FACTORS ASSOCIATED WITH BREASTFEEDING SELF-EFFICACY IN THE IMMEDIATE PUERPERIUM IN A PUBLIC MATERNITY HOSPITAL

Siqueira, Laíse Sousa; Santos, Floriacy Stabnow; Santos, Romila Martins de Moura Stabnow; Santos, Livia Fernanda Siqueira; Santos, Leonardo Hunaldo dos; Pascoal, Livia Maia; Santos Neto, Marcelino

doi:10.1590/ce.v28i0.88970

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ORIGINAL ARTICLE • Cogitare Enferm. 28 • 2023 • https://doi.org/10.1590/ce.v28i0.88970 copy

FACTORS ASSOCIATED WITH BREASTFEEDING SELF-EFFICACY IN THE IMMEDIATE PUERPERIUM IN A PUBLIC MATERNITY HOSPITAL

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to verify the association between sociodemographic variables, obstetric history, current pregnancy, and puerperium with breastfeeding self-efficacy.

Method:

cross-sectional study conducted in southwestern Maranhão, Brazil, between October 2020 and July 2021 with the participation of 240 postpartum women, using the Breastfeeding Self-Efficacy Scale - Short Form. Descriptive analysis, possible associations, simple and multiple logistic regression models were performed.

Results:

83.3% had high breastfeeding self-efficacy, 46.7% were between 26 and 35 years old, 81.2% were married or in a stable union, 94.2% breastfed in the first hour of life, 37.9% received orientation on breastfeeding in the Primary Health Care Unit, and 84.2% offered only breast milk to the newborn in the maternity hospital. These factors were associated with high breastfeeding self-efficacy (p<0.05).

Conclusion:

The research contributed to guide health professionals to provide superior quality care to pregnant and postpartum women and lactating mothers, aiming to increase breastfeeding self-efficacy, identifying, among these women, those who need more support.

DESCRIPTORS:
Breast Feeding; Self-Efficacy; Infant Nutrition; Weaning; Postpartum Period.

Variables	n (%)
Age, years
18-25	102 (42.5)
26-35	112 (46.7)
≥36	26 (10.8)
Race
White	44 (18.3)
Yellow	104 (43.3)
Brown	86 (35.8)
Black	6 (2.6)
Marital Status
Single and/or divorced	45 (18.8)
Married and/or stable union	195 (81.2)
Education, years
< 8	43 (17.9)
8-12	149 (62.1)
>12	48 (20.0)
Employment relationship
Yes	46 (19.2)
No	194 (80.8)
Family income, minimum wage^* * Value of minimum wage R$1,100.00.
<1	58 (24.2)
1-2	127 (52.9)
>2	55 (22.9)
Children
1	71 (29.6)
2 to 3	149 (62.1)
≥ 4	20 (8.3)
Parity
Primiparous	71 (29.6)
Second Parity	86 (35.8)
Multiparous	83 (34.6)
Prematurity
Yes	60 (25.0)
No	180 (75.0)
Previous breastfeeding
Yes	167 (69.6)
No	73 (30.4)
Reasons for breastfeeding
Felt obliged	90 (37.5)
Desired to breastfeed	74 (30.8)
Received help and support	6 (2.5)
No previous experience	36 (15.0)
Others	34 (14.2)
Breastfeeding Interruption
Yes	78 (32.5)
No	162 (67.5)
Reasons for interruption
Breast problems	14 (17.9)
Insufficient milk production	42 (53.9)
Return to work	4 (5.1)
New pregnancy	18 (23.1)
Performing PN
Yes	221 (92.1)
No	19 (7.9)
Professional responsible for the NP
Nurse	79 (34.0)
Physician	9 (3.9)
Both	144 (62.1)
Received orientation on breastfeeding
Yes	214 (89.2)
No	26 (10.8)
Place of orientation
BHU	81 (37.9)
Maternity Hospital	94 (43.9)
BHU and Maternity	39 (18.2)
Professional who oriented
Doctor	2 (0.9)
Nurse	123 (57.5)
Nurse and doctor	74 (34.6)
Others	15 (7.0)
Breastfed in the first hour of life
Yes	226 (94.2)
No	14 (5.8)
Intend to breastfeed exclusively
Yes	236 (98.3)
No	4 (1.7)
Less than 6 months	3 (1.3)
Intended time of breastfeeding
6 months	135 (56.5)
More than 6 months	101 (42.3)
Breastfed in the first hour of life
Yes	202 (84.2)
No	35 (14.6)
Intend to breastfeed exclusively	3 (1.3)
Yes
No	3 (1.3)
Less than 6 months	37 (15.4)
Intended time of EBF	200 (83.3)

		High self-efficacy
Variables	n (%)	OR (95%CI)	p^* * Wald chi-square; † value of minimum wage R$ 1,100.00; ‡ presence of zero values that make it impossible to calculate the OR. value
Age, years
18-25	83 (81.4)	1.0
26-35	95 (84.6)	2.2 (1.6-3.6)	0.10
≥36	22 (84.8)	2.3 (1.7-4.1)	0.16
Race
Brown	68 (79.1)	1.0
White	35 (79.5)	0.9 (0.4-2.4)	0.95
Black	5 (83.3)	1.3 (0.5-2.8)	0.83
Yellow	92 (88.5)	1.9 (0.8-5.1)	0.26
Marital status
Single or divorced	32 (71.1)	1.0
Married or in a stable union	168 (86.2)	2.5 (1.2-5.4)	0.02
Education. years
>12	34 (70.8)	1.0
8-12	128 (85.9)	2.5 (1.2-5.4)	0.10
<8	38 (88.4)	3.1 (1.5-6.2)	0.11
Employment relationship
Yes	33 (71.7)	1.0
No	167 (86.1)	2.4 (1.1-5.2)	0.02
Family income. minimum wages†
>2	41 (74.5)	1.0
<1	49 (84.5)	1.8 (0.7-4.8)	0.21
1-2	110 (86.6)	2.2 (1.0-4.8)	0.05
Number of children
1	54 (77.1)	1.0
2-3	128 (85.3)	1.7 (1.0-3.5)	0.14
≥4	18 (90.0)	2.7 (0.6-5.7)	0.22
Performing prenatal care
No	15 (78.9)	1.0
Yes	185 (83.7)	1.4 (0.4-4.3)	0.59
Professional responsible for prenatal care
Physician	7 (77.8)	1.0
Nurse	64 (81.0)	0.8 (0.1-4.3)	0.82
Both	121 (84.0)	1.2 (0.6-2.5)	0.57
Parity
Multipara	55 (77.5)	1.0
Primipara	69 (83.1)	1.4 (0.6-3.2)	0.38
Second parity	76 (88.4)	2.2 (0.9-5.2)	0.26
Prematurity
No	146 (81.1)	1.0
Yes	54 (90.0)	2.1 (0.8-5.3)	0.22
Previous breastfeeding
No	57 (78.1)	1.0
Yes	143 (85.6)	1.7 (0.8-3.4)	0.25
Reasons for breastfeeding
No previous experience	27 (75.0)	1.0
Other	26 (76.5)	0.9 (0.3-2.7)	0.88
Received help and support	5 (83.3)	1.5 (0.2-4.1)	0.71
Desired to breastfeed	62 (83.8)	1.6 (0.6-4.3)	0.36
Felt obliged	80 (88.9)	2.4 (0.9-6.9)	0.86
Interrupted breastfeeding
Yes	64 (82.1)	1.0
No	136 (84.0)	1.1 (0.6-2.3)	0.71
Reasons for interruption
Return to work	3 (75.0)	1.0
Insufficient milk production	33 (78.6)	0.6 (0.2-3.2)	0.56
Breast problems	12 (85.7)	0.7 (0.3-3.5)	0.61
New pregnancy	15 (88.2)	1.2(0.4-5.2)	0.83
Breastfed in the first hour of life
No	7 (50.0)	1.0
Yes	193 (85.4)	5.8 (1.9-17.7)	0.02
Intend to breastfeed exclusively
No	3 (75.0)	1.0
Yes	197 (83.5)	1.6 (0.2-16.6)	0.65
Breastfeeding time. months
>6	87 (86.1)	1.0
6	109 (80.7)	0.7 (0.3-1.4)	0.27
<6	3 (100.0)	‡	‡
Received orientation on breastfeeding
No	20 (76.9)	1.0
Yes	180 (84.1)	1.6 (0.6-4.2)	0.36
Place of orientation
Maternity hospital	73 (77.7)	1.0
Maternity and BHU	31 (79.5)	0.9 (0.4-2.2)	0.81
BHU	76 (93.8)	3.9 (1.2-12.9)	0.02
Professional orientation
Nurse and Doctor	59 (79.7)
Nurse	106 (86.2)	1.0
Others	13 (86.7)	0.6 (0.1-2.9)	0.53
Physician	2 (100.0)	0.9 (0.2-4.6)	0.95
NB feeding maternity		‡	‡
Breast milk + occasional complement	9 (25.7)
Breast milk + occasional complement	1 (33.3)	1.0
Only breast milk	190 (94.1)	0.6 (0.2-4.5)	0.77

Variables	OR	CI95%	P^* * Wald chi-square; † value of minimum wage R$ 1,100.0. value
Age, years
18-25	1.0	-	-
26-35	2.5	1.9-4.0	0.02
≥36	3.0	2.0-5.3	0.01
Marital status
Single or divorced	1.0	-	-
Married or in a stable union	3.0	1.6-6.1	0.01
Education, years
>12	1.0	-	-
8-12	1.7	0.84.2	0.15
<8	1.9	0.9-4.3	0.13
Employment relationship
Yes	1.0	-	-
No	3.5	1.7-7.1	0.01
Family income. minimum wages†
>2	1.0	-	-
<1	1.5	0.5-4.2	0.32
1-2	1.7	0.6-4.1	0.10
Number of children
1	1.0	-	-
2-3	1.2	0.8-2.1	0.15
≥4	2.1	0.9-5.2	0.25
Breastfed in the first hour of life
No	1.0	-	-
Yes	5.0	1.6-12.2	0.01
Place of orientation
Maternity hospital	1.0	-	-
Maternity and BHU	1.1	0.6-2.8	0.45
BHU	4.1	1.7-13.2	0.03
NB feeding maternity
Breast milk + occasional complement	1.0
Breast milk + occasional complement	0.8	0.4-4.0	0.34
Only breast milk	4.0	2.3-8.2	<0.001

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[1] *
Article extracted from the master’s/PhD thesis “Autoeficácia em amamentar no pós-parto imediato: fatores associados e intervenção educativa”, Universidade Federal do Maranhão, Imperatriz, MA, Brasil, 2021.