Factors Associated with Breastfeeding Initiation in Adolescent Mothers

• Published in: The Journal of pediatrics 2013-11, Vol.163 (5), p.1489-1494
• Main Authors: Apostolakis-Kyrus, Katherine, MD, Valentine, Christina, MD, MS, RD, DeFranco, Emily, DO, MS
• Format: Article
• Language: English
• Subjects: adolescence; Adolescent; adolescent mothers; at-risk population; breast feeding; Breast Feeding - ethnology; Breast Feeding - statistics & numerical data; Cohort Studies; education; Female; Health Communication - methods; Health Promotion - methods; hospitals; Humans; Infant, Newborn; Mothers; neonates; Ohio; Pediatrics; Pregnancy; Pregnancy in Adolescence - ethnology; Prenatal Care - utilization; regression analysis; relative risk; Retrospective Studies; Risk; risk factors; ROC Curve; Social Class; Social Support; socioeconomic factors
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2013.06.027

Objective To identify the most influential factors on breastfeeding initiation in adolescent mothers in order to identify the highest risk population to focus education and support services. Study design Retrospective population-based cohort study of all non-anomalous live births in Ohio (2006-2007). Breastfeeding initiation rates were compared between adolescent mothers age ≤19 years and a reference group age >19 years. A multivariate logistic regression model assessed the association between breastfeeding initiation in adolescent mothers while adjusting for important concomitant risk factors including race, socioeconomic, demographic, prenatal, and delivery factors. Results Of 308 380 births during the study period, following exclusions there were 30 402 mothers ≤19 years of age (10.5% of study population) and 257 840 mothers age >19 years. Of adolescent mothers, 44% initiated breastfeeding compared with 65% of older mothers, P < .001. Adolescents were 33% less likely to breastfeed after adjusting for important coexisting factors, adjusted relative risk 0.77 (95% CI 0.75-0.80). Socioeconomic factors had the most significant influence on breastfeeding initiation in adolescent mothers. Conclusion Adolescent mothers who have the least social support and are socioeconomically disadvantaged are the least likely to breastfeed their newborn infants. In addition, maternal perception, societal barriers, and a lack of prenatal intervention contribute unique barriers to breastfeeding in adolescence. Opportunities exist for school programs, baby-friendly hospitals, and postpartum education to improve breastfeeding rates in this population.