The mediating role of comfort in the relationship between social support and breastfeeding self‐efficacy among primiparous mothers after cesarean

Abstract Objective Postpartum comfort refers to the mother's perceived physical, psychospiritual, and sociocultural well‐being during the postpartum period. The present study examined the mediating role of postpartum comfort in the effect of perceived social support on breastfeeding self‐efficacy among primiparous mothers who had undergone a cesarean delivery. Methods This cross‐sectional correlational study was conducted between June 2024 and June 2025 at a university hospital. Data were collected using self‐report questionnaires completed by the mothers, including the maternal personal information form, the multidimensional scale of perceived social support (MSPSS), the breastfeeding self‐efficacy scale–short form (BSES‐SF), and the postpartum comfort scale (PCS). Higher scores indicate higher perceived social support, higher postpartum comfort, and greater breastfeeding self‐efficacy. The data were analyzed using hierarchical regression analysis with the Statistical Package for the Social Sciences (SPSS) version 25.0. Results In the present study which included 314 primiparous mothers, correlation analysis revealed a moderate positive relationship between total MSPSS and total BSES‐SF scores ( r = 0.357; P < 0.001), a weak positive relationship between total MSPSS and total PCS scores ( r = 0.225; P < 0.001), and a strong positive relationship between total PCS and total BSES‐SF scores ( r = 0.703; P < 0.001). In the hierarchical regression analysis, Model 1 showed that social support significantly predicted breastfeeding self‐efficacy and explained 12.8% of the variance ( F 1,312 = 45.623; P < 0.001). In Model 2, when postpartum comfort was added, both variables remained significant predictors, and the explained variance increased to 53.6% ( F 2 ,311 = 179.517; P < 0.001). The standardized effect of social support decreased from β = 0.357 to β = 0.210. The Sobel test ( z = 6.26; P < 0.001) confirmed the partial mediating role of postpartum comfort. Conclusion A substantial part of the effect of perceived social support on breastfeeding self‐efficacy is explained by postpartum comfort. The findings indicate integrating strategies that enhance comfort and social support into policies and nursing practices can strengthen maternal–infant health and improve breastfeeding outcomes.