Antenatal and postnatal breastfeeding motivation and self-efficacy in primiparous women: a prospective observational study

Abstract

Despite widespread breastfeeding education, achieving target breastfeeding rates requires understanding the interplay between motivation and self-efficacy across the antenatal and postnatal periods. This study examined their relationship in primiparous women and identified predictors of postnatal breastfeeding self-efficacy. A prospective observational study with a correlational approach was conducted with 112 primiparous women at 32-42 weeks of gestation. Antenatal data were collected using the Descriptive Characteristics Form, Antenatal Breastfeeding Self-Efficacy Scale (ABSES-SF), and a visual analog scale for breastfeeding motivation. Postnatally, the Postnatal Breastfeeding Self-Efficacy Scale (PBSES-SF), Breastfeeding Motivation Scale (BMS), LATCH Breastfeeding Assessment Tool, and Postnatal Breastfeeding Information Form were administered at the first week, first month, and second month. Significant time-dependent increases were demonstrated in BMS subdimensions, PBSES-SF, and LATCH scores (p < 0.05). Antenatal breastfeeding self-efficacy was positively associated with postnatal breastfeeding self-efficacy and selected breastfeeding motivation subdimensions. Antenatal breastfeeding motivation showed strong correlations with postnatal self-efficacy and multiple BMS subdimensions. Regression analyses revealed that motivation subdimensions significantly predicted postnatal self-efficacy at the first week (R² = 38%), first month (R² = 63%), and second month (R² = 73%).

Conclusion: Antenatal motivation and self-efficacy strongly influence postnatal breastfeeding self-efficacy, with key motivational dimensions varying over time. Integrating antenatal assessment and enhancement of motivation and self-efficacy into breastfeeding education, alongside targeted postnatal support, may improve breastfeeding outcomes and contribute to healthier generations.

What is known: • Breastfeeding self-efficacy is a key determinant of maternal breastfeeding behavior and plays a critical role in the nutritional outcomes of the infant. • The antenatal and postnatal periods influence each other in shaping breastfeeding behavior.

What is new: • Breastfeeding motivation during the antenatal period influences a woman's breastfeeding behavior. • Breastfeeding self-efficacy and motivation show variation at different time points during the postpartum period. • There is a significant relationship between antenatal and postnatal breastfeeding motivation and self-efficacy.

Keywords: Antenatal; Breastfeeding; Motivation; Postnatal; Self-efficacy; Women.