title: A systematic review of the nature of support for breast-feeding adolescent mothers.
abstract: OBJECTIVE
  to review the evidence on the nature of support for breast-feeding adolescent mothers.
  
  
  METHODS
  a systematic review of relevant English-language papers was conducted using an a-priori search strategy. Agreement on final inclusion was reached by consensus across the team. The findings were tabulated and described narratively and thematically.
  
  
  RESULTS
  of 209 studies identified, seven fitted the inclusion criteria. The papers included in this review varied in design, quality and focus. Five types of support were identified: emotional, esteem, instrumental, informational and network. The participants in the included studies seemed to find the emotional, esteem and network components of support most helpful. Support from the participants' mothers seemed to be particularly powerful. The provision of continuity of support from an expert individual who is skilled in both lactation support and working with adolescents was also highly valued by breast-feeding adolescents. There was also evidence to suggest that targeted breast-feeding educational programmes, specifically designed for the adolescent learner, may be successful in improving breast-feeding initiation and continuation rates in this population. However, a question still arises about which elements of the complex package on offer were most effective.
  
  
  CONCLUSIONS
  the studies included in the review are diverse. Although the support provided by known and trusted individuals emerges as important to the adolescents, further research is required on the specific nature of that support and the person best placed to provide it. The acceptability and feasibility of other aspects of support and modes of provision also requires additional exploration. Further qualitative and feasibility studies are therefore warranted in order to inform future randomised-controlled interventions trials.
authors.affiliation: Maternal and Infant Nutrition and Nurture Unit (MAINN), Faculty of Health, University of Central Lancashire, Preston, Lancashire, UK. vlmoran@uclan.ac.uk
authors.forename: Victoria
authors.initials: V
authors.lastname: Hall Moran
authors.forename: Janet
authors.initials: J
authors.lastname: Edwards
authors.forename: Fiona
authors.initials: F
authors.lastname: Dykes
authors.forename: Soo
authors.initials: S
authors.lastname: Downe
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D001903:Bottle Feeding / Q000523:psychology; D001942:Breast Feeding / Q000523:psychology*; D005260:Female; D006801:Humans; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn; D008880:Midwifery / Q000379:methods*; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology*; D033262:Narration; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D011181:Postnatal Care; D011247:Pregnancy; D012944:Social Support; D011795:Surveys and Questionnaires