The effect of prenatal education on exclusive breastfeeding among women in Quito: prospective cohort study
Abstract Background Breast milk is the optimal food for humans, however, many mothers face challenges in sustaining exclusive breastfeeding (EBF). Prenatal education (PE) has been suggested as a strategy to promote EBF, but there is evidence that its impact on EBF duration remains inconclusive. This...
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BMC
2025-05-01
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| Series: | BMC Pregnancy and Childbirth |
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| Online Access: | https://doi.org/10.1186/s12884-025-07651-8 |
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| author | Betzabé Tello Herminio Hernández Iván Dueñas-Espín Eduardo Tejera |
| author_facet | Betzabé Tello Herminio Hernández Iván Dueñas-Espín Eduardo Tejera |
| author_sort | Betzabé Tello |
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| description | Abstract Background Breast milk is the optimal food for humans, however, many mothers face challenges in sustaining exclusive breastfeeding (EBF). Prenatal education (PE) has been suggested as a strategy to promote EBF, but there is evidence that its impact on EBF duration remains inconclusive. This study aimed to evaluate the effect of PE on EBF continuation among mothers who gave birth in private and public hospitals in Quito, Ecuador, and to identify modifiable risk factors associated with EBF discontinuation. Methods A prospective cohort study was conducted, recruiting 278 mothers, of whom 152 received PE and 126 did not. Participants were followed from birth to six months postpartum. Data collection included a structured survey, with baseline clinical information obtained through face-to-face interviews before hospital discharge and follow-up telephone interviews at one, four, and six months postpartum. Results Comparisons between the PE and non-PE groups revealed significant differences in education level, health insurance, antenatal care visits, rooming-in rates, parity, and maternal breastfeeding (BF) intentions. Participants who received PE had a significantly longer mean EBF duration (89.4 ± 77.2 days vs. 66.1 ± 70.2 days, p = 0.004). The incidence rate of EBF abandonment was 11.81 per 100 person-months in the PE group and 14.91 per 100 person-months in the non-PE group. Cox survival analysis indicated a lower risk of EBF cessation among mothers who received PE (adjusted hazard ratio [aHR] = 0.58, 95% CI = 0.40-0.84, p = 0.004). Other factors associated with EBF discontinuation included delivery at a public health facility, postpartum depression, insufficient milk supply, return to work, healthcare provider recommendations, family advice, and negative BF experiences. Conclusion Standardized PE programs have a significant and independent positive impact on EBF duration among mothers in Quito, Ecuador. Integrating PE into routine prenatal care and providing comprehensive postpartum support is essential to promoting BF continuation. Targeted interventions should address modifiable risk factors, such as postpartum mental health, return-to-work policies, and healthcare provider recommendations regarding BF. |
| format | Article |
| id | doaj-art-1507aba6ea674e1684114072f3d09f2e |
| institution | OA Journals |
| issn | 1471-2393 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj-art-1507aba6ea674e1684114072f3d09f2e2025-08-20T02:10:56ZengBMCBMC Pregnancy and Childbirth1471-23932025-05-0125111410.1186/s12884-025-07651-8The effect of prenatal education on exclusive breastfeeding among women in Quito: prospective cohort studyBetzabé Tello0Herminio Hernández1Iván Dueñas-Espín2Eduardo Tejera3Center for Research on Health in Latin America (CISeAL), Facultad de Salud y Bienestar, Pontificia Universidad Católica del EcuadorFacultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia12 de Octubre and Roca, Instituto de Salud Pública, Pontificia Universidad Católica del EcuadorGrupo de Bio-Quimioinformática. Facultad de Ingeniería en Ciencias Aplicadas, Universidad de las AméricasAbstract Background Breast milk is the optimal food for humans, however, many mothers face challenges in sustaining exclusive breastfeeding (EBF). Prenatal education (PE) has been suggested as a strategy to promote EBF, but there is evidence that its impact on EBF duration remains inconclusive. This study aimed to evaluate the effect of PE on EBF continuation among mothers who gave birth in private and public hospitals in Quito, Ecuador, and to identify modifiable risk factors associated with EBF discontinuation. Methods A prospective cohort study was conducted, recruiting 278 mothers, of whom 152 received PE and 126 did not. Participants were followed from birth to six months postpartum. Data collection included a structured survey, with baseline clinical information obtained through face-to-face interviews before hospital discharge and follow-up telephone interviews at one, four, and six months postpartum. Results Comparisons between the PE and non-PE groups revealed significant differences in education level, health insurance, antenatal care visits, rooming-in rates, parity, and maternal breastfeeding (BF) intentions. Participants who received PE had a significantly longer mean EBF duration (89.4 ± 77.2 days vs. 66.1 ± 70.2 days, p = 0.004). The incidence rate of EBF abandonment was 11.81 per 100 person-months in the PE group and 14.91 per 100 person-months in the non-PE group. Cox survival analysis indicated a lower risk of EBF cessation among mothers who received PE (adjusted hazard ratio [aHR] = 0.58, 95% CI = 0.40-0.84, p = 0.004). Other factors associated with EBF discontinuation included delivery at a public health facility, postpartum depression, insufficient milk supply, return to work, healthcare provider recommendations, family advice, and negative BF experiences. Conclusion Standardized PE programs have a significant and independent positive impact on EBF duration among mothers in Quito, Ecuador. Integrating PE into routine prenatal care and providing comprehensive postpartum support is essential to promoting BF continuation. Targeted interventions should address modifiable risk factors, such as postpartum mental health, return-to-work policies, and healthcare provider recommendations regarding BF.https://doi.org/10.1186/s12884-025-07651-8Exclusive breastfeedingPostpartum depressionPrenatal educationPublic health practiceMaternal health |
| spellingShingle | Betzabé Tello Herminio Hernández Iván Dueñas-Espín Eduardo Tejera The effect of prenatal education on exclusive breastfeeding among women in Quito: prospective cohort study BMC Pregnancy and Childbirth Exclusive breastfeeding Postpartum depression Prenatal education Public health practice Maternal health |
| title | The effect of prenatal education on exclusive breastfeeding among women in Quito: prospective cohort study |
| title_full | The effect of prenatal education on exclusive breastfeeding among women in Quito: prospective cohort study |
| title_fullStr | The effect of prenatal education on exclusive breastfeeding among women in Quito: prospective cohort study |
| title_full_unstemmed | The effect of prenatal education on exclusive breastfeeding among women in Quito: prospective cohort study |
| title_short | The effect of prenatal education on exclusive breastfeeding among women in Quito: prospective cohort study |
| title_sort | effect of prenatal education on exclusive breastfeeding among women in quito prospective cohort study |
| topic | Exclusive breastfeeding Postpartum depression Prenatal education Public health practice Maternal health |
| url | https://doi.org/10.1186/s12884-025-07651-8 |
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