Factors influencing breastfeeding intention among hepatitis B virus-infected mothers: An ABC-X cross-sectional analysis

YaNan Jiang, Zhijie Geng, Wei Yang, Li Tian

Abstract

Despite international guideline recommendations supporting breastfeeding among HBV-infected mothers, breastfeeding rates remain suboptimal. This study investigated factors influencing breastfeeding intention among HBV-infected mothers using the ABC-X theoretical framework. A hospital-based cross-sectional study was conducted from January to December 2025 among 119 HBV-infected pregnant women. Structured questionnaires assessed demographic characteristics, disease-related factors, social support, self-efficacy, stigma, breastfeeding attitudes, and breastfeeding intention. Descriptive statistics, t-tests, chi-square tests, and multivariate logistic regression were performed. Among participants, 45.3% (n = 54) intended to breastfeed. Univariate analysis showed significant differences in self-efficacy (p = 0.003) and breastfeeding attitude scores (p = 0.046) between mothers with and without breastfeeding intention. After adjustment for potential confounders, self-efficacy was the only independent predictor of breastfeeding intention (OR = 3.71, 95% CI: 1.35–10.19, p = 0.011). The prediction model showed good discrimination, with an area under the ROC curve of 0.782. Maternal self-efficacy was the strongest predictor of breastfeeding intention among HBV-infected mothers. Interventions enhancing self-efficacy and clearly communicating breastfeeding safety with immunoprophylaxis may improve breastfeeding support in this population.

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