Social Pressure and Body Image in Breastfeeding Mothers: Development and Validation of a Psychosocial Scale

Abstract: Although breastfeeding is widely promoted as a public health ideal, many mothers experience intense social scrutiny regarding both their infant feeding practices and their bodies. This form of social pressure—often expressed through unsolicited advice, criticism, and body-related judgments—can undermine maternal psychological well-being, body image, and breastfeeding persistence, yet remains largely unmeasured in reproductive and infant psychology research. This study aimed to develop and psychometrically validate a psychosocial scale assessing perceived social pressure and criticism experienced by breastfeeding mothers. Scale items were generated through focus group interviews with breastfeeding women to capture lived experiences of social judgment related to infant feeding and maternal body image. Content validity was established using expert review and the Lawshe method. Following pilot testing, the final 12-item scale was administered to 400 breastfeeding mothers. Construct validity was evaluated using exploratory and confirmatory factor analyses, and internal consistency was assessed using Cronbach’s alpha coefficients. Factor analyses supported a two-factor structure—Infant Feeding Pressure and Maternal Body Image Pressure—explaining 59% of the total variance. The model demonstrated good fit to the data (χ²/df = 2.96, RMSEA = 0.07, CFI = 0.95, NNFI = 0.97). Internal consistency was high for the total scale (α = 0.84) and for both subscales. The Breastfeeding-Related Social Pressure Scale is a reliable and valid instrument for assessing a largely overlooked psychosocial burden in breastfeeding mothers. By operationalising social pressure and body surveillance, this scale supports research on maternal well-being and infant feeding experiences.