Content Analysis: Media Representation of Infant-Feeding Practices of Adolescent Mothers

Background: The American Academy of Pediatrics considers breastfeeding to be the optimal form of infant nutrition ^1,2 and Healthy People 2020 objectives target increasing breastfeeding rates ³. Though national rates have improved, those among several subgroups have not. Adolescent mothers initiate breastfeeding only 58% of the time, which is lower than the national objective of 81.9%³. Research focusing on other health behaviors indicates that media may play an important role in developing these behaviors in adolescents. However, knowledge of media-influences on infant-feeding decisions and attitudes among adolescents is insufficient.

Objective: The objective of this study was to assess the presentation of infant-feeding mode in a reality television program through the constructs of the Theory of Planned Behavior. Methods: This was a qualitative study, using content analysis methodology to evaluate infant-feeding content of a reality television program that follows adolescents from late pregnancy through the first months of parenthood. The first two seasons of the program were coded for infant-feeding content, using constructs of the Theory of Planned Behavior (TPB). Content was then divided into percent contribution from each of the TPB domains. Short vignettes were created describing how the relative weight of the three TPB domains may have influenced the infant feeding decision and been portrayed to the audience. Results: Eleven episodes of the program were transcribed and coded to determine the presentation of infant-feeding content. Only 4% of episode content was related to infant-feeding concepts with the majority showing bottle-feeding (73%), and the remainder showing infant-feeding equipment (21%), and breastfeeding (6%). Verbal infant-feeding content, coded by TPB domain, showed that Control Beliefs were the most frequently expressed domain. Conclusions: Content analysis of a reality television program appears to portray infant-feeding as a minor component in the lives of these adolescent mothers. Further, framing infant-feeding conversations in terms of TPB domains appears to indicate a great deal of desire for control by adolescent mothers. In the context of existing infant-feeding literature, these findings reveal important gaps in accuracy of infant-feeding behaviors such as the time-commitment, duration of breastfeeding, and overall issues related to breastfeeding behaviors.