CoChat
Sign Up
Cited by 139Breastfeeding Practices and InfluencesMaternal Mental Health During Pregnancy and PostpartumMaternal and Perinatal Health Interventions

Association between postpartum depression level, social support level and breastfeeding attitude and breastfeeding self-efficacy in early postpartum women

Open access
Mercan, Yeliz, Tari Selcuk, Kevser·2021·PLOS ONE
DOI 10.1371/journal.pone.0249538PMC PMC8018654
Open this paper in CoChat — free accountOpen PDF

Abstract

Objective: The study was aimed at investigating the association between postpartum women’s breastfeeding self-efficacy levels and their depression levels, social support levels, and breastfeeding attitudes in early postpartum period. Methods: The cross-sectional study was carried out in Kirklareli in Turkey. The population of the study consisted of 398 women aged 15–49 in the first 42 days of the postpartum period who presented to eight family health centers. The study data were collected face-to-face using the Personal Information Form, Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), Edinburgh Postnatal Depression Scale (EPDS), Multidimensional Scale of Perceived Social Support (MSPSS), and Breastfeeding Attitudes of the Evaluation Scale (BAES). Results: The mean age of the participants was 28.61±5.72 (Min:18, Max: 44), and the mean score they obtained from the BSES-SF was 55.13±8.39. Statistically significant differences were detected between the participants’ BSES-SF scores and age groups, employment status, perceived income level, and the number of living children (p < 0.05). No statistically significant differences were detected between marital status, educational status and BSES-SF scores (p > 0.05). In the multivariate regression analysis adjusted according to the sociodemographic characteristics, BAES, EPDS and MSPSS accounted for 48.3% of the BSES-SF. A negative association was found between BSES-SF scores and EPDS scores (β = −0.178, 95% CI:−0.349, −0.006), and a positive relation between the BAES scores (β = 0.194, 95% CI: 0.163, 0.226) and the MSPSS scores (β = 0.114, 95% CI: 0.037, 0.191). Conclusion: As the level of depression of women increases in the postpartum period, the level of breastfeeding self-efficacy decreases. The breastfeeding self-efficacy increases as the level of social support increases and as the attitudes that drive breastfeeding behavior change positively.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1371/journal.pone.0249538

Cites

4 of 4 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Social support has been shown to reduce symptoms of postpartum depression.

    “Some researches had demonstrated that social support has been shown to reduce symptoms of postpartum depression [40, 44, 45].”

    From Understanding mothers’ lived experiences of postpartum depression: a qualitative phenomenological study (2025) · cites this paper as [45]

    The Introduction reports an association between social support and postnatal depression, and the Discussion describes low social support as a determinant of postpartum depression level. However, this paper’s cross-sectional findings do not show that providing social support reduces depressive symptoms; its reported results concern breastfeeding self-efficacy. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 33

  1. [1]Hansen K. Breastfeeding: a smart investment in people and in economies. Lancet. 2016; 387(10017): 416. 10.1016/S0140-6736(16)00012-X 26869553 · DOI
  2. [4]Faridvand F, Mirghafourvand M, Mohammad-Alizadeh-Charandabi S, Malakouti J. Breastfeeding performance in Iranian women. Int J Nurs Pract. 2018; 24(4): e12659. 10.1111/ijn.12659 29676039 · DOI
  3. [5]de Jager E, Skouteris H, Broadbent J, Amir L, Mellor K. Psychosocial correlates of exclusive breastfeeding: a systematic review. Midwifery. 2013; 29(5): 506– 518. 10.1016/j.midw.2012.04.009 23099152 · DOI · Paper page
  4. [7]Dennis C. The Breastfeeding Self‐Efficacy Scale: Psychometric Assessment of the Short Form. JOGN Nurs. 2003; 32(6): 734– 744. 10.1177/0884217503258459 14649593 · DOI
  5. [8]Tuthill EL, McGrath JM, Graber M, Cusson RM, Young SL. Breastfeeding self-efficacy: A critical review of available instruments. J Hum Lact. 2016; 32(1): 35– 45. 10.1177/0890334415599533 26319113 PMC4882127 · DOI
  6. [9]Alus Tokat M, Okumus H, Dennis CL. Translation and psychometric assessment of the Breast-feeding Self-Efficacy Scale-Short Form among pregnant and postnatal women in Turkey. Midwifery. 2010; 26(1): 101– 108. 10.1016/j.midw.2008.04.002 18541350 · DOI
  7. [10]Brockway M, Benzies K, Hayden KA. Interventions to Improve Breastfeeding Self-Efficacy and Resultant Breastfeeding Rates: A Systematic Review and Meta-Analysis. J Hum Lact. 2017; 33(3): 486– 499. 10.1177/0890334417707957 28644764 · DOI
  8. [11]Victora CG, Bahl R, Barros AJ, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016; 387(10017): 475– 490. 10.1016/S0140-6736(15)01024-7 26869575 · DOI · Paper page
  9. [12]Gercek E, Sarikaya Karabudak S, Ardic Celik N, Saruhan A. The relationship between breastfeeding self-efficacy and LATCH scores and affecting factors. J Clin Nurs. 2017; 26(7–8): 994– 1004. 10.1111/jocn.13423 27272098 · DOI
  10. [13]Kilci H, Coban A. The Correlation Between Breastfeeding Success in the Early Postpartum Period and the Perception of Self-Efficacy in Breastfeeding and Breast Problems in the Late Postpartum. Breastfeed Med. 2016; 11: 188– 95. 10.1089/bfm.2015.0046 27027656 · DOI
  11. [14]Balogun OO, Kobayashi S, Anigo KM, Ota E, Asakura K, Sasaki S. Factors Influencing Exclusive Breastfeeding in Early Infancy: A Prospective Study in North Central Nigeria. Matern Child Health J. 2016; 20(2): 363– 375. 10.1007/s10995-015-1835-6 26520155 · DOI
  12. [15]Ngo LTH, Chou HF, Gau ML, Liu CY. Breastfeeding self-efficacy and related factors in postpartum Vietnamese women. Midwifery. 2019; 70: 84– 91. 10.1016/j.midw.2018.12.014 30594613 · DOI
  13. [16]Hendrick V, Altshuler LL, Suri R. Hormonal changes in the postpartum and implications for postpartum depression. Psychosomatics. 1998; 39(2): 93– 101. 10.1016/S0033-3182(98)71355-6 9584534 · DOI
  14. [17]Robertson E, Celasun N, Stewart DE. Risk factors for postpartum depression. In Stewart DE, Robertson E, Dennis CL, Grace SL, & Wallington T. Postpartum depression: Literature review of risk factors and interventions, 2003.
  15. [18]Santos HP, Kossakowski JJ, Schwartz TA, Beeber L, Fried EI. Longitudinal network structure of depression symptoms and self-efficacy in low-income mothers. PLoS One. 2018; 13(1): e0191675. 10.1371/journal.pone.0191675 29360876 PMC5779701 · DOI
  16. [21]Zhang Y, Jin S. The impact of social support on postpartum depression: The mediator role of self-efficacy. J Health Psychol. 2016; 21(5): 720– 726. 10.1177/1359105314536454 24925546 · DOI
  17. [22]Maleki-Saghooni N, Amel Barez M, Zahra Karimi F. Investigation the relationship between social support and breastfeeding self-efficacy in primparous breastfeeding mothers. J Matern Fetal Neonatal Med. 2020; 33(18): 3097– 102. 10.1080/14767058.2019.1568986 30632820 · DOI
  18. [23]Casal CS, Lei A, Young SL, Tuthill EL. A Critical Review of Instruments Measuring Breastfeeding Attitudes, Knowledge, and Social Support. J Hum Lact. 2017; 33(1): 21– 47. 10.1177/0890334416677029 28135474 PMC6377936 · DOI
  19. [24]Altamimi E, Nsour RA, Dalaen DA, Almajali N. Knowledge, Attitude, and Practice of Breastfeeding Among Working Mothers in South Jordan. Workplace Health Saf. 2017; 65(5): 210– 218. 10.1177/2165079916665395 27794075 · DOI
  20. [27]Arslan Ozkan H. Breastfeeding Attitudes of the Evaluation Scale. J Womens Health. 2015; 2(1): 53– 58.
  21. [29]Engindeniz AN, Küey L, Kültür S. Edinburgh Postpartum Depression Scale validity and reliability study of Turkish form. Spring Symposiums. 1996; 1: 51– 52.
  22. [30]Aydin N, Inandi T, Yigit A, Hodoglugil NN. Validation of the Turkish version of the Edinburgh Postnatal Depression Scale among women within their first postpartum year. Soc Psychiatry Psychiatr Epidemiol. 2004; 39(6): 483– 486. 10.1007/s00127-004-0770-4 15205733 · DOI
  23. [32]Eker D, Arkar H. Perceived social support: psychometric properties of the MSPSS in normal and pathological groups in a developing country. Soc Psychiatry Psychiatr Epidemiol. 1995; 30(3): 121– 126. 10.1007/BF00802040 7624805 · DOI
  24. [33]Pakseresht S, Pourshaban F, Khalesi ZB. Comparing maternal breastfeeding self-efficacy during first week and sixth week postpartum. Electron Physician. 2017; 9(2): 3751– 3755. 10.19082/3751 28465802 PMC5410901 · DOI
  25. [34]Yang X, Gao LL, Ip WY, Sally Chan WC. Predictors of breast feeding self-efficacy in the immediate postpartum period: A cross-sectional study. Midwifery. 2016; 41: 1– 8. 10.1016/j.midw.2016.07.011 27479635 · DOI
  26. [35]Cinar N, Kose D, Altinkaynak S. The relationship between maternal attachment, perceived social support and breast-feeding sufficiency. J Coll Physicians Surg Pak. 2015; 25(4): 271– 275. doi: 04.2015/JCPSP.271275 25899193
  27. [36]Corby K, Kane D, Dayus D. Investigating Predictors of Prenatal Breastfeeding Self-Efficacy. Can J Nurs Res. 2019;844562119888363. 10.1177/0844562119888363 31744322 · DOI
  28. [37]Chaput KH, Nettel-Aguirre A, Musto R, Adair CE, Tough SC. Breastfeeding difficulties and supports and risk of postpartum depression in a cohort of women who have given birth in Calgary: a prospective cohort study. CMAJ Open. 2016; 4(1), E103– 9. 10.9778/cmajo.20150009 27280109 PMC4866929 · DOI
  29. [38]Alghamdi S, Horodynski M, Stommel M. Racial and ethnic differences in breastfeeding, maternal knowledge, and self-efficacy among low-income mothers. Appl Nurs Res. 2017; 37: 24– 27. 10.1016/j.apnr.2017.07.009 28985916 · DOI
  30. [39]Figueiredo B, Dias CC, Brandão S, Canário C, Nunes-Costa R. Breastfeeding and postpartum depression: state of the art review. J Pediatr (Rio J). 2013; 89(4): 332– 8. 10.1016/j.jped.2012.12.002 23791236 · DOI
  31. [40]Abbass-Dick J, Stern SB, Nelson LE, Watson W, Dennis CL. Coparenting breastfeeding support and exclusive breastfeeding: a randomized controlled trial. Pediatrics. 2015; 135(1): 102– 110. 10.1542/peds.2014-1416 25452653 · DOI
  32. [41]Fishbein M, Ajzen I. Predicting and changing behavior: The reasoned action approach. New York: 1st Edition, 2010, Psychology Press. p. 538
  33. [42]Wu YH, Ho YJ, Han JP, Chen SY. The Influence of breastfeeding self-efficacy and breastfeeding intention on breastfeeding behavior in postpartum women. Hu Li Za Zhi. 2018; 65(1): 42– 50. 10.6224/JN.201802_65(1).07 29405019 · DOI

Cited by

Sorted by citations

Authors
Mercan, Y., & Tari Selcuk, K.
Affiliations
Kırklareli University (TR)
Corresponding author
Mercan, Yeliz
ORCID
Mercan, Yeliz
Venue
PLOS ONE
Publisher
Public Library of Science (PLoS)
Published
2021-04-02
Volume
16
Issue
4
Pages
e0249538
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0249538
PMC
PMC8018654
OpenAlex
W3150898546
Cited by
139
References
4
Citations by year
2026: 35 · 2025: 38 · 2024: 29 · 2023: 22 · 2022: 12 · 2021: 3
FWCI
11.67
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Kırklareli University Institutional Repository (Kırklareli University) (submittedVersion, other-oa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Epidemiology › Breastfeeding Practices and Influences
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
Keywords
postpartum depression, social support, breastfeeding self-efficacy, breastfeeding attitudes, early postpartum period, postpartum women, sociodemographic factors
MeSH terms
Adolescent, Adult, Breast Feeding, Cross-Sectional Studies, Female, Humans, Mothers, Psychometrics, Surveys and Questionnaires, Social Support, Depression, Postpartum, Self Efficacy, Postpartum Period, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review