Development and psychometric testing of the Breastfeeding Self-Efficacy Scale

TLDR

Many new mothers stop breastfeeding early, and maternal confidence has been shown to be a key factor in continuation. The study aimed to develop and preliminarily evaluate a scale measuring breastfeeding confidence in new mothers. Based on self‑efficacy theory, the Breastfeeding Self‑Efficacy Scale was created, content‑validated by experts and mothers, then pilot‑tested with 130 in‑hospital mothers to assess reliability, factor structure, group differences, and construct correlations. Higher BSES scores predicted more continued breastfeeding at six weeks, indicating the scale can identify mothers at high risk of early discontinuation.

Abstract

Many new mothers discontinue breastfeeding prematurely. Researchers have shown that maternal confidence is an important factor in the continuation of breastfeeding. The purpose of this methodological study was to develop and conduct preliminary psychometric assessment of an instrument to measure confidence in new breastfeeding mothers. Using self-efficacy theory as a conceptual framework, the Breastfeeding Self-Efficacy Scale (BSES) was developed and content validity was judged by a panel of experts and through interviews with experienced breastfeeding mothers. Following a pilot test, the revised BSES was assessed with 130 in-hospital breastfeeding mothers for reliability and validity, including internal consistency, principal components factor analysis, comparison of contrasted groups, and correlations with measures of similar constructs. Support for predictive validity was demonstrated with positive correlations between BSES scores and infant feeding patterns at 6 weeks postpartum. Following further testing, this instrument may be used to identify new mothers with low breastfeeding confidence who are at high risk to prematurely discontinue breastfeeding.