The Perceived Behavioral Control of Breastfeeding Among Pregnant Adolescents and Its Relation to Postpartum Breastfeeding Difficulties

Abstract

Despite a large body of evidence supporting breastfeeding as best for infants and mothers, rates still fall short of the Healthy People 2010 Goals. The initiation and duration rates of adolescents are even lower, despite the fact that benefits for this population may be greater. Breastfeeding can be explained using the theory of planned behavior and its concepts of attitude, subjective norm, perceived behavioral control, and intentions. The purpose of this secondary analysis (N = 289) was 1) to determine the relationship between prenatal breastfeeding control (PBC), prenatal feeding intentions and breastfeeding at birth; and 2) among those who initiate breastfeeding, the relationship between PBC and breastfeeding concerns and difficulties at three and six weeks postpartum. Data from a randomized control trial was obtained from a questionnaire measuring theory concepts upon enrollment and at 32 – 36 weeks gestation. Upon delivery, 69% of the teens (n = 201) initiated exclusive or partial breastfeeding. All breastfeeding participants were contacted by phone at 3 and 6 weeks postpartum, and completed the Breastfeeding Experiences Scale. Data analyses included descriptive statistics, Pearson or Spearman correlations, Chi‐Square analysis, and narrative content and frequency analysis. PBC perceptions were significantly related to prenatal intentions to breastfeed (r = .54, p = .01), but not significantly related to three and six week breastfeeding problem severity perceptions. Among those who breastfed at birth, mean prenatal PBC levels were higher among those who continued breastfeeding at three weeks (t = ‐2.3 (163), p = .026). Weaning decisions in the early postpartum period were based on physical issues, but included psychosocial issues as time progressed. In conclusion, the TPB is a useful model for predicting intentions to breastfeed in this vulnerable population.