Effect of an integrative nursing intervention on breastfeeding self-efficacy and exclusive breastfeeding practice: A quasi-experimental study

Background: Exclusive breastfeeding remains below national targets in Indonesia despite its well-established benefits for maternal and child health. Integrative nursing interventions that address behavioral, psychosocial, and informational determinants may enhance breastfeeding outcomes. Objective: The objective of this study is to evaluate the effect of an integrative nursing intervention on breastfeeding self-efficacy and exclusive breastfeeding practice. Materials and Methods: A quasi-experimental pretest–posttest control group study was conducted among 150 mothers attending primary healthcare facilities in Indonesia. Participants were allocated to an intervention group ( n = 75), which received nurse-led counseling, structured family support, and digital education, or a control group ( n = 75), which received routine maternal and child healthcare services. Breastfeeding self-efficacy was assessed using the Breastfeeding Self-Efficacy Scale–Short Form, and exclusive breastfeeding practice was assessed according to the World Health Organization criteria. Results: Breastfeeding self-efficacy improved significantly in both groups but increased more substantially in the intervention group (mean difference: 16.2 vs. 4.4; P < 0.001; Cohen’s d = 1.15). Exclusive breastfeeding practice was more common among mothers receiving the intervention than among those receiving routine care (82.7% vs. 61.3%; P = 0.004). Participation in the intervention was independently associated with exclusive breastfeeding (adjusted odds ratio = 3.12; 95% confidence interval: 1.55–6.28). Conclusion: The integrative nursing intervention improved breastfeeding self-efficacy and exclusive breastfeeding practice. This multidimensional approach may provide a scalable strategy for strengthening maternal and child health services in resource-constrained settings.