Relationship and Determinants of Breastfeeding Self-Efficacy Among Postpartum Mothers and Fathers in Malawi: A Cross-Sectional Study

Background: Breastfeeding self-efficacy among both mothers and fathers is critical in enhancing exclusive breastfeeding rates. However, the interrelationship between maternal and paternal breastfeeding self-efficacy and their determinants remains unknown.Research Aims: We aimed to (a) investigate the relationship between breastfeeding self-efficacy scores postpartum for mothers and fathers; (b) explore factors associated with breastfeeding self-efficacy in this group; and (c) examine determinants of combined self-efficacy scores among breastfeeding parents in Malawi.Methods: We conducted a cross-sectional study on postpartum mother-father couples at a tertiary maternity facility in central Malawi. Breastfeeding self-efficacy was measured using the Breastfeeding Self-Efficacy Scale Short-Form. Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale. A structured questionnaire was used to collect demographic and health variables. Data were analyzed using multivariable logistic regression and multinomial logistic regression.Results: Mothers demonstrated a higher score of self-efficacy (M = 55.7, SD = 6.5) in comparison to fathers (M = 50.2, SD = 11.9). A significant moderate positive correlation was identified between mothers' and fathers' breastfeeding self-efficacy (r = 0.32). Age, employment status, mode of birth, and practicing exclusive breastfeeding were significantly associated with maternal and paternal breastfeeding self-efficacy. Factors including advanced age, Cesarean delivery, and depressive symptoms emerged as significant determinants of combined breastfeeding self-efficacy scores among couples.Conclusion: Breastfeeding self-efficacy is highly correlated between mothers and fathers, with a relatively higher score in mothers. Importantly, sociodemographic, obstetric, and psychological determinants play a substantial role in influencing parental breastfeeding efficacy. This highlights the necessity of incorporating both mothers and fathers into future breastfeeding promotion strategies.