Exploring Breastfeeding Practices and Maternal Psychosocial Factors in Gauteng, South Africa: An Exploratory Study

Objective: Exclusive breastfeeding (EBF) is critical for optimal growth of infants and for maternal health. Despite global, country, and local initiatives, EBF rates remain low in South Africa, particularly beyond the immediate postpartum period. There is limited research that has explored the psychosocial factors influencing breastfeeding practices among White South African mothers. This study aimed to explore breastfeeding practices and assess the influence of maternal psychosocial factors in the province of Gauteng, South Africa. Methods: An exploratory cross-sectional study was conducted among 106 lactating mothers attending private postnatal clinics in Gauteng, with 55 completing the questionnaires. Data were collected using validated tools, including the Breastfeeding Self-Efficacy Scale, Iowa Infant Feeding Attitude Scale, Edinburgh Postnatal Depression Scale, and State-Trait Anxiety Inventory. Descriptive statistics were used to summarize sociodemographic characteristics, breastfeeding practices, and psychosocial factors. Point-biserial correlation analysis was used to assess relationships between breastfeeding practices and psychosocial measures. Results: Participants were primarily White (89.1%), married (92.6%), and highly educated (72.2% had tertiary qualifications). Out of the households that participated, 73.8% had an income above 20,000 South African rand (U.S.$1,142) per month. Most respondents (94.6%) reported being food-secure. EBF prevalence reached 93.5% by 6 weeks postpartum. High breastfeeding self-efficacy was reported (Breastfeeding Self-Efficacy Scale mean score: 141/172). Most mothers (63.6%) experienced low anxiety, and 21.8% exhibited depressive symptoms. Positive associations were observed between EBF and higher self-efficacy ( r = .40, p < .001), positive attitudes ( r = .29, p = .03), and lower anxiety ( r = .36, p = .01). Conclusions: The findings highlight predominantly optimal breastfeeding practices in this high socioeconomic population, with high self-efficacy and low anxiety contributing to EBF success. Impactful interventions should sustain breastfeeding beyond the early postpartum period by enhancing maternal confidence and addressing early introduction of complementary foods. Further research with a larger sample size is required to ascertain factors that significantly influence breastfeeding.