The advantages of exclusive breastfeeding for the first 6 months are well-known.Unfortunately, adolescent mothers have lower rates of breastfeeding exclusivity and shorter duration of breastfeeding. There is limited evidence regarding exclusive breastfeeding determinants in adolescent mothers. The purpose of this study was to obtain adolescent mother-generated factors related to exclusive breastfeeding at 6 months. A mixed-methods design was conducted through concept mapping. Thirty adolescent mothers aged 15-19 years who had wide range of exclusive breastfeeding experiences brainstormed about specific factors. They then sorted and rated the statements into key clusters. Finally, half of the participants were involved in the interpretation of the mapping results and the creation of pathway diagrams. Data were analysed by multivariate statistics in the Concept System Global MAX program. The results showed that the adolescent mothers brainstormed about 104 statements on the factors related to exclusive breastfeeding at 6 months. These factors can be categorized into the following six key clusters: (a) breastfeeding advantages; (b) facilitating factors and necessary skills; (c) promotion and support needed; (d) community and social influence; (e) internal and external barriers; and (f) key problems in families. The pattern matching provided understanding of how key clusters are important to successful breastfeeding through comparing three groups of exclusive breastfeeding durations. Finally, the relationships of the stated factors were drawn in pathway diagrams. Exclusive breastfeeding experiences among Thai adolescent mothers showed complexity involving multilevel influences of social systems. The promotion of optimal breastfeeding should recognize the influences of both personal and environmental factors.

Prematurity and the associated maternal-infant separation after birth can affect the attachment process. The role of nurses in facilitating the process of attachment should be based on an understanding of these behaviors. This descriptive study explored the attachment behaviors demonstrated by mothers during their first visit with their premature infant in the neonatal care unit. The results revealed that all mothers demonstrated most attachment behaviors (ie, inspection, facial expression, touching, verbal expression, and eye-to-eye contact) except holding during their first visit. However, some mothers spent little time with their infant. The findings suggest that nurses should encourage mothers to interact with their infants in order to enhance maternal-infant attachment.

The Self-Efficacy in Infant Care Scale (SICS) is a self-administered measure to assess maternal judgments about the ability to care for the baby during the first year of life. The SICS was initially composed of 67 items and was tested on 397 Thai mothers with infants < 12 months old. The test demonstrated adequate internal consistency and test-retest reliability. Factor analysis yielded 42 items with five dimensions of self-efficacy in infant care. With an acceptable model fit using confirmatory factor analysis, a final version of the SICS contained 40 items with four dimensions of self-efficacy in infant care: developmental promotion, general health care, safety, and diet. This preliminary test for the psychometric properties revealed that the SICS has potential uses for both research and clinical purposes. However, the model selected must be viewed as tentative; further refinement is suggested.