Measuring paternal breastfeeding self-efficacy: A psychometric evaluation of the Breastfeeding Self-Efficacy Scale–Short Form among fathers

The reliability and validity of the Postpartum Partner Support Scale among Chinese women

BACKGROUND

The benefits of partner support have been well documented for maternal and child health and wellbeing. Chinese women who practice traditional postpartum rituals may lack support during the confinement and often rely heavily on their partners. Currently, there is no validated measure to assess postpartum partner support in China.

AIM

To translate the Postpartum Partner Support Scale (PPSS) into Chinese, evaluate its psychometric properties and assess postpartum support among Chinese women.

METHODS

The PPSS was translated into Chinese using a validated process and administered to 428 postpartum women residing in the city of Quanzhou in the Fujian Province in China between September 2021 and July 2022.

RESULTS

Reliability analysis demonstrated a Cronbach's α coefficient of 0.97, a split-half coefficient of 0.93, and a retest correlation coefficient of 0.91 (p < 0.01). The item analysis and content validity results fell within the recommended range, with no items requiring deletion. Exploratory factor analysis revealed the extraction of a single common factor, which accounted for 74.05% of the cumulative variance. Confirmatory factor analysis yielded a χ2/df ratio of 1.48 and an RMSEA value of 0.05. Several demographic variables were associated with significantly lower levels of postnatal partner support including older maternal and paternal age, lower maternal education, higher household income, fair relationship with in-law family, female infant sex, and premature birth.

CONCLUSION

The Chinese version of the PPSS exhibited good reliability and validity providing evidence that it may be suitable for evaluating partner support among postpartum women in China.

The Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF): German Translation and Psychometric Assessment

BACKGROUND

German-speaking mothers have breastfeeding rates below the international breastfeeding recommendations. Previous research has found that breastfeeding self-efficacy is an important and modifiable predictor of breastfeeding outcomes, thus improving breastfeeding rates. The Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) is used in many countries to assess maternal breastfeeding self-efficacy. This instrument has not been available in German.

RESEARCH AIMS

To translate the BSES-SF into German and assess its psychometric properties among breastfeeding mothers up to 12 weeks postpartum.

METHODS

This cross-sectional study was conducted online with 355 breastfeeding mothers recruited from breastfeeding groups through Facebook. The BSES-SF was translated into German using forward and back-translation. To test reliability, item-total characteristics, including Cronbach's alpha, were examined. We used principal component analysis, as well as known-groups comparisons for evaluating construct validity, and examined the relationship between breastfeeding self-efficacy and demographic variables.

RESULTS

The mean age of participants was 32.4 years (SD = 4.32). The Cronbach's alpha coefficient was .88 and corrected item-total correlations ranged between .37 and .73. Principal components analysis yielded one component with factor loadings >.40 and an eigenvalue of 5.62, which explained 40% of the total variance. In addition, known group comparisons provided further evidence for construct validity. There was no significant difference in BSES-SF scores in terms of demographic and obstetrics characteristics.

CONCLUSION

Our results provide evidence that the German version of the BSES-SF is a reliable and valid tool for measuring breastfeeding self-efficacy among mothers in German-speaking countries.

Development and psychometric evaluation of the paternal support scale of breastfeeding

BACKGROUND

Social support positively affects the adaptation process of the woman to the maternal role during pregnancy and the postpartum period and increases her sensitivity to her baby. It is known that the support provided by fathers to their wives during this process positively affects their decision to breastfeed and continue.

PURPOSE

The aim of this study is to contribute to the literature by the Paternal Support Scale of Breastfeeding, testing its validity, reliability and psychometric properties.

METHODS

The study, which included 203 fathers with babies 0-6 months of age who were actively breastfed between January and June 2022, was completed in a Medical Faculty Hospital at Konya in Turkey. The psychometric properties of the scale were evaluated with exploratory factor analysis and confirmatory factor analysis. In addition, number/percentage, t-test for dependent and independent groups and correlation analysis were used in the evaluation of the data.

RESULTS

Total item correlation coefficient of this scale was found to vary between 0.63 and 0.81. According to the confirmatory factor analysis results the goodness-of-fit index values of the scale indicated that the model has an acceptable fitness, and the 21-item one-dimensional scale has confirmed validity.

CONCLUSION

Our findings showed that this scale is a good reliable measurement tool that can be used to evaluate levels of paternal support in breastfeeding. The scale can be adapted to different cultures, and cross-cultural comparisons can be planned in future studies.

PRACTICE IMPLICATIONS

Spouse and family support increases breastfeeding success. Due to their active role in the decisions made within the family, fathers positively influence mothers' breastfeeding decisions and increase mothers' motivation to continue breastfeeding. This measurement tool, developed to measure partner support in breastfeeding, helps nurses, to determine fathers' support levels in breastfeeding. In this way, nurses can contribute to increasing the duration of breastfeeding by making effective interventions for the solution of partner support problems related to breastfeeding.

Psychometrics of the breastfeeding self-efficacy scale and short form: a systematic review

BACKGROUND

The Breastfeeding Self-Efficacy Scale and its short-form were developed in Canada and have been used internationally among numerous maternal populations. However, the psychometric properties of the scales have not been reviewed to confirm their appropriateness in measuring breastfeeding self-efficacy in culturally diverse populations. The purpose of this research was to critically appraise and synthesize the psychometric properties of the scales via systematic review.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Three databases (EMBASE, MEDLINE, and PsycINFO) were searched from 1999 (original publication of the Scale) until April 27, 2022. The search was updated on April 1, 2023. Studies that assessed the psychometric properties of the BSES or BSES-SF were included. Two researchers independently extracted data and completed the quality appraisals.

RESULTS

Forty-one studies evaluated the psychometrics of the BSES (n = 5 studies) or BSES-SF (n = 36 studies) among demographically or culturally diverse populations. All versions of the instrument demonstrated good reliability, with Cronbach's alphas ranging from .72 to .97. Construct validity was supported by statistically significant differences in mean scores among women with and without previous breastfeeding experience and by correlations between the scales and theoretically related constructs. Predictive validity was demonstrated by statistically significant lower scores among women who ultimately discontinued breastfeeding compared to those who did not.

CONCLUSION

The BSES and BSES-SF appear to be valid and reliable measures of breastfeeding self-efficacy that may be used globally to (1) assess women who may be at risk of negative breastfeeding outcomes (e.g., initiation, duration and exclusivity), (2) individualize breastfeeding support, and (3) evaluate the effectiveness of breastfeeding interventions.

A complex intervention to support breastfeeding: A feasibility and acceptability study

AIMS

The aims of this study are to assess the acceptability and feasibility of a multicomponent intervention to support breastfeeding women and their families and explore its effectiveness.

METHODS

A pilot study with control and intervention groups was conducted using the complex intervention framework in two primary healthcare centres. Overall, 44 childbearing women, their partners/relatives and 20 healthcare professionals participated in the study. The intervention's feasibility and acceptability were measured. The percentage of exclusive breastfeeding rates and women's self-efficacy were measured at pre-intervention, at 10 days postpartum, and again at 2, 4 and 6 months postpartum. Postpartum depression risk was measured at 2 and 6 months postpartum. Professional self-efficacy was measured at pre-intervention and 3 months later.

RESULTS

The intervention was feasible and acceptable. No difference in self-efficacy existed between the intervention and control groups. Preliminary effects of the intervention were found in exclusive breastfeeding percentage and postpartum depression risk in the intervention group.

CONCLUSION

The intervention is feasible and acceptable. The results are promising not only for breastfeeding maintenance but also for preventing postpartum depression and recovering exclusive breastfeeding during pandemics.

TRIAL REGISTRATION

ClinicalTrials.gov ID: NCT03944642.

Breastfeeding Self-Efficacy: A Systematic Review of Psychometric Properties Using COSMIN

BACKGROUND

Breastfeeding self-efficacy has been proven to play a predictive role in enhancing breastfeeding initiation and continuation. Breastfeeding self-efficacy measurement tools have facilitated healthcare professionals' early identification and support of women at higher risk of early discontinuation of breastfeeding.

RESEARCH AIM

The aim of this study was to assess the psychometric properties of breastfeeding self-efficacy measurement tools.

METHOD

A systematic review was carried out in three phases. Phase One comprised a systematic literature review performed in PubMed, SCOPUS, Web of Science, and Cochrane Database of Systematic Reviews from February 2021 to January 2023, including 36 studies for final analysis. Phase Two provided a quality appraisal of the psychometric properties of each of the seven breastfeeding self-efficacy measurement tools, according to COnsensus-based Standards for the selection of health Measurement Instrument checklist (COSMIN) guidelines. Phase Three summarized and graded the overall quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) modified approach.

RESULT

The included articles comprised 9,225 participants and seven breastfeeding self-efficacy measurement tools. The Breastfeeding Self-Efficacy Scale, Breastfeeding Self-Efficacy Scale - Short Form (BSES-SF), and Prenatal Breastfeeding Self-Efficacy Scale were supported by Grade A evidence sustaining their validity and reliability to assess breastfeeding self-efficacy in the continuum of maternity care. The BSES-SF is the most feasible tool in clinical practice and the most utilized internationally, available in 15 languages.

CONCLUSION

This systematic review provided a Grade A recommendation on breastfeeding measurement tools that will be helpful both for clinical and research purposes.Registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42021238450).

Factors Affecting Thai Fathers' Self-Efficacy to Support Exclusive Breastfeeding

BACKGROUND

Breastfeeding is the ideal approach for feeding infants and is an important public health consideration. Successful exclusive breastfeeding initiation and duration is influenced by fathers' support. Paternal self-efficacy to support breastfeeding has also been shown to mediate infant feeding practices. The aim of this study was to investigate factors associated with Thai fathers' self-efficacy to support maternal exclusive breastfeeding.

METHODS

We adopted a cross-sectional survey design for this study. In total, 215 Thai fathers who had a partner with a term (37-42 weeks) pregnancy participated in the study. Data were collected from antenatal care clinics at two hospitals in Northern Thailand between June and August 2022. Participants completed a sociodemographic questionnaire, the Fathers' Attitude toward Exclusive Breastfeeding questionnaire, the Fathers' Knowledge about Exclusive Breastfeeding questionnaire, and the Breastfeeding Self-Efficacy Scale (Short-Form). Multiple linear regression and hierarchical regression were used to analyze factors influencing Thai fathers' self-efficacy to support maternal exclusive breastfeeding.

RESULTS

The mean breastfeeding self-efficacy score was 52.94 (SD = 8.58), indicating that fathers were confident they were able to support their partners' breastfeeding. Regression analysis revealed family type, fathers' attitude toward, and fathers' knowledge about exclusive breastfeeding significantly explaining 14.90% of the variance in paternal breastfeeding support self-efficacy. However, fathers' age, education, employment, income, and number of living children were not associated with their self-efficacy.

CONCLUSIONS

The results demonstrated that family type and fathers' attitudes/knowledge about breastfeeding influenced their self-efficacy to support exclusive breastfeeding. Nurses should consider implementing breastfeeding interventions specific to fathers to enhance their attitudes and knowledge about breastfeeding, including increasing fathers' self-efficacy to support maternal exclusive breastfeeding efforts.

Maternal and co-parental experiences and satisfaction with a co-parenting breastfeeding eHealth intervention in Canada

BACKGROUND

Suboptimal breastfeeding rates are a public health priority. Interventions that include both breastfeeding women and their co-parents can increase breastfeeding initiation, duration, and exclusivity. eHealth can be an effective means of designing such interventions, as parents increasingly use the internet to access health information. The objective of this study was to determine maternal and co-parent satisfaction with an eHealth intervention.

METHODS

The study was part of a larger randomized controlled trial that took place in Canada between March 2018 and April 2020. Data was collected from mothers (n = 56) and co-parents (n = 47).

INTERVENTION

The eHealth intervention group received: 1) continued access to an eHealth breastfeeding co-parenting resource from the prenatal period to 52 weeks postpartum; 2) a virtual meeting with a research assistant; and 3) 6 weekly emails reminders. Follow-up data were collected via online questionnaires completed at 2 weeks post enrollment and 4, 12, 26, and 52 weeks postpartum to determine use and satisfaction with the intervention components.

FINDINGS

The majority of mothers and co-parents independently reviewed the eHealth resource (95% and 91%, respectively), with higher use in the prenatal period. Participants found the resource to be useful (92%), informative (93%), targeted both parents (90%), and easy to understand (97%). Participants indicated the resource was comprehensive, easily navigated, convenient, and engaging.

APPLICATION TO PRACTICE

Providing mothers and their co-parents with breastfeeding co-parenting support via an eHealth intervention delivers accessible, comprehensive information which may assist them in meeting their breastfeeding goals.

Validity and reliability of the Turkish version of the paternal breastfeeding self-efficacy scale - Short form for fathers

BACKGROUND

Women supported by their partners are more likely to initiate and maintain breastfeeding and overcome related challenges. Therefore, reliable measurement tools are needed to determine whether fathers can provide this support.

AIM

This study aimed to (1) examine the psychometric properties of the Paternal Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) in Turkish fathers, including internal consistency reliability, test-retest reliability, construct validity using Confirmatory Factor Analysis (CFA); and (2) assess the relationship between the BSES-SF and paternal demographic factors.

METHODS

A methodologically study was conducted between December 26-2018 and June 26-2019 at the pediatrics clinics of two research hospitals of medical schools in Konya, Turkey. The sample consisted of 221 fathers of infants aged 2 to 6 weeks who visited the clinics for routine examinations. Data were collected using a sociodemographic questionnaire and the Turkish version of the Paternal BSES-SF. After evaluating the language equivalence and content validity of the scale, test-retest reliability, internal consistency and construct validity were examined. In evaluation of the data frequency/percentage, mean, standard deviation, independent groups t test, ANOVA Analysis, Bartlett's Test of Sphericity, Confirmatory Factor Analysis, Pearson Product-Moment correlation and Cronbach α analysis were used. The study was approved by Interventional Clinical Research Ethics Committee of the Faculty of Health Sciences of Selcuk University in Turkey.

RESULTS

The translated Paternal BSES-SF had a Cronbach's alpha of 0.93 and a test-retest reliability coefficient of 0.96. The factor loadings ranged from 0.42 to 0.76. The Paternal BSES-SF had a one-factor structure similar to the original scale. Fathers who were unemployed, had lower economic status, and unplanned pregnancy had significantly lower mean Paternal BSES-SF scores. Paternal education regarding breastfeeding increased mean Paternal BSES-SF retest scores (p<0.05).

CONCLUSIONS

The Paternal BSES-SF was a valid and reliable measure to assess fathers' confidence in their ability to assist mothers with breastfeeding in Turkey. Turkish researchers and health workers can use this instrument as a reference for promoting exclusive breastfeeding.

Psychometric Assessment of the Breastfeeding Self-Efficacy Scale-Short Form: A Confirmatory Factor Analysis of Indonesian Mothers

This study aimed to evaluate the psychometric properties of the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) in Indonesian postpartum women. We conducted a cross-sectional study including 237 postpartum women in Yogyakarta City, Indonesia. Participants completed the BSES-SF, Edinburgh Postnatal Depression Scale (EPDS), and Hospital Anxiety and Depression Scale (HADS). Construct validity, internal reliability, and divergent validity were examined using confirmatory factor analysis, Cronbach's alpha, and Pearson's correlations. We identified a unidimensional structure through confirmatory factor analysis with an excellent internal consistency by Cronbach's alpha of .90. Divergent validity was evidenced by low correlation of the BSES-SF with the depressive symptoms (EPDS, r = -.21; HADS-D, r = -.17, p < .05) and anxiety symptoms (HADS-A, r = -.15, p = .02). It is concluded that the Indonesian version of BSES-SF is a valid and reliable measurement tool to assess breastfeeding self-efficacy among postpartum women.

Psychometric Assessment of the Paternal Breastfeeding Self-Efficacy Scale-Short Form: A Confirmatory Factor Analysis of Malawian Fathers

BACKGROUND

Only 61% of Malawian women exclusively breastfeed to the recommended 6 months. Paternal support is predictive of exclusive breastfeeding, and significantly related to paternal breastfeeding self-efficacy, defined as fathers' confidence in their ability to assist mothers with breastfeeding.

RESEARCH AIMS

To (1) examine the psychometric properties of the Paternal Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) in Malawian fathers, including internal consistency reliability, test-retest reliability, construct validity using Confirmatory Factor Analysis (CFA), and convergent validity; and (2) assess the relationship between the BSES-SF and paternal demographic and health factors.

METHODS

A cross-sectional study was conducted at a maternity hospital in Lilongwe, Malawi, and 180 fathers whose partners had delivered a singleton infant were included. Participants completed the Breastfeeding Self-Efficacy Scale and Quality of Life with confirmatory factor analysis performed to assess the construct validity. The internal consistency reliability and test-retest reliability were evaluated using Cronbach's alpha coefficient and intra-class correlations. Convergent validity was also assessed.

RESULTS

A unidimensional factorial structure of the Malawian Paternal BSES-SF was identified using confirmatory factor analysis. The scale had an excellent Cronbach's alpha of .90 and a test-retest reliability of .93. Participants' breastfeeding self-efficacy was significantly correlated with the Quality of Life domains of psychological health (r = .23; p < .01), social relationships (r = .28; p < .001), and environmental health (r = .30; p < .001). Participants who were older, married, and with ≥ two children had significantly higher breastfeeding self-efficacy and were more confident in their ability to support their partner's breastfeeding.

CONCLUSION

The Paternal Breastfeeding Self-Efficacy Scale-Short Form was a valid and reliable measure to assess fathers' confidence in their ability to assist mothers with breastfeeding in Malawi.

Predictive capacity for breastfeeding and determination of the best cut-off point for the breastfeeding self-efficacy scale-short form

INTRODUCTION

The most widely used tool for assessing breastfeeding self-efficacy is the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). This study assesses the relationship between the BSES-SF score and the risk of breastfeeding (BF) cessation and determines the cut-off point in the scale score that optimizes detection of this risk in primary health care pediatric consultations.

METHODS

Secondary data analysis of the LAyDI study. Cohort study carried out through a research network of primary care pediatricians (PAPenRed). A newborn was recruited every month for one year by 210 pediatricians. The cohort was followed for 24 months. Mothers responded to the BSES-SF at the first visit. General pregnancy and delivery data were collected and assessed to determine whether breastfeeding was exclusive or supplemented during the first 6 months.

RESULTS

N = 1845. The Area Under the ROC Curve for the exclusive BF was 0.790 (0.765-0.815) the first month and 0.760 (0.734-0.786) the second month. For 4 and 6 months, as well as for any age in mothers who give supplemented BF, the Area Under the Curve was less than 0.75 and its predictive capacity was not considered to be good. For a sensitivity of 80% in detecting mothers at risk of BF cessation with the BSES-SF, the cut-off score was 58.

CONCLUSIONS

Mothers with a BSES-SF score below 58 points in primary health care, are at risk of early withdrawal of exclusive BF within two months.

[Predictive capacity for breastfeeding and determination of the best cut-off point for the breastfeeding self-efficacy scale-short form]

INTRODUCTION

The most widely used tool for assessing breastfeeding self-efficacy is the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). This study asses the relationship between the BSES-SF score and the risk of breastfeeding (BF) cessation and determine the cut-off point in the scale score that optimizes detection of this risk in primary health care pediatric consultations.

METHODS

Secondary data analysis of the LAyDI study. It is a cohort study. It was carried out through a research network of primary care pediatricians (PAPenRed). A newborn was recruited every month for one year by 210 pediatricians. The cohort was followed for 24 months. Mothers responded to the BSES-SF at the first visit. General pregnancy and delivery data were collected and assessed to determine whether breastfeeding was exclusive or supplemented during the first six months.

RESULTS

n = 1,845. The area under the ROC curve for the exclusive BF was 0.790 (0.765-0.815) the first month and 0.760 (0.734-0.786) the second month. For four and six months, as well as for any age in mothers who give supplemented BF, the Area Under the Curve was less than 0.75 and its predictive capacity was not considered to be good. For a sensitivity of 80% in detecting mothers at risk of BF cessation with the BSES-SF, the cut-off score was 58.

CONCLUSIONS

Mothers with a BSES-SF score below 58 points in primary health care, are at risk of early withdrawal of exclusive BF within two months.

Psychometric properties of the modified breastfeeding self-efficacy scale-short form (BSES-SF) among Chinese mothers of preterm infants

OBJECTIVE

Preterm mother-infant dyads face more challenges than healthy term infants in breastfeeding initiation and continuation due to maternal health status, preterm infant's immaturity or comorbidities, and breastfeeding policy of the neonatal units. Breastfeeding self-efficacy affects breastfeeding outcomes in preterm infants. No specific instrument in Chinese is available to assess maternal breastfeeding self-efficacy of preterm infants. This study aims to assess the psychometric characteristics of the modified Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) among Chinese mothers of preterm infants.

DESIGN

A cross-sectional study was conducted.

SETTING

Two tertiary hospitals in China.

PARTICIPANTS

A total of 153 women who gave birth before 37 weeks of gestation.

MEASUREMENTS

The instrument was translated and back translated. The internal consistency reliability was investigated using Cronbach's alpha coefficient. The content validity, construct validity, and criterion validity were conducted to evaluate the validity of the scale. Exploratory factor analysis was used to investigate the factor structure.

FINDINGS

The scale had good reliability with Cronbach´s alpha above the acceptable level of 0.7. The Item-Content Validity Index (I-CVI) ranged from 0.800 to 1.000, and the Scale-Content Validity Index (S-CVI) is 0.950. The principal component analysis revealed the presence of two factors with eigenvalues greater than 1, explaining a total variance of 74.665%. The modified BSES-SF scores were correlated with women's parity, breastfeeding knowledge, previous breastfeeding experience, perceived support from the spouse and health professionals, and amounts of expressed milk.

KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

The Chinese version of modified BSES-SF is a reliable, valid screening instrument to evaluate the maternal breastfeeding self-efficacy of preterm infants. It is recommended to provide interactive, face-to-face breasting education and support to help mothers of preterm infants maintain high level of breastfeeding self-efficacy and further to achieve satisfactory breastfeeding outcomes.

The comparison of access to an eHealth resource to current practice on mother and co-parent teamwork and breastfeeding rates: A randomized controlled trial

BACKGROUND

Breastfeeding rates are suboptimal, putting mothers and their infants' health at risk. One modifiable risk factor amenable to intervention is partner support. Having women work as a team with their co-parents to meet their breastfeeding goals has been found to improve breastfeeding outcomes. eHealth resources have been found to be accessible and feasible ways to provide breastfeeding education yet, the best way to design breastfeeding interventions for mothers and their co-parents is not known.

OBJECTIVES

To compare two study conditions to determine: (1) which way is more effective to provide breastfeeding education to women and their co-parents on increasing breastfeeding rates and associated secondary outcomes, such as breastfeeding knowledge, attitude, self-efficacy and overcoming challenges; (2) the difference in co-parenting and partner support between the study groups; (3) how parents in both groups preferred to access breastfeeding information; and (4) the groups' satisfaction with the eHealth resource that was provided.

DESIGN

This study used a randomized controlled trial design (Clinicaltrials.org #NCT03492411). Participants were randomly allocated to study groups with concealed opaque envelopes by a blinded research assistant. Participants in Study Condition #1 (SC1) accessed a previously created, online e-Health resource, in addition to other generally available resources they could access in the community; participants in Study Condition #2 (SC2) accessed only the generally available resources.

SETTING

Participants were recruited in health care providers' offices and services for expectant parents in Ontario and via social media throughout Canada.

PARTICIPANTS

Expectant women (n = 113) and their co-parents (n = 104) were enrolled.

METHODS

After eligibility was determined, consents obtained and baseline surveys completed, group allocation was conducted. SC1 had a virtual meeting with a research assistant to review the eHealth resource. Weekly emails were sent to all participants for 6 weeks as reminders. Follow-up data were electronically collected from mothers and co-parents at 2 weeks post enrollment and 4, 12, 26 and 52-weeks postpartum.

RESULTS

Breastfeeding rates were high in both groups (SC1 63% and SC2 57% 'exclusive' 6 months) and (SC1 71% and SC2 78% 'any' 12 months) and not statistically significantly different. High scores were found in both groups in secondary outcome measures. Generally available breastfeeding resources were used in both groups with websites being used often and rated as most helpful. SC1 rated the eHealth resource provided to them highly.

CONCLUSION

The findings suggest both mothers and their co-parents should be targeted in breastfeeding education and web-based resources designed to meet their needs.

Marital Adjustment and Prenatal Breastfeeding Efficacy of First Time Mothers in A Low-Income Community in The Philippines

Introduction: All women should be offered support to breastfeed their babies to increase the duration and exclusivity of breastfeeding. This study aims to assess the level of marital satisfaction and its influence to prenatal breastfeeding self-efficacy in   first time mothers during late pregnancy.Methods: A descriptive correlational was conducted among 128 simple randomized prim gravid women who agreed to participate and had prenatal care check-up in the health center at the time of data gathering. The instruments used were 15-item Marital Adjustment Test (MAT) to measure marital adjustment and 14-item Breastfeeding Self efficacy Scale-Short Form (BSES-SF) as a measure of breastfeeding self-efficacy. Pearson’s correlation coefficient was utilized to test the relationships between the sample’s marital adjustment scores to correlate with BFSE of the respondents. Fisher’s t test was utilized to determine the significance of correlations. A p-value of equal to or less than .05 was considered statistically significant.Results: The study revealed that the sampled mothers have a high level of marital adjustment score (112.05± 21.83). Prenatal mothers responded in the study were highly confident and have high self-efficacy in breastfeeding first child currently bearing (4.55±.51). Lastly, it was found that there is no significant correlation between marital adjustment and prenatal breastfeeding self-efficacy (β=-.052, p-value=.280).Conclusion: It was found  that there is a high level of marital adjustment and breastfeeding self-efficacy among sampled mothers. However, there is no significant correlation between marital adjustment and prenatal breastfeeding self-efficacy. The study suggests incorporating co-parenting intervention involving father’s involvement and assistance with breastfeeding when creating interventions in breastfeeding.

Development, psychometric assessment, and predictive validity of the comprehensive breastfeeding knowledge scale

AIM

To develop a breastfeeding knowledge scale that aligns with the Baby Friendly Hospital Initiative and psychometrically test it among expectant parents.

BACKGROUND

Although breastfeeding is recommended by all leading health authorities, rates remain suboptimal with women often not achieving their breastfeeding goals. One factor found to positively influence infant feeding behaviours is increased maternal breastfeeding knowledge. However, little research has been conducted validating the dimensions of breastfeeding knowledge to guide interventions to promote positive breastfeeding outcomes.

DESIGN

Following an extensive literature review, the 28-item Comprehensive Breastfeeding Knowledge Scale (CBKS) was developed and psychometrically tested.

METHOD

A sample of 217 Canadian expectant parents (113 women and 104 coparents) was recruited and administered the CBKS with follow-up questionnaires at 4 and 12 weeks postpartum. Psychometric analyses included exploratory factor analysis, internal consistency, concurrent validity, and predictive validity.

RESULTS

Exploratory factor analysis resulted in three dimensions: (1) managing milk supply; (2) persisting through challenges; and (3) correcting misconceptions. Coefficient alpha for the total scale was 0.83 and support for concurrent validity was demonstrated through significant positive correlations with the Iowa Infant Feeding Attitude scale. Further, higher total and subscale scores in pregnancy were associated with exclusive breastfeeding at 4 and 12 weeks postpartum, providing good evidence for predictive validity.

CONCLUSION

Preliminary data suggest the CBKS is a valid and reliable measure of breastfeeding knowledge. Upon further testing, this self-report measure may be used to (1) identify women with low breastfeeding knowledge requiring targeted support, (2) individualize health professional care with breastfeeding women, and (3) evaluate the effectiveness of breastfeeding interventions and programs.

The Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF): a validation study in Iranian mothers

OBJECTIVE

The Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) is a widely used instrument that measures breastfeeding self-efficacy. This study aimed to examine the reliability and validity of the Persian version of BSES-SF in Iranian mothers.

RESULTS

The English version of BSES-SF was translated into Persian using the standard forward-backward translation procedure. No changes (i.e., neither delete nor rephrase the items) were made to the BSES-SF items. The mean BSES-SF total score was 50.80 ± 8.91. The Cronbach's alpha coefficient for internal consistency for the BSES-SF was 0.910. The confirmatory factor analysis results provided evidence for unidimensionality of the scale (χ²/df = 4.42; CFI = 0.96; NFI = 0.95; IFI = 0.96; RMSEA = 0.095 and SRMR = 0.054). The divergent validity of the BSES-SF was proved via a significant negative correlation with scores of the Edinburgh Postnatal Depression Scale (r = - 0.273, P < 0.001). In sum, the Persian version of the BSES-SF is a reliable and valid instrument for measuring breastfeeding self-efficacy in Iranian mothers. Trial registration number This was a cross-sectional study (not clinical trial).