Examining the relationship between health literacy and adolescent breastfeeding

Introduction Health literacy has been identified as a critical and modifiable factor for improving health outcomes and reducing health disparities. Due to the higher risk of disease and worse health outcomes among adolescent mothers and their infants, breastfeeding may be especially beneficial. However, adolescent moms are less likely to breastfeed and do so for shorter periods than adult mothers. Further understanding the relationship between adolescent health literacy and breastfeeding is important to inform future preventative efforts. Methods Adolescent mothers from a large Midwestern urban setting were recruitment to complete a breastfeeding questionnaire and three health literacy assessments. Participants were randomized into one of six groups to determine the order health literacy assessments were administered. Assessments include the three minute, orally administered REALM-Teen, the TOFHLA, a timed 22 minute test with oral instructions, and the Chew three question health literacy screening tool. The questionnaire assessed participants' previous breastfeeding outcomes and breastfeeding knowledge. Results Two hundred adolescent mothers participated. There were differences between the three health literacy tools. When comparing the health literacy rates using the Chew three question tool and breastfeeding outcomes, mothers with low health literacy were less likely to breastfeed. Discussion The results of this study are the first step to evaluating the potential for successful, health literacy-appropriate interventions that promote adolescent breastfeeding. Increasing breastfeeding among adolescents has benefits for infants and mothers, and has the potential to improve infant mortality in this high risk population. In addition, few health literacy tools have been assessed for use among adolescents.