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Maternal and Child Health Journal

, Volume 18, Issue 1, pp 296–306 | Cite as

Effectiveness of a Breastfeeding Self-efficacy Intervention: Do Hospital Practices Make a Difference?

  • Keiko OtsukaEmail author
  • Masataka Taguri
  • Cindy-Lee Dennis
  • Kiriko Wakutani
  • Masayo Awano
  • Takuhiro Yamaguchi
  • Masamine Jimba
Article

Abstract

Breastfeeding self-efficacy interventions are important for improving breastfeeding outcomes. However, the circumstances that may influence the effectiveness of the interventions are unclear, especially in the context of hospitals with suboptimal infant feeding practices. Thus, we aimed to evaluate the effect of a self-efficacy intervention on breastfeeding self-efficacy and exclusive breastfeeding, and further assessed the difference in its effect by hospital-routine type. In this intervention study with a control group, 781 pregnant women were recruited from 2 “Baby-Friendly”-certified hospitals (BFH) and 2 non-Baby-Friendly Hospitals (nBFH) in Japan, and were allocated to an intervention or control group. Participants in the intervention group were provided with a breastfeeding self-efficacy workbook in their third trimester. The primary outcome was breastfeeding self-efficacy and the secondary outcome was infant feeding status. All analyses were stratified by the type of hospital, BFH or nBFH. In BFHs, the intervention improved both breastfeeding self-efficacy through 4 weeks postpartum (p = 0.037) and the exclusive breastfeeding rate at 4 weeks postpartum (AOR 2.32, 95 % CI 1.01–5.33). In nBFHs, however, no positive effect was observed on breastfeeding self-efficacy (p =  0.982) or on the exclusive breastfeeding rate at 4 weeks postpartum (AOR 0.97, 95 % CI 0.52–1.81); in nBFHs, supplementation was provided for breastfed infants and the mother and infant were separated in the vast majority of cases. Infant feeding status at 12 weeks was not improved in either hospital type. The intervention improved breastfeeding self-efficacy and exclusive breastfeeding at 4 weeks postpartum only in BFHs. When breastfeeding self-efficacy interventions are implemented, hospital infant feeding practices may need to be optimized beforehand.

Keywords

Baby-Friendly Hospitals Breastfeeding self-efficacy Exclusive breastfeeding Intervention Japan 

Notes

Acknowledgments

This study was funded by the St. Luke’s Life Science Institute. The authors are most grateful to the women who participated in the survey at a particularly busy time in their lives, and to the staff members of the hospitals who distributed and collected the questionnaires. We also thank the following researchers who contributed to the development of the research protocol and analytic strategy: Colin Binns, Andy Lee, Toshinori Kitamura, Krishna Poudel, Junko Yasuoka, and Akira Shibanuma. Finally, we acknowledge the contribution of the following researchers in the conduct of the survey: Xiu-Fang Wang, Sumiyo Okawa, Yuko Matsuoka, and Kayoko Yoshikawa.

References

  1. 1.
    Ip, S., Chung, M., & Raman, G., et al. (2007). Breastfeeding and maternal and infant health outcomes in developed countries: Evidence report/technology assessment no. 153. Rockville, MD: Agency for Healthcare research and Quality; AHRQ Publication no. 07-E.Google Scholar
  2. 2.
    American Academy of Pediatrics, Section on Breastfeeding. (2012). Breastfeeding and the use of human milk. Pediatrics, 129, e827–e841.CrossRefGoogle Scholar
  3. 3.
    WHO & UNICEF. (2009). Baby-Friendly Hospital Initiative-Revised, Updated, and Expanded for Integrated Care, 2009. Available at: http://www.unicef.org/nutrition/index_24850.html. Accessed December 28, 2011.
  4. 4.
    Mass, S. B. (2011). Supporting breastfeeding in the United States: The Surgeon General’s call to action. Current Opinion in Obstetrics and Gynecology, 23, 460–464.CrossRefGoogle Scholar
  5. 5.
    WHO. (2011). World Health Statistics 2011. Geneva: WHO.Google Scholar
  6. 6.
    Equal Employment, Children and Families Bureau, Japanese Ministry of Health, Labour and Welfare. (2006). Report on infant feeding in Japan. Tokyo, Japan: Ministry of Health Labour and Welfare (in Japanese).Google Scholar
  7. 7.
    Equal Employment, Children and Families Bureau, Japanese Ministry of Health Labour and Welfare. (2011). Survey on the growth of infants and preschool children in Japan, 2010. Tokyo, Japan: Equal employment, Children and Families Bureau, Ministry of Health Labour and Welfare (in Japanese).Google Scholar
  8. 8.
    Inoue, M., Binns, C. W., Otsuka, K., Jimba, M., & Matsubara, M. (2012). Infant feeding practices and breastfeeding duration in Japan: A review. International Breastfeeding Journal, 25, 15.CrossRefGoogle Scholar
  9. 9.
    Meedya, S., Fahy, K., & Kable, A. (2010). Factors that positively influence breastfeeding duration to 6 months: A literature review. Women Birth, 23, 135–145.CrossRefGoogle Scholar
  10. 10.
    Dennis, C. L. (1999). Theoretical underpinnings of breastfeeding confidence: A self-efficacy framework. Journal of Human Lactation, 15, 195–201.CrossRefGoogle Scholar
  11. 11.
    Blyth, R., Creedy, D. K., Dennis, C. L., et al. (2002). Effect of maternal confidence on breastfeeding duration: An application of breastfeeding self-efficacy theory. Birth, 29, 278–284.CrossRefGoogle Scholar
  12. 12.
    Dennis, C. L., Heaman, M., & Mossman, M. (2011). Psychometric testing of the breastfeeding self-efficacy scale-short form among adolescents. Journal of Adolescent Health, 49, 265–271.CrossRefGoogle Scholar
  13. 13.
    Oliver-Roig, A., d’Anglade-González, M. L., García-García, B., et al. (2012). The Spanish version of the Breastfeeding Self-Efficacy Scale-Short Form: reliability and validity assessment. International Journal of Nursing Studies, 49, 169–173.CrossRefGoogle Scholar
  14. 14.
    Otsuka, K., Dennis, C. L., Tatsuoka, H., & Jimba, M. (2008). The relationship between breastfeeding self-efficacy and perceived insufficient milk among Japanese mothers. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 37, 546–555.CrossRefGoogle Scholar
  15. 15.
    Aluş Tokat, M., Okumuş, H., & Dennis, C. L. (2010). Translation and psychometric assessment of the Breast-feeding Self-Efficacy Scale-Short Form among pregnant and postnatal women in Turkey. Midwifery, 26, 101–108.CrossRefGoogle Scholar
  16. 16.
    Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84, 191–215.CrossRefGoogle Scholar
  17. 17.
    Nichols, J., Schutte, N. S., Brown, R. F., et al. (2009). The impact of a self-efficacy intervention on short-term breast-feeding outcomes. Health Education & Behavior, 36, 250–258.CrossRefGoogle Scholar
  18. 18.
    McQueen, K. A., Dennis, C. L., Stremler, R., & Norman, C. D. (2011). A pilot randomized controlled trial of a breastfeeding self-efficacy intervention with primiparous mothers. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 40, 35–46.CrossRefGoogle Scholar
  19. 19.
    Noel-Weiss, J., Bassett, V., & Cragg, B. (2006). Developing a prenatal breastfeeding workshop to support maternal breastfeeding self-efficacy. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 35, 349–357.CrossRefGoogle Scholar
  20. 20.
    Noel-Weiss, J., Rupp, A., Cragg, B., et al. (2006). Randomized controlled trial to determine effects of prenatal breastfeeding workshop on maternal breastfeeding self-efficacy and breastfeeding duration. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 35, 616–624.CrossRefGoogle Scholar
  21. 21.
    Hill, P. D., Humenick, S. S., Brennan, M. L., & Woolley, D. (1997). Does early supplementation affect long-term breastfeeding? Clinical Pediatrics, 36, 345–350.CrossRefGoogle Scholar
  22. 22.
    Renfrew, M. J., Lang, S., Martin, L., & Woolridge, M. W. (2000). Feeding schedules in hospitals for newborn infants. Cochrane Database of Systematic Reviews, 2, CD000090.Google Scholar
  23. 23.
    Declercq, E., Labbok, M. H., Sakala, C., & O’Hara, M. (2009). Hospital practices and women’s likelihood of fulfilling their intention to exclusively breastfeed. American Journal of Public Health, 99, 929–935.CrossRefGoogle Scholar
  24. 24.
    Takeshi, H., Takeo, S., Taku, Y., & Michiko, N. (2002). Starting prevention of childrearing anxiety in perinatal period. Tokyo: Japanese Ministry of Health, Labour, and Welfare.Google Scholar
  25. 25.
    Bandura, A. (1997). Self-efficacy: The exercise of control. New York, NY: Worth Publishers.Google Scholar
  26. 26.
    Labbok, M., & Krasovec, K. (1990). Toward consistency in breastfeeding definitions. Studies in Family Planning, 21, 226–230.CrossRefGoogle Scholar
  27. 27.
    Labbok, M. H., & Coffin, C. J. (1997). A call for consistency in definition of breastfeeding behaviors. Social Science and Medicine, 44, 1931–1932.CrossRefGoogle Scholar
  28. 28.
    Thulier, D., & Mercer, J. (2009). Variables associated with breastfeeding duration. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 38, 259–268.CrossRefGoogle Scholar
  29. 29.
    Kaneko, A., Kaneita, Y., Yokoyama, E., et al. (2006). Factors associated with exclusive breast-feeding in Japan: For activities to support child-rearing with breast-feeding. Journal of Epidemiology, 16, 57–63.CrossRefGoogle Scholar
  30. 30.
    Dennis, C. L., & McQueen, K. (2009). The relationship between infant-feeding outcomes and postpartum depression: A qualitative systematic review. Pediatrics, 123, e736–e751.CrossRefGoogle Scholar
  31. 31.
    de la Mora, A., Russell, D. W., Dungy, C. I., et al. (1999). The Iowa Infant Feeding Attitude Scale: Analysis of Reliability and Validity. Journal of Applied Social of Psychology, 29, 2362–2380.CrossRefGoogle Scholar
  32. 32.
    Smilkstein, G., Ashworth, C., & Montano, D. (1982). Validity and reliability of the family APGAR as a test of family function. Journal of Family Practice, 15, 303–311.PubMedGoogle Scholar
  33. 33.
    Nagamine, T., Wada, Y., Ishikawa Y., & Maezawa, M. (1988). The explanatory model among patients with asthma. Gekkann Chiiki Iryo, 7, 126–133 (in Japanese).Google Scholar
  34. 34.
    Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. The British Journal of Psychiatry, 150, 782–786.CrossRefGoogle Scholar
  35. 35.
    Okano, T., Murata, M., & Masuji, F. (1996). Validation and reliability of a Japanese version of the EPDS. Archives of Psychiatric Diagnostics and Clinical Evaluation, 7, 525–533.Google Scholar

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Authors and Affiliations

  • Keiko Otsuka
    • 1
    Email author
  • Masataka Taguri
    • 2
  • Cindy-Lee Dennis
    • 3
  • Kiriko Wakutani
    • 4
  • Masayo Awano
    • 5
  • Takuhiro Yamaguchi
    • 6
  • Masamine Jimba
    • 1
  1. 1.Department of Community and Global Health, Graduate School of MedicineThe University of TokyoTokyoJapan
  2. 2.Department of Biostatistics and Epidemiology, Graduate School of MedicineYokohama City UniversityYokohamaJapan
  3. 3.Faculties of Nursing and Medicine, Department of PsychiatryUniversity of Toronto and Women’s College HospitalTorontoCanada
  4. 4.Women’s Health Outpatient WardOkinawa Miyako HospitalMiyakoJapan
  5. 5.Kanazawa UniversityKanazawaJapan
  6. 6.Division of BiostatisticsTohoku University Graduate School of MedicineSendaiJapan

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