The Relationship Between Breastfeeding Self-Efficacy and Perceived Insufficient Milk Among Japanese Mothers


Keiko Otsuka, MD, MHSc, Department of International Community Health, University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.


Objective: To examine the relationship between maternal perceptions of insufficient milk and breastfeeding confidence using the Breastfeeding Self-Efficacy Scale.

Design: Cross-sectional study.

Participants: Two hundred and sixty-two in-hospital breastfeeding mothers in Japan.

Main Outcome Measure: Breastfeeding self-efficacy was measured in-hospital and perception of insufficient milk was measured at 4 weeks postpartum.

Results: Although most mothers intended to exclusively breastfeed, less than 40% were doing so at 4 weeks postpartum. Among the mothers using formula, 73% cited perceived insufficient milk as the primary reason for supplementation or completely discontinuing breastfeeding. Mothers' perception of insufficient milk at 4 weeks postpartum were significantly related to breastfeeding self-efficacy in hospital in the immediate postpartum period (r=.45, p<.001). Hierarchical multiple regression revealed that breastfeeding self-efficacy explained 21% of the variance in maternal perceptions of insufficient milk, and the contribution was independent of sociodemographic variables.

Conclusions: Enhancing breastfeeding self-efficacy in the immediate postpartum period may reduce maternal perceptions of insufficient milk and the premature discontinuation or supplementation of breastfeeding. Additional research is warranted.