Underpinnings of breastfeeding motivation: A systematic review

Breastfeeding is a fundamental practice for child and maternal health, recommended by the World Health Organisation (WHO) and the United Nations International Children's Emergency Fund (UNICEF). However, despite its proven benefits, exclusive breastfeeding rates remain suboptimal in many countries. Mothers' motivation plays a crucial role in the initiation, continuation and prolongation of breastfeeding, but various factors can negatively influence this motivation.

This research explores the complex motivational dynamics surrounding breastfeeding, encompassing both the intrinsic motivation of mothers and the motivational interventions of health professionals.

A systematic review encompassing both qualitative and quantitative inquiries, was undertaken. Research questions were formulated, and a search strategy devised, to review PubMed, Scopus, and Web of Science repositories, with a retrospective scope spanning the past three decades, applying filters and eligibility criteria. We included scientific articles whose participants were healthy mothers aged 18-48 years with uncomplicated eutocic deliveries, together with their healthy full-term infants. The study aimed to analyze the motivation for breastfeeding from the prenatal stage to prolongation beyond the two years recommended by the WHO.

A total of 23 studies, from a variety of perspectives and sociocultural contexts, were identified and recovered. Average breastfeeding duration was 2.73 months shorter than the recommended 6-month period. Deciding to breastfeed "as long as possible" and prior breastfeeding experience were associated with meeting breastfeeding expectations. Instead, maternal age, caesarean delivery, and socio-environmental factors negatively affected the breastfeeding process. Our findings highlighted intrinsic maternal motivations and the impact of healthcare professional interventions, revealing the complex interplay of psychological, social, and cultural factors in breastfeeding decisions.

An exhaustive typological analysis of maternal motivation throughout breastfeeding phases is feasible. Motivational dynamics may vary, concretely influencing breastfeeding exclusivity and duration. These dynamics are foreseen by maternal intent and bolstered by self-efficacy conducive to successful progression. Furthermore, sociocultural and clinical variables modulate motivational pathways. In-depth analysis allows for more effective professional interventions within the framework of humanized care and the development of innovative health plans and policies.