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The European Journal of Public Health Advance Access published online on December 26, 2007
The European Journal of Public Health, doi:10.1093/eurpub/ckm121
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© The Author 2007. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Health visitors and breastfeeding support: influence of knowledge and self-efficacy

Hanne Kronborg1, Michael Væth2, Jørn Olsen3,4 and Ingegerd Harder1

1 Department of Nursing Science, Institute of Public Health, University of Aarhus, Denmark
2 Department of Biostatistics, Institute of Public Health, University of Aarhus, Denmark
3 Department of Epidemiology, Institute of Public Health, University of Aarhus, Denmark
4 Department of Epidemiology, School of Public Health, UCLA, Los Angeles, USA

Correspondence: Hanne Kronborg, Institute of Public Health, University of Aarhus, Høegh-Guldbergsgade 6A, 8000 Aarhus C, Denmark, tel: +458942 4854, fax: +458942 5500, e-mail: hk{at}nursingscience.au.dk

Received August 2, 2007 , accepted November 15, 2007

Background: Little is known about what influences health visitors’ breastfeeding support. The objective was to describe health visitors’ breastfeeding experiences, beliefs, knowledge and self-efficacy in breastfeeding guidance and determine the impact of a training course on these factors, and how they were reflected in practice. Methods: A randomized intervention study enrolled 52 health visitors in the intervention group and 57 in the comparison group. The intervention group participated in an 18-hour pre-study training course that focused on knowledge about lactation and how to guide the mother to learn the mechanisms of breastfeeding. Data were collected through self-administered questionnaires before the intervention and after the follow-up period. One hundred and six (97%) health visitors and 1302 (82%) mothers responded. Results: At baseline no substantial differences were seen between the two groups on years since education, own breastfeeding experiences, beliefs or self-efficacy in breastfeeding guidance except that health visitors in the intervention group, who had completed the course, demonstrated significantly higher scores on knowledge questions (P < 0.01). After the intervention health visitors in the intervention group reported significantly higher self-efficacy in guidance on three of five breastfeeding problems (P < 0.01). Mothers in the intervention group reported having received more support than mothers in the comparison group. Conclusion: An interactive course increased the health visitors’ knowledge of breastfeeding practice. After the intervention period the health visitors in the intervention group had increased their self-efficacy in helping mothers with common breastfeeding problems. The mothers in the intervention group reported more informational and instrumental breastfeeding support.

Keywords: breastfeeding, education, knowledge, public health professional, self-efficacy


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