weeks | Health literacy will be assessed using the Turkish version of the 12-item Short-Form Health Literacy Instrument (HLS-SF12). Scores are converted to an index ranging from 0 to 50, with higher scores indicating better health literacy. |
| Fathers' breastfeeding support level | Baseline and postpartum 6-8 weeks | Fathers' breastfeeding support will be assessed using the Breastfeeding Support Scale for Fathers. The scale consists of 21 items rated on a 5-point Likert scale. Higher scores indicate greater breastfeeding support. |
| Maternal breastfeeding self-efficacy | Baseline and postpartum 6-8 weeks | Maternal breastfeeding self-efficacy will be assessed using the 14-item Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). Total scores range from 14 to 70, with higher scores indicating greater breastfeeding self-efficacy. |
| Fathers' breastfeeding self-efficacy | Baseline and postpartum 6-8 weeks | Fathers' breastfeeding self-efficacy will be assessed using the Fathers' Breastfeeding Self-Efficacy Scale. Total scores range from 14 to 70, with higher scores indicating greater breastfeeding self-efficacy. |
| Breastfeeding success | Baseline and postpartum 6-8 weeks | Breastfeeding success will be assessed using the LATCH Breastfeeding Assessment Tool. Total scores range from 0 to 10, with higher scores indicating greater breastfeeding success. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Breastfeeding outcomes | Baseline and postpartum 6-8 weeks | Breastfeeding outcomes will be assessed using a researcher-developed questionnaire including infant feeding practices, bottle or pacifier use, breastfeeding-related problems, and infant characteristics. |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATOROzlem ASCI, PhD
Nigde Omer Halisdemir University
Outcome results
None listed