The Effect of Prenatal Education on Breastfeeding Uptake

CQ #266 - January 2, 2023

by Anne Eglash MD, IBCLC, FABM

#LactFact

Prenatal breastfeeding education improves breastfeeding uptake.

The effectiveness of prenatal breastfeeding education on breastfeeding uptake postpartum: A systematic review
Midwifery. 2022 Dec 14;118:103579. doi: 10.1016/j.midw.2022.103579

Does prenatal education improve breastfeeding rates?

The Baby Friendly Hospital Initiative (BFHI) includes prenatal breastfeeding education as a crucial strategy to increase breastfeeding rates. The World Health Organization set a 2025 goal of 50% exclusive breastfeeding at 6 months, yet we are far from that goal. In the USA, our 2019 six-month exclusive breastfeeding rate was 24.9%.

There is evidence that lack of knowledge among lactating individuals has a negative impact on breastfeeding rates, as many parents have difficulty understanding and assessing lactation issues, such as sore nipples, latch, low milk production, etc.

The authors of today’s article conducted a systematic review of 14 studies that reported quantitative and qualitative evaluation or effectiveness of all forms of prenatal breastfeeding education on breastfeeding uptake postpartum. Breastfeeding uptake included breastfeeding self-efficacy, attitude, knowledge, family support, and rates of breastfeeding initiation/duration.

The researchers found that overall, various forms of prenatal breastfeeding education increased breastfeeding uptake. Check out the question for details!

What do you think are true statements regarding the effectiveness of prenatal breastfeeding education, based on this systematic review. Choose 1 or more:

Individual prenatal breastfeeding education was found to be less effective than group prenatal education.
Prenatal education in general increased maternal self-efficacy, which in turn increased breastfeeding rates.
Face to face, interactive prenatal breastfeeding education was found to be more effective than pre-recorded computer-based education.

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Correct Answers: B (not A or C)

The effectiveness of prenatal breastfeeding education on breastfeeding uptake postpartum: A systematic review
Midwifery. 2022 Dec 14;118:103579. doi: 10.1016/j.midw.2022.103579
Jennifer Kehinde, Claire O’Donnell, Annmarie Grealish

Abstract

Objective

The decision to breastfeed is influenced by physiological, psychological, and emotional factors. However, the importance of equipping mothers with the necessary knowledge for successful breastfeeding practice cannot be ruled out. Studies suggest that the decline in global breastfeeding rate can be linked to lack of adequate breastfeeding education during prenatal stage. Therefore, this review aims to determine the effectiveness of prenatal breastfeeding education on breastfeeding uptake postpartum.

Method

A systematic review of the studies identified by electronic database search (Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Psych INFO, and Sociological Abstracts and Applied Social Sciences Index and Abstracts (ASSIA) published between 2014 - 2021.

Results

A total of 14 studies met the inclusion criteria. Results showed an increase in breastfeeding uptake, breastfeeding knowledge, increase in positive attitude to breastfeeding and an increase in maternal breastfeeding self-efficacy among mothers who participated in breastfeeding educational programs during prenatal care.

Conclusion

Prenatal breastfeeding education increases women's knowledge of breastfeeding. Mothers who are knowledgeable about breastfeeding and hold a positive approach towards breastfeeding have the tendency to initiate breastfeeding and continue for a lengthened period. Findings demonstrate a general correlation between prenatal breastfeeding education and increased breastfeeding uptake postpartum. The high level of positive breastfeeding outcome inherent in all the studies can be attributed to prenatal breastfeeding education.

IABLE Comment by Anne Eglash MD, IBCLC, FABM

The 14 studies in this systematic review incorporated different strategies of prenatal education, which are nicely outlined in a chart for anyone looking for ideas on incorporating prenatal lactation education and support.

There is no strong evidence that group education is more effective than individualized education. Some of the studies used computer-based programs and interactive computer games for education, while others provided live group prenatal education. The systematic review was largely descriptive and didn’t compare the different educational methods to determine those that were most effective. All of the studies found that prenatal education improved breastfeeding self-efficacy scoring, and a general awareness of the importance of breastfeeding.

Some of the studies found that including family members in the prenatal education increased mothers’ self-efficacy because of perceiving more social support.

The authors acknowledge that more research is needed to determine best strategies for prenatal education, although one format will not likely fit all populations. I encourage people to share, in the comments, what prenatal breastfeeding education strategies they have found to be successful in their communities or practices.

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Comments (2)

Jeana Rude, IBCLC

January 3, 2023 at 10:40 AM

This is so validating as a prenatal educator. Although I am surprised that the pre-recorded computer education was the same as in person interactive education, it is so nice to know that I may be making a difference, even if I don’t get to follow the people who take my classes to see how successful they are in their breastfeeding journey. It is such a balance in prenatal education to balance the realism, the challenges and maintain optimism that breastfeeding is possible and worth the work.

Mirine Richey

January 3, 2023 at 11:49 AM

In our home visiting curriculum we have strategically placed topics in both our prenatal and postpartum materials to review with the client/family. We offer an extended training on breastfeeding (20 hours) to help ensure home visiting staff are minimally skilled to dive a little deeper than the basics when needed and to know how to refer. I am working on evaluating the standard education vs standard education given by a BF trained home visitor, as I feel many of the studies published do not explore the education or training level of the educator or counselor.