Breastfeeding Attitudes and Their Associated Factors Among Chinese Nursing Undergraduates: A Cross-Sectional Study

Breastfeeding promotion is a public health priority in China, yet the exclusive breastfeeding rate remains below national targets. Nursing students, as future key promoters, often report insufficient knowledge, but their attitudes are less clear.

This study aimed to assess breastfeeding attitudes and identify their associated factors among Chinese nursing undergraduates, thereby providing an evidence base for the design of effective educational interventions.

A cross-sectional study was conducted from October 2024 to January 2025 at a medical university in Anhui Province, China, with 753 nursing students participating.

The participants completed the General Information Questionnaire, the Chinese version of the Comprehensive Breastfeeding Knowledge Scale (CBKS), and the Iowa Infant Feeding Attitude Scale (IIFAS). We analyzed the data via Spearman correlation, univariate analysis, and multiple linear regression.

The overall IIFAS score for nursing students was 54 (51, 59), with attitude scores showing a significant positive correlation with knowledge (r = 0.462, p < 0.001). Multiple linear regression revealed that breastfeeding attitudes were significantly predicted by CBKS score (β = 2.975), grade (β = 2.887), major (β = 3.235), and breastfeeding intention (β = 8.089, all p < 0.001), as well as by feeding type before six months (β = -1.591, p = 0.020). The overall model accounted for 32.7% of the variance (R² = 0.327, F = 51.666, p < 0.001).

This study demonstrates that Chinese nursing undergraduates hold predominantly neutral attitudes toward breastfeeding. These attitudes show significant associations with their knowledge level and personal feeding intention, which underscores the necessity of integrating attitude-focused education into nursing curricula.