Problem Statement: The health benefits of breastfeeding for both mother and infant are well documented and breastfeeding rates have been rising since the 1990’s. Rates, however, remain significantly lower among certain groups of women including adolescent mothers.

Literature Review (Abbreviated): Among recent studies regarding the views of adolescents and breastfeeding the majority of teens reported knowing that breastfeeding was “best” or “healthy” for infants (Connolly, Friel, Nic Gabhainn, Becker & Kelleher, 1998; Forrester, Wheelock & Warren, 1997; Ineichen, Pierce, & Lawrenson, 1997; Leffler, 2000; Wambach & Koehn, 2004), expressed concerns over breast exposure during feedings (Berg & Jarmillo, 2000; Forrester et al., 1997; Goulet et al., 2003; Hannon, Willis, Bishop-Townsend, Martinez & Scrimshaw, 2000; Landry, 2001; Leffler, 2000; Nelson, 2001, Wambach & Koehn, 2004), and acknowledged that the baby’s father and their own mother impacted breastfeeding decision-making (Hannon et al., 2000; Nelson, 2001; Ratananugool, 2001; Wambach & Koehn, 2004).

Limitations of this body of work are that the majority of research is over 10 years old and much has been conducted outside of the U.S. In order to translate evidence-based breastfeeding guidelines (AWHONN, 2007) into support for U.S. adolescents it is necessary to gain a better understanding of the breastfeeding attitudes, beliefs, and concerns of the adolescent population.

Methodology
Design: An exploratory, qualitative design was employed using a focus group methodology.

Sampling Procedures/ Data Gathering Strategies: Pregnant and postpartum adolescents up to age of 19 who were enrolled in a young parents outreach program at an inner city health center were invited to participate in focus groups by case workers. The sample population was low income and largely Black and Hispanic. The final sample consisted of 16 participants in four focus groups. The focus groups were audio taped and transcribed by a legal transcriptionist.

Data Analysis: The primary researcher analyzed unabridged, typed transcripts and field notes from a qualitative perspective using a hand-sort approach (Krueger & Casey, 2000). The content analysis technique of “clustering” was used to identify common themes under the constructs of adolescent attitudes, concerns, and beliefs related to breastfeeding (Krippendorff, 2004).

Findings: Six major focus group themes were identified, (1)  BELIEFS: “They say” it’s healthy, It hurts; (2) ATTITUDES: Breastfeeding is a mother’s “choice,” The baby comes first; (3) CONCERNS: Privacy matters, and Breastfeeding leads to dependency.

Interpretation/ Implications for Practice/Future Research: Findings suggest active learning strategies are called for that might assist young women to “discover” the benefits of breastfeeding and empower them to breastfeed despite fears of pain and infant dependency. Encouraging adolescents antenatally to ask for assistance if they experience pain and addressing fear of physical exposure through discussing creative strategies to preserve modesty also are warranted. Finally, various levels of breastfeeding exclusivity should be considered when working with teens to find a pattern that is subjectively workable yet preserves the breastfeeding relationship. Future research is needed to test breastfeeding interventions designed to incorporate an understanding of adolescent attitudes, beliefs and concerns as revealed in this study.