Multidimensional sleep health and breastfeeding self-efficacy: A cross-sectional study

Breastfeeding is recommended for new mothers. However, the rate of breastfeeding is far below the recommendation, and researchers have devoted themselves to exploring the associated factors to promote breastfeeding.

To explore the association between maternal multidimensional sleep health and prenatal breastfeeding self-efficacy.

A cross-sectional survey was conducted among pregnant women attending obstetrics departments at three hospitals in Jiangsu, China. The RU_SATED 2.0, Prenatal Breastfeeding Self-efficacy Scale, Maternity Social Support Scale, 7-item Generalized Anxiety Disorder Scale, and 9-item Patient Health Questionnaire were administered to evaluate multidimensional sleep health, prenatal breastfeeding self-efficacy, social support, and anxiety and depression symptoms of pregnant women, respectively. Independent t-tests and multiple linear regression were applied to explore the association between multidimensional sleep health and prenatal breastfeeding self-efficacy.

A total of 349 pregnant women completed the survey, with a mean age of 30.59 years (SD=3.96, Range: 20-45). The scores of sleep health and prenatal breastfeeding self-efficacy were 15.07±3.65 and 56.96±15.31, respectively. Independent t-tests revealed that pregnant women with better sleep health demonstrated significantly higher scores in prenatal breastfeeding self-efficacy, including the skills and needs and information acquisition domains (Cohen's d ranging from 0.330 to 0.435). Moreover, the linear regression model showed that better sleep health (B=0.58, P=0.011), more social support (B=0.65, P=0.022), and current children (B=14.05, P<0.001) were associated with higher prenatal breastfeeding self-efficacy, while gestational age was negatively associated with prenatal breastfeeding self-efficacy (B=-0.21, P=0.027) after adjusting for covariates.

Optimal multidimensional sleep health is associated with better prenatal breastfeeding self-efficacy, and targeted sleep health interventions should be implemented to enhance maternal sleep health and promote better breastfeeding outcomes.