Breastfeeding Support Provided to Mothers Through WhatsApp Messaging Application
Condition: Exclusive Breastfeeding; Breastfeeding Support
Study type: Interventional

Summary: 
      The research was planned as a randomized controlled experimental study in order to determine
      the effect of continuous breastfeeding support provided to mothers through WhatsApp messaging
      application on breastfeeding.

      Research Hypotheses H0: Continuous breastfeeding support provided to mothers through WhatsApp
      messaging application has no effect on breastfeeding.

      H1: Continuous breastfeeding support provided to mothers through WhatsApp messaging
      application increases the rate of exclusive breastfeeding.

      H2: Continuous breastfeeding support provided to mothers through WhatsApp messaging
      application increases the breastfeeding duration of the mothers.

      H3: Continuous breastfeeding support provided to mothers through WhatsApp messaging
      application reduces the rate of mothers giving their babies other foods than breast milk.

      H4: Continuous breastfeeding support provided to mothers through WhatsApp messaging
      application reduces bottle feeding rates.

      H5: Continuous breastfeeding support provided to mothers through WhatsApp messaging
      application reduces the rate of pacifier use.

      H6: Continuous breastfeeding support provided to mothers through WhatsApp messaging
      application reduces the incidence of mothers' breastfeeding problems.

      H7: Continuous breastfeeding support provided to mothers through WhatsApp messaging
      application affects mothers' breastfeeding attitude positively.

      H8: Continuous breastfeeding support provided to mothers through WhatsApp messaging
      application increases the motivation of breastfeeding mothers.
    

Detailed description: 
      METHOD:

      Place of the Research:

      The data of the research will be collected in the postpartum service of Zeynep Kamil Women
      And Chıldren Dıseases Tranıng And Research Hospıtal in Istanbul. After then 6 months of
      follow-up will be continued trough WhatsApp application.

      The Universe and the Sample of the Research:

      The universe of the research; It will comprise primipa mothers and babies who are
      hospitalized in the postpartum ward of the specified dates, deliver vaginal or cesarean
      delivery, and meet the sample selection criteria.

      The sample of the research was determined by statistic analysis by power analysis. Power
      analysis was performed by using G * Power (v3.1.7) program to determine the number of
      samples. The power of the study is expressed as 1-β (olasılığı = type II error probability)
      and research should generally have 80% power. According to Cohen's effect size coefficients;
      Assuming that the evaluations to be made between the two independent groups will have a
      medium effect size (d = 0.5), considering the fact that there should be at least 64 people in
      the groups and there may be losses in the working process, each group decided to recruit 70
      people. 140 people in total. it is given. Computerized randomization method will be used in
      the research.

      In the collection of research data; Mother and Newborn Data Collection Form Postpartum
      Breastfeeding Evaluation and Follow-up Form Application Satisfaction Evaluation Form
      Breastfeeding Attitudes of The Evaluation Scale Primipara Breastfeeding Motivation Scale
      (PBMS) 5 data collection forms will be used.

      Application of the research:

      The researcher will briefly talk about the scope and content of the research by meeting with
      the mothers who meet the case selection criteria. Written consents will be obtained through
      the "Informed Volunteer Consent Form" asking mothers whether they want to participate in the
      study. Mothers who wish to participate in the study will be randomly determined by
      computer-assisted randomization method. Applications made after randomization will be carried
      out with the following steps; Experimental group; Information will be obtained from the
      mothers who agreed to participate in the study in line with the "Mother and Newborn Data
      Total Form", Mothers participating in the study will receive routine breastfeeding training
      at the hospital after birth, The breastfeeding attitude of the mother will be evaluated with
      the "Breastfeeding Attitude Scale", and the breastfeeding motivation of the mother will be
      evaluated with the "Breastfeeding Motivation Scale", In line with the needs of the mothers,
      breastfeeding support and motivation will be provided, In the first 1 month, basic standard
      information sharing (see "Basic Standard Information Sharing") will be made determined by the
      researcher. Later, information sharing will be made regarding the questions and problems of
      the mother, Individual breastfeeding support provided to mothers through WhatsApp will
      continue for 6 months, Mothers will be contacted once a week through WhatsApp and feedback
      will be received on the breastfeeding process, The questions of the mother regarding
      breastfeeding will be answered by text / voice message or video call, In the postpartum
      period (day 7, day 15, month 1, month 2, month 4 and month 6) mothers will be called by
      phone. Breastfeeding conditions will be evaluated with "Postpartum Breastfeeding Evaluation
      and Follow-up Form".

      Breastfeeding attitudes of the mothers will be assessed with the Breastfeeding Attitudes of
      the Evaluation Scale" before breastfeeding education in hospital and through online survey at
      the 6th Month.

      Breastfeeding motivations of the mothers will be assessed with the " Primipara Breastfeeding
      Motivation Scale " through online survey at the 6th Month.

      The mothers' satisfaction with the continuous breastfeeding support provided through WhatsApp
      will be evaluated with the "Application Satisfaction Evaluation Form" through online survey.

      Basic Standard Information Sharing; New coronavirus (COVID-19) and breastfeeding Suggestion
      on breastfeeding (motivational-enhancing videos that emphasize breastfeeding is instinctive)
      The importance of breast milk (positive effects on mother and baby will be explained) Sharing
      of health institutions emphasizing the importance of breastfeeding (WHO, UNICEF, Ministry of
      Health) Milk production of breasts (Frequent breastfeeding will be supported by videos) Baby
      holding the breast (Mothers will be emphasized that the baby's sucking ability instinctively
      and will be supported with videos) Skin-to-skin contact and breastfeeding Reasons for
      breastfeeding only for the first 6 months Symptoms that show that the baby is sucking
      effectively Control Group; Information will be obtained from the mothers who agreed to
      participate in the study in line with the "Mother and Newborn Data Total Form", Mothers
      participating in the study will receive routine breastfeeding training at the hospital after
      birth, The breastfeeding attitude of the mother will be evaluated with the "Breastfeeding
      Attitude Scale", and the breastfeeding motivation of the mother will be evaluated with the
      "Breastfeeding Motivation Scale", In line with the needs of the mothers, breastfeeding
      support and motivation will be provided, In the postpartum period (day 7, day 15, month 1,
      month 2, month 4 and month 6) mothers will be called by phone. Breastfeeding conditions will
      be evaluated with "Postpartum Breastfeeding Evaluation and Follow-up Form".

      Breastfeeding attitudes of the mothers will be assessed with the Breastfeeding Attitudes of
      the Evaluation Scale" before breastfeeding education in hospital and through online survey at
      the 6th Month.

      Breastfeeding motivations of the mothers will be assessed with the " Primipara Breastfeeding
      Motivation Scale " through online survey at the 6th Month.

      Analysis:

      NCSS (Number Cruncher Statistical System) 2007 (Kaysville, Utah, USA) program will be used
      for statistical analysis of the research. Statistical significance will be accepted as p
      <0.05.
    

Intervention name(s): Breastfeeding Support Provided to Mothers Through WhatsApp Messaging Application
Intervention type(s): Other
Intervention description(s): Breastfeeding support provided to mothers through WhatsApp messaging application will be maintained for the first 6 months after birth. In the first 1 month, standard information sharing will be made through whatsApp. Also, for the first 6 months, solutions generating shares will be made according to the problems and questions of the mother regarding breastfeeding.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Randomized Controlled Study
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: Breastfeeding support; Exclusive breastfeeding; WhatsApp messaging application; Motivation; Attitude