Validation of the Arabic Maternal Breastfeeding Evaluation Scale (MBFES-A) among Lebanese women

Abstract

Background Maternal satisfaction with the breastfeeding experience is an important determinant of breastfeeding success. There is currently no valid tool to measure perceived maternal satisfaction with breastfeeding in the Arab context. Methods This cohort study tested the Maternal Breastfeeding Evaluation Scale (MBFES) on 450 healthy Lebanese mothers for internal consistency reliability and construct validity. Participants were recruited between April 2018 and February 2020. Results The Cronbach’s alpha reliability coefficient of the Arabic MBFES (MBFES-A) was 0.87. Exploratory factor analysis revealed that it has three components: Infant Satisfaction/Growth, Maternal Enjoyment/Role Attainment, and Lifestyle/Body Image with reliability coefficients of 0.88, 0.87, and 0.68, respectively. Four items were deleted because of low factor loadings and three items were relocated to the Infant Satisfaction/Growth subscale based on their factor loadings. Participants who were exclusively breastfeeding at one and/or 3 months had higher mean MBFES-A total and Infant Satisfaction/Growth and Maternal Enjoyment/Role Attainment subscale scores than participants who were partially breastfeeding, and significantly higher mean scores than mothers who were not breastfeeding (all p values < 0.001), findings that support the scale’s construct validity. Moreover, scores on the Infant Satisfaction/Growth subscale correlated with exclusive breastfeeding at one (r = 0.37, p < 0.001) and 3 months (r = 0.31, p < 0.001). The MBFES-A score had positive modest correlations with maternal attitude towards breastfeeding (r = 0.30, p < 0.001), exclusive breastfeeding at one (r = 0.27) and at 3 months (r = 0.26, p < 0.001 for both), as well as with the longest previous exclusive breastfeeding (r = 0.27, p < 0.001). Conclusions The 26-item MBFES-A is a reliable and valid instrument to use in future breastfeeding research in Middle East North Africa countries. There is a need for replication of our findings in other Arab contexts using new constructs to establish stronger construct validity.

Validation of the Arabic Maternal postpartum quality of life questionnaire among Lebanese women: A cohort study

“…The modest correlation between maternal quality of life and satisfaction with certain aspects of breastfeeding domains supports the external validity of the Arabic MAPP-QOL. However, satisfaction with breastfeeding did not translate into higher rates of exclusive breastfeeding in this cohort, a finding that is consistent with our previous report on the same cohort [ 13 ]. It is well-established that a mother’s decision to breastfeed her infant and the duration of breastfeeding may be affected by several factors, and not only her satisfaction with the breastfeeding experience.…”

“…The participants were also administered the Arabic Maternal Breastfeeding Evaluation Scale (MBFES-A) at one month. This 26-item instrument has been shown to be a reliable and valid tool to measure maternal perceived overall quality of the breastfeeding experience in Lebanese women, with a Cronbach’s alpha reliability coefficient of 0.87 [ 13 ]. The item scoring uses a 5-point Likert-type scale that ranges from 1 ( strong disagreement ) to 5 ( strong agreement ) resulting in a minimum score of 26 and a maximum of 130 points, with higher scores indicating more satisfaction with the breastfeeding experience.…”

Psychometric properties of the Maternal Breastfeeding Evaluation Scale: confirmatory factor analysis

“…On the other hand, correlations with breastfeeding were also found, meaning that mothers who continued breastfeeding had higher scores in maternal enjoyment, satisfaction with infant growth, and maternal body image compared to mothers who no longer breastfed. This relationship was also examined and con rmed in other validation studies, such as the Japanese [18], Arabic [9] and Portuguese versions [17].…”

“…The MBFES-A versión [9] discovered an association between the maternal satisfaction and infant satisfaction dimensions with exclusive breastfeeding at three months. Hence, it can be utilized as an indicator of successful outcomes and the maintenance of breastfeeding.…”

“…In any case, breastfeeding success has traditionally been measured by its duration, without taking into account other factors such as satisfaction with the experience [7,8]; which could be considered as a relevant outcome measure [9]. Currently, it is essential not to overlook the signi cant value that Patient-Reported Outcome Measures (PROMs) are achieving in global healthcare services, assessing individuals' perceptions of their own situation, as well as Patient-Reported Experience Measures (PREMs) regarding the clinical care received [10].…”