Evaluation of the Effect of Video-Based Breastfeeding Education Provided to Mothers Who Delivered by Cesarean Section and Vaginal Birth on Infant Feeding Attitudes (ViBE-IFA)

The purpose of this randomized controlled study is to evaluate the effect of video-based breastfeeding education on infant feeding attitudes among primiparous mothers who delivered by cesarean section or vaginal birth. Breastfeeding education may improve mothers' knowledge and attitudes, thereby supporting optimal infant feeding practices.

The main questions this study aims to answer are:

Does video-based breastfeeding education improve infant feeding attitudes among primiparous mothers who deliver by vaginal birth? Does video-based breastfeeding education improve infant feeding attitudes among primiparous mothers who deliver by cesarean section? Is there a difference in infant feeding attitudes between mothers who receive video-based breastfeeding education and those who receive routine postpartum care? Does the effect of video-based breastfeeding education differ between mothers who deliver by cesarean section and those who deliver by vaginal birth?

Participants were randomly assigned to one of three groups: a cesarean section intervention group, a vaginal birth intervention group, or a control group. Mothers in the intervention groups received video-based breastfeeding education through a QR code in addition to routine postpartum care, while the control group received routine postpartum care only. Infant feeding attitudes were assessed at baseline and again three months after delivery using the Turkish version of the Iowa Infant Feeding Attitude Scale (IIFAS).

Study Overview

• Status: Completed
• Conditions: Video-Based Breastfeeding Education, Infant Feeding Attitudes
• Intervention / Treatment: Behavioral: Video-Based Breastfeeding Education

Detailed Description

Breastfeeding is the recommended method of infant feeding because it provides substantial health benefits for both infants and mothers. However, many primiparous mothers experience difficulties initiating and maintaining breastfeeding, particularly after cesarean section. Digital educational interventions, such as video-based breastfeeding education, may improve maternal knowledge and infant feeding attitudes by providing standardized and accessible educational content.

This randomized controlled experimental study was conducted to evaluate the effect of video-based breastfeeding education on infant feeding attitudes among primiparous mothers who delivered by cesarean section or vaginal birth. The study used a pretest-posttest design with a three-month follow-up and was conducted at Zonguldak Women and Children's Hospital in Türkiye between April 15, 2025, and October 30, 2025.

The target sample size was determined using G*Power version 3.1.9.7. A minimum of 84 participants was required to achieve 80% statistical power with a significance level of 0.05. To compensate for possible loss to follow-up, the target sample size was increased to 90 participants. A total of 111 mothers were initially enrolled, and the study was completed with 90 participants after follow-up.

Participants were randomly assigned to one of three groups: a vaginal birth intervention group, a cesarean section intervention group, or a control group. Mothers in the intervention groups completed baseline assessments and then received standardized video-based breastfeeding education through a QR code that provided access to an educational video. The control group received routine postpartum care without the educational intervention.

Data were collected using a Sociodemographic Information Form and the Turkish version of the Iowa Infant Feeding Attitude Scale (IIFAS). The educational video was developed based on current breastfeeding guidelines and expert review. Its quality was evaluated using the DISCERN instrument before implementation, and a pilot test was conducted to assess comprehensibility before use in the main study.

Infant feeding attitudes were assessed at baseline and again three months after delivery. Follow-up data were collected electronically using Google Forms distributed through WhatsApp, with telephone reminders provided when necessary to maximize participant retention.

The primary objective of the study was to determine whether video-based breastfeeding education improves infant feeding attitudes among primiparous mothers and whether its effectiveness differs between mothers who delivered by cesarean section and those who delivered by vaginal birth.

• Study Type: Interventional
• Enrollment (Actual): 90
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Zonguldak Province
    • Zonguldak, Zonguldak Province, Turkey (Türkiye), 67100
      • Zonguldak Kadın Doğum ve Çocuk Hastalıkları Hastanesi

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

-Primiparous mothers (first childbirth). Mothers who delivered by cesarean section or vaginal birth. Currently breastfeeding their infant. No previous breastfeeding education or counseling. Able to communicate in Turkish.

Exclusion Criteria:

• Multiparous mothers. Mothers who were not breastfeeding. Mothers who had previously received breastfeeding education or counseling. Mothers who were unable to communicate in Turkish.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Cesarean Section Intervention Group; All mothers in the intervention groups were initially administered the "Sociodemographic Data Form" and the "Baby Feeding Attitude Scale (BBTÖ)" (pre-test). Subsequently, the mothers received video-based breastfeeding education prepared by the researcher, which was accessible on YouTube via a QR code. Immediately following the education, the BBTÖ (post-test) was re-administered to the same mothers. At the end of the three-month follow-up period, a personalized Google Forms link containing the BBTÖ was sent to each mother via WhatsApp, accompanied by a brief informational message. When necessary, the researcher contacted the mothers by phone, introduced themselves, and provided reminders and information.	Behavioral: Video-Based Breastfeeding Education; The intervention consisted of a standardized video-based breastfeeding education program developed by the researcher based on current evidence and international breastfeeding guidelines. The educational content was reviewed by experts using the Written Materials Suitability Assessment Form and subsequently converted into a two-dimensional animated educational video with technical support from a graphic designer and a software developer. The quality and reliability of the video were evaluated using the DISCERN instrument, and its comprehensibility was assessed in a pilot study involving five mothers before implementation. The final educational video was approximately 9 minutes in duration and was delivered to participants through a QR code linking to a YouTube video. Mothers in the intervention groups viewed the video in addition to receiving routine postpartum care.
Experimental: Vaginal Birth Intervention Group; All mothers in the intervention groups were initially administered the "Sociodemographic Data Form" and the "Baby Feeding Attitude Scale (BBTÖ)" (pre-test). Subsequently, the mothers received video-based breastfeeding education prepared by the researcher, which was accessible on YouTube via a QR code. Immediately following the education, the BBTÖ (post-test) was re-administered to the same mothers. At the end of the three-month follow-up period, a personalized Google Forms link containing the BBTÖ was sent to each mother via WhatsApp, accompanied by a brief informational message. When necessary, the researcher contacted the mothers by phone, introduced themselves, and provided reminders and information.	Behavioral: Video-Based Breastfeeding Education; The intervention consisted of a standardized video-based breastfeeding education program developed by the researcher based on current evidence and international breastfeeding guidelines. The educational content was reviewed by experts using the Written Materials Suitability Assessment Form and subsequently converted into a two-dimensional animated educational video with technical support from a graphic designer and a software developer. The quality and reliability of the video were evaluated using the DISCERN instrument, and its comprehensibility was assessed in a pilot study involving five mothers before implementation. The final educational video was approximately 9 minutes in duration and was delivered to participants through a QR code linking to a YouTube video. Mothers in the intervention groups viewed the video in addition to receiving routine postpartum care.
No Intervention: Control Group(Vaginal Birth +Cesarean Section); All mothers in the control group who gave birth vaginally or via cesarean section and agreed to participate in the study were included. These mothers were administered the "Sociodemographic Data Form" and the "Baby Feeding Attitude Scale (BBTÖ)" (pre-test). No educational intervention was provided to the control group, and the mothers were informed that a follow-up would be conducted via WhatsApp after three months. Data security was ensured by assigning a unique identification number to each mother. At the end of the three-month follow-up period, follow-up data were collected from each mother in the control group by sending a personalized Google Forms link containing the BBTÖ via WhatsApp, accompanied by a brief informational message. When necessary, the researcher contacted the mothers by phone, introduced themselves, and provided information.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Infant Feeding Attitudes	Infant feeding attitudes were assessed using the Turkish version of the Iowa Infant Feeding Attitude Scale (IIFAS). The scale was used to evaluate the effect of video-based breastfeeding education on maternal infant feeding attitudes. Higher scores indicate more positive attitudes toward breastfeeding.	3 months after delivery
Infant Feeding Attitudes	Infant feeding attitudes were assessed using the Turkish version of the Iowa Infant Feeding Attitude Scale (IIFAS). The scale was used to evaluate the effect of video-based breastfeeding education on maternal infant feeding attitudes. Higher scores indicate more positive attitudes toward breastfeeding.	Baseline and 3 months after delivery

Collaborators and Investigators

• Sponsor: Zonguldak Bulent Ecevit University

Study record dates

Study Major Dates

• Study Start (Actual): April 1, 2025
• Primary Completion (Actual): October 25, 2025
• Study Completion (Actual): July 7, 2026

Study Registration Dates

• First Submitted: July 22, 2026
• First Submitted That Met QC Criteria: July 22, 2026
• First Posted (Actual): July 27, 2026

Study Record Updates

• Last Update Posted (Actual): July 27, 2026
• Last Update Submitted That Met QC Criteria: July 22, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Keywords: Infant feeding attitudes, breastfeeding, vaginal birth, cesarean section, video-based education.
• Additional Relevant MeSH Terms: Behavior; Feeding Behavior; Breast Feeding
• Other Study ID Numbers: 569181; 26.02.2025/569181 (Other Identifier: Zonguldak Bulent Ecevit University)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data will not be shared because the informed consent obtained from participants did not include permission for public data sharing, and sharing individual-level data could compromise participant confidentiality and privacy.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No