A Critical Review of Instruments Measuring Breastfeeding Attitudes, Knowledge, and Social Support

Corrine S. Casal, Ann Lei, Sera L. Young, Emily L. Tuthill*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

45 Scopus citations


Background: Breastfeeding provides beneficial health outcomes for infants and their mothers, and increasing its practice is a national priority in many countries. Despite increasing support to exclusively breastfeed, the prevalence at 6 months remains low. Breastfeeding behavior is influenced by a myriad of determinants, including breastfeeding attitudes, knowledge, and social support. Effective measurement of these determinants is critical to provide optimal support for women throughout the breastfeeding period. However, there are a multitude of available instruments measuring these constructs, which makes identification of an appropriate instrument challenging. Research aim: Our aim was to identify and critically examine the existing instruments measuring breastfeeding attitudes, knowledge, and social support. Methods: A total of 16 instruments was identified. Each instrument's purpose, theoretical underpinnings, and validity were analyzed. Results: An overview, validation and adaptation for use in other settings was assessed for each instrument. Depth of reporting and validation testing differed greatly between instruments. Conclusion: Content, construct, and predictive validity were present for most but not all scales. When selecting and adapting instruments, attention should be paid to domains within the scale, number of items, and adaptation.

Original languageEnglish (US)
Pages (from-to)21-47
Number of pages27
JournalJournal of Human Lactation
Issue number1
StatePublished - Feb 2017


  • attitudes
  • breastfeeding
  • human milk
  • instruments
  • knowledge
  • psychometric analysis
  • review
  • social support

ASJC Scopus subject areas

  • Obstetrics and Gynecology


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