Influence of Mother's Self-Efficacy, Social Support & Intention on Exclusive Breastfeeding: A Systematic Review

Abstract

Breastmilk is widely considered to be the best source of nutrition for infants. Psychosocial factors such as maternal attitude, intention, self-efficacy and social support may influence EBF practice. The study aimed to examine the influence of mothers' self-efficacy, social support, and intention on their decision to breastfeed exclusively. A systematic and comprehensive search was conducted across four databases (PubMed, Scopus, Embase, CINAHL) from 2010 to 2024. Observational studies assessing psychosocial determinants of EBF were included. The screening of studies, the methodological quality assessment of selected studies using the Newcastle-Ottawa scale, and the analysis were performed independently by four reviewers. Study selection followed PRISMA guidelines, and findings were synthesised narratively. A total of 16 studies conducted across various countries were included, revealing that the majority of mothers initiate breastfeeding within 1–6 hours. Non-working mothers had higher EBF rates, whereas employed mothers had lower rates of exclusively breastfed infants. Most studies reported positive associations between breastfeeding self-efficacy, intention, social support and EBF practices. The review highlights the need for improved antenatal education, practical support, and counselling from healthcare providers to increase breastfeeding rates and mothers' confidence.