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Compassion-Based Breastfeeding Counseling and Its Effects on Self-Compassion, Mindful Breastfeeding, and Self-Efficacy (COMBFED)

28 april 2026 bijgewerkt door: Şengül Yaman Sözbir, Gazi University

The Effect of Compassion-Based Breastfeeding Counseling During the Perinatal Period on Self-Compassion, Mindful Breastfeeding, and Breastfeeding Self-Efficacy

This randomized controlled trial aims to evaluate the effects of compassion-based breastfeeding counseling on self-compassion, mindful breastfeeding, and breastfeeding self-efficacy during the perinatal period.

Pregnant women between 24-28 weeks of gestation who meet the eligibility criteria are enrolled. After obtaining informed consent, participants are randomly assigned to either the intervention or control group using simple randomization.

The intervention group receives a total of 6 face-to-face compassion-based breastfeeding counseling sessions between 30-37 weeks of gestation, with follow-up counseling continued until 6 weeks postpartum. The control group receives only routine antenatal care with no additional intervention.

Outcome measures are assessed at three time points: pretest (24-28 weeks of gestation), posttest (36-38 weeks of gestation), and follow-up (6 weeks postpartum). Instruments used include the Self-Compassion Scale, the Breastfeeding Self-Efficacy Scale-Short Form, and the Mindful Breastfeeding Scale.

The study is conducted at Iğdır Dr. Nevruz Erez State Hospital, Türkiye.

Studie Overzicht

Toestand

Voltooid

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

Breastfeeding is the most effective intervention for protecting infant and maternal health. Despite its well-documented benefits, breastfeeding continuation rates decline over time due to insufficient support, breastfeeding difficulties, and psychosocial challenges in the postpartum period. Mothers experiencing breastfeeding problems may develop feelings of shame, failure, and inadequacy, which can negatively affect breastfeeding self-efficacy and increase the risk of early weaning.

Self-compassion - defined as treating oneself with kindness, acceptance, and non-judgment in the face of difficulties - has been associated with reduced depressive symptoms, increased psychological flexibility, and stronger mother-infant bonding in the perinatal period. Compassion-based breastfeeding counseling differs from traditional breastfeeding education by integrating emotional support, empathy, and psychosocial care alongside technical knowledge, thereby addressing both the informational and emotional needs of mothers.

This single-center, randomized controlled trial with a pretest-posttest-follow-up design is planned to assess the effectiveness of structured compassion-based breastfeeding counseling. Participants are pregnant women at 24-28 weeks of gestation attending Iğdır Dr. Nevruz Erez State Hospital. Eligible participants are randomly assigned to intervention (n=27) or control (n=27) groups. Sample size was calculated based on a power analysis (G*Power 3.1; repeated measures ANOVA, within-between interaction; partial η²=0.06; α=0.05; power=0.95) with a 20% dropout buffer.

The intervention consists of 6 structured face-to-face compassion-based breastfeeding counseling sessions delivered between 30-37 weeks of gestation, followed by counseling and follow-up support up to 6 weeks postpartum. The control group receives standard antenatal care only.

Outcome measures:

Self-Compassion Scale (Öz-Anlayış Ölçeği; Neff, 2003; Turkish adaptation: Deniz et al., 2008) - 24 items, 5-point Likert scale Breastfeeding Self-Efficacy Scale - Short Form (Dennis & Faux, 1999; Turkish adaptation: Tokat Aluş et al., 2010) - 14 items, 5-point Likert scale Mindful Breastfeeding Scale (Körükcü et al., 2021) - 9 items, 5-point Likert scale

Assessment timepoints:

T0 (Pretest): 24-28 weeks of gestation T1 (Posttest): 36-38 weeks of gestation T2 (Follow-up): 6 weeks postpartum

Randomization is performed by an independent statistician using computer-generated allocation. Data analysis is conducted by a blinded independent statistician. Bias risk is assessed using the Cochrane Risk of Bias Tool (RoB 2). The study is reported in accordance with CONSORT guidelines.

Studietype

Ingrijpend

Inschrijving (Werkelijk)

54

Fase

  • Niet toepasbaar

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

  • Turkije (Türkiye)
    • Ankara
      • Ankara, Ankara, Turkije (Türkiye), 06000
        • Gazi University Institute of Health Sciences, Ankara, Ankara 06000

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

  • Volwassen

Accepteert gezonde vrijwilligers

Ja

Beschrijving

Inclusion Criteria:

  • Literate or above
  • Primigravida
  • Between 18-35 years of age
  • Between 24-28 weeks of gestation
  • Spontaneous conception
  • Owns a smartphone

Exclusion Criteria:

  • Diagnosed with any psychiatric disorder (self-reported)
  • High-risk pregnancy (preeclampsia, gestational diabetes mellitus, placenta previa, chronic disease, fetal anomaly, multiple pregnancy, Rh incompatibility, obesity)
  • Previously attended any compassion or mindfulness-based training
  • Communication barriers (inability to speak Turkish, hearing/speech impairment, or intellectual disability)

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Ondersteunende zorg
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Enkel

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Experimenteel: Intervention Group
Receives 6 face-to-face compassion-based breastfeeding counseling sessions between 30-37 weeks of gestation, with follow-up counseling continued until 6 weeks postpartum.
Gedragsmatig: Compassion-Based Breastfeeding Counseling
A structured, compassion-based breastfeeding counseling program consisting of 6 face-to-face sessions delivered between 30-37 weeks of gestation. Each session integrates self-compassion practices (based on Neff's self-compassion model), mindfulness-based breastfeeding techniques, and evidence-based breastfeeding education. Sessions address emotional barriers to breastfeeding, strengthen breastfeeding self-efficacy, and promote mindful mother-infant interaction. Follow-up counseling is continued until 6 weeks postpartum.
Geen tussenkomst: Control Group
Receives routine antenatal care only, with no additional intervention.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Breastfeeding Self-Efficacy
Tijdsspanne: Baseline (24-28 weeks gestation), post-intervention (36-38 weeks gestation), and follow-up (6 weeks postpartum)
Measured by the Breastfeeding Self-Efficacy Scale-Short Form (Turkish adaptation, Tokat Aluş et al., 2010). 14-item, 5-point Likert scale; scores range 14-70. Higher scores indicate greater self-efficacy.
Baseline (24-28 weeks gestation), post-intervention (36-38 weeks gestation), and follow-up (6 weeks postpartum)
Self-Compassion
Tijdsspanne: Baseline (24-28 weeks gestation), post-intervention (36-38 weeks gestation), and follow-up (6 weeks postpartum)
Measured by the Self-Compassion Scale (Turkish adaptation, Deniz et al., 2008). 24-item, 5-point Likert scale; scores range 24-120. Higher scores indicate greater self-compassion.
Baseline (24-28 weeks gestation), post-intervention (36-38 weeks gestation), and follow-up (6 weeks postpartum)
Mindful Breastfeeding
Tijdsspanne: Baseline (24-28 weeks gestation), post-intervention (36-38 weeks gestation), and follow-up (6 weeks postpartum)
Measured by the Mindful Breastfeeding Scale (Körükcü et al., 2021). 9-item, 5-point Likert scale; scores range 9-45. Higher scores indicate greater mindfulness during breastfeeding.
Baseline (24-28 weeks gestation), post-intervention (36-38 weeks gestation), and follow-up (6 weeks postpartum)

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Gazi University

Onderzoekers

  • Hoofdonderzoeker: ŞENGÜL YAMAN SÖZBİR, PhD, Gazi University, Faculty of Health Sciences, Department of Nursing

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

1 mei 2025

Primaire voltooiing (Werkelijk)

1 december 2025

Studie voltooiing (Werkelijk)

1 december 2025

Studieregistratiedata

Eerst ingediend

28 april 2026

Eerst ingediend dat voldeed aan de QC-criteria

28 april 2026

Eerst geplaatst (Werkelijk)

5 mei 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

5 mei 2026

Laatste update ingediend die voldeed aan QC-criteria

28 april 2026

Laatst geverifieerd

1 april 2026

Meer informatie

Termen gerelateerd aan deze studie

Trefwoorden

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers

  • 2025 - 1341

Plan Individuele Deelnemersgegevens (IPD)

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NEE

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Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

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