Impact of Psychosexual Development Theory-Based Breastfeeding Education on Infant Feeding Attitudes and Knowledge of Primiparous Mothers: A Randomized Controlled Study

Breastfeeding is known to play a health-enhancing and disease-preventive role for both the mother and the baby. While it is recognized to reduce postpartum blood loss in mothers and provide protection against conditions like depression, Type 2 diabetes, hypertension, and breast & ovarian cancer; for infants, it is noted that breastfeeding offers protection against many infectious diseases due to the antibodies it, reduces sudden infant deaths and decreases mortality under the age of five [6]. However, despite these benefits, breastfeeding rates have not yet reached desired levels in many countries today.

The World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) recommend that during the first six months, infants should be exclusively breastfed, avoiding the use of water, other liquids, supplementary foods/formula, and solid foods.In our country, according to the Turkey Demographic and Health Survey 2018 data, the rate of exclusive breastfeeding during the first six months is 41%. Among these mothers, it has been determined that 41.7% of them provide their babies with additional liquids/foods other than breast milk within the first three days after birth. Contrary to recommendations, the use of additional liquids/foods in the early days increases the risk of discontinuing breastfeeding before six months by threefold.

Regardless of medical reasons, the main reasons for the consumption of supplementary foods/formula in the early days include the baby's frequent hunger cues and the mother's concern that her milk might not be sufficient. Additionally, the physiological weight loss that newborns experience in the first few days after birth further supports and amplifies mothers' concerns of "not having enough milk." After the 3rd to 5th day following birth, as milk production advances in the mother's body, the subsequent process involves milk becoming fattier and the baby beginning to gain weight. Therefore, it is crucial for mothers to be properly informed about this process, including the baby's behaviors and the content of the milk.

In addition to these physiological changes, Freud has developed a theory on psychosexual development. At the core of the theory lies a pleasurable pursuit for bodily sensations and control. The period from birth to one year of age is referred to as the "Oral Stage" in that theory. During this period, it is emphasized that the newborn starts to explore the world orally and derives satisfaction/pleasure from sucking behavior. Examples of this are finger sucking, pacifier use, and the behavior of putting any object they hold into their mouth, commonly observed in babies. These are typical processes of a healthy newborn and a developing baby within the context of psychosexual development over time. Hence, infants can exhibit hunger cues not only to satisfy their hunger but also for the purpose of experiencing pleasure. However, no study in the literature has directly correlated this information with newborn-sucking behavior. Current research underscores the need for effective interventions with proper timing and highlights that primiparous mothers tend to have greater concerns about insufficient milk than multiparous mothers. Proper guidance and information about physiological processes are crucial for acquiring breastfeeding behavior. In this study, in line with Freud's psychosexual development theory, the impact of breastfeeding education provided after childbirth on primiparous mothers' feeding attitudes and behaviors has been investigated.