Evaluation of the Effect of Video-Based Breastfeeding Education Provided to Mothers Who Delivered by Cesarean Section and Vaginal Birth on Infant Feeding Attitudes

Breastfeeding is the recommended method of infant feeding because it provides substantial health benefits for both infants and mothers. However, many primiparous mothers experience difficulties initiating and maintaining breastfeeding, particularly after cesarean section. Digital educational interventions, such as video-based breastfeeding education, may improve maternal knowledge and infant feeding attitudes by providing standardized and accessible educational content.

This randomized controlled experimental study was conducted to evaluate the effect of video-based breastfeeding education on infant feeding attitudes among primiparous mothers who delivered by cesarean section or vaginal birth. The study used a pretest-posttest design with a three-month follow-up and was conducted at Zonguldak Women and Children's Hospital in Türkiye between April 15, 2025, and October 30, 2025.

The target sample size was determined using G*Power version 3.1.9.7. A minimum of 84 participants was required to achieve 80% statistical power with a significance level of 0.05. To compensate for possible loss to follow-up, the target sample size was increased to 90 participants. A total of 111 mothers were initially enrolled, and the study was completed with 90 participants after follow-up.

Participants were randomly assigned to one of three groups: a vaginal birth intervention group, a cesarean section intervention group, or a control group. Mothers in the intervention groups completed baseline assessments and then received standardized video-based breastfeeding education through a QR code that provided access to an educational video. The control group received routine postpartum care without the educational intervention.

Data were collected using a Sociodemographic Information Form and the Turkish version of the Iowa Infant Feeding Attitude Scale (IIFAS). The educational video was developed based on current breastfeeding guidelines and expert review. Its quality was evaluated using the DISCERN instrument before implementation, and a pilot test was conducted to assess comprehensibility before use in the main study.

Infant feeding attitudes were assessed at baseline and again three months after delivery. Follow-up data were collected electronically using Google Forms distributed through WhatsApp, with telephone reminders provided when necessary to maximize participant retention.

The primary objective of the study was to determine whether video-based breastfeeding education improves infant feeding attitudes among primiparous mothers and whether its effectiveness differs between mothers who delivered by cesarean section and those who delivered by vaginal birth.

Inclusion criteria

-Primiparous mothers (first childbirth). Mothers who delivered by cesarean section or vaginal birth. Currently breastfeeding their infant. No previous breastfeeding education or counseling. Able to communicate in Turkish.

Exclusion criteria

• Multiparous mothers. Mothers who were not breastfeeding. Mothers who had previously received breastfeeding education or counseling. Mothers who were unable to communicate in Turkish.