Evaluation of the impact of breastfeeding support groups in primary health centres in Andalusia, Spain: a study protocol for a cluster randomized controlled trial (GALMA project)

Abstract Background In 2003, the World Health Organization recommended exclusive breastfeeding (EB) during the newborn’s first 6 months of life and, if possible, during the first 2 years. However, EB rates resist these recommendations. In developed countries, only 1 out of 3 babies is breastfed during its first 6 months of life, and great differences between areas and countries can be observed. Only 35% of the newborns receive breastfeeding at 3–4 months of age. There are diverse strategies described in the literature that have proven their efficiency in improving breastfeeding rates. It has also been proven that professional support is an effective tool to extend any kind of breastfeeding; besides, it has been observed that mother-to-mother support also increases breastfeeding initiation, sustainment, and exclusive duration. The overall aim of the study is to assess the impact of the support groups on the sustainment of exclusive breastfeeding until 6 months after birth. Methods/design This study is a cluster-random multicentric clinical trial with a control group and an intervention group, without blinding because it is impossible to mask the intervention. A randomization by centres of primary health (clusters) will be carried out. The women allocated to the intervention or control group will be randomized with a simple randomization sampling. The participants’ breastfeeding rate will be followed up at the first 10 days, and at 2, 4, and 6 months of their newborn’s life. Discussion There is a need to assess the impact of mother support groups on exclusive breastfeeding. This study aims to analyse the outcomes related to the support received and to identify what should the structure of these groups be; in other words, to describe factors related to a better breastfeeding experience in order to help women increase breastfeeding rates. Trial registration The trial is prospectively recorded at the ISRCTN registry (Trial ID: ISRCTN17263529). Date recorded: 17/06/2020.

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The effectiveness of using a WeChat account to improve exclusive breastfeeding in Huzhu County Qinghai Province, China: protocol for a randomized control trial

BMC Public Health ◽

10.1186/s12889-019-7676-2 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 4

Author(s):

Qiong Wu ◽

Yiwen Huang ◽

Michelle Helena van Velthoven ◽

Wei Wang ◽

Suying Chang ◽

...

Keyword(s):

Exclusive Breastfeeding ◽

Rural Areas ◽

Controlled Trial ◽

Severe Disease ◽

Intervention Group ◽

Mobile Technologies ◽

World Health ◽

Control Group ◽

Qinghai Province ◽

Breastfeeding Rate

Abstract Background An exclusive breastfeeding rate in the first 6 months of life of at least 50% is one of the six World Health Organization global nutrition targets for 2025. However, the exclusive breastfeeding rate in China is quite low and decreasing which makes it urgent to explore effective ways to reverse the current downward trend. As mobile technologies have rapidly developed, mobile communication apps such as WeChat (one of the largest social networking platforms in China) are well accepted and have the potential to improve health behaviors in a convenient way. The current paper describes the study protocol of a WeChat intervention that aims to promote breastfeeding in rural areas in China. Methods The study is designed as a randomized controlled trial in rural Qinghai Province, China. Women who are 14–36 weeks pregnant will be randomized to routine antenatal and postnatal care, or routine care plus the WeChat breastfeeding education. pregnant women with a severe disease and complications of pregnancy or HIV-1 will be excluded. Breastfeeding knowledge and promotion information will be delivered to the intervention group through a WeChat official account from 3 months pregnancy to 6 months postpartum. The outcome assessments are conducted at baseline through face-to-face interviews, and at one week, 1 month, 3 months and 6 months postpartum by telephone interviews. The primary outcome is difference in the exclusive breastfeeding rate at 1 month, 3 months, and 6 months postpartum between the intervention group and the control group. Secondary outcomes include the overall duration of any and exclusive breastfeeding across the first 6 months postpartum; mothers’ knowledge of breastfeeding; the proportion of early initiation of breastfeeding; and the timing of the introduction of solid food to infants. Intention-to-treat-analysis will be used. Survival analysis will be used to compare the overall duration of any and exclusive breastfeeding between groups. Discussion This study is the first effort to promote exclusive breastfeeding through WeChat in China. Our results will provide scientific evidence for the effect of health education through WeChat on breastfeeding. Thereby this may offer a comprehensive intervention to promote exclusive breastfeeding in China and other settings. Trial registration Chinese Clinical Trial Registry –ChiCTR1800017364. Registered 26 July 2018. http://www.chictr.org.cn/showproj.aspx?proj=29325

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Comparing breastfeeding experiences between mothers spending the traditional Chinese confinement period in a confinement centre and those staying at home: a cohort study

10.21203/rs.3.rs-26168/v4 ◽

2020 ◽

Author(s):

Siew Cheng Foong ◽

May Loong Tan ◽

Wai Cheng Foong ◽

Jacqueline J Ho ◽

Fairuz Fadzilah Rahim

Keyword(s):

Logistic Regression ◽

Breast Milk ◽

Support Groups ◽

Exclusive Breastfeeding ◽

World Health ◽

Multiple Logistic Regression ◽

Breastfeeding Support ◽

Ethnic Chinese ◽

Chinese Mothers ◽

Breastfeeding Rates

Abstract BackgroundEthnic Chinese mothers in Malaysia adhere to 30 days of traditional postpartum practices (the “confinement period”) aimed at recuperation after delivery. Recently there has been an emergence of confinement centres (CCs) where mothers stay and receive traditional confinement care. Ethnic Chinese mothers have low breastfeeding rates. There are concerns that practices in CCs could contribute to this but no data exists. We described mother’s breastfeeding experience at CCs and identify areas for potential improvement in breastfeeding support.MethodsEthnic Chinese mothers intending to breastfeed their healthy infants were recruited post-delivery between August and October 2017 then, at 1 and 6 months, were telephone interviewed about their experience. For every participant going to a CC, another mother going home was recruited.Chi-square test was used to compare groups and multiple logistic regression was used to assess the effect of confinement place on exclusive breastfeeding. We defined exclusive breastfeeding according to the World Health Organisation’s definition which means no other food or drink, not even water, except breast milk (including milk expressed or from a donor).Results Of 187 mothers, 88(47%) went to CCs. Significantly more were primipara and fewer had previous breastfeeding experience. Response rates for the 1- and 6- month interviews were 88%(CC) versus 97%(home); and 77%(CC) versus 87%(home).Exclusive breastfeeding rates were similar between the groups: 62%(CC) versus 56%(home) at 1 month (p=0.4); and 37%(CC) versus 42%(home) at 6 months (p=0.5). Multiple logistic regression did not show that CCs were a factor affecting exclusive breastfeeding rates at 1 month, (adjusted odds ratio(aOR) 1.7, 95% confidence interval(CI) 0.9, 3.3), or 6 months (aOR 0.9, 95% CI 0.4, 1.7). However, significantly more CC participants only fed expressed breast milk. Despite 66% of CC participants reporting that their centre supported breastfeeding, only 6(8%) CC participants compared to 66(69%) of home participants slept with their baby (p<0.001). The proportion encountering breastfeeding difficulties were similar between groups. CC participants sought help for breastfeeding problems mainly from CC staff and support groups while home participants obtained help from friends and healthcare professionals.ConclusionBreastfeeding rates appeared to be similar at CCs and home but there were gaps in how CCs supported breastfeeding. Targeted training to CC staff to support breastfeeding may result in better outcomes for mothers staying in CCs.

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Effectiveness of WeChat for Improving Exclusive Breastfeeding in Huzhu County China: Randomized Controlled Trial

Journal of Medical Internet Research ◽

10.2196/23273 ◽

2020 ◽

Vol 22 (12) ◽

pp. e23273

Author(s):

Qiong Wu ◽

Yiwen Huang ◽

Zijun Liao ◽

Michelle Helena van Velthoven ◽

Wei Wang ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Pregnant Women ◽

Exclusive Breastfeeding ◽

Controlled Trial ◽

Intervention Group ◽

Mobile Technologies ◽

Control Group ◽

Randomized Controlled ◽

Breastfeeding Rate ◽

Significant Difference

Background The benefits of breastfeeding for both infants and mothers have been well recognized. However, the exclusive breastfeeding rate in China is low and decreasing. Mobile technologies have rapidly developed; communication apps such as WeChat (one of the largest social networking platforms in China) are widely used and have the potential to conveniently improve health behaviors. Objective This study aimed to assess the effectiveness of using WeChat to improve breastfeeding practices. Methods This 2-arm randomized controlled trial was conducted among pregnant women from May 2019 to April 2020 in Huzhu County, Qinghai Province, China. Pregnant women were eligible to participate if they were aged 18 years or older, were 11 to 37 weeks pregnant with a singleton fetus, had no known illness that could limit breastfeeding after childbirth, used WeChat through their smartphone, and had access to the internet. A total of 344 pregnant women were recruited at baseline, with 170 in the intervention group and 174 in the control group. Women in the intervention group received breastfeeding knowledge and promotion information weekly through a WeChat official account from their third month of pregnancy to 6 months postpartum. The primary outcome of exclusive and predominant breastfeeding rate was measured 0-1 month, 2-3 months, and 4-5 months postpartum. Results At 0-1 month postpartum, the exclusive breastfeeding rate was significantly higher in the intervention group than that in the control group (81.1% vs 63.3%; odds ratio [OR] 2.75, 95% CI 1.58-4.78; P<.001). Similarly, mothers in the intervention group were more likely to provide predominantly breast milk (OR 2.77, 95% CI 1.55-4.96; P<.001) and less likely to give dairy products to their children (OR 0.40, 95% CI 0.21-0.75; P=.005). There was no statistically significant difference for exclusive breastfeeding rate 2-3 months (P=.09) and 4-5 months postpartum (P=.27), though more children in the intervention group were exclusively breastfed than those in the control group 2-3 months postpartum (intervention: 111/152, 73.0%; control: 96/152, 63.2%) and 4-5 months postpartum(intervention: 50/108, 46.3%; control: 46/109, 42.2%). Conclusions This study is the first effort to promote exclusive breastfeeding through WeChat in China, which proved to be an effective method of promoting exclusive breastfeeding in early life. WeChat health education can be used in addition to local breastfeeding promotion programs. Trial Registration Chinese Clinical Trial Registry ChiCTR1800017364; http://www.chictr.org.cn/showproj.aspx?proj=29325 International Registered Report Identifier (IRRID) RR2-10.1186/s12889-019-7676-2

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The Effect of Cyberspace-based Education on the Well-Being of Caregivers of Elderly People with Dementia

Current Aging Science ◽

10.2174/1874609814666210208180051 ◽

2021 ◽

Vol 14 ◽

Author(s):

Yadollah Abolfathi Momtaz ◽

Parisa Mollaei ◽

Parisa Taheri-Tanjani

Keyword(s):

Elderly People ◽

Negative Impact ◽

Intervention Group ◽

Well Being ◽

World Health ◽

Control Group ◽

People With Dementia ◽

Age Related ◽

Significant Difference ◽

The Impact

Introduction: One of the consequences of aging is the prevalence of chronic and age-related diseases, such as dementia. Caring for patients with dementia has a negative impact on the caregiver's well-being. This study aimed to examine the impact of cyberspace-based education on the well-being of caregivers of demented elderly people. Methods: This experimental study was done on a sample of 86 caregivers of elderly with dementia in 2018. The study sample was selected from memory clinic of Taleghani Hospital and randomly assigned into groups (intervention n = 43, control n = 43 groups). The well-being was measured using the World Health Organization - Five Well-Being Index (WHO-5), before and two months after the intervention. Cyberspace-based educational intervention was conducted for one month. The SPSS software version 23 was employed in data analysis. Results: The mean age of the caregivers in the intervention and control groups were (M = 51.95, SD = 10.90) and (M = 51.36, SD = 15.12) respectively. No significant difference was found between two groups in terms of age, gender and level of education. The results of analysis showed that while the well-being of the intervention group was significantly increased (t (38) = -11.38, P<0.001) the well-being in the control group was significantly reduced ( t(36) =4.71 , P<0.001). Conclusion: The findings showed that cyberspace-based education can improve the well-being of caregivers of the elderly with dementia.

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WeChat-based intervention to support breastfeeding for Chinese mothers: protocol of a randomised controlled trial

BMC Medical Informatics and Decision Making ◽

10.1186/s12911-020-01322-8 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Li Tang ◽

Andy H. Lee ◽

Colin W. Binns ◽

Lian Duan ◽

Yi Liu ◽

...

Keyword(s):

Randomised Controlled Trial ◽

Exclusive Breastfeeding ◽

Intervention Program ◽

Controlled Trial ◽

Control Group ◽

Worst Case ◽

Breastfeeding Rate ◽

Maternity Hospitals ◽

Breastfeeding Rates ◽

Randomised Controlled

Abstract Background Exclusive breastfeeding for the first 6 months of life is the optimal way to feed infants. However, recent studies suggest that exclusive breastfeeding rates in China remain low and are well below the recommended target. There has been evidence that a lack of awareness of, or exposure to, breastfeeding information is associated with poor breastfeeding practices. WeChat, the most widely used social networking platform in China, has shown some potential to promote health behaviours. We thus hypothesised that a breastfeeding intervention program delivered via WeChat would achieve at least a 10% increase in exclusive breastfeeding prevalence at 6 months compared to the control group. Methods A two-arm, parallel, multicentre randomised controlled trial of 1000 pregnant women will be conducted at four maternity hospitals of Chengdu, China. Eligible women who consent to participate in the trial will be recruited at 28–30 weeks of gestation, and randomly allocated to either the intervention group (participants receive breastfeeding-related information from WeChat) or the control group (participants receive non-breastfeeding information from WeChat) using a central randomisation system on a 1:1 ratio at each participating site. The primary outcomes are exclusive breastfeeding rate and full breastfeeding rate at 6 months postpartum. All randomised participants will be included in the outcome analyses with missing data being imputed based on the best-case and worst-case scenarios. Multilevel mixed regression models will be used in the primary analyses to assess the effectiveness of intervention program on the breastfeeding rates. Discussion This trial uses the most widely used social media program as a means of delivering messages to mothers to increase exclusive breastfeeding in China. Increasing exclusive breastfeeding will contribute to meeting the health and environmental goals of the Sustainable Development Guidelines. Trial registration ClinicalTrials.gov, NCT04499404. Registered 5 August 2020—Retrospectively registered, https://clinicaltrials.gov/show/NCT04499404

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The Effectiveness of Using Breastfeeding Program for Father via Facebook to knowledge, Attitude, Behavior of Supporting of 6-Month Exclusive Breastfeeding in Low-Income Country

10.21203/rs.3.rs-915603/v1 ◽

2021 ◽

Author(s):

Thiwawan thepha ◽

Ampornpan Theeranut

Keyword(s):

Low Income ◽

Exclusive Breastfeeding ◽

Intervention Group ◽

Income Country ◽

Control Group ◽

P Value ◽

Low Income Country ◽

Breastfeeding Rate ◽

The Mean ◽

Attitude Behavior

Abstract Background: The six-month exclusive breastfeeding rate in the Northeast region of Thailand has recently significantly decreased in contrast to all other regions in Thailand. Facebook is world widely use to increase that knowledge, attitude and behaviour to support breastfeeding. Therefore, the aim of this study is to test the effectiveness of using 6-month breastfeeding program for father via Facebook to knowledge, attitude, behavior of supporting of breastfeeding in low-income country.Method: A quasi-experimental design was used. The study was carried out from September 2020 – August 2021. The data of experimental group and control group were conducted in two tertiary hospital in Khonkaen province, Northeast Thailand. The participants were husbands of postpartum mothers who were admitted to the Obstetrics ward , Khonkaen Hospital, 2A and 2B ward, Srinagarin Hospital. The demographic data were analyzed by distribution of frequency, mean, percentage and standard deviation. The t-test were used to analyse the mean score of knowledge, attitude and behaviour of father by SPSS version 27. Results: 72 father were included. The different mean score of knowledge, attitude, behaviors of father to support the EBF among baseline and 6-month were shown. In intervention group, the different mean score of knowledge among baseline and 6-month was significant at P-value 0.01. The mean of knowledge at 6 months (mean=19.78, SD=5.50) was higher than the mean of knowledge baseline (mean=16.42, SD=4.22). Similarly, the different mean score of attitudes among baseline and 6-month was significant at P-value 0.14. The mean of attitude at 6-month (mean=108.03, SD=19.89) was higher than the mean of behaviour at baseline (mean=101.81, SD=17.99). In addition, the different score of behaviour among baseline (mean=65.86, SD=7.01) and 6-month (mean=68.58, SD=10.42) was significant at P-value=0.16. The mean score of behavior at baseline is lower than the mean of behaviour at 6 months. In control group, these is only the different mean of behavior baseline and 6-month was significant at P-value=0.00.Conclusions: This confirm that FB is good platform to transfer the breastfeeding knowledge to father in low income country. In the future, this program can be improved and test in other country that has the same condition.

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The Effect of “Insufficient Milk Supply” Concept Intervention on Mother's Perception of Breast Milk Production

INDONESIAN NURSING JOURNAL OF EDUCATION AND CLINIC (INJEC) ◽

10.24990/injec.v1i1.92 ◽

2016 ◽

Vol 1 (1) ◽

pp. 71

Author(s):

Mekar Dwi Anggraeni ◽

Lutfatul Latifah ◽

Ima Rismawati

Keyword(s):

Exclusive Breastfeeding ◽

Intervention Program ◽

Intervention Group ◽

World Health Organisation ◽

T Test ◽

World Health ◽

Milk Supply ◽

Breast Milk Production ◽

Breastfeeding Rate ◽

Insufficient Milk

Background: World Health Organisation (WHO) recommends every mother to provide exclusive breastfeeding for their infants because of its benefits. However the exclusive breastfeeding rate in Indonesia was only 35%in 2013. One of the main factors affecting low exclusive breastfeeding rate was maternal perception of having low breastmilk supply. There were no previous studies examining the effect of "Insufficient Milk Supply" concept intervention on mother’s perception of low breastmilk production. This research was an innovation in nursing.Aim: To investigate the effect of intervention program based on “Insufficient Milk Supply” concept on mother’s perception of low breastmilk supply.Methods: This study was a quasy experiment pretest-posttest. Postpartum mothers were provided an intervention using a module based on the concept of "Insufficient Milk Supply". The perception of breastmilk production was measured using the Nine-items of Lactation Scale. Data were analyzed using independent t test and paired t test.Results: The t test assumptions were examined and yielded that the data were normally distributed and the variances were homogeneous. The results showed there were significant differences between the scores of pre- and post-test in the intervention group (t = -9,03, p < 0.001).Conclusion: This study offers evidence that Insufficient Milk Supply can be used in nursing practice as a concept to improve the perception of the mother's breastmilk supply.

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Trends in breastfeeding rates in Portugal: results from five National Health Interview Surveys

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.963 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

I Kislaya ◽

P Braz ◽

C M Dias ◽

I Loureiro

Keyword(s):

National Health ◽

Exclusive Breastfeeding ◽

Maternity Leave ◽

World Health ◽

Breastfeeding Support ◽

Positive Role ◽

Breastfeeding Practices ◽

Breastfeeding Rate ◽

Breastfeeding Rates ◽

Positive Evolution

Abstract Background The World Health Organization advice breast milk as the perfect food for the newborn starting immediately after birth and exclusively up to at least 6 months of age. However, there are considerable differences in breastfeeding rates between countries related to their policies on breastfeeding promotion and duration of maternity leave. This study aims to describe changes in breastfeeding rates over time in Portugal as a way to inform social policies and public health initiatives on breastfeeding. Methods To examine the breastfeeding rates evolution we used data from five National Health Surveys. Breastfeeding was assessed based on information provided by the mothers of children born between 1982 and 2014. Birth cohorts were grouped in block of 3-year period. We estimated 3 and 6-months exclusive breastfeeding rates and 95% confidence intervals. Trends in breastfeeding rates for each outcome were assessed by linear regression weighting each cohort-specific estimate by the inverse of variance in the logit scale. Results We analyzed data on 9172 children; sample size by birth cohort ranged from 213 in 2012/14 to 1651 in 1994/96. Proportion of infants ever breastfed during the study period varied between 71.7% and 86.7%. The 3 months exclusive breastfeeding rate increased by 9.5% (CI95%:7.8-11.3%) per 3-year period, from 41.3% (CI95%:38.7-43.9%) in 1982/84 to 62.4% (CI95%:55.7-68.7%) in 2012/14. The 6 months exclusive breastfeeding rate raised up from 23.5% (CI 95%:21.2-25.7%) in 1982/84 to 31.9% (CI95%:26.0-38.5%) in 2012/14, corresponding to 5.6% increase per 3-year period. Conclusions This study shows a positive evolution in breastfeeding practices, with an increased in the prevalence of women who reported exclusively breastfeeding until the 3rd and 6th month after birth. Our results may be explained by changes in maternity leave duration. Furthermore, the results emphasize the need for further investment in breastfeeding support services and professionalś training. Key messages Positive evolution in breastfeeding practices in Portugal. Maternity leave duration could have a positive role.

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Improved exclusive breastfeeding rates in preterm infants after a neonatal nurse training program focusing on six breastfeeding-supportive clinical practices

PLoS ONE ◽

10.1371/journal.pone.0245273 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0245273

Author(s):

Ragnhild Maastrup ◽

Ane L. Rom ◽

Sisse Walloee ◽

Helle B. Sandfeld ◽

Hanne Kronborg

Keyword(s):

Training Program ◽

Preterm Infants ◽

Exclusive Breastfeeding ◽

Intervention Group ◽

Control Group ◽

Clinical Practices ◽

Neonatal Nurses ◽

Skin Contact ◽

Postmenstrual Age ◽

Breastfeeding Rates

Background Early breast milk expression, prolonged skin-to-skin contact, rooming-in, use of test-weighing and minimizing use of pacifiers are positively associated with exclusive breastfeeding of preterm infants, whereas use of nipple shields is negatively associated. Aim To test whether a training program for neonatal nurses with a focus on these six breastfeeding-supportive clinical practices affects the rate of preterm infants exclusively breastfed at discharge to home, the postmenstrual age at establishment of exclusive breastfeeding, and maternal self-reported use of the practice in the neonatal intensive care unit, the. Methods A quasi-experimental multi-centre intervention study from 2016–2019 including a control group of 420 preterm mother-infant dyads, an intervention with a training program for neonatal nurses and implementation of weekly breastfeeding meetings for neonatal nurses, and an intervention group of 494 preterm mother-infant dyads. Results Significantly more preterm infants in the intervention group were exclusively breastfed at discharge to home (66.6%) than in the control group (58.1%) p = 0.008. There was no significant difference in postmenstrual age at establishment of exclusive breastfeeding between control and intervention group (37.5 vs.37.8 weeks, p = 0.073). Compared to the control group the number of infants continuing daily skin-to-skin contact after incubator care increased (83.2% vs. 88.3%, p = 0.035), infants using a nipple shield decreased (61.8% vs. 54.2%, p = 0.029), and the number of mothers initiating breast milk expression before six hours post-partum increased (32.6% vs. 42.4%, p = 0.007). There was a significant correlation between percentage of neonatal nurses participating in the breastfeeding training program and changes in exclusive breastfeeding rates (Pearson Correlation 0.638, p = 0.047). Conclusion Exclusive breastfeeding rates in preterm infants and maternal self-reported use of breastfeeding-supportive practices increased by training neonatal nurses in the six clinical practices. It is important to include all nurses in the breastfeeding training program to ensure positive effect on exclusive breastfeeding rates.

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Increasing Hospital Breastfeeding Rates Through Online Education for Staff Registered Nurses

Clinical Lactation ◽

10.1891/2158-0782.6.1.24 ◽

2015 ◽

Vol 6 (1) ◽

pp. 24-34

Author(s):

Ann Baker ◽

Yvonne Weideman ◽

Debra Facello

Keyword(s):

Online Education ◽

Registered Nurses ◽

Exclusive Breastfeeding ◽

Negative Attitude ◽

Cost Effective ◽

Breastfeeding Initiation ◽

Improvement Project ◽

Breastfeeding Rate ◽

Breastfeeding Rates ◽

Clinically Significant

Background: The Baby-Friendly Hospital Initiative of 2010 recommends the proportion of mothers who breastfeed their babies in the early postpartum period should be at least 75% (Baby-Friendly USA, 2010). The exclusively breastfeeding rate at a community hospital located in the Appalachian region is 44%, well below the proposed standard. Registered nurses who lack knowledge or exhibit a negative attitude toward breastfeeding, can impede the understanding and skills necessary to empower mothers to effectively breastfeed.Purpose: This performance improvement project was designed to determine whether an online educational module was effective in increasing the knowledge and improving the attitudes of nurses working with breastfeeding mothers.Methods: A pre- and posttest design was used to evaluate nurse’s attitudes and knowledge of breastfeeding.Results: The results of the paired-sample t-test indicated a significant increase in the Breastfeeding Initiation Practice scores pre- and posttest. The exclusive breastfeeding rate had a clinically significant change from 44% to 58%.Conclusion: An online educational intervention was effective in increasing the knowledge of nurses working with breastfeeding mothers. This efficient and cost-effective intervention may be valuable to hospitals desiring to increase exclusive breastfeeding rates by increasing the knowledge and skill of staff.

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