Factors influencing breast-feeding among adolescents

During a 15-month study period, 244 adolescent mothers under 18 years of age were surveyed, of whom 53% elected to breast-feed. A subset of 60 primiparous breastfeeding adolescents were studied regarding the influence of several factors on the duration of breast-feeding. 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. Eighty-three percent made the decision to breast-feed before the third trimester. Thirty-five percent discontinued breast-feeding within the first 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% breast-fed for 2 months or more. None of the variables examined (maternal age, ethnic group, education level, involvement of the baby's father, timing of the breast-feeding decision, intended duration of breastfeeding, age at which formula supplementation was started, or availability of maternal support) was predictive of the duration of breast-feeding. Contrary to adolescent stereotypes, 65% of mothers chose breast-feeding because it was “good for the baby,” and 67% identified the “closeness” of the nursing relationship as the most enjoyable part of breast-feeding. Twenty-eight percent cited modesty issues about breast-feeding as the greatest disadvantage, and 17% returned to work or school within the first 2 postpartum months, posing additional obstacles to breast-feeding. Our data suggest that adolescents are receptive to breast-feeding, but they may require close follow-up and anticipatory guidance tailored to their individual needs. Specific strategies for supporting breastfeeding among adolescent mothers are discussed.