I think I can: exploring the influence of psychological factors on breastfeeding duration

I think I can: exploring the influence of psychological factors on breastfeeding duration

[Abstract]: Only a minority of Australian women continue to breastfeed for what is known to be the optimal duration for the health of the mother and her baby. This mixed method study of the determinants of breastfeeding duration is situated within the post-positivist paradigm, and uses both qualitative and quantitative data in a triangulated study design. The study aimed to identify the psychological factors which influence the duration of breastfeeding, in the hope that modifiable factors would arise which may assist women to meet their longer term breastfeeding goals. This two-phase study was conducted in Toowoomba, Queensland and began with a qualitative enquiry involving three groups of mothers separated according to their various experiences of breastfeeding, and one group of experienced breastfeeding clinicians (n = 21). Using the nominal group technique, these women were asked to generate a list of the psychological factors they believed influenced the duration of breastfeeding. Group results were considered individually and collectively, and comparisons between groups were made. The groups generated a list of 53 psychological factors they believed may have an influence on the duration of breastfeeding. In Phase 2, these data and the extant literature were used to inform the content of a questionnaire constructed to measure the relevant individual psychological characteristics of a sample of postnatal women, and the relationship between these factors and breastfeeding duration to 6 months postpartum. Participants for Phase 2 were recruited from one public and one private hospital in the regional city of Toowoomba, Queensland (n = 372), and completed a self-report questionnaire during the 14 days following the birth. Telephone interviews at 6 months postpartum gathered data regarding the woman’s current feeding method and time of weaning. The duration of breastfeeding was associated with psychological factors including dispositional optimism, breastfeeding self-efficacy, faith in breastmilk, breastfeeding expectations, anxiety, planned duration of breastfeeding and the time of the infant feeding decision. After removing the effect of socio-demographic variables, the woman’s faith in breastmilk and her planned breastfeeding duration were unique predictors of the duration of Fully breastfeeding. Analysis of the data for the duration of Any breastfeeding revealed three unique predictors including faith in breastmilk, planned breastfeeding duration and breastfeeding self-efficacy. The data also showed that 44% of the sample experienced some form of postnatal distress in the 14 days following the birth in the form of anxiety, stress and/or depression. Of these three distinct states, only anxiety was associated with breastfeeding duration. This enhanced knowledge of the psychological variables which influence breastfeeding duration may be used to construct a tool capable of identifying women at risk of early weaning for additional support or interventions. Additionally, this knowledge may form the basis of an intervention designed to modify psychological variables known to place breastfeeding at risk, thereby assisting women to breastfeed for longer.