Validation of the Breastfeeding Score-A Simple Screening Tool to Predict Breastfeeding Duration.

Hanne Kronborg,Michael Væth

doi:10.3390/nu11122852

Abstract

Easy to use screening tools to identify mothers in risk of early breastfeeding cessation are needed. The purpose was to validate a revised version of the breastfeeding score, consisting of four questions addressing completed education, earlier breastfeeding duration, self-efficacy, and sense of security not knowing the exact amount of milk the baby ingests. We used two cohorts from 2004 (n = 633) and 2017 (n = 579) to explore the predictive validity of the breastfeeding score to identify mothers at risk of breastfeeding cessation within the first 17 weeks postpartum. The analyses included sensitivity and specificity, clinically relevant cut-points, and calibrations plots. A cut-point ≥5 points identified 61% of first-time and 42% of multiparous mothers in the validation cohort 2017 to be at risk of early breastfeeding cessation with a sensitivity and specificity of 80% and 60% for first-time, and 69% and 82% for multiparous, respectively. The corresponding numbers in the 2004 cohort were almost identical. The area under the receiver operating characteristic (ROC) curves were 0.77 and 0.78 and the calibration plots showed good agreement for the two cohorts. The breastfeeding score indicated good ability to discriminate between mothers at risk of early exclusive breastfeeding cessation. The simple form of the tool makes it easy to use in daily practice.

Highlights

Breastfeeding has been shown to be beneficial for the health of both the mother and infant, in the postnatal period, and later in life [1]
In 2007, we introduced a breastfeeding score, developed on the basis of data from a cohort of breastfeeding mothers from 1999 and validated using cohort data from 2004 [15]
The transferability of the breastfeeding score was supported by the validation of the cohort from 2017, consisting of an unselected study population of new mothers living in different geographical areas of Denmark, with a diverse population of mothers reflecting the Danish background population according to age and level of education [25]

Summary

Introduction

Breastfeeding has been shown to be beneficial for the health of both the mother and infant, in the postnatal period, and later in life [1]. Breastfeeding rates are still below the recommended in western societies [2]. One third of new mothers experience that establishment of breastfeeding is complicated by early breastfeeding problems [3,4]. From ongoing Cochrane reviews, we know that professional support in the early postpartum period helps mothers to successfully establish breastfeeding [5]. The challenge is to identify the mothers at risk of early breastfeeding cessation and in need of early support. Usable screening tools have to be simple to use in practice and reliable to discriminate between mothers

Objectives

Methods

Results

Discussion

Conclusion