Effectiveness of Breastfeeding Education Using a Lactation Simulation Model Among Nursing Students: A Randomized Controlled Trial

Breastfeeding is recognized as the optimal method of infant feeding and is associated with significant short- and long-term health benefits for both mothers and infants. International organizations recommend exclusive breastfeeding during the first six months of life and continued breastfeeding with appropriate complementary feeding thereafter. Effective breastfeeding counseling provided by healthcare professionals is essential for improving breastfeeding outcomes.

Nursing students frequently encounter breastfeeding mothers during maternity clinical placements; however, many students report insufficient confidence and practical competence in breastfeeding counseling. Simulation-based education has emerged as an effective educational strategy that enables students to practice clinical procedures, communication skills, and patient education in a realistic but safe learning environment before interacting with actual patients.

This randomized controlled trial evaluated the effectiveness of a lactation simulation model on nursing students' breastfeeding education competencies and maternal breastfeeding outcomes. Fourth-year nursing students enrolled in the Department of Nursing at Izmir Katip Celebi University were randomly allocated to intervention and control groups using a computer-generated randomization sequence.

All participants received routine theoretical breastfeeding education as part of the undergraduate nursing curriculum. Students allocated to the intervention group additionally received simulation-based breastfeeding education using a lactation simulation model in the Women's Health Nursing Skills Laboratory before beginning their maternity clinical placement. The simulation sessions focused on breastfeeding techniques, positioning, latch assessment, management of common breastfeeding problems, effective communication, and breastfeeding counseling.

Following completion of the educational intervention, students provided standardized breastfeeding education to postpartum mothers hospitalized in the postpartum unit of Izmir Ataturk Training and Research Hospital. Maternal breastfeeding self-efficacy was evaluated using the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), breastfeeding success was assessed using the LATCH Breastfeeding Assessment Tool, students' educational performance was evaluated using a Breastfeeding Education Evaluation Form, and educational satisfaction was assessed using the Adult Education Satisfaction Scale.

The study aimed to determine whether simulation-based breastfeeding education improved nursing students' educational competencies and contributed to better maternal breastfeeding outcomes compared with routine theoretical education alone.

Inclusion criteria

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Nursing Students:

• Fourth-year undergraduate nursing students enrolled in the Department of Nursing at Izmir Katip Celebi University.
• Students undertaking their maternity nursing clinical placement during the study period.
• Students who voluntarily agreed to participate and provided written informed consent.

Postpartum Mothers:

• Mothers hospitalized in the postpartum unit of Izmir Ataturk Training and Research Hospital.
• Mothers aged 18 years or older.
• Mothers who delivered a healthy singleton infant.
• Mothers who were breastfeeding their infants.
• Mothers who were able to communicate in Turkish.
• Mothers who voluntarily agreed to participate and provided written informed consent.

Exclusion criteria

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Nursing Students:

• Students who did not complete the educational intervention or clinical placement.
• Students who withdrew from the study or had excessive absenteeism during the clinical placement.

Postpartum Mothers:

• Mothers with medical conditions contraindicating breastfeeding.
• Infants with congenital anomalies or medical conditions preventing breastfeeding.
• Mothers whose infants required admission to the neonatal intensive care unit.
• Mothers who declined participation or withdrew consent.