Impact of Video-Based Breastfeeding Education on Self-Care Competencies of Postnatal Women ^†

The postnatal period is a critical stage in the lives of both mothers and newborn infants [1]. Postnatal and newborn discharge education lacks standard teaching material, leading to unclear teaching at discharge and exposing unmet maternal expectations [2]. This study aimed to assess the effectiveness of video-based breastfeeding education in improving self-care competencies of postnatal women. The objectives of this study were to (a) examine the proportion of breastfeeding-related information received by women from healthcare providers before discharge and (b) develop and evaluate the effectiveness of a video-based breastfeeding education regarding self-care competencies of postnatal women. The study was conducted in two phases. In phase one, a survey, 130 postnatal women who were recruited through purposive sampling completed a 7-item five-point Likert scale questionnaire to express their satisfaction with breastfeeding information received before discharge from healthcare providers. The scale ranged from 5, fully satisfied, to 1, not satisfied. The overall scores were interpreted as <50%, inadequately satisfied; 50–75%, adequately satisfied; and >75%, highly satisfied. The postnatal women's satisfaction with addressing maternal questions or issues with breastfeeding by healthcare providers was also assessed (satisfied/dissatisfied). Based on these results, a video on breastfeeding education was prepared. In phase two, the impact of a video-based breastfeeding education program on postnatal women’s self-care competencies was evaluated using a pre-experimental one-group pre-test post-test design. Self-care competencies included the knowledge and proficiency of postnatal women on breastfeeding and its technique. Fifty postnatal women completed a 12-item breastfeeding knowledge questionnaire before and after the intervention. The breastfeeding knowledge questionnaire had items related to breast milk characteristics, initiation of breastfeeding, exclusive breastfeeding, and breast care [3]. The breastfeeding knowledge questionnaire developed by the investigator was validated by nursing experts, and reliability was established using the test re-test method with a value of 0.7. Postnatal women’s proficiency in breastfeeding their infants was observed before and after the intervention using the standardized LATCH tool [4] by research assistants who were blinded to postnatal women’s exposure to video-based breastfeeding education. LATCH is a breastfeeding documentation tool that assigns a numerical score of 0, 1, or 2 to five key components of breastfeeding, such as latch, audible swallowing, type of nipple, comfort (breast/nipple), and hold (positioning), for a possible total score of 10 points. The key components were scored based on observation and interpreted as 0–3: poor, 4–7: moderate, and 8–10 as good. Frequency and percentages were used to assess the postnatal women's satisfaction with information received from healthcare providers before discharge and their satisfaction with information from healthcare providers’ regarding the maternal questions/issues on breastfeeding. Mean and standard deviation are used to report the level of self-care competencies before and after intervention. A paired t-test was used to compare the differences in the self-care competencies before and after intervention. The results of phase one revealed that 11 (8.5%) postnatal women were highly satisfied and 96 (73.8%) were adequately satisfied with information received regarding breastfeeding before discharge. However, the majority of postnatal women (114 (87.6%)) expressed dissatisfaction with the healthcare providers’ information on maternal questions/issues regarding breastfeeding. In phase two, the mean pre-test knowledge score on breastfeeding of 8.6 ±1.63 improved to 10.82 ± 1.77 (p < 0.001) in the post-test after the video-based breastfeeding education program. Observation showed that during the pre-test, 11 women (22%) had moderate LATCH scores and 39 women (78%) had good latching skills. Subsequently, in the post-test, 100% of postnatal women had good LATCH scores. This study concluded that women were not fully satisfied with the information from healthcare providers regarding maternal questions/issues on breastfeeding during discharge. Utilization of a well-developed, evidence-supported video-based breastfeeding education prior to discharge successfully enhanced the self-care competencies of postnatal women with breastfeeding.