The Effect of Web-Based Breastfeeding Education Based on Knowledge, Motivation, Behavioral Skills Model on Fathers' Breastfeeding Support

Overview

Breast milk is a highly bioavailable, easily digestible, and miraculous food that meets all the nutrient, energy, and fluid needs of the baby for physical, mental, and psychological development. International health organizations emphasize that breastfeeding is the key to sustainable development and recommend exclusive breastfeeding for the first six months, followed by continued breastfeeding with complementary feeding for two years or longer. However, only a limited proportion of infants, both globally and in Turkey, are exclusively breastfed during the first six months, which remains below the targeted rates set within the scope of sustainable development goals. When the factors underlying mothers' discontinuation of breastfeeding are examined, many social, cultural, and psychological reasons are reported. One of these reasons is spousal/father support. In recent years, studies have focused on fathers to increase breastfeeding rates. In this direction, breastfeeding training based on the Knowledge-Motivation-Behavioral Skills (BMB) model, planned to be given to fathers to support the breastfeeding process and to accompany mothers and babies in breastfeeding, is of great importance. In the literature, no web-based online study was found to support fathers in the breastfeeding process based on the BMB model. The fact that the training is based on a theoretical model and planned to be web-based in terms of accessibility for fathers constitutes the original aspect of the study. The aim of this study was to examine the effect of web-based breastfeeding education, based on the Knowledge-Motivation-Behavioral Skills Model, on fathers' breastfeeding support.

Breastfeeding plays a vital role in ensuring the healthy growth and development of infants. Breastfed children are more likely to survive and reach their full developmental potential. Breast milk supports not only the physical but also the cognitive and psychological development of the child, and it has been shown to reduce the risk of obesity later in life. Additionally, in low-income and developing countries, breastfeeding significantly contributes to the reduction of malnutrition, infectious diseases, and child mortality. Beyond its benefits for infants, breastfeeding also has long-term positive effects on maternal health. These benefits persist throughout the lives of both mother and child, making breastfeeding a crucial practice that should be actively promoted and supported. The World Health Organization has emphasized the significance of breastfeeding, recognizing it as a key driver of sustainable development. It is recommended to initiate breastfeeding within the first hour after birth, continue exclusive breastfeeding for the first six months, and maintain breastfeeding for two years or longer with complementary feeding. However, global breastfeeding rates remain below the target of 50% by 2025. During this process, both national and international health authorities have emphasized that the perceptions and attitudes of family members-particularly fathers-toward breastfeeding significantly influence mothers' perspectives on breastfeeding. Paternal support for breastfeeding has been shown to contribute to improved breastfeeding outcomes, and fathers play a crucial role in promoting breastfeeding. Supportive and positive attitudes of fathers toward their partners influence maternal breastfeeding self-efficacy during the postpartum period. Increasing fathers' knowledge, self-efficacy, and involvement in breastfeeding-related interventions positively affects mothers' breastfeeding experiences. However, studies investigating paternal behavior during the breastfeeding period have revealed that many fathers lack sufficient knowledge about breastfeeding and breast milk. Moreover, they often do not fully understand the significance of breastfeeding for both maternal and infant health. Fathers have also reported uncertainty about how to support the breastfeeding process and expressed a desire for guidance on how to assist their partners. Basing nursing practices on a specific theoretical model has been shown to positively influence both the quality of nursing care and overall health outcomes. In this context, a variety of models have been developed to facilitate health education, individual development, and behavioral change in health-related practices. One such model is the Information-Motivation-Behavioral Skills (IMB) Model. The IMB model was developed to understand the social and psychological factors that influence health-related behaviors. According to this model, once individuals are provided with accurate health information and sufficient motivation, they are more likely to acquire and adopt positive behavioral skills. In this framework, encouraging fathers to actively participate in the breastfeeding process may extend breastfeeding duration and positively influence the breastfeeding experience. Such involvement can also enhance the relationships between father and infant, father and mother, and mother and infant. Applying the IMB model may help fathers develop appropriate, simple, and effective behavioral skills based on their own motivation. Moreover, these acquired behaviors are expected to be sustainable and impactful over time. Therefore, the aim of the proposed study is to examine the effect of a web-based breastfeeding education program-designed in accordance with the Information-Motivation-Behavioral Skills (IMB) Model-on paternal support for breastfeeding.