Elsevier

Journal of Adolescent Health

Volume 53, Issue 3, September 2013, Pages 394-400
Journal of Adolescent Health

Original article
Breastfeeding Behavior Among Adolescents: Initiation, Duration, and Exclusivity

https://doi.org/10.1016/j.jadohealth.2013.04.005Get rights and content

Abstract

Purpose

Despite a substantial amount of evidence on breastfeeding among non-adolescent mothers, research and strategies uniquely designed to target adolescent mothers are critical because their rates of breastfeeding are disproportionately low and their transition to parenthood is often unlike that of older mothers. Literature to date, however, offers limited evidence for designing effective interventions. Therefore, we aimed to fill this gap in the literature by examining breastfeeding behaviors among a cohort of female adolescents as they transition to parenthood.

Methods

Data were derived from a longitudinal cohort of pregnant adolescent females (ages 14–21 years) and their male partners, observed from pregnancy through 6 months postpartum. Means and frequencies were used to describe breastfeeding experiences, breastfeeding behaviors, and sociodemographic characteristics. We used multivariate logistic regression and Cox proportional hazards models to identify factors independently associated with breastfeeding initiation, exclusive breastfeeding, and breastfeeding duration.

Results

Approximately 71% initiated breastfeeding. Intending to breastfeed, having had complications in labor and delivery, and lower social support were associated with greater odds of breastfeeding initiation. Of the adolescent mothers who initiated breastfeeding, 84% had stopped by 6 months postpartum; among those, average breastfeeding duration was 5 weeks. Participants who exclusively breastfed had longer breastfeeding duration, and participants who had experienced intimate partner violence had shorter breastfeeding duration. Obese women and women who had more difficulty breastfeeding had lower odds of exclusive breastfeeding.

Conclusions

Enhanced clinical support and the promotion of exclusive breastfeeding should be considered when designing interventions to improve breastfeeding rates among adolescent mothers.

Section snippets

Sample

We derived data from this study from a cohort of pregnant adolescent females and their partners, who were observed from pregnancy through 6 months postpartum. Couples were recruited between July 2007 and February 2011 from obstetrics and gynecology clinics in four university-affiliated hospitals in Connecticut. Research staff provided informational materials to the female and asked her to discuss the study with her partner if he was not present. Young women ages 14–21 years, who were in their

Sample characteristics

Approximately 42% of female participants were <19 years of age at baseline, and 85% had education appropriate for age (Table 1). Forty percent of the sample was non-Hispanic black, 42% was Hispanic, and 18% was non-Hispanic white or another race/ethnicity. At baseline, approximately 43% were in school, 27% were employed, 74% received public assistance from WIC, and almost 80% were expecting their first baby.

Breastfeeding experiences and behavior

During pregnancy, 75% of female participants reported intending to breastfeed and 81% of

Discussion

Breastfeeding initiation rates among this sample population were higher than expected based on national data; however, rates fell short of the Healthy People 2020 goal of more than 80% [1]. Breastfeeding duration, on the other hand, was markedly short. Only 11% were breastfeeding at the 6-month visit, well below the Healthy People 2020 goal of more than 60% and national rates of 20% [1]. Among participants who initiated breastfeeding but had stopped by the 6-month postpartum visit, the average

Acknowledgments

This study was supported by Grant 1R01MH75685 from the National Institutes of Mental Health.

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