Adolescent breastfeeding and health literacy

Introduction Low health literacy rates have been associated with less health knowledge and behaviors less advantageous for health outcomes. As such, health literacy has been identified as a critical and modifiable factor for improving preventive care and reducing health disparities. The importance of breastfeeding in reducing infant morbidity and enhancing growth and development has been well established in the literature. Adolescent mothers are less likely to breastfeed (56%) and do so for shorter periods (24% at 6 months) than adult mothers. Methods Adolescent mothers from a family medicine residency program were recruited to participate in the study. Several focus groups and key informant interviews were conducted to understand adolescent attitudes toward breastfeeding. An assessment was administered based on the findings from the focus group to further understand their health knowledge about breastfeeding and their health literacy rate. The validated health literacy measure, the Short Test of Functional Health Literacy in Adults, was modified to include four additional questions relevant to adolescent mothers. Previous studies have also modified the S-TOFHLA for use with adolescents. As a result of the information obtained through the focus groups, key informant interviews, and assessment, a breast feeding health promotion campaign was implemented in the clinic. The health promotion campaign was tailored to the adolescent population and included low literacy materials about the health and economic benefits of breastfeeding and links to available community resources to support their decision. This information was given to all pregnant adolescent females (up to the age of 20) at the clinic when they first presented for prenatal care (if they did) and in the last trimester (or at birth). Results The majority of adolescent mothers reported low health knowledge but adequate health literacy rates. The mothers identified the lack of understandable materials on breastfeeding, lack of social support, and availability of breast milk substitutes as common reasons they did not initiate or quit breastfeeding. Adolescents who were patients of the clinic increased initiation of breastfeeding by 30% and increased the duration of breastfeeding from an average of three weeks to eight weeks. Discussion The implementation of the modified S-TOFLHA with adolescent mothers extends the functionality of the tool. This study sought to address the breastfeeding health disparity through assessment and intervention based on health literacy, which resulted in favorable breastfeeding outcomes among adolescents. This study was one of the first to study adolescent health literacy and breastfeeding rates.