Impact of health education on knowledge of, attitude to and practice of breastfeeding among women attending primary health care centres in Almadinah Almunawwarah, Kingdom of Saudi Arabia: Controlled pre–post study

ObjectivesTo explore the knowledge of, attitude to and practice of breastfeeding among women attending primary health care centres before and after health education.MethodsA cohort of 360 gravid women attending primary health care centres in Almadinah Almunawwarah were selected randomly and allocated randomly to receive health education sessions or not. An antenatal questionnaire was filled in initially by both groups and filled in again after health education only by the intervention group. Postnatal questionnaires were filled in by both groups. Significant differences between the two groups and in the intervention group before and after health education sessions were tested. Multivariate analysis was used to detect predictors of change.ResultsParameters of knowledge and attitude before the intervention did not differ between the two groups. Significant differences were found within the intervention group before and after health education and between the two groups in all parameters. Mode of delivery (odds ratio [OR], 2.5), educational level (OR, 1.6), age (OR, 5.6), parity (OR, 2.5), work status (OR, 3.3) and motivation from mothers, other relatives and health care workers (OR, 3.7, 2.1, 4.1, respectively) were significant predictors of change in knowledge of, attitude to and practice of breastfeeding.ConclusionHealth education improved knowledge, attitude and practice; however, the percentage of women who initiated early breastfeeding, gave colostrum, practised feeding on demand and intended to continue breastfeeding should still be improved. Health care workers play an important role in disseminating knowledge and motivating women to breastfeed.