Randomized Controlled Trial of a Prenatal Breastfeeding Self-Efficacy Intervention in Primiparous Women in Iran

Objective: To determine the effects of a prenatal breastfeeding self-efficacy intervention on breastfeeding self-efficacy and breastfeeding outcomes. Design: Randomized controlled trial. Setting: Four health centers in Ahvaz, Iran. Participants: A total of 120 low-risk, nulliparous women between 35 and 37 weeks gestation who intended to breastfeed their singleton infants. Methods: Women were randomly assigned to receive the breastfeeding self-efficacy intervention (n - 60) or standard care (n = 60). The intervention was multifaceted and included two prenatal group sessions, an information package with breastfeeding images, and text messages until 8 weeks postpartum to promote exclusive breastfeeding. The primary outcome was breastfeeding self-efficacy measured with the Breastfeeding Self-Efficacy Scale-Short Form, translated into Persian, at 8 weeks postpartum. Additional outcomes included rates of breastfeeding exclusivity, duration, practices, satisfaction, and problems. Results: At 8 weeks postpartum, participants in the intervention group had significantly higher mean Breastfeeding Self-Efficacy Scale-Short Form scores and rates of exclusive breastfeeding than those in the control group. No significant group differences were found with regard to breastfeeding duration. Conclusion: Emerging evidence supports the use of breastfeeding self-efficacy interventions to improve breastfeeding self-efficacy and rates of exclusive breastfeeding. Further evaluation of this prenatal intervention is warranted.