The effects of mindfulness-based interventions on mothers’ stress reduction and breastfeeding self-efficacy: A randomized controlled trial

Background: In spite of the crucial role of breast milk for infant growth and immune development, the initiation of breastfeeding immediately after birth and the continuation of exclusive breastfeeding have declined. This issue is often attributed to several factors including maternal concerns due to competency to breastfeed and sufficiency of her breast milk that affect her perceived self-efficacy to initiate and continue breast feeding. To address these challenges, the present study aimed to assess the effects of a mindfulness-based intervention on reducing maternal stress and enhancing breastfeeding self-efficacy in nulliparous women. Materials and Methods: This randomized clinical trial involved 66 pregnant women from Talesh, Iran. The intervention group received progressive muscle relaxation training and guided imagery starting at 30 weeks of gestation. The training program was given in two group sessions and then followed by in an individual session to check their practices for better results. Both groups were followed for 2 months after giving birth. Data were collected using the Breastfeeding Self-Efficacy Scale-Short Form, the Breastfeeding Performance Checklist, and the Breastfeeding Adequacy Questionnaire in three turns. Statistical analysis was conducted using SPSS software version 27, with a significance level set at P < 0.05. Results: In the control group, breastfeeding self-efficacy scores increased from 62.88 ± 3.75 to 66.24 ± 4.20, while in the intervention group, scores rose significantly from 64.18 ± 3.75 to 84.58 ± 3.54 ( P < 0.001). Similar trends were observed for breastfeeding adequacy and performance, with significant improvements in the intervention group. The mean breastfeeding adequacy score in the first and third visits was 62.88 ± 3.75 and 66.24 ± 4.20 in the control group and 64.18 ± 3.75 and 84.58 ± 3.54 in the intervention group, respectively ( P < 0.001). The mean breastfeeding performance scores in the first and third visits were 62.88 ± 3.75 and 66.24 ± 4.20 in the control group and 64.18 ± 3.75 and 84.58 ± 3.54 in the intervention group, respectively ( P < 0.001). Additionally, infant growth metrics, including height, weight, and head circumference, showed greater increases in the intervention group compared to the control group. Conclusion: A mindfulness-based intervention effectively reduces maternal stress, significantly enhancing breastfeeding self-efficacy, adequacy, and performance, as well as improving infant growth indices. Trial registration: This study was registered in the Iranian Registry of Clinical Trials under the IRCT20231028059885N1 Number.