Predictors of breastfeeding self-efficacy among women attending an urban postnatal clinic, Uganda

The COVID-19 pandemic's impact on breastfeeding self-efficacy: A path analysis

Aims

The COVID-19 pandemic has impacted breastfeeding self-efficacy directly or indirectly. This is likely due to the adverse effect of movement and community activity restrictions to prevent virus transmission. This study aims to measure how breastfeeding self-efficacy has been affected by the COVID-19 pandemic.

Method

This study uses a cross-sectional design with participants consisting of mothers giving birth from June to July 2021 in Bekasi, Indonesia. The recruitment used a consecutive sampling method. The data were collected using the breastfeeding self-efficacy scale-short form, the postpartum bonding questionnaire, the Zung self-rating anxiety scale, and the multidimensional scale of perceived social support. The COVID-19-related factors, i.e., anxiety, bonding and social support on breastfeeding self-efficacy, were measured using the Path Analysis.

Results

The results showed that anxiety, bonding, and social support affected breastfeeding self-efficacy among the 118 respondents. While anxiety had a negative effect on breastfeeding self-efficacy, bonding and social support had a positive effect. The effect of anxiety was more direct (β -0.239; p 0.00) than indirect (β -0.076; p 0.04). Social support also had a more direct (β 0.248; p 0.00) than indirect effect (β 0.118; p 0.046). Likewise, bonding had a significant impact on breastfeeding self-efficacy (β 0.235; p 0.039). However, the effect of anxiety and social support indirectly on breastfeeding self-efficacy via bonding was less significant than their direct impacts.

Conclusion

The factors related to breastfeeding self-efficacy affected by the COVID-19 pandemic are anxiety, bonding, and social support. Interventions during a crisis such as the pandemic could aim to reduce anxiety and improve social support. Health education and counselling are essential to enhance competence and self-efficacy in breastfeeding their babies and build more positive interactions with their children.

Breastfeeding Self-efficacy in COVID-19 Positive Postpartum Mothers in a Community Maternal Facility in South India: A Case Control Study

Background

Breastfeeding experiences have altered during the COVID-19 pandemic. Breastfeeding self-efficacy is a strong determinant of the breastfeeding behaviour of women. We aimed to study breastfeeding self-efficacy and assess the perceived factors for breastfeeding hindrance in COVID-19 positive mothers in the postpartum period.

Method

A facility based case-control study was conducted with 63 COVID-19 positive (cases) and 63 COVID-19 negative postnatal mothers (controls). A breastfeeding self-efficacy short form (BFSE SF) instrument measured Breastfeeding self-efficacy 24 to 48 hours post-delivery. Mothers who tested positive for COVID-19 were interviewed about perceived factors for breastfeeding hindrance. Data was analyzed by SPSS version 25. Descriptive statistics were used for maternal parameters. BFSE SF scores were compared by a t test.

Results

The mean BFSE SF score of COVID-19 positive mothers was 53.14 which was significantly lower than the mean BFSE SF score of 56.52 of COVID-19 negative mothers (p=0.013). Mothers who had received postpartum breastfeeding advice had significantly higher BFSE SF mean scores (p= 0.031). Sixty-seven percentage of COVID-19 positive mothers reported fear of transmission of illness to the neonate as a hindering factor.

Conclusions

Breastfeeding self-efficacy scores were significantly lower in COVID- 19 positive mothers. Higher breastfeeding self-efficacy scores were observed in mothers who had received postpartum breastfeeding advice. The fear of transmission of the COVID-19 illness to the neonate was perceived as a breastfeeding hindering factor in most of the mothers. These observations imply the need for professional lactation support programs.

Evaluation of breastfeeding success and self-efficacy in mothers giving birth via vaginal delivery or cesarean section: a cross-sectional study

This cross-sectional observational study was conducted to compare breastfeeding success and breastfeeding self-efficacy levels of mothers who gave birth via vaginal delivery (spontaneous or via epidural analgesia) or cesarean section (under general or spinal anesthesia). The study was conducted between September 2019 and February 2020 in the obstetric clinic. Data were collected using a Data Collection Form, the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), and the LATCH Breastfeeding Evaluation Tool. Throughout the study, we followed the STROBE Checklist. Mothers who gave birth via spontaneous vaginal delivery had a statistically higher mean Breastfeeding Self-Efficacy score (54.92 ± 7.72; p < .001) than those who gave birth under spinal anesthesia (43.21 ± 10.04; p < .001) and then those who gave birth via cesarean section under general anesthesia (37.39 ± 10.64; p < .001). The difference between the delivery modes in terms of breastfeeding self-efficacy and breastfeeding success scores was statistically significant (respectively, KW = 40.168, p < .001 and KW = 52.420, p < .001). In order to increase the breastfeeding success of mothers who give birth via cesarean section under general anesthesia or spinal anesthesia, lactation nurses need to strengthen the perception of breastfeeding self-efficacy and provide more breastfeeding support to them compared to mothers who give birth via SVD.

Effect of Postpartum Yoga on Breastfeeding Self-Efficacy and Maternal Attachment in Primiparous Mothers

Objective: This study was conducted to determine the effect of yoga practice on the breastfeeding self-efficacy and maternal attachment of primiparous mothers in the postpartum period. Methods: This study was performed in a quasi-experimental model with pretest and posttest control groups. The domain of the study was formed with women with 20-40-day-old babies enrolled in two Family Health Centers. One hundred and twenty-four women participated in the study. The Individual Identification Form, Breastfeeding Self-Efficacy Scale, and Maternal Attachment Scale were completed by the experimental and control groups. The experimental group engaged in 60 minutes of postpartum yoga practice 2 days a week for 8 weeks in the company of the researcher. Results: After yoga practice, there was a statistically significant increase in the breastfeeding self-efficacy and improvement in the maternal attachment of the experimental group (p < 0.05). The corresponding increase and improvement of the mothers in the control group were less than those of the mothers in the experimental group (p < 0.05). Conclusion: This study finds that it is beneficial for both the mother's and the baby's physical and psychological health for health professionals to teach mothers to practice yoga, which positively affects breastfeeding and maternal attachment in the postpartum period.

Breastfeeding Self-efficacy and Related Socio-demographic, Perinatal and Psychological Factors: a Cross-sectional Study Among Postpartum Greek Women

Background:

Studies have shown that breastfeeding self-efficacy constitutes a determinant used to forecast breastfeeding behaviours.

Objective:

The aim of this study was to examine the factors associated to breastfeeding self-efficacy and identify its predictors among Greek women in their immediate postpartum period.

Methods:

A cross-sectional study was conducted at the General Hospital of Volos, Greece. A convenience sample of 120 postpartum women who gave birth at the hospital and met all the inclusion criteria were invited to participate; 100 responded. Questionnaires on socio-demographic, perinatal and breastfeeding-related characteristics, the Edinburgh Postnatal Depression Scale, and the Breastfeeding Self-Efficiency Scale were completed. Univariate and multivariate analyses were performed with the use of the linear regression model.

Results:

Women reported a rather good level of breastfeeding self-efficacy (mean = 3.65; SD = 0.85) in the early postpartum period. 52% of women carried out exclusive breastfeeding in the hospital. The prevalence of postnatal depression was 25%. The best-fit regression analysis revealed four predictors (timing of the mother’s decision to breastfeed, infant’s feeding pattern, previous breastfeeding experience, levels of postnatal depression) explaining 44.7% of the variance in breastfeeding self-efficacy.

Conclusion:

Acknowledging the determinants which affect breastfeeding self-efficacy of women in the immediate postpartum period is a necessary condition in designing targeted intervention services.

Effect of a brief motivational intervention in the immediate postpartum period on breastfeeding self-efficacy: Randomized controlled trial

Brief motivational intervention (bMI) is a therapeutic approach that encourages self-efficacy and may have a positive effect on breastfeeding self-efficacy (BSE). The purpose of this study was to analyze the effectiveness of a bMI in increasing BSE in women who started breastfeeding in the immediate postpartum period and to explore the roles of general self-efficacy and other baseline variables in this relationship. A randomized, parallel-group clinical trial was carried out. A bMI was compared with an educational session on breastfeeding. Changes in BSE and its dimensions and the interaction and mediation/moderation of general self-efficacy and other variables were analyzed. BSE increased in the bMI group from a mean baseline score of 59.14 (±9.35) to 64.62 (±7.91) at 1st month (p < 0.001). An interaction was found in that only women with higher education had an improvement in BSE during the follow-up period that was attributable to the bMI (mean difference between the bMI and the attention control group: 18.25 (95% confidence interval: 5.86-30.19; p = 0.006). This interaction was not found for the changes produced in the intrapersonal thoughts dimension of BSE, whose scores were higher in the bMI group at 3 and 6 months. General self-efficacy exerted a moderating effect on the association of bMI with BSE change. The effect of bMI was no longer significant when the general self-efficacy score was above 84. Thus, bMI is effective in increasing BSE. This effectiveness was limited by the mother's educational level and moderated by baseline general self-efficacy.

Determinants of low breastfeeding self-efficacy amongst mothers of children aged less than six months: results from the BADUTA study in East Java, Indonesia

Background

Despite the increasing rate of exclusive breastfeeding in Indonesia, there is still a need for supportive interventions. The breastfeeding self-efficacy of mothers is a key factor positively associated with optimum breastfeeding practices. Our analysis aims to assess the determinants of low breastfeeding self-efficacy amongst a sample of women with children aged under 6 months in Malang and Sidoarjo Districts, East Java, Indonesia.

Methods

We used information from 1210 mothers of children aged < 6 months recruited in the BADUTA study conducted in 2015–2016 in Malang and Sidoarjo Districts. The outcome variable in this analysis was mothers’ self-efficacy for breastfeeding using the 14 statements in the Breastfeeding Self-Efficacy-Short Form. We evaluated 17 potential predictors of breastfeeding self-efficacy, organized into six sub-groups of variables: (1) context/demographic; (2) household factors; (3) maternal characteristics; (4) child characteristics; (5) breastfeeding practices; and (6) antenatal and delivery care. Logistic regression analyses were employed to examine factors associated with mothers’ self-efficacy with breastfeeding.

Results

More than half of the women in this study had a low level of self-efficacy. One of the factors associated with low breastfeeding self-efficacy found in this study was mothers’ problems related to breastfeeding. Mothers who had problems with breastfeeding not related to illness (adjusted odds ratio [aOR] 3.27; 95% CI 2.45, 4.36) or problems related to both illness and non-illness conditions (aOR 3.57; 95% CI 1.37, 9.33) had higher odds of low breastfeeding self-efficacy than those who did not have any problems. Compared to mothers who completed university education, there was a significantly higher odds of low breastfeeding self-efficacy in mothers who completed primary school or lower (aOR 1.88; 95% CI 1.16, 3.05); completed junior high school (aOR 2.27; 95% CI 1.42, 3.63); and completed senior high school (aOR 1.94; 95% CI 1.29, 2.91). Other significant predictors of low breastfeeding self-efficacy were mothers not exposed to any breastfeeding interventions (aOR 1.87; 95% CI 1.09, 3.22); working outside the house (aOR 1.69; 95% CI 1.23, 2.32); not obtaining any advice on breastfeeding (aOR 1.40; 95% CI 1.08, 1.82); with low knowledge of breastfeeding (aOR 1.38; 95% CI 1.03, 1.84); and delivered by Caesarean section (aOR 1.34; 95% CI 1.05, 1.70).

Conclusions

Multipronged breastfeeding education programs and support are required to improve women’s self-efficacy with breastfeeding. Improved access to breastfeeding counselors, active support for mothers following cesarean delivery, and increased supporting facilities at workplaces are essential to improve self-efficacy with breastfeeding.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13006-021-00357-5.