Reliability and validity of the Romanian version of a scale to measure infant feeding attitudes and knowledge

Aim: To describe the development and testing of the Romanian version of the Iowa Infant Feeding Attitude Scale (IIFAS‐R). The original instrument has well‐established psychometrics for use in English‐speaking countries. Methods: Questionnaires including demographics and items about prior pregnancy and opinions about breastfeeding in public were administered to women in Cluj‐Napoca, Romania, attending antenatal clinic (n = 336) and to a separate cohort of mothers within 24 h of delivery (n = 276). Postpartum follow‐up was conducted with a sample of maternity cohort subjects who initiated breastfeeding in the hospital (n = 52). Results: Internal consistency was adequate in both cohorts (antenatal α= 0.50; maternity α= 0.63), with improved reliability for antenatal multigravid (α= 0.60) and university‐educated women (α= 0.57). Score distributions were comparable and item means were approximately central across cohorts. Among pregnant women, higher scores (more positive towards breastfeeding) were associated with longer planned maternity leave (χ2= 17.8; p = 0.02). Higher maternity cohort scores were associated with age (r = 0.31, p = 0.003), urban residence (χ2= 10.2, p = 0.04), breastfeeding a prior infant for at least 6 weeks (χ2= 6.4, p = 0.04), and with intending to breastfeed for at least 6 weeks (χ2= 4.7, p = 0.03). Postpartum women still breastfeeding at follow‐up also scored higher (χ2= 9.3, p = 0.009). Conclusion: This is the first study to report on use of the IIFAS in Eastern Europe. The IIFAS‐R is easy to administer, reliable and valid in Romania. The IIFAS‐R can support data collection to promote and assess breastfeeding initiatives consistent with World Health Organization recommendations.