Barring major medical conditions (e.g., HIV), breastfeeding is widely recognized as the healthiest feeding option for babies. In the United States, approximately three out of every four mothers initiate breastfeeding; however, less than one in five mothers exclusively breastfeeds her child at six months. With that as the backdrop, this project aimed to evaluate a prenatal, educational video on breastfeeding as a cost-effective, feasible strategy for modifying factors that positively influence exclusive breastfeeding duration. Adult, primiparous (i.e., first-time) mothers in their third trimester of pregnancy (28 to 40 weeks gestation) and residing in the U.S. were recruited through an online crowdsourcing data acquisition platform. At Time 1, 51 of 104 participants were assigned to the video intervention group; the other participants did not view the video. The 28-minute, professionally produced video, BabyBabyOhBaby: Nurturing Your Gorgeous and Growing Baby by Breastfeeding, was initially evaluated through a pre-post design within the video group. After watching the video, nearly all (98%) of participants said they would recommend the video to other women. In addition, relative to scores on measures completed before watching the video, participants endorsed significantly higher scores on a measure of breastfeeding self-efficacy and a scale assessing breastfeeding knowledge and attitudes. The degree of change in these scores reflected a large, positive effect for breastfeeding self-efficacy, t(50) = 7.01, p < .001, d = .98, and a medium, positive effect for breastfeeding knowledge and attitudes, t(50) = 3.76, p < .001, d = .53. A second data collection (Time 2) occurred when participants were four- to six-weeks postpartum; 26 video group and 16 no treatment group participants (n = 42) completed the surveys used at Time 1 (breastfeeding self-efficacy, breastfeeding knowledge and attitudes) as well as items added to assess peer support utilization and infant feeding practices. In this study, consistent with prior work (e.g., McQueen et al., 2011), breastfeeding included any breastmilk, regardless of how it was expressed. Results of a hierarchical multiple regression suggest that, after controlling for prenatal scores, women who reported higher levels of postpartum breastfeeding self-efficacy were more likely to continue breastfeeding exclusively; overall, postpartum breastfeeding self-efficacy and breastfeeding knowledge and attitudes accounted for 37% of the variance in exclusive breastfeeding duration. Adding peer support utilization and whether or not the video intervention had been viewed did not contribute meaningfully to the model or provide additional insights into women’s exclusive breastfeeding duration. A subsequent path analysis provided evidence that the video indirectly, positively influenced exclusive breastfeeding duration through breastfeeding self-efficacy (r = .20) and breastfeeding knowledge and attitudes (r = .22). Taken together, these results suggest that utilizing high-quality, prenatal, educational videos on breastfeeding that positively influence women’s breastfeeding self-efficacy and breastfeeding knowledge and attitudes may prolong exclusive breastfeeding duration in the U.S. Implications for healthcare providers are considered.
