The Effect of QR Code Supported Online Breastfeeding Training Given to Pregnant Women Expecting Twin Babies on Breastfeeding Intention and Feeding With Breast Milk in the First Six Months

Background: With the increase in the use of assisted reproductive techniques thanks to the studies and developing technology in recent years, a significant increase has been observed in multiple pregnancy rates. Studies conducted in the world and in our country have stated that the twin birth rate is between 1.86-10.9%. With the increase in twin pregnancies evaluated in the risky pregnancy group, the responsibilities of healthcare professionals on issues such as regular follow-up in both antenatal and postnatal periods, ensuring successful breastfeeding, and care of babies have increased.

Breast milk is the most appropriate and valuable food source for multiple babies like single babies. Although there is strong evidence about the benefits of breast milk, it has been emphasized in studies that the rate and duration of breastfeeding in twin babies are low and not at the desired level compared to single babies. Although there are many factors affecting these rates, the most important one is the mother's decision and intention to breastfeed her babies during pregnancy. During the mother's pregnancy; The feeling of uncertainty and inadequacy about birth, feeding and care of the baby causes loss of trust in the mother and results in unwanted experiences by affecting her motivation.This situation can be further complicated by the thought of being a twin mother. Therefore, the continuation of breastfeeding training that started before birth in the postnatal period in line with the needs of the mothers, and individualized breastfeeding support have an important role in the initiation and maintenance of successful breastfeeding.

Today, it is recommended to use different materials and techniques in order to ensure continuity in the training given to healthy and sick individuals. One of them is QR code supported training. Quick Response (QR) codes, which act as a bridge between old and new educational materials, make the learning process more permanent with visual materials by providing instant access to different media applications such as audio, image and video, beyond reading texts and reading the resources at any time. For this reason, QR Codes increase the effectiveness of the training by giving booklets during the education of expectant mothers, as well as satisfying the participants who are interested in traditional learning methods, while at the same time increasing the effectiveness of the learned theoretical knowledge to be practiced by following it practically at the desired time and place. QR codes also for organizations in developing countries such as Turkey have limited resources available can be integrated easily because it requires high cost and user-provided printed materials instantly accessible. QR codes, which are integrated into the booklet used in neonatal care education, because they require theory and skills, facilitate access to videos and enable the acquisition and adoption of many care practices with the interaction of image, sound and movement supported by mobile applications. In addition, considering the rapid increase in the use of smart phones today, mobile applications have a significant effect in improving health in order to increase the quality of health services. The cost-effectiveness of mobile applications, enabling individuals to learn whenever they want and appropriate for themselves without limitation of time and space, allowing individuals to follow-up and training at any time and being accessible make these applications more attractive.

In this extraordinary period in which we have experienced the COVID-19 pandemic, which has deeply affected the world recently, the need to review health education methods, especially for vulnerable groups such as pregnant women, has arisen due to the risk of hospital environments. This method we offer will be effective in ensuring safe health education and continuity. The QR Code application can also be used by integrating into different healthy / sick individual trainings, thus reducing the workload of healthcare professionals.

In the light of this information; The study was planned to determine the effect of QR code supported online breastfeeding training given to pregnant women expecting twins on breastfeeding intention and feeding with breast milk in the first six months.