Virtual Counseling Boosted New Moms' Breastfeeding Confidence
In a randomized trial of 70 Iranian mothers, a program of one in-person plus ten virtual counseling sessions significantly raised breastfeeding confidence. At six months, 61.3% of the counseling group were still exclusively breastfeeding versus 33.3% of the control group, nearly double the rate.
New-parent life is a lot, and breastfeeding can come with a steep learning curve that no one fully warns you about. Confidence — the quiet belief that you can actually do this — turns out to matter a great deal for whether breastfeeding goes smoothly. So researchers asked a timely question: could counseling delivered mostly online help mothers feel more capable, and would that translate into real breastfeeding outcomes months down the line?
What the researchers wanted to know
Maternal self-efficacy — a mother's confidence in her own ability to breastfeed — plays a pivotal role in achieving exclusive breastfeeding, meaning feeding a baby only breast milk. The researchers wanted to know whether a structured virtual counseling program could raise that confidence and improve exclusive breastfeeding rates. Their program was built around an approach called REDI, which stands for Rapport building, Exploration, Decision-making, and Implementation — a step-by-step framework designed to guide supportive, practical conversations rather than just hand mothers a pamphlet.
How they studied it
This was a randomized clinical trial, one of the more rigorous study designs, conducted in comprehensive health centers in Hamadan City, Iran, between 2023 and 2024. Seventy eligible women were randomly assigned — using a method called block randomization — to either the intervention group or a control group. Random assignment matters because it helps ensure the two groups start out similar, so any later differences are more likely due to the counseling itself. The intervention consisted of one face-to-face breastfeeding counseling session followed by ten virtual sessions guided by the REDI framework. Confidence was measured with a validated tool called the Breastfeeding Self-Efficacy Scale, and the researchers also tracked how many mothers were still exclusively breastfeeding down the road. Reassuringly, the two groups did not differ significantly in their background characteristics or in their confidence scores before the program began — so they were on even footing at the start.
What they found
After the intervention, the mothers who received counseling reported significantly higher breastfeeding confidence than those in the control group. The difference was statistically meaningful, meaning it is unlikely to be a fluke of chance. Even more striking was what happened at six months: 61.3% of mothers in the counseling group were still exclusively breastfeeding, compared with 33.3% in the control group. That is nearly double the rate. The researchers concluded that virtual counseling was effective at improving breastfeeding outcomes — both the confidence that supports breastfeeding and the sustained exclusive breastfeeding that often follows from it.
“A little face-to-face time followed by a run of virtual sessions left mothers more confident about breastfeeding — and more of them were still exclusively breastfeeding six months on.”
What this means for you
If you are a new or expecting parent, the encouraging message here is that meaningful breastfeeding support does not have to mean repeated trips to a clinic. A single in-person visit paired with a series of guided virtual check-ins was enough to help mothers in this study feel more capable and stick with exclusive breastfeeding longer. It is worth pausing on why confidence, specifically, seems to matter so much. Breastfeeding challenges often snowball: a hard early feed dents a mother's belief in herself, that self-doubt makes the next feed feel harder, and the discouragement can build until stopping feels like the only option. Support that rebuilds confidence appears to interrupt that spiral, which may be part of why the counseling group kept going where others did not. That is good news for anyone juggling a newborn, limited time, and the logistics of leaving the house with an infant. If breastfeeding feels hard right now, it may help to know that confidence is something that can be built with the right kind of support — and that structured, ongoing guidance seems to work better than being left to figure it out alone. Ask your health provider or a lactation consultant whether virtual counseling or follow-up sessions are available where you are. The value seems to lie not just in information, but in the steady, personal, step-by-step encouragement of someone in your corner.
The honest caveats
This was a single trial, and a fairly small one — 70 women in a specific set of health centers in one city. Results from one location and population do not automatically transfer to mothers elsewhere, whose circumstances, resources, and support systems may differ. The counseling was also delivered by trained professionals following a specific framework, so the benefits reflect that structured approach rather than any casual virtual chat. And while the six-month exclusive breastfeeding difference is impressive, the study cannot tell us everything about why some mothers continued and others did not; many factors shape feeding decisions. Finally, breastfeeding is deeply personal and sometimes not possible for medical, physical, or life reasons, and fed babies thrive in many ways. Nothing here is medical advice — for guidance tailored to you and your baby, talk with a qualified health professional or lactation specialist who knows your situation.
- ✓Mothers who got one in-person plus ten virtual counseling sessions reported significantly higher breastfeeding confidence than a comparison group.
- ✓Six months later, far more of them were still exclusively breastfeeding (61% versus 33%).
- ✓It was a single trial of 70 women in one city, so the findings need confirmation elsewhere.
Frequently asked questions
What is the REDI framework used in the counseling?
REDI stands for Rapport building, Exploration, Decision-making, and Implementation. It is a step-by-step framework designed to guide supportive, practical conversations rather than simply handing mothers a pamphlet. The virtual sessions in the study followed this approach.
How much of a difference did the counseling make at six months?
A substantial one. About 61.3% of mothers in the counseling group were still exclusively breastfeeding at six months, compared with 33.3% in the control group, nearly double. The counseling group also reported significantly higher breastfeeding confidence on a validated self-efficacy scale.
Why does confidence matter so much for breastfeeding?
The article explains that breastfeeding challenges tend to snowball: a hard early feed dents a mother's belief in herself, making the next feed feel harder until stopping seems like the only option. Support that rebuilds confidence appears to interrupt that spiral, which may be why the counseling group kept going.
The Effect of Virtual Breastfeeding Counseling on Breastfeeding Self- Efficacy and Exclusive Breastfeeding: A Randomized Controlled Clinical Trial
Read the full studyThis is a plain-English summary reviewed by Jillian Schafer. It is educational, not medical advice.
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