Strategies to promote breast-feeding among adolescent mothers.
OBJECTIVE
To identify characteristics of adolescent mothers who bottle-feed who considered breast-feeding their infants and strategies to promote breast-feeding within this special group.


METHODS
Adolescents completed an hour-long interview within 48 hours of delivery that elicited factors considered important to the mother's feeding decision and indices of mental health.


METHODS
Postpartum ward of university hospital.


METHODS
A total of 693 adolescents 18 years old or younger (mean age, 16.7 years) from African American, Mexican American, or white race or ethnicity; 27% of Mexican American participants spoke little or no English.


METHODS
Factors associated with breast-feeding decision.


RESULTS
Those who chose bottle-feeding (hereafter, bottle-feeders) who had considered breast-feeding were first compared with bottle-feeders who had not considered breast-feeding and then with adolescents who breast-fed. After controlling for ethnicity, bottle-feeders who had considered breast-feeding were more likely than those who had not considered breast-feeding to be impoverished (adjusted odds ratio [AOR] = 4.8), to have delayed their feeding decision until the later stages of pregnancy (AOR = 4.6), to have been encouraged to breast-feed (AOR = 4.5), to have friends who breast-fed (AOR = 2.3), and to have experienced low financial, tangible, emotional, or informational support from their families (AOR = 1.6). They were more likely to cite barriers associated with breast-feeding while returning to school or work (AOR = 2.0) and less likely to state that bottle-feeding was healthier (AOR = 0.3) as reasons for bottle-feeding. Compared with those who chose breast-feeding (hereafter, breast-feeders), this group was more likely to have made the feeding decision alone rather than relying on advice (AOR = 4.6), to have made this decision in the later stages of pregnancy (AOR = 4.4), to report fewer breast-feeding role models (AOR = 1.8) and fewer significant others who encouraged breast-feeding (AOR = 2.8), and to report at least 2 significant others who encouraged bottle-feeding (AOR= 3.2). They were also less likely to have attempted to breast-feed a previous child (AOR = 3.3).


CONCLUSIONS
A subgroup of adolescent mothers who had considered breast-feeding but ultimately chose to bottle-feed may be identified in the late stages of gestation by collecting information on financial status, family support, perceived barriers to breast-feeding and attending school or working, timing of the feeding decision, prior breast-feeding experience, breast-feeding role models, and encouragement to breast-feed. We speculate that strategies to promote breast-feeding should focus on role modeling and facilitation.
Wiemann
C M
CM
Department of Obstetrics & Gynecology, The University of Texas Medical Branch, Galveston, USA. cwiemann@utmb.edu
DuBois
J C
JC
Berenson
A B
AB
D000293:Adolescent; D001903:Bottle Feeding; D001942:Breast Feeding / Q000523:psychology*; D003657:Decision Making; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D011247:Pregnancy; D011253:Pregnancy in Adolescence; D000297:Psychology, Adolescent; D012944:Social Support