Centre for Technology Enabled Health Research, Coventry University, UK.
School of Psychology and Clinical Language Sciences, University of Reading, UK.
Br J Health Psychol. 2017 Nov;22(4):763-785. doi: 10.1111/bjhp.12254. Epub 2017 Jun 23.
Breastfeeding confers important health benefits to both infants and their mothers, but rates are low in the United Kingdom and other developed countries despite widespread promotion. This study examined the relationships between personal and vicarious experience of infant feeding, self-efficacy, the theory of planned behaviour variables of attitudes and subjective norm, and the likelihood of breastfeeding at 6-8 weeks post-natally.
A prospective questionnaire study of both first-time mothers (n = 77) and experienced breastfeeders (n = 72) recruited at an antenatal clinic in South East England.
Participants completed a questionnaire at 32 weeks pregnant assessing personal and vicarious experience of infant feeding (breastfeeding, formula-feeding, and maternal grandmother's experience of breastfeeding), perceived control, self-efficacy, intentions, attitudes (to breastfeeding and formula-feeding), and subjective norm. Infant feeding behaviour was recorded at 6-8 weeks post-natally. Multiple linear regression modelled the influence of vicarious experience on attitudes, subjective norm, and self-efficacy (but not perceived control) and modelled the influence of attitude, subjective norm, self-efficacy, and past experience on intentions to breastfeed. Logistic regression modelled the likelihood of breastfeeding at 6-8 weeks.
Previous experience (particularly personal experience of breastfeeding) explained a significant amount of variance in attitudes, subjective norm, and self-efficacy. Intentions to breastfeed were predicted by subjective norm and attitude to formula-feeding and, in experienced mothers, self-efficacy. Breastfeeding at 6 weeks was predicted by intentions and vicarious experience of formula-feeding.
Vicarious experience, particularly of formula-feeding, has been shown to influence the behaviour of first-time and experienced mothers both directly and indirectly via attitudes and subjective norm. Interventions that reduce exposure to formula-feeding (perhaps by limiting advertising) or cushion mothers from its effects may enable more mothers to meet their breastfeeding goals. Statement of contribution What is already known on this subject? Rates of breastfeeding in the United Kingdom are low and resistant to change. Self-efficacy may be an important and modifiable factor for breastfeeding initiation and maintenance. What does this study add? Self-efficacy may only be a relevant factor among mothers who already have personal experience of breastfeeding. Vicarious experience of formula-feeding has been shown to be related to a lower rate of breastfeeding at 6 weeks.
母乳喂养对婴儿及其母亲都有重要的健康益处，但在英国和其他发达国家，尽管广泛推广，母乳喂养率仍然很低。本研究调查了个人和间接母乳喂养体验、自我效能感、计划行为理论中的态度和主观规范变量，以及产后 6-8 周母乳喂养的可能性之间的关系。
在英格兰东南部的一家产前诊所，对首次生育的母亲（n=77）和有经验的母乳喂养者（n=72）进行了前瞻性问卷调查研究。
参与者在怀孕 32 周时完成了一份调查问卷，评估个人和间接的婴儿喂养经验（母乳喂养、配方奶喂养和母亲祖母的母乳喂养经验）、感知控制、自我效能感、意图、态度（对母乳喂养和配方奶喂养）和主观规范。产后 6-8 周记录婴儿喂养行为。多元线性回归模型分析了间接经验对态度、主观规范和自我效能感（但不是感知控制）的影响，并分析了态度、主观规范、自我效能感和过去经验对母乳喂养意图的影响。逻辑回归模型分析了产后 6-8 周母乳喂养的可能性。
先前的经验（特别是个人母乳喂养经验）解释了态度、主观规范和自我效能感的大量差异。母乳喂养的意图受到主观规范和对配方奶喂养的态度以及有经验的母亲的自我效能感的预测。6 周时的母乳喂养受到意图和间接的配方奶喂养经验的预测。
间接经验，特别是配方奶喂养的经验，已被证明会直接和间接地通过态度和主观规范影响初次生育和有经验的母亲的行为。减少接触配方奶喂养（也许通过限制广告）或减轻母亲对其影响的干预措施可能使更多的母亲能够实现母乳喂养的目标。
关于这个主题已经知道什么？
英国的母乳喂养率很低，而且难以改变。
自我效能感可能是母乳喂养启动和维持的一个重要且可改变的因素。
这项研究增加了什么新内容？
自我效能感可能仅在已经有个人母乳喂养经验的母亲中是一个相关因素。
间接体验配方奶喂养与产后 6 周母乳喂养率较低有关。
