Huang Rong, Han Hui, Ding Lijing, Zhou Yi, Hou Yanwen, Yao Xiao, Cai Chenting, Li Xiaohan, Song Jianqi, Zhang Shuying, Jiang Hui
Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China.
School of Medicine, Tongji University, Shanghai, China.
Front Psychol. 2023 Sep 8;14:1228769. doi: 10.3389/fpsyg.2023.1228769. eCollection 2023.
Exclusive breastfeeding (EBF) in the first 6 weeks postpartum is key to continued breastfeeding. This study aimed to explore the role of EBF-related predictors (particularly breastfeeding intention) in breastfeeding behavior among preterm mothers at week 6 postpartum based on the theory of planned behavior (TPB).
A total of 352 mothers of preterm infants were recruited, 340 of whom participated in this study. Prior to discharge, participants completed the Chinese versions of the modified Breastfeeding Attrition Predictive Tool, the Breastfeeding Knowledge Questionnaire (BKQ), the Infant Feeding Intention, and the Edinburgh Postnatal Depression Scale. Responses to the items of the Breastfeeding Behavioral Questionnaire (BBQ) were also collected by telephone at week 6 postpartum. The final analyses included 321 participants who completed the full two-wave data collection.
The fitness indices of the modified TPB model were acceptable. Breastfeeding knowledge and EBF before discharge positively impacted breastfeeding intention, whereas depression had a negative impact. Before discharge, breastfeeding intention fully mediated the impacts of breastfeeding attitude, social and professional support, knowledge, depression, and EBF on breastfeeding behavior and partially mediated the influence of perceived breastfeeding control on breastfeeding behavior.
These findings indicate that TPB accurately predicts breastfeeding behavior among preterm mothers at week 6 postpartum, and breastfeeding intention is key to the above-mentioned EBF-related factors and breastfeeding behavior. The findings underline the need for further longitudinal studies and corresponding interventions for preterm mothers with a high risk of EBF attrition.
产后前6周纯母乳喂养是持续母乳喂养的关键。本研究旨在基于计划行为理论（TPB）探讨纯母乳喂养相关预测因素（尤其是母乳喂养意愿）在早产母亲产后6周母乳喂养行为中的作用。
共招募了352名早产儿母亲，其中340名参与了本研究。出院前，参与者完成了中文版的改良母乳喂养损耗预测工具、母乳喂养知识问卷（BKQ）、婴儿喂养意愿和爱丁堡产后抑郁量表。产后6周时还通过电话收集了母乳喂养行为问卷（BBQ）各项的回答。最终分析纳入了321名完成完整两波数据收集的参与者。
改良TPB模型的拟合指数可以接受。出院前的母乳喂养知识和纯母乳喂养对母乳喂养意愿有积极影响，而抑郁有负面影响。出院前，母乳喂养意愿完全介导了母乳喂养态度、社会和专业支持、知识、抑郁和纯母乳喂养对母乳喂养行为的影响，部分介导了感知母乳喂养控制对母乳喂养行为的影响。
这些发现表明，TPB能够准确预测早产母亲产后6周的母乳喂养行为，母乳喂养意愿是上述与纯母乳喂养相关因素和母乳喂养行为的关键。研究结果强调了对有高纯母乳喂养损耗风险的早产母亲进行进一步纵向研究和相应干预的必要性。
