Does benefits-of-breastfeeding language or risks-of-formula-feeding language promote more-positive attitudes toward breastfeeding among nurses?

Abstract

Abstract Background. Nurses are crucial in helping new mothers to learn the necessary skills and overcome the difficulties of breastfeeding. Few studies have explored appropriate language for nursing education on breastfeeding. We assessed the impact of the language used on breastfeeding attitudes among Japanese nurses. Methods. A quasi-experimental study was conducted online in Japan among 174 nurses who had work experience in obstetrics or pediatrics. Participants were allocated to three groups to receive different text messages as the intervention (the benefit of breastfeeding for Group 1; the risk of formula feeding for Group 2; the importance of childcare for Group 3 as the comparison). The Japanese version of the Iowa Infant Feeding Attitude Scale (IIFAS-J) was used to assess breastfeeding attitudes before and after reading the texts. Also, participant reactions to the text were assessed by their responses to three statements. ANOVA, the chi-square test, and the t-test were used for outcome assessments. Results. The post-test IIFAS-J score was significantly higher than the pre-test score only for Group 1 (p < 0.01). The percentage of nurses who agreed with the content of the text was 70.7% in Group 1 and 48.3% in Group 2. The percentage of nurses who reported discomfort with the text was 34.5% in Group 1 and 55.2% in Group 2. No significant difference among groups existed regarding interest in the text. In all three groups, participants who agreed with the text had higher post-test IIFAS-J score than those who disagreed with the text (6.85 points higher, p < 0.01 in Group 1; 7.19 points higher, p < 0.01 in Group 2; 8.00 points higher, p < 0.02 in Group 3). Discomfort with the text and interest in the text were associated with higher post-test IIFAS-J score in Group 1 and Group 2 but not significantly associated in Group 3. Conclusions. “Benefits of breastfeeding” language is suggested to be better than “risks of infant formula” language for producing a positive attitude to breastfeeding in nursing education. Trial registration. This study was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000023322). Registered 05/08/2016.