Effects of a theory-based breastfeeding promotion intervention on exclusive breastfeeding in China

Abstract

The benefits of exclusive breastfeeding (EBF) are well known; EBF is recommended for the first six months of an infant's life. However, EBF rates remain low and unsatisfactory in China. This study aimed to investigate the effectiveness of a breastfeeding promotion intervention based on the theory of planned behavior (TPB) to promote long-term exclusive breastfeeding rates among first-time Chinese mothers. A longitudinal, randomized, controlled trial was conducted at Shanghai First Maternity and Infant Hospital in Shanghai, China. The participants were 285 first-time Chinese mothers. The intervention group (n=157) was offered a specially designed nursing intervention program based on TPB, whereas the control group (n=128) received routine nursing care. Data of exclusive breastfeeding practices were collected at 3 days, 6 weeks, and 4 and 6 months postpartum. Data pertaining to breastfeeding mediating factors were collected three times at the first day after birth, 3 days, and 6 weeks postpartum. A Chi-square test and repeated measures ANOVA were used for the data analysis. The results showed that the intervention group had significantly higher scores than the control group in breastfeeding knowledge, attitude, subjective norm, and perceived control (at least p < 0.01). The rates of exclusive breastfeeding at the different time points of the intervention group (40.1%, 57.3%, 56.7%, and 42.0%) were consistently and significantly higher than those of the control group (10.9%, 29.7%, 15.6%, and 10.2%) (at least p < 0.01). It could be concluded that this theory-based breastfeeding promotion intervention was effective for improving long-term exclusive breastfeeding rates in China.