de Jager, Emily, Broadbent, Jaclyn, Fuller-Tyszkiewicz, Matthew, Nagle, Cate, McPhie, Skye, and Skouteris, Helen (2015) A longitudinal study of the effect of psychosocial factors on exclusive breastfeeding duration. Midwifery, 31 (1). pp. 103-111.

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Abstract

Objective: to examine the effect of psychosocial factors on exclusive breastfeeding duration to six months postpartum

Design: longitudinal, prospective questionnaire based study.

Setting: participants were recruited from a publically funded antenatal clinic located in the western metropolitan region of Melbourne, Victoria, Australia and asked to complete questionnaires at three time points; 32 weeks pregnancy, two months postpartum and six months postpartum.

Participants: the participants were 125 pregnant women aged 22-44 years.

Measurements and findings: psychosocial variables such as breastfeeding self-efficacy, body attitude, psychological adjustment, attitude towards pregnancy, intention, confidence and motivation to exclusively breastfeed and importance of exclusive breastfeeding were assessed using a range of psychometrically validated tools. Exclusive breastfeeding behaviour up to six months postpartum was also measured. At 32 weeks gestation a woman's confidence to achieve exclusive breastfeeding was a direct predictor of exclusive breastfeeding duration to six months postpartum. At two months postpartum, psychological adjustment and breastfeeding self-efficacy were predictive of exclusive breastfeeding duration. Finally, at six months postpartum, psychological adjustment, breastfeeding self-efficacy, confidence to maintain and feeling fat were directly predictive of exclusive breastfeeding duration.

Key conclusions: psychosocial factors are significantly predictive of exclusive breastfeeding duration. Self-efficacy, psychological adjustment, body image, motivation and confidence are all important psychosocial factors implicated in a woman's ability to maintain exclusive breastfeeding over time.

Implications for practice: Individualised antenatal breastfeeding education and support may be strengthened by strategies that build a woman's confidence to exclusive breastfeeding. Implementing psychosocial supports and methods providing positive feedback that increase a women's self-efficacy to exclusively breastfeed to six months are also important two months postpartum.

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