Breastfeeding. Validation of a reduced Breastfeeding Assessment Score in a group of Italian women

Aim and objective. To assess the accuracy of a reduced Breastfeeding Assessment Score in a group of Italian women; the reduced Breastfeeding Assessment Score considers only five of the eight original Breastfeeding Assessment Score items studied, those not indicating a pathology. Background. The World Health Organization recommends exclusive breastfeeding for the first 6months of life because of its many benefits. A prognostic approach that identifies mothers at increased risk of early breastfeeding cessation is needed to provide preventive support. The Breastfeeding Assessment Score is useful to this approach. Design. This is a descriptive, prospective study. This study involves two Italian hospitals. Method. We included healthy Italian mothers who gave birth from 7 July 2008-15 January 2009. The exclusion criteria on the convenience sample were: non-Italian nationality, birth under 36weeks and twin birth. The authors calculated a reduced Breastfeeding Assessment Score ('reduced' because the original eight items studied by Hall, were reduced to five) 48hours after birth. After 4weeks a structured follow-up telephone interview was carried out: the primary outcome was breastfeeding cessation. Results. We recruited 386 women, with six lost during follow-up. Out of 380 women, 127 (33·4%) stopped breastfeeding. With a cut off point of 8, the reduced Breastfeeding Assessment Score sensitivity was 52·0%, which increased to 77·9% by using a cut-off point of 9. We also calculated a modified Breastfeeding Assessment Score with different age categories, which is adequate based on the Italian situation: in this case sensitivity was 70·1%. This study suggests that a reduced Breastfeeding Assessment Score with a different cut-off point or modified with a different age classification is useful in identifying Italian mothers who will discontinue breastfeeding, as in both cases sensitivity does increase. Relevance to clinical practice. Italian midwives could use this modified Breastfeeding Assessment Score to identify mothers at increased risk of early breastfeeding cessation.