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Using Multivariate Statistics

Objective The study was aimed at investigating the association between postpartum women's breastfeeding self-efficacy levels and their depression levels, social support levels, and breastfeeding attitudes in early postpartum period. Methods The cross-sectional study was carried out in Kirklareli in Turkey. The population of the study consisted of 398 women aged 15-49 in the first 42 days of the postpartum period who presented to eight family health centers. The study data were collected face-to-face using the Personal Information Form, Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), Edinburgh Postnatal Depression Scale (EPDS), Multidimensional Scale of Perceived Social Support (MSPSS), and Breastfeeding Attitudes of the Evaluation Scale (BAES). Results The mean age of the participants was 28.61±5.72 (Min:18, Max: 44), and the mean score they obtained from the BSES-SF was 55.13±8.39. Statistically significant differences were detected between the participants' BSES-SF scores and age groups, employment status, perceived income level, and the number of living children (p 0.05). In the multivariate regression analysis adjusted according to the sociodemographic characteristics, BAES, EPDS and MSPSS accounted for 48.3% of the BSES-SF. A negative association was found between BSES-SF scores and EPDS scores (β = -0.178, 95% CI:-0.349, -0.006), and a positive relation between the BAES scores (β = 0.194, 95% CI: 0.163, 0.226) and the MSPSS scores (β = 0.114, 95% CI: 0.037, 0.191). Conclusion As the level of depression of women increases in the postpartum period, the level of breastfeeding self-efficacy decreases. The breastfeeding self-efficacy increases as the level of social support increases and as the attitudes that drive breastfeeding behavior change positively.

/pdf/association-between-postpartum-depression-level-social-2r6irng2l7.pdf

Association between postpartum depression level, social support level and breastfeeding attitude and breastfeeding self-efficacy in early postpartum women.

BACKGROUND
Latinas have high breastfeeding initiation rates that decrease significantly in the first postpartum months. Little is known about the effects of self-efficacy and sociocultural factors on early breastfeeding among low-income Latinas. This study quantifies early breastfeeding rates and identifies factors associated with breastfeeding at 4-6 weeks postpartum in our community.


SUBJECTS AND METHODS
Mothers were recruited from a newborn clinic (NBC) in the first postpartum week. Questionnaires in the NBC and 4-6 weeks later assessed feeding practices, breastfeeding self-efficacy, and sociocultural factors. Feeding practices in the well baby nursery (WBN) were obtained by chart review. A scale from "1" (exclusive formula feeding) to "5" (exclusive breastfeeding) characterized feeding practices. Paired-sample t tests assessed change in feeding practices, and regression analysis assessed the impact of factors on breastfeeding at 4-6 weeks.


RESULTS
We interviewed 209 women: 86.1% Latina, 47.3% foreign-born, and 94.2% Medicaid-recipients. Breastfeeding increased from WBN to NBC (2.6±1.2 to 2.9±1.4; p<0.05) and then decreased by 4-6 weeks (2.9±1.4 to 2.5±1.44; p<0.05), without significant change between WBN and 4-6 weeks. Higher levels of education [β=0.21 (0.08, 0.56)], breastfeeding a previous child for ≥6 months [β=0.35 (0.57, 1.8)], foreign birth [β=0.2 (0.06, 1.07)], and higher breastfeeding self-efficacy scores [β=0.38 (0.02, 0.05)] were associated with more breastfeeding. Higher breastfeeding self-efficacy scores were associated with exclusive breastfeeding [adjusted odds ratio=1.18 (1.05, 1.32)].


CONCLUSIONS
Breastfeeding self-efficacy was the sole, modifiable factor associated with exclusive breastfeeding. Efforts to improve breastfeeding self-efficacy may serve to support breastfeeding in this population.

Impact of Breastfeeding Self-Efficacy and Sociocultural Factors On Early Breastfeeding in An Urban, Predominantly Latino Community

OBJECTIVE: To evaluate the effectiveness of a professional one-to-one antenatal breastfeeding support and education intervention on the exclusivity and duration of breastfeeding. METHODS: A total of 469 primiparous women who attended the antenatal clinics of two geographically distributed public hospitals in Hong Kong were randomized to receive either standard antenatal care or a one-to-one antenatal breastfeeding support and education session. The primary outcome was the prevalence of exclusive breastfeeding at 6 weeks postpartum. Secondary outcomes were the prevalence of exclusive breastfeeding at 3 and 6 months postpartum as well as the overall duration of any and exclusive breastfeeding across the first 6 months postpartum. RESULTS: The exclusive breastfeeding rate in the intervention group was 37.8% at 6 weeks postpartum compared with 36.4% in the standard care group (P=.77; 95% confidence interval [CI] −0.08 to 0.11). There were no significant differences between the two treatment groups in exclusive breastfeeding rates at 3 and 6 months or in the overall duration of any (hazard ratio [HR] 1.11, 95% CI 0.88–1.40] or exclusive breastfeeding (HR 0.96, 95% CI 0.79–1.17). The study had a least 80% power to detect a 50% increase in the rate of exclusive breastfeeding at 6 weeks postpartum. CONCLUSION: In a setting with a high breastfeeding initiation rate, one-to-one antenatal breastfeeding support and education did not increase the exclusivity or duration of breastfeeding. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.clinicaltrials.gov, NCT01648114. LEVEL OF EVIDENCE: I

Antenatal Education to Increase Exclusive Breastfeeding: A Randomized Controlled Trial

Background: Breastfeeding is an ideal nutritional method that has many benefits for mothers, infants and the health system.Negative attitude toward breastfeeding is accompanied with unpleasant consequences. We aimed to determine the predictors of breastfeeding attitude in Iranian breastfeeding mothers. Materials and Methods: This descriptive-analytical and cross-sectional study was conducted on 346 mothers in the first 24-48 hours after delivery in selected hospitals of Shahid Beheshti University of Medical Sciences in Tehran, Iran. Convenience and continuous sampling method was used in this study. The Iowa Infant Feeding Attitude Scale (IIFAS), Breastfeeding self-efficacy scale-shortform (BSES-SF(, and researcher made questioner for socio-demographic, obstetric and breastfeeding characteristics were used for data collection. Results: The mean score of attitude was 45.90 ± 4.68 out of 11-55, which indicates a positive attitude toward breastfeeding. The results showed a significant relationship between mother age, breastfeeding self-efficacy score, mother’s employment status, planned pregnancy, selected feeding method for infant, and the breastfeeding duration of the previous child with breastfeeding attitude score (P<0.05). According to multiple linear regression model, maternal age (B=0.110, P=0.015), breastfeeding self-efficacy (B=0.102, P=0.001), maternal employment (B=1.286, P=0.021), and planned pregnancy (B=1.638, P=0.003) were predictors of breastfeeding attitude in mothers. Conclusion: According to the results maternal age, breastfeeding self-efficacy, maternal employment and planned pregnancy were predictors of breastfeeding attitude in mothers. Hence, development of suitable educational programs tailored to the needs of mothers, during pregnancy and the postpartum periodand adequate support of mothers are essential to improve and enhance breastfeeding attitude and self-efficacy in breastfeeding mothers.

http://ijp.mums.ac.ir/article_11772_ee3729d412c17c2177877112203f2743.pdf

Predictor Factors of Breastfeeding Attitude in Iranian Breastfeeding Mothers: A Cross-Sectional Study

BackgroundWhile breastfeeding is considered the optimal method of infant feeding, Canadian breastfeeding rates remain below the World Health Organization recommendations. Breastfeeding self-efficac...

/pdf/investigating-predictors-of-prenatal-breastfeeding-self-1qpjaf1f8q.pdf

Investigating Predictors of Prenatal Breastfeeding Self-Efficacy:

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Investigating Predictors of Prenatal Breastfeeding Self-Efficacy: