Abstract
BackgroundMaternal satisfaction with the breastfeeding experience is an important determinant of breastfeeding success. There is currently no valid tool to measure perceived maternal satisfaction with breastfeeding in the Arab context.MethodsThis cohort study tested the Maternal Breastfeeding Evaluation Scale (MBFES) on 450 healthy Lebanese mothers for internal consistency reliability and construct validity. Participants were recruited between April 2018 and February 2020.ResultsThe Cronbach’s alpha reliability coefficient of the Arabic MBFES (MBFES-A) was 0.87. Exploratory factor analysis revealed that it has three components: Infant Satisfaction/Growth, Maternal Enjoyment/Role Attainment, and Lifestyle/Body Image with reliability coefficients of 0.88, 0.87, and 0.68, respectively. Four items were deleted because of low factor loadings and three items were relocated to the Infant Satisfaction/Growth subscale based on their factor loadings. Participants who were exclusively breastfeeding at one and/or 3 months had higher mean MBFES-A total and Infant Satisfaction/Growth and Maternal Enjoyment/Role Attainment subscale scores than participants who were partially breastfeeding, and significantly higher mean scores than mothers who were not breastfeeding (all p values < 0.001), findings that support the scale’s construct validity. Moreover, scores on the Infant Satisfaction/Growth subscale correlated with exclusive breastfeeding at one (r = 0.37, p < 0.001) and 3 months (r = 0.31, p < 0.001). The MBFES-A score had positive modest correlations with maternal attitude towards breastfeeding (r = 0.30, p < 0.001), exclusive breastfeeding at one (r = 0.27) and at 3 months (r = 0.26, p < 0.001 for both), as well as with the longest previous exclusive breastfeeding (r = 0.27, p < 0.001).ConclusionsThe 26-item MBFES-A is a reliable and valid instrument to use in future breastfeeding research in Middle East North Africa countries. There is a need for replication of our findings in other Arab contexts using new constructs to establish stronger construct validity.
Highlights
Maternal satisfaction with the breastfeeding experience is an important determinant of breastfeeding success
The availability of a validated tool to measure maternal satisfaction with breastfeeding experience is essential for Arab investigators conducting breastfeeding research in the Middle East/North Africa (MENA) region
Design and setting This is a cohort instrument validation study that was conducted in a tertiary care center in Beirut Lebanon
Summary
Maternal satisfaction with the breastfeeding experience is an important determinant of breastfeeding success. The MBFES was developed in the United States by Leff, Jefferis, and Gagne [15], and validated on a sample of American mothers by Riordan, Woodley, and Heaton [16] It has been used in studies from several Englishspeaking countries [17,18,19,20,21,22,23], and validated in Japanese [24, 25] and Brazilian contexts [26], but to date, there is no validated version in Arabic. The availability of a validated tool to measure maternal satisfaction with breastfeeding experience is essential for Arab investigators conducting breastfeeding research in the MENA region
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