Iran Journal of Nursing

Background & Aims: World Health Organization (WHO) greatly recommends exclusive breastfeeding as the perfect nutrition for infant feeding. Breastfeeding is associated with short -term and long- term advantages for maternal and child health. Short term advantages in children include reduction of diarrhea and pneumonia. And the long- term advantages of breastfeeding include reduced risk of obesity and chronic diseases such as type I & II diabetes, hypertension, heart diseases, and hyperlipidemia in adulthood and improved cognitive functions. Breastfeeding advantages for mothers include more mother–infant bonding and reduced risk of breast cancer, ovarian cancer, and type II diabetes. Many studies have documented the relationship between healthy behaviors and personality traits, so it seems that breastfeeding is related to such traits. So, this study aimed to investigate predicting exclusive breastfeeding based on maternal personality traits.
Material & Methods: A descriptive-predictive study was used to achieve the research purpose. The study followed random cluster sampling method. For this purpose, first Valfajr and Enghelab Centers were selected as clusters, and three comprehensive health care centers were selected randomly from these clusters. Finally, 120 eligible mothers referring to 6 comprehensive health centers of Shiraz participated in this study.  In order to determine the sample size, the rule of sixty in the structural equation prediction model was employed. According to this law, 10 samples were selected for each parameter. Data were collected between May to December 2019. The inclusion criteria were willingness to participate in the study, Iranian mothers with an infant aged 6-12 months and the experience of exclusive breastfeeding, singleton pregnancy, lack of any breast disorders, normal vaginal delivery, not using any lactation-inducing medications, not having any medical complications, not having been hospitalized for any reasons, not using any psychiatric medications during the breastfeeding period, and term pregnancy. The exclusion criteria were incomplete questionnaires. Data were gathered using a demographic questionnaire which included items relating to maternal and child age, education level of couples, income, occupation, breastfeeding education during pregnancy and after childbirth, emotional support during the breastfeeding period on the part of the husband or family, and delivery type. The other instruments included Exclusive Breastfeeding Scale with 23 items on attitude, abstract norms, perceived behavior control, and behavioral intention; and the shortened scale of Big Five Factors (BFF) about Personality Traits which included 21 items relating to extraversion, neuroticism, openness to experience, task-orientation, and agreeableness. The researcher selected the samples who met inclusion criteria; and then, she introduced herself to them and explained the research objectives. The participants were also ensured about the confidentiality of the data. A written consent form was obtained from anyone who agreed to participate in the study. Afterwards, the questionnaires were completed in the presence of the researchers. Descriptive statistical methods (mean, standard deviation, and Pearson correlation coefficient) were used to analyze the data. In order to predict exclusive breastfeeding based on personality traits, multiple linear regression through Enter method was used in SPSS 16. Before the multiple regression analysis, the presumption of multicollinearity and normality effects of the data were evaluated, which indicated the normal distribution of the variables and there were no outliers in data. The variance inflation factor (VIF) index was accounted to be less than 1.5. The P -value was set at 0.5 for all tests.
Results: The participants aged 17-45 years ((M = 31.04, SD = 5.12).  The infants aged 6-12 months (M = 9.56, SD = 2.41). In this study 88.3% of the participants were housewives. Almost half of them had a Bachelor’s degree and above (48.3%) and their spouses had diplomas (45.8%). The majority of the participants (91.7%) were emotionally supported and encouraged to breastfeed by their spouses and 95% by their families. Also, the majority of subjects (89.2%) received breastfeeding training during pregnancy and 95.8% of them received the training during the postpartum period. The table of mean scores of personality traits showed that individuals with agreeableness showed the highest mean score (16.13, SD =2.16) and individuals with neuroticism characteristics showed the lowest mean score (12.13, SD =2.68). The results of the Pearson correlation coefficient showed that among the personality traits, the extraversion component had a meaningfully positive relationship with exclusive breastfeeding (r =. / 36, p=0.024). The results of linear multiple regression analysis showed that the predictor variables were the extraversion (P=0.0001, β = 0.43) and task- orientation (P=0.048, β = 0.18). These variables explained 21% of total variance. All other variables were not meaningful.
Conclusion: It can be concluded that extraversion and task- orientation predicted exclusive breastfeeding positively. Given that personality traits are relatively stable, the relationship between extraversion and task- orientation with exclusive breastfeeding has beneficial outcomes for maternal and child health. Positive emotion is one of the features of extravert people and competency is the feature of task- oriented people. If it is possible to provide situations for mothers to experience more positive excitement or to feel more adequacy and competence, breastfeeding quality will be improved. For this purpose, it is necessary to teach the discipline in breastfeeding, tell the mothers to have a happy life, and tell them about mother- infant intimacy. It is hoped that presenting the results of this study to health care providers leads to more encouragement and support for women in the field of exclusive breastfeeding and the provision of safe breastfeeding counseling in health centers. One of the limitations of the present study was inadequate access to eligible mothers participating in the study due to the restricted time of the researcher in collecting data and reduced mother’ desire to exclusive breastfeeding, which can be effective in the lack of significant relationship between other components of personality traits and exclusive breastfeeding. The strength of this study was that it was one of the few studies conducted in Iran which investigated the relationship between two essential and vital variables, i.e. personality traits and exclusive breastfeeding in analyzing the mother and infants' health. Future researches should examine the role of mediator variables in the relationship between these personality traits and exclusive breastfeeding and effect of socio-cultural and economic factors on exclusive breastfeeding. Finally, designing qualitative study to determine other barriers to exclusive breastfeeding is recommended.