A Pilot Randomized Controlled Trial of an Online Educational Program for Primiparous Women to Improve Breastfeeding

Abstract

Background: There are different approaches to breastfeeding interventions, but the global 6-month exclusive breastfeeding rates remain suboptimal. The COVID-19 pandemic has brought extra difficulties in promoting breastfeeding. Research Aim: To test the feasibility and effectiveness of a theory-based, real-time online educational and support program for breastfeeding related outcomes. Methods: An assessor-blinded, prospective pilot randomized controlled trial with parallel-group, repeated-measures design was used. The sample was low-risk primiparous mothers ( N = 40) who delivered in the local public hospitals. Study outcomes consisted of exclusive breastfeeding rate, breastfeeding self-efficacy, and other breastfeeding outcomes measured by a self-reported questionnaire, including the Breastfeeding Self-Efficacy Scale and the Edinburgh Postnatal Depression Scale. Comparisons between the differences in the intervention and control groups were carried out. Results: Thirteen participants in the intervention group successfully completed the program. They had a higher exclusive breastfeeding rate, breastfeeding self-efficacy, breastfeeding initiation rate, and longer exclusive breastfeeding duration than the control group. Additionally, the intervention group had a lower partial breastfeeding rate, and a higher maternal postnatal depression score and infant’s morbidity at postnatal 2 months. However, all the results were not statistically significant ( p > .050). Overall, the intervention was highly valued by all participants who appreciated the regular postnatal follow-ups. Conclusions: Despite showing the satisfactory feasibility of the program, no significant improvements were found in all study outcomes. Considering the participants’ comments, we suggest refining and further testing the intervention with a larger sample size over a longer-term follow-up to confirm its effectiveness. This study has been registered at ClinicalTrials.gov (NCT04741425)