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Bayesian item response model, breast-feeding attrition, Breast-feeding Attrition Prediction Tool, infant feeding, instrument revision, intention to breast-feed



  1. Gill, Sara L. PhD, RN, IBCLC
  2. Reifsnider, Elizabeth PhD, APRN, BC
  3. Lucke, Joseph F. PhD
  4. Mann, Angela R. MSN/MPH, RN


Context: Current breast-feeding rates fall short of the recommendations set forth in Health People 2010. The Breast-feeding Attrition Prediction Tool (BAPT), administered in the postpartum period, has been useful in predicting breast-feeding attrition. However, assessing a woman's intention to breast-feed prior to birth would identify women at risk for breast-feeding attrition.


Purpose: The purpose of this study was to describe a revised BAPT, administered antepartally that measures intention to breast-feed.


Methods: The BAPT, comprising 94 items on a 6-point Likert-type scale, was translated into Spanish and back-translated for accuracy. The BAPT was then revised by reducing the number of items to 35 (32 were used for analysis) and contracting the 6-point scale to 3 categories. A Bayesian item response model provided the psychometric properties of the revised BAPT.


Results: The revised BAPT was completed by 143 Mexican American pregnant women. Items, some reverse scored, were recoded as "agree" versus "disagree." Item analyses indicated a wide range of item discriminabilities, with most items being useful measures of intention to breast-feed. Person analyses provided scores for intention to breast-feed. A simpler scoring system was devised for applications.


Conclusions: The revised BAPT shows promise as a measure of intention to breast-feed. The scoring system also indicates which women may need additional interventions to promote breast-feeding.