title: Breastfeeding behavior among adolescents: initiation, duration, and exclusivity.
abstract: OBJECTIVE
  Despite a substantial amount of evidence on breastfeeding among non-adolescent mothers, research and strategies uniquely designed to target adolescent mothers are critical because their rates of breastfeeding are disproportionately low and their transition to parenthood is often unlike that of older mothers. Literature to date, however, offers limited evidence for designing effective interventions. Therefore, we aimed to fill this gap in the literature by examining breastfeeding behaviors among a cohort of female adolescents as they transition to parenthood.
  
  
  METHODS
  Data were derived from a longitudinal cohort of pregnant adolescent females (ages 14-21 years) and their male partners, observed from pregnancy through 6 months postpartum. Means and frequencies were used to describe breastfeeding experiences, breastfeeding behaviors, and sociodemographic characteristics. We used multivariate logistic regression and Cox proportional hazards models to identify factors independently associated with breastfeeding initiation, exclusive breastfeeding, and breastfeeding duration.
  
  
  RESULTS
  Approximately 71% initiated breastfeeding. Intending to breastfeed, having had complications in labor and delivery, and lower social support were associated with greater odds of breastfeeding initiation. Of the adolescent mothers who initiated breastfeeding, 84% had stopped by 6 months postpartum; among those, average breastfeeding duration was 5 weeks. Participants who exclusively breastfed had longer breastfeeding duration, and participants who had experienced intimate partner violence had shorter breastfeeding duration. Obese women and women who had more difficulty breastfeeding had lower odds of exclusive breastfeeding.
  
  
  CONCLUSIONS
  Enhanced clinical support and the promotion of exclusive breastfeeding should be considered when designing interventions to improve breastfeeding rates among adolescent mothers.
authors.affiliation: Department of Women, Children, and Family Health Science, University of Illinois at Chicago College of Nursing, Chicago, IL, USA. heather.sipsma@yale.edu
authors.forename: Heather L
authors.initials: HL
authors.lastname: Sipsma
authors.forename: Urania
authors.initials: U
authors.lastname: Magriples
authors.forename: Anna
authors.initials: A
authors.lastname: Divney
authors.forename: Derrick
authors.initials: D
authors.lastname: Gordon
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Gabzdyl
authors.forename: Trace
authors.initials: T
authors.lastname: Kershaw
mesh_terms: D000293:Adolescent; D001942:Breast Feeding / Q000523:psychology* / Q000706:statistics & numerical data*; D003710:Demography; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011247:Pregnancy; D011253:Pregnancy in Adolescence; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
keywords: Adolescents; Breastfeeding duration; Breastfeeding initiation; Exclusive breastfeeding