The Infant Feeding Intentions scale demonstrates construct validity and comparability in quantifying maternal breastfeeding intentions across multiple ethnic groups

Abstract

Research tools that are comparable across ethnic groups are needed in order to understand sociodemographic disparities in breastfeeding rates. The Infant Feeding Intentions (IFI) scale provides a quantitative measure of maternal breastfeeding intentions. IFI score ranges from 0 (no intention to breastfeed) to 16 (very strong intentions to fully breastfeed for 6 months). The objective of this study was to examine intra- and inter-ethnic validity of the IFI scale. The IFI scale was administered to 218 white non-Hispanic, 75 African-American, 80 English-speaking Hispanic, 62 Spanish-speaking Hispanic and 64 Asian expectant primiparae. Participants were asked their planned duration of providing breast milk as the sole source of milk (full breastfeeding). The IFI scale was examined for intra-ethnic internal consistency and construct validity and for inter-ethnic comparability. For all five ethnic categories, principal component analysis separated the scale into the same two factors: intention to initiate breastfeeding and intention to continue full breastfeeding. Across ethnic categories, the range in Cronbach's alpha was 0.70-0.85 for the initiation factor and 0.90-0.93 for the continuation factor. Within each ethnic category, IFI score increased as planned duration of full breastfeeding increased (P < 0.0001 for all). Within the planned duration categories of <1, 1-3, 3-6 and ≥6 months, the median IFI score by ethnic category ranged from (low-high) 5-8, 9-10, 12-14 and 16-16, respectively. The IFI scale provides a valid measure of breastfeeding intentions in diverse populations of English- and Spanish-speaking primiparae, and may be a useful tool when researching disparities in breastfeeding practices.

Conflict of interest statement

No conflicts of interest have been declared.

Figures

Figure 1

Intra‐ethnic and inter‐ethnic comparison of median Infant Feeding Intentions scale scores by planned full breastfeeding duration category (in months): □ 1 to <3 months; 3 to <6 months; 6 months or more; upper and lower bars represent the 75th and 25th percentiles, respectively (within the Spanish‐speaking Hispanic ethnic category, upper and lower bars do not appear for the highest category because the median score = 75th percentile = 25th percentile). Total possible score ranges from 0 to 16. Within ethnic category Kruskal‐Wallis test of equivalence of rank sum scores stratified by planned full breastfeeding duration category (intra‐ethnic construct validity): P < 0.0001 for all 5 ethnic categories. Within planned full breastfeeding duration category Kruskal‐Wallis test of equivalence of rank sum scores stratified by ethnic category (inter‐ethnic comparability) chi‐square and P‐values: 5.3 and 0.26; 0.8 and 0.94; 6.8 and 0.15; 11.5 and 0.02; for full breastfeeding duration categories of <1 month, 1 to <3 months, 3 to <6 months, and 6 months or more, respectively.