<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT04478682</url>
  </required_header>
  <id_info>
    <org_study_id>AhiEvranU</org_study_id>
    <nct_id>NCT04478682</nct_id>
  </id_info>
  <brief_title>Breastfeeding Support Provided to Mothers Through WhatsApp Messaging Application</brief_title>
  <official_title>The Effect of Continuous Breastfeeding Support Provided to Mothers Through WhatsApp Messaging Application on Breastfeeding: A Randomized Controlled Trial</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Ahi Evran University Education and Research Hospital</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>Ahi Evran University Education and Research Hospital</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      The research was planned as a randomized controlled experimental study in order to determine&#xD;
      the effect of continuous breastfeeding support provided to mothers through WhatsApp messaging&#xD;
      application on breastfeeding.&#xD;
&#xD;
      Research Hypotheses H0: Continuous breastfeeding support provided to mothers through WhatsApp&#xD;
      messaging application has no effect on breastfeeding.&#xD;
&#xD;
      H1: Continuous breastfeeding support provided to mothers through WhatsApp messaging&#xD;
      application increases the rate of exclusive breastfeeding.&#xD;
&#xD;
      H2: Continuous breastfeeding support provided to mothers through WhatsApp messaging&#xD;
      application increases the breastfeeding duration of the mothers.&#xD;
&#xD;
      H3: Continuous breastfeeding support provided to mothers through WhatsApp messaging&#xD;
      application reduces the rate of mothers giving their babies other foods than breast milk.&#xD;
&#xD;
      H4: Continuous breastfeeding support provided to mothers through WhatsApp messaging&#xD;
      application reduces bottle feeding rates.&#xD;
&#xD;
      H5: Continuous breastfeeding support provided to mothers through WhatsApp messaging&#xD;
      application reduces the rate of pacifier use.&#xD;
&#xD;
      H6: Continuous breastfeeding support provided to mothers through WhatsApp messaging&#xD;
      application reduces the incidence of mothers' breastfeeding problems.&#xD;
&#xD;
      H7: Continuous breastfeeding support provided to mothers through WhatsApp messaging&#xD;
      application affects mothers' breastfeeding attitude positively.&#xD;
&#xD;
      H8: Continuous breastfeeding support provided to mothers through WhatsApp messaging&#xD;
      application increases the motivation of breastfeeding mothers.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      METHOD:&#xD;
&#xD;
      Place of the Research:&#xD;
&#xD;
      The data of the research will be collected in the postpartum service of Zeynep Kamil Women&#xD;
      And Chıldren Dıseases Tranıng And Research Hospıtal in Istanbul. After then 6 months of&#xD;
      follow-up will be continued trough WhatsApp application.&#xD;
&#xD;
      The Universe and the Sample of the Research:&#xD;
&#xD;
      The universe of the research; It will comprise primipa mothers and babies who are&#xD;
      hospitalized in the postpartum ward of the specified dates, deliver vaginal or cesarean&#xD;
      delivery, and meet the sample selection criteria.&#xD;
&#xD;
      The sample of the research was determined by statistic analysis by power analysis. Power&#xD;
      analysis was performed by using G * Power (v3.1.7) program to determine the number of&#xD;
      samples. The power of the study is expressed as 1-β (olasılığı = type II error probability)&#xD;
      and research should generally have 80% power. According to Cohen's effect size coefficients;&#xD;
      Assuming that the evaluations to be made between the two independent groups will have a&#xD;
      medium effect size (d = 0.5), considering the fact that there should be at least 64 people in&#xD;
      the groups and there may be losses in the working process, each group decided to recruit 70&#xD;
      people. 140 people in total. it is given. Computerized randomization method will be used in&#xD;
      the research.&#xD;
&#xD;
      In the collection of research data; Mother and Newborn Data Collection Form Postpartum&#xD;
      Breastfeeding Evaluation and Follow-up Form Application Satisfaction Evaluation Form&#xD;
      Breastfeeding Attitudes of The Evaluation Scale Primipara Breastfeeding Motivation Scale&#xD;
      (PBMS) 5 data collection forms will be used.&#xD;
&#xD;
      Application of the research:&#xD;
&#xD;
      The researcher will briefly talk about the scope and content of the research by meeting with&#xD;
      the mothers who meet the case selection criteria. Written consents will be obtained through&#xD;
      the &quot;Informed Volunteer Consent Form&quot; asking mothers whether they want to participate in the&#xD;
      study. Mothers who wish to participate in the study will be randomly determined by&#xD;
      computer-assisted randomization method. Applications made after randomization will be carried&#xD;
      out with the following steps; Experimental group; Information will be obtained from the&#xD;
      mothers who agreed to participate in the study in line with the &quot;Mother and Newborn Data&#xD;
      Total Form&quot;, Mothers participating in the study will receive routine breastfeeding training&#xD;
      at the hospital after birth, The breastfeeding attitude of the mother will be evaluated with&#xD;
      the &quot;Breastfeeding Attitude Scale&quot;, and the breastfeeding motivation of the mother will be&#xD;
      evaluated with the &quot;Breastfeeding Motivation Scale&quot;, In line with the needs of the mothers,&#xD;
      breastfeeding support and motivation will be provided, In the first 1 month, basic standard&#xD;
      information sharing (see &quot;Basic Standard Information Sharing&quot;) will be made determined by the&#xD;
      researcher. Later, information sharing will be made regarding the questions and problems of&#xD;
      the mother, Individual breastfeeding support provided to mothers through WhatsApp will&#xD;
      continue for 6 months, Mothers will be contacted once a week through WhatsApp and feedback&#xD;
      will be received on the breastfeeding process, The questions of the mother regarding&#xD;
      breastfeeding will be answered by text / voice message or video call, In the postpartum&#xD;
      period (day 7, day 15, month 1, month 2, month 4 and month 6) mothers will be called by&#xD;
      phone. Breastfeeding conditions will be evaluated with &quot;Postpartum Breastfeeding Evaluation&#xD;
      and Follow-up Form&quot;.&#xD;
&#xD;
      Breastfeeding attitudes of the mothers will be assessed with the Breastfeeding Attitudes of&#xD;
      the Evaluation Scale&quot; before breastfeeding education in hospital and through online survey at&#xD;
      the 6th Month.&#xD;
&#xD;
      Breastfeeding motivations of the mothers will be assessed with the &quot; Primipara Breastfeeding&#xD;
      Motivation Scale &quot; through online survey at the 6th Month.&#xD;
&#xD;
      The mothers' satisfaction with the continuous breastfeeding support provided through WhatsApp&#xD;
      will be evaluated with the &quot;Application Satisfaction Evaluation Form&quot; through online survey.&#xD;
&#xD;
      Basic Standard Information Sharing; New coronavirus (COVID-19) and breastfeeding Suggestion&#xD;
      on breastfeeding (motivational-enhancing videos that emphasize breastfeeding is instinctive)&#xD;
      The importance of breast milk (positive effects on mother and baby will be explained) Sharing&#xD;
      of health institutions emphasizing the importance of breastfeeding (WHO, UNICEF, Ministry of&#xD;
      Health) Milk production of breasts (Frequent breastfeeding will be supported by videos) Baby&#xD;
      holding the breast (Mothers will be emphasized that the baby's sucking ability instinctively&#xD;
      and will be supported with videos) Skin-to-skin contact and breastfeeding Reasons for&#xD;
      breastfeeding only for the first 6 months Symptoms that show that the baby is sucking&#xD;
      effectively Control Group; Information will be obtained from the mothers who agreed to&#xD;
      participate in the study in line with the &quot;Mother and Newborn Data Total Form&quot;, Mothers&#xD;
      participating in the study will receive routine breastfeeding training at the hospital after&#xD;
      birth, The breastfeeding attitude of the mother will be evaluated with the &quot;Breastfeeding&#xD;
      Attitude Scale&quot;, and the breastfeeding motivation of the mother will be evaluated with the&#xD;
      &quot;Breastfeeding Motivation Scale&quot;, In line with the needs of the mothers, breastfeeding&#xD;
      support and motivation will be provided, In the postpartum period (day 7, day 15, month 1,&#xD;
      month 2, month 4 and month 6) mothers will be called by phone. Breastfeeding conditions will&#xD;
      be evaluated with &quot;Postpartum Breastfeeding Evaluation and Follow-up Form&quot;.&#xD;
&#xD;
      Breastfeeding attitudes of the mothers will be assessed with the Breastfeeding Attitudes of&#xD;
      the Evaluation Scale&quot; before breastfeeding education in hospital and through online survey at&#xD;
      the 6th Month.&#xD;
&#xD;
      Breastfeeding motivations of the mothers will be assessed with the &quot; Primipara Breastfeeding&#xD;
      Motivation Scale &quot; through online survey at the 6th Month.&#xD;
&#xD;
      Analysis:&#xD;
&#xD;
      NCSS (Number Cruncher Statistical System) 2007 (Kaysville, Utah, USA) program will be used&#xD;
      for statistical analysis of the research. Statistical significance will be accepted as p&#xD;
      &lt;0.05.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Completed</overall_status>
  <start_date type="Actual">December 1, 2020</start_date>
  <completion_date type="Actual">September 1, 2021</completion_date>
  <primary_completion_date type="Actual">February 28, 2021</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <intervention_model_description>Randomized Controlled Study</intervention_model_description>
    <primary_purpose>Supportive Care</primary_purpose>
    <masking>None (Open Label)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Breastfeeding Attitudes of The Evaluation Scale</measure>
    <time_frame>In our study, will be applied before breastfeeding education in hospital and through online survey at postpartum 6th months for both groups</time_frame>
    <description>This scale assesses various aspects of attitudes that direct mothers' breastfeeding behavior. Examines breastfeeding as behavior.&#xD;
The scale is a five-point Likert type consisting of 46 items, easy to apply, and which people can answer on their own, and it can be applied to all mothers. Some items in the scale (3, 4, 6, 7, 8, 11, 13, 15, 19, 23, 24, 26, 27, 28, 29, 30, 31, 32, 37, 38, 42, 43) As a positive attitude, I agree with the statement &quot;I totally disagree&quot; to 4-3-2-1-0, while some items (1, 2, 5, 9, 10, 12, 14, 16, 17, 18, 20, 21 (22, 25, 33, 34, 35, 36, 39, 40, 41, 44, 45, 46) are considered negative, and the opposite score is scored as 0-1-2-3-4 from the statement entirely agree. In this way, the total score that can be obtained from the scale is between 0 and 184. As the score increases, breastfeeding attitude is evaluated as positive.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Primipara Breastfeeding Motivation Scale (PBMS)</measure>
    <time_frame>at postpartum 6th months through online survey for both groups</time_frame>
    <description>This scale evaluates postpartum breastfeeding motivation level in primiparous. The scale consists of 24 items in total. After applying to the sample group, the factor analysis of the scale was made and it was determined to have 5 factors.&#xD;
Intrinsic motivation and integrated regulation&#xD;
Identified regulation&#xD;
Mirrored editing&#xD;
External regulation is examined in two sub-dimensions:&#xD;
External regulation (instrumental needs)&#xD;
External regulation (baby health) Scale items are rated from 1 = Never disagree to 4 = Strongly agree. The scale is in 4-point Likert type, and each item is scored between 1-4. The scale does not have a total score. The score of the sub-dimensions is calculated by taking the average of the scale sub-dimension scores. As the score obtained from the sub-dimension of the scale increases, the motivation representing that sub-dimension increases.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Application Satisfaction Evaluation Form</measure>
    <time_frame>at postpartum 6th months through online survey for only experimental group</time_frame>
    <description>Evaluates the satisfaction of mothers from breastfeeding support provided through WhatsApp messaging application.&#xD;
It is a form consisting of 10 questions by the researcher to evaluate the satisfaction of the mothers from the breastfeeding support given through the social media group (WhatsApp) by making use of the literature information.&#xD;
The answer to each question will be evaluated as yes / no. In the tenth question, he will be asked to score the application. There will be a minimum of 1 and a maximum of 10 points.</description>
  </primary_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Actual">150</enrollment>
  <condition>Exclusive Breastfeeding</condition>
  <condition>Breastfeeding Support</condition>
  <arm_group>
    <arm_group_label>WhatsApp Messaging Application</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>Continuous breastfeeding support will be provided for the first 6 months through WhatsApp messaging application. Mothers will be contacted once a week through WhatsApp and feedback will be received on the breastfeeding process. The questions of the mother regarding breastfeeding will be answered by text / voice message or video call.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Standard breastfeeding support</arm_group_label>
    <arm_group_type>No Intervention</arm_group_type>
    <description>She will receive standard breastfeeding support after delivery. Breastfeeding will not receive continuous breastfeeding support for the first 6 months after discharge.</description>
  </arm_group>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>Breastfeeding Support Provided to Mothers Through WhatsApp Messaging Application</intervention_name>
    <description>Breastfeeding support provided to mothers through WhatsApp messaging application will be maintained for the first 6 months after birth. In the first 1 month, standard information sharing will be made through whatsApp. Also, for the first 6 months, solutions generating shares will be made according to the problems and questions of the mother regarding breastfeeding.</description>
    <arm_group_label>WhatsApp Messaging Application</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
        For the mother;&#xD;
&#xD;
          -  18 years and older&#xD;
&#xD;
          -  Primipar,&#xD;
&#xD;
          -  Having healthy pregnancy and uncomplicated birth,&#xD;
&#xD;
          -  No health problems preventing breastfeeding (drug use, HIV, etc.),&#xD;
&#xD;
          -  Not having any obstacle to communication (not knowing Turkish, mental retardation&#xD;
             etc.),&#xD;
&#xD;
          -  Being literate,&#xD;
&#xD;
          -  Having a smart phone and internet connection,&#xD;
&#xD;
          -  It was determined to be able to use WhatsApp application. For baby;&#xD;
&#xD;
          -  Being healthy and term&#xD;
&#xD;
          -  No health problems preventing breastfeeding (Esophageal atresia, cleft palate, cleft&#xD;
             lip etc.)&#xD;
&#xD;
          -  Its weight is between 2500-4000 gr.&#xD;
&#xD;
          -  It was determined that the Apgar Score was above 7.&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Mothers with multiple pregnancies,&#xD;
&#xD;
          -  Infants lying in NICU due to health problems in the postpartum period will be excluded&#xD;
             from the scope of the research.&#xD;
      </textblock>
    </criteria>
    <gender>Female</gender>
    <gender_based>Yes</gender_based>
    <gender_description>18 years and older who primiparous women who gave birth</gender_description>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>49 Years</maximum_age>
    <healthy_volunteers>Accepts Healthy Volunteers</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Sevda KORKUT ÖKSÜZ, R.A</last_name>
    <role>Principal Investigator</role>
    <affiliation>Kirsehir Ahi Evran Universitesi</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>Zeynep Kamil Women And Chıldren Dıseases Tranıng And Research Hospıtal</name>
      <address>
        <city>İstanbul</city>
        <state>Üsküdar</state>
        <zip>34660</zip>
        <country>Turkey</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>Turkey</country>
  </location_countries>
  <reference>
    <citation>Balaguer Martinez JV, Valcarce Perez I, Esquivel Ojeda JN, Hernandez Gil A, Martin Jimenez MDP, Bernad Albareda M. [Telephone support for breastfeeding by primary care: a randomised multicentre trial]. An Pediatr (Engl Ed). 2018 Dec;89(6):344-351. doi: 10.1016/j.anpedi.2018.02.007. Epub 2018 Mar 22. Spanish.</citation>
    <PMID>29576447</PMID>
  </reference>
  <reference>
    <citation>Reiss K, Andersen K, Barnard S, Ngo TD, Biswas K, Smith C, Carpenter J, Church K, Nuremowla S, Pearson E. Using automated voice messages linked to telephone counselling to increase post-menstrual regulation contraceptive uptake and continuation in Bangladesh: study protocol for a randomised controlled trial. BMC Public Health. 2017 Oct 3;17(1):769. doi: 10.1186/s12889-017-4703-z.</citation>
    <PMID>28974209</PMID>
  </reference>
  <reference>
    <citation>Simonetti V, Palma E, Giglio A, Mohn A, Cicolini G. A structured telephonic counselling to promote the exclusive breastfeeding of healthy babies aged zero to six months: a pilot study. Int J Nurs Pract. 2012 Jun;18(3):289-94. doi: 10.1111/j.1440-172X.2012.02040.x.</citation>
    <PMID>22621300</PMID>
  </reference>
  <reference>
    <citation>Cavalcanti DS, Cabral CS, de Toledo Vianna RP, Osorio MM. Online participatory intervention to promote and support exclusive breastfeeding: Randomized clinical trial. Matern Child Nutr. 2019 Jul;15(3):e12806. doi: 10.1111/mcn.12806. Epub 2019 Apr 11.</citation>
    <PMID>30825414</PMID>
  </reference>
  <reference>
    <citation>Kapinos K, Kotzias V, Bogen D, Ray K, Demirci J, Rigas MA, Uscher-Pines L. The Use of and Experiences With Telelactation Among Rural Breastfeeding Mothers: Secondary Analysis of a Randomized Controlled Trial. J Med Internet Res. 2019 Sep 3;21(9):e13967. doi: 10.2196/13967.</citation>
    <PMID>31482848</PMID>
  </reference>
  <reference>
    <citation>Durmaz S, Ergin I, Durusoy R, Hassoy H, Caliskan A, Okyay P. WhatsApp embedded in routine service delivery for smoking cessation: effects on abstinence rates in a randomized controlled study. BMC Public Health. 2019 Apr 8;19(1):387. doi: 10.1186/s12889-019-6727-z.</citation>
    <PMID>30961557</PMID>
  </reference>
  <verification_date>November 2021</verification_date>
  <study_first_submitted>July 16, 2020</study_first_submitted>
  <study_first_submitted_qc>July 16, 2020</study_first_submitted_qc>
  <study_first_posted type="Actual">July 21, 2020</study_first_posted>
  <last_update_submitted>November 26, 2021</last_update_submitted>
  <last_update_submitted_qc>November 26, 2021</last_update_submitted_qc>
  <last_update_posted type="Actual">November 29, 2021</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>Ahi Evran University Education and Research Hospital</investigator_affiliation>
    <investigator_full_name>Sevda KORKUT ÖKSÜZ</investigator_full_name>
    <investigator_title>Research Assistant</investigator_title>
  </responsible_party>
  <keyword>Breastfeeding support</keyword>
  <keyword>Exclusive breastfeeding</keyword>
  <keyword>WhatsApp messaging application</keyword>
  <keyword>Motivation</keyword>
  <keyword>Attitude</keyword>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT04478682
org study id: AhiEvranU
nct id: NCT04478682
lead sponsor: 
has dmc: No
is fda regulated drug: No
is fda regulated device: No
The research was planned as a randomized controlled experimental study in order to determine
      the effect of continuous breastfeeding support provided to mothers through WhatsApp messaging
      application on breastfeeding.

      Research Hypotheses H0: Continuous breastfeeding support provided to mothers through WhatsApp
      messaging application has no effect on breastfeeding.

      H1: Continuous breastfeeding support provided to mothers through WhatsApp messaging
      application increases the rate of exclusive breastfeeding.

      H2: Continuous breastfeeding support provided to mothers through WhatsApp messaging
      application increases the breastfeeding duration of the mothers.

      H3: Continuous breastfeeding support provided to mothers through WhatsApp messaging
      application reduces the rate of mothers giving their babies other foods than breast milk.

      H4: Continuous breastfeeding support provided to mothers through WhatsApp messaging
      application reduces bottle feeding rates.

      H5: Continuous breastfeeding support provided to mothers through WhatsApp messaging
      application reduces the rate of pacifier use.

      H6: Continuous breastfeeding support provided to mothers through WhatsApp messaging
      application reduces the incidence of mothers' breastfeeding problems.

      H7: Continuous breastfeeding support provided to mothers through WhatsApp messaging
      application affects mothers' breastfeeding attitude positively.

      H8: Continuous breastfeeding support provided to mothers through WhatsApp messaging
      application increases the motivation of breastfeeding mothers.
METHOD:

      Place of the Research:

      The data of the research will be collected in the postpartum service of Zeynep Kamil Women
      And Chıldren Dıseases Tranıng And Research Hospıtal in Istanbul. After then 6 months of
      follow-up will be continued trough WhatsApp application.

      The Universe and the Sample of the Research:

      The universe of the research; It will comprise primipa mothers and babies who are
      hospitalized in the postpartum ward of the specified dates, deliver vaginal or cesarean
      delivery, and meet the sample selection criteria.

      The sample of the research was determined by statistic analysis by power analysis. Power
      analysis was performed by using G * Power (v3.1.7) program to determine the number of
      samples. The power of the study is expressed as 1-β (olasılığı = type II error probability)
      and research should generally have 80% power. According to Cohen's effect size coefficients;
      Assuming that the evaluations to be made between the two independent groups will have a
      medium effect size (d = 0.5), considering the fact that there should be at least 64 people in
      the groups and there may be losses in the working process, each group decided to recruit 70
      people. 140 people in total. it is given. Computerized randomization method will be used in
      the research.

      In the collection of research data; Mother and Newborn Data Collection Form Postpartum
      Breastfeeding Evaluation and Follow-up Form Application Satisfaction Evaluation Form
      Breastfeeding Attitudes of The Evaluation Scale Primipara Breastfeeding Motivation Scale
      (PBMS) 5 data collection forms will be used.

      Application of the research:

      The researcher will briefly talk about the scope and content of the research by meeting with
      the mothers who meet the case selection criteria. Written consents will be obtained through
      the "Informed Volunteer Consent Form" asking mothers whether they want to participate in the
      study. Mothers who wish to participate in the study will be randomly determined by
      computer-assisted randomization method. Applications made after randomization will be carried
      out with the following steps; Experimental group; Information will be obtained from the
      mothers who agreed to participate in the study in line with the "Mother and Newborn Data
      Total Form", Mothers participating in the study will receive routine breastfeeding training
      at the hospital after birth, The breastfeeding attitude of the mother will be evaluated with
      the "Breastfeeding Attitude Scale", and the breastfeeding motivation of the mother will be
      evaluated with the "Breastfeeding Motivation Scale", In line with the needs of the mothers,
      breastfeeding support and motivation will be provided, In the first 1 month, basic standard
      information sharing (see "Basic Standard Information Sharing") will be made determined by the
      researcher. Later, information sharing will be made regarding the questions and problems of
      the mother, Individual breastfeeding support provided to mothers through WhatsApp will
      continue for 6 months, Mothers will be contacted once a week through WhatsApp and feedback
      will be received on the breastfeeding process, The questions of the mother regarding
      breastfeeding will be answered by text / voice message or video call, In the postpartum
      period (day 7, day 15, month 1, month 2, month 4 and month 6) mothers will be called by
      phone. Breastfeeding conditions will be evaluated with "Postpartum Breastfeeding Evaluation
      and Follow-up Form".

      Breastfeeding attitudes of the mothers will be assessed with the Breastfeeding Attitudes of
      the Evaluation Scale" before breastfeeding education in hospital and through online survey at
      the 6th Month.

      Breastfeeding motivations of the mothers will be assessed with the " Primipara Breastfeeding
      Motivation Scale " through online survey at the 6th Month.

      The mothers' satisfaction with the continuous breastfeeding support provided through WhatsApp
      will be evaluated with the "Application Satisfaction Evaluation Form" through online survey.

      Basic Standard Information Sharing; New coronavirus (COVID-19) and breastfeeding Suggestion
      on breastfeeding (motivational-enhancing videos that emphasize breastfeeding is instinctive)
      The importance of breast milk (positive effects on mother and baby will be explained) Sharing
      of health institutions emphasizing the importance of breastfeeding (WHO, UNICEF, Ministry of
      Health) Milk production of breasts (Frequent breastfeeding will be supported by videos) Baby
      holding the breast (Mothers will be emphasized that the baby's sucking ability instinctively
      and will be supported with videos) Skin-to-skin contact and breastfeeding Reasons for
      breastfeeding only for the first 6 months Symptoms that show that the baby is sucking
      effectively Control Group; Information will be obtained from the mothers who agreed to
      participate in the study in line with the "Mother and Newborn Data Total Form", Mothers
      participating in the study will receive routine breastfeeding training at the hospital after
      birth, The breastfeeding attitude of the mother will be evaluated with the "Breastfeeding
      Attitude Scale", and the breastfeeding motivation of the mother will be evaluated with the
      "Breastfeeding Motivation Scale", In line with the needs of the mothers, breastfeeding
      support and motivation will be provided, In the postpartum period (day 7, day 15, month 1,
      month 2, month 4 and month 6) mothers will be called by phone. Breastfeeding conditions will
      be evaluated with "Postpartum Breastfeeding Evaluation and Follow-up Form".

      Breastfeeding attitudes of the mothers will be assessed with the Breastfeeding Attitudes of
      the Evaluation Scale" before breastfeeding education in hospital and through online survey at
      the 6th Month.

      Breastfeeding motivations of the mothers will be assessed with the " Primipara Breastfeeding
      Motivation Scale " through online survey at the 6th Month.

      Analysis:

      NCSS (Number Cruncher Statistical System) 2007 (Kaysville, Utah, USA) program will be used
      for statistical analysis of the research. Statistical significance will be accepted as p
      <0.05.
allocation: Randomized
intervention model: Parallel Assignment
intervention model description: Randomized Controlled Study
primary purpose: Supportive Care
masking: None (Open Label)
measure: Breastfeeding Attitudes of The Evaluation Scale
time frame: In our study, will be applied before breastfeeding education in hospital and through online survey at postpartum 6th months for both groups
description: This scale assesses various aspects of attitudes that direct mothers' breastfeeding behavior. Examines breastfeeding as behavior.
The scale is a five-point Likert type consisting of 46 items, easy to apply, and which people can answer on their own, and it can be applied to all mothers. Some items in the scale (3, 4, 6, 7, 8, 11, 13, 15, 19, 23, 24, 26, 27, 28, 29, 30, 31, 32, 37, 38, 42, 43) As a positive attitude, I agree with the statement "I totally disagree" to 4-3-2-1-0, while some items (1, 2, 5, 9, 10, 12, 14, 16, 17, 18, 20, 21 (22, 25, 33, 34, 35, 36, 39, 40, 41, 44, 45, 46) are considered negative, and the opposite score is scored as 0-1-2-3-4 from the statement entirely agree. In this way, the total score that can be obtained from the scale is between 0 and 184. As the score increases, breastfeeding attitude is evaluated as positive.
measure: Primipara Breastfeeding Motivation Scale (PBMS)
time frame: at postpartum 6th months through online survey for both groups
description: This scale evaluates postpartum breastfeeding motivation level in primiparous. The scale consists of 24 items in total. After applying to the sample group, the factor analysis of the scale was made and it was determined to have 5 factors.
Intrinsic motivation and integrated regulation
Identified regulation
Mirrored editing
External regulation is examined in two sub-dimensions:
External regulation (instrumental needs)
External regulation (baby health) Scale items are rated from 1 = Never disagree to 4 = Strongly agree. The scale is in 4-point Likert type, and each item is scored between 1-4. The scale does not have a total score. The score of the sub-dimensions is calculated by taking the average of the scale sub-dimension scores. As the score obtained from the sub-dimension of the scale increases, the motivation representing that sub-dimension increases.
measure: Application Satisfaction Evaluation Form
time frame: at postpartum 6th months through online survey for only experimental group
description: Evaluates the satisfaction of mothers from breastfeeding support provided through WhatsApp messaging application.
It is a form consisting of 10 questions by the researcher to evaluate the satisfaction of the mothers from the breastfeeding support given through the social media group (WhatsApp) by making use of the literature information.
The answer to each question will be evaluated as yes / no. In the tenth question, he will be asked to score the application. There will be a minimum of 1 and a maximum of 10 points.
arm group label: WhatsApp Messaging Application
arm group type: Experimental
description: Continuous breastfeeding support will be provided for the first 6 months through WhatsApp messaging application. Mothers will be contacted once a week through WhatsApp and feedback will be received on the breastfeeding process. The questions of the mother regarding breastfeeding will be answered by text / voice message or video call.
arm group label: Standard breastfeeding support
arm group type: No Intervention
description: She will receive standard breastfeeding support after delivery. Breastfeeding will not receive continuous breastfeeding support for the first 6 months after discharge.
intervention type: Other
intervention name: Breastfeeding Support Provided to Mothers Through WhatsApp Messaging Application
description: Breastfeeding support provided to mothers through WhatsApp messaging application will be maintained for the first 6 months after birth. In the first 1 month, standard information sharing will be made through whatsApp. Also, for the first 6 months, solutions generating shares will be made according to the problems and questions of the mother regarding breastfeeding.
arm group label: WhatsApp Messaging Application
criteria: 
gender: Female
gender based: Yes
gender description: 18 years and older who primiparous women who gave birth
minimum age: 18 Years
maximum age: 49 Years
healthy volunteers: Accepts Healthy Volunteers
last name: Sevda KORKUT ÖKSÜZ, R.A
role: Principal Investigator
affiliation: Kirsehir Ahi Evran Universitesi
facility: 
country: Turkey
citation: Balaguer Martinez JV, Valcarce Perez I, Esquivel Ojeda JN, Hernandez Gil A, Martin Jimenez MDP, Bernad Albareda M. [Telephone support for breastfeeding by primary care: a randomised multicentre trial]. An Pediatr (Engl Ed). 2018 Dec;89(6):344-351. doi: 10.1016/j.anpedi.2018.02.007. Epub 2018 Mar 22. Spanish.
PMID: 29576447
citation: Reiss K, Andersen K, Barnard S, Ngo TD, Biswas K, Smith C, Carpenter J, Church K, Nuremowla S, Pearson E. Using automated voice messages linked to telephone counselling to increase post-menstrual regulation contraceptive uptake and continuation in Bangladesh: study protocol for a randomised controlled trial. BMC Public Health. 2017 Oct 3;17(1):769. doi: 10.1186/s12889-017-4703-z.
PMID: 28974209
citation: Simonetti V, Palma E, Giglio A, Mohn A, Cicolini G. A structured telephonic counselling to promote the exclusive breastfeeding of healthy babies aged zero to six months: a pilot study. Int J Nurs Pract. 2012 Jun;18(3):289-94. doi: 10.1111/j.1440-172X.2012.02040.x.
PMID: 22621300
citation: Cavalcanti DS, Cabral CS, de Toledo Vianna RP, Osorio MM. Online participatory intervention to promote and support exclusive breastfeeding: Randomized clinical trial. Matern Child Nutr. 2019 Jul;15(3):e12806. doi: 10.1111/mcn.12806. Epub 2019 Apr 11.
PMID: 30825414
citation: Kapinos K, Kotzias V, Bogen D, Ray K, Demirci J, Rigas MA, Uscher-Pines L. The Use of and Experiences With Telelactation Among Rural Breastfeeding Mothers: Secondary Analysis of a Randomized Controlled Trial. J Med Internet Res. 2019 Sep 3;21(9):e13967. doi: 10.2196/13967.
PMID: 31482848
citation: Durmaz S, Ergin I, Durusoy R, Hassoy H, Caliskan A, Okyay P. WhatsApp embedded in routine service delivery for smoking cessation: effects on abstinence rates in a randomized controlled study. BMC Public Health. 2019 Apr 8;19(1):387. doi: 10.1186/s12889-019-6727-z.
PMID: 30961557
responsible party type: Principal Investigator
investigator affiliation: Ahi Evran University Education and Research Hospital
investigator full name: Sevda KORKUT ÖKSÜZ
investigator title: Research Assistant
sharing ipd: No