A review of the psychometric properties of breastfeeding assessment tools

To compare and contrast the clinical usefulness and psychometric properties of existing self-report instruments designed to assess maternal breastfeeding attitudes, experience, satisfaction, and confidence.

CINAHL, PsycINFO, MEDLINE, PubMed databases from 1990 through 2009, and reference lists from selected articles were included in the search. Only published research articles written in English that provided reliability and validity of the self-report instruments for breastfeeding assessment were reviewed.

A total of 301 articles were retrieved according to the initial selection criteria; 24 articles met the final inclusion criteria.

Data extracted from research studies addressing the purpose of the review and demonstrating psychometric properties were presented.

Seven breastfeeding assessment tools were identified, and each tool demonstrated acceptable reliability and validity.

Seven self-report instruments were found to be valid, reliable, and feasible measures for assessing breastfeeding relationships. But two of the seven self-report instruments were only tested in one study, and only one study used a self-report instrument (the Breastfeeding Attrition Prediction Tool-BAPT) to test the effectiveness of an intervention. It is recommended that researchers consider using the existing self-report instruments in future experimental studies to test the feasibility and effectiveness of breastfeeding interventions. Moreover, it is important to continue to conduct more well designed research to further test and refine these self-report instruments in a variety of diverse populations and ethnic groups and to further examine their psychometric properties. Clinical applications have not been well addressed and need to be considered in the design of these future works. Understanding how to best support the breastfeeding mother must be the long-term outcome of instrument development in this area.