The Effect of Breastfeeding Counseling on Social Support Perception, Breastfeeding Self-Efficacy and Outcomes

March 19, 2025 updated by: Hümeyra TÜLEK DENİZ, Ondokuz Mayıs University

The Effect of the Theory-Based Breastfeeding Self-Efficacy Resources Developing Nurse Consultancy Program on Social Support Perception, Breastfeeding Self-Efficacy and Outcomes

The purpose of this study is to examine the effects of the Breastfeeding Self-Efficacy Resources Development Nurse Consultancy Program (EMÖZGEDAP), based on Dennis's Breastfeeding Self-Efficacy Theory along with the hypno-breastfeeding philosophy given to mothers and family relatives, on social support perception, breastfeeding self-efficacy and outcomes. The study will involve pregnant women and close others assigned randomly to the intervention (n=50) or control (n=50) groups in a state hospital in Turkey. Individual counseling will be provided to the intervention group within the scope of the EMÖZGEDAP, based on Denis's Breastfeeding Self-Efficacy theory and hypnobreastfeeding philosophy. EMÖZGEDAP, which will be applied to pregnant women and their family relatives, will consist of 5 sessions lasting 7.5 hours (2 sessions with the woman and her family relatives, two sessions with the woman alone, and one with her family relatives alone). The Antenatal Breastfeeding Self-Efficacy Scale will be evaluated before the counseling program is given in the antepartum period. Breastfeeding and Nutrition Results, Postpartum Breastfeeding Self-Efficacy Scale, Breastfeeding Self-Efficacy Scale for Fathers, Assessment Scale for Perceived Support of Close Others in Relation to Breastfeeding Self-Efficacy and Scale of Perception of Close Others' Support For Breastfeeding Self-Efficacy will be evaluated at the 1st, 3rd, and 6th months postpartum.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

The World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) recommend that babies start breastfeeding within the first hour after birth and be exclusively breastfed for the first six months. In this situation, the baby is not given any other food or liquid, including water, defined as "full breastfeeding." Breastfeeding schemes were developed by Labbok and Krosovec in 1990 to ensure consistency in research. According to this scheme, breastfeeding methods are divided into full, partial, and symbolic, according to the baby's nutritional characteristics. According to the Turkey Demographic and Health Survey (TNSA, 2018) data, 98% of children are breastfed at some point, and 42% receive food other than breast milk in the pre-lacteal (before breastfeeding) period. In Turkey, 71% of children under two are breastfed within the first hour after birth, and only 41% of babies under six months are exclusively breastfed.

Self-efficacy is an essential factor in breastfeeding at the desired level. Influenced by Bandura's definition of self-efficacy, Cindy-Lee Dennis developed the "Breastfeeding Self-Efficacy Theory" by identifying the sources and influencing factors of Breastfeeding Self-Efficacy Perception. According to Dennis and Faux, a mother's breastfeeding self-efficacy includes whether she breastfeeds her baby, how much time she spends caring for her baby, her thoughts about breastfeeding, and her ability to cope with emotional difficulties during breastfeeding. Mothers with high self-efficacy encourage themselves to face challenges and try to solve events by thinking positively. These mothers prefer breastfeeding more, are more courageous, and act ultimately when they experience difficulties. Mother's breastfeeding self-efficacy is affected by four primary sources of information: The mother's previous experiences regarding breastfeeding, the examples the mother sees from others regarding breastfeeding, the support of the environment regarding breastfeeding, and the mother's psychological state regarding breastfeeding. Healthcare personnel should influence these factors to improve self-efficacy. Maternal breastfeeding self-efficacy has been identified as an important modifiable factor for successful breastfeeding.

Various factors, such as breastfeeding self-efficacy and social support, affect the sustainability of breastfeeding. The studies stated that social and especially spousal support is adequate for successful breastfeeding and the mother's decision to breastfeed early at birth. According to some studies, those with more social support have higher breastfeeding self-efficacy rates. The studies emphasized that family support is an essential factor in encouraging breastfeeding. The failure of family members to provide adequate breastfeeding support and information to women resulted in the use of formula. It is stated that the older generation, especially the baby's grandmother or paternal grandmother, plays a central role in various aspects of pregnancy decision-making and child-rearing within the family structure. A study conducted among mothers-in-law in Nepal found that mothers-in-law "view themselves as key providers and decision makers of perinatal care practices." Therefore, the woman needs to receive support from her social circle through participation and encouragement during breastfeeding.

Hypnobreastfeeding is a relaxation technique that helps improve the breastfeeding process by holistically caring for the mind, body, and spirit of breastfeeding mothers. Hypnobreastfeeding produces positive feedback by making the mother more relaxed, calm, and comfortable during breastfeeding, that is, an increase in the release of oxytocin and prolactin by the pituitary. In the hypnobreastfeeding philosophy, affirmation, relaxation, imagination, and visualization positively affect the subconscious. When the positive affirmations provided by hypnobreastfeeding are placed in the subconscious, they automatically affect daily life and actions and increase mothers' self-confidence. Therefore, hypnobreastfeeding is suitable for creating positive intention and motivation in breastfeeding, reducing anxiety and stress, maximizing the amount and quality of breast milk, increasing mother-baby bonding, and accelerating the involution process.

Study Type

Interventional

Enrollment (Estimated)

100

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Turkey
    • Center
      • Kars, Center, Turkey, 36100
        • Recruiting
        • Kars Harakani State Hospital
        • Contact:
        • Contact:
          • Hümeyra TÜLEK DENİZ, Lecturer, MSc
        • Contact:
          • Özen KULAKAÇ, Professor, PhD

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Being 18 years or older,
  • 28-37. be between weeks,
  • Being primiparous,
  • Having a healthy singleton pregnancy,
  • Being at least a primary school graduate,
  • Living with his/her spouse,
  • There is a relative who will support the mother, whom she defines as a relative (spouse, the woman's mother, or mother-in-law), and this person also agrees to participate in the study,
  • There is no condition that prevents breastfeeding for the mother and the baby (medication use, history of any psychiatric or chronic disease, history of any disease in the baby such as cleft palate-lip, etc.),

Exclusion Criteria:

  • Not filling out the forms in the study or filling them incompletely,
  • The participant wishes to leave the research,
  • The emergence of a condition that prevents breastfeeding in the mother and baby,
  • Moving from the city where the work is done or moving out of the town,
  • Family support is for less than 1 month,

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
No Intervention: Control Group
The control group will not receive individual counseling; they will go through the hospital's routine monitoring and counseling process.
Experimental: Intervention Group
Individual counseling will be provided to the intervention group within the scope of the Breastfeeding Self-Efficacy Resources Developing Nurse Consultancy Program (EMÖZGEDAP), based on Denis's Breastfeeding Self-Efficacy theory and hypnobreastfeeding philosophy. EMÖZGEDAP, which will be applied to pregnant women and their family relatives, will consist of 5 sessions lasting 7.5 hours (2 sessions with the woman and her family relatives, two sessions with the woman alone, and one with her family relatives alone).
Behavioral: Nurse Consultancy Program to Develop Breastfeeding Self-Efficacy Resources
Breastfeeding Self-Efficacy Resources Developing Nurse Consultancy Program (EMÖZGEDAP) was developed based on Denis's Breastfeeding Self-Efficacy theory along with the hypnobreastfeeding philosophy. In the individual counseling program focusing on the philosophy of hypnobreastfeeding, it will be emphasized that breastfeeding is an intuitive, natural, and unique process. Techniques such as affirmations, breathing exercises, relaxation, endorphin, serotonin, and oxytocin-enhancing practices will be used. Concepts from Dennis' breastfeeding self-efficacy theory will be integrated into the training program. The individual counseling program will be carried out by adult education criteria, methods such as slide presentation, three-dimensional models, video, role-play, peer opinions with positive breastfeeding experiences, case discussion, and question and answer will be used.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Breastfeeding and Nutrition Results
Time Frame: This form will be evaluated at the 1st, 3rd, and 6th months postpartum.
This form was prepared based on Labbok & Krosovec's classification (Labbok & Krasovec, 1990). It enables the evaluation of the characteristics of the baby's breastfeeding or feeding as complete, partial, and symbolic breastfeeding.
This form will be evaluated at the 1st, 3rd, and 6th months postpartum.
Postpartum Breastfeeding Self-Efficacy Scale-Short Form
Time Frame: This form will be evaluated at the 1st, 3rd, and 6th months postpartum.
Dennis developed the Breastfeeding Self-Efficacy Scale. Aluş Tokat, Okumus, and Dennis (2010) started to study the Turkish reliability standard of the Short Form of the Breastfeeding Self-Efficacy Scale. It is used to evaluate how competent postpartum mothers feel about breastfeeding postpartum. The scale, consisting of 14 items, is assessed on a 5-point Likert type. There are no reverse-scored items in the scale. A minimum of 14 points and a maximum of 70 points are obtained from the scale. A high score on the scale means that breastfeeding self-efficacy is also high (Dennis and Faux, 1999).
This form will be evaluated at the 1st, 3rd, and 6th months postpartum.
Breastfeeding Self-Efficacy Scale for Fathers Short Form
Time Frame: This form will be evaluated at the 1st, 3rd, and 6th months postpartum.
It was developed by Dennis, Brennenstuhl, and Abbass-Dick (2018) to evaluate fathers' perspectives and impact on breastfeeding. Its Turkish validity and reliability were tested by Küçükoğlu, Kurt Sezer, and Dennis in 2019. The scale, which can be applied to all fathers with newborns and breastfed babies, is a 5-point scale with no reverse-scored items. The lowest score is 14, and the highest score is 70 from the one-dimensional 14-item scale, and as the score increases, self-efficacy increases.
This form will be evaluated at the 1st, 3rd, and 6th months postpartum.
Assessment Scale for Perceived Support of Close Others in Relation to Breastfeeding Self-Efficacy
Time Frame: This form will be evaluated at the 1st, 3rd, and 6th months postpartum.
This scale evaluates the mother's perception of support for breastfeeding self-efficacy provided by close others. The scale consisting of 14 items is a 4-point Likert type. Researchers and Dennis are developing it as part of her doctoral thesis.
This form will be evaluated at the 1st, 3rd, and 6th months postpartum.
Scale of Perception of Close Others' Support For Breastfeeding Self-Efficacy
Time Frame: This form will be evaluated at the 1st, 3rd, and 6th months postpartum.
This scale evaluates the close others 's perception of support for breastfeeding self-efficacy. The scale consisting of 14 items is a 4-point Likert type. Researchers and Dennis are developing it as part of her doctoral thesis.
This form will be evaluated at the 1st, 3rd, and 6th months postpartum.
Antenatal Breastfeeding Self-Efficacy Scale Short Form
Time Frame: This form will be administered to pregnant women at 28 weeks of gestation before the intervention.
The Breastfeeding Self-Efficacy Scale was developed by Dennis in 2003. Aluş Tokat, Okumus, and Dennis (2010) started to study the Turkish reliability standard of the Short Form of the Breastfeeding Self-Efficacy Scale. It is used to evaluate how competent pregnant women feel about breastfeeding. The scale, consisting of 14 items, is assessed on a 5-point Likert type. There are no reverse-scored items in the scale. A minimum of 14 points and a maximum of 70 points are obtained from the scale. A high score on the scale means that breastfeeding self-efficacy is also high (Dennis and Faux, 1999).
This form will be administered to pregnant women at 28 weeks of gestation before the intervention.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Ondokuz Mayıs University

Investigators

  • Study Director: Özen KULAKAÇ, Professor, Ondokuz Mayıs University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

July 15, 2024

Primary Completion (Estimated)

June 30, 2025

Study Completion (Estimated)

June 30, 2025

Study Registration Dates

First Submitted

February 11, 2024

First Submitted That Met QC Criteria

February 11, 2024

First Posted (Actual)

February 20, 2024

Study Record Updates

Last Update Posted (Actual)

March 25, 2025

Last Update Submitted That Met QC Criteria

March 19, 2025

Last Verified

December 1, 2024

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • OndokusMU55

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Study Data/Documents

  1. Article
    Information comments: Kilci Erciyas, Ş., Sevil, Ü. (2021). Laktasyonu Arttıran Yöntemler: Hipnoemzirme. Ege Üniversitesi Hemşirelik Fakültesi Dergisi, 37(3), 229-234.
  2. Article
    Information comments: Sofiyanti, I., Astuti, F. P., & Windayanti, H. (2019). Penerapan Hypnobreastfeeding pada Ibu Menyusui. Indonesian Journal of Midwifery (IJM), 2(2): 84-9.
  3. Article
    Information comments: Dini, P.R., Suwondo, A., Hardjanti, T.S., Hadisaputro, S. (2017). The effect of hypnobreastfeeding and oxytocin massage on breastmilk production in postpartum. Journal of Medical Science and Clinical Research, 5(10), 28600-4. doi:https://dx.doi.org/10.18535/jmscr/v5i10.19.
  4. Article
    Information comments: Sari, L., Salimo, H., Budihastuti, U.R. (2017). Optimizing the combination of oxytocin massage and hypnobreastfeeding for breast milk production among post-partum mothers. Journal of Maternal and Child Health, 1(1), 20-29.
  5. Article
    Information comments: Duman FN, Gölbaşı Z. Türkiye'de Emzirme Eğitiminin Annelerin Emzirme Öz-Yeterlilik Düzeyine Etkisinin İncelenmesi. TJFMPC. 2022;16(1):140-5.
  6. Article
    Information comments: Yalçınöz Baysal, H, Türkoğlu, N., & Küçükoğlu, S. Sağlıklı ve Hasta Bebeği Olan Annelerin Emzirme Öz-Yeterlilik Algılarının Karşılaştırılması. İzmir Dr. Behçet Uz Çocuk Hast. Dergisi, 2014; 4(1):31-36.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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