A critical analysis of the content of the tools that measure breast-feeding interaction

Objective: to undertake a critical analysis of the content of six tools, wh ich have been designed to evaluate the breast-feeding interaction. Design: the tools are viewed as discourses and are examined in terms of the insight they give into the assumptions about and attitudes towards breast- feeding inherent in the authors who have produced them, Findings: the findings indicate that there is little agreement between the existing breastfeeding assessment tools as to how to measure a successful b reast feed and that the tools appear to place insufficient reliance upon th e research evidence related to lactation. Key conclusions: the lack of commonality between evaluation tools appears t o reflect a prevailing inconsistency in the advice given by health workers to breast-feeding mothers. Reports of their unreliability may be indicative of the problems inherent when: attempting to impose a biomedical model upo n an intrinsically natural interaction. Implications for practice: it is suggested that, if evaluations of the brea st-feeding interaction are to be useful, a tool which places greater emphas is on the research evidence is called for. Otherwise, given the limitations of such tools, their use may actively hinder the establishment of successf ul breast feeding. (C) 2000 Harcourt publishers Ltd.