Maternal Breastfeeding Evaluation Scale

Information about the Maternal Breastfeeding Evaluation Scale (MBFES) Purpose: The MBFES is intended to measure the mother’s evaluation of breastfeeding, considering the breastfeeding experiences of both mother and infant. Development: MBFES items were based on the findings of an interview study (Leff et al., 1994a) of women who had breastfed one or more infants. The analysis identified factors that contributed to successful and unsuccessful breastfeeding experiences. The factors were categorized into groups: infant health, infant satisfaction, maternal enjoyment, maternal role attainment, and compatibility with desired maternal lifestyle. Concepts from the interview study were incorporated into potential questionnaire items for measuring maternal evaluation of breastfeeding (Leff et al., 1994b). Often, the interviewees’ own words and phrases were included. The questionnaire was refined and content validity was established through review by a panel of mothers who breastfed; a panel of expert maternity nurses and a lactation consultant; and a pilot study of women (N=25) who had breastfed. The resulting questionnaire was mailed to 1000 women who had given birth at one hospital in the previous year. Recipients were asked to complete and return the questionnaire if they had breastfed their baby, even if only for a few days. The 442 usable returned questionnaires were analyzed using factor analysis, which identified three major factors. Thirty items that loaded highly on the factors were selected for the final MBFES. The three factors (subscales) were identified as Maternal Enjoyment/Role Attainment, Infant Satisfaction/Growth, and Lifestyle/Maternal Body Image. Reliabilities (using Cronbach’s alpha) of the full scale and subscales were 0.93, 0.93, 0.88, and 0.80, respectively. Test-retest (N=28) correlations were 0.93, 0.93, 0.94, and 0.82. Correlations with participants’ overall satisfaction with breastfeeding were 0.83, 0.79, 0.70, and 0.55. Correlations with duration of breastfeeding were 0.48, 0.44, 0.45, and 0.28. Use and scoring: The MBFES is appropriate for use after breastfeeding is completed or after the first two or three months of breastfeeding. It is intended to measure the mother’s evaluation of breastfeeding, considering the breastfeeding experiences of both mother and infant. The Maternal Enjoyment/Role Attainment Subscale consists of items 1,2,6,9,11,12,16,17,18,20,21,23,25, and 30. The Infant Satisfaction/Growth Subscale consists of items 3,4,7,10,15,19,24, and 28. The Lifestyle/Maternal Body Image Subscale consists of items 5,8,13,14,22,26,27, and 29. For analysis, we used a score of 1 for strongly disagree, up to 5 for strongly agree. Items worded negatively are reflected for scoring. These are items 3,5,8,13,14,15,19,22,27,28, and 29. To transform (reflect) the scores, subtract each participant’s rating from 6 (i.e., 1 becomes 5, 2 becomes 4, etc.). Each participant’s scores can be added for a total MBFES score as well as subscale totals. References: Leff EW, Gagne MP, Jefferis SC. Maternal Perceptions of Successful Breastfeeding. Journal of Human Lactation. 1994;10(2):99-104. doi:10.1177/089033449401000216 Leff EW, Jefferis SC, Gagne MP. The Development of the Maternal Breastfeeding Evaluation Scale. Journal of Human Lactation. 1994;10(2):105-111. doi:10.1177/089033449401000217 Corresponding author: Ellen W. Leff at leffellen@gmail.com