OBJECTIVE: To identify the most influential factors on breastfeeding initiation in adolescent mothers in order to identify the highest risk population to focus education and support services. STUDY DESIGN: Retrospective population-based cohort study of all non-anomalous live births in Ohio (2006-2007). Breastfeeding initiation rates were compared between adolescent mothers age ≤ 19 years and a reference group age >19 years. A multivariate logistic regression model assessed the association between breastfeeding initiation in adolescent mothers while adjusting for important concomitant risk factors including race, socioeconomic, demographic, prenatal, and delivery factors. RESULTS: Of 308,380 births during the study period, following exclusions there were 30,402 mothers ≤ 19 years of age (10.5% of study population) and 257,840 mothers age >19 years. Of adolescent mothers, 44% initiated breastfeeding compared with 65% of older mothers, P < .001. Adolescents were 33% less likely to breastfeed after adjusting for important coexisting factors, adjusted relative risk 0.77 (95% CI 0.75-0.80). Socioeconomic factors had the most significant influence on breastfeeding initiation in adolescent mothers. CONCLUSION: Adolescent mothers who have the least social support and are socioeconomically disadvantaged are the least likely to breastfeed their newborn infants. In addition, maternal perception, societal barriers, and a lack of prenatal intervention contribute unique barriers to breastfeeding in adolescence. Opportunities exist for school programs, baby-friendly hospitals, and postpartum education to improve breastfeeding rates in this population.
OBJECTIVE: To identify the most influential factors on breastfeeding initiation in adolescent mothers in order to identify the highest risk population to focus education and support services. STUDY DESIGN: Retrospective population-based cohort study of all non-anomalous live births in Ohio (2006-2007). Breastfeeding initiation rates were compared between adolescent mothers age ≤ 19 years and a reference group age >19 years. A multivariate logistic regression model assessed the association between breastfeeding initiation in adolescent mothers while adjusting for important concomitant risk factors including race, socioeconomic, demographic, prenatal, and delivery factors. RESULTS: Of 308,380 births during the study period, following exclusions there were 30,402 mothers ≤ 19 years of age (10.5% of study population) and 257,840 mothers age >19 years. Of adolescent mothers, 44% initiated breastfeeding compared with 65% of older mothers, P < .001. Adolescents were 33% less likely to breastfeed after adjusting for important coexisting factors, adjusted relative risk 0.77 (95% CI 0.75-0.80). Socioeconomic factors had the most significant influence on breastfeeding initiation in adolescent mothers. CONCLUSION: Adolescent mothers who have the least social support and are socioeconomically disadvantaged are the least likely to breastfeed their newborn infants. In addition, maternal perception, societal barriers, and a lack of prenatal intervention contribute unique barriers to breastfeeding in adolescence. Opportunities exist for school programs, baby-friendly hospitals, and postpartum education to improve breastfeeding rates in this population.