Effect of Antenatal Breastfeeding Counseling on Early Initiation and Exclusive Breastfeeding Among Primigravida Women: A Hospital-based Quasi-experimental Study

Background Breastfeeding is critical for infant nutrition and reducing childhood morbidity and mortality. The objective of the study was to estimate and compare the rates of early initiation of breastfeeding (EIBF) and exclusive breastfeeding (EBF) among counseled and non-counseled primigravida mothers. Methods A hospital-based quasi-experimental study conducted during the years 2023-2024. A total of 260 primigravida antenatal women, 130 each in the intervention and control groups, were enrolled on alternate days until the desired sample size was achieved. Two antenatal breastfeeding counseling sessions by a skilled counselor (between 28 and 36 gestational weeks) and information, education, and communication (IEC) material were provided to participants in the intervention group. During the study, EIBF and EBF rates were assessed on three occasions: first, within 3 days of delivery; second, at the end of 3 months; and third, at the end of 6 months. Results Both groups were sociodemographically comparable, and the difference found was not statistically significant. The EIBF rate was higher in the intervention (24%) than in the control group (14.9%). Lower segment cesarean section (LSCS) and episiotomy-related pain were common reasons for delayed initiation of breastfeeding in both groups. Pre-lacteal feeding to newborns was more in the control group (15.7%) compared to the intervention (8.8%). No statistically significant difference was observed in EIBF ( P = .07), and pre-lacteal feed ( P = .09). The intervention group’s EBF rate was higher throughout the study. The difference in EBF rate between the two groups was non-significant at the first follow-up ( P = .09), but significant at the second ( P = .001) and third ( P < .0001) follow-ups. Pre-lacteal feeds to newborns, perception of low/no milk output, and mother and child illness were primary factors for non-EBF within the first 6 months. Conclusion Antenatal counseling by a skilled lactation counselor may improve rates of EIBF and assist mothers in maintaining EBF practices.