The effects of a breastfeeding self-efficacy intervention on short-term breastfeeding outcomes among primiparous mothers in Wuhan, China. Antenatal training to improve breast feeding: a randomised trial. Randomized controlled trial to determine effects of prenatal breastfeeding workshop on maternal breastfeeding self-efficacy and breastfeeding duration. Evaluation of a computer-based bilingual breastfeeding educational program on breastfeeding knowledge, self-efficacy and intent to breastfeed among rural Hispanic women Use of an Interactive Computer Agent to Support Breastfeeding The effect of a self-efficacy-based educational programme on maternal breast feeding self-efficacy, breast feeding duration and exclusive breast feeding rates: A longitudinal study. Predictors of the duration of exclusive breastfeeding among first-time mothers. A pilot randomized controlled trial of a breastfeeding self-efficacy intervention with primiparous mothers. Relationship of newborn weight loss to milk supply concern and anxiety: the impact on breastfeeding duration. Are 2 weeks of daily breastfeeding support insufficient to overcome the influences of formula?
AIMS To evaluate the effects of a breastfeeding intervention on primiparous mothers '  breastfeeding self-efficacy , breastfeeding duration and exclusivity at 4 and 8 weeks postpartum . BACKGROUND Few studies have examined the effects of breastfeeding self-efficacy on improved breastfeeding outcomes among primiparous mothers in China . DESIGN An experimental pre-test and posttest , two-group design was used in the study . METHODS A total of 74 participants were recruited to the study from a tertiary hospital in central China , from June-October 2012 . An individualized , st and ardized nursing intervention based on the Self-Efficacy Theory was delivered to enhance mothers ' breastfeeding self-efficacy , breastfeeding duration and exclusivity at 4 and 8 weeks postpartum . Participants were r and omly assigned to an intervention or referent group . Participants in the intervention group received three individualized , self-efficacy-enhancing sessions . Participants in the referent group received st and ard care . RESULTS Participants in the intervention group showed significantly greater increases in breastfeeding self-efficacy , exclusivity and duration than participants in the control group at 4 and 8 weeks postpartum ( except for duration at 4 weeks ) . High baseline breastfeeding self-efficacy predicted higher breastfeeding self-efficacy later and more exclusive breast-feeding . CONCLUSION The findings in this study suggest that intervention aim ed at increasing self-efficacy has a significant impact on maternal breastfeeding self-efficacy and short-term breastfeeding outcomes OBJECTIVE to assess the effect of an antenatal training programme on knowledge , self-efficacy and problems related to breast feeding and on breast-feeding duration . DESIGN a r and omised controlled trial . SETTING the Aarhus Midwifery Clinic , a large clinic connected to a Danish university hospital in an urban area of Denmark . PARTICIPANTS a total of 1193 nulliparous women were recruited before week 21 + 6 days of gestation , 603 were r and omised to the intervention group , and 590 to the reference group . INTERVENTION we compared a structured antenatal training programme attended in mid-pregnancy with usual practice . MEASUREMENTS data were collected through self-reported question naires sent to the women 's e-mail addresses and analysed according to the intention to treat principle . The primary outcomes were duration of full and any breast feeding collected 6 weeks post partum ( any ) and 1 year post partum ( full and any ) . FINDINGS no differences were found between groups according to duration of breast feeding , self-efficacy score , or breast-feeding problems , but after participation in the course in week 36 of gestation women in the intervention group reported a higher level of confidence ( p=0.05 ) , and 6 weeks after birth they reported to have obtained sufficient knowledge about breast feeding ( p=0.02 ) . Supplemental analysis in the intervention group revealed that women with sufficient knowledge breast fed significantly longer than women without sufficient knowledge ( HR=0.74 CI : 0.58 - 0.97 ) . This association was not found in the reference group ( HR=1.12 CI : 0.89 - 1.41 ) . KEY CONCLUSIONS AND IMPLICATION S FOR PRACTICE antenatal training can increase confidence of breast feeding in pregnancy and provide women with sufficient knowledge about breast feeding after birth . Antenatal training may therefore be an important low-technology health promotion tool that can be provided at low costs in most setting s. The antenatal training programme needs to be followed by postnatal breast-feeding support as it is not sufficient in itself to increase the duration of breast feeding or reduce breast-feeding problems OBJECTIVE To determine the effects of a prenatal breastfeeding workshop on  maternal breastfeeding self-efficacy and breastfeeding duration . DESIGN R and omized controlled trial . SETTING Large tertiary hospital in Ontario , Canada . PARTICIPANTS 110 primiparous women expecting a single child , an uncomplicated birth , and planning to breastfeed . INTERVENTION 2.5-hour prenatal breastfeeding workshop based on adult learning principles and self-efficacy theory . MAIN OUTCOME MEASURE Maternal breastfeeding self-efficacy and the numbers of days and amount of breastfeeding were measured at four and eight weeks postpartum . RESULTS / DATA ANALYSIS : Over time , maternal breastfeeding self-efficacy scores increased in both groups . Women who attended the workshop had higher self-efficacy scores and a higher proportion were exclusively breastfeeding compared to women who did not attend the workshop . There was little difference in the average number of days of breastfeeding , but the intervention group had less weaning . CONCLUSIONS The workshop increased maternal breastfeeding self-efficacy and exclusive breastfeeding OBJECTIVE To evaluate the impact of an interactive , computer based , bi-lingual breastfeeding educational program on breastfeeding knowledge , self-efficacy and intent to breastfeed among rural Hispanic women living in Scottsbluff , Nebraska . METHODS A two-group , repeated measures quasi-experimental study was conducted to evaluate the impact of a breastfeeding intervention .  Forty six rural Hispanic women between ages 18 and 38 years were enrolled at the Regional West Medical Center in Scottsbluff , Nebraska . Study participants were r and omized into intervention and control groups , with the intervention group ( n=23 ) receiving bi-lingual ( English and Spanish ) breastfeeding education on a touch screen computer program , while the control group received printed educational material . Study participants were enrolled during their last six weeks of pregnancy , with follow up assessment s conducted post-partum at days 3 and 7 , weeks 2 and 6 , and months 3 and 6 . The study protocol was approved by the University of Nebraska Medical Center Institutional Review Board ( IRB protocol # 430 - 12-EP ) and City University of New York Institutional Review Board ( IRB protocol # 642980 - 1 ) . RESULTS A significant improvement in the breastfeeding knowledge and intent to breastfeed scores was seen over a 6 month period among all the study participants ( p<0.05 ) . There was a gradual increase in the breastfeeding self-efficacy scores till week 6 followed by a decrease in self-efficacy scores at month 3 ( p=0.46 ) , and month 6 ( P=0.54 ) . Breastfeeding knowledge scores differed significantly between the study participants in the control and intervention groups at week 6 ( p=0.03 ) . There were no significant differences in the breastfeeding knowledge between the control and intervention groups at other time points . The control group showed gradual decline in their self-efficacy scores at month 3 and month 6 compared to the intervention group that showed a gradual increase in their self-efficacy scores at different time points during their follow up period . However , there were no significant differences in the self-efficacy scores between the intervention and control groups at different points . The control group showed significantly higher negative breastfeeding sentiment scores compared to the intervention group at days 3 ( p=0.02 ) and 7 ( p=0.03 ) indicating a lower intent to breastfeed . CONCLUSION Hispanic women living in rural setting s showed improvement in breastfeeding knowledge , self-efficacy and intent to breastfeed using the computer based bi-lingual educational program . Results show week 6 and month 3 to be the critical time points of intervention so that women continue to breastfeed Mothers need consistent , sustained information and support to develop and meet personal breastfeeding goals , but often receive insufficient assistance and conflicting and incorrect advice . The use of technology may be helpful in supplementing existing health care professional breastfeeding education and support efforts . We developed and evaluated a computer-based animated , interactive agent design ed to provide breastfeeding information and support to mothers interested in breastfeeding . A r and omized controlled study of a first-generation system was conducted to determine the feasibility of ( 1 ) use of the Computer Agent ; ( 2 ) the recruitment plan ; and ( 3 ) the planned outcome evaluation ( assessing the impact of the intervention on intent to breastfeed , attitudes towards breastfeeding , and breastfeeding self-efficacy ) . The pilot study ( N = 15 ) showed that the use of the Computer Agent , the recruitment plan , and the planned outcome evaluation were all feasible . Mothers who used the Computer Agent  had greater intentions to exclusively breastfeed after exposure to the Agent ( intent to exclusively breastfeed for 6 months 1–7 scale score of 6.14 ( post ) vs. 5.14 ( pre ) ; p < 0.05 ) . Non-statistically significant trends in improvement with use of the Computer Agent breastfeeding support system were also seen in the between subjects analyses of intent to breastfeed and breastfeeding self-efficacy . The pilot study demonstrated the feasibility of using a Computer Agent to support breastfeeding mothers and informed the design of a larger r and omized clinical trial . An interactive Computer Agent may be helpful in improving rates of exclusive breastfeeding , particularly when there is not adequate health care professional support BACKGROUND breast feeding has a number of well-documented benefits . Numerous studies have been conducted to investigate an effective approach to increase the breast feeding rate , duration and exclusive breast feeding rate , in which maternal breast feeding self-efficacy was determined as one of the major contributors . Although numerous breast feeding educational programmes have been developed to enhance maternal breastfeeding self-efficacy , results on the effectiveness of these programmes remain inconclusive . OBJECTIVE this study aims to investigate the effectiveness of a self-efficacy-based breast feeding educational programme ( SEBEP ) in enhancing breast feeding self-efficacy , breast feeding duration and exclusive breast feeding rates among mothers in Hong Kong . METHODS eligible pregnant women were r and omized to attend a 2.5-hour breast feeding workshop at 28 - 38 weeks of gestation and receive 30 - 60minutes of telephone counselling at two weeks post partum , whereas both intervention and control groups received usual care . At two weeks postpartum , the Breast feeding Self-Efficacy Scale-Short Form ( BSES-SF ) and a self-developed post partum question naire were completed via telephone interviews . The breast feeding duration , pattern of breast feeding and exclusive breast feeding rates were recorded at two weeks , four weeks , eight weeks and six months post partum . RESULTS results of analyses based on an intention-to-treat ( ITT ) assumption showed a significant difference ( p<0.01 ) in the change in BSES-SF mean scores between the mothers who received SEBEP and those who did not receive SEBEP at two weeks post partum . The exclusive breast feeding rate was 11.4 % for the intervention group and 5.6 % for the control group at six months post partum . CONCLUSION the findings of this study highlight the feasibility of a major trial to implement breast feeding education targeted at increasing breast feeding self-efficacy and exclusive breast feeding rates in Hong Kong Few women currently meet revised WHO recommendations to breastfeed exclusively for 6 months postpartum . In this prospect i ve study we aim ed to determine the influence of socio-demographic , psychosocial , and perinatal factors on the length of exclusive breastfeeding  among 189 Canadian primiparous mothers . A majority of the participants did not meet their exclusive breastfeeding goals , and only 5 % breastfed exclusively for a full 6 months . Breastfeeding self-efficacy , in-hospital formula supplementation , prenatal class attendance , and type of delivery independently predicted exclusive breastfeeding duration . Findings underscore the complex interplay of factors influencing breastfeeding , highlight the early postpartum weeks as a critical period for the establishment of exclusive breastfeeding , and suggest the need for a continuum of pre- and postnatal strategies for prolonging the exclusive breastfeeding period OBJECTIVES To pilot test a newly developed breastfeeding self-efficacy intervention . DESIGN Pilot r and omized controlled trial ( RCT ) . SETTING An acute care hospital located in Northwestern Ontario that is the sole provider of maternity care for the city and referral center for the region . PARTICIPANTS One-hundred- and -fifty primiparous women intending to breastfeed their healthy , term , singleton infant . INTERVENTION A st and ardized , individualized nursing intervention protocol was design ed and administered to increase mothers ' breastfeeding self-efficacy . Participants were r and omly allocated to the intervention group or control group using sealed , opaque envelopes . Participants in the intervention group received three individualized , self-efficacy enhancing sessions with the research er : two in-hospital and one by telephone . Participants in the control group received st and ard in-hospital and community care . MAIN OUTCOME MEASURES Feasibility , compliance , and the acceptability of the breastfeeding self-efficacy intervention . Other outcomes assessed were breastfeeding self-efficacy , duration , and exclusivity . RESULTS Findings suggest that the intervention was feasible ; there was a high degree of protocol compliance , and the majority of mothers reported that the intervention was beneficial . Mothers in the intervention group had higher rates of breastfeeding self-efficacy , duration , and exclusivity at 4 and 8 weeks postpartum . However , the differences between groups were not statistically significant . CONCLUSION The pilot RCT provided valuable information in examining the feasibility of the trial design and intervention Milk supply concern is the most common reason for breastfeeding discontinuation and maternal anxiety is also associated with reduced breastfeeding duration . Newborn excess weight loss ( EWL ) could trigger milk supply concern and anxiety and might be amenable to modification . Our objective was to determine the relationship between EWL and the development of milk supply concern and anxiety and the effect of such development on breastfeeding duration . We conducted a cohort analysis using data previously obtained from a r and omised controlled trial comparing two post-hospital discharge follow-up strategies . For 1107 well , singleton infants born at ≥34 weeks , we extracted data on all inpatient infant weights . EWL was defined as the loss of ≥10 % of birthweight . We surveyed mothers to obtain data on state  anxiety and milk supply concern at birth and at 2 weeks . Our final outcome was breastfeeding at 6 months . Seventy ( 6.3 % ) infants developed EWL during the birth hospitalisation . At 2 weeks , milk supply concern and positive anxiety screen were more common ( 42 % and 18 % , respectively ) among mothers whose infants had had EWL than among mothers whose infants had not had EWL ( 20 % and 6 % , respectively ) ( P < 0.001 for each comparison ) . Mothers with milk supply concern at 2 weeks were much less likely to be breastfeeding at 6 months , with odds ratio of 0.47 ( 0.30 , 0.74 ) in multivariate analysis . EWL may increase milk supply concern and anxiety and these may reduce breastfeeding duration . Ameliorating EWL might alleviate milk supply concern and anxiety and improve breastfeeding duration OBJECTIVE To evaluate the effectiveness of proactive telephone breastfeeding support in low-income , primiparous , primarily Latina women on 1 ) duration and exclusivity of breastfeeding  , 2 ) satisfaction with feeding , 3 ) rationale for discontinuing breastfeeding and 4 ) health care utilization . METHODS R and omized controlled trial comparing usual care to 2 weeks of daily telephone calls by nurses by using culturally informed scripted protocol s ; and qualitative study of focused interviews on a sample of women in the intervention group ( n = 40 ) . RESULTS Breastfeeding duration and exclusivity rates , feeding method satisfaction , and reasons for stopping breastfeeding did not differ significantly between intervention ( n = 161 ) and control ( n = 180 ) groups , with 74 % of both breastfeeding at 1 month and 28 % and 37 % , respectively , at 6 months . Insufficient milk supply was the main reason for stopping in both groups . Intervention infants were less likely to have a sick visit by 1 month ( 25 % ) than controls ( 35 % , P = .05 ) . Qualitative interviews revealed that the intervention was informative and helpful , with breastfeeding reported as healthier but harder ; formula was a good alternative . Intervention mothers reporting < or = 2 supplemental formula feedings on day 4 were more likely than mothers reporting > or =3 supplemental feedings to breastfeed at 1 month ( odds ratio 7.7 ; 95 % confidence interval 2.4 - 24.3 ) . CONCLUSIONS Two weeks of daily telephone support did not increase breastfeeding duration but was associated with a decrease in sick visits in the first month . Early supplementation and the perception of formula as a good alternative to dealing with the breastfeeding difficulties appeared to be factors in failure of the intervention
The aim of this systematic review and meta- analysis was to assess the efficacy on an intervention on breastfeeding self-efficacy and perceived insufficient milk supply outcomes .