Development and Psychometric Testing of the Japanese Version of the Maternal Breastfeeding Evaluation Scale

Abstract

Exclusive breastfeeding for 6 months after delivery is globally recommended as optimal infant feeding. However, if mothers evaluate their own breastfeeding by this standard, many might be disappointed because they fail to meet it. In contrast, the Maternal Breastfeeding Evaluation Scale (MBFES) measures mothers' satisfaction with breastfeeding regardless of the duration or exclusivity of breastfeeding. The MBFES has been used in Western countries, but not in Japan. This study aimed to develop a Japanese version of the MBFES (the JMBFES) and to conduct psychometric testing among Japanese-speaking mothers in Japan. The JMBFES was developed using forward translation, blind back-translation, panel discussion, and pilot testing. Breastfeeding Japanese mothers (n = 414) completed the JMBFES when their infants were 4 months old. For validation testing we used principal components analysis (promax rotation). We deleted items as necessary to improve reliability. We also used multiple linear regression to examine associations of JMBFES scores with breastfeeding intention and with breastfeeding outcomes. The analysis revealed subscales that were generally similar to the original 30-item MBFES. Reliability was satisfactory (Cronbach's alpha ≥ .77). Scores on the JMBFES and on most of its subscales were positively associated with both breastfeeding intention and breastfeeding outcomes. The subscale measuring potentially negative experiences was not statistically significantly associated with breastfeeding at 1 month, after adjustment for likely confounders. The results of reliability testing (Cronbach's alpha) and of validation testing indicate that the JMBFES can be used in Japan to explore mothers' satisfaction with breastfeeding.