A Critical Review of Breastfeeding Instruments Derived From Self-Determination Theory

Background: Understanding the motivational factors that influence breastfeeding behavior is critical for addressing suboptimal breastfeeding outcomes. Self-determination theory has been used as a framework to understand these factors. Research Aim: The aim of this article is to identify and critically review breastfeeding instruments derived from self-determination theory and their subsequent uses in the literature. Method: This critical review was guided by Grant and Booth’s typological description. Eligibility criteria included full-text, peer-reviewed original instrument development and validation articles, written in the English language without limitation to specific years. Articles describing the use of the eligible instruments were also included. There were 164 articles identified initially, and four instruments were included in the final sample. Finally, five articles, including subsequent uses of the instruments were critically analyzed and an overview, assessment of validation, and analysis of subsequent use of each instrument is presented. Results: All instruments examine the degree of autonomy underlying breastfeeding motivation. The extent and quality of validation varied. Two instruments have been used in subsequent studies; one was adapted and translated into Turkish and used in three other studies, and another was used in full in one subsequent use and in part in another study. Three of four were initially developed for prenatal administration. Conclusions: Instruments derived from self-determination theory hold promise in exploring the autonomy underlying breastfeeding motivations. Researchers who wish to use or adapt these instruments should consider the instruments’ domains, validity, and administration. New measures are needed to explore other constructs from self-determination theory related to breastfeeding.