Effect of a brief motivational intervention in the immediate postpartum period on breastfeeding self-efficacy: Randomized controlled trial

Brief motivational intervention (bMI) is a therapeutic approach that encourages self-efficacy and may have a positive effect on breastfeeding self-efficacy (BSE). The purpose of this study was to analyze the effectiveness of a bMI in increasing BSE in women who started breastfeeding in the immediate postpartum period and to explore the roles of general self-efficacy and other baseline variables in this relationship. A randomized, parallel-group clinical trial was carried out. A bMI was compared with an educational session on breastfeeding. Changes in BSE and its dimensions and the interaction and mediation/moderation of general self-efficacy and other variables were analyzed. BSE increased in the bMI group from a mean baseline score of 59.14 (+/- 9.35) to 64.62 (+/- 7.91) at 1st month (p < 0.001). An interaction was found in that only women with higher education had an improvement in BSE during the follow-up period that was attributable to the bMI (mean difference between the bMI and the attention control group: 18.25 (95% confidence interval: 5.86-30.19; p = 0.006). This interaction was not found for the changes produced in the intrapersonal thoughts dimension of BSE, whose scores were higher in the bMI group at 3 and 6 months. General self-efficacy exerted a moderating effect on the association of bMI with BSE change. The effect of bMI was no longer significant when the general self-efficacy score was above 84. Thus, bMI is effective in increasing BSE. This effectiveness was limited by the mother's educational level and moderated by baseline general self-efficacy.