Factors influencing breast-feeding among adolescents
Neifert, M.; Gray, J.; Gary, N.; Camp, B.
Journal of Adolescent Health Care Official Publication of the Society for Adolescent Medicine 9(6): 470-473
1988
ISSN/ISBN: 0197-0070 PMID: 3182360 DOI: 10.1016/s0197-0070(88)80003-2Document Number: 544905
During a 15-month study period, 244 US adolescent mothers under 18 years of age were surveyed, of whom 53% elected to breastfeed. A subset of 60 primiparous breastfeeding adolescents were studied regarding the influence of several factors on the duration of breastfeeding. An attitude questionnaire was administered in the hospital within 48 hours of delivery. Follow-up interviews were obtained by telephone or in person at approximately 2 weeks and 2 months after birth. 83% made the decision to breastfeed before the 3rd trimester. 35% discontinued breastfeeding within the 1st postpartum month, the most common reason being "nipple confusion" in the infant; 22% nursed for more than 1 month but less than 2 months, and 43% breastfed for 2 months or more. None of the variables examined (maternal age, ethnic groups, education level, involvement of the baby's father, timing of the breastfeeding decision, intended duration of breastfeeding, age at which formula supplementation was started, or availability of maternal support) was predictive of the duration of breastfeeding. Contrary to adolescent stereotypes, 65% of mothers chose breastfeeding because it was "good for the baby," and 67% identified the "closeness" of the nursing relationship as the most enjoyable part of breastfeeding. 28% cited modesty issues about breastfeeding as the greatest disadvantage, and 17% returned to work or school within the 1st 2 postpartum months, posing additional obstacles to breastfeeding. Our data suggest that adolescents are receptive to breastfeeding, but they may require close follow-up and anticipatory guidance tailored to their individual needs. Specific strategies for supporting breastfeeding among adolescent mothers include: starting breastfeeding education programs in elementary or junior high school, (35% of the women studied made the decision to breastfeed prior to pregnancy); early exposure to breastfeeding as a community norm to help alleviate some of the modesty concerns; instruction by hospital personnel for anticipatory guidance in modesty, strategies for combining breastfeeding with going to school or work; specific instruction in technique; prenatal breast examination and interventions for flat or inverted nipples; and initiation of breastfeeding soon after delivery and avoidance of routine supplementation.