Nineteen-year-old Ashley wasn’t exactly ready to be a parent. She didn’t even get a full nine months to prepare, since her daughter was born nine weeks early. Ashley agonized over whether or not to keep her baby. Her boyfriend was against adoption. Ashley herself had been adopted, and she ultimately decided she couldn’t put her daughter through that. She also decided to give breastfeeding a try, visiting the hospital multiple times a day to pump breast milk.
Ashley, a lanky African-American girl with tightly cropped curly hair, says it was difficult to pump enough milk while her preemie daughter was in the hospital. Ashley developed a fever and backache from engorgement (when your breasts get full of milk and become extremely swollen, hard and heavy). She was in terrible pain, and even though her boyfriend wanted her to keep pumping he didn’t want to see her hurting. She had to stop breastfeeding.
“The only guilt I feel is that she’s so small, that she might be bigger now if I kept breastfeeding,” Ashley said.
For those who have never pumped breast milk full time, just know that it can be overwhelming. Pumps are not as effective or efficient as babies at emptying milk out of breasts; and being stressed can hinder the milk-ejection reflex. If your breasts are engorged for too long, they can become infected—known as mastitis—or even develop an abscess. And with infection comes a fever.
Her gynecologist was the one who initially encouraged her to breastfeed, but Ashley feels she wasn’t prepared enough for such painful potential side effects. Her boyfriend comes from a big family where everyone breastfeeds without any issues, so Ashley had trouble explaining how much discomfort it caused her.
“They’re all tiny little women—they don’t know what I went through,” said Ashley.
Now a full-time student at Northern Virginia Community College studying mass communications, Ashley says using formula does make it easier for her boyfriend to care for her baby while she goes to class. Her daughter is 4 months old now—sound asleep on a fuzzy blanket on the floor of a ranch house with a white picket fence in a quiet south Arlington neighborhood. The delicate little girl is wearing the tiniest pair of jeans ever.
This is the residence where Borromeo Housing, Inc. ensures that teens and their children have a safe place to call home. Two nights a week, teen moms convene here to discuss hardships, offer support, learn about parenting, and share a meal. Tonight’s topic: breastfeeding.
By the time their babies are a year old, a mere 2.5 percent of teen moms are still breastfeeding, as opposed to nearly a quarter of older moms. Only 43 percent of teen moms have ever breastfed their baby, compared with three quarters of older moms. Since 2000, the rate of moms under age 20 who have ever breastfed their baby has decreased by nearly 9 percent. In the last decade, formula use by teen moms within the first two days of life and before age 6 months have both increased 10 percent.
Three overarching themes emerged when British researchers compiled input on the factors that impact infant feeding decisions of teens: moral norms, sexuality of the breast, and self-esteem, with concerns related to breastfeeding in public cutting across all themes.The likelihood that breastfeeding would be embarrassing or feel inappropriate may simply be too much for a teen's fragile self-esteem.
Also at Borromeo tonight is 19-year-old Andrea. The small, confident Hispanic girl with a glowing smile cradles her lightly sleeping chubby-cheeked 2-month-old daughter in her arms. Andrea breastfeeds her baby, and says she plans to continue until her daughter is 1 year old. She is no longer in a relationship with her baby’s father, but he is a part of their life. When he’s around and Andrea breastfeeds in public, he tells her to cover up.
“I don’t see what the big deal is. Everyone has seen breasts before,” Andrea says.
And while Ashley has to defend her formula use to her baby’s father’s family, Andrea has to defend her breastfeeding. When her former boyfriend brought his mom to the hospital after the baby was born, she became convinced Andrea wasn’t producing enough milk because the baby was crying. She even went and tracked down a nurse to come in and try to convince Andrea of the benefits of formula feeding.
Andrea is a senior at a high school for teen moms that is part of Arlington’s Teenage Parenting Program. Her daughter is in the nursery downstairs at her school, and they call her throughout the school day to come breastfeed whenever her baby is hungry. She says very few of the girls at her school breastfeed their babies, because they don’t realize how important it is.
Exclusive breastfeeding of infants is recommended until 6 months old, and continuing after the introduction of solid foods to 2 years old or beyond. Breastfed babies experience fewer ear infections, gastrointestinal illnesses, and upper respiratory infections. In the long term, breastfeeding decreases the risk of diabetes, asthma, obesity, and certain types of childhood cancers. In mothers, breastfeeding reduces the risk of breast, ovarian, endometrial, and uterine cancers; protects against rheumatoid arthritis, osteoporosis, and Type 2 diabetes; and helps moms lose weight more easily.
Nancy Williams has been a lactation consultant and prenatal educator since 1978. She co-authored Teens and Breastfeeding, a La Leche League publication aimed at educating lactation consultants about how best to support this struggling subgroup.
“Many adults in her life think she ought to be working after school to support her baby,” said Williams. “Then you add … doctor appointments, baby care when she does get home, homework, and the normal desire for a social life, and how can we expect her to breastfeed?”
The most likely portion of the population to breastfeed are educated, economically advantaged white adult women. The least likely to breastfeed are low-income minorities and teens; and unfortunately the birthrate for black and Hispanic teenagers is more than twice that of white teenagers.
Affectionately known as “Miss Ronnie,” Veronica Cross is the child development coordinator at Borromeo. A petite, energetic, and opinionated black woman, she informs the girls that a breastfeeding quiz will follow tonight’s discussion. She says she “likes to piggyback” on every topic. She’s not kidding. There will be a quiz. Miss Ronnie educates each new group of girls about breastfeeding, but says she sees fewer and fewer teens breastfeeding every year.
“They don’t understand the differences between breast milk and formula. They think as long as their baby’s getting milk, what’s the big deal?” Cross said.
Resources are partly to blame, as they used to have a nurse come in and talk to the young moms exclusively about breastfeeding. Williams thinks encouraging teen breastfeeding may be less about health-care providers and more about peers. What she has seen to be most powerful is a breastfeeding teen who demonstrates leadership qualities.
To their fellow teen moms out there, Andrea and Ashley have some advice about breastfeeding: Don’t be embarrassed; be prepared to leak—a lot (especially at night); it might hurt at first, but it will get better; and do more research.