Allattamento al seno: validazione del breastfeeding assessment score ridotto, su un gruppo di puerpere italiane. [Breastfeeding: validation of a reduced Breastfeeding Assessment Score (BAS) in a group of Italian women]

Abstract. Title: Breastfeeding: validation of a reduced Breastfeeding Assessment Score (BAS) in a group of Italian women Aim and objective. To assess the accuracy of a reduced Breastfeeding Assessment Score (BAS) in a group of Italian women; the reduced BAS considers only 5 of the 8 original BAS items studied, those not indicating a pathology. Background. The WHO and many Professional Organizations recommend exclusive breastfeeding for the first 6 months of life because of its many benefits for mother and child. A prognostic approach that identifies mothers at increased risk of early breastfeeding cessation is needed in order to provide preventive support. The BAS, elaborated in Kansas, is useful to this approach. Design. This is a descriptive, prospective study. This study involves two Italian hospitals. Method. We included healthy Italian mothers who gave birth from July 7, 2008 to January 15, 2009. The exclusion criteria on the convenience sample were: non-Italian nationality, birth under 36 wks and twin birth. The authors calculated a reduced BAS (“reduced” because the original 8 items studied by Hall, were reduced to 5) 48 hours after birth. After 4 weeks a structured follow-up telephone interview was carried out: the primary outcome was breastfeeding cessation (including mixed feeding). Results. We recruited 386 women, with 6 lost during follow-up. Out of 380 women, 127 (33.4%) stopped breastfeeding. With a cut off point of 8, the reduced BAS sensitivity was 52.0%, which increased to 77.9% by using a cut-off point of 9. We also calculated a modified BAS with different age categories, which is adequate based on the Italian situation: in this case sensitivity was 70.1%. This study suggests that a reduced BAS with a different cut-off point or modified with a different age classification is useful in identifying Italian mothers who will discontinue breastfeeding, as in both cases sensitivity does increase. Relevance to clinical practice. Italian midwives could use this modified BAS to identify mothers at increased risk of early breastfeeding cessation needing special support.