The development of the Maternal Breastfeeding Evaluation Scale.

A Maternal Breastfeeding Evaluation Scale was developed from categories identified in qualitative research. Content validity was tested according to procedures described by Imle and Atwood and Lynn. A sample of 442 women who had breastfed completed an instrument of 56 Likert-scale items. A retest questionnaire was completed by a subsample of 28 women. Exploratory factor analysis resulted in three factors, accounting for 38.5 percent of the variance: Maternal Enjoyment/Role Attainment (29 percent), Infant Satisfaction/Growth (5 percent), and Lifestyle/Maternal Body Image (4 percent). A revised 30-item MBFES was developed using items loading strongly on these three factors. Cronbach's alphas for the revised scale and subscales were .93, .93, .88, and .80, respectively. Test-retest correlations (n = 28) were .93, .93, .94, and .82, respectively (p < .001 for all).

Maternal perceptions of successful breastfeeding.

Twenty-six mothers were interviewed concerning successful and unsuccessful breastfeeding. Constant comparative analysis yielded five major categories of successful breastfeeding: infant health, infant satisfaction, maternal enjoyment, desired maternal role attainment, and lifestyle compatibility. A core concept, working in harmony, emerged as a unifying theme. Mothers described successful breastfeeding as a complex interactive process resulting in mutual satisfaction of maternal and infant needs. This concept broadens definitions of successful breastfeeding often used by health professionals, which emphasize breastfeeding duration and nutritional aspects.

The breast-feeding experience of women with type I diabetes.

The purpose of this exploratory study was to identify the factors influencing the initiation and maintenance of breast-feeding in women with insulin-dependent diabetes. The lack of research in this area and the need for in-depth data necessitated exploratory methodology. Twenty-two mothers who were insulin dependent before pregnancy and who had given birth in the past 2 years were interviewed. Diabetes was not a principal factor in the decision to breast-feed or bottle-feed for the majority of the women. When diabetes was a factor, women were seeking a "normal" childbearing experience, including breast-feeding. Although the women did not perceive diabetes as influencing their breast-feeding experiences, they did find that maintaining good diabetic control required greater effort and flexibility during breast-feeding.