Breastfeeding experiences of adolescents participating in a randomized clinical trial study

Despite substantial evidence of the positive benefits of breastfeeding for both mother and child, adolescent mothers initiate breastfeeding less often and maintain breastfeeding for shorter durations of time when compared to their adult counterparts. As part of a RCT to enhance breastfeeding decision-making and increase initiation and duration of breastfeeding among disadvantaged urban adolescent mothers, we identified breastfeeding problems, reasons for weaning, and types of encouragement given for breastfeeding. Breastfeeding problem data were collected using the Breastfeeding Experience Scale (BES) at 3 and 6 weeks postpartum. Qualitative analysis was also completed on textual responses obtained during breastfeeding status check at 2, 4, and 6 months, and telephone interviews at 3 and 6 months postpartum. Study participants (N = 289) were 15-18 years of age and predominantly African American, single, and primiparous. Of 289 participants, 201 (69.5%) initiated breastfeeding. Breastfeeding problems reported at 3 and 6 weeks included leaking, engorgement, sore nipples, frequent feedings, maternal fatigue, and low milk supply. Major qualitative categories related to weaning from birth to 6 months included: maternal breast and nipple issues, infant feeding issues, maternal responses to additional demands and roles, and new infant growth and development needs. The major categories related to types of encouragement included: getting through those first weeks of breastfeeding and breastfeeding is best for baby. These findings will contribute to further understanding additional interventions and supports that may be needed to help adolescent mothers deal with initial breastfeeding problems and to sustain breastfeeding throughout the infant's first year of life.