Development and validation of the Malay version knowledge and attitude questionnaire on breastfeeding among postpartum mothers in the northeast region of Peninsular Malaysia


Che’ Muda CHE MUZAINI 1, Tengku Ismail TENGKU ALINA 1, Abdul Jalil ROHANA 1,  Mohd Hairon SUHAILY 1, Sulaiman ZAHARAH 2, Johar NAZIRAH 3

1 Department of Community Medicine, 2 Women’s Health Development Unit, School of Medical Sciences,  and 3 Lactation Unit, Hospital Universiti Sains Malaysia




Introduction: Knowledge and attitude are important modifiable factors influencing exclusive breastfeeding practice. A valid and reliable questionnaire is needed to assess the knowledge and attitude among mothers towards breastfeeding. This study aims to develop and validate a Malay version Knowledge and Attitude Breastfeeding Questionnaire (KA-BFQ) and to describe the breastfeeding knowledge and attitude among postpartum mothers in Hospital Universiti Sains Malaysia. Materials and Methods: A cross-sectional validation study was conducted from the 1st October 2014 to 31st December 2014 among postpartum mothers who delivered vaginally to healthy infants and were able to initiate breastfeeding while in the postnatal ward. The interviewer-guided KA-BFQ contains 47 items assessing knowledge and 23 items assessing attitude were given. The questions on knowledge were adapted from previous study while questions on attitude were developed in stages for content validity. Face validity, item level characteristics and analysis, exploratory factor analysis, internal consistency reliability, and descriptive analysis of respondents’ knowledge and attitude were conducted. Results: A total of 150 postpartum mothers with mean age of 28.04 (SD 4.97) years participated in this study. Item analysis showed acceptable difficulty index with excellent discrimination index. Exploratory factor analysis constructed for knowledge domain leaving 41 items loaded from 0.19 to 0.82 and 11 items for attitude domain loaded from 0.53 to 0.86. Cronbach’s alpha of the final questionnaire was 0.85 for knowledge and 0.79 for attitude. The mean total score was 29.34 (SD 6.23) for knowledge and 44.16 (SD 4.26) for attitude. Conclusion: The Malay version KA-BFQ is a valid and reliable tool to assess the breastfeeding knowledge and attitude among postpartum mothers.  


Keywords: Breastfeeding, knowledge, attitude, validity, reliability, questionnaire study


Correspondence author: TI TENGKU ALINA Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan,  Malaysia. Tel: +6097676645 E mail:

Brunei Int Med J. 2016; 12 (3): 104-115