Effectiveness of Breastfeeding Self-efficacy Enhancement: A Systematic Review
Keywords:
Breastfeeding, Effectiveness, Breastfeeding self-efficacy, Systematic reviewAbstract
Breast milk provides the optimal food for infants. Breastfeeding self-efficacy is the most influential factor in successful breastfeeding. The purpose of this systematic review was to study the effectiveness of breastfeeding self-efficacy enhancement in pregnant women and/or postpartum women. A comprehensive search was performed on all published and unpublished randomized controlled trial and quasi-experimental studies in Thai and English from 2006 to 2017. The systematic review was conducted using a systematic guideline developed by the Joanna Briggs Institute (JBI, 2016). An Appraisal Form and Data Extract Form developed by JBI were used for this systematic review. Ten studies met the review inclusion criteria: 6 randomized controlled trials and 4 quasi-experimental studies. Data were analyzed using meta-analysis and narrative summarization.
The findings of this study indicated that:
- The meta-analysis included two studies. In comparison to control groups, breastfeeding self-efficacy enhancement in postpartum women significantly increased breastfeeding self-efficacy at 4 weeks postpartum period (WMD -5.56; 95% CI: -7.91, -3.21; P<0.001) and at 8 weeks postpartum period (WMD -6.06; 95% CI: -8.67, -3.46; P<0.001).
- Narrative summarization of eight studies revealed that participants in the intervention group showed greater increases in breastfeeding self-efficacy through 4 sources: 1) performance accomplishments, 2) vicarious experiences, 3) verbal persuasion, and 4) physiological responses. Both individual and group interventions had positive outcomes on breastfeeding self-efficacy. Continuous enhancement delivered from pregnancy through postpartum period could increase breastfeeding self-efficacy and breastfeeding behavior.
Based on this systematic review, the researcher recommends that enhancing breastfeeding self-efficacy in the postpartum period should be performed to increase breastfeeding self-efficacy in postpartum women. Moreover, primary research in experimental research design should be conducted, especially randomized controlled trials, to ensure the outcomes of the intervention for enhancing breastfeeding self –efficacy.
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