The Mediating Role of Maternal Confidence in the Relationship Between Breastfeeding Promotion and Exclusive Breastfeeding Duration

Background For public health, exclusive breastfeeding is essential for a child's health. However, many mothers stop breastfeeding prematurely. This study aimed to investigate the influence of maternal confidence on the relationship between breastfeeding promotion activities and the duration of exclusive breastfeeding among mothers after childbirth in Thi Qar Governorate, Iraq. Methods A descriptive, cross-sectional correlational design was used. A 406 postpartum mothers were recruited from hospitals and primary health care centers using a systematic random sample. Data were collected through interview-conducted questionnaires, including the Breastfeeding Support Scale (BSS), the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), and measures of duration of exclusive breastfeeding. Mediation analysis was conducted using the PROCESS macro model (Model 4) with resampling (5000 samples). Results Breastfeeding promotion was significantly associated with both maternal confidence (r = 0.52; p < 0.001) and duration of exclusive breastfeeding (r = 0.47; p < 0.001). Mediation analysis confirmed that maternal confidence partially mediated the relationship between breastfeeding promotion and duration of exclusive breastfeeding (indirect effect = 0.36; 95% CI: 0.19–0.54). Conclusion Enhancing maternal confidence through breastfeeding promotion strategies can effectively prolong the duration of exclusive breastfeeding. Interventions should prioritize confidence-building approaches in postnatal care.