Measuring the Effectiveness of a Midwife-led Education Programme in Terms of Breastfeeding Knowledge and Self-efficacy, Attitudes Towards Breastfeeding, and Perceived Barriers of Breastfeeding Among Pregnant Women

INTRODUCTION: Exclusive breastfeeding is the optimal mode of feeding for the first six months of a child’s life. Modifiable factors associated with increased breastfeeding, may be addressed through antenatal breastfeeding education. In Greece, the rates of exclusive breastfeeding remain rather low. AIM: The aim of the current study was to evaluate the effectiveness of a structured in-hospital midwife-led antenatal breastfeeding educational programme on breastfeeding knowledge and self-efficacy, attitudes towards breastfeeding and perceived-barriers of breastfeeding. PATIENTS AND METHODS: This was a quasi-experimental study with two study groups: an intervention group (following a four-hour midwife-led antenatal breastfeeding programme) and a control group. All nulliparous women attending antenatal care at the tertiary hospital in Athens, Greece during May 2016–January 2017 were invited to participate, of which 203 nulliparous pregnant women took part. Demographic data forms, the Breastfeeding Self-efficacy Scale, the Iowa Infant Feeding Attitude Scale, the Breast Feeding Knowledge Questionnaire and the Perceived Breast Feeding Barriers Questionnaire were used for data collection. RESULTS: Post-intervention, women in the intervention group had a more positive attitude towards breastfeeding (73.5% versus 66.1%, p<0.001), greater knowledge (14.6% versus 13.1%, p<0.001) and more breastfeeding self-efficacy (51.4% versus 45.6%, p<0.001) compared to the control group. Furthermore, they had significantly less perceived barriers regarding breastfeeding (27.4% versus 31.0%, p<0.001). CONCLUSION: The four-hour antenatal breastfeeding education intervention which occurred and was evaluated for the first time in the Greek female population was effective in increasing breastfeeding knowledge, self-efficacy and a positive attitude towards breastfeeding. The intervention was furthermore effective in lowering perceived breastfeeding barriers. This midwife-led antenatal breastfeeding education programme could be suitable for integration to routine antenatal care in health care services in Greece.