Breastfeeding Assessment Score: Systematic Review and Meta-analysis

Abstract

BACKGROUND: Previous studies have revealed conflicting results for the Breastfeeding Assessment Score (BAS) in predicting early breastfeeding cessation. Our objective was to externally validate the BAS and provide summary accuracy estimates for this clinical prediction model. METHODS:We used the original data from a prospective cohort study. Additional studies were identified by searching electronic databases (Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, and Cochrane) from 2002 to 2013 and contacting research groups that had derived or validated the BAS. Prospective cohort studies were eligible if the BAS was computed at baseline and mothers were followed up for breastfeeding cessation. Two physicians extracted relevant information and independently assessed the methodological quality for the included studies. CONCLUSIONS: Substantial between-study heterogeneity limited the interpretation of summary accuracy estimates. The BAS predicts early breastfeeding cessation with moderate accuracy, although local recalibration is advised before implementation. Further study is warranted to determine whether the BAS can help pediatricians in identifying mother-infant pairs that may benefit from more extensive breastfeeding assessment and support.

Critical Appraisal Tools and Reporting Guidelines

“…Finally, authors should use reporting guidelines together with journal-specific instructions for authors when preparing a manuscript for publication. (Johnson et al, 2020) A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) (Shea et al, 2017) Systematic Reviews of Randomized or Nonrandomized Studies (Fair et al, 2021) Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS 2) (Whiting et al, 2011) Diagnostic Accuracy Studies (Raskovalova et al, 2015) Note. 1 Not lactation study.…”

Validation of a Breastfeeding History Questionnaire for the Risk of In-Hospital Formula Supplementation Among Multiparous Women

“…This suggests that the tool is particularly useful for identifying women who are most likely to utilize formula for the majority of their infant feeds in the hospital. In comparison to other instruments previously developed to predict breastfeeding success including Breastfeeding Assessment Score (BAS) and Breastfeeding Attrition Prediction Tool (BAPT), our tool is significantly shorter and, as a result of its brevity, can encourage the provider and mother to engage in a discussion regarding infant feeding (Raskovalova et al, 2015; Casal, Lei, Young, & Tuthill, 2017).…”

To Individualize the Management Care of High-Risk Infants With Oral Feeding Challenges: What Do We Know? What Can We Do?

“…It is well-acknowledged that stress can interfere with the neuro-endocrine regulation of lactation both at the level of milk synthesis and milk release/ejection (6,41,46). Although a number of breastfeeding assessment scales have been developed based on a variety of infant behavioral criteria, they are not yet well-recognized (48)(49)(50)(51)(52)(53). This situation is similar to that of feeding therapists' evaluation of infant's bottle-feeding difficulties as lactation consultants' feedback lack objective evidence-based studies supporting their proposed treatment(s).…”