Background While appropriate care for children is essential for optimal growth and protection against child morbidity and mortality, teenage mothers have been shown to deviate from the recommended childcare practices. This study explored the childcare practices among teenage mothers in Ghana using Ecological Systems Theory by Bronfenbrenner as a theoretical framework. Methods Employing qualitative approach to inquiry, evidence was drawn from 30 teenage mothers using in-depth interviews. The data were analysed and presented following systematic qualitative-oriented text analysis strategy with verbatim quotes from study participants to support the emergent themes. Results It was evident that teenage mothers have limited skills in childcare practices and often resorted to practices with potentially adverse health outcomes for their children. They, for instance, applied hot towels they had heated with hot stones to the children’s umbilical stump. We found that teenage mothers were not in sync with their macro- and exo-systems, thereby depriving themselves and their babies of the much-needed guidance and support in caring for their babies. Teenage mothers were often confused and sometimes clueless about best childcare practices at a given point in time. Conclusions Childcare practices by teenage mothers are far from the ideal. To improve on child health (especially children born to teenage mothers), efforts at both the macro- and exo-systems should be directed at exposing teenage mothers to best child care practices that inure to the benefits of their children. Ante- and postnatal visits should be used to provide specific education for mothers, especially first-time teenage mothers on the care needs of babies and how to provide these needs.