Explaining Intentions for Exclusive Breastfeeding Among Israeli Women: An Extension of the Theory of Planned Behavior

BACKGROUND: Despite significant public health efforts, exclusive breastfeeding (EBF) rates among Israeli women remain low. Using the Extended Theory of Planned Behavior, this study aimed to identify key predictors of EBF among pregnant and preconception women in Israel. METHODS: This cross-sectional study used a two-wave online survey conducted in 2022 and 2024. Women who were pregnant or planning a pregnancy (n = 209) completed a questionnaire evaluating knowledge and social-cognitive perceptions of breastfeeding, previous breastfeeding duration, and personal characteristics. A hierarchical regression analysis was conducted to identify the factors predicting EBF intention. RESULTS: Participants demonstrated a moderate level of knowledge, positive attitudes, and high levels of subjective norms, perceived behavioral control, and intentions to practice EBF. The hierarchical regression revealed that previous breastfeeding duration (β = 0.32, p < 0.001), knowledge level (β = 0.18, p < 0.010), attitudes (β = 0.30, p < 0.001), and subjective norms (β = 0.12, p = 0.050) were significant positive predictors of EBF intention. Perceived behavioral control was not significantly associated with EBF intention (β = 0.07, p = 0.190). CONCLUSIONS: There is a need to enhance knowledge about the benefits of breastfeeding, foster supportive environments, and target specific interventions for women whose initial breastfeeding experiences were not successful. We conclude with a series of specific actions that healthcare providers and policymakers can take to improve breastfeeding rates.