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Health Education & Behavior
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The Behavioral Determinants of Breast-Feeding in the Netherlands: Predictors for the Initiation of Breast-Feeding

Els J. Kools, MD, MPH, PhD

Department of Epidemiology, Maastricht University, Maastricht, the Netherlands

Carel Thijs, MD, MPH, PhD

Department of Epidemiology, Maastricht University, Maastricht, the Netherlands, c.thijs{at}epid.unimaas.nl

Hein de Vries, PhD

Department of Health Education and Promotion, Maastricht University, the Netherlands

The aim of this study was to evaluate the behavioral determinants of the initiation of breast-feeding at birth. The prospective cohort study used the attitude, social influence, self-efficacy (ASE) model in 373 pregnant women in five child health care centers. Prenatally, 72% of the women had the intention to breast-feed, and 73% actually started with breast-feeding at birth. Mothers who initiated breast-feeding differed in almost all the attitude, social influence, and self-efficacy determinants fromm others who initiated formula feeding. Intention was a very strong predictor of the initiation of breast-feeding. The components of the ASE model predicted the initiation of breast-feeding. Hence, the results may be used to tailor future interventions aimed at promoting breast-feeding.

Key Words: breast-feeding • ASE model • behavioral determinants

Health Education & Behavior, Vol. 32, No. 6, 809-824 (2005)
DOI: 10.1177/1090198105277327
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