The Beginning Breastfeeding Survey-Cumulative (BBSC) is an instrument that assesses the overall maternal perception of breastfeeding effectiveness during the early postpartum period.
Research aims:
The aims of this study were to adapt and validate a Spanish version of the BBSC and provide new evidence regarding its validity.
Methods:
A standard forward and back-translation process was used to obtain the Spanish version of the questionnaire (BBSC-E). A sample of 793 breastfeeding mothers was used. Data were obtained from clinical records and questionnaires self-administered at discharge and at 1–4 months postpartum. The factorial structure of the BBSC-E was examined with both an exploratory and confirmatory approach. Internal consistency, comparisons between known groups, and correlations with other variables were also assessed, and receiver operating characteristics (ROC) curves were used to determine its predictive validity.
Results:
Analysis revealed a two-dimensional structure, with infant and maternal subscales, and adequate fit statistics. The Root Mean Squared Error of Approximation (RMSEA) was .067. The Cronbach’s α of the overall scale was .91. There were statistically significant associations between the BBSC-E and (1) previous breastfeeding experience, early skin-to-skin contact, exclusive breastfeeding, breastfeeding difficulty and self-efficacy, and infant weight loss during hospitalization and (2) at 1–4 months postpartum, with the breastfeeding status, the intensity of breastfeeding problems, and satisfaction with breastfeeding. The total BBSC-E area under the ROC curve for any breastfeeding at 60 days postpartum was .73, and a score of 88 was the most discriminative cut-off point for maximum performance.
Conclusion:
The BBSC-E is a reliable and valid instrument for measuring breastfeeding effectiveness during early postpartum.
AcquadroC.ConwayK.GirourdetC.MearI. (2004). Linguistic validation manual for patient-reported outcomes (PRO) instruments. Lyon: MAPI Research Trust.
2.
AltmanD. G. (1991). Practical statistics for medical research (1st ed.). London: Chapman & Hall/CRC.
3.
AltuntasN.KocakM.AkkurtS.RaziH. C.KislalM. F. (2015). LATCH scores and milk intake in preterm and term infants: A prospective comparative study. Breastfeeding Medicine, 10(2), 96–101. doi:10.1089/bfm.2014.0042
4.
Bagci BosiA. T.EriksenK. G.SobkoT.WijnhovenT. M.BredaJ. (2016). Breastfeeding practices and policies in WHO European region member states. Public Health Nutrition, 19(4), 753–764. doi:10.1017/S1368980015001767
5.
BandalosD. L.FinneyS. J. (2010). Exploratory and confirmatory. In HancockG. R.MuellerR. O.StapletonL. M. (Eds.), The Reviewer’s guide to quantitative methods in the social sciences (1st ed., pp. 93–114). New York: Routledge.
6.
CangölE.ŞahinN. H. (2017). The effect of a breastfeeding motivation program maintained during pregnancy on supporting breastfeeding: A randomized controlled trial. Breastfeeding Medicine, 12(4), 218–226. doi:10.1089/bfm.2016.0190
7.
Fox-WasylyshynS. M.El-MasriM. M. (2005). Handling missing data in self-report measures. Research in Nursing & Health, 28(6), 488–495. doi:10.1002/nur.20100
8.
GerçekE.Sarıkaya KarabudakS.Ardıç ÇelikN.SaruhanA. (2016). The relationship between breastfeeding Self-Efficacy and LATCH scores and affecting factors. Journal of Clinical Nursing, 26(7–8), 994–1004. doi:10.1111/jocn.13423
9.
HuL.BentlerP. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1–55. doi:10.1080/10705519909540118
10.
IBM Corporation. (2015). SPSS 23 for windows Armonk, NY: Scientific Software International, Inc.
11.
JöreskogK. G.SörbomD. (2006). LISREL 8.80 for windows Lincolnwood, IL: Scientific Software International, Inc.
12.
KılcıH.ÇobanA. (2016). The correlation between breastfeeding success in the early postpartum period and the perception of self-efficacy in breastfeeding and breast problems in the late postpartum. Breastfeeding Medicine, 11(4), 188–195. doi:10.1089/bfm.2015.0046
13.
KlineR. B. (2015). Principles and practice of structural equation modeling (4th ed.). New York, NY, US: Guilford Press.
14.
KronborgH.VæthM. (2009). How are effective breastfeeding technique and pacifier use related to breastfeeding problems and breastfeeding duration?Birth, 36(1), 34–42. doi:10.1111/j.1523-536X.2008.00293.x
15.
KronborgH.VæthM.OlsenJ.IversenL.HarderI. (2007). Effect of early postnatal breastfeeding support: A cluster-randomized community based trial. Acta Paediatrica, 96(7), 1064–1070. doi:10.1111/j.1651-2227.2007.00341.x
16.
KumarS. P.MooneyR.WieserL. J.HavstadS. (2006). The LATCH scoring system and prediction of breastfeeding duration. Journal of Human Lactation, 22(4), 391–397. doi:10.1177/0890334406293161
LedesmaR. D.Valero-MoraP. (2007). Determining the number of factors to retain in EFA: An easy-to-use computer program for carrying out parallel analysis. Practical Assessment, Research & Evaluation, 12(2), 1–11.
19.
Lloret-SeguraS.Ferreres-TraverA.Hernández-BaezaA.Tomás-MarcoI. (2014). Exploratory item factor analysis: A practical guide revised and up-dated. Anales De Psicología/Annals of Psychology, 30(3), 1151–1169. doi:10.6018/analesps.30.3.199361
20.
McFaddenA.GavineA.RenfrewM.WadeA.BuchananP.TaylorJ.. . .NeimanS. (2017). Support for healthy breastfeeding mothers with healthy term babies. Cochrane Database of Systematic Reviews, 28(2), CD001141. doi:10.1002/14651858.CD001141.pub5
21.
MooreE. R.BergmanN.AndersonG. C.MedleyN. (2016). Early skin-to-skin contact for mothers and their healthy newborn infants. The Cochrane Database of Systematic Reviews, 11, CD003519. doi:10.1002/14651858.CD003519.pub4
22.
MulderP. (2006). A concept analysis of effective breastfeeding. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 35(3), 332–339. doi:10.1111/j.1552-6909.2006.00050.x
23.
MulderP. (2013). Revision of the beginning breastfeeding survey: A cumulative assessment of breastfeeding. Journal of Nursing Measurement, 21(1), 80–95. doi:10.1891/1061-3749.21.1.80
24.
MulderP.JohnsonT. (2010). The beginning breastfeeding survey: Measuring mothers’ perceptions of breastfeeding effectiveness during the postpartum hospitalization. Research in Nursing & Health, 33(4), 329–344. doi: https://doi.org/10.1002/nur.20384
25.
MulolH.CoutsoudisA. (2018). Limitations of maternal recall for measuring exclusive breastfeeding rates in South African mothers. International Breastfeeding Journal, 13(1), 19. doi:10.1186/s13006-018-0159-8
26.
MuñizJ.ElosuaP.HambletonR. K., & International Test Commission. (2013). International test commission guidelines for test translation and adaptation: Second edition. [Directrices para la traduccion y adaptacion de los tests: Segunda edicion] Psicothema, 25(2), 151–157. doi:10.7334/psicothema2013.24
27.
NunnallyJ. C. (1975). Psychometric theory. 25 years ago and now. Educational Researcher, 4(10), 7–21. doi:10.2307/1175619
28.
Oliver-RoigA.d’Anglade-GonzálezM.García-GarcíaB.Silva-TubioJ.Richart-MartínezM.DennisC. (2012). The spanish version of the breastfeeding self-efficacy scale-short form: Reliability and validity assessment. International Journal of Nursing Studies, 49(2), 169–173. doi:10.1016/j.ijnurstu.2011.08.005
29.
PadosB. F.ParkJ.EstremH.AwotwiA. (2016). Assessment tools for evaluation of oral feeding in infants younger than 6 months. Advances in Neonatal Care, 16(2), 143–150. doi:10.1097/ANC.0000000000000255
30.
PapastavrouE.EfstathiouG.CharalambousA. (2011). Nurses’ and patients’ perceptions of caring behaviours: Quantitative systematic review of comparative studies. Journal of Advanced Nursing, 67(6), 1191–1205. doi:10.1111/j.1365-2648.2010.05580.x
31.
PerkinsN. J.SchistermanE. F. (2006). The inconsistency of “optimal” cutpoints obtained using two criteria based on the receiver operating characteristic curve. American Journal of Epidemiology, 163(7), 670–675. doi:10.1093/aje/kwj063
32.
PeyreH.LeplègeA.CosteJ. (2011). Missing data methods for dealing with missing items in quality of life questionnaires. A comparison by simulation of personal mean score, full information maximum likelihood, multiple imputation, and hot deck techniques applied to the SF-36 in the French 2003 decennial health survey. Quality of Life Research, 20(2), 287–300. doi:10.1007/s11136-010-9740-3
33.
RollC. L.CheaterF. (2016). Expectant parents’ views of factors influencing infant feeding decisions in the antenatal period: A systematic review. International Journal of Nursing Studies, 60, 145–155. doi:10.1016/j.ijnurstu.2016.04.011
34.
RollinsN. C.BhandariN.HajeebhoyN.HortonS.LutterC. K.MartinesJ. C.. . . VictoraC. G. (2016). Why invest, and what it will take to improve breastfeeding practices?The Lancet, 387(10017), 491–504. doi:10.1016/S0140-6736(15)01044-2
35.
SchlomerJ. A.KemmererJ.TwissJ. J. (1999). Evaluating the association of two breastfeeding assessment tools with breast-feeding problems and breastfeeding satisfaction. Journal of Human Lactation, 15(1), 35–39. doi:10.1177/089033449901500110
TorneseG.RonfaniL.PavanC.DemariniS.MonastaL.DavanzoR. (2012). Does the LATCH score assessed in the first 24 hours after delivery predict non-exclusive breastfeeding at hospital discharge?Breastfeeding Medicine, 7(6), 423–430. doi:10.1089/bfm.2011.0120
38.
VictoraC. G.BahlR.BarrosA. J.FrançaG. V.HortonS.KrasevecJ.. . . RollinsN. C. (2016). Breastfeeding in the 21st century: Epidemiology, mechanisms, and lifelong effect. The Lancet, 387(10017), 475–490. doi:10.1016/S0140-6736(15)01024-7
YoungF. W.BannC. M. (1997). ViSta: The visual statistics system. In StineR. A.FoxJ. (Eds.), Statistical computing environments for social research (1st ed., pp. 207–235). Thousand Oaks, CA, USA: Sage Publications, Inc. Retrieved from https://pdfs.semanticscholar.org/deab/9f6f42e554e01ecbded70cccacdbedfa98ec.pdf
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
