Motivational Interviewing to Support Breastfeeding After Cesarean Section: A Randomized Controlled Trial

Background: Cesarean delivery is associated with delayed initiation and shorter duration of exclusive breastfeeding. Motivational interviewing, by addressing ambivalence and enhancing women’s confidence, may improve breastfeeding outcomes. Research Aim: To compare breastfeeding self-efficacy, breastfeeding importance and confidence, and exclusive breastfeeding duration between women who received motivational interviewing-based breastfeeding counseling and those who received standard counseling. Methods: A single-blind randomized controlled trial was conducted in Türkiye between September 2023 and June 2024. Women who delivered by Cesarean section ( n = 74) were randomly assigned to the intervention group (motivational interviewing, n = 37) or the control group (standard counseling, n = 37). Participants in both groups received three breastfeeding counseling sessions, consisting of either motivational interviewing-based or routine standardized counseling according to group allocation. Outcomes were assessed at baseline and at 24–48 hours, 14 days, 1 month, 3 months, and 6 months postpartum. Results: Of the 74 women recruited, 63 completed the study. No significant baseline differences were found between the groups in sociodemographic or obstetric characteristics. At follow-up, women in the intervention group reported significantly higher breastfeeding self-efficacy, greater importance attached to breastfeeding, and higher breastfeeding confidence scores compared to controls ( p < .05). Exclusive breastfeeding rates were significantly higher in the intervention group at 6 months postpartum ( p < .05). Conclusions: Motivational interviewing-based breastfeeding counseling appears to enhance maternal breastfeeding self-efficacy, perceived confidence, the importance attributed to breastfeeding, and exclusive breastfeeding outcomes. Results suggest that motivational interviewing may be considered as a promising strategy to support breastfeeding among women planning Cesarean delivery.