The components of the tool are relevant for a wide age range of
infants and are also sensitive to the subtle changes that are
important for improving breast feeding following frenotomy. It is
simple to use whilst giving details of positioning and attachment
skills. The mother-reported comfort aspects of breast feeding are
important, but less consistent results were shown when including
them within the midwife-observed breast feeding assessment
items of the tool, and we concluded that comfort should be
recorded as a separate score linked to pain.