Abstract
To evaluate the effects of using a flipchart (serial album) on maternal self-efficacy in breastfeeding and its effects on exclusive breastfeeding (EBF) in children's first two months of life. Clinical trial in Recife, Northeastern Brazil, with 112 women in the third trimester of gestation, randomly distributed in intervention group (IG) and control group (CG). The intervention was the use of the flipchart in IG. Data collection was performed through interviews in the prenatal period, and telephone contact at second, fourth and eighth weeks postpartum. The Breastfeeding Self-Efficacy Scale-Short-Form (BSES-SF) was used to measure self-efficacy scores. In the analysis, was used descriptive, bivariate statistics through tests of comparisons of proportions and means, and relative risk assessment. There was a statistically significant difference in mean values of self-efficacy scores between women in the IG and CG (p<0.001) and in EBF rates (p<0.001). The probability of exclusively breastfeeding in IG was twice as high than in CG (RR 2.2, CI 1.51-3.21). The use of a flipchart as an educational tool had positive effects on self-efficacy scores for breastfeeding and in maintenance of EBF in the IG. Brazilian Registry of Clinical Trials: RBR-5N7K99.
Highlights
Discontinuation of exclusive breastfeeding (EBF) before 6 months of life is an event observed worldwide regardless of the reason, in spite the benefits of this practice for both child and the mother(1)
The intervention and control groups were homogeneous in most variables, since there was no statistically significant difference in relation to marital status, occupation, educational level, family income, number of pregnancies, previous experience with breastfeeding, time of exclusive breastfeeding of the last child, and routine guidelines on breastfeeding during prenatal care
The educational intervention tested in this study with women in the pregnancy-puerperal cycle served as an effective pedagogical tool, and allowed pregnant women in the intervention group (IG) to be protagonists of the learning process in the practice of breastfeeding.The success of this intervention is supported by the use of educational tools based on the theory of self-efficacy for breastfeeding(7), and application of the Breastfeeding Self-Efficacy Scale-Short-Form (BSES-SF) to measure self-efficacy because this is a modifiable factor strongly associated with EBF(17-18)
Summary
Discontinuation of exclusive breastfeeding (EBF) before 6 months of life is an event observed worldwide regardless of the reason, in spite the benefits of this practice for both child and the mother(1). In low- and middle-income countries, there are prevalences below 37% in children under 6 months of age(2). This percentage is similar to that found in the evaluation of the breastfeeding indicators trend in Brazil in the last three decades(3). High self-efficacy scores for breastfeeding were positively associated with exclusive breastfeeding between 4 and 6 weeks postpartum(9-10), and women who report lack of confidence in breastfeeding have about two to three times more chances of weaning the child in that period(8)
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