The possible mediating relationship promoted by the self-efficacy of breastfeeding associated with the Kangaroo Method on indicators of exclusive breastfeeding

“Breastfeeding at Night Is Awesome” Mothers’ Intentions of Continuation of Breastfeeding Extreme and Very Preterm Babies upon Discharge from a Kangaroo Mother Care Unit of a Tertiary Hospital in South Africa

“…South Africa has implemented kangaroo mother care (KMC) for more than two decades [ 1 ] as a care model to strengthen the family bond, encourage breastfeeding, and promote safe hospital discharge for preterm babies and their families [ 2 ]. KMC is an intervention aimed at improving outcomes among preterm and low-birth-weight new-borns.…”

“…The KMC method is a public health policy with several health benefits for the mother–child dyad. KMC is important for the promotion of EBF during the hospital stay and has been linked to an increase in breastfeeding (BF) rates and the duration of BF of preterm very low birth weight (VLBW) infants [ 2 , 5 ]. The World Health Organisation (WHO) classifies preterm infants based on gestational age as extremely preterm (<28 weeks), very preterm (born between 28 and 32 weeks), and moderate to late preterm (born between 32 and 37 weeks) [ 6 ].…”

“…In previous studies, it was established that preterm infants often have a delayed initiation of BF compared to full-term infants [ 13 , 14 ]. In addition to the physiological reasons, such as difficulty with latching, sucking, and swallowing due to their immaturity, separation of the mother from her VLBW infant contributes greatly to the delayed initiation of BF [ 2 , 6 , 14 , 15 ]. There is significant evidence that VLBW babies are at the highest risk of lower rates and a shorter duration of EBF than term infants [ 16 , 17 ].…”

“…In addition to a supportive environment in the KMC and at home, special efforts from the mother, her motivation, and belief in BF are essential for successful BF [ 6 , 19 , 28 ]. It is therefore evident that the mothers’ BF self-efficacy is key to the establishment and maintenance of BF in the short and long term [ 2 , 29 ]. BF self-efficacy encompasses the mother’s ability and confidence to successfully BF and has been identified as a protective factor against short BF duration [ 30 ].…”

“…Although data from previous studies emphasise that KMC is effective in increasing mothers’ initiation and maintenance of BF during the hospital stay [ 2 , 8 , 31 , 32 , 33 ], there is a dearth of this kind of research and data in South Africa. Furthermore, the focus of previous studies conducted elsewhere was on mothers’ experiences of BF VLBW infants during their stay in KMC or in a neonatal unit [ 34 ].…”