Breastfeeding Self-efficacy and Determinants among Mothers with and without COVID-19 during Childbirth An Ambidirectional Cohort Study

Background: Breastfeeding self-efficacy (BSE) refers to a mother's confidence in her ability to breastfeed her baby and it is a key factor during breastfeeding. The current study aimed to investigate the relationship between BSE and its related factors with the history of COVID-19 during childbirth in breastfeeding mothers.Methods: The present ambidirectional cohort study was conducted on 60 breastfeeding mothers who were divided into two study and control groups. Participants were selected randomly from referrals to Shahid Sadoughi Hospital, Yazd, Iran. To collect data, a BSE questionnaire a checklist consisting of midwifery-demographic and baseline characteristics were completed through interviews. Chi-square test, t-test, univariate binary, and multivariable logistic regression were applied for analysis. P value less than 0.05 was considered statistically significant.Results: Although the study and control groups were homogeneous in terms of baseline characteristics, they differed significantly in terms of delivery type of, NICU admission, and skin contact as midwifery-demographic factors (P<0.01). Breastfeeding self-efficacy mean score (BSES) in the control and study groups were 52.33 and 39.56, respectively, showing a significant difference between the two groups (P<0.01). According to univariate binary logistic regression analysis, type of delivery, NICU admission, and COVID-19 were significantly related to poor BSE (P<0.05). Based on multivariable logistic regression analysis, a positive test result for COVID-19 during childbirth was the only statistically significant predictor of BSES (P=0.02).Conclusion: In the present study, the positive test result for COVID-19 was the only significant predictor of BSE during childbirth.