A longitudinal study of the effect of psychosocial factors on exclusive breastfeeding duration

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.