Psychometric Evaluation of 5- and 4-Item Versions of the LATCH Breastfeeding Assessment Tool during the Initial Postpartum Period among a Multiethnic Population

Abstract

ObjectivesThe aim of this study was to evaluate the internal consistency, structural validity, sensitivity and specificity of the 5- and 4-item versions of the LATCH assessment tool among a multiethnic population in Singapore.MethodsThe study was a secondary analysis of a subset of data (n = 907) from our previous breastfeeding survey from 2013 to 2014. The internal consistency of the LATCH was examined using Cronbach’s alpha. The structural validity was assessed using an exploratory factor analysis (EFA), and the proposed factors were confirmed by confirmatory factor analysis (CFA) using separate samples. Receiver operating characteristic analysis was used to evaluate the sensitivity and specificity of the LATCH score thresholds for predicting non-exclusive breastfeeding.ResultsThe Cronbach’s alpha values of the 5- and 4-item LATCH assessments were 0.70 and 0.74, respectively. The EFA demonstrated a one-factor structure for the 5- and 4-item LATCH assessments among a randomized split of 334 vaginally delivered women. Two CFA of the 4-item LATCH demonstrated better fit indices of the models compared to the two CFA of the 5-item LATCH among another randomized split of 335 vaginally delivered women and 238 cesarean delivered women. Using cutoffs of 5.5 and 3.5 were recommended when predicting non-exclusive breastfeeding for 5- and 4-item versions of the LATCH assessment among vaginally delivered women (n = 669), with satisfactory sensitivities (94% and 95%), low specificities (0% and 2%), low positive predictive values (25%) and negative predictive values (20% and 47%). A cutoff of 5.5 was recommended to predict non-exclusive breastfeeding for 5- and 4-item versions among cesarean delivered women (n = 238) with satisfactory sensitivities (93% and 98%), low specificities (4% and 9%), low positive predictive values (41%) and negative predictive values (65% and 75%). Therefore, the tool has good sensitivity but poor specificity, positive and negative predictive values.ConclusionsWe found that the 4-item version demonstrated sound psychometric properties compared to the 5-item version. Health professionals can use the 4-item LATCH as a clinical tool because it is a concise, easy-to-use and valid tool for assessing breastfeeding techniques among a multiethnic population.

Maxillary Frenulum in Newborns: Association with Breastfeeding

“…7 The 5-item LATCH score exhibits a Cronbach alpha of 0.70, indicating acceptable internal consistency across multiethnic populations. 8 It also positively and significantly correlates with other breastfeeding assessment tools. 9 Of note, our goal was to record a LATCH score at 24 hours postbirth and any subsequent LATCH scores.…”

The effect of mother and newborn early skin-to-skin contact on initiation of breastfeeding, newborn temperature and duration of third stage of labor

“…The fourth instrument was the LATCH breastfeeding assessment tool. LATCH is a sensitive, reliable and valid tool that evaluates breastfeeding techniques based on observations and descriptions of effective breastfeeding [ 19 , 20 ]. The letters of the acronym LATCH designate five separate assessment parameters: “L” for how well the infant latches onto the breast, “A” for the amount of audible swallowing, “T” for the mother’s nipple types, “C” for the mother’s level of comfort, and “H” for the amount of support the mother has be given to hold her infant to the breast.…”

Breastfeeding Techniques and Associated Factors among Mothers before Discharge: A Cross-Sectional Study

“…The Cronbach' s α is 0. 7 [8] . The LATCH scoring system is a simple and effective tool to evaluate breastfeeding techniques, which has a good consistency and sensitivity among different ethnic groups so that it can be used in multi-ethnic population [8] .…”

“…In old days, the hospital stay was long enough for mothers building effective breastfeeding before discharge. At the present, with a limited hospital stay for 2-3 days, it's of great importance to make timely assessment and targeted breastfeeding guidance to the mothers to improve breastfeeding techniques before discharge, such as the correct posture and lactation, informing the common problems and corresponding solutions in breastfeeding [8] .…”