Successful breastfeeding promotion: a motivational instructional model applied and tested

INTERVENTION: Control group: The control group received breastfeeding instruction in step with the Baby Friendly Initiative and according to National Institute for Clinical Excellence (NICE) guidelines. Intervention group: The intervention group received a motivationally‐enhanced version of the same instruction which was called 'Designer Breastfeeding'. As a result both groups received a two‐hour antenatal infant feeding class, a breastfeeding book and midwife support for the first three postnatal weeks. CONDITION: Breastfeeding promotion ; Pregnancy and Childbirth ; Breastfeeding PRIMARY OUTCOME: Using seven point Likert scales women's motivational profile was measured in relation to three motivational factors:; 1. Total value placed on breastfeeding; 2. Total perceived midwife support; 3. Total expectancy for successful breastfeeding; ; The Breastfeeding Instructional Motivation Measurement Tool was developed specifically for this study. Using factor analysis (n = 199) the reliability coefficients for the three motivational factors were satisfactory (Cronbach Alpha .8622, .8751, .8549). Data were collected on discharge from hospital by structured interview.; ; Primary outcomes were measured on discharge from hospital. SECONDARY OUTCOME: 1. Breastfeeding behaviour was measured as a secondary outcome on discharge from hospital and at 3 weeks postnatal; 2. Breastfeeding initiation was defined according to the Department of Health as giving one breastfeed or one episode of expressed breastmilk; 3. Duration of breastfeeding was categorised in accordance with the Index of Breastfeeding Status (cited by Harmon‐Jones, 2006), which classified breastfeeding on a scale in accordance with the amount of breastmilk the infant is receiving (1 = 100% breastmilk, 2 = more than 80% breastmilk and less than 20% other, 3 = 50 ‐ 80% breastmilk, 4 = 50% breastmilk, 5 = 20 ‐ 50% breastmilk, 6 = less than 20% breastmilk, 7 = 100% artificial milk).; ; Secondary outcomes were measured on discharge from hospital, and were repeated at 3 weeks postnatal (in the community and just prior to transfer of care to the health visiting services). INCLUSION CRITERIA: 1. All consenting primgravida women (20 weeks gestation) who attended at the time of recruitment 2. Inclusion criteria included their intention to have their baby at the research hospital 3. No age limit was applied