Hospital practices to promote breastfeeding: The effect of maternal age.
Breastfeeding rates are disproportionately low among young mothers in the United States. Although the use of hospital practices to promote breastfeeding is widely supported, the extent to which these practices help explain breastfeeding disparities by maternal age is unclear. Accordingly, we aimed to explore how maternal age may affect (1) receipt of hospital practices and (2) associations between these practices and exclusive breastfeeding.



Data were derived from participants (n = 1598) of Listening to Mothers III, a national survey administered to mothers of singleton births in United States hospitals from July 2011 to June 2012. We used multivariable logistic regression models and interaction terms to examine maternal age as an effect modifier.



Compared with mothers aged 30 and older, mothers aged 18-19 had lower odds of reporting that nurses helped them initiate breastfeeding when ready (OR 0.59 [95% CI 0.35-0.99]), they roomed-in with their baby (OR 0.32 [95% CI 0.19-54]) and they did not receive a pacifier (OR 0.53 [95% CI 0.32-0.90]). Many associations with breastfeeding were stronger among mothers aged 18-19 and 20-24 than mothers aged 25-29 and 30 and older. Additionally, compared with receiving a pacifier, not receiving a pacifier was associated with greater odds of exclusive breastfeeding at 1 week among mothers aged 30 and older (OR 1.47 [95% CI 1.02-2.11]) but lower odds among mothers aged 18-19 (OR 0.26 [95% CI 0.10-0.70]).



Hospital practices to promote breastfeeding may be differentially implemented by maternal age. Encouraging teenage mothers to room-in with their babies may be particularly important for reducing breastfeeding disparities. Pacifier use among babies of teenage mothers requires further exploration.
Center for Interdisciplinary Inquiry and Innovation in Sexual and Reproductive Health, University of Chicago, Chicago, IL, USA.|Department of Public Health, Benedictine University, Lisle, IL, USA.
Heather L
0000-0002-7742-6435
HL
Sipsma
Department of Health Systems Science, University of Illinois at Chicago College of Nursing, Urbana, IL, USA.
Krista
K
Jones
Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.|Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, Canada.
Nathan C
NC
Nickel
D000293:Adolescent; D000328:Adult; D001942:Breast Feeding; D005260:Female; D006293:Health Promotion; D006761:Hospitals; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D008423:Maternal Age; D015999:Multivariate Analysis; D016017:Odds Ratio; D041361:Pacifiers / Q000706:statistics & numerical data; D057184:Practice Patterns, Nurses' / Q000706:statistics & numerical data*; D011247:Pregnancy; D012386:Rooming-in Care / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult
breastfeeding; health equity; maternal age; maternity care