The United States has established breastfeeding as an important health indicator within the Healthy People agenda. Healthy People target goals for breastfeeding initiation, duration, and exclusivity remain unmet. The US Surgeon General's Office reports that lack of knowledge and widespread misinformation about breastfeeding are barriers to meeting Healthy People goals. Breastfeeding mothers are vulnerable to messages that cast doubt on their ability to breastfeed. Very little research has examined specific approaches to help people resist negative messages about health beliefs and behaviors. The objective of this quasi-experimental study was to test an intervention designed to help mothers defend their breastfeeding decisions and resist influences that attempted to persuade them to give formula to their babies. Women attending prenatal breastfeeding classes were recruited and assigned to comparison and intervention groups. The intervention was a board game based on McGuire's inoculation theory of resistance to influence. Controlling for intention to breastfed, intervention and comparison groups were examined for differences in maternal self-efficacy to resist persuasion to give formula and breastfeeding rates for initiation, duration, and exclusivity. Data analyses consisted of analysis of covariance and logistic regression. There was no significant difference between comparison and intervention groups, both groups had high self-efficacy to resist giving formula to their babies; nor were there significant differences regarding breastfeeding initiation, duration and exclusivity. The lack of significant differences may have been influenced by ceiling effects in all of the breastfeeding variables, possibly due to the high socioeconomic level of the sample. The intervention may have worked better in women who were more prone to dissuasive influence, such as those with lower education.

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