Examining social norms and barriers among adolescents to inform local policy change

Introduction Social influences impact behavior, including adolescent breastfeeding initiation and duration. Factors such as media (e.g., aggressive marketing of breast milk substitutes), hospital policies, school policies, and support from personal networks have been previously noted to affect breast feeding rates. The features of one's community, workplace, and school also impact breast feeding rates, although to what extent and how these elements interact is less known. Methods Adolescent mothers from a family medicine clinic were invited to participate in a series of focus groups about breast feeding. During focus groups the mothers discussed their own experiences with breastfeeding including: social support, available resources and barriers. Participants were also asked to describe what social influences and support would have made it easier for them to breast feed. After the focus groups concluded, participants filled out a mailed questionnaire about their social support and environment (based on findings from the focus groups). Results The focus groups identified several hospital and school policies that increased the likelihood of adopting breast milk substitutes. Social support was also identified as an important predictor for breastfeeding. Those participants who lived with a female that supported breastfeeding and those who attended a school with supportive breastfeeding policies reported higher rates of breast feeding. Discussion The findings gave the current mothers data to use for policy change within their own community and helped explain the relationship between environmental exposures and breast feeding outcomes. The group decided to advocate for breast feeding friendly policies for adolescents at their local schools and discussed ways to create social support for young mothers within their community.