The Effect of Breastfeeding Position Education on Breastfeeding

Study Overview
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Brief Summary
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Planned for the purpose to evaluate, breast problems (nipple fissure, nipple pain), breastfeeding self-efficacy, breastfeeding success, and infant feeding attitude of mothers by given breastfeeding education with a laid back (semi-sitting or semi-lying) and upright position (sitting upright) using lactation simulation model.

Detailed Description
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This study aims to increase breastfeeding success, breastfeeding self-efficacy and effective infant feeding, reduce breast problems, and to affect positively the mother's infant feeding attitude of breastfeeding positions taught to mothers in the antenatal period with the lactation simulation model. Also, it carried out to reveal the importance of midwife/nurse support and education that starts in the antenatal period and continues in the postpartum period, by increasing the adaptation of the mother to the breastfeeding process with the education given in the antenatal period, aims to contribute to the initiation and maintenance of breastfeeding. his study will be conducted as a randomized controlled experimental study. The population of the study will be primiparous pregnant women who applied to Kastamonu Education and Research Hospital between 01/05/2022-01/05/2023. The sample will consist of 105 pregnant women (35 pregnant women for each group) who met the inclusion criteria and accepted to participate in the study. The mothers in the experimental group will be trained with the lactation simulation model during the antenatal care follow-ups in the last trimester of their pregnancy (one group laid back and another group breastfeeding position education) and the necessary forms will be filled in their first interview, A second interview will be held within the first 24 hours after the birth, and the breastfeeding position taught to the mothers will be shown in practice by supporting the mother, and the necessary forms will be filled. The third meeting will be held between 7.-10. days of postpartum and the necessary forms will be filled. The mothers in the control group will be interviewed during the antenatal care follow-ups in the last trimester of their pregnancy. Mothers in the control group will receive routine care and routine breastfeeding education both in the prenatal and postnatal period. Necessary forms will be filled with the mothers in the control group by meeting in the first 24 hours and on the days 7th-10th. of postpartum. Personal information form, breastfeeding self-efficacy scale, Iowa infant feeding attitude scale, LATCH, visual comparison scale, postpartum breastfeeding follow-up form, breast problems evaluation form and IMDAT form will be used as data collection tools. Breastfeeding has numerous benefits for mother and baby. While it prevents many diseases such as otitis media, respiratory tract infections, obesity, sudden infant death syndrome, allergies and diabetes in infants, it neurodevelopmentally contributes positive effects to the development of the baby. Postpartum depression, cardiovascular diseases, diabetes, breast cancer, ovarian cancer and osteoporosis rates are lower in mothers who breastfeed for more than 1 year. The fact that there is less feeding cost contributes to the family economically.

Official Title
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The Effect of Different Breastfeeding Position Education With Lactation Simulation Model on Breastfeeding

Conditions
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Breastfeeding Education

Intervention / Treatment
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* Behavioral: Breastfeeding position education with lactation simulation model


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Pregnant Women Primiparous Women aged 18-35 years Sign the informed consent form Those planning a vaginal birth Absence of a health problem that prevents breastfeeding Having a healthy baby at term Exclusion Criteria: Diseases in which breastfeeding is a problem Baby with anomalies Cesarean births Patients admitted to neonatal intensive care

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 35 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Randomized Controlled Experimental Design
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Experimental: Laid back breastfeding position education group<br>Breastfeeding education will be given to pregnant women in the laid-back breastfeeding position group, which includes the laid back breastfeeding position with a lactation simulation model. | Behavioral: Breastfeeding position education with lactation simulation model<br>* pregnant women will receive training with a lactation simulation model once in the last trimester.The pregnant woman will wear the lactation simulation model during the education period and show what she has learned practically on the model.Mothers who have given birth will be supported to practice the breastfeeding position in the postpartum service.<br>|
| Experimental: Experimental: Upright breastfeeding position education group<br>Breastfeeding education will be given to pregnant women in the upright breastfeeding position group, which includes the upright breastfeeding position with a lactation simulation model. | Behavioral: Breastfeeding position education with lactation simulation model<br>* pregnant women will receive training with a lactation simulation model once in the last trimester.The pregnant woman will wear the lactation simulation model during the education period and show what she has learned practically on the model.Mothers who have given birth will be supported to practice the breastfeeding position in the postpartum service.<br>|
| No Intervention: No Intervention: Control Group<br>Mothers in the control group will receive routine hospital care | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Iowa Infant Feeding Attitude Scale | It is a scale that evaluates the attitudes of women towards breastfeeding and the choice of infant feeding method, as well as the duration of breastfeeding.The scale consists of a 5-point Likert-type scale ranging from 1 (strongly disagree) to 5 (strongly agree) and 17 items. While 9 items in the scale affirm the issue of breastfeeding, 8 items contain positive statements about formula feeding. Formula nutrition items are scored in reverse (1=5, 2=4, 4=2 and 5=1). The total attitude score ranges from 17 (reflecting a positive attitude towards bottle feeding) to 85 points (reflecting a positive attitude towards breastfeeding). The scale has no cut-off value, high scores indicate a positive breastfeeding attitude. In the literature, those with a score between 70-85 were considered determined to breastfeed. If the score is between 49-69, the undecided group; Those with a score between 17-48 were accepted as having a tendency to feed with formula. | Measurement for each group at the third encounter (10th day after birth). | 
| Breastfeeding Self-Efficacy Scale | Breastfeeding self-efficacy levels of mothers and their self-confidence in breastfeeding are measured using the breastfeeding self-efficacy scale. The Breastfeeding Self-Efficacy Scale (short form) consists of 14 items that measure the mother's breastfeeding self-efficacy. The maximum score that can be obtained from the scale is 70, and the minimum score is 14.High scores from the scale indicate high breastfeeding self-efficacy. The scale is 5-point Likert type; 1 = Not at all sure, 2 = Not very sure, 3 = Sometimes I am sure, 4 = I am sure, 5 = I am very sure. | Measurement for each group at the third encounter (10th day after birth). | 
| LATCH | Observation and evaluation of mothers' breastfeeding success is measured using the LATCH scale.The LATCH Breastfeeding Diagnostic and Evaluation Scale is a scale filled by the researcher through observation. L: (Latch on the brest)) A: (Audible Swallowing) T: (Type of Nipple) C: (Comfort of Breast/ Nipple) H: (Hold/ Position) LATCH consists of the combination of the first letters of the English equivalent of the five criteria defined above. Each item is evaluated between 0-2 points. The lowest score that can be obtained from the entire scale is 0 and the highest score is 10. The scale has no breakpoints. The low score on the scale indicates the need for active intervention, support and follow-up after discharge in breastfeeding. The higher the LATCH Breastfeeding Diagnosis and Evaluation Scale score, the higher the success of breastfeeding. | Measurement for each group at the third encounter (10th day after birth). | 
| Visual Analogue Scale | It measures the severity of pain in individuals.This distance, which is usually measured in centimeters, is reported as points. Numbers from 0 to 10 are written on the two ends of a 10 cm line on the parameter to be evaluated, and the patient is asked at what level of pain he is.The patient marks her own pain on a 10 cm ruler, with painlessness on one end and the most severe pain on the other. As the VAS value approaches 10, the pain is considered to be very severe, and as it approaches 0, the pain decreases. | Measurement for each group at the third encounter (10th day after birth). | 
| IMDAT | The amount of breast milk the baby receives is measured using the IMDAT scale.The form consists of 5 sections: the weight of the babies, their satisfaction, the frequency and characteristics of urinating and defecation, and the condition of the mother's breasts. With the form, the features of each situation are evaluated as 0, 1, 2 points, and the maximum total score that can be obtained is 10. A score of 8-10 is considered the best breast milk intake, and a score of 0-7 is considered insufficient. | Measurement for each group at the third encounter (10th day after birth). | 
| Breast Problems Evaluation Form | Problems such as pain, cracks and redness in the breast are measured using the breast evaluation form.The form consists of 9 questions questioning the breast problems of the mothers in the first 10 days postpartum. The form will be collected by the researcher through a face-to-face interview | Measurement for each group at the third encounter (10th day after birth). | 
| Postpartum Breastfeeding Follow-Up Form | This form was developed by the researcher by scanning the literature. The form consists of 13 questions questioning the postpartum breastfeeding status of mothers. The form will be collected by the researcher through a face-to-face interview. | Measurement for each group at the third encounter (10th day after birth). | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Breastfeeding Education, Lactation Simulation Model, Nipple problems, Breastfeeding self-efficacy, Breastfeeding success