Hybrid Breastfeeding Education in Late Pregnancy: Effects on Antenatal Attachment and Breastfeeding

The Effect of Individualized Hybrid Breastfeeding Education in Late Pregnancy on Antenatal Attachment and Breastfeeding Behaviors in Primiparous Women

This randomized controlled study aims to examine the effect of individualized hybrid breastfeeding education provided during late pregnancy on antenatal attachment and breastfeeding behaviors among first-time mothers. Participants will be randomly assigned to either the intervention or control group. Women in the intervention group will receive individualized hybrid breastfeeding education beginning at the 36th week of pregnancy. The program includes a face-to-face individual breastfeeding education session at 36 weeks of pregnancy and a reinforcement and practice session at 38 weeks. Participants will also have access to personalized digital educational materials, short educational videos, and online consultation support. In the postpartum period, participants will receive an online support session during the first week after birth and a follow-up session through online communication or telephone at the sixth postpartum week. The control group will receive routine hospital education during pregnancy. After completion of the study, the same educational materials will be provided to the control group in accordance with ethical principles. Data will be collected using the Demographic Information Form, Breastfeeding Behavior Evaluation Form, Antenatal Attachment Inventory, and Breastfeeding Self-Efficacy Scale. Written informed consent will be obtained from all participants prior to enrollment.

Maternal emotional attachment to the fetus during pregnancy is an important factor influencing breastfeeding success and the quality of mother-infant interaction in the postpartum period. Higher levels of antenatal attachment have been associated with earlier initiation of breastfeeding and stronger emotional bonding with the infant after birth. Educational and psychosocial interventions during pregnancy may therefore play an important role in strengthening the maternal-infant relationship and improving breastfeeding outcomes.

Breastfeeding is not only a nutritional practice but also a biological and psychosocial process that supports the development of secure attachment between mother and infant. Sustained breastfeeding contributes to maternal responsiveness and supports the infant's emotional security and development. First-time mothers often experience lower breastfeeding self-efficacy and may require additional professional guidance and support during the breastfeeding process.

Educational interventions implemented during pregnancy can enhance maternal knowledge, confidence, and emotional readiness for breastfeeding. Hybrid educational models that combine face-to-face and online approaches may increase accessibility while accommodating the physical and time limitations experienced during late pregnancy. Personalized digital educational materials and online counseling can further support mothers by providing flexible access to breastfeeding information and professional guidance.

However, studies examining individualized hybrid breastfeeding education programs initiated during the late stages of pregnancy for first-time mothers remain limited. Evaluating the effectiveness of such programs may contribute to improving antenatal attachment and promoting positive breastfeeding behaviors after birth.

Therefore, the purpose of this randomized controlled study is to evaluate the effect of individualized hybrid breastfeeding education initiated during late pregnancy (approximately at the 36th week of gestation) on antenatal attachment and breastfeeding behaviors among primiparous women.

Inclusion Criteria:

Aged 18-35 years,

At 36 weeks of gestation or later,

Experiencing their first pregnancy (primiparous),

Having a singleton pregnancy,

Able to read and write in Turkish and capable of communication,

Having access to a smartphone or the internet,

Free from any physical or mental health problems that would prevent participation in the education,

Willing to voluntarily participate in the study and provide written informed consent.

Exclusion Criteria:

Presence of chronic physical illness or pregnancy complications (e.g., preeclampsia, gestational diabetes),

Multiple pregnancy,

Gestation earlier than 36 weeks,

Inability to actively participate in the education due to communication barriers or cognitive impairment,

Lack of access to a smartphone or the internet,

Failure to attend any stage of the educational program or voluntary withdrawal from the study,

Refusal to participate in the study or failure to sign the informed consent form.