Objective To investigate the current situation and factors associated with self-efficacy of early postpartum breastfeeding, aiming at exploring the feasible ways to enhance breastfeeding self-efficacy in the early stage and improve the rate of exclusive breastfeeding within 6 months.

Methods Totally 477 women who delivered in Shanghai Obstetrics and Gynecology Hospital of Fudan University from March to August 2022 were investigated through questionnaire survey within 7 days postpartum. Factors associated with self-efficacy of breastfeeding were analyzed through random forest algorithm and multiple linear regression.

Results The average score of breastfeeding self-efficacy of 477 participants was 43.98 ± 12.80. Random forest algorithm analysis showed that the top three variables affecting maternal breastfeeding self-efficacy in the early postpartum period were per capita monthly household income, breastfeeding method, and overnight breastfeeding. Multiple linear regression analysis showed that subjective insufficient breast milk, difficulties in breastfeeding, attitudes of postpartum women, scores of Breastfeeding Evaluation Scales (BES) and Edinburgh Postnatal Depression Scale (EPDS) were factors associated with breastfeeding self-efficacy (P < 0.05).

Conclusion Health professionals can improve women's self-efficacy of breastfeeding and promote exclusive breastfeeding within 6 months postpartum by changing their misconceptions, strengthening guidance in the early stages of breastfeeding, paying attention to postpartum depression, and encouraging family members' support.