The Effect of Receiving Education in Pregnancy School on Pregnant Women's Breastfeeding Health Literacy: A Randomized Controlled Study

F.2 Subject

Breastfeeding is one of the most effective natural methods for protecting maternal and infant health. The World Health Organization (WHO, 2023) recommends exclusive breastfeeding for the first six months after birth and emphasizes that breastfeeding education provided during this period positively influences mothers' breastfeeding behaviors. However, studies indicate that many mothers lack adequate breastfeeding knowledge and health literacy (Nutbeam, 2022). Therefore, it is important to examine the impact of education provided during pregnancy-particularly "Pregnancy School" (antenatal education programs)-on breastfeeding health literacy.

Health literacy refers to individuals' capacity to access, understand, evaluate, and apply health-related information (Sørensen et al., 2012). Breastfeeding health literacy is a specific sub-dimension of this concept and encompasses a mother's ability to access breastfeeding-related information, interpret it accurately, and translate it into appropriate behaviors (Koh et al., 2020). The literature shows that mothers with higher levels of breastfeeding health literacy are more successful in initiating breastfeeding early and maintaining it for longer durations (Zhao et al., 2021).

Studies conducted in Türkiye have shown that women who attend pregnancy schools have significantly higher levels of breastfeeding knowledge and self-confidence compared to those who do not (Aydın & Arslan, 2022). Similarly, an international study by Oggero et al. (2024) reported that prenatal breastfeeding education increases both the duration of breastfeeding and maternal self-efficacy in the postpartum period. While the effects of pregnancy school education on breastfeeding knowledge and self-efficacy have been addressed in various studies, there are no systematic investigations in the literature that evaluate the concept of breastfeeding health literacy in relation to participation in pregnancy schools. Most existing studies focus on general health literacy or breastfeeding knowledge levels and do not comprehensively address the multidimensional structure of breastfeeding health literacy, including the dimensions of accessing, understanding, evaluating, and applying information (Nutbeam, 2022; Sørensen et al., 2012).

In this context, the present study aims to both fill an important gap in the national literature and provide new evidence on the impact of antenatal education on breastfeeding behaviors.

F.2. Aim

The aim of this study is to evaluate the relationship between participation in pregnancy school (antenatal education programs) and the level of breastfeeding health literacy among pregnant women.

F.3. Scope

The effects of education provided in pregnancy schools on breastfeeding knowledge and self-efficacy levels have been addressed in various studies. However, there are no studies in the literature that systematically evaluate the concept of breastfeeding health literacy in relation to participation in pregnancy schools. Most existing studies focus on general health literacy or breastfeeding knowledge levels and do not address breastfeeding health literacy in a comprehensive manner that includes the dimensions of accessing, understanding, evaluating, and applying information (Nutbeam, 2022; Sørensen et al., 2012).

The study by Aydın and Arslan (2022) examined the effect of prenatal breastfeeding education on knowledge levels but did not include the health literacy dimension. On the other hand, the international study entitled "A Prospective Evaluation of Health Literacy Levels of Pregnant Women in Antenatal Classes" (Kowalska et al., 2024) evaluated the relationship between general health literacy and birth outcomes but did not conduct a breastfeeding-specific assessment.

Therefore, the present study has the potential to be one of the first studies to directly examine the effect of participation in pregnancy school programs on breastfeeding health literacy.