Factors Influencing the Infant Feeding Decision for Socioeconomically Deprived Pregnant Teenagers: The Moral Dimension

Authors

  • Lisa Dyson BA, MSc,

    1. Lisa Dyson is a Research Fellow, Josephine M. Green is Deputy Director, and Mary J. Renfrew is Director at the Mother and Infant Research Unit, University of York, Heslington, York; Brian McMillan is a Visiting Research Fellow, Institute of Psychological Sciences, University of Leeds; and Mike Woolridge is a Senior Lecturer in Infant Feeding at the School of Healthcare, University of Leeds, Leeds, UK.
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  • Josephine M. Green BA, CPsychol, PhD,

    1. Lisa Dyson is a Research Fellow, Josephine M. Green is Deputy Director, and Mary J. Renfrew is Director at the Mother and Infant Research Unit, University of York, Heslington, York; Brian McMillan is a Visiting Research Fellow, Institute of Psychological Sciences, University of Leeds; and Mike Woolridge is a Senior Lecturer in Infant Feeding at the School of Healthcare, University of Leeds, Leeds, UK.
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  • Mary J. Renfrew BSc, SCM, PhD,

    1. Lisa Dyson is a Research Fellow, Josephine M. Green is Deputy Director, and Mary J. Renfrew is Director at the Mother and Infant Research Unit, University of York, Heslington, York; Brian McMillan is a Visiting Research Fellow, Institute of Psychological Sciences, University of Leeds; and Mike Woolridge is a Senior Lecturer in Infant Feeding at the School of Healthcare, University of Leeds, Leeds, UK.
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  • Brian McMillan BSSc, PhD,

    1. Lisa Dyson is a Research Fellow, Josephine M. Green is Deputy Director, and Mary J. Renfrew is Director at the Mother and Infant Research Unit, University of York, Heslington, York; Brian McMillan is a Visiting Research Fellow, Institute of Psychological Sciences, University of Leeds; and Mike Woolridge is a Senior Lecturer in Infant Feeding at the School of Healthcare, University of Leeds, Leeds, UK.
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  • Mike Woolridge BSc, DPhil

    1. Lisa Dyson is a Research Fellow, Josephine M. Green is Deputy Director, and Mary J. Renfrew is Director at the Mother and Infant Research Unit, University of York, Heslington, York; Brian McMillan is a Visiting Research Fellow, Institute of Psychological Sciences, University of Leeds; and Mike Woolridge is a Senior Lecturer in Infant Feeding at the School of Healthcare, University of Leeds, Leeds, UK.
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  • The research project underpinning this manuscript was “The LIFT Project—Looking at Infant Feeding Today: reducing inequalities in health among socio-economically disadvantaged and ethnic groups by increasing breastfeeding uptake: an examination of intentions and outcomes.” The LIFT study was conducted by the Mother and Infant Research Unit, formerly at the University of Leeds, Leeds, United Kingdom. This project was funded by the Policy Research Programme, Department of Health, London, England, from November 1, 1999, to October 31, 2002. This paper does not represent the views of the Department of Health.

Address correspondence to Lisa Dyson, York Trials Unit, Department of Health Sciences, Lower Ground Floor, ARRC Building, University of York, Heslington, York YO10 5DD, UK.

Abstract

Abstract:  Background: The importance of breastfeeding-related health outcomes in reducing inequalities in health has been recognized as a National Health Service target to increase initiation rates especially among disadvantaged groups in England. This study examined the psychosocial factors influencing infant feeding intention among pregnant teenagers expecting their first baby and living in deprived urban areas in England.

Methods: A mixed methods study, using a quantitative questionnaire based on the Theory of Planned Behaviour, was conducted in four English regions with predominantly white and Asian teenagers (n = 71). This method identified which of all known Theory of Planned Behaviour variables were the most important in influencing feeding intentions. Focus groups provided contextual insight into the meaning of these variables for white pregnant teenagers living in a northern English inner city (n = 17).

Results: Moral norms were identified as the most predictive variable influencing teenage intention to formula feed or breastfeed. The likelihood that breastfeeding “will be embarrassing” was the only attitudinal belief rated as significantly important in influencing teenage intention to breastfeed. Three overarching themes emerged from the focus group data: “moral norms,”“sexuality of the breast,” and “self-esteem,” with concerns relating to breastfeeding in public cutting across all themes.

Conclusions: Breastfeeding was viewed as a morally inappropriate behavior by most of these teenagers, with formula feeding being perceived as the appropriate behavior. Existing breastfeeding promotion activities are likely to continue to fail to reach teenagers experiencing deprivation in England in the absence of effective strategies to change the underlying negative moral norms toward breastfeeding. (BIRTH 37:2 June 2010)

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