Letter to Editor

Health literacy and breastfeeding self-efficacy: Clarity needed beyond correlation

Volume: 24 Number: 1 November 5, 2026

Health literacy and breastfeeding self-efficacy: Clarity needed beyond correlation

Abstract

Objective: To critically appraise methodological, reporting, and interpretational aspects of a recent study examining the association between health literacy (HL) and breastfeeding self-efficacy (BSE) among postpartum mothers. Methods: A structured review of the published article was conducted focusing on conceptual clarity, statistical methodology, data presentation, and generalisability. Specific attention was given to the framing of key constructs, completeness of tabular reporting, regression modelling strategy, and consideration of potential biases. Results: A misleading conceptual statement was identified in the Introduction, where HL was incorrectly implied to increase pregnancy-related risks. Table 2 demonstrated inconsistencies, including missing subgroup sample sizes and percentages, limiting reproducibility. The regression analysis incorporated BSE as both an independent and dependent variable across models, raising concerns of endogeneity and circular interpretation. Additionally, the use of single-site, short-duration convenience sampling without adequate discussion of selection bias restricts generalisability. Several typographical and formatting errors were also noted, affecting overall clarity. Conclusions: While the study contributes to the growing body of literature on maternal HL and breastfeeding behaviour in the early postpartum period, addressing the identified conceptual, methodological, and reporting issues would enhance the validity, interpretability, and public health applicability of the findings.

Keywords

Health literacy, Breastfeeding self-efficacy, Postpartum period, Methodological bias, Cross-sectional studies

References

  1. Çifçi S, Yaşar BN. Health literacy and breastfeeding self-efficacy: A cross-sectional study among postpartum mothers. Turk J Public Health. 2026;(1).
  2. Salarvand S, Ghazvineh S, Mousivand F, Ahmadi Gharaei H, Bitaraf S. Health literacy and its related factors as predictors for the breastfeeding self-efficacy in a western province in Iran. BMC Public Health. 2023;23(1):593.
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  4. Gaupšienė A, Vainauskaitė A, Baglajeva J, Stukas R, Ramašauskaitė D, Paliulytė V, et al. Associations between maternal health literacy, neonatal health and breastfeeding outcomes in the early postpartum period [Internet]. doi:10.18332/ejm/170161
APA
Verma, S., Prasad, S. A., & Borgaonkar, C. (2026). Health literacy and breastfeeding self-efficacy: Clarity needed beyond correlation. Turkish Journal of Public Health, 24(1). https://doi.org/10.20518/tjph.1944690
AMA
1.Verma S, Prasad SA, Borgaonkar C. Health literacy and breastfeeding self-efficacy: Clarity needed beyond correlation. TJPH. 2026;24(1). doi:10.20518/tjph.1944690
Chicago
Verma, Shristi, S Adithya Prasad, and Chaitali Borgaonkar. 2026. “Health Literacy and Breastfeeding Self-Efficacy: Clarity Needed Beyond Correlation”. Turkish Journal of Public Health 24 (1). https://doi.org/10.20518/tjph.1944690.
EndNote
Verma S, Prasad SA, Borgaonkar C (November 1, 2026) Health literacy and breastfeeding self-efficacy: Clarity needed beyond correlation. Turkish Journal of Public Health 24 1
IEEE
[1]S. Verma, S. A. Prasad, and C. Borgaonkar, “Health literacy and breastfeeding self-efficacy: Clarity needed beyond correlation”, TJPH, vol. 24, no. 1, Nov. 2026, doi: 10.20518/tjph.1944690.
ISNAD
Verma, Shristi - Prasad, S Adithya - Borgaonkar, Chaitali. “Health Literacy and Breastfeeding Self-Efficacy: Clarity Needed Beyond Correlation”. Turkish Journal of Public Health 24/1 (November 1, 2026). https://doi.org/10.20518/tjph.1944690.
JAMA
1.Verma S, Prasad SA, Borgaonkar C. Health literacy and breastfeeding self-efficacy: Clarity needed beyond correlation. TJPH. 2026;24. doi:10.20518/tjph.1944690.
MLA
Verma, Shristi, et al. “Health Literacy and Breastfeeding Self-Efficacy: Clarity Needed Beyond Correlation”. Turkish Journal of Public Health, vol. 24, no. 1, Nov. 2026, doi:10.20518/tjph.1944690.
Vancouver
1.Shristi Verma, S Adithya Prasad, Chaitali Borgaonkar. Health literacy and breastfeeding self-efficacy: Clarity needed beyond correlation. TJPH. 2026 Nov. 1;24(1). doi:10.20518/tjph.1944690