Effect of a Breastfeeding Chatbot on Mothers' Breastfeeding Attitudes, Behaviors, and Self-Efficacy

This randomized controlled trial aims to evaluate the effects of an artificial intelligence (AI)-based chatbot developed to address breastfeeding problems on mothers' breastfeeding attitudes, behaviors, and self-efficacy. The study will also assess exclusive breastfeeding rates, breastfeeding duration, and the technical performance and usability of the developed chatbot. The study is planned to include 92 primiparous mothers allocated to intervention and control groups. The intervention involves an AI-based breastfeeding counseling chatbot developed using natural language processing (NLP) and Retrieval-Augmented Generation (RAG) technology. The chatbot will provide evidence-based breastfeeding education, information, and counseling support using an expert-reviewed breastfeeding knowledge base. The system is designed to support mothers in managing breastfeeding-related difficulties and will not provide medical diagnoses or replace healthcare professionals. Breastfeeding attitudes, self-efficacy, and behaviors will be evaluated during the postpartum follow-up period. Assessments will be conducted at baseline and at the first, third, and sixth postpartum months. Exclusive breastfeeding rates and breastfeeding duration will also be assessed. Additionally, the chatbot's technical performance, response reliability, medical safety, user satisfaction, and usability will be evaluated. The study aims to provide scientific evidence regarding the effectiveness and feasibility of an AI-supported, evidence-based breastfeeding counseling intervention.

Inclusion Criteria: * Mothers aged 18 years or older. Primiparous mothers. Having delivered a healthy singleton infant. Having a term infant born between 37+0 and 41+6 weeks of gestation. Infant birth weight of at least 2500 grams. No infant health condition directly preventing oral feeding or breastfeeding. Mother and infant staying together after delivery. Breastfeeding initiated during the early postpartum period. Intention to breastfeed. No maternal physical condition directly preventing breastfeeding. Continuing breastfeeding at hospital discharge. Ability to read and write Turkish. Access to a smartphone and internet connection. Voluntary participation with informed consent. Exclusion Criteria: \- Multiple births. Maternal disease or physical condition preventing breastfeeding. Receipt of structured or individualized professional breastfeeding counseling beyond routine care during pregnancy. Diagnosed severe mental health conditions that could substantially affect study participation or interaction with the intervention. Infant admission to the neonatal intensive care unit. Maternal or neonatal health conditions resulting in separation of mother and infant and preventing early initiation of breastfeeding.