Income,Breastfeeding Problems,Infant Care Support,and Sleep Are Associated With Maternal Satisfaction With Breastfeeding

Abstract

Background:

Maternal satisfaction with breastfeeding is an important indicator of breastfeeding success. However, little is known about the satisfaction of women in lower-middle-income countries, whose breastfeeding rates tend to be higher than those in high-income countries.

Aim:

To investigate the factors associated with maternal satisfaction with breastfeeding.

Methods:

This is a cross-sectional and observational study with 291 women in the 6 months postpartum, all users of the public health network in the city of Aracaju, Brazil. Data were collected using the Maternal Breastfeeding Evaluation Scale, along with a semi-structured questionnaire covering demographic, pregnancy, childbirth, and postpartum characteristics. A multivariable logistic regression model with intra-block analysis was constructed to identify factors associated with maternal satisfaction with breastfeeding.

Results:

The average maternal satisfaction score was 125.3 (SD = 13.7). Higher maternal satisfaction was associated with lower monthly family income (less than half the minimum wage; OR = 2.12; 95% CI [1.20, 3.74]), absence of problems in breastfeeding (OR = 2.09; 95% CI [1.19, 3.67]), current exclusive breastfeeding (OR = 1.82; 95% CI [1.09, 3.04]), support in caring for the child (OR = 1.89; 95% CI [1.05, 3.40]), and good quality of maternal sleep (OR = 1.71; 95% CI [1.01, 2.90]).

Conclusion:

Preventing breastfeeding problems and providing support in childcare, with a focus on improving maternal sleep quality, are essential to increasing breastfeeding satisfaction in low-resource women. These strategies are low-cost and feasible for implementation within routine health services.

Keywords

breastfeeding breastfeeding assessment lactation observational study postpartum period satisfaction

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References

Avilla

J. C.

Giugliani

Bizon

A. M. B. L.

Martins

A. C. M.

Senna

A. F. K.

Giugliani

E. R. J.

(2020). Association between maternal satisfaction with breastfeeding and postpartum depression symptoms. PLOS ONE, 15(11), Article e0242333. https://doi.org/10.1371/journal.pone.0242333

Awaliyah

S. N.

Rachmawati

I. N.

Rahmah

(2019). Breastfeeding self-efficacy as a dominant factor affecting maternal breastfeeding satisfaction. BMC Nursing, 18(Suppl. 1), 30. https://doi.org/10.1186/s12912-019-0359-6

Azevedo

R. S.

(2008). Qual o tamanho da amostra ideal para se realizar um ensaio clínico? [What is the ideal sample size to carry out a clinical trial?]. Revista da Associação Médica Brasileira [Magazine of the Brazilian Medical Association], 54(4), Article 289. https://doi.org/10.1590/S0104-42302008000400007

Brasil

Ministério da Saúde

Secretaria

de Atenção à Saúde

Departamento

de Atenção Básica

. (2013). Atenção ao pré-natal de baixo risco (1ª ed. rev.). Editora do Ministério da Saúde. https://bvsms.saude.gov.br/bvs/publicacoes/cadernos_atencao_basica_32_prenatal.pdf

Cooke

Schmied

Sheehan

(2007). An exploration of the relationship between postnatal distress and maternal role attainment, breast feeding problems and breast feeding cessation in Australia. Midwifery, 23(1), 66–76. https://doi.org/10.1016/j.midw.2005.12.003

Cooke

Sheehan

Schmied

(2003). A description of the relationship between breastfeeding experiences, breastfeeding satisfaction, and weaning in the first 3 months after birth. Journal of Human Lactation, 19(2), 145–156. https://doi.org/10.1177/0890334403252472

de Senna

A. F. K.

Giugliani

Avilla

Bizon

A. M. B. L.

Martins

A. C. M.

Giugliani

E. R. J

. (2020). Maternal satisfaction with breastfeeding in the first month postpartum and associated factors. International Breastfeeding Journal, 15(1), Article 72. https://doi.org/10.1186/s13006-020-00312-w

Edwards

(2018). An exploration of maternal satisfaction with breastfeeding as a clinically relevant measure of breastfeeding success. Journal of Human Lactation, 34(1), 93–96. https://doi.org/10.1177/0890334417722509

Guo

Shang

Deng

(2025). The effects of a newborn care education program on mothers’ self-confidence, care knowledge, and breastfeeding behavior: A systematic review and meta-analysis. Public Health Nursing, 42(1), 395–410. https://doi.org/10.1111/phn.13484

10.

Hongo

Green

Shibanuma

Nanishi

Jimba

(2020). The influence of breastfeeding peer support on breastfeeding satisfaction among Japanese mothers: A randomized controlled trial. Journal of Human Lactation, 36(2), 337–347. https://doi.org/10.1177/0890334419869601

11.

Instituto Brasileiro de Geografia e Estatística. (2022). Censo Demográfico 2022 [Demographic census 2022]. https://censo2010.ibge.gov.br/resultados.html

12.

Labarère

Gelbert-Baudino

Laborde

Baudino

Durand

Schelstraete

François

(2012). Determinants of 6-month maternal satisfaction with breastfeeding experience in a multicenter prospective cohort study. Journal of Human Lactation, 28(2), 203–210. https://doi.org/10.1177/0890334411429114

13.

Leff

E. W.

Jefferis

S. C.

Gagne

M. P.

(1994). The development of the maternal breastfeeding evaluation scale. Journal of Human Lactation, 10(2), 105–111. https://doi.org/10.1177/089033449401000217

14.

Minkel

J. D.

Banks

Htaik

Moreta

M. C.

Jones

C. W.

McGlinchey

E. L.

Simpson

N. S.

Dinges

D. F.

(2012). Sleep deprivation and stressors: Evidence for elevated negative affect in response to mild stressors when sleep deprived. Emotion, 12(5), 1015–1020. https://doi.org/10.1037/a0026871

15.

Miot

H. A.

(2011). Tamanho da amostra em estudos clínicos e experimentais [Sample size in clinical and experimental trials]. Jornal Vascular Brasileiro [Brazilian Vascular Journal], 10(4), 275–278. https://doi.org/10.1590/S1677-54492011000400001

16.

Nabulsi

Smaili

Tamim

Wahidi

El-Jamal

(2021). Validation of the Arabic Maternal Breastfeeding Evaluation Scale (MBFES-A) among Lebanese women. International Breastfeeding Journal, 16(1), 60. https://doi.org/10.1186/s13006-021-00409-w

17.

Rollins

N. C.

Bhandari

Hajeebhoy

Horton

Lutter

C. K.

Martines

J. C.

Piwoz

E. G.

Richter

L. M.

Victora

C. G.

, Lancet Breastfeeding Series Group. (2016). Why invest, and what it will take to improve breastfeeding practices? Lancet, 387(10017), 491–504. https://doi.org/10.1016/S0140-6736(15)01044-2

18.

Senna

A. F. K.

Giugliani

Lago

J. C. A.

Bizon

A. M. B. L.

Martins

A. C. M.

Oliveira

C. A. V.

Giugliani

E. R. J.

(2020). Validation of a tool to evaluate women’s satisfaction with breastfeeding for the Brazilian population. Jornal de Pediatria, 96(1), 84–91. https://doi.org/10.1016/j.jped.2018.08.008

19.

Symon

A. G.

Whitford

Dalzell

(2013). Infant feeding in Eastern Scotland: A longitudinal mixed methods evaluation of antenatal intentions and postnatal satisfaction—the Feeding Your Baby study. Midwifery, 29(7), e49–e56. https://doi.org/10.1016/j.midw.2012.06.017

20.

Universidade Federal do Rio de Janeiro. (2021). Aleitamento materno: Prevalência e práticas de aleitamento materno em crianças brasileiras menores de 2 anos 4: ENANI 2019 [Breastfeeding: Prevalence and breastfeeding practices in Brazilian children under 2 years old 4: ENANI 2019]. Documento eletrônico. Rio de Janeiro, RJ: UFRJ (108 p.). Coordenador geral, Gilberto Kac. https://enani.nutricao.ufrj.br/wp-content/uploads/2023/10/Relatorio-4-ENANI-2019-Aleitamento-Materno.pdf

21.

Victora

C. G.

Bahl

Barros

A. J.

França

G. V.

Horton

Krasevec

Murch

Sankar

M. J.

Walker

Rollins

N. C.;

Lancet Breastfeeding Series Group. (2016). Breastfeeding in the 21st century: Epidemiology, mechanisms, and lifelong effect. Lancet, 387(10017), 475–490. https://doi.org/10.1016/S0140-6736(15)01024-7

22.

Victora

C. G.

Huttly

S. R.

Fuchs

S. C.

Olinto

M. T.

(1997). The role of conceptual frameworks in epidemiological analysis: A hierarchical approach. International Journal of Epidemiology, 26(1), 224–227. https://doi.org/10.1093/ije/26.1.224

23.

Witkowska-Zimny

Zhyvotovska

Isakov

Boiko

D. I.

Nieradko-Iwanicka

(2024). Maternal sleeping problems before and after childbirth—A systematic review. International Journal of Women’s Health, 16, 345–371. https://doi.org/10.2147/IJWH.S446490

24.

World Health Organization, & United Nations Children’s Fund (2009). Baby-friendly hospital initiative: Revised, updated and expanded for integrated care. World Health Organization. https://apps.who.int/iris/handle/10665/43593

25.

World Health Organization, & United Nations Children’s Fund (2022). Global breastfeeding scorecard 2022: Protecting breastfeeding through further investments and policy actions. World Health Organization. https://apps.who.int/iris/handle/10665/365140