Evaluating and predicting exclusive breastfeeding behaviour based on an energy vitality model during women’s lactation: a longitudinal study

Abstract Background Exclusive breastfeeding is the best nutritional choice for infants. However, the factors influencing exclusive breastfeeding behaviour are multifaceted. According to an energy and vitality model, identifying the factors that reduce or increase vitality and developing related stra...

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Main Authors: Yibo Gu, Yuxin Xiang, Xingtong Chen, Liuhua Wang, Chunjian Shan, Minghui Ji
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Pregnancy and Childbirth
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Online Access:https://doi.org/10.1186/s12884-025-07851-2
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author Yibo Gu
Yuxin Xiang
Xingtong Chen
Liuhua Wang
Chunjian Shan
Minghui Ji
author_facet Yibo Gu
Yuxin Xiang
Xingtong Chen
Liuhua Wang
Chunjian Shan
Minghui Ji
author_sort Yibo Gu
collection DOAJ
description Abstract Background Exclusive breastfeeding is the best nutritional choice for infants. However, the factors influencing exclusive breastfeeding behaviour are multifaceted. According to an energy and vitality model, identifying the factors that reduce or increase vitality and developing related strategies could improve exclusive breastfeeding behaviour. Our study aimed to clarify the related factors that affect exclusive breastfeeding behaviour and their impacts on the risk of exclusive breastfeeding termination, and further develop an effective nomogram to predict the risk of ceasing exclusive breastfeeding behaviour within 6 months. Methods A total of 570 women were recruited for this study at a baby-friendly hospital in Nanjing, China. A total of 529 women completed a 6-month follow-up and their sociodemographic characteristics, breastfeeding motivation scores, fertility motivation scores, mother’s child care stress scores, social support scores, and infant feeding data were collected. Three classical regression methods (Logistic, COX and Lasso regression) were used to identify significant predictors of exclusive breastfeeding. The nomogram was built on the basis of a multivariable COX regression model, and the performance was evaluated by rigorous testing. Results The average duration of exclusive breastfeeding was (4.08 ± 2.12) months. With the extension of exclusive breastfeeding, mother’s child care stress increases. Relative to not familiar with breastfeeding knowledge, familiarity with breastfeeding knowledge can reduce the risk of stopping exclusive breastfeeding at 6 months. Longer maternity leave duration, autonomous breastfeeding motivation, social support, and fertility motivation (nurturance) can improve the level of 6-month exclusive breastfeeding. Mother’s child care stress reduces the possibility of exclusive breastfeeding at 6 months. Support from the husband for breastfeeding, planned pregnancy, autonomous breastfeeding motivation, social support and fertility motivation (nurturance and positive exposure) can prolong the duration of exclusive breastfeeding. However, mothers with child care stress cannot sustain exclusive breastfeeding. The nomogram integrated and quantified the seven predictive factors (husband’s attitude towards breastfeeding, planned pregnancy, mother’s child care stress, positive exposure, nurturance, autonomous breastfeeding motivation, social support) into specific scores to predict the termination risk of exclusive breastfeeding within 6 months. The nomogram was robust and practical under the performance evaluation. Conclusions Women’s breastfeeding motivation, fertility motivation, the child care stress, and social support during lactation are factors that need attention to support exclusive breastfeeding. Moreover, an easy-to-use nomogram that predicts the termination risk of exclusive breastfeeding within 6 months was developed. This model could be an effective tool for professionals to develop precision exclusive breastfeeding intervention measures.
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spelling doaj-art-57d51bf48c5c4aaaa201bea5e62d88472025-08-20T03:06:28ZengBMCBMC Pregnancy and Childbirth1471-23932025-07-0125111710.1186/s12884-025-07851-2Evaluating and predicting exclusive breastfeeding behaviour based on an energy vitality model during women’s lactation: a longitudinal studyYibo Gu0Yuxin Xiang1Xingtong Chen2Liuhua Wang3Chunjian Shan4Minghui Ji5School of Nursing, Nanjing Medical UniversitySchool of Nursing, Nanjing Medical UniversitySchool of Nursing, Nanjing Medical UniversityNorthern Jiangsu People’s Hospital Affiliated with Yangzhou UniversitySchool of Nursing, Nanjing Medical UniversitySchool of Nursing, Nanjing Medical UniversityAbstract Background Exclusive breastfeeding is the best nutritional choice for infants. However, the factors influencing exclusive breastfeeding behaviour are multifaceted. According to an energy and vitality model, identifying the factors that reduce or increase vitality and developing related strategies could improve exclusive breastfeeding behaviour. Our study aimed to clarify the related factors that affect exclusive breastfeeding behaviour and their impacts on the risk of exclusive breastfeeding termination, and further develop an effective nomogram to predict the risk of ceasing exclusive breastfeeding behaviour within 6 months. Methods A total of 570 women were recruited for this study at a baby-friendly hospital in Nanjing, China. A total of 529 women completed a 6-month follow-up and their sociodemographic characteristics, breastfeeding motivation scores, fertility motivation scores, mother’s child care stress scores, social support scores, and infant feeding data were collected. Three classical regression methods (Logistic, COX and Lasso regression) were used to identify significant predictors of exclusive breastfeeding. The nomogram was built on the basis of a multivariable COX regression model, and the performance was evaluated by rigorous testing. Results The average duration of exclusive breastfeeding was (4.08 ± 2.12) months. With the extension of exclusive breastfeeding, mother’s child care stress increases. Relative to not familiar with breastfeeding knowledge, familiarity with breastfeeding knowledge can reduce the risk of stopping exclusive breastfeeding at 6 months. Longer maternity leave duration, autonomous breastfeeding motivation, social support, and fertility motivation (nurturance) can improve the level of 6-month exclusive breastfeeding. Mother’s child care stress reduces the possibility of exclusive breastfeeding at 6 months. Support from the husband for breastfeeding, planned pregnancy, autonomous breastfeeding motivation, social support and fertility motivation (nurturance and positive exposure) can prolong the duration of exclusive breastfeeding. However, mothers with child care stress cannot sustain exclusive breastfeeding. The nomogram integrated and quantified the seven predictive factors (husband’s attitude towards breastfeeding, planned pregnancy, mother’s child care stress, positive exposure, nurturance, autonomous breastfeeding motivation, social support) into specific scores to predict the termination risk of exclusive breastfeeding within 6 months. The nomogram was robust and practical under the performance evaluation. Conclusions Women’s breastfeeding motivation, fertility motivation, the child care stress, and social support during lactation are factors that need attention to support exclusive breastfeeding. Moreover, an easy-to-use nomogram that predicts the termination risk of exclusive breastfeeding within 6 months was developed. This model could be an effective tool for professionals to develop precision exclusive breastfeeding intervention measures.https://doi.org/10.1186/s12884-025-07851-2WomenExclusive breastfeedingInfluencing factorsPrediction
spellingShingle Yibo Gu
Yuxin Xiang
Xingtong Chen
Liuhua Wang
Chunjian Shan
Minghui Ji
Evaluating and predicting exclusive breastfeeding behaviour based on an energy vitality model during women’s lactation: a longitudinal study
BMC Pregnancy and Childbirth
Women
Exclusive breastfeeding
Influencing factors
Prediction
title Evaluating and predicting exclusive breastfeeding behaviour based on an energy vitality model during women’s lactation: a longitudinal study
title_full Evaluating and predicting exclusive breastfeeding behaviour based on an energy vitality model during women’s lactation: a longitudinal study
title_fullStr Evaluating and predicting exclusive breastfeeding behaviour based on an energy vitality model during women’s lactation: a longitudinal study
title_full_unstemmed Evaluating and predicting exclusive breastfeeding behaviour based on an energy vitality model during women’s lactation: a longitudinal study
title_short Evaluating and predicting exclusive breastfeeding behaviour based on an energy vitality model during women’s lactation: a longitudinal study
title_sort evaluating and predicting exclusive breastfeeding behaviour based on an energy vitality model during women s lactation a longitudinal study
topic Women
Exclusive breastfeeding
Influencing factors
Prediction
url https://doi.org/10.1186/s12884-025-07851-2
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