To identify characteristics of adolescent mothers who bottle-feed who considered breast-feeding their infants and strategies to promote breast-feeding within this special group.
Adolescents completed an hour-long interview within 48 hours of delivery that elicited factors considered important to the mother's feeding decision and indices of mental health.
Postpartum ward of university hospital.
A total of 693 adolescents 18 years old or younger (mean age, 16.7 years) from African American, Mexican American, or white race or ethnicity; 27% of Mexican American participants spoke little or no English.
Main Outcome Measures
Factors associated with breast-feeding decision.
Those who chose bottle-feeding (hereafter, bottle-feeders) who had considered breast-feeding were first compared with bottle-feeders who had not considered breast-feeding and then with adolescents who breast-fed. After controlling for ethnicity, bottle-feeders who had considered breast-feeding were more likely than those who had not considered breast-feeding to be impoverished (adjusted odds ratio [AOR]=4.8), to have delayed their feeding decision until the later stages of pregnancy (AOR=4.6), to have been encouraged to breast-feed (AOR=4.5), to have friends who breast-fed (AOR=2.3), and to have experienced low financial, tangible, emotional, or informational support from their families (AOR=1.6). They were more likely to cite barriers associated with breast-feeding while returning to school or work (AOR=2.0) and less likely to state that bottle-feeding was healthier (AOR=0.3) as reasons for bottle-feeding. Compared with those who chose breast-feeding (hereafter, breast-feeders), this group was more likely to have made the feeding decision alone rather than relying on advice (AOR=4.6), to have made this decision in the later stages of pregnancy (AOR=4.4), to report fewer breast-feeding role models (AOR=1.8) and fewer significant others who encouraged breast-feeding (AOR=2.8), and to report at least 2 significant others who encouraged bottle-feeding (AOR=3.2). They were also less likely to have attempted to breast-feed a previous child (AOR=3.3).
A subgroup of adolescent mothers who had considered breast-feeding but ultimately chose to bottle-feed may be identified in the late stages of gestation by collecting information on financial status, family support, perceived barriers to breast-feeding and attending school or working, timing of the feeding decision, prior breast-feeding experience, breast-feeding role models, and encouragement to breast-feed. We speculate that strategies to promote breast-feeding should focus on role modeling and facilitation.