Translation to Spanish and validation of a scale for the observation of breastfeeding: The Bristol Breastfeeding Assessment Tool.

INTRODUCTION: The observation of a feeding by a professional is important to strengthen breastfeeding. The Bristol Breastfeeding Assessment Tool (BBAT) was translated into Spanish and validated. MATERIAL AND METHODS: Translation and back-translation of the original scale was done. Six pediatricians and six pediatric nurses collaborated. At the newborn's first visit, a feeding was observed and the pediatrician and nurse scored the BBAT scale independently. The nurse also scored the LATCH Breastfeeding Assessment (LATCH) and each mother filled out the Breastfeeding Self-Efficacy Scale (BSES-SF). Mothers were appointed a week later and the nurse re-scored the BBAT. RESULTS: A total of 62 mothers participated. There was good internal consisitency for the BBAT (Cronbach's alpha = 0.83 in the assessment made by the nurses and Cronbach's alpha = 0.79 in the assessment made by the pediatricians). Inter-rater consistency showed an intra-class correlation coefficient of 0.91, while for the test-retest was 0.67. Concurrent validity with the BSES-SF scale was good and with the LATCH scale very good. The factor analysis showed the one-dimensional character of the scale and a good homogeneity of the 4 items (positioning = 0.771, attachment = 0.852, sucking = 0.856 and swallowing = 0.679). CONCLUSIONS: The scale obtained in Spanish shows good reliability and validity. The BBAT is an easy-to-use tool that allows breastfeeding assessment and determines the aspects that need to be improved.

[Translation to Spanish and validation of a scale for the observation of breastfeeding: The Bristol Breastfeeding Assessment Tool]. / Traducción al español y validación de una escala para la observación de una toma de lactancia materna: la «Bristol Breastfeeding Assessment Tool¼.

INTRODUCTION: The observation of a feeding by a professional is important to strengthen breastfeeding. The Bristol Breastfeeding Assessment Tool (BBAT) was translated into Spanish and validated. MATERIAL AND METHODS: Translation and back-translation of the original scale was done. Six pediatricians and six pediatric nurses collaborated. At the newborn's first visit, a feeding was observed and the pediatrician and nurse scored the BBAT scale independently. The nurse also scored the LATCH Breastfeeding Assessment (LATCH) and each mother filled out the Breastfeeding Self-Efficacy Scale (BSES-SF). Mothers were appointed a week later and the nurse re-scored the BBAT. RESULTS: A total of 62 mothers participated. There was good internal consistency for the BBAT (Cronbach's alpha = 0.83 in the assessment made by the nurses and Cronbach's alpha = 0.79 in the assessment made by the pediatricians). Inter-rater consistency showed an intra-class correlation coefficient of 0.91, while for the test-retest was 0.67. Concurrent validity with the BSES-SF scale was good and with the LATCH scale very good. The factor analysis showed the one-dimensional character of the scale and a good homogeneity of the 4 items (positioning = 0.771, attachment = 0.852, sucking = 0.856 and swallowing = 0.679). CONCLUSIONS: The scale obtained in Spanish shows good reliability and validity. The BBAT is an easy-to-use tool that allows breastfeeding assessment and determines the aspects that need to be improved.

Apoyo telefónico de la lactancia materna desde Atención Primaria: ensayo clínico aleatorizado y multicéntrico / Telephone support for breastfeeding by primary care: a randomised multicentre trial

OBJETIVO: Evaluar un programa de apoyo telefónico a madres que dan lactancia materna los 6 primeros meses. MÉTODOS: Ensayo clínico aleatorizado no enmascarado. Colaboraron 5 centros de salud de medio urbano. Se incluyeron madres con recién nacidos sanos que tomaban lactancia materna exclusiva (LME) o parcial (LMP). El grupo control recibió la atención habitual. El grupo intervención recibió además apoyo telefónico semanal los 2 primeros meses y quincenal hasta el sexto mes. Se valoró el tipo de lactancia en las revisiones habituales (1, 2, 4 y 6 meses). RESULTADOS: Grupo intervención n = 193, grupo control n = 187. La mayor diferencia en porcentaje de LME se apreció a los 6 meses: 21,4% de grupo control frente al 30,1% del grupo intervención. No obstante, en el análisis ajustado de las odds ratio los intervalos de confianza no mostraron significación estadística. Las odds ratio al mes, 2 meses, 4 meses y 6 meses para LME fueron respectivamente: 1,45 (0,91-2,31); 1,35 (0,87-2,08); 1,21 (0,80-1,81) y 1,58 (0,99-2,53). Las odds ratio en los mismos cortes para cualquier tipo de lactancia materna (LME+LMP) fueron: 1,65 (0,39-7,00); 2,08 (0,94-4,61); 1,37 (0,79-2,38) y 1,60 (0,98-2,61). CONCLUSIONES: La intervención telefónica no fue suficientemente efectiva como para generalizarla

OBJECTIVE: To evaluate a telephone support programme for mothers who breastfeed for the first 6 months. METHODS: A randomised unmasked clinical trial was conducted in 5 urban Primary Care centres that included mothers with healthy newborns who were breastfeeding exclusively (EBF) or partially (PBF). The control group received the usual care. The intervention group also received telephone support for breastfeeding on a weekly basis for the first 2 months and then every 2weeks until the sixth month. The type of breastfeeding was recorded in the usual check-up visit (1, 2, 4 and 6 months). RESULTS: The study included 193 patients in the intervention group, and 187 in a control group. The greatest increase in the percentage of EBF was observed at 6 months: 21.4% in the control group compared to 30.1% in the intervention group. However, in the adjusted odds ratios analysis, confidence intervals did not show statistical significance. The odds ratio at 1 month, 2 months, 4 months, and 6 months for EBF were 1.45 (0.91-2.31), 1.35 (0.87-2.08), 1.21 (0.80-1.81), and 1.58 (0.99-2.53), respectively. The odds ratio in the same age groups for any type of breastfeeding (EBF + PBF) were 1.65 (0.39-7.00), 2.08 (0.94-4.61), 1.37 (0.79-2.38), and 1.60 (0.98-2.61), respectively. CONCLUSIONS: Telephone intervention was not effective enough to generalise it

[Telephone support for breastfeeding by primary care: a randomised multicentre trial]. / Apoyo telefónico de la lactancia materna desde Atención Primaria: ensayo clínico aleatorizado y multicéntrico☆.

OBJECTIVE: To evaluate a telephone support programme for mothers who breastfeed for the first 6 months. METHODS: A randomised unmasked clinical trial was conducted in 5 urban Primary Care centres that included mothers with healthy newborns who were breastfeeding exclusively (EBF) or partially (PBF). The control group received the usual care. The intervention group also received telephone support for breastfeeding on a weekly basis for the first 2months and then every 2weeks until the sixth month. The type of breastfeeding was recorded in the usual check-up visit (1, 2, 4 and 6 months). RESULTS: The study included 193 patients in the intervention group, and 187 in a control group. The greatest increase in the percentage of EBF was observed at 6 months: 21.4% in the control group compared to 30.1% in the intervention group. However, in the adjusted odds ratios analysis, confidence intervals did not show statistical significance. The odds ratio at 1 month, 2 months, 4 months, and 6 months for EBF were 1.45 (0.91-2.31), 1.35 (0.87-2.08), 1.21 (0.80-1.81), and 1.58 (0.99-2.53), respectively. The odds ratio in the same age groups for any type of breastfeeding (EBF + PBF) were 1.65 (0.39-7.00), 2.08 (0.94-4.61), 1.37 (0.79-2.38), and 1.60 (0.98-2.61), respectively. CONCLUSIONS: Telephone intervention was not effective enough to generalise it.