Determinants of breastfeeding self-efficacy among postpartum women in rural China: A cross-sectional study

Linhua Li; Yuju Wu; Qingzhi Wang; Yefan Du; Dimitris Friesen; Yian Guo; Sarah-Eve Dill; Alexis Medina; Scott Rozelle; Huan Zhou

doi:10.1371/journal.pone.0266273

Determinants of breastfeeding self-efficacy among postpartum women in rural China: A cross-sectional study

PLoS One. 2022 Apr 7;17(4):e0266273. doi: 10.1371/journal.pone.0266273. eCollection 2022.

Authors

Affiliations

¹ Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
² Stanford Center on China's Economy and Institutions, Stanford University, Stanford, California, United States of America.

Abstract

Background: Breastfeeding self-efficacy is known to positively influence breastfeeding behaviors. While previous research has studied the determinants of breastfeeding self-efficacy in general, these determinants are unstudied among postpartum women in rural China. This study aims to describe the breastfeeding self-efficacy of postpartum women in rural China and identify determinants of breastfeeding self-efficacy using the Dennis breastfeeding self-efficacy framework.

Methods: Using a multi-stage random cluster sampling design, cross-sectional survey data were collected from 787 women within the 0-6 months postpartum period in 80 rural townships. Surveys collected data on breastfeeding self-efficacy, characteristics related to the Dennis breastfeeding self-efficacy framework, and demographic characteristics. Multiple linear regression analysis was used to identify determinants of breastfeeding self-efficacy.

Results: Participants reported a moderate level of breastfeeding self-efficacy, with an item mean score of 3.50. Self-efficacy was lowest for exclusive breastfeeding. Breastfeeding attitudes (β = 0.088, P< 0.001), breastfeeding family support (β = 0.168, P< 0.001), and social support from significant others (β = 0.219, P< 0.001) were positively associated with breastfeeding self-efficacy. Breastfeeding problems, including trouble with latching (β = -0.170, P< 0.001), not producing enough milk (β = -0.148, P< 0.001), and milk taking too long to secrete (β = -0.173, P< 0.001) were negatively associated with breastfeeding self-efficacy.

Conclusion: The findings indicate that positive attitudes, breastfeeding family support and social support contribute to greater breastfeeding self-efficacy in rural China, whereas difficulties with breastfeeding are associated with reduced self-efficacy. Researchers and practitioners should investigate effective strategies to improve social support and family support for breastfeeding, promote positive attitudes towards breastfeeding, and provide women with actionable solutions to breastfeeding problems.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Breast Feeding*
China
Cross-Sectional Studies
Female
Humans
Mothers
Postpartum Period
Self Efficacy*
Surveys and Questionnaires

Grants and funding

This work was supported by the National Natural Science Foundation of China [grant no. 71874114] and Health Commission of Sichuan Province [grant no. 19PJ072] in the form of grants to HZ. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.