Relationships Among Breastfeeding Self-Efficacy, Postpartum Depressive Symptoms, and Perceived Social Support among Iranian Postpartum Women: A Cross-Sectional Study
Roya Ahmadi Niyatabesh, Elham Fatholahi, Zahra Masoumi, Mansoureh Refaei, Arezoo Shayan, Fahimeh Ezzati Arasteh, Azita Tiznobik, Omid HamidiBackground:
Successful breastfeeding is influenced by both physiological and psychosocial factors. Postpartum Depression (PPD) and perceived social support have been shown to affect breastfeeding outcomes, partly through their association with Breastfeeding Self-Efficacy (BSE). However, evidence on the interrelationships among these variables in Iranian postpartum women remains limited.
Methods:
This descriptive cross-sectional study was conducted in Hamadan, Iran, between March and September 2024. A total of 240 postpartum women within six months after delivery were selected using multistage cluster sampling. Data were collected using a demographic-obstetric questionnaire, the Breastfeeding Self-Efficacy Scale–Short Form (BSES-SF), the Edinburgh Postnatal Depression Scale (EPDS), and the Multidimensional Scale of Perceived Social Support (MSPSS). Data were analyzed using descriptive statistics, independent-samples ttests, and Pearson correlation coefficients.
Results:
The mean age of participants was 29.77 ± 5.85 years. The mean BSE score was 37.53 ± 6.07 (range: 18–57). Based on the EPDS cutoff (≥12), 90.0% of participants screened positive for depressive symptoms. BSE was negatively correlated with EPDS scores (r = −0.507, p < 0.001). Family support showed a positive correlation with BSE (r = 0.212, p = 0.001). No statistically significant correlation was found between overall perceived social support and EPDS scores.
Discussion:
Lower breastfeeding self-efficacy was associated with higher depressive symptom scores, highlighting the psychological vulnerability of postpartum women. Family support appeared to play a particularly important role in supporting maternal confidence in breastfeeding. Recent studies emphasize that enhanced social support can mitigate PPD risks and boost BSE, particularly in cultural contexts where family involvement is key.
Conclusion:
The findings suggest that breastfeeding self-efficacy is closely associated with postpartum depressive symptoms and perceived family support. Interventions aimed at strengthening family-based social support may help improve maternal mental health and breastfeeding confidence during the postpartum period.