Maternal Mindfulness and Breastfeeding Self-Efficacy: Exploring the Relationship

Abstract

Background:

Breastfeeding mindfulness—defined as a mother’s present-moment awareness, emotional attunement, and focused attention during breastfeeding—is an emerging concept with significant implications for lactation outcomes. While mindfulness and breastfeeding self-efficacy are recognized determinants of breastfeeding success, evidence regarding their relationship remains limited, particularly within the Turkish context. This study examined the association between maternal mindfulness during breastfeeding and breastfeeding self-efficacy.

Methods:

A descriptive and analytic cross-sectional study was conducted with 268 breastfeeding mothers who gave birth between July 2024 and February 2025 at a university hospital in Turkey. Data were collected via face-to-face interviews using a personal information form, the Mindfulness in Breastfeeding Scale, and the Breastfeeding Self-Efficacy Scale–Short Form. Statistical analyses were performed using SPSS Statistics 22.0. Due to nonnormal data distribution, nonparametric tests and correlation analyses were employed.

Results:

The mean score for the Mindfulness in Breastfeeding Scale was 36.49 ± 4.56, and the mean score for the Breastfeeding Self-Efficacy Scale was 53.19 ± 8.68. A significant positive correlation was observed between mindfulness in breastfeeding and breastfeeding self-efficacy (r = 0.365, p < 0.001).

Conclusion:

Higher maternal mindfulness during breastfeeding is associated with increased breastfeeding self-efficacy. These findings suggest that integrating mindfulness-based strategies into prenatal and postpartum nursing interventions can enhance maternal emotional well-being and promote more effective breastfeeding. Consequently, incorporating mindful breastfeeding concepts into childbirth preparation and counseling programs is essential to equip mothers with these skills and support positive breastfeeding outcomes.

Keywords

breastfeeding breastfeeding self-efficacy mindfulness nursing practice postpartum

Background

Breastfeeding is universally recognized as a cornerstone of global public health, offering profound protective effects against morbidity and mortality while supporting long-term cognitive and socioeconomic development (Al-Thubaity et al., 2023; World Health Organization [WHO], 2023). Beyond infant health, it provides maternal benefits, including reduced risks of breast and ovarian cancers, and yields substantial economic gains for healthcare systems (WHO, 2023). However, a significant gap persists between international recommendations and actual practices. Although the WHO targeted a 50% rate of exclusive breastfeeding for infants aged 0–6 months by 2025, current global data indicate that only 44% of infants in this age group are exclusively breastfed, with similar rates observed in Turkey (41%; Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü, 2018; WHO, 2023).

To address these suboptimal rates, research has emphasized the importance of understanding the interplay between contextual determinants and modifiable psychological factors (Ergezen et al., 2021; Kantrowitz-Gordon & Byrom, 2022). Sociodemographic and obstetric variables—including educational attainment, pregnancy planning, parity, employment status, and mode of delivery—act as critical contextual determinants that shape a mother’s initial readiness; meanwhile, psychological constructs have emerged as the primary predictors of sustained breastfeeding success (Al-Thubaity et al., 2023; Brockway et al., 2023; Emmott, 2023; Ergezen et al., 2021). Among these contextual factors, the impact of delivery mode is particularly noteworthy and remains a subject of debate; whereas vaginal delivery is traditionally associated with earlier breastfeeding initiation, emerging evidence suggests that diverse birth experiences can uniquely influence a mother’s psychological adaptation (Ayala et al., 2025; Ulfa et al., 2023). These contextual elements, by shaping initial readiness, provide the foundation for breastfeeding self-efficacy—defined as a mother’s confidence in her ability to breastfeed effectively (Dennis, 2003). Although factors such as education and social support provide a necessary base (Brockway et al., 2023; Ergezen et al., 2021), high self-efficacy allows a mother to be more resilient against challenges such as postpartum pain and stress (Al-Thubaity et al., 2023; Çınar et al., 2023; Körükcü et al., 2021). In the Turkish context, where breastfeeding is culturally prioritized and institutional support is provided (e.g., a standard 48-hour postpartum stay for cesarean births), these background factors may interact with psychological resources in distinct ways (Sarı-Öztürk & Demir, 2023). Therefore, examining how such variables influence both mindfulness and self-efficacy is essential for identifying specific subgroups who require targeted support.

In this context, mindfulness offers a promising yet underutilized psychological resource. Mindfulness-based breastfeeding extends beyond the mechanical act of feeding; it involves a conscious, nonjudgmental focus on the present moment and emotional attunement with the infant (Lönnberg et al., 2021; Pan et al., 2023). In this study, mindfulness was conceptualized as dispositional mindfulness, which refers to an individual’s inherent or natural tendency to be mindful in daily life rather than a skill acquired through a specific intervention or training (Brown & Ryan, 2003). Specifically, this practice encompasses concrete sensory and physical behaviors such as inhaling the infant’s scent before breastfeeding, focusing on the rhythmic sounds and sensations of the infant’s sucking, and maintaining awareness of the physical release of milk. Mothers also may employ paced breathing technique to anchor their attention to these immediate experiences. By transforming breastfeeding from a routine task into a meaningful practice of connection, mindfulness may reduce maternal anxiety and strengthen the mother–infant bond (Brown & Ryan, 2003; Körükcü et al., 2021). Furthermore, in the Turkish cultural context, breastfeeding is often viewed as a sacred maternal duty, deeply influenced by the involvement of extended family members. Although grandmothers and elder relatives provide significant practical support, their frequent evaluations regarding milk supply and nursing frequency can inadvertently create performance anxiety and perceived pressure for the mother. In such an environment, we anticipate that mindfulness may function as a protective shield for mothers, allowing them to focus on their unique bond with the infant and maintain emotional composure despite external social intrusions.

The theoretical synergy between this mindful connection and breastfeeding self-efficacy can be elucidated through Bandura’s (1977) social cognitive theory, which identifies enactive mastery experiences and physiologic/affective states as primary sources of self-efficacy. Mindfulness acts as a cognitive and emotional regulator that directly feeds into these sources; by engaging in mindful behaviors, a mother cultivates positive mastery experiences, characterized by peace rather than distress. Furthermore, by modulating affective states and reducing the physiologic noise of anxiety, mindfulness allows for a clearer cognitive appraisal of one’s own capabilities. Research has shown that mindfulness strengthens self-efficacy by quieting negative and intrusive thoughts during stressful moments (Pan et al., 2023; Sharma and Kumra, 2022). Instead of worrying about failure, mothers employing mindfulness can focus entirely on the present interaction with their infant. By blocking these self-doubting thoughts, mothers can maintain their confidence and feel more in control. Additionally, being mindful helps mothers regulate their emotions; a calm and regulated mother is naturally more likely to perceive herself as competent at breastfeeding. Consequently, we posit that this heightened state of awareness may serve as a mechanism to bolster breastfeeding self-efficacy, allowing mothers to navigate difficulties with greater composure. Despite the potential synergy between these two constructs, evidence regarding their relationship remains limited. Therefore, this study aimed to examine the association between mothers’ mindfulness in breastfeeding and their breastfeeding self-efficacy levels.

Key Messages

• Maternal mindfulness is positively and significantly associated with breastfeeding self-efficacy, acting as a psychological resource that empowers mothers to navigate breastfeeding challenges with greater confidence.

• Contrary to the traditional deficit model, mothers who delivered via cesarean section exhibited higher levels of both mindfulness and breastfeeding self-efficacy, suggesting a compensatory mechanism where mothers consciously invest more effort into the breastfeeding process.

• Mindful breastfeeding serves as a protective buffer against modern postpartum distractions and anxiety, facilitating deeper emotional attunement and responsiveness to infant cues.

• Integrating brief, accessible mindfulness-based strategies (micropractices) into routine prenatal and postpartum nursing care offers a cost-effective pathway to enhance maternal well-being and breastfeeding outcomes.

Methods

Research Design and Setting

This study employed a descriptive and analytic cross-sectional design to evaluate the relationship between maternal mindfulness and breastfeeding self-efficacy. The research was conducted at the Obstetrics and Gynecology Clinic of a university hospital in Turkey between July 2024 and February 2025. This tertiary care center serves a diverse population, providing a representative sample of the region. In accordance with national postpartum care protocols, mothers typically remain hospitalized for a minimum of 24 hours following vaginal delivery and 48 hours following a cesarean section. This timeframe allowed for the assessment of early postpartum breastfeeding experiences prior to discharge.

Participants and Sampling

Participants were recruited using purposive sampling to ensure a homogeneous group free from confounding medical factors. The inclusion criteria were defined as (a) being ≥18 years of age, (b) having literacy in Turkish and the ability to communicate verbally, (c) having a healthy term birth (38–42 gestational weeks) with a birth weight of between 2,500 and 4000 g, (d) initiating breastfeeding without any medical contraindications, and (e) having a healthy newborn requiring no intensive care admission. Table 1 lists demographic and obstetric characteristics of the mothers.

Table 1.

Demographic and Obstetric Characteristics of Mothers (n = 268).

Characteristic		Median (min–max)
Mother’s age, years		27 (18–42)
Father’s age, years		30,5 (22–46)
Marriage duration, months		48 (9–240)
Variable		n (%)
Educational status	Primary	67 (25)
	Secondary	57 (21.3)
	High	103 (38.4)
	≥University	41 (15.3)
Employment status	Employed	28 (10.4)
Employment status	Unemployed	240 (89.6)
Spouse’s educational status	Primary	62 (23.1)
	Secondary	60 (22.4)
	High	107 (39.9)
	≥University	39 (14.6)
Spouse’s employment status	Employed	254 (94.8)
Spouse’s employment status	Unemployed	14 (5.2)
Income status	Low	57 (21.3)
	Medium	186 (69.4)
	High	25 (9.3)
Gravida	Primigravida	99 (36.9)
Gravida	Multigravida	169 (63.1)
Parity	Primiparous	115 (42.9)
Parity	Multiparous	153 (57.1)
Pregnancy plan	Yes, planned	109 (40.7)
	No, unplanned	30 (11.2)
	Unplanned, but happy	129 (48.1)
Mode of delivery	Vaginal	134 (50)
Mode of delivery	Cesarean	134 (50)
Baby’s gender	Female	113 (42.2)
Baby’s gender	Male	155 (57.8)
Participation in birth preparation class	Yes	9 (3.4)
Participation in birth preparation class	No	259 (96.6)
Breastfeeding education	Yes	5 (1.9)
Breastfeeding education	No	263 (98.1)

Sample size estimation was conducted using G*Power software, version 3.1 (Faul et al., 2009). Based on previous literature reporting (Körükcü et al., 2021), correlations between mindfulness and breastfeeding outcomes, a priori power analysis indicated that a minimum of 212 participants was required to detect a significant effect with 95% power (α = 0.05). To account for potential data loss or incomplete responses, the final sample included 268 mothers. A post hoc power analysis confirmed that the study achieved a power of 0.817 (effect size r = 0.155), ensuring adequate statistical strength.

Data-Collection Tools

Data were collected using a three-part structured questionnaire consisting of a personal information form, the Mindfulness in Breastfeeding Scale (MIND-BFS), and the Breastfeeding Self-Efficacy Scale–Short Form (BSES-SF).

Personal information form. Developed by the researchers based on current literature (Brockway et al., 2023; Ergezen et al., 2021; Körükcü et al., 2021; Lönnberg et al., 2021), this form consists of 15 items. It evaluates sociodemographic characteristics (e.g., age, education, employment status, spouse’s age/education/employment, income status, and marriage duration) and obstetric/breastfeeding history (e.g., number of pregnancies/births, pregnancy planning status, mode of delivery, infant’s gender, prenatal class participation, and breastfeeding education). The form uses a mixed format primarily consisting of multiple-choice questions, with open-ended items included for numerical variables (e.g., age and marriage duration) and specific details.

Mindfulness in Breastfeeding Scale (MIND-BFS). Developed by Körükcü et al. (2021), this nine-item instrument specifically measures mindfulness practices during the act of breastfeeding. In this scale, mindfulness is defined as the mother’s sensory and emotional awareness during the breastfeeding process. Specifically, the scale evaluates behaviors through items focusing on sensory awareness (e.g., smelling the infant, listening to suckling sounds, and feeling the physical sensations of the latch and milk flow), emotional presence (e.g., feeling peaceful and relaxed during the feed), and attentive observation (e.g., watching the infant’s peacefulness and focusing on the importance of the moment). The scale is unidimensional and rated on a 5-point Likert scale (1 = “never” to 5 = “always”). Total scores range from nine to 45, with higher scores reflecting higher levels of mindful awareness. The scale has demonstrated strong psychometric properties in the Turkish population (original Cronbach’s α = 0.83; in the present study, α = 0.89).

Breastfeeding Self-Efficacy Scale–Short Form (BSES-SF). Originally developed by Dennis (2003) and adapted into Turkish by Aluş et al. (2010), this 14-item scale assesses a mother’s confidence in her ability to breastfeed. Items are rated on a 5-point Likert scale, where higher cumulative scores indicate stronger breastfeeding self-efficacy. The scale showed high internal consistency in this study (Cronbach’s α = 0.93).

Procedure

Data collection was performed via face-to-face interviews conducted in the mothers’ hospital rooms prior to discharge. To minimize interviewer bias and social desirability bias, data were collected by trained researchers who were not members of the active clinical care team. Participants were informed about the study purpose and assured that their responses would not affect their clinical care. The interviews lasted approximately 15–20 minutes.

Data Analysis

Statistical analyses were performed using IBM SPSS Statistics for Windows, version 22.0 (IBM Corp, Armonk, NY). The normality of data distribution was assessed using the Shapiro–Wilk test, which indicated a nonnormal distribution for the scale scores. Consequently, descriptive statistics were presented as median (minimum–maximum) for continuous variables and frequency (percentage) for categorical variables. To identify factors influencing maternal mindfulness and self-efficacy, univariate analyses were conducted across all sociodemographic and obstetric characteristics. Nonparametric tests, specifically the Mann–Whitney U test (for two groups) and the Kruskal–Wallis test (for more than two groups), were used for these group comparisons. Additionally, Spearman’s rank correlation coefficient was used to assess the relationships between continuous variables (e.g., maternal/paternal age and marriage duration) and scale scores as well as the primary relationship between mindfulness and breastfeeding self-efficacy. Statistical significance was established at p < 0.05.

Ethical Considerations

The study adhered to the principles of the Declaration of Helsinki. Ethical approval was obtained from the İzmir Kâtip Çelebi University Non-Interventional Clinical Research Ethics Committee (Decision No. 0205; date: April 25, 2024), and institutional permission was granted by the hospital administration. Written informed consent was obtained from all participants after the study’s aim and their right to withdraw were explained. Confidentiality and anonymity were strictly maintained throughout the study. Permissions for the use of the scales were secured from the original authors.

Results

Participant Characteristics

A total of 268 mothers were included in the study. The median age of the mothers was 27 years (min–max 18–42 years), whereas the median age of the fathers was 30.5 years (min–max 22–46 years). The median duration of marriage was 48 months. Regarding obstetric history, most participants were multigravida (63.1%) and multiparous (57.1%). The mode of delivery was evenly distributed, with 50% of mothers delivering vaginally and 50% delivering via cesarean section. Although nearly half the pregnancies were unplanned (48.1%), they were reported as welcomed. Notably, participation in formal prenatal education was low; only 3.4% of mothers had attended childbirth preparation classes, and a mere 1.9% had received specific breastfeeding education. Most of the mothers (89.6%) were not employed outside the home.

Descriptive Statistics and Correlation Analysis

The mean score for the MIND-BFS was 36.49 ± 4.56, and the mean score for the BSES-SF was 53.19 ± 8.68. These scores indicate that the mothers in this sample possessed moderate to high levels of both mindfulness and breastfeeding self-efficacy.

Spearman’s correlation analysis revealed a statistically significant positive relationship between the two main variables. Higher levels of mindfulness in breastfeeding were moderately correlated with higher levels of breastfeeding self-efficacy (r = 0.365, p < 0.001; Table 2).

Table 2.

Correlation Between the Mindfulness in Breastfeeding Scale and the Breastfeeding Self-Efficacy Scale Scores.

Scale	n	Mean ± SD	Median	Min–Max	Test value, p value
Mindfulness in Breastfeeding Scale	268	36.49 ± 4.56	36	21–45	r = 0.365,p < 0.001
Breastfeeding Self-Efficacy Scale	268	53.19 ± 8.68	53	14–70	r = 0.365,p < 0.001

Note. r = Spearman’s correlation analysis. Bold values indicate statistical significance.

Factors Associated with Mindfulness and Breastfeeding Self-Efficacy

Univariate analyses highlighted several sociodemographic and obstetric factors influencing the scale scores (Table 3).

Table 3.

Relationship Between the Demographic and Obstetric Characteristics of Mothers and the Scores on the Mindfulness in Breastfeeding Scale and the Breastfeeding Self-Efficacy Scale.

Characteristic		Median	Mindfulness in Breastfeeding Scale	Breastfeeding Self-Efficacy Scale
Mother’s age, years		27	r = 0.005p = 0.937	r = 0.158p = 0.009
Father’s age, years		30,5	r = 0.001p = 0.988	r = 0.163p = 0.007
Marriage duration, months		48	r = 0.049p = 0.423	r = 0.180p = 0.003
Variable		Mindfulness in Breastfeeding Scale total score median	Test value,p value	Breastfeeding Self-Efficacy Scale total score median	Test value,p value
Educational status	Primary	34	χ² = 25.357,p < 0.001	52	χ² = 11.987,p = 0.007
	Secondary	36		55
	High	36		53
	≥University	37		54
Employment status	Employed	36	U = 0.689,p = 0.491	53	U = 0.606,p = 0.545
Employment status	Unemployed	36	U = 0.689,p = 0.491	53	U = 0.606,p = 0.545
Spouse’s educational status	Primary	35	χ² = 4.318,p = 0.229	52	χ² = 0.807,p = 0.848
	Secondary	36		53.5
	High	36		53
	≥University	36		54
Spouse’s employment status	Employed	36	U = 2.548,p = 0.011	53	U = 1.908,p = 0.056
Spouse’s employment status	Unemployed	33	U = 2.548,p = 0.011	52	U = 1.908,p = 0.056
Income status	Low	36	χ² = 2.093,p = 0.351	54	χ² = 0.309,p = 0.857
	Medium	36		53
	High	36		54
Gravida	Primigravida	36	U = 1.405,p = 0.160	53	U = 2.822,p = 0.005
Gravida	Multigravida	36	U = 1.405,p = 0.160	54	U = 2.822,p = 0.005
Parity	Primiparous	36	U = 0.595,p = 0.552	53	U = 2.976,p = 0.003
Parity	Multiparous	36	U = 0.595,p = 0.552	54	U = 2.976,p = 0.003
Pregnancy plan	Yes, planned	38	χ² = 16.60,p < 0.001	54	χ² = 4.936,p = 0.085
	No, unplanned	36		52
	Unplanned but happy	35		53
Mode of delivery	Vaginal	35	U = 2.080,p = 0.038	53	U = 2.919,p = 0.004
Mode of delivery	Cesarean	36	U = 2.080,p = 0.038	54	U = 2.919,p = 0.004
Baby’s gender	Female	36	U = 0.462,p = 0.644	53	U = 0.282,p = 0.778
Baby’s gender	Male	36	U = 0.462,p = 0.644	53	U = 0.282,p = 0.778
Participation in birth preparation class	Yes	42	U = 1.681,p = 0.093	56	U = 1.063,p = 0.288
Participation in birth preparation class	No	36	U = 1.681,p = 0.093	53	U = 1.063,p = 0.288
Breastfeeding education	Yes	43	U = 1.099,p = 0.272	68	U = 1.672,p = 0.094
Breastfeeding education	No	36	U = 1.099,p = 0.272	53	U = 1.672,p = 0.094

Note. χ² = Kruskal–Wallis test; r = Spearman’s correlation analysis.

Regarding mindfulness, mothers with higher educational levels attained significantly higher MIND-BFS scores (χ² = 25.357, p < 0.001). Similarly, higher mindfulness scores were observed among mothers with employed partners (U = 2.548, p = 0.011) and those with planned pregnancies (χ² = 16.603, p < 0.001). Notably, mothers who delivered via cesarean section had significantly higher mindfulness scores than those who delivered vaginally (U = 2.080, p = 0.038).

Regarding breastfeeding self-efficacy, positive correlations were found with maternal age (r = 0.158, P = 0.009), paternal age (r = 0.163, p = 0.007), and duration of marriage (r = 0.180, p = 0.003). Consistent with the mindfulness findings, mothers with higher education levels (χ² = 11.987, p = 0.007) and those who delivered via cesarean section (U = 2.919, p = 0.004) reported higher self-efficacy scores. Additionally, multiparous mothers demonstrated significantly higher self-efficacy than primiparous mothers (U = 2.976, p = 0.003).

No statistically significant associations were found between the scale scores and maternal employment status, income level, infant gender, or prior participation in childbirth/breastfeeding classes (p > 0.05).

Discussion

This study provides empirical evidence of a robust positive association between breastfeeding mindfulness and breastfeeding self-efficacy. By examining these constructs together, the research addresses a critical gap in the literature regarding the psychological determinants of breastfeeding success. The findings suggest that a mother’s capacity to direct her attention to the present moment—cultivating a nonjudgmental awareness during feeding—serves as a powerful catalyst for enhancing breastfeeding self-efficacy. This supports the theoretical premise that mindfulness is not merely a passive state but an active psychological resource that reduces maternal stress, regulates emotions, and fosters responsive parenting behaviors (Körükcü et al., 2021; Lönnberg et al., 2021).

A particularly salient contribution of this study is the framing of mindfulness as an antidote to modern distracted parenting. In a sociocultural landscape increasingly saturated with digital distractions (e.g., smartphones and social media) and high postpartum cognitive load, a mother’s ability to maintain focus is constantly challenged. Our findings indicate that mindfulness acts as a protective buffer, allowing mothers to filter out external and internal distractors. This focus enables greater emotional clarity and responsiveness to infant cues, creating a positive-feedback loop: As the mother feels more connected and calm, her perceived competence (self-efficacy) increases. This interpretation aligns with longitudinal studies by Lönnberg et al. (2021) and Pan et al. (2023), which posited that postpartum mindfulness practices are pivotal for maternal emotional well-being and the establishment of successful breastfeeding routines.

One of the most notable and novel findings of this study concerns the mode of delivery. Regarding mode of delivery, our findings diverged from traditional literature, which often associates vaginal delivery with higher initial breastfeeding success (Amanak & Demirkol, 2023; Kaya & Küçükkelepçe, 2024; Konukoğlu & Pasinlioğlu, 2021). In this study, mothers who delivered via cesarean section exhibited significantly higher levels of both mindfulness and breastfeeding self-efficacy. Rather than viewing this as an anomaly, we propose a compensatory investment hypothesis: Mothers who undergo cesarean sections may consciously invest more psychological effort into breastfeeding to reclaim their maternal agency and deepen the mother–infant bond. Furthermore, the extended hospitalization period for cesarean sections (typically 48 hours, as noted in “Methods”) likely provided these mothers with greater exposure to clinical breastfeeding support and counseling compared with the shorter stay associated with vaginal births. This finding challenges the deficit model often applied to cesarean mothers and suggests that with adequate time and support, they can effectively leverage mindfulness strategies.

Sociodemographic analyses further contextualized these findings. The positive association between higher education levels and mindfulness echoes previous research linking education to better access to psychological resources and emotional regulation strategies. Similarly, the link between planned pregnancies and higher mindfulness scores suggests that psychological readiness plays a crucial role in how mothers engage with the postpartum experience. The influence of the cultural context is particularly evident in these results. Our findings regarding mindfulness scores are consistent with those reported by Özdemir (2024), reinforcing the relevance of this construct in the Turkish population. As outlined in the “Introduction,” the unique blend of high family involvement and sacred maternal expectations in Turkey can inadvertently create a pressurized environment for breastfeeding mothers. In this context, mindfulness serves not just as a skill but also as a protective shield that allows mothers to navigate those cultural pressures with greater resilience. Therefore, future mindfulness interventions should be culturally responsive, framing awareness not as a clinical task to be mastered but as a vital tool for maternal self-compassion and psychological well-being against social intrusions.

Implications for Nursing Practice

The results underscore the necessity of integrating mindfulness-based interventions into standard nursing care (Lönnberg et al., 2020; Pan et al., 2023). The significance of this finding for nursing practice is rooted in the fact that nurses are the primary healthcare providers during the critical first 48–72 hours postpartum. This role establishes nurses as the first line of defense for the strong and effective initiation of breastfeeding. Healthcare professionals, particularly nurses, should promote mindfulness-based breastfeeding interventions by directing maternal attention to sensory cues such as suction rhythm and milk ejection sensations. The clinical integration of these practices can be achieved through the implementation of paced breathing exercises prenatally and during breastfeeding, thereby enhancing the mother’s mindful engagement with the act of feeding. Because these practices do not require extensive clinical time or specialized equipment, they serve as highly feasible tools for nurses to reduce maternal anxiety in real time within busy clinical settings. For mothers recovering from cesarean sections, who exhibited high levels of mindfulness in this study, nursing care should explicitly reinforce this psychological strength. By acknowledging their capacity for mindful connection, nurses can help these mothers use mindfulness to navigate postoperative pain and boost breastfeeding confidence during physical recovery. Furthermore, incorporating psychometric assessments of mindfulness and self-efficacy into prenatal education can help identify mothers with low baseline scores early, allowing for targeted, proactive support before the postpartum period begins.

Limitations

Several limitations warrant consideration. First, the cross-sectional design precludes causal inferences; although we established a correlation, longitudinal studies are needed to determine whether mindfulness predicts self-efficacy over time or vice versa. Second, reliance on self-report measures introduces the potential for recall and social desirability biases. Third, the study was conducted in a single university hospital, which may limit generalizability to rural or different socioeconomic populations. Additionally, while delivery mode was assessed, the study did not distinguish between elective and emergency cesarean sections. Given that the physical and emotional exhaustion associated with emergency procedures might uniquely impact a mother’s capacity for mindfulness, this remains a nuance for future investigation. Future research should use experimental designs to test the efficacy of structured mindful breastfeeding programs, compare different clinical contexts of childbirth, and explore the physiologic correlates (e.g., cortisol levels) of these psychological gains.

Conclusion

This study has demonstrated that mindful breastfeeding is significantly associated with enhanced breastfeeding self-efficacy. By remaining present and emotionally attuned, mothers can navigate breastfeeding challenges with greater resilience. The findings particularly highlight the resilience of mothers delivering via cesarean section, suggesting that mindfulness may serve as a vital compensatory mechanism for this group. Ultimately, integrating mindfulness principles into maternal health services offers a cost-effective, holistic approach to improving breastfeeding outcomes and maternal well-being.

Footnotes

Acknowledgements

We thank the Scientific and Technological Research Council of Türkiye (TÜBİTAK) for its financial support (Grant No: 1919B012338156). We also extend our gratitude to all the pregnant women who participated in this study.

ORCID iDs

Beyza Nur Atak

Seda Çetin Avcı

Ethical Considerations

Permission was obtained from Izmir Kâtip Çelebi University Non-Interventional Clinical Research Ethics Committee (Decision No. 205; date: April 25, 2024).

Author Contributions

Beyza Nur Atak: Conceptualization; Data curation; Methodology; Project administration; Writing–original draft.

Seda Çetin Avcı: Conceptualization; Formal analysis; Supervision; Writing–original draft; Writing–review & editing.

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Financial support was received within the scope of the Scientific and Technological Research Council of Türkiye (TÜBİTAK) 2209 Program (1919B012338156).

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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