Although breastfeeding is a common practice in Türkiye, breastfeeding rates remain below the levels recommended by the World Health Organization. This study aimed to determine the effects of simulation-based breastfeeding education given in the antenatal period on the breastfeeding success of primiparous women in the postnatal period, their perceptions of breastfeeding self-efficacy, and their attitudes and knowledge regarding breastfeeding.
Methods:
This randomized controlled study included 128 primigravida women (intervention group: 64, control group: 64). The intervention group received simulation-based breastfeeding education during the antenatal period, while the control group watched the routine hospital breastfeeding education video. Data were collected using the Personal Information Form, Postnatal Follow-Up Form, Breastfeeding Attitudes and Knowledge Questionnaire (BAKQ), LATCH Assessment Tool, and Breastfeeding Self-Efficacy Scale–Short Form (BSES-SF). The BSES-SF and BAKQ were administered at baseline and within 24 hours after delivery, while breastfeeding success was evaluated twice postnatally using the LATCH Assessment tool. Data analysis involved chi-squared tests, independent-samples t-tests, and multiple linear regression.
Results:
The postintervention scores of these scales were significantly higher in the intervention group compared with the control group (p < 0.001). The LATCH Assessment tool score was significantly higher in the intervention group at both postnatal follow-ups (p < 0.001).
Conclusions:
Women who received simulation-based breastfeeding education had more successful breastfeeding practices, greater knowledge and better attitudes toward breastfeeding, as well as better perceptions of breastfeeding self-efficacy, than women who received routine breastfeeding education.
Pérez-EscamillaR, TomoriC, Hernández-CorderoS, et al.Breastfeeding: Crucially important, but increasingly challenged in a market-driven world. Lancet2023;401(10375):472–485.
2.
World Health Organization (WHO). Global breastfeeding scorecard 2023: Rates of breastfeeding increase around the world through improved protection and support. Available from: https://www.who.int/publications/i/item/WHO-HEP-NFS-23.17
3.
PatnodeCD, HenriksonNB, WebberEM, et al.Breastfeeding and health outcomes for infants and children: A systematic review. Pediatrics.2025;156(1):e2025071516.
4.
LiuJ-Z, LiaoM-Q, ZhengL, et al.Associations of breastfeeding with maternal and child health outcomes: Umbrella review. Am J Clin Nutr2025;122(4):1061–1074.
5.
NorthK, GaoM, AllenG, et al.Breastfeeding in a global context: Epidemiology, impact, and future directions. Clin Ther.2022;44(2):228–244; doi: 10.1016/j.clinthera.2021.11.017
ParryKC, TullyKP, HopperLN, et al.Evaluation of ready, set, BABY: A prenatal breastfeeding education and counseling approach. Birth2019;46(1):113–120; doi: 10.1111/birt.12393
9.
PatilDS, PundirP, DhyaniVS, et al.A mixed-methods systematic review on barriers to exclusive breastfeeding. Nutr Health2020;26(4):323–346; doi: 10.1177/0260106020942967
10.
KaragözA. The effect of antenatal education on breastfeeding self-sufficiency breastfeeding process. Master’s thesis. Istanbul Medipol University Institute of Health Sciences: Istanbul; 2018.
11.
MuradA, RenfrewMJ, SymonA, et al.Understanding factors affecting breastfeeding practices in one city in the Kingdom of Saudi Arabia: An interpretative phenomenological study. Int Breastfeed J2021;16(1):9; doi: 10.1186/s13006-020-00350-4
12.
DündarT. Factors affecting breastfeeding. In: Counseling on Breastfeeding and Feeding with Breast Milk/Current Approaches, 1st ed. (ÖzsoyS., eds.) Türkiye Klinikleri: Ankara; 2021; pp. 59–65.
13.
ChipojolaR, ChiuHY, HudaMH, et al.Effectiveness of theory-based educational interventions on breastfeeding self-efficacy and exclusive breastfeeding: A systematic review and meta-analysis. Int J Nurs Stud2020;109:103675.
14.
Martín-IglesiasS, Santamaría-MartínMJ, Alonso-ÁlvarezA, et al.Effectiveness of an educational group intervention in primary healthcare for continued exclusive breastfeeding: Prolact study. BMC Pregnancy Childbirth.2018;18(1):59; doi: 10.1186/s12884-018-1679-3
15.
MizrakB, OzerdoganN, ColakE. The effect of antenatal education on breastfeeding self-efficacy: Primiparous women in Turkey. Int J Caring Sci2017;10(1):503–510.
16.
SelviY, DesdicioğluR, Karataş Erayİ. Evaluation of the effect of breastfeeding education given in the antenatal period on breastfeeding knowledge level and breastfeeding self-efficacy scale. Ankara Med J2021;21(1):12–21; doi: 10.5505/amj.2021.49140
17.
TerzioğluF, BoztepeH, DuyguluS, et al.An important component of simulation education: Debriefing. Cumhuriyet Hemşirelik Dergisi2013;2(2):57–63.
18.
SaleemM, KhanZ. Healthcare simulation: An effective way of learning in health care. Pak J Med Sci2023;39(4):1185–1190.
19.
SabrianF, ZulfitriR, Pristiana DewiA, et al.The effectiveness of simulation health education to mother breastfeeding skill between two groups in rural area of Riau, Indonesia. Enferm Clin2019;29:9–12.
20.
KaizaR, JohoAA. The effect of low-fidelity simulation training on breastfeeding knowledge, practice, and self-efficacy among young lactating mothers in Tanzania: A quasi-experimental study. PLoS One2023;18(11):e0285392.
21.
Tetik MetinH, YiğitF. Comparison of the effectiveness of video and breastfeeding simulator support to mothers who could not breastfeed their babies in the neonatal intensive care unit: A randomized controlled study. BMC Pregnancy Childbirth2025;25(1):973.
22.
BichTH, LongTK, HoaDP. Community‐based father education intervention on breastfeeding practice—Results of a quasi‐experimental study. Matern Child Nutr2019;15(S1):1–12; doi: 10.1111/mcn.12705
23.
NukpezahRN, NuvorSV, NinnoniJ.Knowledge and practice of exclusive breastfeeding among mothers in the tamale metropolis of Ghana. Reprod Health2018;15(1):140; doi: 10.1186/s12978-018-0579-3
24.
GönenliS, ÇalıkKY, KocatürkAA. Breastfeeding success rate during the early postpartum period among primiparous mothers who had vaginal delivery and associated factors. Sürekli Tıp Eğitimi Derg2019;28(3):191–200.
25.
JensenD, WallaceS, KelsayP. LATCH: A breastfeeding charting system and documentation tool. J Obstet Gynecol Neonatal Nurs1994;23(1):27–32.
26.
DemirhanF. Assessment of breastfeeding in the province of Sakarya. Master’s thesis. Marmara University Institute of Health Sciences: Istanbul; 1997.
27.
YenalK, OkumuşH. Reliability of the LATCH breastfeeding assessment tool. HEMAR-G Derg2003;5(1):38–44.
DennisCL. The breastfeeding self-efficacy scale: Psychometric assessment of the short form. J Obstet Gynecol Neonatal Nurs2003;32(6):734–744.
30.
TokatMA, OkumuşH, DennisCL. Translation and psychometric assessment of the breastfeeding self-efficacy scale—Short form among pregnant and postnatal women in Turkey. Midwifery2010;26(1):101–108.
31.
TokatMA, OkumuşH. Mothers’ breastfeeding self-efficacy and success: An analysis of the effect of education based on improving breastfeeding self-efficacy. Hemşirelikte Eğitim ve Araştırma Derg2013;10(1):21–29.
32.
AbuidhailJ, MrayanL, JaradatD. Evaluating effects of prenatal web-based breastfeeding education for pregnant mothers in their third trimester of pregnancy: Prospective randomized control trial. Midwifery2019;69:143–149; doi: 10.1016/j.midw.2018.11.015
33.
SariC, AltayN. Effects of providing nursing care with a web‐based program on maternal self‐efficacy and infant health. Public Health Nurs2020;37(3):380–392.
34.
KöksalO, AtalayB. Teaching principles and methods with contemporary practices, 3rd ed. Eğitim Yayınevi: Konya; 2016.
35.
SaljughiF, Savabi EsfahaniM, KohanS, et al.Promoting breastfeeding self-efficacy through role-playing in pregnant women. Int J Pediatr2016;4(7):2061–2068.
36.
ShahsavanZ, OveisiS, JourabchiZ. The effect of cognitive-behavioral counseling on breastfeeding self-efficacy of pregnant women. J Holist Nurs Midwifery2019;29(3):61–68.
BraunSA. Program content regarding breast pumps, breast milk, and methods of education offered by lactation counseling centers. Doctoral dissertation. D’Youville College: New York; 2017.
39.
PiroSS, AhmedHM. Impacts of antenatal nursing interventions on mothers’ breastfeeding self-efficacy: An experimental study. BMC Pregnancy Childbirth.2020;20(1):19.
40.
IliadouM, LykeridouK, PrezerakosP, et al.Measuring the effectiveness of a midwife-led education programme in terms of breastfeeding knowledge and self-efficacy, attitudes towards breastfeeding, and perceived barriers of breastfeeding among pregnant women. Mater Sociomed2018;30(4):240–245.
41.
LeurerMD, MisskeyE. “Be positive as well as realistic”: A qualitative description analysis of information gaps experienced by breastfeeding mothers. Int Breastfeed J2015;10(1):10.
42.
NuryatiE, HashimF, PonnampalamP. Breastfeeding education for third trimester pregnant women as an effort for the success of exclusive breastfeeding. J Aisyah J Ilmu Kesehatan2022;7(1):181–186.
