Believing you CAN breastfeed
Ah, the magical journey of breastfeeding. The beautiful first moment baby latches on, the little squeaks and smiles during nursing sessions, the satisfaction of expressing milk and knowing baby is getting everything they need from milk we make from scratch. And then, the not so beautiful moments. The first time baby rejects the breast and won't latch on, the first time we experience nipple discomfort or engorgement, perhaps even the first time we realize we've hit a roadblock and are uncertain how to get past it. Breastfeeding can be a breathtaking experience and it can also, unexpectedly, be challenging, frustrating and exhausting if we're not prepared, supported and if we don't believe in ourselves.
So what makes these moments the make or break for us? What factors encourage us to breastfeed and reach our goals and what are those that discourage us and get in the way of our goals?
Research reveals there are a few factors that can predict whether we will breastfeed and for how long. One of these major indicators is our self-efficacy.
WHAT IS SELF-EFFICACY?
Self-efficacy is "one's belief in one's ability to succeed in a specific situation" (1). Basically, do you believe you will be able to successfully breastfeed?
HOW IS SELF-EFFICACY DIFFERENT FROM CONFIDENCE?
Albert Bandura (the father of the social cognitive theory and the concept of self-efficacy), clarified that self-efficacy is the belief you can succeed while confidence is simply how strongly you believe something - meaning, you can be confident you will fail and you can be confident you will succeed (2). Self-efficacy mixes how strongly you believe in something (i.e. confidence) AND the "affirmation of [your] capability" (p. 382, 2).
Breastfeeding self-efficacy is the confidence that you CAN breastfeed your baby, it influences how you respond to challenges (3). Having high self-efficacy is believing that even with potential challenges, you are capable of breastfeeding your baby.
WHAT DOES THE RESEARCH SAY ABOUT SELF-EFFICACY?
Our belief that we can successfully breastfeed is one predictor of our breastfeeding outcome - whether we will try to breastfeed at all (initiation after birth) and how long we will breastfeed (duration).
Why is that?
Well, having high self-efficacy (aka strongly believing we can breastfeed) may give us the motivation and confidence to overcome hurdles we may face throughout our breastfeeding journey, especially early on such as issues getting baby to latch or latch properly, anxieties about milk supply quantity/quality or navigating our return to work (3, 4).
HOW DO WE INCREASE OUR SELF-EFFICACY?
If self-efficacy has such an impact on if we breastfeed and for how long, do we have any control over it and can we change it? Yes! There are things you and those around you can do to boost your self-efficacy. So, how do we boost our confidence in our ability to successfully breastfeed?
- Plan. Making the decision before baby arrives that you plan to breastfeed can lower the risk that you will stop breastfeeding early and setting milestones goals may help you hit longer durations of breastfeeding (5, 8).
Consider this: a marathon race. You've been planning for months, running daily, practicing your breathing, eating well and staying hydrated. Race day comes and mile 10 you're starting to feel the exhaustion kick in, do you stop or do you continue to the finish line? Now, imagine you woke up this morning and a friend asked you to run with them in a marathon race. You're not ready, you haven't run in six months, it's hot outside but you'll give it a try. Mile 10 comes in - do you decide to push on or do you tell your friend you'll see them on the other side?
Research suggests without preparation, we are more likely to do the latter.
- Learn about breastfeeding. Learning about breastfeeding is one of the most consistent ways to boost our self-efficacy and that mothers who take a prenatal breastfeeding class report higher self-efficacy than those who do not take a class (9, 10). Why? Education allows us to become more familiar with breastfeeding, to set realistic expectations and have some basic tips in our tool belt to troubleshoot if and when we need it - having this knowledge can help us feel more capable - we like to call this feeling empowered (6).
That's where we come in. We've developed our Breastfeeding Basics course to help you prepare for your breastfeeding experience and to help you set realistic expectations and be more familiar with what is to come and how to navigate those first few months. Beyond that, our course provides you with 6 months of email service to send us your questions any time of day or night, because we're here for you and we are ready to help you reach your goals.
- Build community. Our self-efficacy increases when we see other women breastfeeding (3, 7). We're big advocates of breastfeeding support groups. Sometimes we are the first to breastfeed among our family and friends so support groups can be a great way to find moms who are going through all the joys and struggles we are - breastfeeding related, sleep related, motherhood related, you name it. Before your baby arrives, consider popping into your local new moms group or La Leche League monthly group meeting. There you will see firsthand, mothers nursing their babies of all ages, asking questions, receiving guidance and bonding in motherhood.
Remember, it takes a village.
- Find your cheerleaders. Having positive support from your partner, midwife/OB and your family can influence your belief in your ability to breastfeed (10). Simply having your support team offer you words of encouragement and help with breastfeeding like bringing you a snack or helping your get comfortable when nursing, these actions can help you to feel supported and in turn, help boost your self-efficacy (11,12).
Let's consider that marathon analogy again. Would you keep running if you had your closest friends and family there to cheer you on and help you reach the finish line? Again, research indicates we would.
- Breastfeeding self-efficacy is simply your belief that you can successfully breastfeed and it can impact if we breastfeed and for how long.
- There are things you can do to boost your self-efficacy like making the decision to breastfeed before baby arrives, taking a prenatal breastfeeding class, seeing others breastfeed and getting support from those closest to you.
- We believe in your ability to breastfeed and we're here for you to support you in reaching your goals. If you need a cheerleader to root for your success, reach out to us at firstname.lastname@example.org.
(1) American Academy of Pediatrics. (n.d.) Breastfeeding initiatives. Retrieved from http://www.aap.org/breastfeeding/.
(2) Bandura, A. (1997). Self-efficacy: The exercise of control. New York: W H Freeman/Times Books/ Henry Holt & Co.
(3) Dennis, C.L. (1999). Theoretical underpinning of breastfeeding confidence: a self-efficacy framework. J Hum Lact, 15(5), 195-201.
(4) McCarter-Spaulding, D. & Kearney, M. (2001). Parenting self-efficacy and perception of insufficient breastmilk. J Obstet Gynecol Neonatal Nurs, 30(5), 515-522.
(5) Scott et al. (1999). Factors associated with the duration of breastfeeding amongst women in Perth, Australia. Acta Paediatrica, 88, 421–426.
(6) Wilhelm, S. et al. (2008). Influence of intention and self-efficacy levels on duration of breastfeeding for midwest rural mothers. Applied Nursing Research, 21, 123-130.
(7) Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84, 191–215.
(8) Chezem, J. et al. (2003). Breastfeeding knowledge, breastfeeding confidence, and infant feeding plans: Effects on actual feeding practices. Journal of Obstetrics, Gynecology, and Neonatal Nursing, 32(1), 40–47.
(9) Brockway, M. et al. (2017). Interventions to improve breastfeeding self-efficacy and resultant breastfeeding rates: A systematic review and meta-analysis. Journal of Human Lactation, 33(3), 486-499.
(10) Yang, X. et al. (2016). Predictors of breast feeding self-efficacy in the immediate postpartum period: A cross-sectional study. Midwifery, 41, 1-8.
(11) Mannion, C.A. et al. (2013). Maternal perceptions of partner support during breastfeeding. International Breastfeeding Journal 8, 4.
(12) Abbass-Dick, J. et al. (2015). Coparenting breastfeeding support and exclusive breastfeeding: a randomized controlled trial. Pediatrics 135, 102–110.