Feeding Connections: Predictors of Breastfeeding Success for Adolescent Mothers [ID 1375]

INTRODUCTION: Adolescents face barriers to successful breastfeeding, including increased risks of prematurity, low birth weight, social stigma, and inadequate structural support. We examine factors influencing breastfeeding initiation before hospital discharge and predictors of continuation postpartum. METHODS: Retrospective cohort study of patients delivering at a single health system from May 1, 2013, to April 30, 2023. Participants included those who delivered after 20 weeks and were 10–17 years old. Sociodemographic and clinical variables were collected from electronic medical records. Patients with intrauterine/neonatal demise or missing breastfeeding data were excluded. Primary analysis focused on breastfeeding at discharge (BFaDC). Secondary analysis assessed breastfeeding continuation at the postpartum visit (PPV). Bivariate statistics compared group characteristics, and regression analysis identified predictors of BFaDC and breastfeeding continuation postpartum. RESULTS: Of 455 patients, 351 (77.1%) were BFaDC. Breastfeeding at discharge was more frequent among Latinx patients and those delivering vaginally, and less common among Black individuals, those delivering preterm, by cesarean, and with preterm prelabor rupture of membranes (all P <.05). In regression models, Latinx ethnicity (adjusted relative risk [aRR] 3.21; 95% CI, 1.47, 6.99) and cesarean delivery (aRR 0.48; 95% CI, 0.27, 0.87) remained associated with BFaDC. Of 204 who attended their PPV, 157 (77.0%) were BFaDC. Of 156 patients with breastfeeding data, 90 (57.7%) were still breastfeeding at PPV. Race/ethnicity, preeclampsia, endometritis, and lactation support held associations with breastfeeding continuation. In regression models, self-identified “other” race (aRR 0.06; 95% CI, 0.003, 0.91), and inpatient lactation consultation (aRR 4.14; 95% CI, 1.12, 15.3) remained significantly associated with breastfeeding continuation at PPV. CONCLUSIONS/IMPLICATIONS: Breastfeeding outcomes are significantly influenced by race/ethnicity, delivery route, and postpartum lactation support. Targeted interventions and clear recommendations may improve breastfeeding rates for this high-risk group.