Hall et al developed the Breast-feeding Assessment Score (BAS) to identify infants at risk for early cessation of breastfeeding. The authors are from Children’s Mercy Hospitals and Clinics and the University of Missouri-Kansas City.
Patient selection: term or near term infant
Timing: prior to discharge from hospital after birth
Outcome: early cessation of breastfeeding
Parameters:
(1) maternal age in years
(2) previous maternal breastfeeding experience
(3) latching difficulty
(4) breastfeeding interval in hours
(5) number of bottles of formula prior to enrollment
(6) history of previous breast surgey
(7) history of maternal hypertension during pregnancy
(8) vacuum-assisted vaginal delivery
Parameter |
Finding |
Points |
---|---|---|
maternal age in years |
< 21 years |
0 |
|
21 to 24 years |
1 |
|
> 24 years |
2 |
previous experience |
failure |
0 |
|
none |
1 |
|
successful |
2 |
latching difficulty |
every feeding |
0 |
|
half of feeding |
1 |
|
none or infrequent (less than 3) |
2 |
breastfeeding interval |
> 6 hours |
0 |
|
3 to 6 hours |
1 |
|
< 3 hours |
2 |
bottles of formula |
>= 2 |
0 |
|
1 |
1 |
|
0 |
2 |
previous breast surgery |
no |
0 |
|
yes |
-2 |
maternal hypertension |
no |
0 |
|
yes |
-2 |
vaccum assisted delivery |
no |
0 |
|
yes |
-2 |
total BAS score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: -6
• maximum score: 10
• In the initial report a score < 8 was associated with an early (within 7-10 days of birth) cessation rate of 21%.
Performance:
• The sensitivity was 80% and specificity 51%.
• The area under the ROC curve was 0.70.
• The accuracy may be increased by local recalibration.
Specialty: Nutrition, Obstetrics & Gynecology, Pedatrics