Journal of Human Lactation最新文献

{"title":"Measurement Properties and Quality of Maternal Breastfeeding Instruments: A Scoping Review.","authors":"Seyedeh Samira Mokhlesi, Vidanka Vasilevski, Kolsoom Safari, Linda Sweet","doi":"10.1177/08903344261430247","DOIUrl":"10.1177/08903344261430247","url":null,"abstract":"<p><strong>Background: </strong>Different questionnaires are available to assess breastfeeding behaviour and factors that impact breastfeeding success. However, it is necessary to determine whether the questionnaire's measurement properties are satisfactory before using them.</p><p><strong>Aim: </strong>Evaluate, compare, and summarise the measurement properties and quality of the original version of maternal breastfeeding questionnaires.</p><p><strong>Methods: </strong>This review used the preferred reporting items for systematic reviews and meta-analysis extension for scoping reviews (PRISMA-Scr). Peer-reviewed primary research studies that focused on the development and evaluation of the psychometric properties of breastfeeding instruments were included. The consensus-based standards for the selection of health measurement instrument (COSMIN) methodology was used to assess the methodological quality and measurement properties of the breastfeeding instruments.</p><p><strong>Results: </strong>From 3,850 abstracts, 25 papers were identified. Only six instruments demonstrated sufficient content validity and internal consistency and were recommended for broad use. The results obtained with these instruments can be trusted. Sixteen of the 25 instruments had evidence of indeterminate (±) content validity. Although they had the potential for recommendation, further research is needed to assess their quality. None of the instruments reported cross-cultural validity/measurement invariance, measurement error, or responsiveness. One instrument was not recommended for use due to insufficient content validity.</p><p><strong>Conclusion: </strong>The review highlights the need for further research into the measurement properties of most existing breastfeeding instruments, especially cross-cultural validity/measurement invariance, measurement error, and criterion validity.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"781-794"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteopathic Manipulative Treatment for the Breastfeeding Dyad: A Scoping Review.","authors":"Alice I Chen, Anna Mercer, Eileen Conaway, Karen M Heskett, A Hope Tobey, Melissa Campbell, Mikaela Panza, Kimberly Wolf","doi":"10.1177/08903344261430249","DOIUrl":"10.1177/08903344261430249","url":null,"abstract":"<p><strong>Background: </strong>Human milk is widely recognized as the optimal source of infant nutrition. While 83.9% of mothers initiate breastfeeding, only 46.3% exclusively breastfeed to 3 months. Common barriers include latch and suck difficulties, painful feeding, and breast infections or engorgement. Osteopathic manipulation, including osteopathic manipulative treatment (OMT) and therapy (OMTh), has been proposed as supportive intervention for breastfeeding challenges.</p><p><strong>Research aim: </strong>This scoping review examines the current literature on OMT/OMTh in the breastfeeding dyad and identifies gaps to inform future research.</p><p><strong>Method: </strong>Seven databases were searched for studies involving OMT use in infants under 24 months and breastfeeding parents. Titles and abstracts were screened, and eligible full-text articles were extracted and analyzed for themes. Data included study characteristics, osteopathic intervention, and reported outcomes. As a scoping review, formal quality and risk of bias assessments were not conducted.</p><p><strong>Results: </strong>Of 9,141 articles screened, 35 met inclusion criteria (three focused on breastfeeding parents, 32 on infants). Among the infant studies, 19 studies included a feeding related outcome-seven involved healthy term infants, and eight on hospitalized preterm infants, one on infants with encephalopathy, and three case reports discussed OMT use in complex feeding scenarios (i.e., oral aversion, esophageal atresia, Pierre Robin Sequence). Five studies were on infants with colic, six on plagiocephaly, and two on postural strain and torticollis.</p><p><strong>Conclusion: </strong>Preliminary evidence suggests OMT may support feeding-related outcomes in the breastfeeding dyad (e.g., latch dysfunction, low milk supply, mastitis). Further interdisciplinary research is warranted to clarify its role and inform clinical practice.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"595-619"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions of Racism and Discrimination in Birthing Centers: Implications for Exclusive Breastfeeding Practices Among Black Mothers.","authors":"Natashia Le'Nee Conner, Cheri N Langley, Yitza Arcelay Rojas","doi":"10.1177/08903344261430461","DOIUrl":"10.1177/08903344261430461","url":null,"abstract":"<p><strong>Background: </strong>Racial disparities in breastfeeding persist, with Black mothers experiencing significantly lower exclusive breastfeeding rates compared with White mothers. Limited research has examined how institutional bias and discrimination within birthing centers affect breastfeeding decisions, creating a gap in understanding the role of these environments in perpetuating lactation inequities.</p><p><strong>Methods: </strong>A basic qualitative study guided by the social ecological model explored how perceived racism and discrimination in birthing centers shape exclusive breastfeeding initiation and duration among Black mothers. Ten participants were recruited through purposive sampling and completed semistructured virtual interviews. Data were coded inductively using ATLAS.ti 9 and verified through analyst triangulation and Krippendorff's α to ensure reliability.</p><p><strong>Results: </strong>Four interconnected themes emerged: (1) individual level-birth trauma and pain dismissal reduced confidence in breastfeeding; (2) interpersonal level-racialized communication barriers and lack of lactation support undermined trust; (3) community level-formula-first norms and underrepresentation of Black lactation professionals limited culturally relevant care; and (4) institutional level-rigid policies and privacy violations reinforced inequitable treatment.</p><p><strong>Conclusion: </strong>Perceived racism and discrimination in birthing centers negatively influence Black mothers' breastfeeding experiences and outcomes. Equity-driven organizational reforms, anti-racist training, and diversification of the lactation workforce are essential to promote breastfeeding equity and improve maternal-infant health.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"675-681"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breastfeeding and Child Oral Health: An Umbrella Review.","authors":"Beatriz Díaz-Fabregat, Wilmer Ramírez-Carmona, Viviane de Oliveira Zequini Amarante, Rogério de Castilho Jacinto, Douglas Roberto Monteiro, Rosana Leal do Prado, Juliano Pelim Pessan","doi":"10.1177/08903344261426894","DOIUrl":"10.1177/08903344261426894","url":null,"abstract":"<p><strong>Background: </strong>Breastfeeding is associated with infant health benefits, such as a reduced risk of infections, obesity, and diabetes, and offers protection against breast and ovarian cancer in mothers. However, its possible relationship with dental caries and malocclusions has recently been suggested.</p><p><strong>Research aim: </strong>The present umbrella review assessed the relationship between breastfeeding and oral health.</p><p><strong>Methods: </strong>This umbrella review evaluated the relationship between breastfeeding and oral health in individuals under 18 years of age by systematically reviewing studies available in databases such as PubMed, Scopus, Web of Science, and others. The Mantel-Haenszel method was used to calculate odds ratios (<i>OR</i>) with 95% confidence intervals.</p><p><strong>Results: </strong>Eighteen reviews on caries, malocclusions, bone mass, muscle function, and cleft lip/palate were analyzed. Breastfeeding was found to be a protective factor against dental caries (<i>OR</i> 0.71), with duration having no significant effect. A lower prevalence of open bite (<i>OR</i> 0.67) and posterior crossbite (<i>OR</i> 0.68) was also observed. Breastfeeding for ≥ 6 months was protective against overjet, dental crowding, and Class II malocclusion. However, it was associated with an increased risk of overbite (<i>OR</i> 1.95). Narrative analysis showed benefits of breastfeeding for muscular and craniofacial development, and it was considered safe in children with post-surgical cleft lip/palate.</p><p><strong>Conclusions: </strong>Breastfeeding has positive effects on multiple aspects of children's oral health, reinforcing its importance for both oral and systemic health, thanks to its nutritional, mechanical and immunological benefits.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"739-750"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Evidence Informing Hypoglycaemia Treatment Thresholds in Asymptomatic, Term, Well Newborns: A Review of Literature and Critical Appraisal of Methodological Challenges.","authors":"Kylie Hodges, Samantha Trenaman, Mary Bushell, Maryam Bazargan, Marjorie Atchan","doi":"10.1177/08903344261426051","DOIUrl":"10.1177/08903344261426051","url":null,"abstract":"<p><strong>Background: </strong>There is worldwide inconsistency in blood glucose level treatment thresholds for hypoglycaemia in healthy, term asymptomatic newborns. Differing testing policies and broader inclusion criteria from maternal conditions have increased the incidence of testing. The use of human milk substitutes to treat hypoglycaemia may adversely influence the establishment of breastfeeding and early bonding between mother and baby.</p><p><strong>Research aim: </strong>To determine if current research informs a high-quality evidence-based therapeutic treatment threshold for hypoglycaemia in well, asymptomatic newborns in the first 24 hours of life.</p><p><strong>Methods: </strong>A comprehensive review accessing CINAHL, Medline, Scopus, Web of Science, Cochrane, and CENTRAL databases was performed. Original English-language quantitative studies reporting hypoglycemic treatment thresholds, and their neurodevelopmental outcomes for over 11,000 newborns, were appraised for quality and validity using independent screening and Crowe's Quality Appraisal Tool.</p><p><strong>Results: </strong>Thirteen papers were included with outcomes grouped into two categorical definitions of hypoglycaemia (statistical and neurodevelopmental). Nine of the included studies were assessed as producing low quality evidence, with a moderate to high risk of bias, unreliable methodology, and smaller sample sizes. One study provided high quality evidence, with a sample size of > 1000 newborns, that a blood glucose threshold of 2.09 mmol/L was a potentially safe treatment threshold.</p><p><strong>Conclusion: </strong>Published high quality research is lacking to inform a therapeutic treatment threshold for hypoglycaemia in well, term asymptomatic newborns in the first 24 hours. Current treatment may interfere with breastfeeding and bonding. Rigorous research is required to establish a safe threshold and inform future practice.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"569-584"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role and Impact of the IBCLC: Updated Position Paper.","authors":"Azza H Ahmed, Wilaiporn Rojjanasrirat, Sushma Malik, Lisa Mandell, Margaret Ansell, Irena Zakarija-Grković","doi":"10.1177/08903344261434475","DOIUrl":"10.1177/08903344261434475","url":null,"abstract":"<p><p>The International Board-Certified Lactation Consultant (IBCLC) has long stood at the intersection of science, advocacy, and care. In the wake of global health disruptions, declining exclusive breastfeeding rates in high resource settings, and urgent calls for workforce equity, new evidence reinforces and redefines the critical role of the IBCLC across healthcare systems. This 2026 position update presents an expanded evidence base demonstrating the IBCLC's impact on clinical outcomes, health equity, maternal health, and cost savings across diverse care environments including neonatal intensive care units, rural communities, and digital platforms. Drawing from peer-reviewed studies, international health agency reports, and longitudinal program evaluations, we reaffirm the IBCLC's role as a catalyst for policy change and a cornerstone of maternal-infant health strategies. New data reveals a significant increase in exclusive breastfeeding rates when IBCLCs are embedded within interprofessional teams. We further explore the IBCLC's evolving leadership in health system transformation, including their influence in shaping perinatal quality metrics, hospital accreditation, and culturally responsive lactation care. As we look to the future, this update challenge systems and stakeholders to elevate, integrate, and invest in the IBCLC role-not as a luxury, but as a necessity for maternal-child health in an era of rising complexity.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"503-510"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Feasibility of Donor Human Milk Banking in Türkiye: A Qualitative Analysis of Religious, Institutional, and Policy Dynamics.","authors":"Nazan Kartal, Gamze Arikan, Ebru Yildirim","doi":"10.1177/08903344261431952","DOIUrl":"10.1177/08903344261431952","url":null,"abstract":"<p><p>Research Aim(s)/Question(s):The study aims to ascertain the views of relevant stakeholders regarding the facilitators and barriers to establishing human milk banks in Türkiye and to identify policy requirements for social acceptance.</p><p><strong>Methods: </strong>A qualitative approach was employed, using in-depth interviews with 22 experts in maternal and child health, including physicians, midwives, nurses, and health managers. Data were analyzed using Braun and Clarke's six-phase thematic analysis framework.</p><p><strong>Results: </strong>Four central themes and twelve categories emerged: (1) the multifaceted value of human milk, (2) perceptions toward human milk donation, (3) social and institutional barriers, and (4) perspectives on current human milk feeding policies. Key findings highlight that while the biological importance of milk is universally recognized, donation is hindered by \"milk kinship\" concerns and legal ambiguities. However, the integration of donation data into the national e-Nabız electronic health record system and alignment with religious foundations (e.g., Surah Al-Baqarah, Verse 233) were identified as critical policy facilitators.</p><p><strong>Conclusion: </strong>Stakeholders emphasize that human milk banking is a viable model for Türkiye if implemented through a framework that resolves legal-religious contradictions. Success depends on extending maternity leaves to support breastfeeding rights and establishing a formal dialogue with religious authorities. These findings provide a strategic roadmap for policymakers to integrate human milk banking into public health policy as a sustainable and socially acceptable service.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"842-849"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Global, Regional, and National Burden of Childhood Lower Respiratory Infections From Nonexclusive Breastfeeding, 1990-2021: Global Burden of Disease, Injuries, and Risk Factors Study 2021 Analysis and Implications for Public Health Strategies.","authors":"Shuai Wang, Jingbo Lv, Xueyuan Cao","doi":"10.1177/08903344261431673","DOIUrl":"10.1177/08903344261431673","url":null,"abstract":"<p><strong>Background: </strong>Nonexclusive breastfeeding is a major risk factor for childhood lower respiratory infections, yet its global burden remains unquantified. Although exclusive breastfeeding is widely recommended, the attributable burden of early infancy lower respiratory infections linked to nonexclusive breastfeeding and cross-country performance gaps have not been systematically assessed. This analysis fills that gap by combining burden estimates with frontier benchmarking.</p><p><strong>Methods: </strong>Using the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 database, we estimated deaths, disability-adjusted life years, age-standardized mortality rates, age-standardized disability-adjusted life-year rates, and population attributable fractions of lower respiratory infections attributable to nonexclusive breastfeeding across 204 countries and territories from 1990 to 2021. Temporal trends were assessed with joinpoint regression, and frontier analysis was applied to identify efficiency gaps.</p><p><strong>Results: </strong>In 2021, nonexclusive breastfeeding accounted for 37,890 lower respiratory infection deaths and 3.41 million disability-adjusted life years globally, with boys carrying a higher burden. India, Nigeria, and Pakistan had the largest absolute numbers, whereas Chad, Somalia, and South Sudan had the highest standardized rates. Neonates (<28 days old) showed the highest mortality and disability-adjusted life-year rates, indicating greater vulnerability than with infants aged 1-5 months. Globally, age-standardized mortality rates and age-standardized disability-adjusted life-year rates declined significantly from 1990 to 2021 (average annual percentage change -4.87%), although sub-Saharan Africa and South Asia still bore the heaviest burden. Frontier analysis revealed substantial potential for further reduction in low- and low-middle sociodemographic index countries through improved breastfeeding and health system strengthening.</p><p><strong>Conclusion: </strong>Despite global progress, nonexclusive breastfeeding remains a major contributor to childhood lower respiratory infections, particularly among neonates and in low-sociodemographic index settings. Strengthening breastfeeding promotion and maternal-child health services is critical to reducing mortality, morbidity, and regional inequities. To achieve this, scaling evidence-based policies, such as Baby-Friendly practices, community lactation support, maternity protection, and strong enforcement of the International Code of Marketing of Breast Milk Substitutes is essential.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"726-738"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Mother-Infant Dyad to Mother-Father-Infant Triad: A Cross-Sectional Study on Fathers' Breastfeeding Attitudes and Participation.","authors":"Zehra Çerçer, Fadime Biçer Şahin, Tuğba Kanarya","doi":"10.1177/08903344261434532","DOIUrl":"10.1177/08903344261434532","url":null,"abstract":"<p><strong>Background and aim: </strong>It is important to include fathers in the evaluation of the breastfeeding process. This study aimed to assess fathers' breastfeeding attitudes and participation.</p><p><strong>Methods: </strong>The cross-sectional study data were collected between March and June 2024 in a maternity and child hospital and completed with the participation of 194 fathers. The study data were collected using the Personal Information Form, Fathers' Breastfeeding Attitude Scale (F-BA), and Fathers' Participation in Breastfeeding Process Scale (F-PB). Descriptive statistics, one-way ANOVA, independent t-tests, and Pearson correlation were used in the analysis.</p><p><strong>Results: </strong>It was determined that the fathers' total F-BA mean score was 58.24 ± 5.62, and the total F-PB mean score was 57.09 ± 6.84. A total of 81% of fathers stated that breastfeeding was healthy for the baby. No statistical significance was found between the fathers' sociodemographic and breastfeeding characteristics and F-BA (<i>p</i> > 0.05). A statistical significance was found between the child's age, the child's nutritional method in the first 6 months, the effect of the father figure during the breastfeeding process, and F-PB (<i>p</i> < 0.05). A positive, moderate, highly significant correlation was found between the total F-BA and the total F-PB (<i>r</i> = 0.476, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Fathers in this study exhibited generally favorable attitudes toward breastfeeding. However, mean scores were close to the scale's cutoff value. Their level of participation varied based on contextual factors. These findings emphasize that positive attitudes are not necessarily associated with higher levels of active participation and highlight the importance of a deeper understanding of fathers' roles in the breastfeeding process.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"648-659"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of the Lactation Psychological Needs Scale.","authors":"Kelsie R Barta, Misty M Richmond, Becky Spencer, Sandra K Cesario","doi":"10.1177/08903344261430141","DOIUrl":"10.1177/08903344261430141","url":null,"abstract":"<p><strong>Background: </strong>According to self-determination theory, when an individual's psychological needs for autonomy, competence, and relatedness are satisfied, human flourishing can occur. The simultaneous satisfaction of the three needs has not yet been examined in the context of lactation and offers a potential explanation for variations in breastfeeding outcomes and well-being among lactating individuals.</p><p><strong>Research aim: </strong>To develop and preliminarily validate an instrument measuring lactation-related psychological need satisfaction.</p><p><strong>Method: </strong>Initial items for the Lactation Psychological Needs Scale were developed based on a literature review, and refined based on content validity testing. An online cross-sectional survey was administered in two phases to lactating individuals in the United States (<i>n</i> = 634) to assess validity and reliability.</p><p><strong>Results: </strong>Exploratory (<i>n</i> = 388) and confirmatory factor analyses (<i>n</i> = 246) in separate samples yielded a three-factor solution with excellent goodness-of-fit (chi-square Bollen-Stine adjusted <i>p =</i> 0.05, root mean square error of approximate: ≤ 0.06, comparative fit index > 0.95, and Tucker-Lewis Index > 0.95). The new instrument includes 12 items on three subscales: autonomy, competence, and relatedness. Internal consistency reliability was acceptable for the full scale (0.856) and subscales (0.790-0.861). The full instrument scores and subscale scores were positively correlated with maternal satisfaction with lactation, and negatively correlated with Edinburgh Postnatal Depression Scale scores.</p><p><strong>Conclusion: </strong>The results of this study provide preliminary psychometric support for the novel instrument. Self-determination theory provides an opportunity for a new paradigm in understanding behavior and well-being among lactating individuals. Further validation of the instrument is required.</p>","PeriodicalId":15948,"journal":{"name":"Journal of Human Lactation","volume":" ","pages":"769-780"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}