Validation of a tool to evaluate women's satisfaction with breastfeeding for the Brazilian population

Senna, Andrea F. Kroll de; Giugliani, Camila; Lago, Juliana C.A.; Bizon, Agnes M.B.L.; Martins, Ana C.M.; Oliveira, Ceres A.V.; Giugliani, Elsa R.J.

doi:10.1016/j.jped.2018.08.008

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Original articles • J. Pediatr. (Rio J.) 96 (1) • Jan-Feb 2020 • https://doi.org/10.1016/j.jped.2018.08.008 copy

Validation of a tool to evaluate women's satisfaction with breastfeeding for the Brazilian population^☆ ☆ Please cite this article as: Senna AF, Giugliani C, Lago JC, Bizon AM, Martins AC, Oliveira CA, et al. Validation of a tool to evaluate women's satisfaction with maternal breastfeeding for the Brazilian population. J Pediatr (Rio J). 2020;96:84-91. ,^☆☆ ☆☆ Study conducted at Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To perform the construct validity and the internal consistency of the Maternal Breastfeeding Evaluation Scale tool, aiming at its application in the Brazilian population.

Methods

Cross-sectional study that applied the tool to 287 Brazilian women 30 days after childbirth. Main component analysis with varimax rotation was used for the factor analysis, verifying the number of subscales and the maintenance or extraction of the components. Four hypotheses were tested using the unpaired Student's t-test for construct validation. The reliability analysis was performed using Cronbach's alpha coefficient.

Results

The exploratory factor analysis identified the need to exclude an item and to reformulate the subscales. The results of the construct validity showed that all hypotheses proposed were confirmed: women who were breastfeeding, those who were exclusively breastfeeding, those who did not have problems related to breastfeeding, and those who intended to breastfeed for at least 12 months achieved significantly higher mean values in the scale. The tool showed adequate internal consistency (Cronbach's alpha = 0.88, 95% CI: 0.86-0.90), as did the pleasure and fulfillment of the maternal role subscales (0.92, 95% CI: 0.91-0.93%); child growth, development, and satisfaction (0.70; 95% CI: 0.65-0.75); and maternal physical, social, and emotional aspects (0.75, 95% CI: 0.70-0.79).

Conclusions

The validation process of the Brazilian version of the Maternal Breastfeeding Evaluation Scale tool showed that it is valid and reliable tool to be applied to the Brazilian population.

Keywords
Questionnaires; Validation studies; Satisfaction; Breastfeeding; Maternal Breastfeeding Evaluation Scale

	n	%
Socioeconomic class A and B ^a a The definition of social classes (A, B1, B2, C1, C2, and DE) was carried out using the scoring system used by the Brazilian Association of Research Companies (ABEP) in Critério Brasil 2015, considering the possession of luxury items, potable water at home, street pavement, and level of schooling of the head of the family. Classes A and B represent families with the highest socioeconomic status.25 Two of the women did not report data for classification (missing data).	163	57.2
Level of schooling (up to complete high school)	163	56.8
Caucasian mother	216	75.3
Living with a partner	248	86.4
Birth in a public maternity hospital	194	67.6
Multiparous	145	50.5
EBF at 30 days	177	61.7
BF at 30 days	275	95.8
Problems with breastfeeding during the first month ^b b Presence of problems during breastfeeding: when the mother/baby dyad has one or more of the following problems in the first month after delivery: breast engorgement, cracked nipple, mastitis, difficulty in getting the baby to latch on, insufficient milk supply, or anatomical nipple problems.	252	87.8
Intention to breastfeed reported in the first month	287	100
≥12 months	192	66.9
<12 months	54	18.8
Did not inform	41	14.3

Item	Pleasure and fulfillment of the maternal role	Child's growth, development and satisfaction		Maternal physical, emotional and social aspects
	Subscale 1	Subscale 2	Subscale 3	Subscale 4	Subscale 5	Subscale 6
1	0.74
2	0.79
3			0.68
4			0.60
5						0.67
6	0.76
7		0.61
8					0.58
9	0.65
10		0.50
11	0.51
12	0.79
13						0.52
14				0.66
15					0.69
16		0.43
17	0.55
18	0.75
19			0.57
20	0.73
21	0.80
22				0.71
23	0.64
24		0.62
25		0.55
26				0.45
27				(0.28)
28			0.62
29					0.48
30	0.83

	Number of items	Score variation	Mean (SD)	Median
Total score MBFES/BRASIL	29	29-145	120.92 ± 13.98	124
Subscale: Pleasure and fulfillment of the maternal role	12	12-60	53.36 ± 6.96	56
Subscale: Maternal physical, emotional and social aspects	8	8-40	28.21 ± 5.77	29
Subscale: Child's growth, development and satisfaction	9	9-45	39.35 ± 4.99	40

	n (%)	Mean score (±SD)	p
Hypothesis 1 ^a a Hypotheses tested through Student's t-test. Breastfeeding at 30 days	287
Yes	275 (95.8)	121.75 ± 12.92	0.011
No	12 (4.2)	101.91 ± 22.57	0.011
Hypothesis 2 ^a a Hypotheses tested through Student's t-test. Breastfeeding pattern at 30 days	275
Exclusive	177 (64.4)	124.44 ± 11.50	<0.001
Partial	98 (35.6)	116.90 ± 13.95	<0.001
Hypothesis 3 ^a a Hypotheses tested through Student's t-test. Breastfeeding problems in the first month	287
No	51 (17.8)	126.88 ± 9.52	<0.001
Yes	236 (82.2)	119.63 ± 14.46	<0.001
Hypothesis 4 ^a a Hypotheses tested through Student's t-test. Intention regarding breastfeeding duration	287
≥12 months	192 (66.9)	125.30 ± 13.67	0.002
<12 months	54 (18.8)	117.29 ± 16.31	0.002

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