1 Department of Midwifery, School of Nursing and Midwifery, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R.Iran

2 Department of General Courses, School of Medicine, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R.Iran

3 Department of Public Health, School of Public Health, Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R.Iran


BACKGROUND: Mothers need the necessary skills to be empowered in successful breastfeeding.
This study aimed to investigate effectiveness of the distance education program on the mothers’
empowerment in exclusive breastfeeding.
MATERIALS AND METHODS: A randomized clinical trial study was done on 72 nulliparous pregnant
women 28–32 weeks with normal pregnancy. The qualified women were randomly assigned to the
intervention and control groups based on the random‑number table. The breastfeeding training
packages were sent to women in the intervention group via Telegram every week from 32 until
37 weeks of gestation. The mothers’ empowerment in breastfeeding (primary outcome) and the
exclusive breastfeeding rate (secondary outcome) were assessed by questionnaires.
RESULTS: Based on the repeated measured tests, although scores for all domains and also the
total score of the mothers’ empowerment in breastfeeding between two groups had increased
during the study period, there was a significant difference between the increasing trends of the
maternal empowerment domains in two groups (interaction P value ‹0.001). Also, the prevalence of
exclusive breastfeeding (secondary outcome) at 6 months was significantly higher in the intervention
group (81.8% and 57.1% in the intervention and control groups, respectively) (P = 0.028).
CONCLUSION: Distance education could increase all domains of the mothers’ empowerment in
breastfeeding after delivery. Also, exclusive breastfeeding at 6 months after delivery was significantly
higher in mothers who were receiving the distance education packages.


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