Effects of a Self-Efficacy-Based Breastfeeding Support Program (SBP) on Primipara’s Breastfeeding and Postnatal Depression
Abstract
Background: We aimed to verify effects of a self-efficacy-based breastfeeding support program (SBP) through a 1:1 face-to-face education and non-face-to-face education via phone counselling on breastfeeding and postnatal depression in primiparous women.
Methods: This is a nonequivalent control group pre-posttest design study and primiparous women who gave birth at a tertiary general hospital in South Korea from May to Oct 2022 participated. Participants in the experimental group were provided with SBP (6 educational sessions) by the researcher for 4 wk after birth. Pre and post-test measures included breastfeeding knowledge, breastfeeding self-efficacy, adaption, breastfeeding rate, and postnatal depression.
Results: The participants were 48, with 26 in the SBP experimental group and 22 in the control group. Breastfeeding knowledge, breastfeeding self-efficacy, and adaption scores level of increase were significantly higher in the experimental group than in the control group (P<.001, P=.010, and P=.012). Breastfeeding rate was significantly higher in the experimental group than in the control group (P=.011). The score of postnatal depression was significantly lower in the experimental group than in the control group (P=.032).
Conclusion: The SBP was validated as a program that could promote the continuation of self-directed breastfeeding even after discharge by primiparous women experiencing breastfeeding for the first time and ultimately improve the health of both mother and infant, thereby providing evidence for effective breastfeeding intervention strategies for nursing in practice.
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7. Kim SH (2009). Development of a Breast Feeding Adaptation Scale (BFAS). J Kore-an Acad Nurs, 39(2):259-69.
8. Brockway M, Benzies K, Hayden KA (2017). Interventions to improve breastfeeding self-efficacy and resultant breastfeeding rates: A systematic review and meta-analysis. J Hum Lact, 33(3):486-99.
9. Zhang Z, Zhu Y, Zhang L, et al (2018). What factors influence exclusive breast-feeding based on the theory of planned behaviour. Midwifery, 62:177-82.
10. Bandura A (1977). Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev, 84(2):191-215.
11. Ngo LTH, Chou HF, Gau ML., et al (2019). Breastfeeding self-efficacy and related factors in postpartum Vietnamese wom-en. Midwifery, 70:84-91.
12. Haga SM, Ulleberg P, Slinning K, et al (2012). A longitudinal study of postpar-tum depressive symptoms: multilevel growth curve analyses of emotion regu-lation strategies, breastfeeding self-efficacy, and social support. Arch Womens Ment Health, 15(3):175-84.
13. Yun SE, Lee HK (2012). Effects of breast-feeding adaptation, attitude and practice of primipara depending on method of postpartum breast-feeding education. Korean J Women Health Nurs, 18(2):75-84.
14. Farias-Antunez S, Santos IS, Matijasevich A, et al (2020). Maternal mood symptoms in pregnancy and postpartum depres-sion: association with exclusive breast-feeding in a population-based birth co-hort. Soc Psychiatry Psychiatr Epidemiol, 55(5):635-43.
15. Lewis NL (2020). Developing a hospital-based postpartum depression education intervention for perinatal nurses. J Nurs-es Prof Dev, 36(1):7-11.
16. Gay CL, Lee KA, Lee SY (2004). Sleep pat-terns and fatigue in new mothers and fa-thers. Biol Res Nurs, 5(4):311-18.
17. Lewkowitz AK, Lopez JD, Werner EF, et al (2021). Effect of a novel smartphone application on breastfeeding rates among low-income, first-time mothers intending to exclusively breastfeed: sec-ondary analysis of a randomized con-trolled trial. Breastfeed Med, 16(1):59-67.
18. Caetano R, Silva AB, Guedes A, et al (2020). Challenges and opportunities for tele-health during the COVID-19 pandemic: ideas on spaces and initiatives in the Brazilian context. Cad Saude Publica, 36(5):e00088920.
19. Dodou HD, Bezerra RA, Chaves AFL, et al (2021). Telephone intervention to pro-mote maternal breastfeeding self-efficacy: randomized clinical trial. Rev Esc Enferm USP, 55:e20200520.
20. Otsuka K, Dennis CL, Tatsuoka H, et al (2008). The relationship between breast-feeding self-efficacy and perceived in-sufficient milk among Japanese moth-ers. J Obstet Gynecol Neonatal Nurs, 37(5):546-55.
21. Lee EJ. The effect of prenatal breastfeed-ing education on breastfeeding practice and retension of knowlege [Master’s Degree]. Daegu: Department of Nurs-ing, Graduate School, Keimyung Uni-versity; 1997
22. Kim SH. Effects of prenatal breastfeeding education intervention on breastfeeding knowledge and practice in primiparous women [Master thesis]. Graduate School of Nursing Sciences, Hallym University, Korea; 2020.
23. Kim SY. The effects of prenatal breast self-massage education on breastfeeding self-efficacy, adaptation, and practice in primiparous women [Master thesis]. Seoul. Graduate School of Nursing, Yonsei University; Korea; 2017.
24. Dennis CL (2003). The breastfeeding self-efficacy scale: Psychometric assessment of the short form. J Obstet Gynecol Neona-tal Nurs, 32(6):734-44.
25. Kim SH (2020). [Breastfeeding Adaptation Scale-Short Form for mothers at 2 weeks postpartum: construct validity, reliability, and measurement invariance]. Korean J Women Health Nurs, 26(4):326-35. [Article in Korean]
26. Helsing E (1985). Infant feeding and infec-tious illness. Report of the World Health Organization Copenhagen, Denmark. https://iris.who.int/bitstream/handle/10665/272658/9789289013543-eng.pdf
27. Cox JL, Holden JM, Sagovsky R (1987). De-tection of postnatal depression. Devel-opment of the 10-item Edinburgh Post-natal Depression Scale. Br J Psychiatry, 150:782-6.
28. Han KW, Kim MJ, Park JM (2004). The Ed-inburgh Postnatal Depression Scale, Ko-rean Version: reliability and validity. J Korean Soc Biol Ther Psychiatry, 10(2):201-7.
29. Koskinen KS., Aho AL, Hannula L, et al (2014). Maternity hospital practices and breast feeding self-efficacy in Finnish primiparous and multiparous women during the immediate postpartum peri-od. Midwifery, 30(4): 464-70.
30. Song SM, Park MK (2016). Effects of breastfeeding empowerment program on breastfeeding self-efficacy, adapta-tion and continuation in primiparous women. J Korean Acad Nurs, 46(3):409-19.
31. Lee BH, Bang KS (2020). A self-efficacy promotion program for the continua-tion of breastfeeding for mothers of premature infants. Perspectives in Nursing Science, 17(2):90-8.
32. Akter S, Tasnim S, Bhuiyan MMA, et al (2015). A study on post partum breast problems of mothers attending at lacta-tion management center (LMC). Bangla-desh Med J, 44(3):136-9.
33. Korean Statistical Information Service (2020). Survey on postpartum care, Min-istry of health and welfare, Korea. https://kosis.kr/statHtml/statHtml.do?orgId=117&tblId=DT_117101_2020A043&conn_path=I2
34. Xia M, Luo J, Wang J, et al (2022). Associa-tion between breastfeeding and postpar-tum depression: A meta-analysis. J Affect Disord, 308:512-9.
35. Avilla JCd, Giugliani C, Bizon AMBL, et al (2020). Association between maternal satisfaction with breastfeeding and postpartum depression symptoms. Plos One, 15(11):e0242333.
2. Maaike A, Vrinda M, Guy T, et al (2018). Breastfeeding: a mother’s gift, for every child. The UNICEF, USA. www.unicef.org/media/48046/file/UNICEF_Breastfeeding_A_Mothers_Gift_for_Every_Child.pdf.
3. Lee SY, Kim EJ, Park JS, et al. (2018). The 2018 national survey on fertility and family health and welfare. Korea Insti-tute for Health and Social Affairs, South Korea. http://repository.kihasa.re.kr/handle/201002/32628?mode=full
4. Kim SH (2010). Factors affecting mother’s adaptation to breastfeeding. J Korean Acad Nurs, 40(2):225-35.
5. Yang HJ, Seo JM (2013). A structural model for primiparas' breastfeeding behavior. J Korean Acad Nurs, 43(3):399-408.
6. Lindblad V, Melgaard D, Jensen KL, et al (2022). Primiparous women differ from multiparous women after early dis-charge regarding breastfeeding, anxiety, and insecurity: A prospective cohort study. Eur J Midwifery, 6:12.
7. Kim SH (2009). Development of a Breast Feeding Adaptation Scale (BFAS). J Kore-an Acad Nurs, 39(2):259-69.
8. Brockway M, Benzies K, Hayden KA (2017). Interventions to improve breastfeeding self-efficacy and resultant breastfeeding rates: A systematic review and meta-analysis. J Hum Lact, 33(3):486-99.
9. Zhang Z, Zhu Y, Zhang L, et al (2018). What factors influence exclusive breast-feeding based on the theory of planned behaviour. Midwifery, 62:177-82.
10. Bandura A (1977). Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev, 84(2):191-215.
11. Ngo LTH, Chou HF, Gau ML., et al (2019). Breastfeeding self-efficacy and related factors in postpartum Vietnamese wom-en. Midwifery, 70:84-91.
12. Haga SM, Ulleberg P, Slinning K, et al (2012). A longitudinal study of postpar-tum depressive symptoms: multilevel growth curve analyses of emotion regu-lation strategies, breastfeeding self-efficacy, and social support. Arch Womens Ment Health, 15(3):175-84.
13. Yun SE, Lee HK (2012). Effects of breast-feeding adaptation, attitude and practice of primipara depending on method of postpartum breast-feeding education. Korean J Women Health Nurs, 18(2):75-84.
14. Farias-Antunez S, Santos IS, Matijasevich A, et al (2020). Maternal mood symptoms in pregnancy and postpartum depres-sion: association with exclusive breast-feeding in a population-based birth co-hort. Soc Psychiatry Psychiatr Epidemiol, 55(5):635-43.
15. Lewis NL (2020). Developing a hospital-based postpartum depression education intervention for perinatal nurses. J Nurs-es Prof Dev, 36(1):7-11.
16. Gay CL, Lee KA, Lee SY (2004). Sleep pat-terns and fatigue in new mothers and fa-thers. Biol Res Nurs, 5(4):311-18.
17. Lewkowitz AK, Lopez JD, Werner EF, et al (2021). Effect of a novel smartphone application on breastfeeding rates among low-income, first-time mothers intending to exclusively breastfeed: sec-ondary analysis of a randomized con-trolled trial. Breastfeed Med, 16(1):59-67.
18. Caetano R, Silva AB, Guedes A, et al (2020). Challenges and opportunities for tele-health during the COVID-19 pandemic: ideas on spaces and initiatives in the Brazilian context. Cad Saude Publica, 36(5):e00088920.
19. Dodou HD, Bezerra RA, Chaves AFL, et al (2021). Telephone intervention to pro-mote maternal breastfeeding self-efficacy: randomized clinical trial. Rev Esc Enferm USP, 55:e20200520.
20. Otsuka K, Dennis CL, Tatsuoka H, et al (2008). The relationship between breast-feeding self-efficacy and perceived in-sufficient milk among Japanese moth-ers. J Obstet Gynecol Neonatal Nurs, 37(5):546-55.
21. Lee EJ. The effect of prenatal breastfeed-ing education on breastfeeding practice and retension of knowlege [Master’s Degree]. Daegu: Department of Nurs-ing, Graduate School, Keimyung Uni-versity; 1997
22. Kim SH. Effects of prenatal breastfeeding education intervention on breastfeeding knowledge and practice in primiparous women [Master thesis]. Graduate School of Nursing Sciences, Hallym University, Korea; 2020.
23. Kim SY. The effects of prenatal breast self-massage education on breastfeeding self-efficacy, adaptation, and practice in primiparous women [Master thesis]. Seoul. Graduate School of Nursing, Yonsei University; Korea; 2017.
24. Dennis CL (2003). The breastfeeding self-efficacy scale: Psychometric assessment of the short form. J Obstet Gynecol Neona-tal Nurs, 32(6):734-44.
25. Kim SH (2020). [Breastfeeding Adaptation Scale-Short Form for mothers at 2 weeks postpartum: construct validity, reliability, and measurement invariance]. Korean J Women Health Nurs, 26(4):326-35. [Article in Korean]
26. Helsing E (1985). Infant feeding and infec-tious illness. Report of the World Health Organization Copenhagen, Denmark. https://iris.who.int/bitstream/handle/10665/272658/9789289013543-eng.pdf
27. Cox JL, Holden JM, Sagovsky R (1987). De-tection of postnatal depression. Devel-opment of the 10-item Edinburgh Post-natal Depression Scale. Br J Psychiatry, 150:782-6.
28. Han KW, Kim MJ, Park JM (2004). The Ed-inburgh Postnatal Depression Scale, Ko-rean Version: reliability and validity. J Korean Soc Biol Ther Psychiatry, 10(2):201-7.
29. Koskinen KS., Aho AL, Hannula L, et al (2014). Maternity hospital practices and breast feeding self-efficacy in Finnish primiparous and multiparous women during the immediate postpartum peri-od. Midwifery, 30(4): 464-70.
30. Song SM, Park MK (2016). Effects of breastfeeding empowerment program on breastfeeding self-efficacy, adapta-tion and continuation in primiparous women. J Korean Acad Nurs, 46(3):409-19.
31. Lee BH, Bang KS (2020). A self-efficacy promotion program for the continua-tion of breastfeeding for mothers of premature infants. Perspectives in Nursing Science, 17(2):90-8.
32. Akter S, Tasnim S, Bhuiyan MMA, et al (2015). A study on post partum breast problems of mothers attending at lacta-tion management center (LMC). Bangla-desh Med J, 44(3):136-9.
33. Korean Statistical Information Service (2020). Survey on postpartum care, Min-istry of health and welfare, Korea. https://kosis.kr/statHtml/statHtml.do?orgId=117&tblId=DT_117101_2020A043&conn_path=I2
34. Xia M, Luo J, Wang J, et al (2022). Associa-tion between breastfeeding and postpar-tum depression: A meta-analysis. J Affect Disord, 308:512-9.
35. Avilla JCd, Giugliani C, Bizon AMBL, et al (2020). Association between maternal satisfaction with breastfeeding and postpartum depression symptoms. Plos One, 15(11):e0242333.
| Files | ||
| Issue | Vol 54 No 4 (2025) | |
| Section | Original Article(s) | |
| Keywords | ||
| Breast feeding Self efficacy Postpartum depression Primiparity | ||
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How to Cite
1.
Oh H-E, Kim H-J. Effects of a Self-Efficacy-Based Breastfeeding Support Program (SBP) on Primipara’s Breastfeeding and Postnatal Depression. Iran J Public Health. 2025;54(4):839-849.
