Predictors of exclusive breastfeeding among adolescent and adult first-time mothers

The American Academy of Pediatrics recommends that mothers breastfeed exclusively for the first six months. Breastfeeding awareness campaigns have touted this same recommendation, and Healthy People 2010 included the goal of increasing breastfeeding rates. However, social science research finds that women face social obstacles when attempting to breastfeed. Indeed, exclusive breastfeeding rates in the U.S. remain low, and studies have found adolescent breastfeeding rates to lag behind those of adult mothers. We analyze data from the Parenting for the First Time study, which prospectively followed the infant feeding practices of three groups of new mothers (adolescents, low-education adults, and high-education adults) from the prenatal period (N=677) through the first three years postpartum. Among adolescent mothers, 27% indicated during the prenatal period that they would like to exclusively breastfeed their baby; at the six-month assessment, only 2.9% of adolescents reported exclusive breastfeeding. Of adult mothers with a low level of education, 37.1% indicated plans to breastfeed exclusively; 7.3% did. Among adult mothers with a high level of education, 70.9% planned to exclusively breastfeed and 18.4% breastfed exclusively at six months. The differences between these groups of mothers were statistically significant (p < .000). Variables that influence breastfeeding, such as social impediments and social supports, are examined. Results reveal an impasse between maternal breastfeeding intentions and behavior, especially among young mothers. Research should aim to tease out maternal breastfeeding intentions and outcomes, and public health messages should account for and reflect the social realities that women face when engaging in infant feeding.