A critical analysis of the content of the tools that measure breast-feeding interaction

Abstract

Objective: to undertake a critical analysis of the content of six tools, which have been designed to evaluate the breast-feeding interaction.Design: the tools are viewed as discourses and are examined in terms of the insight they give into the assumptions about and attitudes towards breast-feeding inherent in the authors who have produced them.Findings: the findings indicate that there is little agreement between the existing breast-feeding assessment tools as to how to measure a successful breast feed and that the tools appear to place insufficient reliance upon the research evidence related to lactation.Key conclusions: the lack of commonality between evaluation tools appears to reflect a prevailing inconsistency in the advice given by health workers to breast-feeding mothers. Reports of their unreliability may be indicative of the problems inherent when attempting to impose a biomedical model upon an intrinsically natural interaction.Implications for practice: it is suggested that, if evaluations of the breast-feeding interaction are to be useful, a tool which places greater emphasis on the research evidence is called for. Otherwise, given the limitations of such tools, their use may actively hinder the establishment of successful breast feeding.