Literature Collection

BACKGROUND: Breastfeeding has a positive impact on child and maternal health outcomes. Black and Latina women and adolescent mothers have lower rates of breastfeeding initiation and continuance in the U.S. Maternal depression and psychosocial stressors may contribute to reduced rates of breastfeeding. The current study aims to better understand behaviours and associated factors related to breastfeeding in a diverse group of adolescent mothers attending a teen-tot clinic for postpartum and infant well care. METHODS: Participants were 191 mother-infant dyads. Mother's age ranged from 13 to 25, and 54% of mothers identified as Latina, 22% Black, 11% more than one race and 5% white. Demographic information and breastfeeding behaviour were abstracted from the medical record. Rates of postpartum mood/anxiety symptoms and psychosocial stressors were obtained from screening measures completed at medical visits. RESULTS: Analyses revealed that 87% of adolescent mothers in the sample initiated breastfeeding at birth and the racial/ethnic breakdown of those mothers closely mirrored the overall population (58% Hispanic or Latina, 17% Black, 10% more than one race, 5% white). At 2 months postpartum, only 41% of the population was still breastfeeding. Mothers with significant mood/anxiety symptoms at the newborn visit were more likely to be breastfeeding at the 1- and 2-month visits. Mothers with psychosocial stressors at the newborn visit were less likely to be breastfeeding at the 1- and 2-month visits. CONCLUSION: Efforts to promote health equity through breastfeeding for at-risk mothers must occur within the first few weeks postpartum and must consider associated factors including postpartum mood/anxiety symptoms and psychosocial stressors.

Maternal mental health during pregnancy interacts with substance use, exacerbating risks for adverse developmental outcomes in offspring. This review synthesizes evidence on the prevalence and co-occurrence of prenatal mental health and substance use, mechanisms linking the two, consequences for maternal and child health, screening and treatment strategies, and system-level policy implications. Key themes include the high prevalence of perinatal mood and anxiety disorders, elevated rates of substance use among pregnant women with mental illness, synergistic effects of combined exposures on developmental outcomes, and substantial barriers to appropriate treatment. Effective practices emphasize universal screening, trauma-informed and nonpunitive approaches, and integrated behavioral health and substance use treatment in perinatal settings. Future research should identify causal pathways from prenatal risk to child outcomes using longitudinal designs with diverse samples, examine culturally responsive interventions to mitigate disparities, and should test scalable models that provide both mental health and substance use services in perinatal care.