The development of a new breastfeeding assessment tool and the relationship with breastfeeding self-efficacy

Jenny C Ingram, Debbie G Johnson, Marion E Copeland, Cathy Churchill, Hazel Taylor

Research output: Contribution to journalArticle (Academic Journal)peer-review

27 Citations (Scopus)
429 Downloads (Pure)


To develop a breastfeeding assessment tool to facilitate improved targeting of optimum positioning and attachment advice and to describe the changes seen following the release of a tongue-tie.

Development and validation of the Bristol Breastfeeding Assessment Tool (BBAT) and correlation with breastfeeding self-efficacy.

Maternity hospital in South West England.

218 breastfeeds (160 mother-baby dyads); 7 midwife assessors.

The tool has more explanation than other tools to remind those supporting breastfeeding women about the components of an efficient breastfeed. There was good internal reliability for the final 4 item BBAT (Cronbach's alpha=0.668) and the midwives who used it showed a high correlation in the consistency of its use (ICC=0.782).

Midwives were able to score a breastfeed consistently using the BBAT and felt that it helped them with advice to mothers about improving positioning and attachment to make breastfeeding less painful, particularly with a tongue-tied baby. The tool showed strong correlation with breastfeeding self-efficacy, indicating that more efficient breastfeeding technique is associated with increased confidence in breastfeeding a baby.

The BBAT is a concise breastfeeding assessment tool facilitating accurate, rapid breastfeeding appraisal, and targeting breastfeeding advice to mothers acquiring early breastfeeding skills or for those experiencing problems with an older baby. Accurate assessment is essential to ensure enhanced breastfeeding efficiency and increased maternal self-confidence.

Implications for practice: The BBAT could be used both clinically and in research to target advice to improve breastfeeding efficacy. Further research is needed to establish its wider usefulness.
Original languageEnglish
Pages (from-to)132-137
Number of pages6
Issue number1
Early online date14 Jul 2014
Publication statusPublished - Jan 2015


  • Breast feeding Self-efficacy
  • Frenotomy
  • Bristol Breastfeeding Assessment Tool

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