Despite substantial evidence of maternal and infant benefits of breastfeeding, adolescent mothers initiate breastfeeding less often and maintain breastfeeding for shorter durations when compared to their adult counterparts. A randomized controlled trial drawing on the theory of planned behavior and developmental theory was conducted to determine if an education and counseling intervention provided by a lactation consultant-peer counselor team increased breastfeeding initiation and duration up to 6 months postpartum among adolescent mothers. Study participants ( N = 289) enrolled from multiple prenatal clinic and school settings, were 15 to 18 years old, and predominately African American, single, and primiparous. The intervention, which started in the second trimester of pregnancy and extended through 4 weeks postpartum, positively influenced breastfeeding duration (p < .001) within the experimental group, but not breastfeeding initiation or exclusive breastfeeding rates. This education/support intervention was partially effective in enhancing breastfeeding outcomes. Implications for research and practice are described.

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Causal modeling was used to test the hypotheses of the theory of planned behavior for the prediction of prenatal breastfeeding intentions and postpartum breastfeeding outcomes with 135 childbearing women. In support of the theory, prenatal breastfeeding attitudes and perceived behavioral control predicted breastfeeding intentions (R2 = 23); however, the subjective norm variable failed to meet statistical criteria for model entry. Breastfeeding intentions weakly predicted duration of breastfeeding up to 6 weeks postpartum (R2 = .04). No additional empirically suggested prenatal and postpartum variables increased the explanatory power of the model in predicting breastfeeding intentions and duration. Implications for practice and research are discussed.

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This pilot study documented maternal fatigue levels and patterns among breastfeeding primiparae; relationships between maternal fatigue and select physiological, psychological, situational, and performance factors; and fatigue interference with activities of daily living. A convenience sample of 41 mothers completed self-report instruments measuring breastfeeding experiences, fatigue, sleep characteristics, perceived stress, depression, and infant temperament at 3 days, 3, 6, and 9 weeks postpartum. Positive moderate relationships were detected at all four times for: breastfeeding problem severity (r = .38-.66, p < .05), depression (r = .45-.71, p < .01), and perceived stress (r = .36-.70, p < .05). Maternal sleep disturbance (r = .40-.54, p < .05) and/or effectiveness (r = -.33-.45, p < .05) correlated with fatigue at each time period. Infant difficulty was positively and mildly related to fatigue at 6 and 9 weeks (r = .32-.43, p < .05). Maternal age correlated positively and moderately to fatigue (r = .31-.50, p < .05). Finally, the impact of fatigue on activities of daily living and maternal role activities was low and nonsignificant. Results suggest fatigue is moderately significant to breastfeeding primiparae in the early to late postpartum period.