A Theory of Planned Behavior-Based Structural Model for Breast-Feeding

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Abstract
Breast-feeding is the recommended method of infant feeding because it is clearly associated with health benefits for infants and their mothers. Yet, many women who initiate breast-feeding fail to meet their own personal goals or recommended standards for duration of breast-feeding. To refine a Theory of Planned Behavior (TPB)-based structural model for explaining variability in breast-feeding intention and duration. The study design was prospective, multicorrelational, and longitudinal. Out of the total sample of 635 women, 602 mothers of healthy, full-term infants provided complete datasets over the entire course of their breast-feeding experience and these datasets were used in the modeling analyses. Simultaneous multisample analysis of covariance structures was used to develop the model. The resulting TPB for Breast-Feeding (TPB-BrF) describes the rational, motivational processes of the original TPB, but reconfigures the relationships among them, for homemakers (TPB-BrF/H), women employed half-time or less (TPB-BrF/EL), and women employed more than half-time (TPB-BrF/EM). Mothers' early postpartum ratings of adequacy of milk supply and stimulus conditions of maternal education and breast-feeding knowledge were included in the TPB-BrF to better explain breast-feeding outcomes. Model complexity increased with employment effort. The TPB-BrF is a comprehensive, theoretically based, empirically verified model that can serve as a useful heuristic for understanding the personal motivational components of breast-feeding behavior.