title: Experiences of infant-feeding decision-making among urban economically disadvantaged pregnant adolescents.
abstract: OBJECTIVE
  The aim of this paper is to report a pilot study of influencing factors in disadvantaged urban pregnant adolescents' decision-making about infant-feeding choices.
  
  
  BACKGROUND
  Research related to decision-making among adolescents indicates that attitudinal, social, perceived control, and commitment factors are influential in choosing and initiating breast- or bottle-feeding. However, there is a need for further description of decision-making processes in disadvantaged teenagers before intervention research is done.
  
  
  METHODS
  Focus group interviews with the Theory of Planned Behavior guiding the questioning were used with 14 pregnant adolescents between 18 and 39 weeks of gestation and between the ages of 14 and 18 in two obstetric clinics in Midwestern USA urban teaching hospitals. The majority of adolescents were African-American and primiparae.
  
  
  RESULTS
  The experiences of infant-feeding decision-making among pregnant adolescents were captured by two major themes: benefits vs. barriers of breastfeeding and bottle-feeding, and independent choice vs. social influences. A common thread in these themes was ambivalence and uncertainty. The adolescents had both positive and negative attitudes toward methods, with many expressing their desire to combine breast- and bottle-feeding. Many reported the health benefits of breastfeeding, yet identified barriers of pain, public exposure, and the complexity of breastfeeding. They viewed bottle-feeding as automatic and simple, allowing freedom to leave the infant with others. Although adolescents were adamant that choice of feeding method was their independent decision, social and family influences were evident.
  
  
  CONCLUSIONS
  Consistent with the Theory of Planned Behaviour and other research, attitudes, perceived social influences, and perceived control factors were influential to adolescents when choosing infant feeding methods. The findings suggest that adolescents need education on decision-making, and are being used to fine-tune the interventions of a randomized clinical trial to investigate promoting and supporting breastfeeding among adolescent mothers.
authors.affiliation: School of Nursing, University of Kansas, Kansas City, Kansas, USA. kwambach@kumc.edu
authors.forename: Karen A
authors.initials: KA
authors.lastname: Wambach
authors.forename: Mary
authors.initials: M
authors.lastname: Koehn
mesh_terms: D000293:Adolescent; D001294:Attitude to Health; D001903:Bottle Feeding / Q000523:psychology; D001942:Breast Feeding / Q000523:psychology; D002755:Choice Behavior; D003657:Decision Making; D004522:Educational Status; D005260:Female; D017144:Focus Groups; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D010865:Pilot Projects; D011203:Poverty; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000523:psychology*; D012959:Socioeconomic Factors; D014504:Urban Health