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Abstract

Background

Self-efficacy serves as a crucial predictor for successful breastfeeding. The standard practice in maternal wards is mother–baby rooming-in, which is believed to enhance breastfeeding rates post-delivery. However, in certain maternal wards, mother–baby separation continues to occur due to diverse factors.

Objectives

The objective of this study is to examine the self-efficacy levels of mothers in mother–infant separation wards and identify the factors that influence their self-efficacy.

Methods

A cross-sectional study was undertaken in 2022 at a hospital in Macau, involving 290 postpartum women in mother–infant separation wards. A self-designed questionnaire encompassing demographic details and breastfeeding information was utilized. Additionally, the Chinese version of the Breastfeeding Self-Efficacy Scale (BSES) and the Social Support Scale (SSRS) were employed. SPSS26.0 software was used to analyze the data. p < .05 indicated statistically significant differences.

Results

The average breastfeeding self-efficacy score among the women was 96.03 ± 23.07, which accounted for 64% of the total score. The factors influencing breastfeeding self-efficacy were ranked based on their impact power as follows: previous experience of breastfeeding, intended length of breastfeeding, employment status, and the number of breastfeeding sessions during hospitalization after childbirth (p < .05). These four factors collectively explained 34.7% (R2 = 0.347) of the variations in breastfeeding self-efficacy scores. A weak but positive correlation was observed between postpartum women's breastfeeding self-efficacy and social support for the mothers (r = .341, p < .001).

Conclusion

The breastfeeding self-efficacy scores of postpartum women were found to be at a moderate level. Mother–infant separation during the postpartum period has an impact on breastfeeding self-efficacy, but the impact can be managed. When developing programs to enhance postpartum mothers’ breastfeeding self-efficacy, it is important to consider their individual and social circumstances, as well as the advantages and disadvantages associated with mother–infant separation during the postpartum period.

Keywords

postpartum breastfeeding self-efficacy social support mother–infant separation

Introduction

The World Health Organization (WHO) has been advocating for rooming-in arrangements in maternal and newborn care since the 1990s. This approach ensures that healthy newborns stay with their mothers in recovery rooms, enabling constant contact between mothers and their babies. This implementation allows for the principle of feeding on demand, which has become a standard practice in postnatal care (Kong, 2023). While rooming-in arrangements prevail in maternal wards, there are certain circumstances where separate care for mothers and babies exists. Research has shown that postpartum separation of mothers and newborns allows for professional caregivers to attend to the babies, giving mothers the opportunity to recover more quickly without the responsibility of constant childcare (Wu & Zhang, 2023). It is evident that both rooming-in services and separate care cater to different needs.

Breast milk is widely acknowledged as the most natural and optimal source of nutrition for infants during their growth and development. It contains a comprehensive array of nutrients and protective substances that help prevent illnesses and enhance immune function. Additionally, breastfeeding contributes to the postnatal recovery of mothers and reduces their risk of developing breast cancer in the future. Recognizing these significant advantages, WHO and the American Academy of Pediatrics (AAP) consistently recommend exclusive breastfeeding for infants from birth up to 6 months of age (AAP, 2021; Liu, 2020). WHO has set a target that, by 2025, a minimum of 50% of mothers should practice exclusive breastfeeding for at least 6 months after giving birth (WHO, 2014). However, the rate of exclusive breastfeeding among mothers in Macau was reported at 13.38–20.2% 6 months postpartum between 2016 and 2022 (Social Welfare Bureau of MSAR Government, 2023). These figures indicate that the current rate of exclusive breastfeeding in Macau falls significantly below the target recommended by the WHO.

Self-efficacy refers to an individual's belief in their capacity to effectively navigate specific circumstances or successfully complete a designated task (Ahmadinezhad et al., 2024; Bandura, 1977). In the context of breastfeeding, self-efficacy is defined by a mother's confidence in her capacity to breastfeed successfully. Research indicates that the self-efficacy of breastfeeding is a significant factor influencing breastfeeding practices among postpartum women (Liu, 2020; Nilsson et al., 2020). Higher levels of self-efficacy are associated with increased willingness to breastfeed and a longer duration of breastfeeding (James et al., 2020; Sheng et al., 2019). To improve the rate of exclusive breastfeeding in the postpartum period, it is crucial for nurses in maternal wards to have an understanding of the breastfeeding self-efficacy of mothers and the factors that influence their self-efficacy. By identifying and addressing these factors, healthcare professionals can provide appropriate support and interventions to enhance mothers’ breastfeeding self-efficacy and promote successful breastfeeding outcomes.

Review of Literature

The self-efficacy of women is influenced by various factors, including age, level of education, health status, and knowledge about breastfeeding. For example, studies have shown that women who are older than 30 years, have a higher level of education and higher social status, and are more willing to breastfeed for a longer time (Ahmadinezhad et al., 2024; Liu, 2020; Zhu et al., 2023). Self-perceived lack of breast milk, lack of breastfeeding knowledge, and inadequate breastfeeding skills influence women's willingness to breastfeed. Those who have had successful experiences with breastfeeding are likely to breastfeed again (Ahmadinezhad et al., 2024; Song & Li, 2022; Yang & Li, 2021). Support from the local health system and national policies has a positive impact on women's willingness to breastfeed (Mercan & Tari Selcuk, 2021). It can be seen that the successful implementation and continuation of breastfeeding depends on the interaction of individual motherhood, the family, and the social environment and is characterized by its local characteristics (Dennis et al., 2024).

Studies have investigated the influence of the social support of the mothers on their breastfeeding self-efficacy and found that the mothers enjoying better social support were more willing to overcome the difficulties encountered with breastfeeding (Yang et al., 2023).

As a Special Administrative Region of the People's Republic of China, Macau has unique political, economic, and cultural characteristics. It is a micro but highly advanced economy. It is also the densest region in the world, with the highest number of populations per square meter. The local government has revised the paternity leave policy several times to offer mothers more time to feed and care for their newborns. Since 2022, civil servants in the public sector can enjoy 90 days of maternity leave, and employees in the private sector enjoy 70 days. Many workplaces and public institutions have breastfeeding rooms for mothers. Despite the increased support for breastfeeding postpartum from the government and the wide society in the past years, the rate of breastfeeding 6 months postpartum in Macau has been astonishingly low. In addition, as rooming-in is the prevalent form of postnatal care everywhere, previous studies on breastfeeding behavior have mostly focused on rooming-in and neglected the postpartum care in mother–baby separate wards.

Research Objectives

This study focuses on postpartum care in mother–baby separation wards to find out the self-efficacy levels of mothers in mother–infant separation wards and identify the factors that influence their self-efficacy.

Methods

Design

This study is a cross-sectional study using convenience sampling. Questionnaires were used to assess the breastfeeding self-efficacy levels of the mothers.

Research Setting

Macau, a Special Administrative Region of China, is a small modern city with a population of 700,000. There are two hospitals in Macau that offer maternity services. Under investigation is the larger one with a centuries-old history in the field of obstetrics. It is a private general hospital with 700 beds and caters to more than 50% of pregnant women in the local area. Due to the women's desire for adequate postnatal recovery and the insufficient space of the wards, the hospital has over a century separated the mother from the baby after delivery. Despite the separation arrangement, the hospital has endeavored to provide the best maternal care and encourage breastfeeding. Newborns are admitted to the neonatal unit after early mother-baby skin-to-skin contact in the delivery room, while the mother is cared for in the maternal ward. During hospitalization, the nursing staff in the maternal ward provide counseling to mothers, including breastfeeding skills. The mothers are encouraged to go to the lactation room for breastfeeding during the allocated time, five times a day, when nurses are present to support the mothers’ breastfeeding.

Participants

The hospital recorded a total of 2622 deliveries in 2021. As the study was to be conducted in the early half of 2022, the number of 2021 deliveries was used to calculate the sample size, which was to be 10% of the total population. Considering the response rate of 90%, the minimum sample size required for this study was set at (2622*10%)/90% = 292. Inclusion criteria were the following: (1) singleton pregnancy; (2) full-term delivery; (3) having breastfed three or more sessions during hospitalization. Exclusion criteria included either of the two: (1) severe postnatal complications; and (2) mental illness.

Instruments

The study was conducted using a questionnaire containing three parts. The first part contained 11 items of socio-demographic characteristics and information on the delivery of the study participants.

The second part was the Chinese version of the scale of Breastfeeding Self-Efficacy Scale (BSES) (Dai et al., 2004). The scale consists of two dimensions (skill aspects and mental activities), with a total of 30 items, and each item has a five-point score. The higher the score, the higher the self-efficacy. The Cranach's alpha coefficient of BSES was 0.93, and the split-half reliability coefficient was 0.91. The BSES has been translated into various languages, including Chinese and Spanish, and applied to diverse populations in different countries, demonstrating good reliability and validity across these groups (Aderibigbe et al., 2023; Creedy et al., 2003; Oliver-Roig et al., 2012).

The third part of the questionnaire was the modified version of the Social Support Scale (SSS)designed by Xiao (1994), with 10 items. The total score of SSS ranged from 12 to 66, with higher scores reflecting better social support. The retest reliability of SSS was 0.92, and the items’ Cronbach's alpha coefficient ranged from .89 to .94. The Social Support Assessment Scale has been utilized in various research fields for over 30 years (Jou & Fukada, 1995; Kong et al., 2013; Qi et al., 2020).

Data Collection

From January 1, 2022, to March 31, 2022, the researchers conducted the survey. Paper-based questionnaires were distributed on the day the postpartum women were scheduled for discharge. The primary researcher, a nurse in the postpartum ward, along with her colleagues, approached the mothers while they were still in their wards to explain the purpose of the survey. Clarifications were provided, and voluntary participation was emphasized. If the mothers expressed interest in the study, they were asked to sign a consent form. Completing the questionnaire took approximately 10 minutes. The researchers reviewed the completed questionnaires on-site, addressing any ambiguities immediately.

Statistical Analysis

The SPSS 26.0 statistical package was used to analyze the data. Breastfeeding self-efficacy level and social support status were analyzed with descriptive statistics, including maximum and minimum values, mean ± standard deviation, etc. T-tests and one-way ANOVA tests were used to compare the differences in self-efficacy levels among the mothers with different demographical and breastfeeding conditions. The correlation between breastfeeding self-efficacy and social support was analyzed using the Pearson correlation. Based on single-factor analytic results, a linear multifactor regression analysis was performed to further investigate the factors influencing breastfeeding self-efficacy. p < .05 indicates statistically significant.

Ethics Consideration

This study was approved by the ethics committee of the university and the hospital where the data were to be collected. Women who met the inclusion criteria in the maternal ward were invited to participate and they were told they had the right to withdraw halfway through if they wished. Their personal information would be processed anonymously to honor the principles of confidentiality and anonymity in research with human beings.

Results

A total of 294 questionnaires were sent out. All were collected, and four collected questionnaires were deemed ineffective, resulting in 290 valid questionnaires, reflecting a valid response rate of 98.6% (290/294).

Demographic Characteristics of the Mothers

About 63.8% (185) of the women were over 30 years old; 64.1% (186) held a college or higher level of degree; 71% (206) were working women; 45.9% (133) would have the maternity leave of 70–89 days after hospital discharge; 73.4% (213) with vaginal delivery; 51.4% (149) being primipara; 59.3% (172) had not attended breastfeeding class before delivery; and 10 of the multipara women were breastfeeding for the first time;48.6% (141) had performed 3–5 sessions of breastfeeding during current hospitalization; 55.9% (162) did not plan breastfeeding for 6 months postpartum.

Relationship Between Breastfeeding Self-Efficacy and Demographic Backgrounds of the Women

The mean score of mothers’ self-efficacy was 96.03 ± 23.07 (maximum 147, minimum 40), which accounted for 64% of the total score. The score for the skill dimension was 44.90 ± 12.06, and the score for mental activity was 51.13 ± 11.91.

Single Factor Analysis

The distribution of breastfeeding self-efficacy scores across demographic variables was checked before the statistical inferencing test. The descriptive histograms and normal Q–Q plots showed that the scores of self-efficacy were generally normally distributed in each group. The data were tested for normality using the Kolmogorov–Smirnov test, and the variance of the data in each group was uniform (p＞.05), which met the conditions of the parametric test. The results showed that there was a statistically significant effect (p < .05) on breastfeeding self-efficacy with the mothers’ employment status, number of deliveries, previous breastfeeding experience, duration of previous breastfeeding, number of breastfeeding sessions during current hospitalization, and planned length of breastfeeding postpartum, as shown in Table 1.

Table 1.

Results of Single Factor Analysis (N = 290).

Items	n	BSES( ± SD)	t/F	p
Age			F = 1.070	.344
≤30years old	105	94.51 ± 21.15
31–35 years old	140	95.74 ± 24.28
≥36years old	45	100.47 ± 23.47
Education			t = 0.482	.631
Tertiary/vocational school or below	104	95.12 ± 25.00
College or above	186	96.54 ± 21.97
Employment status			t = −2.337	.020*
Working women	206	94.02 ± 23.25
Housewife	84	100.95 ± 22.00
Maternity Leave(days)			F = 2.522	.082
No	89	100.11 ± 22.21
70–89	133	93.08 ± 23.37
≧90	68	96.47 ± 23.07
Mode of delivery			t = −1.692	.092
Vaginal delivery	213	94.66 ± 22.26		t
Cesarean section	77	99.00 ± 24.95
Obstetric History			t = −6.354	<.001**
Primipara	149	88.17 ± 20.48
Multipara	141	104.33 ± 22.81
Participation of prenatal breastfeeding lectures			t = 1.607	.109
Yes	118	98.65 ± 21.74
No	172	94.23 ± 23.84
Previous breastfeeding experience			t = 7.230	<.001**
Yes	131	105.98 ± 22.09
No	159	87.84 ± 20.56
Previous length of Breastfeeding			F = 49.462	<.001**
No history of breastfeeding	159	87.84 ± 20.56
≤6 months	56	93.27 ± 20.24
＞6 months	75	115.47 ± 18.41
Number of breastfeeding sessions during current hospitalization	F = 10.782	p＜.001**
3–5times	141	89.99 ± 24.46
6–10 times	106	100.35 ± 20.21
＞10 times	43	105.21 ± 19.76
Planned length of breastfeeding postpartum			t = −7.549	<.001**
≤6months	162	87.71 ± 22.31
＞6months	128	106.56 ± 19.50

Multifactor Analysis

Those variables that showed statistically significant self-efficacy in the single factor analysis were transformed into the multiple linear regression models as independent variables, maternal breastfeeding self-efficacy was used as the dependent variable (Table 2), and the regression analyses were performed using the global optimal method. According to the standardized bias regression coefficient beta, the order of the effect power of breastfeeding self-efficacy was listed as previous breastfeeding experience, the planned length of breastfeeding postpartum, employment status, and the number of breastfeeding sessions during the current hospitalization (p < .05) (Table 3). These four influences had an effect size of 34.7% (R2 = 0.347) on the total breastfeeding self-efficacy score (Table 3). Those women who had breastfed more than 6 months in the past, who intend to breastfeed more than 6 months postpartum, who were housewives, or who had more breastfeeding sessions during current hospitalization, demonstrated a higher level of self-efficacy.

Table 2.

Independent Variable and Dummy Variable Assignment.

Independent variables	Dummy variable
Employment status	Working women＝0; housewife＝1
Mode of delivery	Vaginal delivery＝0; caesarean section＝1
Obstetric history	Primipara＝0; multipara＝1
Previous length of breastfeeding	No history of breastfeeding =(0,0,0)
	≤6 months＝(0,1,0)
	＞6 months＝(0,0,1)
Number of breastfeeding sessions during current hospitalization	3–5 times = (0,0,0)
	5–10times＝(0,1,0)
	>10times＝(0,0,1)
Planned length of breastfeeding postpartum	≤6 months＝0; >6 months＝1

Table 3.

Result of Multifactorial Regression Analysis (N = 290).

Independent variables	B	Beta	t	p	R ²
Employment status (working women)	7.280	0.143	2.898	.004*	.347
Mode of delivery (vaginal delivery)	3.328	0.640	1.272	.205
Obstetric history (primipara)	−2.814	−0.061	−0.449	.653
Previous length of breastfeeding (no history of breastfeeding)
≤6 months of breastfeeding experience	7.556	0.129	1.153	.250
＞6 months of breastfeeding experience	24.373	0.463	3.667	.001**
Number of breastfeeding sessions during current hospitalization (3–5 times)
5–10 times	6.251	0.131	2.488	.013*
>10 times	7.293	0.113	2.076	.039*
Planned length of breastfeeding postpartum (≤6 months)	8.089	0.174	3.045	.003*

*p<.05, **p<.001.

Maternal Social Support Level and Correlation With Breastfeeding Self-Efficacy

The score for maternal social support was 41.30 ± 6.61 (maximum 59, minimum 25), which accounted for 62.6% of the total score (Table 4). Husbands and parents were the most important sources of social support. Breastfeeding self-efficacy correlated positively but weakly with social support (r = .341, p < .001).

Table 4.

Maternity Social Support Score (N = 290).

Categories	Number of items	Maximum	Minimum	Score (x±SD)
Objective support	3	12	1	10.90 ± 2.88
Subjective support	4	32	12	22.79 ± 4.13
Utilization of support	3	12	3	7.61 ± 1.74
Totality	10	59	25	41.30 ± 6.61

Discussion

Current Status of Breastfeeding Self-Efficacy Among Mothers

The self-efficacy level of breastfeeding of the study participants is moderate, lower than that reported in some studies with postpartum mothers from mainland China and other regions. For example, Zhu et al. (2022) reported that a group of mothers in China achieved 72% of the total score in self-efficacy measurement; Chen et al. (2022) also reported 74% of the total score of self-efficacy in another group of mothers in Shanghai, China. Al-Thubaity et al. (2023) reported a group of mothers in Saudi Arabia achieving 93% of the full score of breastfeeding self-efficacy. The lower level of breastfeeding self-efficacy among the mothers in Macau may have been attributed to the demographic features of the participant mothers. Compared to the mother participants in other studies (Gümüşsoy et al., 2020; Monteiro et al., 2020), the mothers in our study are older, more educated, and most of them are employed. Further discussion will be provided in the following discussions on how these futures may have contributed to lower levels of breastfeeding self-efficiency.

Influences on Breastfeeding Self-Efficacy

This study found that the number of breastfeeding sessions during the current hospital stay and the planned length of breastfeeding after birth were the most important factors influencing women's breastfeeding self-efficacy. This study also found that breastfeeding self-efficacy was higher in those who had already experienced breastfeeding, which is consistent with the findings of other studies (Wang et al., 2021). Previous successful feeding experiences can enhance the mother's confidence in future breastfeeding. However, not many mothers had previous breastfeeding experience, which relates to the low birth rate in Macau. Like other developed economies in East Asia, Macau is struggling with a low birth rate among reproductive-aged women. The birth rate in Macau has declined in recent years (Social Welfare Bureau of MSAR Government, 2024).

Although over 60% of the mothers in the study were older than 30 years, over half of the mothers were primipara, illustrating a possible phenomenon of late marriage and late birth in Macau. Our study also found that working women had lower breastfeeding self-efficacy levels compared to housewives and up to 71%participants were employed. Further, almost 60% of the mothers had not attended a breastfeeding lecture. All these would have contributed to the low level of breastfeeding self-efficacy.

This study also found that the number of breastfeeding sessions during current hospitalization influenced women's breastfeeding self-efficacy. However, nearly 50% of the women in this study did not breastfeed more than five times during their hospitalization, which may be due to the constraints caused by the mother–baby separation postpartum care arrangement. However, this assumption is plausible. In Macau, a normal delivery usually stays in the hospital for 48 hours and a woman after a cesarean section usually stays for 5 days. The mother–baby separation wards provide feeding opportunities for the mothers every 3 hours during the daytime, so mothers can have five feeding opportunities a day. If the mothers make the most use of the feeding opportunities, they will have at least 10 sessions of breastfeeding. Other studies have shown that mothers’ concern about their own lack of milk is a major obstacle to breastfeeding (Thorpe et al., 2020; Yan, 2021; Yu, 2021).On the other hand, high quality of sleep can increase the breast milk produced by postpartum women (Ahmadinezhad et al., 2024; Yang et al., 2023; Zulkarnaini et al., 2023). The main advantage of mother–baby separation is that it allows the mother to rest better compared to room-in wards. Therefore, obstetric nurses should advise the mothers to take advantage of the mother–baby separation arrangements to maintain good rest, while at the same time using the feeding opportunities offered by the wards to feed their newborns so that breast milk can be increased by the mother–baby intimate touching and feeding.

Maternity Social Support and Its Relationship With Breastfeeding Self-Efficacy

The total score of social support among the mother participants is at the modern level of the total score, which is slightly lower than the scores reported in some studies in mainland China and other places (Maleki-Saghooni et al., 2020). For example, Zhu et al. (2023), reported a group of mothers in Suzhou China achieved 67% of the total score in Social Support measurement; Mercan and Tari Selcuk (2021) reported a group of mothers in Turkey achieved 75.9% of the full score of social support. This study also found that breastfeeding self-efficacy is weakly positively correlated with social support, confirming other studies on the positive correlation between social support and self-efficacy (Chen et al., 2022; Maleki-Saghooni et al., 2020).

Macau is a small and densely populated city, where residents live in close proximity to each other, and family members can visit each other frequently. On the other hand, Macau is a highly developed economy with a small family structure and local residents’ private space. The average number of members per household in Macau was 2.89 in 2022 (Statistics and Census Service[DSEC], 2023). The density of high-rise buildings has led to a decrease in face-to-face contact among neighbors and extended family members. What's more, Macaunese enjoys better social welfare than people in most parts of the world, and Macaunese can apply for economic or care support from the government in case of difficulties, which reduces the need for support from family members. Such a complicated political, economic, and cultural context leads to the particular phenomenon of low personal social support despite the proximity of family and friends and reflects the positive correlation between social support and low breastfeeding self-efficacy in postpartum women. Husbands and parents are the most important supporters and caregivers for postpartum women, a phenomenon reported by numerous studies (Hu & Pan, 2022; Page et al., 2022; Xiong et al., 2021). Therefore, it is necessary to develop family-centered training and support and involve husbands and parents in health promotion for breastfeeding (Ahmadinezhad et al., 2024; Koksal et al., 2022; Salehian & Karimi, 2022; Yang & Li, 2021).

Implication of Practice

The most important factor for continued breastfeeding is maternal self-confidence (James et al., 2020). At the same time, social support is positively related to breastfeeding self-efficacy. Good social support can improve breastfeeding self-efficacy. Among them, family Support is the most important. Although there are a large number of studies at home and abroad that explore the influencing factors of breastfeeding self-efficacy and social support, different regions have different social cultures, environments, and humanistic characteristics. Reviewing the literature in Macao, there is currently no relevant research. Therefore, through this study, we will understand the breastfeeding self-efficacy and social support of mothers currently giving birth in a hospital in Macao, and analyze the influencing factors of breastfeeding self-efficacy and the current situation of social support so that clinical nurses can evaluate different mothers with sociological characteristics, targeted health education and nursing intervention should be carried out to strengthen maternal social support, to improve maternal breastfeeding self-efficacy, thereby extending the duration of maternal breastfeeding.

Limitations

This study has been conducted with the women in the maternal wards in only one hospital in Macau, so the findings of the study may not be generalized to the women in other regions and organizations. Furthermore, the study was a cross-sectional survey, which did not allow for continuous tracking and follow-up of dynamic changes in women's breastfeeding self-efficacy in long-term postpartum. In the future, the sample size of the study can be more representative by using more rigorous sampling methods such as probability sampling to invite all the women who give birth in all hospitals in Macau. Alternatively, longitudinal design or qualitative research can be devised to complement the findings in this study in the future.

Conclusion

This study depicted the various factors that influence breastfeeding self-efficacy in postpartum women in the mother–baby separation wards, with previous breastfeeding experience as the greatest influence. Other significant factors include the number of breastfeeding sessions during current hospitalization and the planned length of breastfeeding postpartum. The explanation of the influence of these factors needs to be linked to local specific political, economic, cultural, and geographical characteristics. Accordingly, measures to improve breastfeeding among postpartum women need to be aligned with the individual and social contexts in the local area. The most important feature of this study lies with the study population, who are the women from mother–baby separation wards. The study found that although the separation has a negative impact on women's breastfeeding self-efficacy to a certain extent, this impact can be manageable. Nurses in the maternal and infant wards should advise the mothers to take full advantage of mother–baby separation care and improve mothers’ breastfeeding self-efficacy, thus increasing continuous breastfeeding postpartum.

Supplemental Material

sj-docx-1-son-10.1177_23779608241298680 - Supplemental material for A Survey Study on the Factors Affecting Breastfeeding Self-Efficacy Among Postpartum Women in Mother–Infant Separation Wards

Supplemental material, sj-docx-1-son-10.1177_23779608241298680 for A Survey Study on the Factors Affecting Breastfeeding Self-Efficacy Among Postpartum Women in Mother–Infant Separation Wards by Cheng Cheng Si and Aimei Mao in SAGE Open Nursing

Supplemental Material

sj-docx-2-son-10.1177_23779608241298680 - Supplemental material for A Survey Study on the Factors Affecting Breastfeeding Self-Efficacy Among Postpartum Women in Mother–Infant Separation Wards

Supplemental material, sj-docx-2-son-10.1177_23779608241298680 for A Survey Study on the Factors Affecting Breastfeeding Self-Efficacy Among Postpartum Women in Mother–Infant Separation Wards by Cheng Cheng Si and Aimei Mao in SAGE Open Nursing

Footnotes

Acknowledgments

The authors would like to thank the participants who joined in the study in order to provide data for this study. In addition, the authors would like to thank Kiang Wu Hospital in Macau for supporting this study.

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethical Committee

The researchers gained ethics approval from the research committees of Kiang Wu Hospital. A written consent form was obtained from participants before they filled the questionnaires.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Cheng Cheng Si

Supplemental Material

Supplemental material for this article is available online.

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