Effects of hybrid breastfeeding counseling on women’s breastfeeding behaviors: a randomized controlled longitudinal study

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Abstract
Effective and accessible breastfeeding practices are essential for enhancing breastfeeding success, strengthening mother-infant bonding, and promoting optimal maternal and infant health. As a personalized support, breastfeeding counseling provides accurate information, supports breastfeeding continuity, and fosters bonding. Therefore, integrating breastfeeding counseling, which is applied in a hybrid (face-to-face and tele-consulting) manner, into maternal care is predicted to be a key strategy in strengthening maternal and child health. This study aims to investigate the effects of hybrid breastfeeding counseling (face-to-face and online), which was started in the last trimester and continued at certain intervals in the postnatal period, on primiparous women’s breastfeeding behaviors. This is a randomized controlled trial with a pretest-posttest design conducted in Türkiye on 90 primiparous women (experimental = 46, control = 44). Data were collected through the Antenatal-Postnatal Information Form, the Breastfeeding Motivation Scale (BMS), the IOWA Infant Feeding Attitude Scale (IIFAS), and the Mother-to-Infant Bonding Scale (MIBS). Data were analyzed using SPSS 25.0. The average age of all the participating women was 25.83 ± 4.63 years. The findings show that women in the experimental group had more positive attitudes and high motivation in terms of IIFAS scores and BMS subscale scores. In addition, data on MIBS scores and infants’ 4th month weight and 4th to 6th month length revealed that the experimental group showed more positive results compared to the control group (p < 0.05). Continuous hybrid breastfeeding support (face-to-face and online) given to primiparous mothers increased their breastfeeding motivation and attitude to breastfeed, and it was found to be effective in ensuring positive mother-to-infant bonding. The clinical trial registration number is NCT05484076/ https://clinicaltrials.gov/study/NCT05484076 Date of registration 07/28/2022 (registered prospectively).

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