Knowledge‑Attitude‑Practice breastfeeding-based model is associated with better outcomes: a retrospective comparative study

Background Sustaining exclusive breastfeeding remains challenging, and integrated antenatal education targeting knowledge, attitudes, and practical skills may improve outcomes.Methods This is a single-centre retrospective study. Women receiving conventional education (January–August 2024) were compared with women receiving a multicomponent knowledge, attitudes, and practices (KAP)-based breastfeeding education programme after its formal implementation (September 2024–June 2025). After 1:1 matching by maternal age, parity, and gestational age at enrolment, 640 women were included. Primary outcomes were KAP total score at 37–39 weeks of gestation and exclusive breastfeeding status at six months postpartum based on a structured 24-hour dietary recall; secondary outcomes included Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) score, early initiation, interim breastfeeding status, and lactation complications.Results The matched cohort included 320 women per group. The multicomponent KAP-based programme group showed higher KAP scores (80.8 ± 5.6 vs 63.4 ± 6.9; p < .001), BSES-SF scores (58.2 ± 4.8 vs 48.6 ± 5.4; p < .001), and a higher prevalence of exclusive breastfeeding at six months based on 24-hour recall (55.9% vs 31.6%; p < .001). Early initiation was increased, while nipple pain, engorgement, and mastitis were reduced (all p < .01). Exposure to the multicomponent KAP-based programme was independently associated with exclusive breastfeeding status at six months based on 24-hour recall (aOR 2.84, 95% CI 1.98–4.07; p < .001).Conclusions Participation in a multicomponent KAP-based breastfeeding education programme was associated with better breastfeeding outcomes and fewer lactation complications. Multicentre studies are needed to confirm these findings.