title: Factors associated with breastfeeding initiation in adolescent mothers.
abstract: 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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Bayfront Medical Center, Department of Obstetrics and Gynecology, St. Petersburg, FL.
authors.forename: Katherine
authors.initials: K
authors.lastname: Apostolakis-Kyrus
authors.forename: Christina
authors.initials: C
authors.lastname: Valentine
authors.forename: Emily
authors.initials: E
authors.lastname: DeFranco
mesh_terms: D000293:Adolescent; D001942:Breast Feeding / Q000208:ethnology / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005260:Female; D058015:Health Communication / Q000379:methods; D006293:Health Promotion / Q000379:methods; D006801:Humans; D007231:Infant, Newborn; D009035:Mothers; D009820:Ohio; D011247:Pregnancy; D011253:Pregnancy in Adolescence / Q000208:ethnology; D011295:Prenatal Care / Q000706:statistics & numerical data; D012372:ROC Curve; D012189:Retrospective Studies; D012306:Risk; D012923:Social Class; D012944:Social Support