1. Teenage Mothers & Breastfeeding

2. Statistics
More than 400,000 babies are born to teenagers in the United States every year
National averages as of 2013:
60% of young females under the age of 20 breast feed
20% of these young women continue breastfeeding after 6 months
Compared to:
80% of women over the age of 30 breastfeed and of those women 50 %
are still breastfeeding after 6 months (Sipsma, 2013).
As the statistics on this slide show, the number of teen mothers who breastfeed and continue to breastfeed after 6 months is low compared to older age group of mothers.

3. Breastfeeding Rate
According to Smith “the breastfeeding rate among adolescent mothers in the United States is low and has been dropping since 2003.
Young women are less likely to breastfeed than older mothers and have a more rapid discontinuation rate.
A significant number of teen mothers have a low income and there is a strong association between living in poverty, crime, poor educational opportunities, teen pregnancy and low breastfeeding (Smith, Avery, & Gizlice, 2013).
Adolescent mothers are less likely to breastfeed or continue to breastfeed because many living in poverty and have fewer education opportunities that could boost their understanding and acceptance of breastfeeding.

4. Barriers
Common barriers for teenage breastfeeding include but are not limited to:
Pain
Latching difficulties
Fatigue
Poor milk supply
Medical complications.
Factors associated with the lack of breastfeeding are being unmarried, low socioeconomic indicators (ie, Medicaid), negative health behaviors such as cigarette smoking and the lack of prenatal care.
Many teen mothers are deterred from breastfeeding because they perceive that it will be or is painful when the baby suckles, they become frustrated when the baby does not latch on readily, and that with breastfeeding they are usually the one to feed the baby and get up with them at night vs. with bottle feeding someone else can feed the baby.

5. Environmental or Community Factors
Lifestyle
Education
Support of Family and Friends
Conditioning to the Parental Role
Many factors influence a teen mother's perception of breastfeeding. What type of lifestyle they live, the level of education they have completed as well as the knowledge the have regarding breastfeeding, whether their family and friends accept and encourage or disapproave of breastfeeding and how they view their role of becoming a parent all weigh in on how likely a teen mother will engage in breastfeeding.

6. Cultural Descriptors
Daley states that “the fact is that 451,000
teens who are bearing children each year
in the United States are more likely to be
living in communities and environments
where they experience the many stressors
associated with poverty” and that “adolescent individuation is highly influenced by culture and social context, adolescents, especially during the middle and later stages, desire to spend more social time outside of the parental household, with their peers and friends” (Daley, Sadler, & Reynolds, 2013).
Simply put culture has a lot of influence on the decision whether or not to breastfeed, especially for young mothers. Some cultures believe breastfeeding is the only way to truly bond with one's baby, others view breastfeeding as “old fashioned” and inappropriate when bottle and formula are available.

7. Environment
If a teenage mother lives in an environment where she is sees other mothers breastfeeding and she receives support she could be successful
(Daley, Sadler, & Reynolds, 2013).
Social support from families, friends, and partners are among the most important issues to a new teenage mother. They are often encouraged to bottle feed with formula because others are often uncomfortable with breastfeeding ( Smith, Avery, & Gizlice, 2013).
Breastfeeding at this age can be embarrassing and feel wrong to the adolescent mother, having a supportive inner group of people such as immediate family and close friends that accept breastfeeding is a major indicator whether or not young mothers will engage in and sustain breastfeeding.

8. Health Belief Model
The Health Promotion Model best supports promoting breast feeding among teenage mothers through education as it “is applicable to any health behavior in which threat is not proposed as a major source of motivation for the behavior” (Pender, 2011).
The best way to promote breastfeeding among teen mothers is to educate, empower, and support them regarding the benefits of breast feeding.

9. The majority of teenagers having children are at risk in several different ways:
They are often still children themselves and not
emotionally and cognitively prepared to be parents.
2) Teen mothers may come from troubled
backgrounds and have mental health issues
that were present before the pregnancy, such as,
depression, post-traumatic stress syndrome,
and abuse.

10. For Young Teenage Women:
This is a natural time when adolescents want to be spending more time with friends, but adolescent mothers may find themselves staying home and relying on their families for assistance, both financially and to assist with care for their child. This situation can prove to be stressful for families with limited space and financial concerns. (Daley, Sadler, & Reynolds, 2013).
Teenage mothers don’t realize the importance of breastfeeding on it’s own, they are more concerned with fitting into society. Also, adolescent mothers may be growing into their own sexuality and comfort with their bodies, even though they have been sexually active in the past.

11. Teenage View of Breastfeeding
Some teen mothers react to the idea of breastfeeding as ‘nasty’ and may feel embarrassed, especially if they would need to the feed the baby in a public place” (Daley, Sadler, & Reynolds, 2013).
Daley states “this potential conflict can be seen in the reluctance on the part of some teen mothers (especially when sexual abuse may have been part of their experience) to consider breastfeeding their infants. .

12. The plan to implement this education is through:
Plan of Action
Plan of action to improve young females breastfeeding is education, women that are not exposed to breastfeeding information are very unlikely to breast feed. Several studies have shown that adolescent education on the benefits of breastfeeding increases breastfeeding initiation as well as duration (Apostolakis-Kyrus, 2013).
The plan to implement this education is through:
* Improving school health curriculums which include breastfeeding
* Focusing on a social marketing campaign on the benefits of breastfeeding
* Increasing discussion and promotion of breastfeeding during Provider appointments and during hospitalization for birth.
In order to change the perspective teen mothers have regarding breastfeeding nurses and other health care workers need to work together with both local clinics and schools to develop and implement health education that enhances teen's knowledge about the benefits of breastfeeding as well as resources that are available for them to utilize.

13. Objectives
1. To educate adolescent pregnant women
about the benefits of breastfeeding (good
effects for baby and cost effective).
2. Continuing to breast feed until at least 6 months.
These objectives can be achieved by encouraging providers to have a lactation consultant on staff so the benefits for breast feeding can be taught early in pregnancy. For those that don't seek out prenatal care school systems should be encouraged to include breastfeeding benefits in their health classes.
Simply put the objective of this project is to increase breastfeeding among young mothers through education and to encourage them to continue to breastfeed at least until the child is 6 months old.

14. Resources National La Leche League Local Lactation Specialists
Local Low Cost Pregnancy & Birth Centers
There are many organizations out there that can provide valuable information and support for teen mothers looking to breastfeed, this slide lists some of them others could include other teen mothers who breast feed, the internet (being careful to chose reliable sources), and of course primary care providers.

15. Setting for Health Promotion Activity
School-Based Programs
Nurse-Managed Health Centers
Health Departments During Prenatal Visits
Hospitals After Delivery of the Newborn
Teenage mothers often lack the knowledge base and skills to perform breastfeeding techniques successfully, and to incorporate these skills into their lives while attending school or working. (Smith, Avery, & Gizlice, 2013).
This slide lists many possible settings in which breastfeeding promotion could take place.

16. Evaluating Objectives
A way to evaluate these objectives would be to survey pediatricians offices, not to violate HIPPA, just get a percentage of babies with mothers under the age of 19, how many are breastfeeding at 1st check up and at 6 months check up. Need to get a Provider to buy into the benefits of breastfeeding.
So, how do we know if we are achieving our goals? We could partner with local physicians and clinics to survey the local teen mother population to see what kind of impact if any our education program has on the surrounding area. Ideally, we would see an increase in the number of teen mothers who self report engaging in breastfeeding and those who continue to breast feed past the first few months of the child's life.

17. It isn’t enough for teenage mothers to comprehend the importance of breastfeeding on the health of their infants. They also have to combat the issues of trying to fit into society among their peers and feeling accepted, as well as the embarrassment regarding the stigma of being a teenage mother (Smith, Avery, & Gizlice, 2013).

18. References
Aspostolakis-Kyrus, K., Valentine, C., DeFranco, E. (2013). Factors associated with
breastfeeding initiation in adolescent mothers. The Journal of Pediatrics. Retrieved
From
Daley, MA, Sadler, L.S., & Reynolds H. D. (2013). Tailoring clinical services to address the antique needs of
adolescents from the pregnancy test to parenthood. Current problems in pediatric and adolescent health
care, 43:4. Retrieved from
Pender, N. J., Murdaugh, C. L., & Parsons, M. A. (2011). Health promotion in nursing practice (6th ed.).
Upper Saddle River, NJ: Pearson Education, Inc.
Rousseau, E. H., Lescop, J. N., Fontaine, S., Lambert, J., Roy, C. C. (1982 October 15). Influence of cultural
and environmental factors on breast-feeding. Canadian Medical Association Journal, 127(8):
Retrieved from
Sipsma, H.L., Magriples, U., Divney, A., Gordon, D., Gabzdyl, E., Kershaw, T. (2013).
Breastfeeding behavior amond adolescents: Initiation, Duration and Exclusivity. Journal
of Adolescent Health. Retrieved from
Smith, P.H., Coley, S.L., Labbok, M.H., Cupito, S., & Nwokah, E. (2012). Early breastfeeding experiences of
adolescent mothers: a qualitative prospective study. International Breastfeeding Journal, 7:13.
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