Effectiveness of Combining LATCH and Bristol Breastfeeding Assessment Scales in Predicting Exclusive Breastfeeding

Early identification of breastfeeding difficulties is crucial for targeted interventions. However, the comparative effectiveness of these assessment tools remains unclear.

To compare the predictive validity of the LATCH and Bristol Breastfeeding Assessment Tool (BBAT) scores measured at 24 hours and day 7 postpartum for exclusive breastfeeding at 42 days and to evaluate their combined predictive performance.

This prospective cohort study included 157 mother-infant dyads (September 2024-March 2025) at a university hospital in Turkey. LATCH and BBAT scores were assessed at 24 hours and on day 7 postpartum. The primary outcome was exclusive breastfeeding at 42 days. Receiver operating characteristic (ROC) analysis was used to determine the optimal cut-off values and predictive performance.

The rate of exclusive breastfeeding (EBF) was 83.4% (n = 132) in the first 24 hours and 68.8% (n = 108) on day 42 of life. The LATCH score in the first week showed the highest specificity for predicting EBF on day 42. (cut-off value ≥10: area under the curve [AUC] 0.671 (95% CI: 0.582-0.760; p < 0.001), sensitivity 55.6%, specificity 72.3%, false positive rate 27.7%). A multiple ROC analysis was conducted to determine which of the four scores was better at predicting EBF on the 42nd day. The cutoff values were 8 for the first-week Bristol score alone, 10 for the first-week LATCH score, 5 for the first 24-hour Bristol score, and 7 for the first 24-hour LATCH score.

Combined early assessment using LATCH and BBAT scores provides a superior prediction of EBF at 42 days compared with single indicators. The implementation of systematic screening using these tools may facilitate targeted lactation support for at-risk dyads.