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NCT Number: NCT07478341

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

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.

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Key information

Age range

18 year–35 year

Sex eligibility

Female

Study type

Interventional

Phase

Not applicable

Primary location

Elbistan Devlet Hastanesi

Elbistan, Kahramanmaraş, 46040, Turkey (Türkiye)

Location status: Recruiting

Location contact

Asst. Prof.

CONTACT

[email protected]

03443004901

About this study

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.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

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.

Treatment and study plan

Individualized Hybrid Breastfeeding Education

Behavioral

Primiparous pregnant women in the intervention group will receive an individualized hybrid breastfeeding education program planned for late pregnancy. The education consists of a hybrid structure including face-to-face sessions and online educational materials. The content covers the importance of breastfeeding, breastfeeding techniques, common breastfeeding problems, approaches to support mother-infant attachment, and preparation for the postpartum breastfeeding process. The intervention will be provided in addition to standard prenatal care.

Other names: Standard Prenatal Care

Primary outcomes

  1. Antenatal Maternal Attachment

    Time frame: 36-38 weeks of pregnancy

    The level of antenatal maternal attachment will be assessed using the Maternal Antenatal Attachment Scale (MAAS). The scale consists of 19 items rated on a 5-point Likert scale. Total scores range from 19 to 95, with higher scores indicating stronger antenatal maternal attachment.

Secondary outcomes

  1. Breastfeeding Self-Efficacy

    Time frame: At 1 and 6 weeks postpartum

    Breastfeeding self-efficacy will be assessed using the Breastfeeding Self-Efficacy Scale (BSES). The scale consists of 33 items rated on a 5-point Likert scale. Total scores range from 33 to 165, with higher scores indicating greater breastfeeding self-efficacy.

Study contacts

Contact information is provided by the study sponsor or research team.

Asst. Prof.

CONTACT

[email protected]

3443004901

Sponsors and collaborators

Lead sponsor

Emel GÜÇLÜ CİHAN

Other

Collaborators

  • Kahramanmaras Sutcu Imam University

Registry information

Official study title

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

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
Mar 17, 2026
Registry last updated
Mar 17, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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