{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T23:51:32Z","timestamp":1777852292990,"version":"3.51.4"},"reference-count":37,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Hum Lact"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Breastfeeding behaviors and experiences exist on a continuum. What differentiates normal from dysfunctional is defined by frequency and severity. No current validated tool addresses the subjective experience of dyads with a predictive score that can be followed over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Research Aim:<\/jats:title>\n                    <jats:p>To create and validate a self-report tool to assess breastfeeding and evaluate its ability to predict risk of breastfeeding dysfunction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This study used a cross-sectional design to determine the validity of a novel instrument to assess breastfeeding dysfunction. We gave the initial questionnaire to 2085 breastfeeding dyads. We assessed content validity by comparison with other tools. We used exploratory factor analysis with varimax rotation for concept identification and Cronbach\u2019s alpha for internal consistency. We employed logistic regression to assess the tool\u2019s ability to differentiate between normal breastfeeding and breastfeeding dysfunction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Factor analysis mapped 17 questions to four concepts to create a score (FLIP; flow, latch, injury [to the nipple], and post-feed behavior). Internal consistency and reliability of the scores in these concepts were acceptable (Cronbach\u2019s alpha\u2009\u2265\u20090.087 for all measures). A logistic regression model that controlled for infant age, with a breastfeeding dysfunction risk classification threshold of 60%, yielded a correct classification of 88.7%, with 93.1% sensitivity, 64.6% specificity, and a 6.5% false positive rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The FLIP score was determined to be a valid and reliable instrument for quantifying the severity of breastfeeding dysfunction in children under 1\u2009year old. Further studies will assess its usefulness in the management of breastfeeding dysfunction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08903344231209306","type":"journal-article","created":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T05:41:10Z","timestamp":1701409270000},"page":"120-131","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["New Validated Tool to Diagnose Breastfeeding Dysfunction"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5253-1802","authenticated-orcid":false,"given":"Rajeev","family":"Agarwal","sequence":"first","affiliation":[{"name":"Agave Pediatrics, Glendale, AZ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mars","family":"Eddis-Finbow","sequence":"additional","affiliation":[{"name":"Agave Pediatrics, Glendale, AZ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jodie","family":"Tam","sequence":"additional","affiliation":[{"name":"University of Arizona, Tucson, AZ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Broatch","sequence":"additional","affiliation":[{"name":"Arizona State University, Glendale, AZ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1001-8207","authenticated-orcid":false,"given":"Kimberly J.","family":"Bussey","sequence":"additional","affiliation":[{"name":"University of Arizona, Tucson, AZ, USA"},{"name":"Midwestern University, Glendale, AZ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,12]]},"reference":[{"key":"e_1_3_3_2_1","author":"American Educational Research Association, American Psychological Association, National Council on Measurement in Education, & Joint Committee on Standards for Educational and Psychological Testing (U.S.)","year":"2014","unstructured":"American Educational Research Association, American Psychological Association, National Council on Measurement in Education, & Joint Committee on Standards for Educational and Psychological Testing (U.S.). 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