Journal of Human Lactation

Breastfeeding satisfaction is usually measured by how long a mother breastfeeds. Lack of another method to measure the mother's evaluation of breastfeeding has been a barrier to breastfeeding research. This study tested validity and reliability of the Maternal Breastfeeding Evaluation Scale (MBFES), a new tool which measures mothers' satisfaction with breastfeeding. The sample consisted of 73 women who attended breastfeeding classes in a midwestern hospital. MBFES scores were significantly correlated with the length of time mothers intended to breastfeed (r = .31) and the length of time they breastfed (r = .49), which supports validity. Correlation coefficients for the scale and subscales, .83, .73, .76 and .78, respectively, indicated acceptable internal consistency among items in the scale. These findings support reliability and validity of the MBFES for clinical use.

Admission of newborn infants to neonatal intensive care units (NICU) has been considered an obstacle to breastfeeding because of mother-infant separation and hospital feeding routines. In order to obtain advice on facilitating breastfeeding, we interviewed by telephone 178 mothers of fullterm NICU patients three months after the infants' discharge from hospital. Mothers' advice, in order of prominence, concerned the disturbing impact of the NICU environment, lack of systematic breastfeeding advice, distance between infants' and mothers' units in the hospital, conflicts about parents' roles, perceived lack of organization of work, dissatisfaction with nurse behavior towards parents, and importance of skin-to-skin contact during the mother's first visit. Adaptation of the NICU environment, nurses' awareness of mothers' perspectives, and nurse attitudes and behavior change appear to be as important for facilitating breastfeeding as are routines for breastfeeding advice.

Influences on the decision to initiate breastfeeding among low income mothers served by a suburban medical center in northern California were explored. Sixtyfour mothers of children 0-24 months of age were interviewed in English or Spanish regarding their infant feeding education, breastfeeding attitudes and behavior, and social support. Fifty-nine percent reported having discussed infant feeding with a physician; these mothers were more likely to attempt breastfeeding than those who did not. Fiftynine percent of the entire study population initiated breastfeeding. Initiation rates were highest for the Asian American group (86 percent), and lowest for Latinas (48 percent). Further research is needed regarding modifiable influences on breastfeeding initiation, including physician encouragement to breastfeed, for various ethnic groups.

A breastfeeding questionnaire was developed to help determine how we could better support our WIC mothers' efforts to breastfeed. The questionnaire was pilot tested in 12 local WIC agencies, wherein 878 participants returned the instrument for tabulation. Forty-six percent of the women who returned questionnaires initiated breastfeeding. The main support for women choosing to breastfeed came from their husbands. Women choosing not to breastfeed identified "self' as the person who most discouraged them from breastfeeding. Using this tool has helped to highlight the breastfeeding needs of our participants.

This study examined the degree to which first-time mothers' perceptions of their marital relationships, various support systems, and adjustment to pregnancy and motherhood were associated with success at initiating and maintaining lactation during the first year postpartum. Additionally, the incidence and duration ofbreastfeeding, feeding problems encountered, as well as the sources and quality of feeding-related help received by these mothers were examined. Mothers in this study showed a pattern of breastfeeding incidence and duration similar to that established statewide and nationwide. The most prevalent problem encountered by these mothers during the first postpartum month was a concern of inadequate milk supply. The type of feeding-related support received varied by source: husbands and (grand)mothers provided the greatest degree of emotional and instrumental support, while doctors and nurses provided more information, which was also associated with success at establishing lactation. Mothers who were themselves breastfed as infants nursed their infants more at one month than those who were bottle-fed. Long-term breastfeeding mothers were those who had adjusted most optimally to pregnancy and motherhood, were most likely to characterize their marriages as satisfying and loving during the prenatal period and throughout the first postpartum year, and were most satisfied with the nature and extent of support received from husbands.