Effects of a theory of planned behavior-based intervention on breastfeeding behaviors after cesarean section: A randomized controlled trial.

Single-center study in one obstetric unit, so results may not apply to other hospitals or countries. Both groups stayed in the same department, so routine breastfeeding care could have reached the control group. The intervention was multi-component, so the study cannot show which part, such as video education, family support, foot massage, bedside checklist, or WeChat follow-up, produced the benefit. Participants had to be able to use internet access for follow-up questionnaires, so findings may not transfer to women without reliable online access. The sample included only planned elective cesarean births and excluded multiple pregnancy, intended formula feeding, and other breastfeeding contraindications. Participants lost to follow-up were included using their last measurement, and the authors note that pain measurement may not be sufficient to examine the intervention's influence.

The authors declare no competing interests.

Do not conclude that any single component, such as foot massage or WeChat follow-up, caused the higher exclusive breastfeeding rates. The intervention combined video education, family support, early skin contact, foot massage, bedside checklist guidance, WeChat support from nurses and lactation consultants, and peer support, and the study cannot separate their individual contributions.