Sensitivity of the Breastfeeding MotivationalMeasurement Scale: A Known Group Analysis of FirstTime Mothers

Doreen Stockdale, Marlene Sinclair, WG KERNOHAN, Evie McCrum-Gardner, John Keller

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Breastfeeding has immense public health value for mothers, babies, and society. But there is an undesirably large gapbetween the number of new mothers who undertake and persist in breastfeeding compared to what would be a preferredlevel of accomplishment. This gap is a reflection of the many obstacles, both physical and psychological, that confront newmothers. Previous research has illuminated many of these concerns, but research on this problem is limited in part by theunavailability of a research instrument that can measure the key differences between first-time mothers and experiencedmothers, with regard to the challenges they face when breastfeeding and the instructional advice they require. Aninstrument was designed to measure motivational complexity associated with sustained breast feeding behaviour; theBreastfeeding Motivational Measurement Scale. It contains 51 self-report items (7 point Likert scale) that cluster into fourcategories related to perceived value of breast-feeding, confidence to succeed, factors that influence success or failure, andstrength of intentions, or goal. However, this scale has not been validated in terms of its sensitivity to profile the motivationof new mothers and experienced mothers. This issue was investigated by having 202 breastfeeding mothers (100 first timemothers) fill out the scale. The analysis reported in this paper is a three factor solution consisting of value, midwife support,and expectancies for success that explained the characteristics of first time mothers as a known group. These resultssupport the validity of the BMM scale as a diagnostic tool for research on first time mothers who are learning to breastfeed.Further research studies are required to further test the validity of the scale in additional subgroups.
Original languageEnglish
JournalPLoS ONE
Issue number12
Publication statusPublished - Dec 2013

Bibliographical note

Reference text: 1. McAndrew F, Thompson J, Fellows L, Large A, Speed M, et al. (2012) Infant
Feeding Survey 2012: Summary. Available at:
Accessed online 4th Jan 2012
2. Begley C, Gallagher L, Clarke M, Carroll M, Millar S (2008). The National
Infant Feeding Survey. Health Service Executive Ireland. Available
Accessed 2nd September 2012.
3. Centre for Disease Control and Prevention (CDC) Breastfeeding Report Card–
United States 2010; Available:
ReportCard2010.pdf Accessed 1st August 2012
4. Wolf JB (2007) Is Breast Really Best? Risk and Total Motherhood in the
National Breastfeeding Awareness Campaign. J Health Polit Policy Law 32(4),
pp 595–636
5. Dennis CL (2003) Breastfeeding Self-efficacy Scale – psychometric assessment.
JOGNN 32 (6): pp734–44
6. Wells KJ, Thompson NJ, Kloeblen-Tarver AS (2002) Intrinsic and Extrinsic
Motivation and Intention to Breast-feed. Am J Health Behav 26(2): pp111–120
7. Wambach KA (1997) Breastfeeding Intention and Outcome: A Test of the
Theory of Planned Behaviour. Res Nurs Health 20: pp51–59
8. Duckett L, Henly S, Avery M, Potter S, Hills-Bonczyk S, et al. (1998) A Theory
of Planned Behavior-Based Structural Model for Breast-Feeding. Nursing
Research 47(6): pp325–33
Validity of a Breastfeeding Motivation Scale
PLOS ONE | 6 December 2013 | Volume 8 | Issue 12 | e82976
9. Dick MJ, Evans ML, Arthurs JB, Barnes JK, Caldwell RS, et al. (2002)
Predicting early breastfeeding attrition. J Hum Lact 18 (1): pp21–28
10. McMillan B, Conner M, Woolridge M, Dyson L, Green J, et al. (2008)
Predicting breastfeeding in women living in areas of economic hardship:
Explanatory role of the theory of planned behaviour. Psychology and Health 23
(7): pp767–788
11. Hoddinott P, Craig LCA, Britten J, McInnes RM (2012). A serial qualitative
interview study of infant feeding experiences: idealism meets realism. BMJ Open
2012;2:e000504 doi:10.1136/bmjopen-2011-000504
12. Keller JM (1987) Development and Use of the ARCS Model of Instructional
Design. Journal of Instructional Development (now Educ Technol Res Dev)
10(3): pp2–9
13. Ajzen I, Madden TJ (1986) Prediction of Goal Directed Behavior: Attitudes,
intentions and perceived behavioral control. J Exp Soc Psychol, 22: pp453–474
14. Bandura A (1977) self-Efficacy: Toward a Unifying Theory of Behavioral
Change. Psychological Review 34 (2): pp191–215
15. Deci EL, Ryan RM (1985). Intrinsic motivation and self-determination in
human behavior. New York: Plenum.
16. Janke JR (1994) Development of the Breast-Feeding Attrition Prediction Tool.
Nursing Research, 43: pp100–104
17. Avery M, Duckett L, Dodgson J, Savik K, Henly SJ (1998) Factors Associated
with Very Early Weaning Among Primparas Intending to Breastfeed. Matern
Child Health J 2 (3): pp167–179
18. Stockdale J, Sinclair M, Kernohan WG, Dunwoody L, Cunningham JB, et al.
(2008) Assessing the impact of midwives’ instruction: the breastfeeding
motivational instructional measurement scale. Evidence Based Midwifery 6(1),
19. Gorsuch RL (1983) Factor Analysis. Hillsdale, N.J. Lawrence Erlbaum (2nd Ed.)
20. Tabachnick BG, Fidell LS (2001) Using Multivariate Statistics 4th ed. By Allyn
and Bacon: Pearson Education Company USA
21. Kaiser HF (1960) The application of electronic computers to factor analysis.
Educ Psychol Meas, 20: pp141–151.
22. Cattell RB, Schuerger JM (1978) Personality Theory in Action. Champaign:
23. Goddard RL, Kirby A (1976) An introduction to factor analysis. Norwich. UK
24. Comrey A L, Lee HB (1992) A First Course in Factor Analysis. (2nd Ed)
Hillsdale, NJ: Lawrence Erlbaum Associates, Publishers.
25. Bulk-Bunschoten AMW, van Bodegom S, Reerink JD, Pasker-de Jong PCM, de
Groot CJ (2001) Reluctance to continue breastfeeding in the Netherlands. Acta
Paediatrica 90(9), pp1047–1053.
26. Kools EJ, Thijs C, De Vries H (2005) The Behavioral Determinants of Breast-
Feeding in the Netherlands: Predictors for the Initiation of Breast-Feeding.
Health Education and Behavior 32(6), pp809–824.
27. Renfrew M, McCormick F, Wade A, Quinn B, Dowswell T (2012) Support for
Healthy Breastfeeding Mothers with Healthy Term Babies. Cochrane Library.
DOI: 10.1002/14651858.CD001141.pub4
28. Costello AB, Osborne JW (2005) Best Practices in Exploratory Factor Analysis:
Four Recommendations for Getting the Most from the Analysis. Practical
Assessment, Research and Evaluation 10:7, pp1–9
29. Worell L (1956) The effect of goal value upon expectancy. J Abnorm Soc
Psychol, Vol 53(1), 48–53. doi:10.1037/h0041704
30. Hauck YL, Irurtita VF (2003) Mothers dealt with incompatible expectations
during breastfeeding and weaning. Evid Based Nurs 6: p92
31. Schmied V, Sheenan A, Barclay L (2001) Contemporary breast-feeding policy
and practice: implications for midwives. Midwifery 17: pp44–54
32. Clifford TJ, Campbell MK, Speechley KN, Gorodzinsky F (2006) Factors
influencing full breastfeeding in a south western Ontario community:
assessments at 1 week and at 6 months postpartum. J Hum Lact 23: pp292–304.
33. Hegney D, Fallon T, O’Brien M (2008) Against all odds: a retrospective casecontrolled
study of women who experience extraordinary breastfeeding
problems. Journal of Clinical Nursing 17(9), pp1182–1192.
34. Martin LL, Tesser M (1996) Striving and Feeling: Interactions Among Goals,
Affect and Self-Regulation. Lawrence Erlbaum Associates Inc. NJ.
35. Hong TM, Callister LC, Schwartz R (2003) First-time mothers’ view of
breastfeeding support. MCN Am J Matern Child Nurs 28(1): pp10–15
36. Chezem J, Friesen C, Boettcher J (2003) Breastfeeding Knowledge, Breastfeeding
Confidence, and Infant Feeding Plans: Effects on Actual Feeding Practices
JOGNN. 32 (1): pp40–7
37. Cloherty M, Alexander J, Holloway I (2003) Supplementing breast-fed babies in
the UK to protect their mothers from tiredness or distress. Midwifery 20: pp194–
38. Hanss K (2004) Confidence and breastfeeding: a view from the front-line. J Fam
Health Care 14(1): pp21–24
39. Jacobs JE, Eccles JS (2000) Parents, task values, and real-life achievement-related
choices. In: Sansone and Harackiewicz (2000) Intrinsic and Extrinsic
Motivation, The Search for Optimal Motivation and Performance. Academic
Press pp408–433
40. Deci EL, Ryan RM (2000). The ‘‘what’’ and ‘‘why’’ of goal pursuits: Human
needs and the self-determination of behavior. Psychological Inquiry, 11, pp227–
41. Sansone C, Harackiewicz J (2000) Intrinsic and Extrinsic Motivation, The
Search for Optimal Motivation and Performance. Academic Press
42. Keller JM (2010). Motivational Design for Learning and Performance: The
ARCS Model Approach. Springer, New York.
Validity of a Breastfeeding Motivation Scale


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