الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Exclusive breastfeeding (EBF) has various benefits for mothers and their infants. It is recommended for the first six months of an infant’s life. Breastfeeding Self-Efficacy (BSE) is considered a mother’s confidence or perception in her ability to breastfeed successfully. There are multiple factors that influence maternal Exclusive Breastfeeding Self-Efficacy (EBFSE). Nurse educators can assess and explore the factors including sociodemographic data of parents, in addition to the factors concerning infants’ clinical data, psychosocial support groups, cultural, and contextual factors.
The aim of the current study is to explore the factors influencing Exclusive Breastfeeding Self-Efficacy (EBFSE).
The study was conducted in three Maternal Child Health (MCH) centers in Alexandria affiliated with the following; San Stefano in East district, Ambrozio, Muharram Bey in Middle district, as well as Al-Hajjari MCHs in Gomrok district, with a convenient sample of 580 lactating mothers who have infants aged from zero-day to less than six months.
Three tools were used to collect data for the present study, namely; Breastfeeding Self-Efficacy Scale to measure Exclusive Breastfeeding (BSES-EBF), an observational checklist regarding mothers’ breastfeeding practices, and factors influencing maternal EBFSE structured interview schedule.
Data was collected over five consecutive months starting from November 2020 to March 2021.
The main results of the present study clarified the following:
• All lactating mothers whose age was less than 20 years old and nearly two-thirds of them (63.7%) whose age ranged from 20 years to less than 30 years old had a low EBFSE score. While nearly three-quarters of lactating mothers (72.8%) who are aged 30 years to less than 40 years old and all mothers aged 40 years and above had a high EBFSE score.
• All lactating mothers who had educational degrees from illiterate to preparatory got a low score of EBFSE and 80.6% of mothers who finished secondary school. On the other hand, 73.5% of those who finished a university degree or higher achieved a total score with a high EBFSE.
• The majority of lactating and employed mothers (88.2%) and 47.8% of unemployed mothers attained EBFSE with a high total score and a statistically significant difference.
• Most of the primipara mothers (94.0%) had a low score of EBFSE. While the majority of multipara (90.8%) accomplished a high EBFSE score. It was clear that 92.0% of primigravida had a low EBFSE score. Most of the multigravida (92.5%) had a high EBFSE score.
• Nearly half of the mothers with no previous abortions (52.4%) had a high EBFSE score. Moreover, 66.7% of mothers who had a one-time abortion and 80.0% of those who had two times abortions and more got a low score of EBFSE.
• The highest percentage of mothers (80.6%) who delivered vaginally attained a high EBFSE score. On the other hand, 50.2% of mothers who delivered by C-section had a low score of EBFSE.
• Nearly half of the mothers with regular menstruation gained a high EBFSE score. While 58.8% of others with irregular menses had a low score of EBFSE. It was observed that 61.8% of mothers who lactated during menses had a high EBFSE score, and, 81.7% of mothers who didn’t lactate had low EBFSE scores with a statistically significant difference.
• According to the cognitive domain of EBFSE, nearly half of the lactating mothers (49.1%) accomplished a high level and 47.3% of them had a low level. As regards the functional domain of EBFSE, half of the lactating mothers (49.1%, and 50.0% respectively) attained high and moderate levels. Globally, it was also found that nearly half of the lactating mothers (50.2%) got a high level whereas 44.8% of them had a low level of EBFSE.
• Concerning mothers’ BF practice, the majority of them (86.2%) and (87.6%) got an unsatisfactory level before and during lactation sessions respectively. While most of the lactating mothers (95.9%) gained a satisfactory level after lactation sessions. Unfortunately, about three-quarters of them (75.2%) had an unsatisfactory level in their total maternal BF practice.
• There was a very strong correlation between mothers’ EBFSE and their BF practices (r= 0.810) with a statistically significant difference (P= 0.000).
• There is a positive strong correlation (R=0.945) (R square = 79.3%) between maternal EBFSE and some criteria in the following factors such as parents’ sociodemographic data, lactating mothers’ obstetrical data, and mothers’ BF practice with statistically significant differences (P= 0.000). In addition, the biological and contextual factors, infants’ clinical data, psychosocial support groups, and cultural factors have a positive strong correlation with maternal EBFSE with a statistically significant difference. While experiencing psychological problems were negatively associated with lactation (B= - 0.099) with a statistically significant difference (P= 0.045).
Based on the results of the current study, the following recommendations are suggested:
1. Conducting periodical cognitive behavioral counseling sessions on EBF by Health Care Providers (HCPs) for lactating mothers and their families.
2. Designing social media platforms such as Facebook educational pages, and online webinars through zoom about EBF to raise the community’s awareness and health literacy about the factors influencing maternal EBFSE.
3. Performing educational sessions using audiovisual materials such as illustrated posters regarding effective BF techniques and proper care of its difficulties is mandatory for HCPs, and pregnant as well as lactating mothers.
4. Reinforcement of policies, regulations, and systems that enable working mothers to exclusively breastfeed their infants up to 6 months of age, by allowing mothers sufficient maternity leave, availability of BF space, and facilities.