Supporting the Adolescent Breastfeeding Mother
By Christine Staricka, IBCLC, CCE
The adolescent mother presents interesting and unique circumstances under which to teach and promote breastfeeding. Generally the young mother is dependent upon another, likely one or both of her own parents, as a co-caregiver to her baby. The adolescent mother is likely to be dependent upon this co-caregiver financially, as well as for shelter, transportation, and babysitting. Partly because of this reality, the adolescent mother does not view her situation quite the same way as the older or more mature, independent mother. The way a healthcare provider or breastfeeding helper approaches this type of scenario should be tailored specifically with the following details in mind.
It is critical that the healthcare provider (HCP) or breastfeeding helper (BH) not align herself with the young mother's parents in the initiation of the teaching/support scenario. Although sharing personal stories or anecdotes can be unifying when working with a mature or independent mother, to a teenager it can feel like another judgmental, older person telling her what to do. To the adults in her family, the baby may represent the result of the teenage mom's "mistakes," and anyone who forms an alliance with those adults seems to her to be likely to also be criticizing her choices and questioning her judgment. In addition, appealing to this adolescent's sense of independence, i.e. discussing how breastfeeding is empowering and sets her apart as the ultimate advocate for her baby, can backfire because this ideal is not sustainable for her when she goes home to the reality of depending on someone else to help care for and support her and her baby. For an independent new mother of age who has baby's father as her co-caregiver or a mature single mother, new motherhood is often viewed as a rite of passage, but for the adolescent, becoming a mother does not instantly make her an adult. It infers great responsibility upon her while at the same time her situation does not offer her the power to handle such responsibility on her own.
With this perspective in mind, there are ways to navigate this teaching scenario and helpfully promote the health and welfare of mom and baby through the breastfeeding relationship. Studies have shown that adolescent mothers prefer to receive teaching regarding feeding their babies in the presence of the co-caregiver. Adolescents are in a perpetual "learning mode" because they are usually high school students and receive information readily. However, they often find that they are not able to re-teach the information they receive to the co-caregiver. Alternately, they find that the co-caregiver does not agree with the information and the dependent adolescent is not in a position to debate these issues. Adolescents are very receptive to hearing breastfeeding portrayed as the biological norm and appreciate that there are risks to formula feeding. Their co-caregivers are not always as eager to embrace the idea. Sometimes this stems from theirown personal experience or their misperceptions about breastfeeding making the co-caregiver's job more difficult. They may fear that a nursing baby will cry inconsolably when mother is away or have concerns about the process of bottlefeeding expressed milk in mother's absence. Simple teaching and suggestions to address these concerns make a difference because they validate the co-caregiver as an important player in the baby's care while also offering practical advice.
The following strategies are designed to address specific concerns of the co-caregiver while also supporting the adolescent mother's desire to nurse her baby.
- Concern: A breastfed baby might cry inconsolably when mother is away. Reality: All babies cry when mother is away. Many comforting techniques exist: swaddling, rocking, babywearing, swings, bouncer seats, strollers for outdoor walks, etc.
- Concern: Preparing breastmilk for feeding is harder than formula. Reality: Both breastmilk and formula preparation require careful attention and safety measures. Proper technique is easily mastered with appropriate information.
- Concern: Mother won't have enough milk because she has to go to school and can't pump there. Reality: Many mothers must leave their infants; some are able to pump while away and others are not. If mother will be away for 4 hours or less, there may not be a big impact on her milk supply due to that separation. Many school districts have policies which support high school student-moms with their pumping and nursing needs. Worst case scenario is that mom is able to nurse baby "only" when they are together, which really is a majority of the time, and all nursing is important.
- Concern: Nursing the baby might encourage her to have more babies because it makes her even more maternal. Reality: This young lady has already had a baby, and the more involved she is in this one's care, the less time she has to become pregnant again anytime soon. She is investing herself in this baby which can help her to see how important and how precarious her situation truly is, lending her the view that another pregnancy very soon would not be in her best interest.
Concern: Mother is too young to properly care for a baby and it's better if "I" do the work and she just holds the baby. Reality: Mother is definitely young and inexperienced in caring for babies, and "you" were also inexperienced when you had your first. Human beings learn by doing things, not by watching others do things in their place. The best support for this young mother is someone standing by to step in when she asks for or obviously needs help.
The adolescent mother may deeply appreciate and comprehend that nursing is a continuation of the normal biological process for her and her baby if it is presented to her that way. Often, out of concern not to offend those who opt not to breastfeed, the impression is given that breastfeeding isn't that important. In fact, breastfeeding is a vital and critical human right and a "public health issue," according to the American Academy of Pediatrics Policy on Breastfeeding (2012). To a young mother who has recently studied biology in school, knowing that breastfeeding is the normal, expected way for babies to feed is very important given that she may have far more exposure to formula feeding in her life, let alone the formula marketing to which she has recently been subjected.
Aside from the clear impact on the infant's health, supporting the adolescent mother in breastfeeding is important to her own health as well, and that appeals to both her and her co-caregiver. As the young mother's body recovers from childbirth, the physical and hormonal roller coaster can be a challenge for her, particularly as she is also dealing with the stresses of new motherhood, the realities of her transformed responsibilities, and other pre-existing issues. The physiological act of nursing a baby produces induces immediate calming effects through oxytocin release. At a time when the young mother may feel as if most of her life is beyond her control, including physical changes in her own body, nursing her baby is strictly within her control and may help her in forming and truly feeling her new identity as a mother. A young mother who is not nursing her baby can more easily push baby care tasks off on another, especially during the times she feels most stressed, and this can lead to feelings of isolation and separation from the responsibility of motherhood.
While the adolescent mother presents some unique challenges with regard to breastfeeding promotion, she can also become a very inspirational and influential person in her circle and especially to those who support her mothering style. Young mothers can be incredibly intuitive about our agendas and biases, and they can also surprise us with their depth of understanding their baby's needs. As one 16- year old mother said in a quiet voice while nursing her 2-week old baby "I would never feed my baby milk that wasn't alive."