Translation, Cross‐Cultural Adaptation, and Psychometric Validation of the Malay Version of the Montreal Children's Hospital Feeding Scale for Screening Pediatric Feeding Difficulties in Malaysia

Background Feeding difficulties are common in early childhood and can lead to adverse nutritional, developmental and psychosocial outcomes. The Montreal Children's Hospital Feeding Scale (MCH‐FS) is a brief, parent‐reported tool developed in Canada using the English and French language to facilitate early screening of such difficulties. However, a culturally adapted version for the Malaysian population was previously unavailable. Aim To translate, culturally adapt and psychometrically validate the Malay version of MCH‐FS to ensure its suitability and reliability for use among Malaysian caregivers of young children with feeding difficulties. Methods & Procedures A five‐stage cross‐cultural adaptation process was undertaken the following Beaton's guidelines: forward translation, synthesis, back translation, expert panels review and pre‐testing with caregivers. Content and face validity were evaluated by seven multidisciplinary experts and 30 caregivers, respectively. Psychometric evaluation involved examining construct validity using confirmatory factor analysis (CFA) on responses from 230 caregivers of children aged six months to six years. Internal consistency was assessed using McDonald's omega and test‐retest reliability was determined in a subsample over a two‐week interval. Outcomes & Results The M‐MCH‐FS demonstrated excellent content (S‐CVI/Ave = 1.00) and face validity (S‐FVI/Ave = 0.998). The original four‐factor model showed unacceptable fit, while a revised 12‐item one‐factor model showed reasonable fit (Comparative Fit Index (CFI) = 0.896; Standardized Root Mean Residual (SRMR) = 0.070; Root Mean Square Error of Approximation (RMSEA) = 0.076; 90% Confidence Interval (CI): 0.055–0.096). The internal consistency was acceptable (omega = 0.786). Two items were removed because of low factor loadings, namely Item 5 (factor loading of 0.059) and Item 14 (factor loading of 0.225), improving the scale's psychometric properties while preserving its conceptual integrity. Conclusion & Implications The M‐MCH‐FS is a culturally relevant, valid and reliable screening tool for identifying pediatric feeding difficulties among Malaysian caregivers. Its brevity and psychometric robustness support its implementation in healthcare and community settings, facilitating early referral and intervention to enhance child health outcomes. WHAT THIS PAPER ADDS? What is already known on the subject The MCH‐FS is a brief, valid parent‐report instrument used internationally to screen feeding difficulties in children aged six months to six years. It has been successfully adapted for various linguistic and cultural contexts. What this paper adds to existing knowledge The study presents the translation, cultural adaptation and psychometric validation of the MCH‐FS for the Malaysian population named M‐MCH‐FS, establishing a 12‐item one‐factor structure with strong validity and reliability indicators. What are the potential or actual clinical implications of this work? The M‐MCH‐FS can serve as a rapid and effective screening tool in primary care, pediatric and community health settings in Malaysia, facilitating early identification and timely intervention for feeding‐related concerns.