Positive body image, weight stigma and breastfeeding self-efficacy among postpartum women: a cross-sectional study

The postnatal period is characterized by significant physiological transformations in women’s bodies. Individuals who have given birth may possess affirmative perceptions of their bodily appearance and experience weight-related stigma, both of which can impact their breastfeeding practices. This research aimed to investigate the association between positive body image, weight stigma, and self-efficacy in breastfeeding among women in the postpartum phase. This study used a cross-sectional methodology. It encompassed a cohort of 258 postpartum women within a 6-month timeframe. Validated measures such as the Body Appreciation Scale-2 (BAS-2) and the Functionality Appreciation Scale (FAS) were utilized to gauge positive body image. The Perceived Weight Stigma Questionnaire (PWS) and the Weight Bias Internalization Scale (WBIS) were employed to evaluate weight stigma, and breastfeeding self-efficacy was assessed using the Breastfeeding Self-Efficacy Scale Short-Form (BSES-SF). Analytical approaches, including univariate analysis and stepwise multi-linear regression analysis, were applied to identify predictors of breastfeeding self-efficacy. Mean body appreciation and functionality appreciation scores were recorded at 3.36 (SD = 1.23) and 3.85 (SD = 0.79), respectively. Total scores for perceived weight stigma, internalized weight stigma, and breastfeeding self-efficacy stood at 0.69(SD = 1.25), 27.52 (SD = 6.40), and 48.02 (SD = 9.97), respectively. Breastfeeding self-efficacy displayed a positive correlation with both body appreciation (r = 0.466, p < 0.01) and functionality appreciation (r = 0.305, p < 0.01). In contrast, breastfeeding self-efficacy manifested negative associations with internalized weight stigma (r=-0.436, p < 0.01) and perceived weight stigma (r=-0.449, p < 0.01). There was a significant correlation between BMI, feeding methods, positive body image, weight stigma, and breastfeeding self-efficacy(p < 0.01). Predictive factors for breastfeeding self-efficacy included body appreciation [B = 0.227, 95% CI (0.026, 0.428)], perceived weight stigma [B = -1.616, 95% CI (-2.559, -0.674)], feeding methods [B = -3.906, 95% CI (-5.956, -1.855)], internalized weight stigma [B = -0.293, 95% CI (-0.493, -0.093)], BMI [B = -1.561, 95% CI (-2.900, -0.222)], and functionality appreciation [B = 0.281, 95% CI (0.007, 0.556)]. The results suggest that non-exclusive breastfeeding and elevated BMI detrimentally impact breastfeeding self-efficacy in postpartum women. Conversely, augmenting positive body image and diminishing weight stigma may beneficially influence breastfeeding self-efficacy.