Breastfeeding self-efficacy among new mothers: Associations with childbirth experience, family intimacy, and postpartum lactation yield

Hongfeng Zhu, Li Huang, Xinju Li, Qi Wu

Abstract

This study explores the relationship between breastfeeding self-efficacy, childbirth experience, family intimacy, and postpartum lactation yield in 168 mothers who gave birth at Hefei Maternal and Child Health Hospital. Participants were divided into high and low self-efficacy groups based on their scores on the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). Data on childbirth experience, family intimacy, and lactation yield were collected. Correlation and logistic regression analyses revealed that breastfeeding self-efficacy positively correlated with childbirth experience, family intimacy, and lactation yield. The high self-efficacy group showed significantly better childbirth experiences, stronger family intimacy, and higher lactation yield compared with the low self-efficacy group. Primiparity, childbirth experience, family intimacy, and postpartum lactation yield were identified as independent factors influencing breastfeeding self-efficacy. These findings highlight the importance of improving childbirth experiences, enhancing family intimacy, and supporting lactation yield to boost maternal self-efficacy in breastfeeding, ultimately contributing to higher breastfeeding success rates

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References

Stordal B. Breastfeeding reduces the risk of breast cancer: A call for action in high-income countries with low rates of breastfeeding. Cancer Med 2023; 12: 4616-4625. doi: 10.1002/cam4.5288.

Patnode CD, Henrikson NB, Webber EM, Blasi PR, Senger CA and Guirguis-Blake JM. Breastfeeding and Health Outcomes for Infants and Children: A Systematic Review. Pediatrics 2025; 156: e2025071516. doi: 10.1542/peds.2025-071516.

Stipelman CH, Stoddard GJ, Bennion J, Young PC and Brown LL. Real-Time Breastfeeding Documentation: Timing of Breastfeeding Initiation and Outpatient Duration. Acad Pediatr 2023; 23: 351-358. doi: 10.1016/j.acap.2022.07.010.

Fan Y, Donovan SM and Bost KF. Psychosocial Influences on Breastfeeding Duration: Maternal, Paternal, and Infant Contributors. Curr Dev Nutr 2025; 9: 107537. doi: 10.1016/j.cdnut.2025.107537.

Lau CYK, Lok KYW and Tarrant M. Breastfeeding Duration and the Theory of Planned Behavior and Breastfeeding Self-Efficacy Framework: A Systematic Review of Observational Studies. Matern Child Health J 2018; 22: 327-342. doi: 10.1007/s10995-018-2453-x.

Saavedra Sanchez S, Rodríguez-Gallego I, Leon-Larios F, Andina-Diaz E, Perez-Contreras R and Gonzalez-Sanz JD. Influence of Perceived Maternal Self-Efficacy on Exclusive Breastfeeding Initiation and Consolidation: A Systematic Review. Healthcare (Basel) 2024; 12: 2347. doi: 10.3390/healthcare12232347.

Coates R, Ayers S and de Visser R. Women's experiences of postnatal distress: a qualitative study. BMC Pregnancy Childbirth 2014; 14: 359. doi: 10.1186/1471-2393-14-359.

Hu L, He W and Zhou L. Association Between Family Support and Breastfeeding Self-Efficacy in a Cross-Sectional Study. Nurs Open 2025; 12: e70210. doi: 10.1002/nop2.70210.

Li J, Bian X. Optimizing Sleep in Athletes: The Potential of α-Lactalbumin in Nutrition Intervention. Protein & Peptide Letters. 2025;32(6):402-413. doi:10.2174/0109298665363873250623103811.

The Innovation Editorial Team. Advancing human dignity: The latest updates to the Declaration of Helsinki. Innovation (Camb) 2024; 6: 100779. doi: 10.1016/j.xinn.2024.100779.

Dennis CL. The breastfeeding self-efficacy scale: psychometric assessment of the short form. J Obstet Gynecol Neonatal Nurs 2003; 32: 734-44. doi: 10.1177/0884217503258459.

Nigussiee L, Demeke T, Bagilkar V, Firetsidk Y, Abageda M and Belachew T. Breastfeeding self-efficacy status and associated factors among postpartum mothers at Hadiya Zone public hospitals, Southern Ethiopia. PLoS One. 2025; 20: e0317763. doi: 10.1371/journal.pone.0317763.

Altman DG and Bland JM. Quartiles, quintiles, centiles, and other quantiles. BMJ 1994; 309: 996. doi: 10.1136/bmj.309.6960.996.

Zhu X, Wang Y, Zhou H, Qiu L and Pang R. Adaptation of the Childbirth Experience Questionnaire (CEQ) in China: A multisite cross-sectional study. PLoS One 2019; 14: e0215373. doi: 10.1371/journal.pone.0215373.

Phillips MR, West CL, Shen Q and Zheng Y. Comparison of schizophrenic patients' families and normal families in China, using Chinese versions of FACES-II and the Family Environment Scales. Fam Process 1998; 37: 95-106. doi: 10.1111/j.1545-5300.1998.00095.x.

Kellams A, Harrel C, Omage S, Gregory C and Rosen-Carole C. ABM Clinical Protocol #3: Supplementary Feedings in the Healthy Term Breastfed Neonate, Revised 2017. Breastfeed Med 2017; 12: 188-198. doi: 10.1089/bfm.2017.29038.ajk.

Katsafadou AI, Vasileiou NGC, Tsangaris GT, et al. Presence of Cathelicidin-1 in Milk as an Indicator of the Severity of Mammary Infection in Ewes. Current Proteomics. 2021;18(2). doi:10.2174/1570164617999200510234638.

Naginevičiūtė M, Bartusevičienė E and Blaževičienė A. Birth experience and early postpartum outcomes: A cross-sectional study of mother-infant bonding, breastfeeding self-efficacy, and depressive symptoms. Eur J Midwifery 2026; 10. doi: 10.18332/ejm/217879.

Hankel MA, Kunseler FC and Oosterman M. Early Breastfeeding Experiences Predict Maternal Self-Efficacy During the Transition to Parenthood. Breastfeed Med 2019; 14: 568-574. doi: 10.1089/bfm.2019.0023.

Jacobzon A, Engström Å, Lindberg B and Gustafsson SR. Mothers' strategies for creating positive breastfeeding experiences: a critical incident study from Northern Sweden. Int Breastfeed J 2022; 17: 35. doi: 10.1186/s13006-022-00474-9.

Rabiee N, Nazari AM, Keramat A, Khosravi A and Bolbol-Haghighi N. The Effectiveness of Dialectical Behavioral Therapy on the Success of Breast Feeding in Traumatic Childbirth: A Randomized Controlled Trial. Iran J Psychiatry 2022; 17: 118-126. doi: 10.18502/ijps.v17i2.8901.

Ni PK and Siew Lin SK. The role of family and friends in providing social support towards enhancing the wellbeing of postpartum women: a comprehensive systematic review. JBI Libr Syst Rev 2011; 9: 313-370. doi: 10.11124/01938924-201109100-00001.

Tsoutsi V and Dikeos D. Family Functioning and Cohesion Scale: Validation of a Short Instrument for the Assessment of Intrafamily Relations. Behav Sci (Basel) 2024; 14: 969. doi: 10.3390/bs14100969.

Henshaw E, Cooper M, Wood T, Krishna S, Lockhart M and Doan S. A randomized controlled trial of the Happy, Healthy, Loved personalized text-message program for new parent couples: impact on breastfeeding self-efficacy and mood. BMC Pregnancy Childbirth 2024; 24: 506. doi: 10.1186/s12884-024-06684-9.

Mc Evoy N, Lehane E, Leahy-Warren P, O'Connell R, Cogan L, O'Driscoll M and Mulcahy H. Women's Breastfeeding Support Experiences in Ireland: A Qualitative Framework Analysis. J Hum Lact 2025; 41: 610-619. doi: 10.1177/08903344251363597.

Zeng J, Zheng QX, Wang QS, Liu GH, Liu XW, Lin HM and Guo SB. Father support breastfeeding self-efficacy positively affects exclusive breastfeeding at 6 weeks postpartum and its influencing factors in Southeast China: a multi-centre, cross-sectional study. BMC Public Health 2024; 24: 2698. doi: 10.1186/s12889-024-20136-1.

Liu Y, Shan H, Chen Y, Zhuang Y, Zhou J and Wang L. Breastfeeding self-efficacy, milk output, and influencing factors in mothers of preterm infants: a prospective cohort study in the NICU. BMC Pregnancy Childbirth 2025; 25: 1176. doi: 10.1186/s12884-025-08254-z.

Seutia FH, Wulandari Z, Budiman C, Arief II. Potent Antioxidant and Antibacterial Activities of ≤3 kDa

Hydrolyzed Sarcoplasmic Proteins from IPB-D1 Chicken. Protein & Peptide Letters. 2026;33(1):325-336. doi:10.2174/0109298665430612260207170942.

Dennis CL. Theoretical underpinnings of breastfeeding confidence: a self-efficacy framework. J Hum Lact 1999; 15: 195-201. doi: 10.1177/089033449901500303.

Keskin M and Emül TG. Assessment of breastfeeding self-efficacy and effectiveness: A comparison of primiparous and multiparous mothers. Afr J Reprod Health 2025 Mar 25;29(3):94-102. doi: 10.29063/ajrh2025/v29i3.12.

Lindblad V, Melgaard D, Jensen KL, Eidhammer A, Westmark S, Kragholm KH and Gommesen D. Primiparous women differ from multiparous women after early discharge regarding breastfeeding, anxiety, and insecurity: A prospective cohort study. Eur J Midwifery 2022; 6: 12. doi: 10.18332/ejm/146897.

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