title: The development of a new breast feeding assessment tool and the relationship with breast feeding self-efficacy.
abstract: OBJECTIVE
  to develop a breast feeding 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.
  
  
  METHODS
  development and validation of the Bristol Breastfeeding Assessment Tool (BBAT) and correlation with breast feeding self-efficacy.
  
  
  METHODS
  maternity hospital in South West England.
  
  
  METHODS
  218 breast feeds (160 mother-infant dyads); seven midwife assessors.
  
  
  RESULTS
  the tool has more explanation than other tools to remind those supporting breast-feeding women about the components of an efficient breast feed. 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 breast feed consistently using the BBAT and felt that it helped them with advice to mothers about improving positioning and attachment to make breast feeding less painful, particularly with a tongue-tied infant. The tool showed strong correlation with breast feeding self-efficacy, indicating that more efficient breast feeding technique is associated with increased confidence in breast feeding an infant.
  
  
  CONCLUSIONS
  the BBAT is a concise breast feeding assessment tool facilitating accurate, rapid breast feeding appraisal, and targeting breast feeding advice to mothers acquiring early breast feeding skills or for those experiencing problems with an older infant. Accurate assessment is essential to ensure enhanced breast feeding efficiency and increased maternal self-confidence.
  
  
  CONCLUSIONS
  the BBAT could be used both clinically and in research to target advice to improve breast feeding efficacy. Further research is needed to establish its wider usefulness.
authors: Centre for Child & Adolescent Health, School of Social & Community Medicine, University of Bristol, Bristol BS8 2BN, UK. Electronic address: jenny.ingram@bristol.ac.uk.
authors: Jenny
authors: J
authors: Ingram
authors: Centre for Child & Adolescent Health, School of Social & Community Medicine, University of Bristol, Bristol BS8 2BN, UK. Electronic address: D.johnson@bristol.ac.uk.
authors: Debbie
authors: D
authors: Johnson
authors: Southmead Hospital, North Bristol NHS Trust, Bristol BS10 5NB, UK. Electronic address: Marion.copeland@nbt.nhs.uk.
authors: Marion
authors: M
authors: Copeland
authors: Southmead Hospital, North Bristol NHS Trust, Bristol BS10 5NB, UK. Electronic address: Cathy.churchill@nbt.nhs.uk.
authors: Cathy
authors: C
authors: Churchill
authors: Research Design Service-South West, Education Centre, University Hospitals Bristol NHS Foundation Trust, Bristol BS2 8AE, UK. Electronic address: Hazel.taylor@uhbristol.nhs.uk.
authors: Hazel
authors: H
authors: Taylor
mesh_terms: D001942:Breast Feeding / Q000379:methods / Q000523:psychology*; D004739:England; D005260:Female; D006801:Humans; D009035:Mothers / Q000523:psychology*; D011181:Postnatal Care / Q000379:methods*; D011247:Pregnancy; D015203:Reproducibility of Results; D020377:Self Efficacy; D012647:Self-Assessment; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Breast feeding; Bristol Breastfeeding Assessment Tool; Frenotomy; Self-efficacy