An online questionnaire study investigating the impact of psychosocial factors on the duration of breastfeeding

Objective:
To examine the psychosocial factors of intention to breastfeed, perceived stress, social support, self-efficacy and their ability to predict the duration of breastfeeding in first-time mothers up to six months postnatally.

Design:
Cross-sectional, quantitative study using a retrospective online survey.

Setting:
Women across West Yorkshire, in the north of the United Kingdom.

Participants:
First-time mothers (n=98) who had given birth in the past six months.

Measures:
An online survey included three established survey instruments measuring the main study variables: The Perceived Stress Scale (Cohen et al., 1983), the Multidimensional Scale of Perceived Social Support (Zimet et al., 1988) and the General Self-Efficacy Scale (Schwarzer and Jerusalem, 1995). The fourth variable was Intention to breastfeed and was measured using a single question. The survey was structured into five main sections 1) During pregnancy, 2) Once the baby was born, 3) Support to feed my baby, 4) Psychosocial factors and 5) Demographics. Open text responses allowed women to elaborate on their infant feeding experiences.

Findings:
80% of the sample said they had intended to breastfeed their baby. Although 96% initiated breastfeeding while in hospital, this decreased to 82% at one week and 75% at six weeks. By six months, the rate had dropped to below 50%. Survival Analysis using Cox’s Regression found no significant predictors of duration of breastfeeding at one week and six weeks. However, a significant negative correlation between perceived stress and self-efficacy suggests that greater perceived stress is linked to lower self-efficacy. Other findings included 91% of mothers decided how they would feed their baby before they were pregnant (57%) or during pregnancy (34%) and the majority answered that breastfeeding support was most useful straight after the birth and up to one week.

Key conclusions:
The findings from this sample of new mothers showed that although many intended to breastfeed, a considerable number of them had stopped by the time their baby was six weeks old. The content analysis highlighted the multiple challenges new mothers can experience with breastfeeding and furthers understanding of the support needs of this group of women.

Implications for practice:
Many of the mothers had already decided how to feed their baby before the baby was born. In this sample, a quarter of those who intended to breastfeed or thought they might breastfeed had stopped by six weeks. In order to increase breastfeeding duration, new mothers with high intention to breastfeed need to be better prepared for potential breastfeeding challenges and given more support with breastfeeding shortly after their baby is born.