Exclusive breastfeeding, breastfeeding self-efficacy and perception of milk supply among mothers in Singapore: A longitudinal study

Aim: This study aimed to examine the factors that affect exclusive breastfeeding among mothers in Singapore.

Design & participants: This was a longitudinal study over 6 months. Data was collected on 400 mothers with breastfed infants who attended at primary care clinics.

Method: Mothers completed self-administered questionnaires on breastfeeding practices, demographic factors, breastfeeding self-efficacy and perception of milk supply at three time points: baseline and follow up visits at infant age 3 months and 6 months. The tools used were the Breastfeeding Self-Efficacy Scale (Short form) (BSES-SF) and Perception of Insufficient Milk (PIM) questionnaire.

Findings: Exclusive breastfeeding rate was 38.2% at infant age 6 months. Baseline breastfeeding self-efficacy and perception of milk supply scores were significantly higher for mothers who continued exclusive breastfeeding up to 6 months compared to those who had stopped exclusive breastfeeding (p < .01). Generalized Estimating Equation model (GEE) showed that mothers who had tertiary education (OR 2.65, 95% CI 1.24-5.66), planned to breastfeed for at least 6 months (OR 6.81, 95% CI 2.15-21.57), had baseline BSES-SF above 50 (OR 1.95, 95% CI 1.07-3.54) and PIM scores above 20 (OR 4.05, 95% CI 2.35-6.97) were significantly more likely to be exclusively breastfeeding at 6 months.