Understanding the psychosocial dilemma in breastfeeding: a narrative review of extended theory of planned behavior and its intervention strategies

Abstract

Abstract Background Breastfeeding provides health benefits for both mothers and children. However, most families face challenges in initiating and maintaining breastfeeding owing to psychosocial factors. Despite the importance of these factors and their practical implications, comprehensive review research based on a robust theory in this area is lacking. This narrative review addresses this research gap by exploring the utility of the extended theory of planned behavior (ETPB) in understanding and promoting breastfeeding. Methods A systematic search was conducted using the relevant Web of Science, Scopus, EBSCO, PubMed, and PsycINFO; 22 studies published between January 2000 and March 2023 were identified. Results These included studies understanding the psychosocial factors of breastfeeding by introducing the ETPB framework, incorporating psychosocial factors such as affective attitude, instrumental attitude, injunctive norms, descriptive norms, perceived behavioral control, breastfeeding self-efficacy, moral norms, breastfeeding knowledge, and breastfeeding self-identity. Based on these factors, intervention strategies for breastfeeding enhancement were categorized into professional breastfeeding education, interpersonal social support, and personalized breastfeeding services. Conclusions The 22 breastfeeding studies related to the ETPB model demonstrate its effectiveness in explaining the psychosocial factors influencing breastfeeding intention and duration. The model’s application in intervention studies suggests that more diverse and proactive approaches are required to empower mothers. Future research should address societal context and cultural influences and expand interventions beyond essential information provision.

Keywords

• Breastfeeding
• Extended theory of planned behavior
• Psychosocial factors
• Intervention strategies