A randomized controlled trail of knowledge sharing practice with empowerment strategies in pregnant women to improve exclusive breastfeeding during the first six months after delivery

Abstract

This study aimed to investigate whether a knowledge sharing practices with empowerment strategies (KSPES) program on antenatal education and postnatal support strategies improves the rate of exclusive breastfeeding during the first six months after delivery compared with a standard knowledge of breastfeeding techniques. The study using a randomized controlled trial was conducted. Pregnant women of more than 32 weeks’ gestation were randomly assigned to receive a routine standard knowledge of breastfeeding techniques with KSPES on antenatal education and postnatal support strategies (study group) or to receive only a routine standard knowledge of breastfeeding techniques (control group) with 40 pregnant women in each group. Intra-group comparison of continuous variables was carried out using paired t-test and unpaired t-test for inter-group comparison. Compare the duration and rates of exclusive breastfeeding practices between the control group and the study group, by running the test on various groups, and calculated by Chi-square test. The relationship of factors that were associated with exclusive breast feeding was determined using the multivariate logistic regression analysis. The primary outcome was the rate of exclusive breastfeeding at 6 months after delivery. The secondary outcomes were the rates of exclusive breastfeeding at 7days, 14 days, 1, 2, 3, 4 and 5 months after delivery. The result showed that the rates of exclusive breastfeeding in the study group were significantly higher when compared with those in the control group at 14 days (82.5% vs 52.6%, P=0.005), 1 month (77.5% vs 52.6%, P=0.021), 2 months (62.5% vs 36.8%, P=0.023), 4 months (35.0% vs 7.9%, P=0.008), 5 months (25.0% vs 2.6%, P=0.012) and 6 months after delivery (20.0% vs 0%, P=0.005). And the mean scores of knowledge about breastfeeding, attitude toward breastfeeding and self-efficacy for self-management toward breastfeeding after intervention were higher than those before intervention in the study group (P<0.001). Also those of them after intervention in the study group were higher than those in the control group (P<0.001).The factors that effect on exclusive breast feeding were infants’ birth weight, attitude toward breastfeeding and mode of delivery. Increasing the infants’ birth weight and increasing the attitude toward breastfeeding were positively effect on exclusive breastfeeding while cesarean section was negatively effect on exclusive breast feeding. Conclusion: KSPES on antenatal education and postnatal support strategies significantly improves the rates of exclusive breastfeeding during the first six months after delivery with statistical significant at .05