The Effect of Prenatal Counseling on Breastfeeding Practice in Mothers with Previous Unsuccessful Breastfeeding Randomized Controlled Trial

Abstract

Background: Breastfeeding is one of the most important factors in the health of infants. Monitoring the practice of mothers and giving feedback to them increases their self-efficacy, their interest in learning and their level of practice. The purpose of this study was to evaluate the effect of prenatal counseling on breastfeeding practice in mothers with previous unsuccessful breastfeeding. Methods & material: This study was a randomized controlled clinical trial that performed on 108 pregnant mothers with unsuccessful breastfeeding who referred to Tabriz health centers in 2017-18. Participants were randomly assigned to intervention and control groups. Before intervention, demographic information questionnaire was completed by two groups. In the intervention group, four breastfeeding counseling sessions were held in the third trimester of pregnancy, while the control group only received routine care. Maternal was delivered to the 15th day after delivery and then to the end of the 4th month in case of a problem, they were contacted by phone or in person and breastfeeding self-efficacy scale (BSES) questionnaire, researcher-made checklists for breastfeeding practice in both intervention and control groups was completed. Data were analyzed using independent T-test, repeated measures ANOVA, and chi-square tests. Results: The two groups didn’t differ significantly in terms of socio-demographic characteristics except for willingness to pregnancy, level of education and spouse’s level of education.. The probability of exclusive breastfeeding on day 15, month 2, and month 4 was significantly higher in the intervention group. The mean infant weight on day 15 postpartum was significant in the intervention group (P=0.008). No statistically significant difference was observed between the groups in terms of infant weight gain in months 2 (P=0.221) and 4 (P=0.128) postpartum. The mean of self-efficacy score on the 15th, 2nd and 4th months after delivery in mothers of the intervention group was significantly different from that of the control group (p <0.001). Frequency of breastfeeding problems on the 15th and 2nd month postpartum was significantly different in the intervention group than the control group (p <0.05). However, the frequency of breast feeding problems in the 4 months after delivery in the intervention group and in the control group ,there was no significant difference between the two groups (p <0.311). Conclusions: The results of the study showed that counseling during pregnancy increases the frequency of exclusive breastfeeding in mothers during postpartum and improves the proper weighing of newborns. It also increases the self-efficacy of breastfeeding mothers in postpartum period and solves most of the breast-feeding problems during post partum.