BACKGROUND:
Breastfeeding is essential for maternal and neonatal health, offering immunological, nutritional, and psychological benefits. The WHO recommends exclusive breastfeeding for the first six months, yet many mothers discontinue early due to several modifiable factors. Early identification of at-risk women during pregnancy is crucial to provide timely support.

OBJECTIVES:
This study aimed to develop and validate the Breastfeeding Success Predictors Inventory (BSPI), a multidimensional predictive tool to identify pregnant women at risk of early breastfeeding cessation.

METHODS:
A longitudinal cohort study was conducted at San Raffaele Hospital in Milan, involving 103 pregnant women. The BSPI questionnaire was administered at four time points: during pregnancy (T0), hospital discharge (T1), and one (T2) and two (T3) months postpartum. Items were derived from known risk factors in literature. Univariate and multivariate logistic regression analyses were conducted. The 75th percentile was used to define BSPI cut-offs.

RESULTS:
The BSPI identified risk factors with p-values below 0.05: maternal (p=0,05) and family preferences (p=0,076), intended breastfeeding duration (p=0,0234), and polycystic ovary syndrome (p=0,0031) in primiparous women; in multiparous women, previous breastfeeding experience (p=0,038), excessive pregnancy weight gain (p=0,0265), and pregnancy stress (p=0,0043) also show significant associations. Primiparous women scoring above 9 and multiparous above 14 had a higher risk of discontinuing breastfeeding. The tool showed strong predictive value.

CONCLUSIONS:
The BSPI is an evidence-based tool that supports early identification of mothers at risk of breastfeeding failure. Its application can guide personalized support and enhance breastfeeding outcomes.

KEY MESSAGE:
Midwives are essential in applying the BSPI during pregnancy to identify at-risk women, provide targeted breastfeeding support and continuity of care Breastfeeding - support (including three-minute presentation competition)