Breastfeeding confidence is often treated as an individual matter, but new research suggests that the social environment around a mother may be closely connected to how capable she feels of breastfeeding successfully.
A peer-reviewed study of 323 breastfeeding mothers in Rasht, Iran, found that greater perceived social support was moderately associated with higher breastfeeding self-efficacy. The strongest relationship involved support from friends. After accounting for selected sociodemographic and obstetric factors, mothers reporting higher friend support had 5.38 times the odds of scoring at or above the study-specific average for breastfeeding self-efficacy.
The findings do not show that friend support causes greater breastfeeding confidence. The research was cross-sectional, meaning social support and self-efficacy were measured at the same point in time. However, the results identify peer support as a potentially important psychosocial factor for breastfeeding programmes to consider.
Social support and breastfeeding confidence
Breastfeeding self-efficacy describes a mother’s confidence in her ability to breastfeed successfully. It can influence how mothers approach breastfeeding challenges, how persistent they feel able to be, and their broader breastfeeding-related behaviour.
Researchers Yasaman Ghorbani, Zahra Bostani Khalesi, Moluk Pouralizadeh and Ehsan Kazemnezhad Leyli examined whether perceived social support was associated with breastfeeding self-efficacy among mothers in Iran, where the authors noted that evidence on this relationship remains limited.
The study was published in Scientific Reports on 25 September 2026.
How the study was conducted
The researchers conducted a cross-sectional study involving 323 breastfeeding mothers recruited from health centres in Rasht, Iran. Participants were selected using multistage cluster sampling, and data were collected between June and October 2024.
Breastfeeding self-efficacy was assessed using the Breastfeeding Self-Efficacy Scale Short Form. Perceived social support was measured with the Multidimensional Scale of Perceived Social Support, which distinguishes support from family, friends and significant others.
The researchers first examined correlations between the social support measures and breastfeeding self-efficacy. They then used multivariable logistic regression. For this analysis, the total breastfeeding self-efficacy score was divided at the study sample’s mean, separating mothers with scores below the mean from those scoring at or above it.
Friend support, family support and support from significant others were entered separately into the model alongside prespecified sociodemographic and obstetric covariates. This allowed the researchers to examine whether the different sources of perceived support were independently associated with the likelihood of having breastfeeding self-efficacy at or above the sample average.
Overall social support was moderately associated with self-efficacy
Total perceived social support showed a moderate positive correlation with breastfeeding self-efficacy, with a correlation coefficient of 0.452. The probability value was below 0.001, indicating that the observed association was statistically significant in the study sample.
This means that mothers who perceived greater support tended to report greater confidence in their ability to breastfeed. The correlation does not establish the direction of the relationship. More confident mothers could perceive or seek support differently, greater support could contribute to confidence, or both could be influenced by other factors.
Friend support showed the strongest relationship
Of the support sources examined, perceived friend support had the strongest correlation with breastfeeding self-efficacy. The correlation coefficient was 0.451, again with a probability value below 0.001.
The adjusted analysis produced an especially notable result. Higher perceived friend support was associated with 5.38 times the odds of having a breastfeeding self-efficacy score at or above the sample mean. The 95% confidence interval ranged from 3.18 to 9.87, and the association was statistically significant at p below 0.001.
An odds ratio of 5.38 should not be interpreted as meaning that friend support makes a mother 5.38 times more confident or guarantees successful breastfeeding. It describes the relative odds of falling into the study’s higher self-efficacy category after adjustment for the variables included in the model.
Support from significant others also mattered
Perceived support from significant others was independently associated with breastfeeding self-efficacy as well. Mothers with higher support in this domain had 1.68 times the odds of scoring at or above the sample mean for self-efficacy. The 95% confidence interval was 1.13 to 2.51, with a probability value of 0.011.
The adjusted model also identified younger maternal age and a greater number of children as statistically associated with higher odds of breastfeeding self-efficacy at or above the sample mean.
Why the findings may matter
Breastfeeding support programmes commonly involve healthcare professionals and family members. These findings suggest that friends and wider peer networks may deserve more explicit attention as part of the support environment surrounding breastfeeding mothers.
The researchers suggest that peer- and community-based social support could be relevant psychosocial domains for breastfeeding promotion. This could include approaches that strengthen supportive relationships, facilitate peer contact or help mothers access communities in which breastfeeding challenges can be discussed without judgement.
Importantly, the study assessed perceived support rather than testing a support intervention. It therefore cannot establish that increasing friend support would produce the magnitude of improvement implied by the observed odds ratio. Intervention studies would be needed to determine whether deliberately strengthening social support changes breastfeeding self-efficacy or breastfeeding outcomes.
Important limitations
The cross-sectional design is the central limitation. Because exposure and outcome were assessed at the same time, temporal order cannot be established and causal conclusions cannot be drawn.
The participants were breastfeeding mothers recruited from health centres in Rasht. Social networks, family structures, healthcare access and cultural expectations surrounding breastfeeding may differ substantially across regions and countries, so the size of the associations should not automatically be generalised to other populations.
The regression analysis also converted breastfeeding self-efficacy into two categories using the sample-specific mean. Dichotomising a continuous measure can reduce information and means the reported odds ratios refer specifically to the threshold used in this sample rather than to a universal clinical definition of high breastfeeding self-efficacy.
Finally, the results concern maternal confidence rather than direct measures of breastfeeding duration, exclusivity or infant health. Higher self-efficacy may be relevant to breastfeeding behaviour, but this study should not be read as evidence that the measured social support directly improved those outcomes.
What the study adds
The study provides contemporary evidence from Iran that perceived social support and breastfeeding self-efficacy are meaningfully related. Its most distinctive result is the strength of the adjusted association with friend support, which remained substantial after the researchers accounted for selected maternal and obstetric characteristics.
The findings reinforce the idea that breastfeeding confidence exists within a social context. They also provide a clear direction for future research: prospective studies and controlled interventions can test whether strengthening peer support before and after birth leads to measurable changes in breastfeeding confidence and, ultimately, breastfeeding behaviour.
Source Information
Study: Association between perceived social support and breastfeeding self-efficacy among Iranian mothers: a cross-sectional study
Authors: Yasaman Ghorbani, Zahra Bostani Khalesi, Moluk Pouralizadeh and Ehsan Kazemnezhad Leyli
Journal: Scientific Reports
Published: 25 September 2026
DOI: 10.1038/s41598-026-73346-5
Study design: Cross-sectional study
Sample: 323 breastfeeding mothers recruited from health centres in Rasht, Iran
