Abstract
Background: Exclusive breastfeeding (EBF)
contributes to the health and survival of the newborns. Many factors influence
the EBF behavior. This study aimed to identify the determinant factors in order
to improve the practice of EBF among Iranian mothers.
Methods: A longitudinal study was carried out in 1445 mothers
with newborns in Qazvin city, Iran (September 2015-March 2016). Demographic
variables as well as the constructs of theory of planned behavior (TBP) were
measured by questionnaires. Bivariate analysis using Pearson and Spearman
correlation tests with analysis of variance were used to investigate the
associations among the variables. Both hierarchal multiple regression and
logistic regression were applied to identify potential determinative factors
for the EBF.
Results: Nearly, 80% (CI: 77.97-82.63%) of the participants had
the intention of EBF. All TPB constructs, moral norms, and self-identity were
significantly correlated with each other (r: 0.09- 0.40, P < 0.01).
Some demographic variables such as age, income, employment and primiparity were
also correlated with the EBF (r: 0.11-0.15, P < 0.05). The constructs
of the TPB were able to predict the EBF behavior, which account for 49% of the
variance in the predicting factors (df = 8, F = 7.70). The self-identity
and moral norms accounted for an additional 15% of the variance (df =
10, F = 3.16). Younger mothers with lower socio-economic status were at higher
risk of EBF cessation. The intention has a greater impact on the initiation of
EBF than perceived behavioral control (PBC) but not for the maintenance of EBF
(OR, 2.88 [CI: 2.38-3.48] & 1.13 [CI:1.03- 1.23] vs. OR, 1.27
[CI:1.15-1.39] & 2.66 [CI: 2.02-3.49]).
Conclusion: The
interventions to promote knowledge, attitude and behavioral control towards the
EBF should be considered especially in the young mothers with low
socio-economic status.