Maternal health literacy and its association with breastfeeding self-efficacy and nutritional performance: A cross-sectional study

Background: Health literacy (HL) lays the foundation for health-related decisions. Moreover, nutrition during infancy plays a critical role in a child’s growth and development. Therefore, it is particularly important to investigate the status of maternal health literacy (MHL) and its relationship with nutritional performance (NP). Objectives: This study aims to investigate the association of mothers’ HL level with their breastfeeding self-efficacy (BSE) and NP. Methods: This cross-sectional study was conducted on 234 mothers recruited from urban integrated healthcare service centers (UIHSCs) and their affiliated healthcare bases using a two-stage cluster sampling method. Data were collected using demographic survey questions, the Health Literacy for Iranian Adults (HELIA), the Breastfeeding Self‑Efficacy Scale‑Short Form (BSES‑SF), and the researcher-made Mother’s Complementary Feeding Performance (MCFP) Questionnaire. Descriptive statistics and the correlation coefficient test were used to analyze the data in SPSS 24. Findings: The mean (SD) scores for Health Literacy, Breastfeeding Self-Efficacy, and Nutritional Performance were 71.47 (11.98), 42.65 (8.79), and 20.36 (4.20), respectively, indicating adequate to satisfactory levels. The mothers' HL and its components were significantly related to their BSE and NP (P<0.05). Conclusion: Given the relationship between mothers’ HL levels and their BSE and NP, the findings of this study highlight the need for greater attention to education across various areas, including mass media, and to the provision of educational courses in UIHSCs.