Cross-cultural adaptation and psychometric validation of a breastfeeding cessation questionnaire in the Peruvian Amazon

Introduction/Objective: Reliable inference about determinants of breastfeeding cessation requires instruments that preserve conceptual meaning across culturally and linguistically diverse settings. We aimed to cross-culturally adapt and psychometrically validate a breastfeeding cessation questionnaire for use in the Peruvian Amazon. Methods Cross-sectional psychometric study among mothers aged ≥ 18 years with infants aged < 6 months recruited across Loreto, San Martín, Ucayali and Amazonas using quota sampling (n = 240). Adaptation was supported by cognitive interviews (n = 20) and iterative semantic/contextual refinement. Content validity was assessed by five experts using Aiken’s V. Internal structure was evaluated using exploratory factor analysis (polychoric correlations, principal axis factoring, oblimin rotation) and confirmatory factor analysis using WLSMV for ordinal indicators. Reliability was assessed using Cronbach’s alpha.¿. Results The final instrument comprised 24 items across five domains. Overall Aiken’s V was 0.80 (range 0.67–0.88) and 83.3% of items met V ≥ 0.75. Exploratory factor analysis supported a five-factor solution explaining 54.54% of total variance. Internal consistency was high for the total scale (α = 0.89) and adequate for most domains (α = 0.75–0.83), with lower reliability for prior experience/perceptions (α = 0.64). Confirmatory factor analysis showed excellent fit (χ²=278.55, df = 242; CFI = 0.987; TLI = 0.985; RMSEA = 0.025; SRMR = 0.093). Missing item responses were 0%. Conclusion This cross-culturally adapted questionnaire showed acceptable content validity, robust internal structure, good internal consistency and high feasibility in a heterogeneous Amazonian sample. Further studies should assess test–retest reliability, predictive validity and measurement invariance across language groups.