Psychosocial Determinants of Exclusive Breastfeeding Intention in the Third Trimester: A Cross-Sectional Study from Türkiye

BACKGROUND: Prenatal intention to exclusively breastfeed is a proximal determinant of later infant-feeding behavior and may be shaped by breastfeeding self-efficacy, depressive symptoms, and perceived social support. MATERIALS AND METHODS: Baseline prenatal data were analyzed from 516 third-trimester pregnant women enrolled in an ongoing prospective cohort at a tertiary university hospital in Istanbul, Türkiye. Exclusive breastfeeding intention was measured with the Infant Feeding Intentions (IFI) scale. Breastfeeding self-efficacy and depressive symptoms were assessed with the Prenatal Breastfeeding Self-Efficacy Scale-Short Form (PBSES-SF) and Edinburgh Postnatal Depression Scale (EPDS), respectively. Social support was evaluated as aggregate spouse/partner or close-family support and further characterized by emotional, informational, and practical/domestic support indicators. RESULTS: Mean IFI, PBSES-SF, and EPDS scores were 13.12 ± 2.34, 32.23 ± 3.62, and 5.88 ± 2.05, respectively. Aggregate social support was reported by 495 participants (95.9%). Emotional, informational, and practical/domestic support were reported by 488 (94.6%), 446 (86.4%), and 465 (90.1%) participants, respectively, and were associated with higher IFI scores in bivariate analyses. In multivariable regression, PBSES-SF, EPDS, planned pregnancy, prior breastfeeding experience, and employment were independently associated with IFI; aggregate social support was not. The PBSES-SF × EPDS interaction was statistically significant. CONCLUSION: Exclusive breastfeeding intention was associated with breastfeeding self-efficacy, depressive symptoms, selected experiential factors, and functional support indicators. Integrated antenatal counseling should address breastfeeding confidence, maternal mental health, and the quality of support available during late pregnancy.