Abstract
OBJECTIVE: To evaluate the effectiveness of a theory-based, Real-time-online Education and Support with Telephone follow-ups (REST) programme for primiparous women on their breastfeeding outcomes over 6 months postpartum. STUDY DESIGN: Randomised controlled trial. METHODS: Convenience sampling was used to recruit 150 low-risk primiparous mothers, and then they were randomly assigned into intervention and control groups by computerised block randomisation. Participants received a 3-month real-time online educational and support programme across antepartum and postpartum period or usual care only (75 mothers per group). Primary outcomes were exclusive breastfeeding (EBF) rate and breastfeeding self-efficacy (BSE); and secondary outcomes were predominant and partial breastfeeding rate, formula feeding rate, mothers' postnatal depression score, infant's morbidity, and EBF duration at 2 and 6 months postpartum, as well as breastfeeding initiation rate. RESULTS: Then, 72 of 75 mothers (96%) successfully completed the REST programme. They had a significantly higher EBF rate, longer EBF duration, and greater increase in BSE, when compared to the control group at the two posttests (except the EBF rate at 6 months postpartum). Overall, the REST was highly valued by all participants on providing detailed useful information and regular postnatal follow-ups with prompt and practical advice. CONCLUSIONS: The REST effectively improved BSE and EBF duration of the primiparous participants over 6 months postpartum and EBF rate at 2 months postpartum. With strong commendations from primiparous mothers, the REST with prenatal and postnatal online breastfeeding support to these mothers can be offered to address breastfeeding and infant-care needs. IMPLICATIONS FOR PATIENT CARE: The findings indicate that the REST conducted from prenatal to 2 months postpartum can be feasible and useful to provide adequate breastfeeding education and support in current maternal care setting under limited staff and resources. Online platforms can be used for future antenatal breastfeeding talks. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT04741425.