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J Pediatr Adolesc Gynecol. 1999 May;12(2):83-9.

Choice of feeding method of adolescent mothers: does ego development play a role?

Author information

1
Division of Adolescent Medicine, Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.

Abstract

STUDY OBJECTIVES:

The purpose of this study was to determine whether, among childbearing adolescents, ego development was associated with intention to breast-feed and with actual breast-feeding behavior at birth and at 2 weeks postpartum. In addition, we sought to determine whether positive attitudes toward breast-feeding influenced pregnant adolescents' intentions to breast-feed and actual breast-feeding at the hospital and at 2 weeks postpartum. We hypothesized that adolescents with higher levels of ego development and positive attitudes toward breast-feeding would be more likely to intend to breast-feed and to actually breast-feed.

DESIGN:

Prospective cohort study of pregnant adolescents who completed questionnaires, Loevinger's Sentence Completion Tests, and attitudes toward breast-feeding scales before delivery and a follow-up questionnaire at 2 weeks postpartum assessing feeding practice in the hospital and at 2 weeks postpartum.

SETTING:

Two adolescents' clinics and two "teen-and-tot" clinics in urban teaching hospitals.

PARTICIPANTS:

Fourteen- to 22-year-old pregnant adolescents who had never given birth and who planned to carry their pregnancy to term and parent their children.

MAIN OUTCOME MEASURES:

1) Intended feeding practice during pregnancy, 2) feeding method in the hospital, and 3) feeding method at 2 weeks postpartum.

RESULTS:

Of the 125 subjects enrolled in the study, 106 were at 2 weeks postpartum or more. Of these 106 participants, 75% (n = 78) completed more than 75% of the attitudes toward breast-feeding scale and Loevinger's Sentence Completion Test and are included in these analyses. Mean age at entry was 17.8 +/- 1.5 years (range, 14.3 to 21.8 years). Mean gestational age at enrollment was 21.2 +/- 11.6 weeks (range, 4 to 41 weeks). Of the 78 participants, 12% (n = 9) were at the preconformist, 85% (n = 66) at the conformist, and 4% (n = 3) at the postconformist level of ego development as determined by the Sentence Completion Test. Attitudes toward breast-feeding, intention to breast-feed, breast-feeding in the hospital, and breast-feeding at 2 weeks postpartum were not significantly associated with adolescents' stages of ego development. Almost three fourths of the adolescents intended to breast-feed, and 85% tried breast-feeding in the hospital. A total of 97% (56 of 58) of those who intended to breast-feed tried breast-feeding in the hospital compared with 40% (4 of 10) of those who did not intend to breast-feed (P < .0001). At 2 weeks postpartum, 58% of the participants were still breast-feeding. Of those participants who intended to breast-feed, 67% (39 of 58) were breast-feeding at 2 weeks postpartum compared with 10% (1 of 10) who did not intend to breast-feed (P = .001). The mean breast-feeding attitude score was 53.7 +/- 11.6 (range, 25 to 72). The mean breast-feeding attitude score was higher for those who intended to breast-feed than for those who intended to formula-feed (P = .009), but the score was not associated with breast-feeding in the hospital or at 2 weeks postpartum.

CONCLUSION:

Adolescent mothers were predominantly in ego stages 4 and 5, the conformist level. Because ego development was not associated with outcome measures in this study, ego development may not be a crucial factor when designing interventions to facilitate breast-feeding among adolescents. Attitudes toward breast-feeding were associated with the intention to breast-feed but not behaviors; the intention to breast-feed was significantly associated with breast-feeding behaviors.

PMID:
10326193
[Indexed for MEDLINE]

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