Breastfeeding improves the survival, health and growth of all children and helps develop human capital [1]. The World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) recommend breastfeeding for all infants from birth to six months, and support and continue breastfeeding by supplementation until infancy is two years old. [2]. Despite the obvious benefits and numerous public health activities to promote breastfeeding, the rate of exclusive breastfeeding is low. According to UNICEF, the global average of exclusive feeding in infants under six months is 41% [3]. Among the effective factors on increasing breastfeeding are the mother's knowledge, support systems, social and economic status and self-efficacy of the mother in breastfeeding [7, 8]. According to Bandura’s theory, with appropriate educational interventions, mothers' self-efficacy and ability to breastfeed can be increased [11]. The present study was conducted to investigate the effect of breastfeeding counseling on the self-efficacy of lactating mothers.


 

This study was conducted as a two-group clinical trial on 60 pregnant women referred to Malayer women's hospitals.
This number of samples was calculated by the following formula:


Pregnant women were selected by available sampling method. Sampling was performed in two groups by block random method and the size of the blocks was considered as a multiple of the number of groups. Data collection tools included a demographic and midwifery characteristics questionnaire and a Fox and Dennis breastfeeding self-efficacy questionnaire. The intervention was carried out in accordance with GATHER's advisory principles. Maternal breastfeeding self-efficacy was assessed before intervention and one month after delivery in both groups.
To analyze the data SPSS statistical software version 23 (SPSS Inc., Chicago, Ill., USA), was used as well as descriptive statistics such as frequency table, mean and standard deviation and inferential statistics such as Chi-square, independent t-test, paired t-test and Fisher's exact test. The level of significance was considered 5%.

The results showed that breastfeeding self-efficacy of mothers before the intervention in both test and control groups was moderate to poor, but after the intervention, a significant increase in breastfeeding self-efficacy was observed in the test group. It seems that the poor awareness of mothers at the beginning of the study is due to the lack of adequate and necessary training. Providing regular and planned education in the present study increased the level of mothers' self-efficacy towards breastfeeding. The results of a study by O'Campo et al., which was performed on 198 pregnant women, showed that breastfeeding self-efficacy is one of the most important and influential variables in the duration of breastfeeding that predicts its duration. Findings of their study showed that women with poor self-efficacy were 3.1 times more likely to stop breastfeeding [23].
Studies on breastfeeding self-efficacy in Iran are limited and few reports have been published in this field. The study of Parsa et al. showed the effect of educational intervention on increasing self-efficacy and continuity of breastfeeding, which is consistent with the findings of the present study [24]. The results of the study of Varaei et al. showed that breastfeeding self-efficacy was significantly associated with breastfeeding status [25]. In a study by McQueen et al. studies by Moafi et al. and Glassman et al. also showed the effect of educational intervention on increasing breastfeeding self-efficacy, which is consistent with the findings of the present study [28, 27]. The study of Saba et al. showed that face-to-face training is effective in increasing mothers' awareness and their performance in breastfeeding their children [29]. Also, in the study of Mete et al. breastfeeding self-efficacy should be considered as an important and effective factor in increasing the duration and level of breastfeeding and a criterion for assessing mothers at risk of early breastfeeding.
Holding educational classes can increase awareness and change the attitude of learners, which is consistent with the present study [32, 31]. Therefore, it is necessary for health care workers to teach mothers the correct information and training related to breastfeeding in breastfeeding promotion classes. It is recommended that educational programs for mothers begin in late pregnancy and continue for at least 6 months after the baby is born. One of the limitations of conducting research is the short time of the study and the loss of samples.

 

The results of the study showed that providing counseling has been very effective in increasing the self-efficacy of breastfeeding mothers and their performance.

 

The authors of this article express their gratitude to the Vice Chancellor for Research of Hamadan University of Medical Sciences, the staff of Dr. Gharazi and Mehr Malayer hospitals, and the mothers who participated in the study, who facilitated the research with their cooperation. This article is taken from the Master’s thesis of Counseling and Midwifery of the School of Nursing and Midwifery of Hamadan University of Medical Sciences with the code of ethics IR.UMSHA.REC.1397.483.

 

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.