The Association Between Breastfeeding Self-Efficacy and Mode of Infant Feeding

Factors Influencing Duration of Breastfeeding: Insights from a Prospective Study of Maternal Health Literacy and Obstetric Practices

Numerous factors concerning early breastfeeding abandonment have been described, including health literacy (HL). This study's objective was to analyze factors related to early breastfeeding abandonment (<6 months). This prospective multicentric study examined the duration of breastfeeding at 6 months postpartum and was conducted in four different regions of Spain from January 2021 to January 2023. A total of 275 women participated in this study, which focused on maternal HL and obstetric practices. A decrease in the breastfeeding rate was observed from hospital discharge (n = 224, 81.5%) to the sixth month postpartum (n = 117, 42.5%). A Cox regression analysis revealed that inadequate HL levels, lack of mobilization during labour, and induced labour were significantly associated with early breastfeeding cessation (p = 0.022, p = 0.019, and p = 0.010, respectively). The results highlight that women with adequate HL had a 32% lower risk of early breastfeeding abandonment. In comparison, mobilization during labour and induction of labour were linked to a 32.4% reduction and a 53.8% increase in this risk, respectively. These findings emphasize the importance of considering obstetric and HL factors when addressing the breastfeeding duration, indicating opportunities for educational and perinatal care interventions.

Household food insecurity is negatively associated with achievement of prenatal intentions to feed only breast milk in the first six months postpartum

Background

Household food insecurity (HFI) has been associated with suboptimal breastfeeding practices. Postpartum factors reported by caregivers include stressful life circumstances and maternal diet quality concerns. It is unknown whether prenatal breast milk feeding intentions, a well-established predictor of breastfeeding outcomes, differ by HFI status. We explored associations between HFI and prenatal intentions to feed any and only breast milk in the first 6 months postpartum, and achievement of these intentions.

Methods

We utilized data from self-identified biological mothers with children 6-12 months of age who responded to a retrospective, cross-sectional online infant feeding survey conducted in Nova Scotia, Canada. HFI (yes/no) was assessed using the Household Food Security Survey Module. Prenatal intentions to feed any and only breast milk were assessed based on responses to five options for infant milk feeding plans. Achievement of intentions was assessed by breast milk and formula feeding practices in the first 6 months. Multivariable logistic regressions were conducted, adjusting for maternal socio-demographics.

Results

Among 459 respondents, 28% reported HFI; 88% intended to feed any breast milk and 77% intended to feed only breast milk, with no difference by HFI status. Of those intending to feed any breast milk, 99% succeeded, precluding further analysis. Among mothers who intended to provide only breast milk, only 51% achieved their intention, with lower odds among those with HFI (aOR 0.54, 95% CI 0.29-0.98).

Conclusion

HFI was not associated with intentions for feeding breast milk in the first 6 months postpartum, but mothers with HFI were less likely to achieve their intention to provide only breast milk. Further research is needed to understand the underlying reasons for this and to guide intervention designs to address HFI and help mothers reach their breastfeeding goals.

Transcultural adaptation of a scale for exclusive breastfeeding to be used in Brazil

OBJECTIVE

The aim of this study was to perform a cross-cultural adaptation of the Breastfeeding Self-Efficacy Scale in Exclusive Breastfeeding for use in a Brazilian-Portuguese context.

METHODS

The cross-cultural adaptation process involved the translation from original English into Brazilian Portuguese by two qualified and independent translators. Both translations were synthesized into a single version that was back-translated into English. An expert committee was created to assess linguistic equivalences, formulating a pre-final version that was tested on ten nursing women attending a maternity hospital. To assess its psychometric properties, a cross-sectional study was carried out. The population consisted of 99 nursing women from a reference maternity hospital in southern Brazil. The scale's stability and internal consistency were measured through Cronbach's alpha. The Pearson's correlation coefficient and the intraclass correlation coefficient between two applications were assessed to ascertain the Breastfeeding Self-Efficacy Scale in Exclusive Breastfeeding-Br scale's reliability. The construct validity was evaluated through exploratory factorial analysis.

RESULTS

The Breastfeeding Self-Efficacy Scale in Exclusive Breastfeeding-Br showed a general Cronbach's alpha of 0.849. The test-retest analysis showed a Pearson's correlation coefficient of 0.483 and intraclass correlation coefficient of 0.645. The exploratory factorial analysis showed two domains among the nine items of the Breastfeeding Self-Efficacy Scale in Exclusive Breastfeeding-Br: the functional domain, including six items, and the cognitive domain, including three items, explaining 59.77% of the variance.

CONCLUSION

The Breastfeeding Self-Efficacy Scale in Exclusive Breastfeeding-Br was considered adequate for the cultural context and reliable and valid for Brazilian nursing women.