Breastfeeding Assessment Score: Systematic Review and Meta-analysis

Area of Science:

• Clinical prediction models
• Maternal and child health
• Breastfeeding research

Background:

• Conflicting results exist regarding the Breastfeeding Assessment Score (BAS) for predicting early breastfeeding cessation.
• External validation of the BAS is needed to clarify its predictive utility.
• This study aimed to validate the BAS and estimate its summary accuracy.

Purpose of the Study:

• To externally validate the Breastfeeding Assessment Score (BAS).
• To provide summary accuracy estimates for the BAS in predicting early breastfeeding cessation.
• To assess the clinical utility of the BAS for identifying mothers at risk of early cessation.

Main Methods:

• Prospective cohort study data was utilized for external validation.
• Electronic databases and research groups were searched to identify additional studies (2002-2013).
• Two physicians extracted data and assessed methodological quality of included studies.

Main Results:

• The BAS demonstrated moderate accuracy in predicting early breastfeeding cessation (AUC=0.70) with inadequate calibration in the validation cohort.
• In higher-quality studies, a BAS value <8 showed 0.80 sensitivity and 0.51 specificity for early cessation.
• Substantial between-study heterogeneity impacted the interpretation of summary accuracy estimates.

Conclusions:

• The Breastfeeding Assessment Score (BAS) offers moderate accuracy for predicting early breastfeeding cessation.
• Local recalibration of the BAS is advised prior to clinical implementation.
• Further research is needed to determine if the BAS can guide pediatricians in providing targeted breastfeeding support.