Document Type : Original Article


Department of Midwifery and Reproductive Health, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran


BACKGROUND: Breastfeeding is beneficial for the health of infants and mothers. It is a complex
social behavior that may be influenced by social support. The study aimed to determine the relationship
between perceived social support of breastfeeding women and their breastfeeding patterns.
MATERIALS AND METHODS: The research was a cross‑sectional study on 300 mothers with
6‑month infants or younger who were selected randomly. The data collection tool consisted standard
social support and breastfeeding patterns questionnaires. We analyzed data using descriptive and
analytical tests and SPSS 18 at a significance level of < 0.05.
RESULTS: The results indicated that 85%, 82.2%, and 38% of the infants were exclusively
breastfed at 1 week, 4, and 6 months after delivery, respectively. The result of post hoc LSD test
indicated that the mean number of supporters for mothers, who were in the 6th month of delivery,
was significantly lower than other times (P = 0.001). The one‑way analysis of variance indicated
no significant difference between perceived satisfaction of social support at different periods after
delivery (P = 0.92). Despite the present results, which indicated that the number of supporters and
scores of satisfaction with support in exclusive breastfeeding were higher than other groups, the
differences were not statistically significant.
CONCLUSIONS: The mean number of supporters was less in women, who had 6‑month‑old infants,
than mothers who had just given birth. It seems mothers with supplements and formula feeding
patterns, such as breastfeeding mothers, may be supported to use these methods. Therefore, more
studies are suggested on this field.


1. Horta BL, Loret de Mola C, Victora CG. Long‑term consequences
of breastfeeding on cholesterol, obesity, systolic blood pressure
and type 2 diabetes: A systematic review and meta‑analysis. Acta
Paediatr 2015;104:30‑7.
2. Victora CG, Horta BL, Loret de Mola C, Quevedo L, Pinheiro RT,
Gigante DP, et al. Association between breastfeeding and
intelligence, educational attainment, and income at 30 years of
age: A prospective birth cohort study from Brazil. Lancet Glob
Health 2015;3:e199‑205.
3. Gunderson EP, Lewis CE, Lin Y, Sorel M, Gross M, Sidney S, et al.
Lactation duration and progression to diabetes in women across
the childbearing years: The 30‑year CARDIA study. JAMA Intern
Med 2018;178:328‑37.
4. Borra C, Iacovou M, Sevilla A. New evidence on breastfeeding
and postpartum depression: The importance of understanding
women’s intentions. Matern Child Health J 2015;19:897‑907.
5. Figueiredo B, Canário C, Field T. Breastfeeding is negatively
affected by prenatal depression and reduces postpartum
depression. Psychol Med 2014;44:927‑36.
6. Section on Breastfeeding. Breastfeeding and the use of human
milk. Pediatrics 2012;129:827‑41.
7. World Health Organization. Health Topics: Breastfeeding. Geneva,
Switzerland: WHO; 2018. Available from:
/topics/breastfeeding/en/. [Last accessed on 2018
Mar 26].
8. UNICEF and Global Databases; 2018. Available from:‑and‑youngchild‑feeding/. [Last accessedon 2019 Apr 14].
9. Esfahani MS, Fathizadeh N. Continuous exclusive breastfeeding
and some related factors in the selected hospitals of Isfahan. Iran
J Nurs Midwifery Res 2011;16:207‑11.
10. Olang B, Farivar K, Heidarzadeh A, Strandvik B, Yngve A.
Breastfeeding in Iran: Prevalence, duration and current
recommendations. Int Breastfeed J 2009;4:8.
11. Kelishadi R, Rashidian A, Jari M, Khosravi A, Khabiri R, Elahi E,
et al. national survey on the pattern of breastfeeding in Iranian
infants: The IrMIDHS study. Med J Islam Repub Iran 2016;30:425.
12. Bernard JY, Cohen E, Kramer MS. Breast feeding initiation rate
across Western countries: Does religion matter? An ecological
study. BMJ Glob Health 2016;1:e000151.
13. Kornides M, Kitsantas P. Evaluation of breastfeeding promotion,
support, and knowledge of benefits on breastfeeding outcomes.
J Child Health Care 2013;17:264‑73.
14. Hauck YL, Dimmock JE. Evaluation of an information booklet on
breastfeeding duration: a clinical trial. J Adv Nurs 1994;20:836‑43.
15. Tarkka MT, Paunonen M, Laippala P. Factors related to successful
breast feeding by first-time mothers when the child is 3 months
old. J Adv Nurs 1999;29:113‑8.
16. Berkman LF, Glass T, Brissette I, Seeman TE. From social integration to health: Durkheim in the new millennium. Soc Sci
Med 2000;51:843‑57.
17. Elsenbruch S, Benson S, Rücke M, Rose M, Dudenhausen J,
Pincus‑Knackstedt MK, et al. Social support during pregnancy:
Effects on maternal depressive symptoms, smoking and
pregnancy outcome. Hum Reprod 2007;22:869‑77.
18. Da Costa D, Dritsa M, Larouche J, Brender W. Psychosocial
predictors of labor/delivery complications and infant birth
weight: A prospective multivariate study. J Psychosom Obstet
Gynaecol 2000;21:137‑48.
19. Feldman PJ, Dunkel‑Schetter C, Sandman CA, Wadhwa PD.
Maternal social support predicts birth weight and fetal growth
in human pregnancy. Psychosom Med 2000;62:715‑25.
20. Collins NL, Dunkel-Schetter C, Lobel M, Scrimshaw SC. Social
support in pregnancy: psychosocial correlates of birth outcomes
and postpartum depression. Journal of Personality and Social
Psychology 1993;65(6):1243
21. Hodnett ED, Fredericks S. Support during pregnancy for women
at increased risk of low birthweight babies. Cochrane Database
Syst Rev 2003:CD000198.
22. Suarez L, Cardarelli K, Hendricks K. Maternal stress, social
support, and risk of neural tube defects among Mexican
Americans. Epidemiology 2003;14:612‑6.
23. Asiodu IV, Waters CM, Dailey DE, Lyndon A. Infant feeding
decision‑making and the influences of social support persons
among first‑time African American mothers. Matern Child Health J
24. Boccolini CS, Carvalho ML, Oliveira MI. Factors associated with
exclusive breastfeeding in the first six months of life in Brazil:
A systematic review. Rev Saude Publica 2015;49:91.
25. Jalal M, Dolatian M, Mahmoodi Z, Aliyari R. The relationship
between psychological factors and maternal social support to
breastfeeding process. Electron Physician 2017;9:3561‑9.
26. Elahidoust S, Rabbani A, Shams B. Women, motherhood and
lactation. Res J Women 2013;4:1‑38.
27. Salarkia N, Amini M, Abdollahi M, Eshrati B. Socio‑economic and
cultural factors affecting child feeding practices: An exploratory
qualitative study in Damavand. Iran J Nutr Sci Food Technol
28. Ford ME, Tilley BC, McDonald PE. Social support among
African‑American adults with diabetes. Part1: Theoretical framework.
J Natl Med Assoc 1998;90:361‑5.
29. Sarason IG, Levine HM, Basham RB, Sarason BR. Assessing social
support: The social support questionnaire. J Pers Soc Psychol
30. Nasseh M, Ghazinour M, Joghataei M, Nojomi M, Richter J.
A Persian version of the social support questionnaire (SSQ). Soc
Welf Q 2011;11:251‑66.
31. Lauria L, Spinelli A, Grandolfo M. Prevalence of breastfeeding in
Italy: A population based follow‑up study. Ann Ist Super Sanita
32. Cooke M, Sheehan A, Schmied V. A description of the relationship
between breastfeeding experiences, breastfeeding satisfaction,
and weaning in the first 3 months after birth. J Hum Lact
33. Lanting CI, Van Wouwe JP, Reijneveld SA. Infant milk feeding
practices in the Netherlands and associated factors. Acta Paediatr
34. Zareai M, O’Brien ML, Fallon AB. Creating a breastfeeding
culture: A comparison of breastfeeding practises in Australia and
Iran. Breastfeed Rev 2007;15:15‑20.
35. Semenic S, Loiselle C, Gottlieb L. Predictors of the duration of
exclusive breastfeeding among first-time mothers. Res Nurs
Health 2008;31:428‑41.
36. Joshi A, Amadi C, Meza J, Aguire T, Wilhelm S. Evaluation of a
computer‑based bilingual breastfeeding educational program on
breastfeeding knowledge, self‑efficacy and intent to breastfeed
among rural Hispanic women. Int J Med Inform 2016;91:10‑9.
37. Marshall JL, Godfrey M, Renfrew MJ. Being a ‘good mother’:
Managing breastfeeding and merging identities. Soc Sci Med
38. Tracey L. Cultural Influences on Irish Attitudes towards Infant
Feeding.[dissertation]. [Dublin]: department of psychology (DBS
School of arts); 2012 .53p.
39. Cinar N, Köse D, Altinkaynak S. The relationship between
maternal attachment, perceived social support and breast‑feeding
sufficiency. J Coll Physicians Surg Pak 2015;25:271‑5.
40. Meedya S, Fahy K, Kable A. Factors that positively influence
breastfeeding duration to 6 months: A literature review. Women
Birth 2010;23:135‑45.
41. Leahy‑Warren P, McCarthy G, Corcoran P. First‑time mothers:
social support, maternal parental self‑efficacy and postnatal
depression. J Clin Nurs 2012;21:388‑97.
42. Hawley NL, Rosen RK, Strait EA, Raffucci G, Holmdahl I,
Freeman JR, et al. Mothers’ attitudes and beliefs about infant
feeding highlight barriers to exclusive breastfeeding in American
Samoa. Women Birth 2015;28:e80‑6.
43. Susin LR, Giugliani ER, Kummer SC. Influence of grandmothers
on breastfeeding practices. Rev Saude Publica 2005;39:141‑7.
44. World Health Organization. Global nutrition targets 2025: Policy
brief series. World Health Organization; 2014