Materials and Methods: This randomized controlled clinical trial was conducted on 60 primiparous women following CS in Ardabil, Iran. The subjects were assigned to the intervention and control groups using the block randomization method, ensuring a fair and unbiased selection process. The intervention group participated in three home counseling sessions on 3 and 7 days and a month after childbirth, and the control group received only routine postpartum care. The demographic and obstetric characteristics, BSE scale-short form, and breastfeeding practice questionnaires were filled out by groups 10 to 15 days and two to four months after childbirth for data collection. After birth and adjusting the birth weight impact, the infant’s weight was measured at two and four months. Chi-square and repeated measures ANOVA (RMANOVA) tests were employed for data analysis, providing a comprehensive and rigorous approach to our research.

Results: In the intervention group, the total mean (SD) score of BSE increased significantly from 50.56 (2.35) during 10-15 days to 62.86 (1.77) two months after birth and 64.2 (1.37) four months after birth. This positive trend was not observed in the control group, where the score changed from 44.26 (5.89) during 10-15 days after birth to 43 (6.93) two months and 39.13 (6.98) four months after birth. Additionally, a significant difference was found in comparing breastfeeding performance in terms of the frequency of breastfeeding during 24 hours, duration of each breastfeeding, exclusive breastfeeding, and frequency of breastfeeding problems between two groups during 10-15 days and two and four months after childbirth (P < 0.05). These results highlight the potential of home counseling to improve BSE and performance, offering hope for better postpartum care.

Conclusions: The results revealed that home counseling effectively influences the improvement of BSE and breastfeeding performance after CS. Therefore, it is suggested that in-home supportive interventions be employed among mothers who underwent CS to promote breastfeeding and exclusive breastfeeding.