Discussion
The present findings suggest that “benefits of breastfeeding” language is better than “risks of infant formula” language for producing a positive attitude to breastfeeding in nursing education. Only the benefits text significantly improved the attitude to breastfeeding. Second, the benefits text was received more favorably than the risks text. Specifically, most participants who received the benefits text agreed with it, while most participants who received the risks text found it uncomfortable. Moreover, agreement and lack of discomfort with a text were associated with more-positive attitudes toward breastfeeding after reading it.Comparison of pre-test and post-test IIFAS-J scores indicated that only the benefits text significantly improved midwives’ and nurses’ attitudes toward breastfeeding; the same information presented with risk language was not effective. This finding was consistent with a study of undergraduate students [When change in IIFAS-J score was compared among the three groups, neither of the intervention groups (i.e., those receiving the benefits text and the risks text) showed more improvement than the group receiving the control text. Most of the participants reported that they had heard of the benefits of breastfeeding and the risks of infant formula before participating in the study. Nurses who are knowledgeable about breastfeeding often have a positive attitude toward breastfeeding [Participants who favorably received the infant feeding text (i.e., were in agreement and felt no discomfort) had higher post-test IIFAS-J scores than did those who felt less favorably about the text in both intervention groups. This finding suggests that the reader’s feelings might impact the effectiveness of the intervention. Participants received the information more favorably when it was presented as the benefits of breastfeeding; thus, presenting infant feeding information that focuses on the benefits of breastfeeding may be more effective for promoting breastfeeding support among midwives and nurses. In addition, when any information is presented to midwives and nurses as a risk of infant formula use, it should be presented in a way that is agreeable and does not cause discomfort.When interpreting our results, it should be noted that our study evaluated the language and not the content of the texts. Nursing education on breastfeeding must encompass more than the benefits of breastfeeding. Lactating mothers expect health professionals to provide sensitive responses to their emotional needs, in addition to relevant knowledge and practical advice [There are several other limitations of the study. The present findings might also be affected by selection bias because of the nature of online surveys [Notwithstanding these limitations, the current study has value in assessing the language used in nursing education. We conclude that a text that presented the benefits of breastfeeding improved breastfeeding attitudes and that most midwives and nurses received it favorably. We found no advantage in using risk language to present infant feeding information. Future studies should attempt to identify the most appropriate way to convey infant feeding information as part of comprehensive nursing education to improve breastfeeding support.