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107. Understanding the Lived Experience, Barriers, and Facilitators of Infant Feeding for Adolescent Mothers

      Purpose

      Data indicates that while 60% of adolescent mothers will initiate breastfeeding, only 20% continue to do so at 6 months. However, there is limited literature exploring the unique social determinants and distinct facilitators and barriers that influence adolescent mothers’ infant feeding practices. This study aims to explore the infant feeding trajectories of adolescent mothers, and to identify facilitators and barriers that may impact breastfeeding initiation and continuation. Additionally, this study seeks to examine adolescent mothers’ experiences with healthcare providers and their preferences with regards to education and support around infant feeding practices.

      Methods

      Telephone-based surveys were administered to a convenience sample of adolescent mothers of infants aged 2-12 months who were presenting for routine care to an adolescent mother-baby medical home model program. Survey data included demographic information, obstetrical information, infant feeding goals, breastfeeding knowledge, facilitators and barriers of infant feeding, personal support systems, interactions with healthcare providers, information preferences, and qualitative responses. The project’s protocol was approved by the SickKids Hospital Quality Improvement Review Board.

      Results

      Between September 2020 and August 2021, 18 adolescent mothers participated (maternal mean age = 18.17 years, infant mean age = 6.17 months). 66.7% endorsed having a positive breastfeeding role model, and 83.3% initiated breastfeeding within 2 hours of delivery. 13 participants planned to exclusively breastfeed on average for 10.83 months; of these, average actual duration of exclusive breastfeeding was 2.1 months. 15 participants began exclusively breastfeeding and switched to combination feeding, with 75% attributing the switch to perceived low milk supply and 68.75% switching feeding methods to allow others to help feed their infant. Other dominant factors for switching feeding methods included nipple pain (56.25%), time commitment (56.25%), and maternal exhaustion (56.25%). Of those who switched feeding methods, 75% linked breastfeeding to maternal excellence, with only 31.25% endorsing breastfeeding was an easier form of feeding. Participants reported moderate anxiety about being judged by their care provider about their feeding choices (2.75/5 on a 5-point Likert scale). 33.3% felt they were given too much infant feeding information on discharge after delivery, while 33.3% reported not enough, highlighting the need for counseling to be tailored to individual preference. Adolescents indicated a desire for increased education from providers on the health benefits of breastfeeding for mothers, breast pumping, and on the breastfeeding experience. Qualitative data indicates that adolescent mothers felt provider-led feeding counselling could improve through more active listening and a non-judgmental approach delivered in an atmosphere that facilitates adolescent engagement.

      Conclusions

      In this small clinical sample, the majority of adolescent mothers intended to breastfeed. Factors influencing their ultimate feeding practices included both their perceived success and their own physical experiences during breastfeeding. Opportunities for enhanced support by providers centered around a more individualized approach to education and counselling. This data highlights the need for trauma-informed, rights-based, and person-centered approaches to infant feeding support for adolescent mothers.

      Sources of Support

      This project was supported by the 2021 Social Paediatrics Research Summer Studentship (SPReSS) Program.