Breastfeeding Self-Efficacy as a Predictor of Exclusive Breastfeeding: A Clinical Trial


1 Institute of Family Health, Maternal, Fetal, and Neonatal Health Research Center, Vali-e-Asr Hospital, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

2 Institute of Family Health, Maternal, Fetal and Neonatal Health Research Center, Val-e-Asr Hospital, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

3 Department of Psychiatry, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

4 Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran

5 Lactation Counseling and Training Center, Vali-e-Asr Hospital, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

6 Vali-e-Asr Hospital, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

7 General Practitioner, Health Center of Akbar Abad, Tehran, Iran


Background: "Exclusive breastfeeding (EBF) is globally promoted as the ideal method of infant feeding during the first six months of life due to its health benefits to both the mother and child" (1). The aim of this study was to examine the effect of the interventions leading to increased awareness, knowledge, and self-efficacy regarding exclusive breastfeeding and duration of breastfeeding.
Methods: This clinical trial was conducted on 129 pregnant women before the gestational age of 21 weeks and 6 days referring to Vali-e-Asr Hospital in Tehran, Iran. The study population was selected using the convenience sampling method. The participants were randomly assigned into two groups of intervention (n=64) and control (n=65). The mothers in the intervention group received one training session on breastfeeding self-efficacy, as well as training and audio packages regarding postpartum care and relationship with neonates. In addition, the women who suffered from anxiety, stress, or depression were provided with psychotherapies. The data collection instruments included the Self-Efficacy Scale, Edinburgh Postnatal Depression Scale, and Spielberger's State-Trait Anxiety Inventory.
Results: Exclusive breastfeeding was higher in the intervention group than in the control group during the first six months postpartum (P=0.015). The follow-up study showed that there were higher rates of breastfeeding for the two-year-old children in the intervention group (P<0.001). In addition, self-efficacy was associated with anxiety and depression.
Conclusion: As the findings indicated, psychological intervention aimed at increasing self-efficacy had a significant impact on maternal breastfeeding self-efficacy and duration of breastfeeding.


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