Aim: This paper reports an assessment of the effects of a breastfeeding journal on breastfeeding prevalence and perceptions of conflicting advice, self-management and self-efficacy.
Background: Breastfeeding prevalence rates in most developed countries are not meeting recommendations. Women's concerns about inconsistent advice, limited involvement in decision-making, accessibility of information and inappropriate follow-up have been recognized. Research on evaluation of interventions addressing these concerns and including antenatal and early postnatal periods is required. Method. An intervention study was conducted from July 2003 to April 2004, with control and intervention groups recruited sequentially. The intervention group received a breastfeeding journal at 36 weeks antenatally in breastfeeding classes that were attended at different times by intervention and control group members. The intervention and control groups were compared during postpartum hospitalization and 12 weeks for breastfeeding prevalence and perceptions of self-efficacy, conflicting advice and self-management.
Findings: No statistically significant differences were noted between the intervention and control groups in breastfeeding prevalence at 12 weeks or self-efficacy during hospitalization. There was a statistically significant difference between groups in conflicting advice at both times. Although conflicting advice continues to present a dilemma for women, levels of conflicting advice did not explain breastfeeding self-efficacy. Breastfeeding self-management was a statistically significant contributor to breastfeeding prevalence prior to the addition of breastfeeding self-efficacy.
Conclusions: Women's perceptions of their ability to manage and be actively involved in decision-making explained breastfeeding prevalence at 12-week postpartum. Efforts to encourage women's involvement in decision-making about breastfeeding are a useful strategy to promote breastfeeding.