The Effect of Web-Based Counselling on Breastfeeding Experiences and Infant Care Competence Among Mothers of Preterm Babies

The Effect of Web-Based Counselling on Breastfeeding Experiences and Infant Care Competence Among Mothers of Preterm Babies

Breast milk is of great importance for preterm infants in terms of optimal growth, immune system development, and neurodevelopment. However, mothers who give birth prematurely may face various challenges during the breastfeeding process due to their infants' need for monitoring in the neonatal intensive care unit, mother-infant separation, and the need to pump breast milk. This situation can negatively affect the experience of expressing breast milk and the mother's perception of her competence in caring for her baby.

The aim of this randomized controlled trial is to evaluate the effect of web-based breastfeeding counseling on the breast milk expression experience and the competence in caring for a preterm infant among mothers of preterm infants. A total of 56 mothers who gave birth preterm at 30 weeks of gestation or later and whose infants are being monitored in the neonatal intensive care unit will be included in the study. Participants will be randomly assigned to the intervention and control groups.

Mothers in the intervention group will have access to a Moodle-based training program that includes video training on breastfeeding counseling and care for premature infants, as well as the opportunity to ask the researcher questions online. Mothers in the control group, on the other hand, will continue to receive the hospital's routine education and care services.

The primary outcome measures of the study will be assessed using the Breastfeeding Experience Scale and the Premature Infant Care Competence Assessment Tool. Measurements will be taken at the start of the study, following the training, and at the end of the one-month follow-up period to examine the effect of web-based counseling on mothers' breastfeeding experience and care competence.

For preterm infants, breast milk is the most important source of nutrition for optimal growth, immune system development, and neurodevelopment. However, mothers who give birth prematurely may face various challenges during the breastfeeding process due to separation from their baby, the baby's admission to the neonatal intensive care unit, the need to pump breast milk, and the physical and psychosocial difficulties experienced after childbirth. This situation can affect the maintenance of breast milk production, the pumping experience, and mothers' confidence in caring for their preterm babies. Today, digital health applications support continuity of care by providing mothers with education and counseling during the postpartum period, independent of time and location. However, evidence evaluating the impact of web-based breastfeeding counseling for mothers of preterm infants on their breast milk expression experience and caregiving competence is limited.

This study is a randomized controlled experimental study designed to evaluate the effect of web-based breastfeeding counseling on the breast milk expression experience and caregiving competence of mothers of preterm infants. The study will include a total of 56 mothers who have given birth prematurely at 30 or more weeks of gestation, whose infants are being monitored in a neonatal intensive care unit, who are first-time mothers, and who have voluntarily agreed to participate in the study. Participants will be randomly assigned to the intervention and control groups.

Mothers in the intervention group will receive breastfeeding counseling and training on the care of premature infants via a Moodle-based online training platform. The training program will consist of short, hands-on instructional videos covering topics such as the importance of breast milk for premature infants, milk expression methods, breast milk storage, maintaining breastfeeding, managing common breastfeeding challenges, kangaroo care, daily care of premature infants, and post-discharge care. Participants will be able to access the educational materials at any time and contact the researcher online to ask questions.

Mothers in the control group, on the other hand, will continue to receive the standard breastfeeding education and routine care services provided at the hospital throughout the study. Data will be collected from both groups at baseline, after the intervention, and at the end of the one-month follow-up period. The Breast Milk Expression Experience Scale and the Premature Infant Care Competency Assessment Tool will be used to evaluate the results.

The aim of this study is to provide evidence on the impact of digital breastfeeding counseling and infant care for mothers of preterm infants on their breast milk expression experience and caregiving competence, and to contribute to the development of sustainable remote counseling models following discharge from the neonatal intensive care unit.

Inclusion Criteria:

• To be a first-time mother (primipara).
• To have had a preterm birth at 30 weeks or more of gestation.
• For the baby to be hospitalized in the neonatal intensive care unit.
• For the newborn to have no medical condition that prevents breastfeeding.
• To be able to read and understand Turkish.
• To be willing to participate in the study.

Exclusion Criteria:

• Mothers with a medical condition contraindicating breastfeeding.
• Infants with a major congenital anomaly or medical condition preventing breast milk feeding.
• Withdrawal of consent or inability to complete follow-up assessments.