Early breastfeeding experiences of adolescent mothers: a qualitative prospective study

Paige Hall Smith,Susan Cupito,Miriam H Labbok,Sheryl L Coley,Eva Nwokah

doi:10.1186/1746-4358-7-13

Abstract

BackgroundTeen mothers face many challenges to successful breastfeeding and are less likely to breastfeed than any other population group in the U.S. Few studies have investigated this population; all prior studies are cross-sectional and collect breastfeeding data retrospectively. The purpose of our qualitative prospective study was to understand the factors that contribute to the breastfeeding decisions and practices of teen mothers.MethodsThis prospective study took place from January through December 2009 in Greensboro, North Carolina in the U.S. We followed the cohort from pregnancy until two weeks after they ceased all breastfeeding and milk expression. We conducted semi-structured interviews at baseline and follow-up, and tracked infant feeding weekly by phone. We analyzed the data to create individual life and breastfeeding journeys and then identified themes that cut across the individual journeys.ResultsFour of the five teenagers breastfed at the breast for nine days: in contrast, one teen breastfed exclusively for five months. Milk expression by pumping was associated with significantly longer provision of human milk. Breastfeeding practices and cessation were closely connected with their experiences as new mothers in the context of ongoing multiple roles, complex living situations, youth and dependency, and poor knowledge of the fundamentals of breastfeeding and infant development. Breastfeeding cessation was influenced by inadequate breastfeeding skill, physically unpleasant and painful early experiences they were unprepared to manage, and inadequate health care response to real problems.ConclusionsContinued breastfeeding depends on a complex interplay of multiple factors, including having made an informed choice and having the skills, support and experiences needed to sustain the belief that breastfeeding is the best choice for them and their baby given their life situation. Teenagers in the US context need to have a positive early breastfeeding experience, be able to identify and claim a reliable support system supportive of breastfeeding, and gain through their experience, a belief in their own agency and competency as mothers.

Highlights

Teen mothers face many challenges to successful breastfeeding and are less likely to breastfeed than any other population group in the U.S Few studies have investigated this population; all prior studies are cross-sectional and collect breastfeeding data retrospectively
Teen mothers in the US face many challenges to successful breastfeeding that are unique to their age and situation including: coping with the stigma and embarrassment related to being a teen mother; lack of parenting readiness; need for peer acceptance; and dependence on social support systems that may not be supportive of breastfeeding [7]
An ethnographic study with African-American and Latina adolescent mothers found that bonding was among the better known “benefits” of breastfeeding; it was not uniformly perceived as a benefit [11]

Summary

Introduction

Teen mothers face many challenges to successful breastfeeding and are less likely to breastfeed than any other population group in the U.S Few studies have investigated this population; all prior studies are cross-sectional and collect breastfeeding data retrospectively. Young women are less likely to breastfeed than older mothers and have a more rapid discontinuation rate [1,2,3] For these teen mothers, as with their older counterparts, knowledge of the benefits of breastfeeding is not sufficient to result in breastfeeding [4,5,6]. A significant number of teen mothers have a low income and there is a strong association between living in poverty, crime, poor educational opportunities, teen pregnancy and low breastfeeding [1,3,8,9,10]. For most teens, their negative views of breastfeeding outweigh the positive. This study, among others, found that “bonding” will make it more difficult for them to leave their babies with others, making their lives more difficult and complicate their return to school [12,13]

Methods

Results

Discussion

Conclusion