Infant feeding experiences among teen mothers in North Carolina: Findings from a mixed-methods study

Christine M Tucker,Ghazaleh Samandari,Ellen K Wilson

doi:10.1186/1746-4358-6-14

Abstract

BackgroundAdolescent mothers in the U.S. are much less likely to initiate breastfeeding than older mothers, and teens who do initiate breastfeeding tend to breastfeed for shorter durations. The purpose of this mixed-methods study is to investigate breastfeeding practices, barriers and facilitators among adolescent mothers ages 17 and younger.MethodsQuantitative descriptive analyses are conducted using data from the North Carolina Pregnancy Risk Assessment Monitoring System (PRAMS). The population-based sample comprises 389 teens ages 13-17 giving birth to a live born infant in North Carolina in 2000 - 2005 and in 2007. Qualitative analyses are based on in-depth interviews with 22 Black, White and Hispanic teen mothers residing in rural and urban areas of North Carolina conducted between November 2007 and February 2009.ResultsIn quantitative analyses, 52% (196 of 389) of North Carolina teen mothers initiated breastfeeding, but half of those who initiated breastfeeding (92/196) stopped within the first month postpartum. Hispanic teens (44/52 or 89%) were much more likely than Black (61/159 or 41%) or White teens (87/164 or 52%) to initiate breastfeeding and to continue for a longer duration. Nearly sixty two percent (29/52) of Hispanic respondents breastfed for greater than four weeks as compared to 16% (29/159) of Black respondents and 26% (39/164) of White respondents. Common barriers to breastfeeding initiation and continuation included not liking breastfeeding, returning to school, nipple pain, and insufficient milk. Qualitative data provided context for the quantitative findings, elucidating the barriers and facilitators to breastfeeding from the teens' perspective and insight into the ways in which breastfeeding support to teens could be enhanced.ConclusionsThe large number of adolescents ceasing breastfeeding within the first month points to the need for more individualized follow-up after hospital discharge in the first few days postpartum, to address common technical challenges and to provide assistance managing the transition back to school. Provision of an extra home visit or outpatient visit for teens within the first few days following hospital discharge, and advocacy to make schools more compatible with breastfeeding, could potentially help teens who desire to breastfeed to successfully continue. These interventions warrant further research to test their effectiveness among adolescents.

Highlights

Adolescent mothers in the U.S are much less likely to initiate breastfeeding than older mothers, and teens who do initiate breastfeeding tend to breastfeed for shorter durations
Adolescents who do initiate breastfeeding tend to breastfeed for shorter durations than older mothers
Due to the small sample size of adolescents identifying as “other” race-ethnicity, we focus racial and ethnic comparisons between White, Black, and Hispanic youth

Summary

Introduction

Adolescent mothers in the U.S are much less likely to initiate breastfeeding than older mothers, and teens who do initiate breastfeeding tend to breastfeed for shorter durations. The purpose of this mixed-methods study is to investigate breastfeeding practices, barriers and facilitators among adolescent mothers ages 17 and younger. Adolescents who do initiate breastfeeding tend to breastfeed for shorter durations than older mothers. Several factors may explain the lower levels of breastfeeding among teen mothers. Given their age, teen mothers are more likely than older mothers to be single and to have lower levels of education and income–characteristics that are negatively associated with breastfeeding [2,3,4]. A lack of confidence in their ability to breastfeed [7] and reticence to ask for help may be other barriers that pertain especially to teens [7,8]

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