Ingram et al developed a tool for the assessment of breastfeeding. This can help monitor breastfeeding and provide guidance for effective interventions. The authors are from the University of Bristol and Southmead Hospital.
Patient selection: woman who is breastfeeding
Parameters:
(1) positioning and support
(2) attachment
(3) sucking (effective)
(4) swallowing
Proper positioning involves:
(1) well-supported infant
(2) infant tucked against the mother's body
(3) neck not twisted
(4) nose opposite the nipple
(5) mother confidentAss
(6) no need for advice
Attachment involves:
(1) positive rooting
(2) wide open mouth
(3) quick latch with a good amount of breast tissue in the mouth
(4) stays attached with a good latch throught the feed
|
Parameter
|
Finding
|
Points
|
|
positioning and support
|
no or few elements
|
0
|
|
|
some elements
|
1
|
|
|
all elements
|
2
|
|
attachment
|
none or poor
|
0
|
|
|
some elements
|
1
|
|
|
all elements
|
2
|
|
sucking (effective)
|
none or ineffective
|
0
|
|
|
some but not satisfactory, on and off the breast
|
1
|
|
|
achieved
|
2
|
|
swallowing
|
none heard, clicking noises
|
0
|
|
|
occasional, some swallows noisy or clicky
|
1
|
|
|
regular and quiet
|
2
|
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 8
• The higher the score the better the breastfeeding.
A fifth parameter for maternal comfort can be used, making the final maximal score 10.
|
Parameter
|
Finding
|
Points
|
|
comfort
|
severe discomfort and/or nipple damage
|
0
|
|
|
some discomfort or nipple damage or nipple redness
|
1
|
|
|
comfortable without nipple damage
|
2
|
Performance:
• The 4-item score had a Cronback alpha of 0.67.
