Testing Inclusive Language Revisions of the Breastfeeding Attrition Prediction Tool Using Cognitive Interviewing: A Pilot Study

Abstract

Background: Recent calls-to-action have recommended the use of gender-inclusive language in the field of human lactation research and clinical care. However, little empirical evidence about parental acceptance and understanding of this new terminology exists. Research Aim: To assess understanding and acceptance of an inclusive language revision of the Breastfeeding Attrition Prediction Tool (BAPT). Methods: This was a prospective qualitative study consisting of two phases, a survey followed by cognitive interview. Pregnant people ( N = 16) were recruited from the Vermont Special Supplemental Nutrition Program for Women, Infants, and Children, which uses the BAPT as a standard of care. The study team revised the BAPT (e.g., changed terms like “breast milk” to “human milk”). Study participants completed the Revised BAPT and then participated in a cognitive interview by phone to assess their understanding and acceptance of revised, inclusive language. Results: Most inclusive language was well understood and accepted by participants. Proposed revisions to the survey to replace terms like “breastfeeding” with other terms like “chestfeeding” or “bodyfeeding” were more difficult for participants to understand and were not well accepted. Conclusions: While it is clear that language in human lactation research and clinical practice should be revised to be more gender inclusive, specific inclusive terms elicit different levels of understanding and acceptance. Inclusive language options should be tested with target populations and more research is needed in this area.