An interventional study of Video-Based Breastfeeding Education in Video-Based Breastfeeding Education, Infant Feeding Attitudes, sponsored by Zonguldak Bulent Ecevit University. Completed at 1 site in Turkey (Türkiye). Open to female participants, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-07-27.
Sponsored by Zonguldak Bulent Ecevit University · Not applicable, Interventional, and Supportive care
The purpose of this randomized controlled study is to evaluate the effect of video-based breastfeeding education on infant feeding attitudes among primiparous mothers who delivered by cesarean section or vaginal birth. Breastfeeding education may improve mothers' knowledge and attitudes, thereby supporting optimal infant feeding practices.
The main questions this study aims to answer are:
Does video-based breastfeeding education improve infant feeding attitudes among primiparous mothers who deliver by vaginal birth? Does video-based breastfeeding education improve infant feeding attitudes among primiparous mothers who deliver by cesarean section? Is there a difference in infant feeding attitudes between mothers who receive video-based breastfeeding education and those who receive routine postpartum care? Does the effect of video-based breastfeeding education differ between mothers who deliver by cesarean section and those who deliver by vaginal birth?
Participants were randomly assigned to one of three groups: a cesarean section intervention group, a vaginal birth intervention group, or a control group. Mothers in the intervention groups received video-based breastfeeding education through a QR code in addition to routine postpartum care, while the control group received routine postpartum care only. Infant feeding attitudes were assessed at baseline and again three months after delivery using the Turkish version of the Iowa Infant Feeding Attitude Scale (IIFAS).
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.
262 studies on the registry are indexed under Breast Feeding; 112 are open to participants now.
This study's enrollment of 90 is close to the median of 95 across 210 interventional studies indexed under Breast Feeding.
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-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:
All mothers in the intervention groups were initially administered the "Sociodemographic Data Form" and the "Baby Feeding Attitude Scale (BBTÖ)" (pre-test). Subsequently, the mothers received video-based breastfeeding education prepared by the researcher, which was accessible on YouTube via a QR code. Immediately following the education, the BBTÖ (post-test) was re-administered to the same mothers. At the end of the three-month follow-up period, a personalized Google Forms link containing the BBTÖ was sent to each mother via WhatsApp, accompanied by a brief informational message. When necessary, the researcher contacted the mothers by phone, introduced themselves, and provided reminders and information.
Behavioral: Video-Based Breastfeeding Education
All mothers in the intervention groups were initially administered the "Sociodemographic Data Form" and the "Baby Feeding Attitude Scale (BBTÖ)" (pre-test). Subsequently, the mothers received video-based breastfeeding education prepared by the researcher, which was accessible on YouTube via a QR code. Immediately following the education, the BBTÖ (post-test) was re-administered to the same mothers. At the end of the three-month follow-up period, a personalized Google Forms link containing the BBTÖ was sent to each mother via WhatsApp, accompanied by a brief informational message. When necessary, the researcher contacted the mothers by phone, introduced themselves, and provided reminders and information.
Behavioral: Video-Based Breastfeeding Education
All mothers in the control group who gave birth vaginally or via cesarean section and agreed to participate in the study were included. These mothers were administered the "Sociodemographic Data Form" and the "Baby Feeding Attitude Scale (BBTÖ)" (pre-test). No educational intervention was provided to the control group, and the mothers were informed that a follow-up would be conducted via WhatsApp after three months. Data security was ensured by assigning a unique identification number to each mother. At the end of the three-month follow-up period, follow-up data were collected from each mother in the control group by sending a personalized Google Forms link containing the BBTÖ via WhatsApp, accompanied by a brief informational message. When necessary, the researcher contacted the mothers by phone, introduced themselves, and provided information.
The intervention consisted of a standardized video-based breastfeeding education program developed by the researcher based on current evidence and international breastfeeding guidelines. The educational content was reviewed by experts using the Written Materials Suitability Assessment Form and subsequently converted into a two-dimensional animated educational video with technical support from a graphic designer and a software developer. The quality and reliability of the video were evaluated using the DISCERN instrument, and its comprehensibility was assessed in a pilot study involving five mothers before implementation. The final educational video was approximately 9 minutes in duration and was delivered to participants through a QR code linking to a YouTube video. Mothers in the intervention groups viewed the video in addition to receiving routine postpartum care.
Infant Feeding Attitudes
Infant feeding attitudes were assessed using the Turkish version of the Iowa Infant Feeding Attitude Scale (IIFAS). The scale was used to evaluate the effect of video-based breastfeeding education on maternal infant feeding attitudes. Higher scores indicate more positive attitudes toward breastfeeding.
Time frame: 3 months after delivery
Infant Feeding Attitudes
Infant feeding attitudes were assessed using the Turkish version of the Iowa Infant Feeding Attitude Scale (IIFAS). The scale was used to evaluate the effect of video-based breastfeeding education on maternal infant feeding attitudes. Higher scores indicate more positive attitudes toward breastfeeding.
Time frame: Baseline and 3 months after delivery
Plan to share: No — Individual participant data will not be shared because the informed consent obtained from participants did not include permission for public data sharing, and sharing individual-level data could compromise participant confidentiality and privacy.
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Zonguldak Bulent Ecevit University