Recent study aimed to assess the impact of prenatal education (PE) on exclusive breastfeeding (EBF) continuation among mothers in Quito, Ecuador, and identify modifiable risk factors associated with EBF discontinuation. PE has been proposed as a strategy to enhance EBF rates, although existing evidence on its effectiveness remains inconclusive. The study was conducted in Quito's private and public hospitals, focusing on mothers who completed the full six-session PE program compared to those who did not. The study encompassed a prospective cohort design and included women in the postpartum period after birth. The findings revealed that mothers who participated in the standardized PE program were more likely to continue EBF compared to those who did not attend. Factors associated with EBF discontinuation included delivery at a public health facility, maternal depression, and specific reasons such as returning to work, healthcare provider recommendations to stop breastfeeding, family advice, and negative breastfeeding experiences. The study also highlighted the importance of maternal intention to breastfeed for six months or more in lowering the risk of EBF cessation. The results demonstrated that structured, theory-informed, and accessible PE significantly contributed to prolonging EBF duration. The program in Ecuador involves six sessions covering various aspects of pregnancy, childbirth, and newborn care, including breastfeeding. The findings align with international literature suggesting that PE can enhance breastfeeding outcomes, mainly when integrated with psychological components and postnatal support.
Study Strengths and Limitations
Although the study had strengths such as a prospective design, standardized intervention, and robust statistical analysis, there were some limitations. Selection bias could have influenced the results, and data collection relied on self-reports, which may have introduced biases. While the study showed a low loss to follow-up rate, a slightly higher attrition rate was observed in the unexposed group.
Conclusion and Recommendations
In conclusion, the study underscored the significance of incorporating structured and accessible PE programs into routine prenatal care to improve EBF outcomes. The results emphasized the need for continued efforts to support breastfeeding mothers by addressing modifiable risk factors, enhancing lactation support, conducting postpartum depression screenings, and implementing supportive workplace policies. Future research directions include exploring the long-term effects of PE, evaluating cost-effectiveness, and adapting educational materials to meet the diverse needs of mothers in different settings.
Key Points
- Prenatal education (PE) was studied in Quito, Ecuador, to assess its impact on exclusive breastfeeding (EBF) continuation, revealing that participation in a standardized PE program increased the likelihood of continuing EBF.
- Modifiable risk factors associated with EBF discontinuation included delivering at a public health facility, maternal depression, returning to work, healthcare provider recommendations to stop breastfeeding, family advice, and negative breastfeeding experiences.
- Maternal intention to breastfeed for at least six months was found to be crucial in reducing the risk of EBF cessation.
- Structured, theory-informed, and accessible PE programs significantly contributed to prolonging EBF duration, covering pregnancy, childbirth, newborn care, and breastfeeding aspects.
- The study strengths included a prospective design, standardized intervention, and robust statistical analysis, while limitations encompassed potential selection bias, reliance on self-reports, and a slightly higher attrition rate in the unexposed group.
- The study highlighted the importance of integrating PE programs into routine prenatal care to enhance EBF outcomes, emphasizing the need to address modifiable risk factors, provide lactation support, screen for postpartum depression, and implement supportive workplace policies to support breastfeeding mothers. Future research areas include exploring long-term effects of PE, cost-effectiveness, and adapting educational materials for diverse maternal needs in various settings.
Reference –
Betzabé Tello et al. (2025). The Effect Of Prenatal Education On Exclusive Breastfeeding Among Women In Quito: Prospective Cohort Study. *BMC Pregnancy And Childbirth*, 25. https://doi.org/10.1186/s12884-025-07651-8.
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