Development and Validation of the Infant Feeding Intentions Scale

Objectives There is a need in breastfeeding behavior studies for a quantitative measure of maternal breastfeeding intentions. The Infant Feeding Intentions (IFI) scale was developed to fill this need. Methods Two items probe strength of intentions to initiate breastfeeding and subsequent items assess strength of intentions to be breastfeeding exclusively (EBF) at 1, 3, or 6 months. Total score ranges from 0 to 16. Content validity was established among women in their third trimester of pregnancy (n = 88). Subsequently, construct validity was assessed in a low-income, multi-ethnic cohort of primiparae (n = 170) interviewed at 25 ± 15 h postpartum and followed to 6 months. Results Cronbach’s coefficient alpha was 0.90 for both the content and construct validity samples. Construct validity was demonstrated by a significant association between IFI score and both planned and actual EBF duration: mean (+standard deviation) IFI scores were 4.6 ± 2.9, 7.5 ± 3.2, 10.3 ± 2.7, 12.0 ± 1.8, and 13.8 ± 2.7 for planned duration of EBF of ‘Never’, up to 1 month, 1 to <3 months, 3 to <6 months, and ≥6 months, respectively; ANOVA, P < 0.0001; and each 1-point increase in IFI score decreased the hazard of not EBF by 23.4% at day 0 and 13.7% at day 30 (Cox proportional hazards model chi-square = 92.5, P < 0.0001). Conclusions In a multi-ethnic U.S. sample of low-income primiparae, the IFI scale was shown to be a valid, simple tool for quantitatively assessing the strength of intentions to initiate and sustain EBF.