Brazilian mothers breastfeeding with confidence.

Boosting Breastfeeding Confidence: Adapting a Proven Tool for Brazilian Mothers

Soraya Malik in Health & Wellness December 2025 • 4 min read.

"Discover how a translated and culturally adapted Breastfeeding Self-Efficacy Scale (BSES) is empowering Brazilian mothers to breastfeed successfully."

Early breastfeeding termination carries significant consequences, impacting not only infant health and the mother-baby bond, but also maternal recovery and family finances due to formula costs. Recognizing the importance of breastfeeding, Brazilian nursing has actively promoted it, leading to increased rates of exclusive breastfeeding and decreased infant illnesses.

One crucial factor influencing breastfeeding duration is a mother's confidence in her abilities. Research indicates that women with low breastfeeding confidence are more likely to discontinue breastfeeding early. This highlights the need for tools to accurately assess and bolster maternal confidence.

Enter the Breastfeeding Self-Efficacy Scale (BSES), a widely used instrument for measuring a mother's belief in her breastfeeding capabilities. Originally developed in Canada, the BSES has been adapted for various cultures. This article explores the translation, cultural adaptation, and validation of the BSES for use with Brazilian mothers, offering a valuable resource for healthcare professionals and mothers alike.

BSES: A Tool to Boost Confidence

Brazilian mothers breastfeeding with confidence.

The Breastfeeding Self-Efficacy Scale (BSES) is designed to measure a mother's confidence in her ability to breastfeed successfully. Understanding the areas where a mother feels less confident allows healthcare providers to offer personalized support and strategies, potentially preventing early breastfeeding cessation. By identifying these specific challenges early on, tailored interventions can be implemented to promote continued breastfeeding.

The process of adapting the BSES for Brazilian mothers involved several key steps to ensure its accuracy and relevance:

Translation and Back-Translation: The original English version was translated into Portuguese, and then back into English by independent translators to verify accuracy.
Cultural Adaptation: A committee of experts reviewed the translated versions, adjusting the language and content to ensure they resonated with Brazilian culture and breastfeeding practices. This involved replacing certain terms with more familiar expressions.
Pre-testing: The adapted scale was tested with a group of Brazilian women to assess their understanding and identify any areas of confusion.
Content Validation: Experts in breastfeeding assessed the scale's content to ensure it accurately reflected the relevant aspects of breastfeeding self-efficacy in the Brazilian context.

The final Brazilian version of the BSES consists of 33 statements that mothers rate on a scale. These statements cover both technical aspects of breastfeeding (e.g., positioning the baby, ensuring a proper latch) and intrapersonal thoughts (e.g., feeling motivated, managing time). The total score provides an overall measure of a mother's breastfeeding self-efficacy.

Empowering Brazilian Mothers for Breastfeeding Success

The successful adaptation and validation of the BSES for Brazilian mothers provides a valuable tool for healthcare professionals. By using the scale, they can identify mothers who may need additional support and tailor interventions to boost their confidence and promote successful breastfeeding.

While this study demonstrates the potential of the BSES in Brazil, further research is needed to assess its effectiveness across different social and educational levels and in various regions of the country. This will ensure that the scale is a reliable and valid measure of breastfeeding self-efficacy for all Brazilian mothers.

Ultimately, by understanding and addressing the factors that influence maternal confidence, we can empower Brazilian mothers to breastfeed successfully, improving the health and well-being of both mothers and infants.

About this Article -

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Everything You Need To Know

What is the Breastfeeding Self-Efficacy Scale (BSES) and how does it help new mothers?

The Breastfeeding Self-Efficacy Scale (BSES) is a tool specifically created to evaluate a mother's confidence in her capability to breastfeed successfully. It pinpoints areas where a mother might feel insecure, enabling healthcare providers to offer targeted support and strategies. By identifying these challenges early, interventions can be implemented to promote continued breastfeeding and prevent early cessation.

What steps were involved in adapting the Breastfeeding Self-Efficacy Scale (BSES) for use with Brazilian mothers?

The adaptation of the Breastfeeding Self-Efficacy Scale (BSES) for Brazilian mothers involved several crucial steps to ensure its relevance and accuracy. These steps include translation and back-translation to maintain linguistic accuracy, cultural adaptation by a committee of experts to ensure the content resonated with Brazilian culture and breastfeeding practices, pre-testing with Brazilian women to identify areas of confusion, and content validation by breastfeeding experts to confirm the scale's relevance to the Brazilian context.

What does the Brazilian version of the Breastfeeding Self-Efficacy Scale (BSES) consist of, and what aspects of breastfeeding does it cover?

The Brazilian version of the Breastfeeding Self-Efficacy Scale (BSES) includes 33 statements that mothers rate on a scale. These statements address both technical aspects of breastfeeding, such as positioning the baby and ensuring a proper latch, and intrapersonal thoughts, such as feeling motivated and managing time. The total score from the BSES provides an overall measurement of a mother's breastfeeding self-efficacy.

How can healthcare professionals use the adapted Breastfeeding Self-Efficacy Scale (BSES) to support Brazilian mothers, and what aspects of breastfeeding are not directly addressed?

By using the adapted Breastfeeding Self-Efficacy Scale (BSES), healthcare professionals can pinpoint mothers who require extra support. This allows them to customize interventions to boost confidence and promote successful breastfeeding, ultimately supporting both the mother and the infant. The BSES doesn't directly address all factors influencing breastfeeding duration, such as social support or access to lactation consultants, which also play significant roles.

What are the potential consequences of early breastfeeding termination, and how can addressing confidence issues with tools like the Breastfeeding Self-Efficacy Scale (BSES) make a difference?

Early breastfeeding termination can lead to negative outcomes for both the infant and the mother. For infants, it increases the risk of infections and allergies, while mothers may experience a less intense mother-baby bond and slower physical recovery. Additionally, families may face financial strain due to the costs associated with formula feeding. By identifying and addressing confidence issues with tools like the Breastfeeding Self-Efficacy Scale (BSES), healthcare providers can positively influence breastfeeding duration and improve outcomes for mothers and infants.