Background One of the most important factors that affects breastfeeding self-efficacy and exclusivity is breastfeeding support provided by the family. The aim of this study was to determine the effect of breastfeeding education sessions for primiparous women, with and without the attendance of maternal grandmothers, on breastfeeding self-efficacy and infant feeding patterns. Methods This quasi-experimental study was conducted on 64 primiparous women who referred to the Antenatal Clinic of Amiralmomenin Hospital, Tehran, Iran from June to December, 2018. Eligible pregnant women were allocated into two groups; either with and without grandmothers in attendance. Group assignments were determined according to the week the women had prenatal care at the hospital. All eligible women seen in the clinic during 1 week were assigned to one group and women who presented in the alternating week were assigned to the other group. In the education group with grandmothers in attendance, each woman participated in two prenatal education programs with her mother and one postpartum program approximately 3 h before discharge. In the other group, participating mothers attended breastfeeding education sessions without the grandmother’s attendance. The participating mothers answered questions from the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) at the time of the hospital discharge, and 4 and 8 weeks after delivery. Questions about the infants’ feeding patterns were asked by telephone contact with the participating mothers from both groups at the same time periods. Results The mean BFSE scores were signficantly different between the groups with grandmothers and without grandmothers at the time of the hospital discharge (60.15 ± 4.47 vs. 56.84 ± 6.22, independent t-test; p = 0.017), and at 4 weeks (61.71 ± 2.66 vs. 56.62 ± 9.12, p = 0.004) and 8 weeks after delivery (63.68 ± 2.14 vs. 60.03 ± 6.32, p = 0.003). No significant difference existed in infant feeding patterns between the groups at the same time periods. Conclusions This study suggests that breastfeeding education with grandmothers’ attendance is effective in improving the mothers’ breastfeeding self-efficacy. A family-centered program should be considered in beastfeeding education for increasing of exclusive breastfeeding.

Background & Aims: Grandmothers play a key role in the success of breastfeeding. The positive attitude of grandmothers toward breastfeeding largely influences the length of breastfeeding. The present study aimed to assess the effect of the education of grandmothers on their attitude toward breastfeeding. Materials & Methods: This clinical trial was conducted with a pretest-posttest design and a control group was conducted on 64 maternal grandmothers referring to Amir Al-Momenin Hospital in Tehran, Iran in 2018. The maternal grandmothers who met the inclusion criteria were selected via continuous sampling until the completion of the sample size and assigned to the groups of intervention (n=32) and control (n=32) weekly. In the intervention group, the maternal grandmothers attended two one-hour sessions of breastfeeding education with their primiparous daughters in weeks 1-34 and 35-37 of gestation, respectively. In the control group, the maternal grandmothers received no training, while they were provided with the educational contents after the two sessions. Data were collected using Iowa Infant Feeding Attitude Scale (IIFAS) before and immediately after the educational intervention. Data analysis was performed using descriptive and inferential statistics. Results: Independent t-test showed no significant difference in the mean score of the breastfeeding attitude between the intervention and control groups before intervention. However, a significant difference was observed in the mean score of the breastfeeding attitude immediately after the intervention between the control (60.12±7.53) and the intervention groups (74.21 ± 1.36) (P<0.001) as the obtained mean score was higher in the intervention group compared to the control group. In other words, the education of the grandmothers significantly increased the score of the breastfeeding attitude in the intervention group. Conclusion: According to the results, breastfeeding education of grandmothers could improve their attitude toward breastfeeding. Therefore, the presence of grandmothers in breastfeeding educational sessions could effectively enhance the attitude toward breastfeeding, thereby promoting exclusive breastfeeding.