title: Breastfeeding: validation of a reduced Breastfeeding Assessment Score in a group of Italian women.
abstract: 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 6 months 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.
  
  
  METHODS
  This is a descriptive, prospective study. This study involves two Italian hospitals.
  
  
  METHODS
  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 36 weeks and twin birth. The authors calculated a reduced Breastfeeding Assessment Score ('reduced' because the original eight items studied by Hall, were reduced to five) 48 hours after birth. After 4 weeks 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.
  
  
  CONCLUSIONS
  Italian midwives could use this modified Breastfeeding Assessment Score to identify mothers at increased risk of early breastfeeding cessation.
authors.affiliation: Università degli Studi di Milano-Bicocca, Monza Brianza, Italy. virna.zobbi@unimi.it
authors.forename: Virna Franca
authors.initials: VF
authors.lastname: Zobbi
authors.forename: Daniela
authors.initials: D
authors.lastname: Calistri
authors.forename: Dario
authors.initials: D
authors.lastname: Consonni
authors.forename: Francesco
authors.initials: F
authors.lastname: Nordio
authors.forename: Walter
authors.initials: W
authors.lastname: Costantini
authors.forename: Paola Agnese
authors.initials: PA
authors.lastname: Mauri
mesh_terms: D000328:Adult; D001942:Breast Feeding; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007558:Italy; D011446:Prospective Studies