Bottle-feeding Mothers Research Articles

A Within-Subject Comparison of Maternal Sensitivity to Infant Cues and Infant Intake During Breastfeeding Versus Bottle-feeding Interactions

Abstract Objectives Bottle-fed infants are at higher risk for overfeeding and rapid weight gain compared to breastfed infants. However, given evidence illustrating sociodemographic and psychosocial differences between breastfeeding and bottle-feeding mothers, it is unclear whether feeding mode versus unmeasured covariates are the primary driver of differences between breast- and bottle-feeding. The objective of the present study was to use a within-subject experimental approach to describe whether and how breastfeeding versus bottle-feeding impacts early feeding interactions. Methods Mothers and their young infants (n = 46) visited our laboratory two times for counterbalanced, video-recorded feeding observations. Mothers breastfed their infants during one visit and bottle-fed their infants expressed breast milk during the other visit. Trained raters blinded to study aims later coded videos to assess maternal sensitivity to infant cues using the Nursing Child Assessment Parent-Child Interaction Feeding Scale. Infant intake was assessed by weighing the baby before and after the feeding. Maternal reported level of pressuring feeding style was assessed via the Infant Feeding Styles Questionnaire and tested as a possible moderator of effects of feeding mode on maternal sensitivity to infant cues and infant intake. Results Infants were 3.2 ± 1.4 months of age (range = 0.8–5.7 months). Mothers were 32.2 ± 4.2 years of age, 67.4% (n = 31) were non-Hispanic white, and 53.3% (n = 24) were primiparous. Mothers exhibited significantly lower sensitivity to infant cues during bottle- vs breastfeeding (P = .005). Infant intake did not differ between bottle- (87.4 ± 5.1 ml) and breastfeeding (90.7 ± 5.1 ml; P = .641). Effects of feeding mode on maternal sensitivity to infant cues or infant intake were not moderated by pressuring feeding style, but mothers who reported greater levels of pressuring feeding style fed their infants more during both conditions compared to mothers with lower levels of pressuring feeding style (P = .047). Conclusions Mothers were less sensitive to infant cues during bottle- compared to breastfeeding, but pressuring feeding style, rather than the act of bottle-feeding, per se, was associated with greater intakes across both modes of feeding. Funding Sources Eunice Kennedy Shriver National Institute of Child Health and Human Development.

Association between breastfeeding duration and postpartum weight retention of lactating mothers: A meta-analysis of cohort studies

To clarify the relationship between different breastfeeding duration and postpartum weight retention through meta-analysis. In this study, all relevant studies that described the effect of breastfeeding duration on postpartum weight retention were identified from Pubmed, Cochrane, and WANGFANG databases and so on (1960-2016). This meta-analysis had been registered in International Prospective Register of Systematic Reviews (CRD42016038409). Fourteen cohort studies involving 66 comparisons were included. Compared with bottle-feeding mothers, breastfeeding mothers had significantly lower postpartum weight retention of-0.38kg (95% confidence interval:-0.64,-0.11kg). Subgroup analysis showed that, mothers who were primipara, less than 30 years old or normal pre-pregnancy body mass index had lower postpartum weight retention. When breastfeeding duration were stratified into <12 weeks, 12 weeks-24 weeks, 24 weeks-48 weeks, and ≥48 weeks, postpartum weight retention in breastfeeding women presented a U-shaped trend: a decline during early breastfeeding duration (year 1) (from 0.23kgat<12 weeks to-1.58kgat 24-48 weeks) and then an increase in the follow-up duration (from-1.58kgat 24-48 weeks to-0.97kgat more than 48 weeks). Our results indicated that breastfeeding including exclusive breastfeeding and mixed breastfeeding were inversely related to postpartum weight retention. The decreasing influence of breastfeeding was more significant when the lactating mothers were less than 30 years old, primipara, normal pre-pregnant body mass index, or breastfeeding duration for 6-12 months.

Comparison of Health-related Behaviors in Pregnant Women and Breast-feeding Mothers vs Non-pregnant Women.

The aim of this study was to assess health-related behavior of pregnant women and breastfeeding mothers by investigating relevant risk factors. Data of 10,396 women (age 19 to 49 years) from the Korea National Health and Nutrition Examination Survey report from 2007 to 2012 was used to analyze factors associated with health-related behavior. The subjects were divided into pregnant women; breastfeeding mothers; and non-pregnant women. Bottle feeding mothers were excluded. Current smoking rate including self-reported smoker and/or positive cotinine urine test were lower for pregnant or breast-feeding group than non-pregnant group. Heavy-drinking was not different among groups while monthly drinking rate was higher in non-pregnant group. Rate of stress recognition was lower in pregnant and breast-feeding group than non-pregnant group. Rate of experience for depressive symptoms and rate of suicidal ideation were not different among groups. Pregnant women and breast-feeding mothers maintain a good pattern of health-related behavior compared to non-pregnant women. However, substantial proportion of pregnant women and breast-feeding mothers continue to drink and smoke. This shows the need for a plan that will modify health-related behavior.

Newborn right-holding is related to depressive symptoms in bottle-feeding mothers but not in breastfeeding mothers

This study examines the relationships between infant holding preferences and maternal depression according to the newborn feeding mode. Links between depression and infant holding biases have been observed in mothers [Vauclair, J., Scola, C. (in press). Dépression, alexithymie et latéralisation dans la façon de porter un nouveau-né [Infant holding biases in relation to depression, alexithymia and laterality]. Annales Médico-psychologiques; Weatherill, R. P., Almerigi, J. B., Levendosky, A. A., Bogat, G. A., von Eye, A., & Harris, L. J. (2004). Is maternal depression related to side of infant holding? International Journal of Behavioral Development, 28, 421–427] but the fact that breastfeeding has never been studied in relation to these two factors is surprising as breastfeeding has some influence on depression (e.g., [Mezzacappa, E. S., Guethlein, W., Vaz, N., & Bagiella, E. (2000). A preliminary study of breast-feeding and maternal symptomatology. Annals of Behavioral Medicine, 22, 71–79]) and must also affect holding biases. Mothers who just gave birth ( N = 100) were tested few days after delivery. Measures of handedness, infant holding-side preferences, and level of depressive symptoms expressed by mothers (assessed with the CES-D scale) were collected via questionnaires. Asymmetries in emotional perception were assessed via a Chimeric Figure Task and a Dichotic Listening Task. Results showed that breastfeeding (1) reduced left-side bias for holding newborns and (2) was associated with lowest levels of depressive symptoms. Moreover, holding biases were related to maternal depression in bottle-feeding but not in breastfeeding mothers, namely that holding on the right-side while bottle-feeding was associated with higher levels of depressive symptoms. These results were not due to hemispheric specialization as auditory and visual asymmetries were similar between breastfeeding and bottle-feeding mothers. The discussion emphasizes the striking role of the early mother/child relationship's establishment on infant holding biases.

Feeding upon awakening in breastfeeding and bottlefeeding mothers does not affect the awakening cortisol response

An acute breastfeeding stimulus is generally followed by a transient decrease in cortisol levels in mothers. It is currently not clear whether breastfeeding upon waking up would affect the awakening cortisol response (ACR), a significant increase in salivary cortisol levels occurring within 30–45 min after awakening. In the present study, we measured the amplitude and stability of the ACR in response to infant feeding in women who were exclusively bottle-feeding (n = 16), or breastfeeding (n = 13) or feeding their child solid food (n = 12). The results show that the type of infant feeding did not affect the amplitude and stability of the ACR. Given that the ACR has been reported to reflect physical and psychological well-being, our finding that infant feeding upon waking up might not be a confounding factor in ACR studies on the postpartum population represents valuable methodological information.

Responses to the 35% CO2 challenge in postpartum women

Lactation has been associated with suppression of some components of the neuroendocrine stress response. In humans, suppression of the hypothalamo-pituitary-adrenal (HPA) axis has been demonstrated in response to both a psychological and an exercise challenge, but appears to be limited to a short period of time following suckling. Information regarding other components of the stress response and to other challenges in humans is limited. We have evaluated the endocrine, autonomic and psychological response to a single breath of 35% CO(2) during lactation. The 35% CO(2) challenge is a safe and simple test that has been shown to stimulate the HPA axis, produce autonomic activation and emotional arousal. Eight breastfeeding and six bottle-feeding mothers, 6 weeks' postpartum, and eight control women were studied. Twenty minutes following the cessation of feeding, plasma cortisol levels were significantly reduced in the breastfeeding women (P = 0.002 compared with control and P = 0.003 compared with bottle-feeders). Despite this, cortisol, blood pressure, heart rate and psychological responses to the challenge were no different in the breastfeeding group compared to either the control or bottle feeding groups. These results confirm that suckling is associated with short-term suppression of cortisol, but this has no effect on the ability of the mother to mount a normal hormonal, autonomic and psychological response to the 35% CO(2) challenge.

The Breastfeeding Self‐Efficacy Scale: Psychometric Assessment of the Short Form

The purpose of this study was to reduce the number of items on the original Breastfeeding Self-Efficacy Scale (BSES) and psychometrically assess the revised BSES-Short Form (BSES-SF). As part of a longitudinal study, participants completed mailed questionnaires at 1, 4, and 8 weeks postpartum. Health region in British Columbia. A population-based sample of 491 breastfeeding mothers. BSES, Edinburgh Postnatal Depression Scale, Rosenberg Self-Esteem Scale, and Perceived Stress Scale. Internal consistency statistics with the original BSES suggested item redundancy. As such, 18 items were deleted, using explicit reduction criteria. Based on the encouraging reliability analysis of the new 14-item BSES-SF, construct validity was assessed using principal components factor analysis, comparison of contrasted groups, and correlations with measures of similar constructs. Support for predictive validity was demonstrated through significant mean differences between breastfeeding and bottle feeding mothers at 4 (p < .001) and 8 (p < .001) weeks postpartum. Demographic response patterns suggested the BSES-SF is a unique tool to identify mothers at risk of prematurely discontinuing breastfeeding. These psychometric results indicate the BSES-SF is an excellent measure of breastfeeding self-efficacy and considered ready for clinical use to (a) identify breastfeeding mothers at high risk, (b) assess breastfeeding behaviors and cognitions to individualize confidence-building strategies, and (c) evaluate the effectiveness of various interventions and guide program development.

Translation and validation of the breastfeeding Self-Efficacy scale into chinese

The purpose of this methodological study was to translate the Breastfeeding Self-Efficacy Scale (BSES) into Mandarin and determine the psychometric characteristics among a sample of 186 Chinese women. The BSES was translated and pilot-tested with 21 breastfeeding women. Following minor revisions to ensure content and semantic equivalence, the instrument was administered to 186 hospitalized breastfeeding women, who were then contacted again at 4 and 8 weeks postpartum to determine their infant feeding method and readminister the Edinburgh Postnatal Depression Scale. The psychometric assessment method used to validate the original BSES (English version) was replicated with the translated Chinese version. The Cronbach's alpha coefficient for the Chinese version BSES was 0.93, suggesting good reliability. Consistent with the English version, the factor analysis procedures resulted in the theorized two-factor solution and as hypothesized, the BSES was significantly correlated with the Edinburgh Postnatal Depression Scale, a theoretically related construct. Support for predictive validity was demonstrated through significant mean differences in BSES scores between breastfeeding and bottle-feeding mothers at 4 and 8 weeks postpartum. The results from this study are the first to examine the psychometric characteristics of the Chinese version BSES administered in a hospital postnatally and provide further evidence of the reliability and validity of the instrument.

Length of stay after vaginal delivery

Objective: Insurance must pay for 48-hour postpartum stay. We sought to determine 1) the percentage of women staying more than 24 hours postpartum, 2) the reasons that women make use of the 48-hour stay, and 3) the reasons that women seek early discharge (<48 hours). Methods: Women at two hospitals were surveyed at discharge. They filled out an anonymous multiple-choice questionnaire indicating their length of stay postpartum and their perception of the most important reason for the length of their stay. Data were analyzed by EIP Info 6 (CDC, Atlanta, GA). Results: The 435 surveys revealed that 61% of the patients (266/435) stayed longer than 24 hours. The length of stay was not affected by the number of children or adults at home, race, or age ( P = NS). Bottle-feeding was associated with a shorter stay (OR 0.53, 95% CI 0.35, 0.80). The most common reasons for a stay longer than 24 hours: the patient perceived that she needed more medical attention (81/266) or that she was too tired to go home (66/266). The most common reason for early discharge was that there was ‘no reason to stay longer‘ (126/168). Conclusion: Most women stay longer than 24 hours after an uncomplicated vaginal delivery; they do so because they perceive a medical indication or they are too tired to go home. Bottle-feeding mothers are more likely to seek early discharge than breastfeeding mothers. For women who are ‘too tired‘ to go home, alternate-care (ie, comfort-care) facilities may be more economical and appropriate for postpartum mothers during the second 24 hours of their postpartum stay.

A qualitative study of women's views about how health professionals communicate about infant feeding.

OBJECTIVE: To look at how communication by health professionals about infant feeding is perceived by first time mothers. DESIGN: Qualitative semi-structured interviews early in pregnancy and 6-10 weeks after birth. SUBJECTS AND SETTING: Twenty-one white, low income women expecting their first baby were interviewed mostly at home, often with their partner or a relative. RESULTS: The personal and practical aspects of infant feeding which were important to women were seldom discussed in detail in ante-natal interviews. In post-natal interviews women described how words alone encouraging them to breastfeed were insufficient. Apprenticeship style learning of practical skills was valued, particularly time patiently spent watching them feed their baby. Women preferred to be shown skills rather than be told how to do them. Some felt pressure to breastfeed and bottle feeding mothers on post-natal wards felt neglected in comparison. Women preferred their own decision-making to be facilitated rather than being advised what to do. Some women experienced distress exposing their breasts and being touched by health professionals. Continuity of care and forming a personal relationship with a health professional who could reassure them were key factors associated with satisfaction with infant feeding communication. CONCLUSIONS: The infant feeding goal for many women is a contented, thriving baby. In contrast, women perceive that the goal for health professionals is the continuation of breastfeeding. These differing goals can give rise to dissatisfaction with communication which is often seen as 'breastfeeding centred' rather than 'woman centred.' Words alone offering support for breastfeeding were often inadequate and women valued practical demonstrations and being shown how to feed their baby. Spending time with a caring midwife with whom the woman had developed a personal, continuing relationship was highly valued. Women were keen to maintain ownership, control and responsibility for their own decision-making about infant feeding.

Lifestyle Factors Related to Postpartum Weight Gain and Body Image in Bottle- and Breastfeeding Women

To explore the relationship of lifestyle variables to postpartum weight gain and body image attitudes of bottle- and breastfeeding women. Mail survey of new mothers at approximately 4 months postpartum. Southwestern community. One hundred one bottle-feeding women (69% white, 20% Hispanic, 11% other) and 106 breastfeeding women (76% white, 19% Hispanic, 5% other) without diabetes. Bottle- and breast-feeding women did not differ on gestational weight gain or weight gain sustained postpartum. Postpartum weight gain (relative to prepregnancy weight) and body image attitudes. Feeding method (breast or bottle) was not associated with postpartum weight gain in the sample as a whole. Bottle-feeding mothers with higher postpartum gains exercised less, had higher fat intake habits, and were more dissatisfied with body image than mothers with lower gains. Breast-feeding mothers with higher and lower gains did not differ on any lifestyle factors. Overall lifestyle and psychologic skill in managing emotions were related negatively to postpartum body image dissatisfaction in both groups of women. Breastfeeding women did not differ from bottle-feeding women in sustained postpartum weight gain. In bottle-feeding women, lifestyle factors were associated with levels of weight gain. Lifestyle-focused programs for weight management would potentially benefit these women.

Association between maternal antibodies to the external envelope glycoprotein and vertical transmission of human T-lymphotropic virus type I. Maternal anti-env antibodies correlate with protection in non-breast-fed children.

Vertical transmission of human T-lymphotropic virus type I (HTLV-I) depends primarily on breast-feeding; substitution of bottle-feeding has reduced the transmission rate from 20% in breast-fed children to 3% among bottle-fed. To determine the correlates of transmission for long breast-feeding (> or = 6 mo), short breast-feeding (< 6 mo), and bottle-feeding mothers, the antibody titers of transmitter (T) mothers and non-transmitter (nT) mothers were analyzed by using synthetic and recombinant epitopes representing the immunodominant epitopes of gag (Gag1a, r24), env (Env1/5, MTA1, RE3), and tax (Tax8/22-24) proteins. Seroreactivity to gag and tax epitopes was not significantly different except for anti-r24 antibody titer, which was significantly higher among T-mothers (geometric mean 134) when compared with nT-mothers (62) in the long-feeding group (P < 0.001). Profiles of antibody titers against env epitopes were different. Within the long-feeding group, Env1/5, MTA1, and RE3 titers were significantly higher among T-mothers (258, 1,476, and 738, respectively) when compared with nT-mothers (106, 279, and 320, respectively) (P < 0.01 for all three epitopes). In contrast, within the bottle-feeding group, antibody titers to Env1/5 (269) and RE3 (418) among nT-mothers were significantly higher than those among T-mothers (80 and 113, respectively) (P < 0.01). These data confirm that high-titered anti-HTLV-I antibodies in the long-feeding group correlate with milk-borne transmission of HTLV-I and, more importantly, imply that maternal anti-env antibodies may reduce the risk of non-milkborne infection.

Maternal sexuality during pregnancy and after childbirth in muslim Kuwaiti women

The sexuality of Kuwaiti Muslim women before pregnancy, during pregnancy, and 6 months after childbirth was studied. A group of 220 women attending the prenatal clinic of the Maternity Hospital Kuwait were randomly selected; 40 (18.2%) declined at the outset, 10 (4.6%) withdrew due to miscarriage and 10 (4.6%) due to failure to attend interviews. The semistructured interview was conducted by a female obstetrician at 4-week intervals starting from 12 weeks pregnancy to 6 months after childbirth. The study led to the following observations: (i) All the women were religious and abided by the Islamic rules and way of life. (ii) The diagnosis of pregnancy led to a decline in sexuality that continued throughout the pregnancy, with a second and early third trimester increase in sexuality but still below the prepregnancy baseline. (iii) Each woman had a consistent pattern of sexuality during pregnancy reflecting her prepregnancy level of sexuality. (iv) Younger age group, multiparity, low-level of education, lesser duration of marriage, and intention of breast-feeding characterized the sexuality pattern positively, as did attitudes towards sexuality during pregnancy and after childbirth. Breast-feeding mothers exceeded their prepregnancy level of sexuality earlier than bottle-feeding mothers.

Evaluation of a health education programme in China to increase breast-feeding rates

Researchers compared data on 106 pregnant women who participated in the health education program A Friend of Pregnant Women which promoted breast feeding with data on pregnant women who did not participate in this program to determine whether the program is effective at increasing breast feeding rates. All the women were from HuiHai neighborhood in Luwan District in Shanghai China. The cases were registered at the Maternal and Child Health Center. Their expected delivery dates fell between December 1990 and June 1991. Those of the controls fell between May and December 1989. Most mothers (94% and 91% respectively) wanted to breast feed and knew that breast feeding would not be difficult. Fewer cases correctly answered knowledge items in the pretest than in the posttest (44% vs. 60%). At 4 months postpartum women in the program group were significantly more likely to be breast feeding than those in the control group (44% vs. 21%). The leading reason for women not breast feeding was insufficient breast milk (76.1% of non-breast feeding mothers). Reasons for poor lactation included delayed first feed (80% within 48 hours) low frequency of breast feeding (53% less than 4 times/day) and Cesarean section which reduces lactation (50%). Many breast feeding mixed-feeding and bottle-feeding mothers (35% 42% and 44% respectively) had husbands and mothers-in-law who did not support breast feeding. Even though most mothers (92%) claimed that their physicians supported breast feeding the support did not influence the feeding chosen by mothers. Hospital policy contributed to reduced breast feeding. The hospital staff placed mothers and babies in different wards. They gave most newborns sugar feeds before their first breast feeding. The hospital accepted artificial milk products. The nurses heavy workload did not allow them time to educate mothers about breast feeding. After changing the hospital policy the breast feeding rate at time of discharge is now more than 90%.

Hospital and other influences on the uptake and maintenance of breast feeding: the development of infant feeding policy in a district

Hospital practices in the post-natal period are now recognised as one of a wide range of influences affecting the success of breast feeding. A study of 48 non-medical maternity unit staff and 250 recently delivered mothers at a District General Hospital was carried out in order to identify obstacles and sources of support in the establishment and maintenance of breast feeding. This study formed part of an evaluation of local policy development which included the appointment of a Baby Feeding Adviser. Eighty-two percent of mothers (95% confidence interval; 87.0-96.4) began breast feeding, and this fell to 57.4% (50.6-64.2) at 6 weeks. A majority of mothers reported that advice was at least partly conflicting, and of those who began breast feeding 92.7% had used supplements within 2 days. In multivariate analysis, factors significantly associated with a lower rate of initial breast feeding were: non-attendance at antenatal classes, Caucasian ethnicity, social class and religious denomination. Social factors were much less important in the maintenance of breast feeding, but mothers who had undergone Caesarian section were more likely to give up breast feeding by 6 weeks. The reported quality of advice and support from the hospital and community were not associated with the maintenance of breast feeding. Many of the maternity unit midwifery staff reported inadequate time for discussion of feeding with mothers. Although two-thirds of the staff felt that there should be an infant feeding policy or were not sure, most of those favouring a policy felt that it should not actively promote breast feeding. Their main reason for this view was the fear of inducing guilt in bottle-feeding mothers. The social and service-related factors associated with the initiation and maintenance of breast feeding may be useful for targeting additional support for some mothers. The ambivalence and concerns among maternity unit midwifery staff about promoting breast feeding must be addressed if successful policy implementation is to be achieved. Plans for implementing change and evaluation are described.

A Comparison of Postpartum Early and Traditional Discharge Groups

Women from a health maintenance organization who chose early postpartum discharge from the hospital were compared with women who chose a traditional stay. Subjects were mailed a questionnaire; 84% (n = 183) were returned. The survey instrument was designed to measure demographic, family, and birth-related characteristics; postpartum values and beliefs; early discharge program awareness; and postpartum care satisfaction. Findings revealed that the early discharge group had fewer primiparas, more rooming-in mothers, more bottle-feeding mothers, more deliveries between midnight and 6:00 AM, more deliveries at one hospital, more mothers who relied on themselves rather than others for their discharge decision, and more mothers who learned about early discharge from printed information rather than from clinic staff. Mothers in the late discharge group placed more value on rest and sleep, a quiet atmosphere, attention from others, and having a knowledgeable person available. Implications for hospitals and staff education are discussed in light of complete study findings.

Relating Mothers?? Anxiety and Perception to Infant Satiety, Anxiety, and Feeding Behavior

The purpose of this study was to explore early psychophysiologic mother-infant interaction using the tenderness and anxiety theorems of Harry Stack Sullivan. Maternal anxiety and perception were assessed and related to changes in infant satiety, anxiety, and feeding behavior. Sixty-five healthy post-partum, bottle-feeding mothers completed the Blank Infant Tenderness Scale and the State-Trait Anxiety Inventory. Blood samples were obtained from the infants just before and 60 minutes after feeding for determination of glucose and cortisol. Formula consumption was also noted. Multivariate analysis of variance demonstrated that maternal state-trait anxiety was related to infant glucose, cortisol, and formula consumption. In particular, mild maternal prefeed state anxiety was associated with lower infant cortisol difference scores, and extremely low maternal prefeed state anxiety was associated with higher infant cortisol difference scores. Mild maternal feed state anxiety, in turn, was associated with greater infant formula consumption, and extremely low maternal feed state anxiety was associated with lower formula consumption. Pearson correlations indicated a significant direct relationship between infant prefeed cortisol and postfeed glucose, but not between infant formula consumption and postfeed glucose.

Social and Psychological Determinants of Breast-Feeding and bottle-Feeding Mothers

Our study examined the psychological and sociological factors of mothers who breast-feed and mothers who bottle-feed. Most of the data came from 124 Israeli mothers who had just given birth, but selective data were also collected on three additional samples—108, 465, and 135 new mothers. The psychological measures included the Bar-Ilan Sex Role Inventory (Tzuriel, 1984) and body image as measured by the drawing of a dressed and a naked woman. None of the psychological factors distinguished between the two groups of women. Social factors, however, did distinguish between the two groups: Mothers who breast-fed were of Asian-African background; were less educated; held blue collar jobs or did not work; perceived their husbands, relatives, and friends as supporting their decision to breast-feed; and tended to be more religious. The discriminant function analysis—which predicted 73% of the cases—showed that the mother's education, her religiousness, and her perceived support of friends and relatives were the most important factors.

Sources of influence on infant feeding practices in Hong Kong

The breastfeeding rate in Hong Kong is low compared to the rates in Western countries. To understand the relative importance of different sources of influence on infant feeding practices, 714 Chinese mothers with infants aged 4 weeks to 6 months were studied. It was found that the bottlefeeding mothers were influenced more by the medical professionals who did not support breastfeeding. This influence was further reinforced by the mass media and particularly television advertisements on infant formulae. The successful breastfeeding mothers, on the other hand, were influenced more by their social networks through which they were told of the dangers of bottlefeeding. The failed breastfeeding mothers differed from the other groups in the lack of support they experienced from friends and relatives. Although they received professional encouragement to breastfeed, they were more sheltered from the influence of mass media and social networks. From these findings, it is suggested that different sources of influence are related to different feeding practices. However, to be able to continue with the practice that one has chosen, the availability of social support is essential. Implications of these findings are discussed and several recommendations to promote breastfeeding are made.

Developmental Issues and the Choice of Feeding Method of Adolescent Mothers

Approximately one million teenagers become pregnant each year, resulting in over 600,000 live births. An exploratory study was conducted to look at attitudes of adolescent mothers toward breastfeeding. Striking differences were found in the responses between groups of breastfeeding and bottlefeeding mothers. The effect of developmental needs and levels on the choice of feeding method was explored.