Designing and Evaluating an Empowering Program for Breastfeeding: A Mixed-Methods Study

Abstract

Background: Breastfeeding empowerment is a key motivational, psychological and flexible factor influencing the continuance of breastfeeding. The purpose of this mixed-methods study was to design and evaluate the empowering program for breastfeeding. Methods: We used a mixed-methods study with a sequential exploratory approach. In the qualitative phase, we explored the experiences of women about empowerment for breastfeeding using conventional content analysis. In the intervention phase, we designed and implemented a breastfeeding empowerment program based on the findings of the qualitative phase and evaluated it 2 weeks, 2 months and 4 months after childbirth. This randomized clinical trial is registered under IRCT2015081723657N1. Results: Analysis of data from the interviews in the qualitative phase yielded three main categories, namely "adequate knowledge and skills about breastfeeding", "overcoming breastfeeding problems" and "perception of family support for breastfeeding". In the qualitative phase, after implementing the program, the mean scores of breastfeeding empowerment were significantly higher in the intervention compared to the control group at 2 weeks (mean difference = -25.30; 95 CI = -5.36, -15.23), 2 months (mean difference = -21.71; 95 CI = -31.24, -12.19), and 4 months (mean difference = -17.72; 95 CI = -27.14, -8.30) after childbirth (P < 0.001). In addition, exclusive breastfeeding was significantly higher in the intervention group at 2 weeks, 2 months and 4 months after childbirth (P = 0.003, P = 0.003, P = 0.044, respectively). Conclusion: To empower women for breastfeeding, the mother, father and key family members should be educated using practical and visual teaching techniques during pregnancy and postpartum period. Moreover, since breastfeeding empowerment is established 2 weeks after childbirth, empowering programs should be implemented prior to this period.