Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
Stanford Center on China's Economy and Institutions, Stanford University, Stanford, California, United States of America.
PLoS One. 2022 Apr 7;17(4):e0266273. doi: 10.1371/journal.pone.0266273. eCollection 2022.
Breastfeeding self-efficacy is known to positively influence breastfeeding behaviors. While previous research has studied the determinants of breastfeeding self-efficacy in general, these determinants are unstudied among postpartum women in rural China. This study aims to describe the breastfeeding self-efficacy of postpartum women in rural China and identify determinants of breastfeeding self-efficacy using the Dennis breastfeeding self-efficacy framework.
Using a multi-stage random cluster sampling design, cross-sectional survey data were collected from 787 women within the 0-6 months postpartum period in 80 rural townships. Surveys collected data on breastfeeding self-efficacy, characteristics related to the Dennis breastfeeding self-efficacy framework, and demographic characteristics. Multiple linear regression analysis was used to identify determinants of breastfeeding self-efficacy.
Participants reported a moderate level of breastfeeding self-efficacy, with an item mean score of 3.50. Self-efficacy was lowest for exclusive breastfeeding. Breastfeeding attitudes (β = 0.088, P< 0.001), breastfeeding family support (β = 0.168, P< 0.001), and social support from significant others (β = 0.219, P< 0.001) were positively associated with breastfeeding self-efficacy. Breastfeeding problems, including trouble with latching (β = -0.170, P< 0.001), not producing enough milk (β = -0.148, P< 0.001), and milk taking too long to secrete (β = -0.173, P< 0.001) were negatively associated with breastfeeding self-efficacy.
The findings indicate that positive attitudes, breastfeeding family support and social support contribute to greater breastfeeding self-efficacy in rural China, whereas difficulties with breastfeeding are associated with reduced self-efficacy. Researchers and practitioners should investigate effective strategies to improve social support and family support for breastfeeding, promote positive attitudes towards breastfeeding, and provide women with actionable solutions to breastfeeding problems.
母乳喂养自我效能感被认为对母乳喂养行为有积极影响。虽然先前的研究已经研究了一般情况下母乳喂养自我效能感的决定因素，但这些决定因素在农村中国的产后妇女中尚未得到研究。本研究旨在描述农村中国产后妇女的母乳喂养自我效能感，并使用 Dennis 母乳喂养自我效能框架确定母乳喂养自我效能感的决定因素。
使用多阶段随机聚类抽样设计，从 80 个农村乡镇的 0-6 个月产后期内的 787 名女性中收集了横断面调查数据。调查收集了母乳喂养自我效能感、与 Dennis 母乳喂养自我效能框架相关的特征以及人口统计学特征的数据。使用多元线性回归分析来确定母乳喂养自我效能感的决定因素。
参与者报告了中等水平的母乳喂养自我效能感，项目平均得分为 3.50。纯母乳喂养的自我效能感最低。母乳喂养态度（β=0.088，P<0.001）、母乳喂养家庭支持（β=0.168，P<0.001）和来自重要他人的社会支持（β=0.219，P<0.001）与母乳喂养自我效能感呈正相关。母乳喂养问题，包括衔乳困难（β=-0.170，P<0.001）、产奶不足（β=-0.148，P<0.001）和奶分泌时间过长（β=-0.173，P<0.001）与母乳喂养自我效能感呈负相关。
研究结果表明，积极的态度、母乳喂养家庭支持和社会支持有助于提高农村中国母乳喂养的自我效能感，而母乳喂养的困难与自我效能感降低有关。研究人员和从业者应研究有效的策略来提高对母乳喂养的社会支持和家庭支持，促进对母乳喂养的积极态度，并为女性提供解决母乳喂养问题的可行方案。
