Midwifery 66 (2018) 49–55 Contents lists available at ScienceDirect Midwifery journal homepage: www.elsevier.com/locate/midw The breastfeeding self-eﬃcacy scale-short form: Psychometric characteristics in Portuguese pregnant women Sónia Brandão, M.Sc. a,b,∗ , Denisa Mendonça, Ph.D. a,c , Cláudia Castro Dias, M.Sc. d , Tiago Miguel Pinto, M.Sc. d , Cindy-Lee Dennis, Ph.D. e,f , Bárbara Figueiredo, Ph.D. d a Instituto de Ciências Biomédicas Abel Salazar (ICBAS), University of Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal b Centro Materno Infantil do Norte – Centro Hospitalar do Porto, Largo da Maternidade de Júlio Dinis, 4050-651 Porto, Portugal c EPIUnit, Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas 135, 4050-600 Porto, Portugal d School of Psychology, University of Minho, Escola de Psicologia da Universidade do Minho, Campus de Gualtar 4710-057 Braga, Portugal e Lawrence S. Bloomberg Faculty of Nursing University of Toronto, Suite 130, 155 College St, Toronto, ON M5T 1P8, Canadá f Li Ka Shing Knowledge Institute St. Michael’s Hospital, 209 Victoria St, Toronto, ON M5B 1T8, Canadá a r t i c l e i n f o Keywords: Breastfeeding Self-eﬃcacy Psychometric assessment Pregnant women Portuguese a b s t r a c t Background: The Breastfeeding Self-Eﬃcacy Scale-Short Form is a reliable instrument to measure mother’s con- ﬁdence in her ability to breastfeed. The Breastfeeding Self-Eﬃcacy Scale-Short Form has traditionally been used postnatally, but evidence suggests that it can be used antenatally to identify mothers at-risk of requiring additional support to improve breastfeeding outcomes. Objective: The aim of this study was to examine the psychometric characteristics of an antenatal version of the Breastfeeding Self-Eﬃcacy Scale-Short Form, among pregnant Portuguese women. Design: Methodological prospective study to examine the psychometric characteristics of the antenatal Portuguese version of the Breastfeeding Self-Eﬃcacy Scale-Short Form. Settings: Two public hospital units in the Northern Portugal. Participants: The sample was comprised of 373 pregnant women recruited at 30–34 gestational weeks. Methods: The original English version of the antenatal Breastfeeding Self-Eﬃcacy Scale-Short Form was trans- lated into Portuguese and the Portuguese antenatal version of the scale was tested in a sample of 373 pregnant women. To examine the psychometric characteristics of the Portuguese antenatal version of the scale, the mater- nal demographic variables and the depressive and anxiety symptomatology of the participants were examined. The predictive validity of the Portuguese antenatal version of the scale was studied according to infant feeding method at one, three, and six months postpartum. Results: The Cronbach’s alpha coeﬃcient was 0.92. The antenatal version of the Breastfeeding Self-Eﬃcacy Scale- Short Form scores were found to be associated with women’s parity, educational level, occupational status, time they intend to breastfeed, and previous breastfeeding experience. Also, the antenatal version of the Breastfeeding Self-Eﬃcacy Scale-Short Form scores signiﬁcantly predicted exclusive breastfeeding at 1 month postpartum. Conclusions: Results provided evidence that the antenatal Portuguese version of the Breastfeeding Self-Eﬃcacy Scale-Short Form is a valid and reliable measure to assess breastfeeding self-eﬃcacy in pregnant women. The antenatal version of the Breastfeeding Self-Eﬃcacy Scale-Short Form could be a useful tool to assist Portuguese health professionals during routine prenatal care appointments to screen women with lower antenatal breastfeed- ing self-eﬃcacy and, consequently, those that could be at risk for not initiating or early breastfeeding cessation. Introduction Breastfeeding is consistently associated with both maternal and child well being. The World Health Organization (WHO, 2003), the European ∗ Corresponding author. E-mail addresses: soniabrandao.obstetricia@chporto.min-saude.pt (S. Brandão), dvmendon@icbas.up.pt (D. Mendonça), cdias@psi.uminho.pt (C.C. Dias), tmpinto@psi.uminho.pt (T.M. Pinto), cindylee.dennis@psi.utoronto.ca (C.-L. Dennis), bbﬁ@psi.uminho.pt (B. Figueiredo). Commission for Public Health (Cattaneo et al., 2005; Cattaneoet al., 2010) and the American Academy of Pediatrics (Gartner et al., 2005) all recommend exclusive breastfeeding for the ﬁrst six months of life, however despite high rates of breastfeeding initiation, exclusivity rates at six months postpartum remain low and a long-standing problem. https://doi.org/10.1016/j.midw.2018.07.014 Received 7 February 2018; Received in revised form 14 June 2018; Accepted 20 July 2018 0266-6138/© 2018 Elsevier Ltd. All rights reserved.