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. 2023 Sep 8:14:1228769.
doi: 10.3389/fpsyg.2023.1228769. eCollection 2023.

Using the theory of planned behavior model to predict factors influencing breastfeeding behavior among preterm mothers at week 6 postpartum: the mediating effect of breastfeeding intention

Rong Huang  1 , Hui Han  2 , Lijing Ding  2 , Yi Zhou  1 , Yanwen Hou  1 , Xiao Yao  1 , Chenting Cai  1 , Xiaohan Li  2 , Jianqi Song  2 , Shuying Zhang  2 , Hui Jiang  1
Affiliations

Using the theory of planned behavior model to predict factors influencing breastfeeding behavior among preterm mothers at week 6 postpartum: the mediating effect of breastfeeding intention

Rong Huang et al. Front Psychol. .

Abstract

Background: 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).

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: breastfeeding behavior; intention; mediating effect; preterm; theory of planned behavior.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
(A) Hypothesized model of breastfeeding behavior of preterm mothers based on the theory of planned behavior. The variables in the solid box represent the application of the framework of the theory of planned behavior in this study, while the variables in the dashed box represent the new variables introduced in this study. Other factors include the socio-demographics of the dyads and the preterm mothers’ knowledge, EBF before discharge, and depression. (B) Modified model of breastfeeding behavior of preterm mothers based on the theory of planned behavior. PBS, SPS, and BFC were the total scores of three subscales of the Chinese version of the Modified Breastfeeding Attrition Predictive Tool (Positive Breastfeeding Sentiment Attitudinal Scale, Social and Professional Support Scale, and Breastfeeding Control Scale, respectively); and BKQ, IFIS, BBQ, and EPDS were the total scores of the Chinese versions of the Breastfeeding Knowledge Questionnaire, the Infant Feeding Intention Scale, the Breastfeeding Behavioral Questionnaire, and the Edinburgh Postnatal Depression Scale, respectively.
Figure 2
Figure 2
Flow diagram of the study process.
See this image and copyright information in PMC

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