Cross-Cultural Adaptation and Psychometric Evaluation of the Neonatal Eating Assessment Tool–Breastfeeding Into Tamil

Gopalakrishnan Jayapradha, Lakshmi Venkatesh, Prakash Amboiram, Prabha Sudalaimani, Radish Kumar Balasubramanium, Britt Frisk Pados

Research output: Contribution to journalArticlepeer-review


Objective: To adapt the Neonatal Eating Assessment Tool–Breastfeeding (NeoEAT-Breastfeeding) into Tamil, a language spoken in several South Asian countries, to identify the tool's factor structure, and to assess its psychometric properties. Design: Cross-sectional. Setting: Tertiary care hospital in South India. Participants: A cohort of 323 mothers of infants ages 1 week to 7 months, including infants with and without feeding difficulties. Method: To adapt the English tool to Tamil, we followed standard procedures specified by the tool developers and international guidelines for tool translation and adaptation, including pilot testing and personal interviews with participants who had infants younger than 7 months. Participants completed the NeoEAT-Breastfeeding (Tamil) after assessment of breastfeeding by professionals. The 62-item tool involves rating each item on a 6-point scale, and higher scores indicate increased feeding difficulties. Results: After exploratory factor analysis, we divided the tool into five subscales in the Tamil version compared to the seven subscales in the original English version. The Tamil version demonstrated high internal consistency reliability (Cronbach's α = 0.97) and test–retest reliability (intraclass correlation = 0.99) for the total scores. Infants with feeding concerns demonstrated significantly higher total and subscale scores on the NeoEAT-Breastfeeding (Tamil) than infants without feeding concerns (p = .000; construct validity). Conclusion: The NeoEAT-Breastfeeding (Tamil) holds promise as a culturally appropriate, clinically useful parent-report tool with evidence for initial reliability and validity for identifying feeding-related concerns among infants younger than 7 months in the Tamil-speaking population.

Original languageEnglish
Pages (from-to)450-460
Number of pages11
JournalJOGNN - Journal of Obstetric, Gynecologic, and Neonatal Nursing
Issue number4
Publication statusPublished - 07-2022

All Science Journal Classification (ASJC) codes

  • Pediatrics
  • Critical Care
  • Maternity and Midwifery


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