| Background:Previous studies suggested lactation women and their important family members needed to be involved in educational interventions to increase their breastfeeding knowledge and family supportive behaviors.But few breastfeeding education programs focus on primiparas and important family members including infants' fathers and grandmothers/grandmothers-in-law to explore their effects on exclusive breastfeeding to date in China.Research aims:(1)To explore the effect of a family-centered breastfeeding education program on improving primiparas' breastfeeding attitude.(2)To evaluate the effect of a family-centered breastfeeding education program on improving primiparas'breastfeeding knowledge.(3)To detect the effect of a family-centered breastfeeding education program on improving breastfeeding knowledge of important family members and further improving family support for breastfeeding.(4)To test the effect of a family-centered breastfeeding education program on promoting exclusive breastfeeding up to 6 months postpartum.(5)To identify the predictive factors of exclusive breastfeeding rates.Methods:This was a quasi-experimental design with multiple comparisons at different time points within and between two groups.Convenience sampling was used to recruit 64 pregnant women and their important family members during their 32?34 weeks gestation in a tertiary hospital in Wuhan,China,from August 2015 to September 2015.They were then assigned to either the intervention group or the control group according to given random numbers without blinding.The intervention group received family-centered breastfeeding education,while the control group received in-hospital care..Participants were asked to complete Iowa Infant Feeding Attitude Scale(IIFAS)and Breastfeeding Knowledge Questionnaire(BKQ)at 6 time points,Breastfeeding Family Support Questionnaire(BFSQ)at 4 time points postpartum.Part I demographic questionnaires were completed by women at the beginning of the study and part II demographic questionnaires at their 6 months postpartum.Both groups were asked to complete forms of feeding methods at 7 days postpartum,1 month postpartum,4 months postpartum,and 6 months postpartum.Data were analyzed by SPSS17.0.Descriptive statistics were used to describe demographic data and breastfeeding methods.Differences in outcome variables within and between groups were examined using repeated measures ANOVA.Differences in outcome variables at different time points between two groups were examined using multivariate test.Generalized estimated equation(GEE)was used to test the longitudinal effect of the intervention on feeding methods over the period from 7 days to 6 months postpartum and identify the predictive factors of exclusive breastfeeding rates.Results:A total of 59 participants were enrolled with 29 in the intervention group and 30 in the control group.There was not reaching statistical significance in all demographic variables between two groups(p>0.05).There were significant differences in Time*Group interactions of women's knowledge(F=6.67,p<0.01),fathers'knowledge(F=10.92,p<0.01),and grandmothers' knowledge[F=3.90,p<0.05].There were significant differences in main effects of women's knowledge(F=16.91,p<0.01),fathers' knowledge(F=18.53,p<0.01)and perceived family support(F=19.60,p<0.01).The intervention group had significantly higher means of women's knowledge(p<0.05)and fathers'knowledge(p<0.05)at each time point than those in the control group.Grandmothers in the intervention group had significantly higher means of knowledge after prenatal lectures,at 1 month,4 months,and 6 months postpartum than those in the control group(p<0.05).Women in the intervention group had significantly higher means of perceived family support at 1 month,4 months and 6 months postpartum than those in the control group(p<0.05).The exclusive breastfeeding rate was 48.3%and 16.7%at 6 months in the intervention group and control group.Compared with the control group,the intervention group was more likely to exclusively breastfeed in the first 6 months(OR,0.44[0.20,0.98]).Compared with women who separated from their infants,those who not separated from their infants were more likely to exclusively breastfeed their infants(OR,0.19[0.05,0.72]).Conclusions:Since breastfeeding education focused on primiparas and their important family members improved their knowledge,family support and increased the likelihood of exclusive breastfeeding rate in the first 6 months,family-centered education is an effective strategy to promote exclusive breastfeeding in China. |
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