Effectiveness of a postpartum breastfeeding support group intervention in promoting exclusive breastfeeding and perceived self-efficacy: a multicentre randomized clinical trial

Abstract

Abstract Background: There are numerous recognized benefits of breastfeeding,however, sociocultural, individual, and environmental factors influence its initiation and continuation; sometimes leading to breastfeeding rates during the postpartum period that are lower than recommended by international guidelines.The aim of this study was to evaluate the effectiveness of a group intervention led by midwives supporting breastfeeding during the postpartum period in promoting exclusive breastfeeding up to when the newborn reached 4 months of age, as well as, to assess the impact of this intervention on perceived self-efficacy and its relationships with the duration and exclusivity of breastfeeding. Methods: A multicentric cluster randomized controlled trial with a control group and an intervention group and was not blinded. Participant recruitment began in October 2021 and ended in May 2023.A total of 382 women from Andalusia (Southern Spain) participated in the study.The control group received usual care, while the intervention group also participated in a postpartum breastfeeding support group led by a midwife. The main variables were measured during the postpartum visit and when the newborn was 2 and 4 months old. Results: At 4 months postpartum, there was a higher prevalence of breastfeeding in the intervention group compared to formula feeding (p = 0.01), as well as a higher prevalence of exclusive breastfeeding (p= 0.03). Perceived self-efficacy was similar in both groups, with slightly higher initial scores in the intervention group than in the control group. From the beginning of the postpartum period to 2 months, there was a notable increase in self-efficacy (control group = 56.15 ± 11.01 vs intervention group = 59.75 ± 9.64), which then remained stable until 4 months (control group = 55.87 ± 13.03 vs intervention group = 59.96 ± 11.04). The intervention improved the average scores of perceived self-efficacy and indirectly caused higher rates of exclusive breastfeeding, an effect observed especially at 4 months postpartum (p= 0.005). Conclusions: The midwife-led group intervention supporting breastfeeding during the postpartum period proved to be effective at maintaining exclusive breastfeeding at 4 months postpartum and also at increasing perceived self-efficacy. Trial registration:International Standard Registered Clinical/Social Study Number registry (Trial ID: ISRCTN17263529; date recorded: 17 June 2020).