Access KeysSkip to MenuSkip to ContentSkip to Footer

6.5 Psychological support

Maternal self-confidence and self-efficacy

Researchers confirm self-confidence and self-efficacy to be major predictors of breastfeeding success. Studies in Denmark, 1 USA, 2 3 Australia, 4 5 New Zealand, 6 Canada 7 and China 8 have all found mothers who have confidence in their ability to breastfeed and mothers with high breastfeeding self-efficacy significantly more likely to breastfeed.

Negative influences on self-confidence and self-efficacy include:

  • A lack of education about breastfeeding was identified by several of the researchers mentioned above.
  • Health professional attitudes and actions in regard to breastfeeding. At 12 weeks postpartum mothers are much more likely to be breastfeeding if they reported having received encouragement from their clinician to breastfeed. 2
  • Health care professionals giving inaccurate or inconsistent advice .
  • Some hospital routines are also potentially detrimental to breastfeeding. 7

Influencing self-confidence and self-efficacy

Include breastfeeding education in:

  • community awareness programs,
  • prenatal classes,
  • prenatal health care provider visits, and
  • postnatally

Integrate self-efficacy enhancing strategies, improve the quality of healthcare delivered and increase a new mother's confidence in her ability to breastfeed.5

Identifying and supporting mothers who exhibit signs of anxiety also increases breastfeeding duration and exclusivity in affected women. 9

Support from the mother's partner or a nonprofessional greatly increases the likelihood of positive breastfeeding behaviors. 7

Never underestimate the role of the father in supporting breastfeeding.

Never underestimate the role of the father in supporting breastfeeding.
© WIC program, USA

The power of words

Many clinicians will tell you that breastfeeding is a confidence game.

Prof Hartmann in his studies of breast growth and development from preconception to weaning noted one woman in their study had no breast changes during her pregnancy. She went on to successfully breastfeed her baby. Prof Hartmann commented that she was successful because no one at any time suggested to her that she might have a problem.

Similarly a woman who exclusively breastfed her triplets for 6 months said that she did it because no one told her she might not be able to, and that had it been suggested she probably wouldn't have had the confidence to even try.

Mothers have reported losing self-confidence to breastfeed from someone commenting about their 'flat' nipples, or small breasts, or red hair, or fair skin, or ability to hold the baby.

Impatience is another factor identified by mothers trying to learn a new skill. Taking the baby from the mother and having him/her settle immediately demonstrates to a mother her lack of skill, and perhaps to an anxious mother, that the baby may 'prefer' someone else.

Be aware at all times of how your seemingly innocent comments and actions can affect maternal confidence.

With such short hospital stays it's important for the mother to assume all care of her infant as soon as she is physically able to, with nurses or midwives available to coach her when needed, providing positive feedback at every opportunity.

Think positive. Sound positive.

It's the little things that count.

What should I remember?

  • Education about breastfeeding is integral to self-confidence and self-efficacy.
  • Health professional encouragement is vital to maternal self-confidence
  • Include the father or mother's support people in education
  • Encourage independence in baby care, with help when required

Self-test Quiz

Notes

  1. # Kronborg H et al. (2004) The influence of psychosocial factors on the duration of breastfeeding
  2. # Taveras EM et al. (2003) Clinician support and psychosocial risk factors associated with breastfeeding discontinuation
  3. # Chezem J et al. (2003) Breastfeeding knowledge, breastfeeding confidence, and infant feeding plans: effects on actual feeding practices
  4. # Creedy DK et al. (2003) Psychometric characteristics of the breastfeeding self-efficacy scale: data from an Australian sample
  5. # Blyth R et al. (2002) Effect of maternal confidence on breastfeeding duration: an application of breastfeeding self-efficacy theory
  6. # Vogel A et al. (1999) Factors associated with the duration of breastfeeding
  7. # Dennis CL (2002) Breastfeeding initiation and duration: a 1990-2000 literature review
  8. # Loke AY et al. (2013) Maternal Breastfeeding Self-Efficacy and the Breastfeeding Behaviors of Newborns in the Practice of Exclusive Breastfeeding.
  9. # Adedinsewo DA et al. (2013) Maternal Anxiety and Breastfeeding: Findings from the MAVAN (Maternal Adversity, Vulnerability and Neurodevelopment) Study.