Psychosocial Determinants of Exclusive Breastfeeding Intention in the Third Trimester: A Cross-Sectional Study from Türkiye
AI Summary
Higher prenatal breastfeeding self-efficacy was independently associated with stronger exclusive breastfeeding intention; interaction with depressive symptoms was statistically significant.
Greater depressive symptoms were independently linked to lower exclusive breastfeeding intention, highlighting the need to address maternal mental health in late pregnancy.
Planned pregnancy, prior breastfeeding experience and current employment independently predicted intention; aggregate social support did not, though functional support indicators correlated in bivariate analyses.
BACKGROUND: Prenatal intention to exclusively breastfeed is a proximal determinant of later infant-feeding behavior and may be shaped by breastfeeding self-efficacy, depressive symptoms, and perceived social support.
MATERIALS AND METHODS: Baseline prenatal data were analyzed from 516 third-trimester pregnant women enrolled in an ongoing prospective cohort at a tertiary university hospital in Istanbul, Türkiye. Exclusive breastfeeding intention was measured with the Infant Feeding Intentions (IFI) scale. Breastfeeding self-efficacy and depressive symptoms were assessed with the Prenatal Breastfeeding Self-Efficacy Scale-Short Form (PBSES-SF) and Edinburgh Postnatal Depression Scale (EPDS), respectively. Social support was evaluated as aggregate spouse/partner or close-family support and further characterized by emotional, informational, and practical/domestic support indicators.
RESULTS: Mean IFI, PBSES-SF, and EPDS scores were 13.12 ± 2.34, 32.23 ± 3.62, and 5.88 ± 2.05, respectively. Aggregate social support was reported by 495 participants (95.9%). Emotional, informational, and practical/domestic support were reported by 488 (94.6%), 446 (86.4%), and 465 (90.1%) participants, respectively, and were associated with higher IFI scores in bivariate analyses. In multivariable regression, PBSES-SF, EPDS, planned pregnancy, prior breastfeeding experience, and employment were independently associated with IFI; aggregate social support was not. The PBSES-SF × EPDS interaction was statistically significant.
CONCLUSION: Exclusive breastfeeding intention was associated with breastfeeding self-efficacy, depressive symptoms, selected experiential factors, and functional support indicators. Integrated antenatal counseling should address breastfeeding confidence, maternal mental health, and the quality of support available during late pregnancy.
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