The assessment tools of the Breastfeeding :Literature review

Abstract

Objective
The present study aimed to integrate the existing assessment tools focused on breastfeeding by mothers for their infants during the lactation period, and to make a review from the viewpoint of different constructs in the features and from the itemized contents and their usefulness.
Methods
We made a keyword search in the domestic and foreign literature on the assessment tools for breast-feeding, and prepared a code table with reference to the integrative research review by Harris (1998). We also qualitatively examined the itemized contents of each tool. Further we made an analysis by using a content analysis for the question contents as factors, and examined the constructs measured by each tool. In addition, we searched the study papers, in which these retrieved assessment tools were used, to compile a code table with reference to the classification of Victoria M, Kate D, Ros B, & Fiona D (2000).
Results
There were a total of 11 tools from the domestic and foreign sources of literature, including the itemized contents which were developed with the aim of supporting breast-feeding for mothers and infants during the lactation period. The breakdowns were primarily related to overall observation of breast-feeding and to evaluation of skills of the helpers. The questions in the tools consisted of "Condition of mind and body in a mother and her infant", "Environment", "Readiness toward lactation", "Breast-feeding behavior" and "Changes after lactation". Among these questions, "breast-feeding behavior" has been the most common focus, but the direct observation on the condition of the breasts, especially on milk production and the secretory condition of milk, was rarely made. There were 16 papers in which these tools were employed. Therefore, the high efficacy was demonstrated in these kinds of tools, such as IBFAT, LATCH that have smaller number of questions, and tools, such as PIBBS that support the premature babies because they not only were easy to use but also provided unique features which other tools did not have. It was suggested that the features of such useful tools were: (1) fewer items, (2) having no misleading or ambiguous expressions, (3) setting up one question for each sentence, and (4) providing evident objective conditions.
Conclusion
Most of the current tools that have been developed for the purpose of supporting breast-feeding focus on breast-feeding behavior, while there have been no tools directly examining the production of milk and the secretory conditions.