Understanding motivations for breastfeeding across cultures: Transcultural validation of the breastfeeding motivation scale within self‑determination theory

Breastfeeding motivations reflect complex internalization processes shaped by cultural values, social expectations, and individual experiences. Grounded in self-determination theory (SDT), this study explored the structure of breastfeeding motivations and their variations across cultural and age-related contexts.

A cross-cultural sample of 915 postpartum women from Türkiye (n = 279), Israel (n = 397), and Spain (n = 239) completed the Breastfeeding Motivation Scale (BMS). Following cultural adaptation and validation, an 18-item version (BMS-18) was identified through confirmatory factor analysis.

Findings support a three-dimensional structure, i.e., introjected, integrated, and intrinsic motivation, which is consistent across countries, explains 48.6% of the variance and demonstrates cross-national robustness. Motivational patterns vary by cultural context and maternal age. Introjected motivation, which is more prominent in contexts emphasizing social expectations, reflects social pressure and the need for approval. Integrated motivation, which reflects deep internalization of health and experiential values, is high across countries, but its association with maternal age varies culturally, highlighting the dynamic interplay between developmental and cultural factors. In contrast, intrinsic motivation aligns with environments fostering autonomy and competence.

Results demonstrate the relevance of SDT for understanding breastfeeding motivations in cultural contexts and underscore the sensitivity of internalization processes to cultural and developmental conditions. The BMS-18 offers a valid, concise, and culturally adaptable instrument for assessing breastfeeding motivations in research and clinical settings.