Defense Date


Document Type


Degree Name

Doctor of Philosophy


Adult Health Nursing

First Advisor

Jacqueline McGrath

Second Advisor

Linda Haddad

Third Advisor

Nancy Jallo

Fourth Advisor

Marilyn Stern


Background: The government in Taiwan has promoted breastfeeding in recent years yet, exclusive initiation rates and continuation of breastfeeding remain low. Maternal attitudes have been found to be better predictors of infant feeding method during the postpartum period than socio-demographic factors. Understanding maternal attitudes related to infant feeding in Taiwan will support the development of better targeted, more effective health promotion programs aimed at increasing breastfeeding rates. Objectives: To examine maternal attitudes toward breastfeeding and the relationship of these factors to breastfeeding duration at six weeks postpartum. The Iowa Infant Feeding Attitude Scale (IIFAS) was translated into Chinese for this study; a secondary aim of the study was to assess the psychometric properties of the translated tool. Design: A prospective longitudinal study. Setting: A public hospital in Taichung City, Taiwan. Participants: Using convenience sample. 140 in-hospital breastfeeding mothers were recruited in the hospital setting to complete the IIFAS. A total of 120 (86%) completed 3 week follow-up interview and of those who continued to breastfeed 102 women (100%) were contacted at 6 weeks and completed the study protocol. Methods: Following a systematic translation procedure, mothers completed IIFAS questionnaire in the hospital. Then, participating women were contacted by telephone at three weeks and six weeks postpartum to obtain information regarding infant feeding status and duration. Results: Maternal breastfeeding attitudes were the only predictive factor of the breastfeeding duration (p=0.05). The Cronbach’s alpha for internal consistency was 0.73. In-hospital IIFAS scores significantly predicted infant feeding methods at six weeks postpartum. 72.9% (n=102) of the mothers were breastfeeding their infants, of which 37 mothers (26.4%) were exclusively breastfeeding, 65 mothers (46.4%) were partially breastfeeding at three weeks postpartum. These102 breastfeeding mothers were continued to be followed through six weeks postpartum. 62.1% (n=87) were still breastfeeding their infants, of which 34 mothers (24.3%) were exclusively breastfeeding and 53 mothers (37.9%) were partially breastfeeding at six weeks postpartum. Insufficient milk supply was the reason most often given for discontinuing breastfeeding. Conclusions: Maternal attitudes were related to breastfeeding duration. This study provides evidence that the translated version of the IIFAS is a valid and reliable tool to assess breastfeeding attitudes among Taiwanese mothers in the population tested. Breastfeeding rates showed that the low rates of exclusive breastfeeding. Health professionals might use this tool to identify mothers at increase risk for not continuing with exclusive breastfeeding and intervention strategies need to be developed to improve rates of successful exclusive breastfeeding.


© The Author

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

May 2010

Included in

Nursing Commons