Building Resiliency in Teen Moms Can Improve Breastfeeding and Save Babies
How do I find time to breastfeed my baby at school?
What will my friends think if they see me breastfeeding?
Shouldn’t my mom just watch my baby? She knows more than me anyway.
We can only begin to imagine how difficult breastfeeding must seem to mothers who are in the midst of their adolescence. Especially given that any obstacles resulting from their age are often compounded by additional social determinants, such as having less money and less education.
These difficulties translate into alarming statistics. Less than one in five adolescent mothers exclusively breastfeeds their babies for the recommended six months. This means that, with the right supports, over 80 percent more teen moms and their babies can gain proven health benefits, including reduced risks of cancer and lower rates of childhood obesity.
Improving teen breastfeeding rates may have an even bigger consequence though, explains Lori Feldman-Winter, MD, MPH, a pediatrician and safe sleep and breastfeeding expert who is currently working with NICHQ on the National Action Partnership to Promote Safe Sleep Improvement and Innovation Network (NAPPSS-IIN).
“Adolescent mothers not only have low rates of breastfeeding,” she explains, “but their babies also have higher rates of sudden infant death syndrome (SIDS). And since exclusive breastfeeding can reduce SIDS by more than 70 percent, improving teenage breastfeeding rates has powerful potential for improving infant health outcomes and reducing infant mortality.”
These findings illuminate a significant opportunity for improvement. Simply put, if we can highlight strategies that uniquely support teenage mothers, we have the potential to improve 80 percent of an at-risk population’s births. That’s 80 percent of the more than 220,000 babies born to teenage mothers every year.
These strategies start by focusing on the psychological state of the teen mother. There are no physiological reasons an adolescent mother cannot breastfeed; in fact, in terms of physical ability, it can actually be easier for them than for more mature mothers. But, as Feldman-Winter explains, being physically capable of breastfeeding is not the same thing as feeling capable.
“Adolescent mothers are, by definition, reliant on others and their pregnancies are often unplanned and come with feelings of shame or self-doubt,” says Feldman-Winter. "Together, these factors can leave them feeling inadequate and unprepared, neither of which is conducive to breastfeeding.”
In short, helping teenage mothers breastfeed starts by building their resiliency, a belief in self that can withstand the insecurities and setbacks that often accompany breastfeeding. And building that resiliency is very much connected to the relationships and support systems surrounding teens. Below, we’ve outlined three opportunities for improvement.
Support Starts at Home
A teen pregnancy can strain the teen’s relationship with her family, leaving the new mom feeling isolated from her most direct support system, explains Feldman-Winter. "I’ll often ask teen mothers, ‘Who believes in you?’ and they’ll just start crying. They think everyone in the world has given up on them. And when they feel that way, they’re simply less likely to breastfeed. That’s why it’s so important that we help repair those relationships. In doing so, we help build champions who can support and empower these young mothers.”
Building these champions starts with open conversations that rally everyone around a common goal: the importance of helping the new baby have the best chance at a healthy start. By establishing this shared understanding, health professionals can create a sense of communal alliance and then transition the conversation to discuss breastfeeding—its benefits for both mom and baby, and the need to build up the new mother’s resiliency so that she can breastfeed successfully.
Feldman-Winter advises counseling caregivers to regularly repeat affirmative messages to the new teen mother. The more she hears, “I believe in you and I believe that you can breastfeed,” the more likely she is to believe in herself and her own abilities.
Prioritize Peer Relationships
Teens’ tendency to reject parental authority responds to an innate desire to be like their peers. And while this desire poses an increased risk of isolation for teen mothers, who are in such a unique situation, it also suggest an opportunity to seek improvement by leveraging teen support groups. These groups can be a powerful force for empowering teen mothers to breastfeed. Adolescent mothers, already uniquely desirous of acceptance, will be spurred on by the advice and behaviors of their peers.
“When they see someone their own age breastfeeding, they start to realize, ‘Hey, this is actually something I can do,’” says NICHQ Executive Project Director Jennifer Ustianov, MS, BSN, RN, IBCLC. “It helps them understand that being a teenager doesn’t limit their ability to breastfeed. Seeing their peers provide their babies with the sustenance they need can really build their confidence.”
In their most powerful form, these peer support groups follow a centering model. With this approach, teen mothers receive all their education and counseling, from prenatal to post birth, in a community of their peers. Centering models have been shown to promote self-advocacy and accountability in new mothers, making them all the more relevant for the adolescent mother.
Elevate the Relationship Between Mother and Baby
Strengthening a teen mother’s bond with her new baby will build resiliency in and of itself. As a new mother connects with her baby, she becomes more confident in her role, and in turn more likely to breastfeed. Hospital staff can start strengthening that bond right at delivery, says Feldman-Winter, by encouraging early skin-to-skin contact and rooming-in, both of which are already recommended behaviors to inspire future breastfeeding.
And just as a strong mother-baby connection encourages breastfeeding, so too does breastfeeding strengthen that connection, the one building off the other. “Breastfeeding helps teen mothers feel a sense of contribution; each time they breastfeed, they’re providing their baby with something only they can offer,” says Feldman-Winter. “We want all mothers to breastfeed immediately; but we need to be especially mindful of its importance for teen mothers. Early initiation sparks a positive feedback loop that helps balance out the insecurities that come with their age. Breastfeeding empowers them as mothers.”
In response, empowering them as mothers will do more than help more babies reach year one; it will inspire a healthy relationship that will improves health outcomes for the mother-child dyad for years to come. Ultimately then, by building teen mothers’ resiliency, we can improve health for two generations of children.
A Physician’s Reflections on Racism and Treating Sickle Cell Disease
For NICHQ’s current and future work, I am motivated by wanting to be a better version of myself in service of others. Wondering whether my own implicit biases impacted my care of patients and families, I realize that I cannot redo past ER experiences. If I could go back, I would slow down to acknowledge and try to set my biases aside and approach patients from a personally more informed perspective. But now, I can use my past, present, and future experiences to ensure NICHQ is amplifying important lessons from this multi-year effort reflecting the compassion, care, and commitment of hundreds of dedicated professionals in pursuit of equitable, accessible, and quality healthcare for people living with sickle cell disease.
Navigating Well-Child Visits and Vaccinations during COVID-19
Well-child visits and recommended vaccinations are essential, ensuring children stay healthy and are protected from preventable diseases and illnesses such as measles, whooping cough, and seasonal flu. But, as the COVID-19 pandemic persists, data shows that fewer childhood vaccinations have been given and many children have fallen behind on their scheduled appointments. Healthcare professionals should utilize the following strategies to work with parents and caregivers to get their children caught up on missed appointments and recommended vaccinations.
Exploring a Nonbinary Approach to Health
NICHQ is not abandoning the traditional use of the terms “mother” and “maternal.” We are embracing the inclusive language of “birthing person/people” across our work. A move toward inclusive language does not force us to stop using language that so many people identify with; at its core, inclusion is about creating more space for one another. We are taking care to expand the use of these terms in our communications, on our website, in our resources, and eventually, in all our projects.
NICHQ Employee Spotlight: Stacey C. Penny
With NICHQ's Rare As One Network Workstream Facilitation Initiative at a halfway point, Senior Project Director Stacey C. Penny, MSW, MPH shares an inside look at one of NICHQ's most collaborative projects.
Are Screens Making our Children’s Eyes Worse?
Even before the COVID-19 pandemic, children of all ages were spending more screen time than ever before on cellphones, tablets, and laptops. Prolonged periods of time staring at a screen that may be too big, too bright, or too close to our eyes can cause eye fatigue or even lead to dry eye, a chronic eye condition common in older adults. With eye conditions becoming more prominent in children, it's important for health professionals to encourage healthy screen viewing habits and support children’s eye health in the digital age.
NICHQ Employee Spotlight: Olivia Giordano
Olivia Giordano, MPH, Project Manager shares how her work with NICHQ’s Supporting Healthy Start Performance Project (SHSPP) is supporting 101 Healthy Start community sites to harness lessons learned, implement innovative approaches to improvement, and ultimately start to close the disparity gap in maternal and child health.