Abstract
Background. Exclusive breastfeeding is one of the most important determinants of infant health and growth. Despite global recommendations, adherence to exclusive breastfeeding remains suboptimal in many countries, and misconceptions continue to be among the main barriers. This study aimed to identify misconceptions related to exclusive breastfeeding among pregnant women and examine their association with demographic factors in the city of Tabriz, Iran.
Methods. This descriptive-analytical cross-sectional study was conducted in 2021 among 225 pregnant women attending outpatient clinics at Al-Zahra and Taleghani hospitals in Tabriz. Data were collected using a 30-item questionnaire rated on a five-point Likert scale (0=strongly disagree to 4=strongly agree). All items represented misconceptions; thus, higher scores indicated greater misconception levels. The total score (0–120) was categorized into four levels (low, moderate, high, very high) based on the 25th, 50th, and 75th percentiles. Content validity was assessed using the Content Validity Ratio (CVR) and Content Validity Index (CVI), with acceptable thresholds of ≥0.62 and ≥0.79, respectively. Reliability was confirmed through a test–retest approach and calculation of the Intraclass Correlation Coefficient (ICC), with values above 0.60 indicating adequate reliability. Data were analyzed using appropriate statistical tests in SPSS version 26, and p<0.05 was considered statistically significant.
Results. The most common misconceptions were the perceived need to give infants water during hot weather, the belief that breastfeeding causes changes in breast shape, and concerns about infants becoming underweight with exclusive breastfeeding. The least frequent misconceptions were the perceived ease of formula feeding and the belief that colostrum is unsuitable. The overall mean misconception score indicated a moderate level. Among demographic variables, only maternal education was significantly associated with misconception scores (p<0.05), with higher-educated mothers reporting more misconceptions. No significant associations were found for age, employment status, or parity.
Conclusion. Misconceptions about exclusive breastfeeding remain prevalent among pregnant women, particularly those related to water supplementation and breast appearance. The higher misconception levels among more educated mothers may reflect exposure to diverse yet unreliable information sources. Strengthening health literacy and providing targeted, evidence-based prenatal education may help correct these misconceptions and improve breastfeeding-related behaviors.