Breastfeeding Self-Efficacy Scale-Short Form Research Articles

Adaptation and psychometric evaluation of the breastfeeding self-efficacy scale to assess exclusive breastfeeding: a cross-sectional study in rural China.

Despite the benefits of exclusive breastfeeding, the proportion of exclusively breastfed children remains low in rural China. Self-efficacy is one of the most crucial modifiable factors predicting breastfeeding behavior. However, existing instruments in China do not specifically measure self-efficacy for exclusive breastfeeding but rather measure self-efficacy for any breastfeeding. Furthermore, they have been validated only in high-income Chinese settings. We sought to adapt and validate an instrument to measure exclusive breastfeeding self-efficacy within rural Chinese contexts. We introduced relevant items to Dennis' Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), which can assess maternal self-efficacy for exclusive breastfeeding. It was then implemented in a multistage random cluster sampling design and cross-sectional survey with home-visit interviews among women 0-6 months postpartum (n = 654) in the rural areas of four counties in Sichuan, China. We performed item-total and adjusted item-total correlations, as well as exploratory factor analysis to remove redundant items and determine the latent factor structure. We further applied confirmatory factor analysis to test the dimensionality of the scale. We then assessed the reliability of the scale and conducted tests of predictive and divergent validity. Known group comparisons were made by primiparous status and breastfeeding support level. We compared the validated Exclusive Breastfeeding Self-Efficacy Scale with the BSES-SF in terms of reliability and validity to explore the added value of scale modification. Our modification of the BSES-SF to target exclusive breastfeeding produced 19 items. This was further reduced to 15 items based on adjusted item-total correlations and exploratory factor analysis, forming the Exclusive Breastfeeding Self-Efficacy Scale. This scale had three dimensions: "Breast milk supply and quality," "Breastfeeding skills," and "Exclusive breastfeeding" subscales. The Exclusive Breastfeeding Self-Efficacy Scale demonstrated strong internal consistency and overall reliability with a Cronbach's alpha coefficient of 0.91. Predictive and divergent validity and known group comparison assessments supported its validity. Robust psychometric evaluations demonstrated enhanced validity and reliability compared to the original BSES-SF. Our Exclusive Breastfeeding Self-Efficacy Scale is valid and reliable for measuring exclusive breastfeeding self-efficacy within rural Chinese contexts and is ready for adaptation and validation for clinical and programmatic use elsewhere, particularly within LMICs.

The Effects of Baby Calming Training Provided to Primiparous Mothers on Maternal Role Perception, Maternal Attachment, and Breastfeeding Self-Efficacy: A Randomized Controlled Trial.

Background: Mothers of crying babies have difficulty adapting to their roles and problems with breastfeeding and attachment. Objective: This study aimed to assess the impact of the baby calming training provided to primiparous mothers on maternal role perception, maternal attachment, and breastfeeding self-efficacy. Methods: The study was conducted in a randomized controlled experimental design between March 2023 and March 2024 in the gynecology and obstetrics services of a public hospital in northeastern Turkey (Clinical Trial Number: NCT05594836). The research was conducted with a total of 84 primiparous mothers, including 41 intervention and 43 control groups, who met the inclusion criteria. The Baby Calming Training was administered face-to-face in the intervention group, utilizing a baby swaddling blanket, a sleep companion emitting white noise, and a training booklet. The control group received routine care. Data were collected through the Mother and Baby Introductory Information Form, Semantic Difference Scale-Me as a Mother, Maternal Attachment Inventory, Breastfeeding Self-Efficacy Scale-Short Form, and Infant Sleep Activity Record. The data were analyzed using descriptive statistics, Pearson's chi-square test, independent samples t-test, Mann-Whitney U test, Wilcoxon test, mixed design ANOVA analysis, Cohen's d, and 95% confidence interval (CI). This study adhered to CONSORT research guidelines. Results: Mothers in the intervention group exhibited higher mean scores on the perception of maternal role (mean ± SD: 70.37 ± 5.92, t: 8.590, 95% confidence interval [CI]: [1.347-2.375], d: 1.865, p < 0.001), maternal attachment (mean ± SD: 100.42 ± 1.52, U: 151.500, 95% CI: [0.732-0.892], d: 0.828, p < 0.001), and breastfeeding self-efficacy (mean ± SD: 64.00 ± 5.98, t: 8.109, 95% CI: [1.248-2.258], d: 1.757, p < 0.001) than the control group. It was determined that the total sleep time of the babies in the intervention group was higher, and the total crying duration was lower (p < 0.001). Conclusion: The study revealed that infant soothing training for primiparous mothers enhanced maternal role perception, maternal attachment, breastfeeding self-efficacy, and extended infants' sleep duration. Furthermore, infants exhibited reduced crying.

The correlation between quality of recovery and parturient outcomes after Cesarean delivery: a cohort study.

Recent studies have reported the use of the obstetric-specific quality of recovery tool (ObsQoR-10) to assess the quality of recovery in parturients after childbirth; however, the correlation between ObsQoR-10 scores and important postpartum outcomes are unclear. The primary aim of the present study was to investigate the correlations between ObsQoR-10 scores at 24hr after Cesarean delivery and breastfeeding, depressive symptomatology, overall health, and pain at seven days postpartum. We recruited parturients who underwent elective Cesarean delivery at KK Hospital in Singapore. Parturients provided responses to post-Cesarean questionnaires at 1) 24hr (ObsQoR-10, EuroQol EQ-Visual Analogue Scale, Edinburgh Postnatal Depression Scale), 2) 48hr (ObsQoR-10, EQ-Visual Analogue Scale), and 3) seven days after Cesarean delivery (ObsQoR-10, Breastfeeding Self-Efficacy Scale-Short form, EQ-Visual Analogue Scale, Edinburgh Postnatal Depression Scale, pain survey). We enrolled 222 participants, 200 (90%) of whom completed the seven-day follow-up between September 2022 and April 2023. There was limited correlation between ObsQoR-10 at 24hr with the Edinburgh Postnatal Depression Scale (r = 0.135), EQ-Visual Analogue Scale (r = 0.158), Breastfeeding Self-Efficacy Scale-Short form (r = 0.225), and averaged pain scores (r = -0.107) at seven days postpartum. ObsQoR-10 breastfeeding sub-score at 24hr was weakly correlated with Breastfeeding Self-Efficacy Scale-Short form at seven days postpartum (r = 0.307). ObsQoR-10 at 24hr postpartum had limited correlation with breastfeeding, depressive symptomatology, overall health, and pain at seven days. ClinicalTrials.gov ( NCT04989894 ); first submitted 4 July 2021.

Mothers' Breastfeeding Self-Efficacy after a High-Risk or Normal Pregnancy: A Greek Longitudinal Cohort Study.

the objective of this longitudinal study (from pregnancy to the end of the sixth month postpartum) is to elucidate the association between maternal self-efficacy, defined as a mother's confidence in her ability to breastfeed, and breastfeeding outcomes. This prospective cohort study was conducted among high-risk pregnant women (including those with conditions such as gestational diabetes, hypertension, pre-eclampsia, and other pathological medical conditions) and normal-risk pregnant women in Greece. The high-risk group included 164 women, while the normal-risk group comprised 154 women. Data were collected using validated psychometric scales, including the Breastfeeding Self-Efficacy Scale-Short Form, State-Trait Anxiety Inventory, Edinburgh Postnatal Depression Scale, Maternal Antenatal Attachment Scale, and Iowa Infant Feeding Attitude Scale. Higher maternal self-efficacy was significantly associated with a longer duration and greater exclusivity of breastfeeding. A statistically significant relationship between the type of breastfeeding and the degree of breastfeeding self-efficacy was observed at multiple postpartum milestones: in the first and third 24 h postpartum, and at the end of the sixth week, third month, and sixth month postpartum. The findings underscore the critical role of maternal self-efficacy in breastfeeding success, influenced by individual psychological factors and broader socio-cultural contexts. Strengthening maternal self-efficacy is essential for improving breastfeeding outcomes.

Breastfeeding Efficacy among Primiparous Mothers: A Survey from Lahore

Background: Breastfeeding is the natural process of infant feeding on milk produced by mothers. The World Health Organization (WHO) recommends exclusive breastfeeding for the first six months and continued breastfeeding until at least 24 months to support optimal growth. A mother’s belief in her ability to breastfeed, known as breastfeeding self-efficacy, significantly impacts her breastfeeding experience and success. Objective: To determine the level of breastfeeding self-efficacy among primiparous mothers in Lahore. Methods: A descriptive cross-sectional study was conducted over six months, from June 2023 to December 2023, in various hospital settings. Data were collected from 150 primiparous mothers selected through nonprobability convenient sampling. Inclusion criteria were primiparous mothers aged 20 to 35 years who had been breastfeeding for at least three months. Exclusion criteria included mothers with a history of cancer or hepatitis and those unable to provide informed consent. The Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) was used to collect data, which was then entered and analyzed using SPSS version 25. BSES-SF is a 14-item self-administered questionnaire with a 5-point rating scale, where a score of 1 indicates “no confidence at all” and a score of 5 represents “very confident.” Total scores range from 14 to 70, with higher scores reflecting higher self-efficacy. Scores were categorized into low (14-33), medium (33-53), and high (53-70) self-efficacy. Results: Out of 150 primiparous mothers, 4 (2.7%) had low breastfeeding self-efficacy, 93 (62.0%) had medium self-efficacy, and 53 (35.3%) had high self-efficacy. The age of participants ranged from 20 to 34 years, with a mean age of 25.02 years (SD = 3.18). Education levels were 42.2% intermediate, 32.7% undergraduate, and 24.7% postgraduate. Employment status showed 27.0% employed and 73.0% unemployed. Conclusion: The majority of primiparous mothers reported a moderate level of breastfeeding self-efficacy. These findings highlight the need for targeted interventions to enhance breastfeeding confidence among new mothers.

The Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF): German Translation and Psychometric Assessment.

German-speaking mothers have breastfeeding rates below the international breastfeeding recommendations. Previous research has found that breastfeeding self-efficacy is an important and modifiable predictor of breastfeeding outcomes, thus improving breastfeeding rates. The Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) is used in many countries to assess maternal breastfeeding self-efficacy. This instrument has not been available in German. To translate the BSES-SF into German and assess its psychometric properties among breastfeeding mothers up to 12 weeks postpartum. This cross-sectional study was conducted online with 355 breastfeeding mothers recruited from breastfeeding groups through Facebook. The BSES-SF was translated into German using forward and back-translation. To test reliability, item-total characteristics, including Cronbach's alpha, were examined. We used principal component analysis, as well as known-groups comparisons for evaluating construct validity, and examined the relationship between breastfeeding self-efficacy and demographic variables. The mean age of participants was 32.4 years (SD = 4.32). The Cronbach's alpha coefficient was .88 and corrected item-total correlations ranged between .37 and .73. Principal components analysis yielded one component with factor loadings >.40 and an eigenvalue of 5.62, which explained 40% of the total variance. In addition, known group comparisons provided further evidence for construct validity. There was no significant difference in BSES-SF scores in terms of demographic and obstetrics characteristics. Our results provide evidence that the German version of the BSES-SF is a reliable and valid tool for measuring breastfeeding self-efficacy among mothers in German-speaking countries.

Efektifitas Edukasi Berbasis Family Centered Maternity Care terhadap Dukungan Keluarga dan Self Efficacy pada Ibu Postpartum dalam Pemberian Asi

This study aims to analyze the effectiveness of family centered maternity care-based education on family support and self-efficacy for postpartum mothers in breastfeeding. The method used is quantitative research with a quasi-experimental design with a pretest and posttest design with a control group. The sample in this study consisted of 52 respondents. The research instrument used a family support questionnaire modified from Nasution's family support questionnaire (2007) and a self-efficacy instrument using the Breastfeeding Self-efficacy Scale-Short Form (BSES-SF). Data analysis used the Paired T-Test and Independent T-Test. The results of research on the effectiveness of interventions on family support, P-Value 0.000 and self-efficacy 0.004. The conclusion is that education based on Family Centered Maternity Care is effective in increasing family support and self-efficacy for postpartum mothers in breastfeeding. Keywords: Education, Family Support, Family Centered Maternity Care, Self efficacy

The impact of mothers’ postnatal sense of security on their breastfeeding self-efficacy and postpartum depression

Objective: This study aimed at determining the impact of mothers' postnatal sense of security on their breastfeeding self-efficacy and postpartum depression. Method: An analytical cross-sectional study was designed. The study included a total of 340 puerperal women who were admitted to the puerperal ward of a state hospital located in southern Turkey. The data for this study were collected using the puerperal women information sheet (PWIS), the Mothers’ Postnatal Sense of Security Scale (MPSSS), the Edinburgh Postnatal Depression Scale (EPDS), and the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). Results: It was determined that the mean age of the participants was 27.92 ± 5.12, educational background 40.2% of them were undergraduate and higher graduates, 71.1% of them were not working. The mean scale scores of the mothers were 47.86 ± 10.36 for MPSSS, 53.69 ± 11.23 for BSES-SF, and 8.79 ± 5.67 for EPDS. The sub-scale scores for MPSSS were as follows: Empowering behaviors: 16.75 ± 5.1, General well-being: 11.18 ± 3.49, Affinity Within the Family: 11.82 ± 3.4, and Breastfeeding: 8.11 ± 2.53. Empowering behaviors scores were found to be moderately positively correlated with Affinity Within the Family, Breastfeeding, and BSES-SF scores (p

COMT Variants are Associated With Breast and Nipple Pain

Estimates suggest that only 24.9% of infants born in 2019 were exclusively breastfed before 6 months of age, despite the known health benefits of exclusive breastfeeding. Breast and nipple pain is one of the primary determinants of exclusive breastfeeding. Environmental contributions to breastfeeding success have been reported extensively in the literature, but the contribution(s) of maternal genetics has yet to be discovered. The purpose of the study was to identify an association between pain and lactation-related gene variants with exclusive breastfeeding determinants. We selected 4 genes having single nucleotide polymorphisms (SNPs) with potential functional significance in breastfeeding and pain: prolactin receptor (PRLR), oxytocin receptor (OXTR), catechol-O-methyltransferase (COMT), and milk fat globule epidermal growth factor and factor V/VIII domain containing (MFGE8). We performed a cross-sectional secondary analysis of a longitudinal randomized controlled trial study, Promoting Self-Management of Breast and Nipple Pain with Biomarkers and Technology for Breastfeeding Women (NCT05262920). Breast and nipple pain, perceived insufficient milk, and breastfeeding self-efficacy were examined using total scale scores for the Brief Pain Inventory, Visual Analog Scale, H&H Lactation Scale, and the Breastfeeding Self-efficacy Scale-short form, respectively. Of the candidate genes examined, SNPs within COMT were significantly associated with breastfeeding-related outcomes. Specifically, COMT rs4633 and rs4680 minor allele carriers (T, A) reported higher breast and nipple pain intensity than women homozygous for the major allele (C, G). COMT is the most widely researched “pain gene” and has been linked to cold, postoperative, and postpartum pain. This study is the first to identify a contribution of COMT variants to breast and nipple pain and, as a result, to breastfeeding exclusivity. PerspectiveTwo SNPs in the pain gene COMT are associated with breast and nipple pain. Clinically, a minor allele in COMT rs4633 and rs4680 may increase a woman’s rating of moderate breast and nipple pain. Trial registrationPROMPT was registered in ClinicalTrials.gov (protocol #NCT05262920).

Dysphoric Milk Ejection Reflex: Characteristics, Risk Factors, and Its Association with Depression Scores and Breastfeeding Self-Efficacy.

Background: Dysphoric milk ejection reflex (D-MER) is a phenomenon that occurs before milk letdown and is described as a wave of negative or devastating emotions, ranging from mild to severe and lasting for seconds to minutes. To date, there has been little research regarding this phenomenon. This study aims to determine the prevalence of D-MER in our population as well as its association with postnatal depression scores and breastfeeding self-efficacy. Methods: Lactating persons between 4 and 12 weeks postpartum at our institution were invited to complete an anonymous 59-question survey via an online platform. Questions asked included patient demographics, presence of symptoms of dysphoria (including timing, duration, and frequency), the Edinburgh Postnatal Depression Scale (EPDS), and the Breastfeeding Self-Efficacy Scale Short Form (BSES-sf). Results: In total, 201 women completed the survey. Twelve women were classified as likely having D-MER (6%). Symptom resolution primarily occurred within a minute to 5 minutes (58%). Mean EPDS scores differed significantly between those with likely D-MER and those without (12.2 vs. 5.4, p = 0.002). BSES-sf scores differed significantly between the two groups (43.1 vs. 52.5, p = 0.009). Preexisting depression or anxiety was not associated with D-MER (p = 0.133), other reported mood disorders differed significantly between those with D-MER and those without (p = 0.004). Demographic characteristics of women with and without D-MER were similar. Conclusion: D-MER prevalence may be lower than previously reported. Patients with likely D-MER appear to have lower breastfeeding self-efficacy and higher depression scores. Those with preexisting mood disorders may be at higher risk of experiencing D-MER.

IJCM_13A: Effect of video based educational intervention in Gestational diabetic mothers on breast feeding self efficacy: a Randomized Control Trial

Background: Women with Gestational diabetes mellitus face a lot of challenges when it comes to breast feeding. Breast feeding self efficacy is an important factor for improving breast feeding outcomes. Objectives: To know the effect of educational intervention on breast feeding efficacy in immediate postpartum period among women with gestational diabetic mellitus using breast feeding self-efficacy scale short form (BSES-SF). Methodology: A randomized control trial was conducted between May 2022 to August 2023 in a tertiary care hospital in Mangalore. Ethics committee approval was obtained. Clinical trial registry was done (CTRI/2023/03/051176). 108 women with Gestational diabetes mellitus were enrolled in this study. Study participants were divided into control and intervention group. Intervention group were shown an informative video on breast feeding practices and techniques while both the groups were educated using flipcharts on essential newborn care. Breast feeding efficacy was scored in both the groups at admission, after intervention within 48 hours puerperium using breast feeding self-efficacy scale short form (BSES-SF) and results were analyzed. Results: The mean age group of the study was 30.15 ± 5.12. The demographic details in both the groups were comparable. The mean BSES-SF scores were 45.13 pre-intervention vs 55.15 post-intervention in the intervention group (p = &lt;0.001) while mean BSES-SF scores were 44.60 pre-intervention vs 47.53 post-intervention in control group (p = &lt;0.001). Conclusion: Video based educational intervention had a positive impact on breast feeding efficacy in women with Gestational Diabetes Mellitus.

The Effects of Antenatal Education on Level of Exclusive Breastfeeding in the First Two Months

Objective: Breastfeeding is a wonderful event that requires strength and dedication from mothers. Effective breastfeeding education provided to pregnant women in the prenatal period can increase the success and level of breastfeeding. This study aimed to determine the effect of prenatal education intervention on the first two-month exclusive breastfeeding level.&#x0D; Method: This experimental study was carried out at a primary family health center between July 2019 and February 2020. One hundred thirty-three pregnant women were included in the study’s control and intervention groups. The Prenatal and postnatal information form, the Infant Feeding Attitude Scale (IIFAS) and the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) were used to collect the data.&#x0D; Results: The first two-month exclusive breastfeeding level was 33.1% in the control group and 68.7% in the intervention group (p

Mothers’ Breastfeeding Satisfaction: Key to Environmental Sustainability

Breastfeeding is the natural way to feed a baby in the first months of life. It is an option with a low environmental impact, as it is a natural and renewable food that does not pollute. It is the optimal food for the infant, with nutritional and immunological advantages that reduce the prevalence of pregnancy disorders and provide benefits for the infant, the mother, and the environment. Its premature abandonment may have medium- and long-term consequences, as the use of formula milk is much more polluting. A descriptive, observational, cross-sectional study was carried out between December 2020 and January 2021, involving 96 breastfeeding women. Sociodemographic and obstetric variables were collected. A validated Spanish version of the Breastfeeding Self-efficacy Scale-Short Form (BSES-SF) was used. Factors that may lead to the early cessation of breastfeeding among the mothers that were studied are a high level of education, a lack of preparation for childbirth, a lack of security, a lack of confidence in preparation for childbirth, a lack of self-confidence, discomfort with breastfeeding in the presence of others, and a low level of maternal satisfaction. Married women and women whose partners support breastfeeding are significantly more satisfied with exclusive breastfeeding than single and divorced women. Adequate and protocolised care must be provided. Education and support for parents to allow for optimal breastfeeding and reduce the environmental impact of formula feeding is essential.

Improvement of Breastfeeding Efficacy Through Small Group Education of Cadres with Pregnant Women

&lt;div&gt;&lt;table cellspacing="0" cellpadding="0" align="left"&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td align="left" valign="top"&gt;&lt;p class="Default"&gt;&lt;em&gt;WHO recommends that every infant should be exclusively breastfed, but until now the coverage of exclusive breastfeeding is still low due to factors such as knowledge, breastfeeding efficacy, family support, lactation problems, and barriers in the health care system. This study aims to determine the effectiveness of Small group education of cadres with pregnant women on breastfeeding efficacy among third trimester pregnant women on Enggano Island. The research design was a quasi-experimental pre-test and post-test with a control group. The treathird trimesterent group was pregnant women who received Small group education of cadres with pregnant women while the control group was pregnant women who received conventional education. The study was conducted at Enggano Health Centre from January to November 2023 with a sample of 50 pregnant women in the third trimester of pregnancy from 25-36 weeks of age, selected by purposive sampling. The research instruments were modules and leaflets on exclusive breastfeeding, developed through a needs assessment, while breastfeeding efficacy was measured using the Breastfeeding Self-efficacy Scale-Short Form (BSES-SF). Data were analysed univariate, bivariate with wilcoxon and multivariate with spearman rank test. The results showed that there was an effect of Small group education of cadres with pregnant women class education on breastfeeding effectiveness with p=0.00 mean difference of 19.56. There was an effect of conventional class education on breastfeeding effectiveness in the control group with p=0.46 mean difference of 1.12. The class was more effective in improving breastfeeding practices among pregnant women with p=0.00 mean difference of 47.26. Class and education level were the most dominant factors in improving breastfeeding efficiency among pregnant women. The conclusion of this study is that the small group education of cadre with pregnant women is effective in improving breastfeeding efficacy in pregnant women in the third trimester. &lt;/em&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt;&lt;/div&gt;&lt;strong&gt;&lt;em&gt;Keywords: Breastfeeding, Education, Efficacy, Small Group&lt;/em&gt;&lt;/strong&gt;

The Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) Versi Indonesia: Studi Pendahuluan Uji Validitas Dan Reliabilitas Pada Ibu Hamil

Breastfeeding self-efficacy is one thing that can influence breastfeeding success. The aim of this study was to test the validity and reliability of the breastfeeding self-efficacy scale short form (BSES-SF) in Indonesian for pregnant women. The sample was 91 third trimester pregnant women in Banyumas Regency taken in 2022 using cluster sampling. The BSES-SF consists of 14 question items with a Likert scale of 1 (not very confident) to 5 (always confident). Data analysis to assess construct validity through factor analysis and internal reliability (internal consistency). The results obtained have a loading factor value of 0.5, the Indonesian version of the BSES-SF is valid for use in the population of pregnant women in Indonesia, the Indonesian version of the BSES-SF has a good internal reliability value (internal consistency), Cronbach's alpha 0.917 and Cronbach's Alpha if value item deleted from 14 items 0.90. So the Indonesian version of the BSES-SF is valid and reliable to use in the population of pregnant women in Indonesia.

Effect of Nurse Support in the Immediate Postpartum Period on Mothers' Breastfeeding Self-Efficacy Levels in Turkey: A Quasi-Experimental Study.

This study aimed to determine the effect of nurse-based breastfeeding support during the immediate postpartum period on mothers' breastfeeding self-efficacy levels. A quasi-experimental study was conducted with 256 mothers in the immediate postpartum period (128 in the intervention group who received nurse-based breastfeeding support and routine care and 128 in the control group who received routine care) during February-June 2018. Data were collected using the Mother-Infant Data Sheet, the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), and the Nurse-Parent Support Tool (NPST). BSES-SF and NPST mean scores of mothers in the intervention group were higher than those of mothers in the control group (p < 0.01). While the association between breastfeeding self-efficacy and nurse support was low in the control group (0.271), it was rather high in the intervention group (0.693) (p < 0.05). It was found that nurse support explained 48% of the variance in breastfeeding self-efficacy in the intervention group, but only 7.3% of the variance in breastfeeding self-efficacy in the control group. The results of the study indicate that nurse support for mothers in the immediate postpartum period based on breastfeeding training has a positive impact on breastfeeding self-efficacy.

The German version of the Bristol breastfeeding assessment tool: A validation study

ObjectivesThis study aimed, first, to validate the Bristol Still [Breastfeeding] Assessment Tool (BSAT) through determining inter-rater reliability, construct and criterion and second, to assess if healthcare professionals viewed the tool as appropriate for use on a maternity ward. Design and settingA validation study was performed at the maternity ward of a university hospital in the German-speaking region of Switzerland. ParticipantsWe included 44 mother–newborns dyads in the validation study, and 15 healthcare professionals assessed its appropriateness for use on a maternity ward. Measurements and findingsInter-rater reliability was determined by observing 82 breastfeeding sessions, which were independently assessed by two assessors based on the criteria of the BSAT. Convergent validity was determined using the Breastfeeding Self-Efficacy Scale Short Form. Predictive validity was determined by breastfeeding status at hospital discharge. A self-developed 5-item questionnaire assessed the appropriateness of the tool for use on a maternity ward.Inter-rater reliability was good at the item level (six out of eight intraclass-correlation coefficient values were greater than 0.75 and p < 0.00). The convergent validity demonstrated a moderate positive correlation with breastfeeding self-efficacy, with a Pearson's correlation coefficient of 0.69 (Confidence Interval = 0.46–0.83, p < 0.00). The predictive validity with breastfeeding status at hospital discharge was not statistically significant with χ2(22, n = 44) = 26.98, p = 0.21). Healthcare professionals confirmed that the tool was appropriate for using in daily practice on the maternity ward. Key conclusionThe BSAT had an overall good inter-rater reliability and a moderate construct validity with the mother's breastfeeding self-efficacy level and has comparable psychometrics properties as the original. Implications for practiceWe recommend assessing breastfeeding with the BSAT and scoring it at the item level and not with a total score. Using the BSAT on maternity wards could help monitor and objectify breastfeeding practices.

The Breastfeeding Self-Efficacy Enhancement Program with LINE Application among Mothers with Cesarean Section: A Quasi-Experimental Study

Exclusive breastfeeding has been shown to promote health outcomes for infants and mothers. Mothers with cesarean section may have reduced confidence in their ability to breastfeed exclusively, especially during the first month postpartum. This quasi-experimental study examined the effects of the Breastfeeding Self-Efficacy Enhancement Program with LINE Application on breastfeeding self-efficacy and exclusive breastfeeding four weeks after childbirth among mothers with a cesarean section. Fifty-two pregnant women prepared for cesarean section at a university hospital in central Thailand were divided into the experimental (n = 26) and control groups (n = 26). The experimental group received the program and usual care. The control group received only usual care. The instruments used for data collection consisted of the Demographic Characteristics Form, the Breast Feeding Self-efficacy Scale-short form, and the Infant Feeding Forms. Descriptive statistics, t-test and Fisher’s exact test were applied for data analysis. Results demonstrated that after participating in the intervention program for four weeks, the experimental group had higher mean scores of breastfeeding self-efficacy and rates of exclusive breastfeeding than those in the control group. The Breastfeeding Self-Efficacy Enhancement Program with LINE Application contributed to higher breastfeeding self-efficacy and rates of exclusive breastfeeding for mothers with cesarean section. Nurse midwives can use this program in practice. However, the program needs to be further tested and content may need to be modified before being widely used.

The Effect of Breastfeeding Self-Efficacy on Infants' Weights and Breastfeeding Outcomes.

The aim of this study was to investigate the effects of breastfeeding self-efficacy (BSE) and breastfeeding success (BFS) on infants' weight gain rates and breastfeeding outcomes. Mothers were evaluated within the postpartum 72 hours with "Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF)" and "LATCH Scale." After 6 months, the mothers were called to learn the exclusive breastfeeding (EB) duration and the weight of the infants. Two hundred mother-infant couples were enrolled, 176 (88%) of them could be reached in the sixth month. The BSES-SF scores were positively correlated with LATCH scores (P = .0001). The EB rate in the sixth month was positively correlated with BFS but not correlated with BSE (r, P = .218, .004; .79, .297, respectively). The percentage of weight gain and the rate of weight percentile change of babies according to birth weight at the sixth month of age were negatively correlated with BSE (r = -0.226, -0.148, P = .003, .049, respectively) but not correlated with BFS. Higher BFS was associated with increased duration of EB in the first 6 months of life, and higher BSE was related to lower increase in the percentage of weight gain and a lower rate of weight percentile change of babies at 6 months of age.

FACTORS ASSOCIATED WITH BREASTFEEDING INTENTION AMONG GESTATIONAL DIABETES MELLITUS MOTHERS

Breastfeeding knowledge, self-efficacy, attitude and breastfeeding intention affect breastfeeding rates, especially in mothers with Gestational Diabetes Mellitus (GDM) who are associated with having poor breastfeeding outcomes. Therefore, this study is aimed to investigate whether breastfeeding knowledge, attitude, self-efficacy, and sociodemographic factors are associated with breastfeeding intention among GDM pregnant mothers attending health clinics in Selangor. Validated questionnaires including Breastfeeding Self-Efficacy Scale Short Form (BSES-SF), Knowledge and Attitude, Breastfeeding Questionnaire (KA-BFQ), and Infant Feeding Intention (IFI) were self-administered to assess maternal knowledge, attitude, self-efficacy, and intention towards breastfeeding. Pearson’s Chi Square and independent t-test were used to investigate factors associated with breastfeeding intention among GDM mothers. Multiple linear regression was executed to explore determinants of breastfeeding intention among the studied population. A total of 124 pregnant women with GDM visiting chosen public health clinics in Selangor were recruited for this study. Findings revealed the scores (Mean ± SD) for breastfeeding knowledge 25.66 ± 8.736, breastfeeding attitude 81 ± 11.5, and breastfeeding self-efficacy 48.5 ± 12. About 84.7% (n = 105) had the intention to breastfeed with a mean score of 11 ± 5.25. Further analysis depicted significant associations between breastfeeding intention with a family history of diabetes (AOR = 3.551, 95% CI: 1.127 to 11.185, p-value = 0.030) and breastfeeding knowledge (AOR = 1.107, 95% CI: 1.036 to 1.182, p-value = 0.003). This study concluded that mothers with GDM had fair breastfeeding knowledge, good attitude, high self-efficacy, and high intention in breastfeeding. These findings highlight the need to develop culture-specific interventions in improving breastfeeding knowledge particularly to enhance breastfeeding intention among GDM mothers.