The Breastfeeding Self-efficacy Scale: Psychometric Assessment of the Short Form

Objective: The purpose of this study was to reduce the number of items on the original Breastfeeding Self-Efficacy Scale (BSES) and psychometrically assess the revised BSES-Short Form (BSES-SF).

Design: As part of a longitudinal study, participants completed mailed questionnaires at 1, 4, and 8 weeks postpartum.

Setting: Health region in British Columbia.

Participants: A population-based sample of 491 breastfeeding mothers.

Main Outcome Measures: BSES, Edinburgh Postnatal Depression Scale, Rosenberg Self-Esteem Scale, and Perceived Stress Scale.

Results: Internal consistency statistics with the original BSES suggested item redundancy. As such, 18 items were deleted, using explicit reduction criteria. Based on the encouraging reliability analysis of the new 14-item BSES-SF, construct validity was assessed using principal components factor analysis, comparison of contrasted groups, and correlations with measures of similar constructs. Support for predictive validity was demonstrated through significant mean differences between breastfeeding and bottle feeding mothers at 4 (p < .001) and 8 (p < .001) weeks postpartum. Demographic response patterns suggested the BSES-SF is a unique tool to identify mothers at risk of prematurely discontinuing breastfeeding.

Conclusions: These psychometric results indicate the BSES-SF is an excellent measure of breastfeeding self-efficacy and considered ready for clinical use to (a) identify breastfeeding mothers at high risk, (b) assess breastfeeding behaviors and cognitions to individualize confidence-building strategies, and (c) evaluate the effectiveness of various interventions and guide program development.