{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T10:13:09Z","timestamp":1784542389940,"version":"3.55.0"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n BACKGROUND:<\/jats:title>\n Women with Gestational Diabetes Mellitus (GDM) frequently encounter challenges that impede successful breastfeeding, despite its significant benefits for postnatal glycemic control. This study aimed to evaluate the effect of the Breastfeeding Education Package (BFEP) on the knowledge, attitude, self-efficacy, and breastfeeding practices among pregnant women with GDM.<\/jats:p>\n <\/jats:sec>\n \n MATERIAL AND METHODS:<\/jats:title>\n \n This Randomized Controlled Trial was conducted in Selangor, Malaysia, randomized 58 pregnant women with GDM into an Intensive Breastfeeding Intervention (IBI) group (\n n<\/jats:italic>\n = 29) or a control group (CG) (\n n<\/jats:italic>\n = 29). The IBI group received three individualized dietitian-led education sessions. Knowledge, attitude, and self-efficacy were assessed at baseline and 37 weeks\u2019 gestation; breastfeeding practices were monitored for six months post-delivery.\n <\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n \n A two-way repeated measures ANOVA confirmed the effectiveness of the intervention, revealing a significant difference between the IBI group and the CG in improving breastfeeding knowledge, attitude, and self-efficacy (\n P<\/jats:italic>\n < 0.005). The IBI group attained significantly higher mean scores for knowledge (35.76 \u00b1 5.77), attitude (89.91 \u00b1 9.9), and self-efficacy (56.02 \u00b1 8.17) compared to the CG (\n P<\/jats:italic>\n < 0.001). This was reflected in practice, as the mean duration of exclusive breastfeeding (EBF) was longer in the IBI group (92.41 \u00b1 82.14 days) than in the CG (55.59 \u00b1 74.90 days). Furthermore, a Pearson\u2019s correlation within the IBI group identified a small, positive relationship between knowledge and attitude scores and the subsequent length of EBF.\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSION:<\/jats:title>\n BFEP is an effective intervention that significantly improves the antenatal knowledge, attitude, and self-efficacy of mothers with GDM. These psychosocial enhancements, in turn, translate into a longer duration of breastfeeding post-delivery.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jehp.jehp_586_25","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T05:00:48Z","timestamp":1782795648000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of a breastfeeding education package on breastfeeding knowledge, attitude, self-efficacy, and breastfeeding practices among women with gestational diabetes mellitus: A randomized controlled trial"],"prefix":"10.4103","volume":"15","author":[{"given":"Farhanah A.","family":"Shuhaimi","sequence":"first","affiliation":[{"name":"Centre for Dietetics Studies, Faculty of Health Sciences, UiTM Selangor Puncak Alam, 42300 Puncak Alam, Selangor Darul Ehsan, Malaysia"},{"name":"Mother, Infant and Young Child Nutrition (MiChild) Research Group, Faculty of Health Sciences, UiTM Selangor Puncak Alam, 42300 Puncak Alam, Selangor Darul Ehsan, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syahrul Bariah","family":"Abdul Hamid","sequence":"additional","affiliation":[{"name":"Centre for Dietetics Studies, Faculty of Health Sciences, UiTM Selangor Puncak Alam, 42300 Puncak Alam, Selangor Darul Ehsan, Malaysia"},{"name":"Mother, Infant and Young Child Nutrition (MiChild) Research Group, Faculty of Health Sciences, UiTM Selangor Puncak Alam, 42300 Puncak Alam, Selangor Darul Ehsan, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aza S.","family":"Mohamad Yususff","sequence":"additional","affiliation":[{"name":"Public Health Unit, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Persiaran Ilmu, Putra Nilai, 71800, Nilai, Negeri Sembilan, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,6]]},"reference":[{"key":"R1-20260720","first-page":"1587","article-title":"The effectiveness of lifestyle changes in glycemic control among pregnant women with gestational diabetes mellitus","volume":"59","author":"Le","year":"2023","journal-title":"Med"},{"key":"R2-20260720","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/s13006-017-0123-z","article-title":"The effect of high-intensity breastfeeding on postpartum glucose tolerance in women with recent gestational diabetes","volume":"12","author":"Yasuhi","year":"2017","journal-title":"Int Breastfeed J"},{"key":"R3-20260720","doi-asserted-by":"crossref","first-page":"S68","DOI":"10.1016\/j.ajog.2015.10.118","article-title":"97: A tailored breastfeeding support intervention for women with gestational diabetes","volume":"214","author":"Stuebe","year":"2016","journal-title":"Am J Obstet Gynecol"},{"key":"R4-20260720","article-title":"No Title. 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