Limitations of our study include the fairly small number of
multiple comparisons between midwives, but these are similar in
number to those reported by others in validating screening tools,
including the LATCH and IBFAT (Riordan and Koehn, 1997). The
relationships between BBAT and breast feeding duration and
exclusivity should be explored in further research studies as our
results were limited to those who had repeated observations
within the frenotomy trial.
Lewallen (2006) reviewed instruments used to assess breast
feeding in the early postpartum period that have been used to
identify women at greatest risk of early breast feeding cessation.
Many of the instruments were long and complicated to score;
some were based on particular theoretical frameworks, on qualitative studies or derived from clinical care. She concluded that
none of the questionnaires proved to be easy to use in the
postpartum period to predict accurately which women needed
breast feeding support and follow-up or to predict which women
would stop breast feeding.