Measuring paternal breastfeeding self-efficacy: A psychometric evaluation of the Breastfeeding Self-Efficacy Scale-Short Form among fathers

The majority of women discontinue breastfeeding before the recommended 6 months postpartum. If health professionals are to improve breastfeeding outcomes, predisposing factors amenable to intervention need to be identified. One possible risk factor to target is breastfeeding self-efficacy, which has been shown to significantly influence breastfeeding outcomes. The Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) was originally designed to assess a mother's confidence in her ability to breastfeed. Fathers play an important role in supporting their breastfeeding partner and their self-efficacy may also influence breastfeeding outcomes. However, it is unknown if the BSES-SF is a valid and reliable measure for measuring self-efficacy among fathers. The goal of this study is to assess the psychometric properties of the BSES-SF among fathers. Fathers (n=214) whose partners were breastfeeding were recruited from a large hospital in Toronto, Canada. Fathers completed the modified BSES-SF in-hospital and at 6 weeks postpartum. The unidimensional structure of the BSES-SF was confirmed, with the best model fit found at 6 weeks. Cronbach's alpha coefficient was 0.91 at baseline and 0.92 at 6 weeks. Paternal BSES-SF scores were significantly correlated with maternal BSES-SF scores, fathers' breastfeeding attitude, importance fathers place on breastfeeding, breastfeeding level and exclusivity, and perception of breastfeeding progress. While paternal in-hospital BSES-SF scores did not predict breastfeeding at 6 and 12 weeks, 6 week BSES-SF scores predicted exclusivity at 12 weeks. This study provides initial evidence that the modified BSES-SF is a valid and reliable measure of breastfeeding self-efficacy among fathers, especially when used following hospital discharge.