Wulan Wijaya | Breastfeeding Problems in Teenage Mothers : A Scoping Review Journal Educational of Nursing (JEN) Vol. 9 No. 1 January Ae June 2026. page 45-62 p-ISSN : 2655-2418. e-ISSN : 2655-7630 journal homepage: https://ejournal. DOI: https://doi. org/10. 37430/jen. Article history: Received: December 16th 2025 Revised: December 17th 2025 Accepted: December 22th 2025 BREASTFEEDING PROBLEMS IN TEENAGE MOTHERS: A SCOPING REVIEW Wulan Wijaya1. Ina Sugiharti2. Linda Listriyati3 Bhakti Kencana University E-mail: wulan. wijaya@bku. Abstract Breastfeeding practices among adolescent mothers are among the lowest globally, despite the increasing proportion of adolescent mothers. Adolescent pregnancies . etween the ages of 10 and . account for 10% of all annual maternal deaths and higher rates of infant mortality and In low- and middle-income countries, breastfeeding is estimated to prevent approximately 13% of all deaths of children under five. Exclusive breastfeeding (EBF) has been shown to provide benefits for both mothers and babies. The purpose of this study was to examine breastfeeding issues among adolescent mothers. This scoping review research method consists of several steps, namely identifying questions about breastfeeding problems in adolescent mothers. Next, researchers conducted screening using inclusion criteria such as articles published between 2013 and 2023. articles in English and Indonesian. fully accessible articles, peer-reviewed articles, primary research, systematic reviews, scoping reviews, literature reviews, exclusion criteria such as opinion articles, blogspots, then researchers selected/selected literature that met the predetermined criteria and classified them into a flowchart. Then, data mapping, summarizing, and reporting the results based on the title, author, year, research objectives, type of research, and After selecting the literature, 19 articles were found. Of the 19 articles, 3 themes were found, namely low education levels, lack of maternal knowledge about breastfeeding, and lack of support for breastfeeding mothers. Conclusion: Breastfeeding problems in adolescent mothers are very diverse, such as low education levels, lack of knowledge about breastfeeding, and lack of support for breastfeeding mothers. Many adolescent mothers want to breastfeed their babies, but due to several obstacles such as lack of knowledge about breastfeeding, low education levels, and lack of breastfeeding support, so that the achievement of breastfeeding for adolescent mothers is not optimal. The problems faced by adolescent mothers are very diverse. The findings of this study can be used as a basis or input for other researchers to study more deeply other problems related to breastfeeding among adolescent mothers. Keywords: Breastfeeding Problems. Teenage Mother Problems. Breastfeeding Mothers INTRODUCTION The World Health Organization (WHO) recommends that breastfeeding should begin in the delivery room within the first hour of life, followed by exclusive breastfeeding (EBF) for the first 6 months of life, and thereafter . The first 1,000 days of life, the period from conception to a child's second birthday, are widely recognized as a critical window of opportunity for optimal child development . Exclusive breastfeeding (EBF) has been shown to benefit both mothers and infants. Such as increasing the baby's immune system, creating boundaries or closeness between mother and baby. Breastfeeding rates among adolescent mothers are among the lowest globally, despite an increasing proportion of adolescent Adolescent pregnancies . etween the ages of 10 and . account for 10% of all annual maternal deaths and higher rates of infant mortality and morbidity . In lowand middle-income countries, breastfeeding is estimated to prevent approximately 13% of all deaths of children under five. Several beneficial effects of EBF have been Journal Educational of Nursing (JEN) Vol. 9 No. Wulan Wijaya | Breastfeeding Problems in Teenage Mothers : A Scoping Review documented worldwide, s such as reduced postnatal mortality and sudden infant death syndrome (SIDS), reduced risk of childhood infections, and reduced risk of diabetes . Breastfeeding can reduce the likelihood of developing postpartum depressive symptoms . Although there is currently limited data on school dropout rates related to teenage pregnancy, approximately 36% of girls drop out of school due to pregnancy . Key reports on teenage pregnancy highlight that those who become pregnant during adolescence . -16 year. are less likely to return to school and have poorer academic performance compared to those who become pregnant during older adolescence . -19 So this makes teenage mothers have low levels of education where teenage mothers are required to be mothers for their babies . , . EBF practices among teenage Exclusive breastfeeding rates for infants under six months of age are reported to be 20% in Central and Eastern European countries and 44% in South Asia . However, only half of neonates . he first 30 days of lif. and 30% of infants aged 1-5 months are exclusively breastfed globally . Factors associated with low rates of breastfeeding among adolescents are not well understood. One study identified teenage pregnancy as a factor in discontinuing EBF. The duration of breastfeeding among adolescent mothers may characteristics such as education level and multiple births. One study noted that previous pregnancies were associated with a higher likelihood of choosing to breastfeed among adolescent mothers . This scoping review aims to better understand the challenges faced by adolescent breastfeeding mothers. The aim of this study was to identify breastfeeding challenges experienced by adolescent METHOD The methodological framework used by the researcher in this study is supported and upheld by proponents of scoping, who state that all methods used are phased and conducted with rigorous and transparent This study follows a scoping review methodology. In this process, the researcher began a three-month literature search (August-October 2. The literature search was based on predetermined criteria. The researcher then documented the findings in detail, enabling the study to be replicated by other researchers. This explicit approach can enhance the findings, ensuring that this study does not introduce methodological errors . The adopted method serves as a guideline for identifying literature in a scoping review to achieve in-depth and comprehensive results. The scoping review method is used to identify all relevant In this study, the researcher aims to reidentify the literature search specifically and in-depth. The researcher's goal is to avoid placing overly narrow or narrow boundaries on the literature search, identification of relevant studies, or initial selection. The following are the stages of the adopted methodological framework for conducting the literature review: Step 1: Identifying the scoping review question. Step 2: Identifying relevant literature sources. Step 3: Selecting Step 4: Data mapping. Step 5: Compiling, summarizing, and reporting the Step 1: Identifying the Scoping Review Question The starting point for identifying the research question to be addressed is based on the literature search guide. Therefore, it is crucial to identify aspects of the research question, such as the study population, intervention, or outcome. Researchers use the Population. Exposure. Outcome, or Theme (POE) framework to formulate research questions and can also be used in a literature This step aims to identify concepts and key elements for effective or relevant The research question for this scoping review is: What does the scoping review reveal about breastfeeding issues among adolescent mothers? Table 1. Framework PEO Journal Educational of Nursing (JEN) Vol. 9 No. Wulan Wijaya | Breastfeeding Problems in Teenage Mothers : A Scoping Review Populasi Breastfeeding mothers of teenagers Eksposure Breastfeeding Step Identifying Relevant Literature Sources Identifying relevant literature sources is Table 2. Inclusion and Exclusion Criteria Inclusion Criteria Articles published from 2013-2023 Articles published in English and Indonesian Articles discussing breastfeeding experiences during the Covid-19 pandemic Articles discussing factors that influence exclusive breastfeeding during the Covid-19 Fully accessible articles, peer reviewed articles, primary research, systematic reviews, scooping reviews, literature reviews The article search used databases such as Pubmed. Google Scholar, and Science Direct. The keywords used in the scoping review research literature search were Breastfeeding Mother OR Mother Breastfeeding OR Outcome Problem done after identifying the scoping review question and meeting the inclusion and exclusion criteria. Exclusion Criteria Opinion articles Blogspot Articles that do not discuss breastfeeding experiences during the Covid-19 pandemic Articles that do not discuss factors influencing exclusive breastfeeding during the COVID-19 pandemic. Breastfeeding Women Female Breastfeeding, mother, breastfeeding teen mother. Exclusive breastfeeding OR successful exclusive Step 3. Literature Selection Articles found in searches: Pubmed: . Science Direct: . Google Scholar: . Duplicate articles removed: n=230 Articles were screened using the title: n=270 Articles irrelevant to the title: n= Articles with relevant full text: n= Excluded articles: 71 with exclusion reasons: 27 inappropriate results 44 articles with inappropriate populations Articles eligible for use: n=19 Figure 1. Prisma Flowchart Based on the Prisma Flowchart, 500 articles were imported into Zotero for After that, 19 articles were selected for use, obtained through article To assess the articles, critical appraisal was performed. Step 4: Data Charting Journal Educational of Nursing (JEN) Vol. 9 No. Wulan Wijaya | Breastfeeding Problems in Teenage Mothers : A Scoping Review Country Table 4. Data Charting Aim Type Research to seek scientific Systematic breastfeeding and bottle-feeding and malocclusion in the mixed and Title/Author/Year Breastfeeding. Brazil bottle feeding and systematic review . (Abreu et al,. Time trends and Nigeria young women in Nigeria, 2003Ae2018 . (Benova et al. key quantitative Nigeria over a 15year young women. Counselling Brazil sessions increased randomized clinical adolescent mothers and grandmothers . to evaluate the quantitative mothers and their duration of EBF. Journal Educational of Nursing (JEN) Vol. 9 No. Result Children with mixed dentition who were breastfed for more average mandibular and maxillary incisor inclination compared to children who were breastfed for less than 6 months or bottle-fed . <0. Teenage rates for three of the six key breastfeeding initiation, exclusive breastfeeding for <6 months, and no prelactational feeding. Compared teenage mothers had a higher prevalence breastfeeding at 1 and 2 years of age. analysis, we found that maternal age associated with early breastfeeding for <6 The duration of EBF by 67 days for the group that excluded grandmothers (HR = 95% CI = 0. and by 46 days for the group that Wulan Wijaya | Breastfeeding Problems in Teenage Mothers : A Scoping Review Title/Author/Year Country Aim (Dias de Oliveira et , 2. The midwife-oriented counseling on selfefficacy adolescent mothers: a clinical trial study . (Fahim et al. , 2. Iran To determine the counseling based on the Ready Set Baby (RSB) breastfeeding selfefficacy Factors Associated with Adherence to Exclusive Breastfeeding. (Fereira et al. Brazil To verify the between maternal breastfeeding in a outpatient clinic in the state of Ceary. Brazil. Journal Educational of Nursing (JEN) Vol. 9 No. Type Of Result Research grandmothers (HR = 95% CI = 0. Counseling sessions during the first four months of a child's life were duration of EBF in adolescent mothers. quantitative After performance scores were measured and confounding factors. The mean scores for self-efficacy 03. (P<0. , with an effect size of 0. [MD=16. CI: 5. 34,26. ], and the mean scores for 30. (P<0. , with an effect size of 1. [MD=2. % CI: 11,3. ] in the quantitative Most women were young, had partners, had attended six or fewer antenatal care visits at a health There was a association between breastfeeding, which Wulan Wijaya | Breastfeeding Problems in Teenage Mothers : A Scoping Review Title/Author/Year Country Associations Amerika breastfeeding with Serikat bulimic behaviors and eating disorders among adolescents . (Iron-Segev et al. The Association Breastfeeding Duration and Lipid Profile Children Adolescents . (Li et al. , 2. Association Turki between postpartum social support level China Aim Type Of Result Research against this practice. Most mothers who exclusively breastfed their prenatal visits, presence of other supporting exclusive quantitative There association between eating, and selfreported history of To use a life course framework to examine the duration and the risk of developing bulimic behavior or a diagnosed eating disorder. To investigate the quantitative duration and lipid cross-sectional conducted, and a 12,110 Chinese adolescents aged 5-19 years. to determine the quantitative between the level self-efficacy Journal Educational of Nursing (JEN) Vol. 9 No. With magnitude of the association between 390, 4. , 1. CI: -3. 709, -0. % CI: 2. mg/dL, and 0. % CI: -0. 129, 0. , respectively, compared to those The associated risk of high TC decreased by 43% . OR: 0. 95% CI: 0. The mean age of the 61A5. (Min: Max: . , and Wulan Wijaya | Breastfeeding Problems in Teenage Mothers : A Scoping Review Title/Author/Year Country Aim and breastfeeding breastfeeding selfefficacy in early postpartum women . (Mercan and Tari Selcuk, 2. for breastfeeding mothers and the depression, level of social support, and breastfeeding attitudes in the early postpartum Factors associated Brazil breastfeeding for 6, 12, and 24 months mothers . (Muelbert Giugliani, 2. The aim of this study was to breastfeeding for at least 6, 12, and 24 months in Factors related to Thailand Thai mothers: Concept mapping approach . (Nuampa et al. to determine the factors produced mothers that are breastfeeding at the age of 6 The through concept Journal Educational of Nursing (JEN) Vol. 9 No. Type Of Result Research obtained from the BSES-SF 13A8. Statistically detected between the BSES-SF scores of the participants and their age groups, employment status, level, and number of (P<0. quantitative Other maintenance at only assessed: 6 months, maternal skin color . lack/brow. daughter and her paternal age and quantitative The results of the study showed that factors related to breastfeeding at 6 These factors can be categorized into the following six main groups: . benefits of breastfeeding. and necessary skills. promotion and support needed. Wulan Wijaya | Breastfeeding Problems in Teenage Mothers : A Scoping Review Title/Author/Year Country Aim Breastfeeding Amerika mixed Serikat feeding and health risk in Costa Rican (Nunez-Rivas et al. To examine the risk, body fat, physical activity in children and What does a doctor Brazil need to know about breastfeeding and adolescent health and pregnancy? . (Nunes et al. , 2. to discuss the current scientific evidence on the benefits of BF on women's health, as well as specific women's health that contraindicate BF, whose use is prohibited during BF, concluding with an addressing of integral concerns Journal Educational of Nursing (JEN) Vol. 9 No. Type Of Result Research social influences. internal and external and . major problems in the family. quantitative The mean age was 4 A 2. 6 years, and 9% were male. middle class. were sedentary, and 16% were obese. Approximately 20% before 6 months of age, 13% were never breastfed, and more months or more. Children who were exclusively breastfed or combined with Ou6 months showed a lower percentage of obesity compared to children who were breastfed only or in Ou6 quantitative Adolescents subjects who have rights and respecting them is important to face the challenges health services. Wulan Wijaya | Breastfeeding Problems in Teenage Mothers : A Scoping Review Title/Author/Year Country Breastfeeding and Brazil behavior disorders among children and systematic review (Poton et al. , 2. Trends and Bangladesh Determinants EBF Adolescent Children Born to Adolescent Mothers Rural Bangladesh . (Rahma et al. Aim Type Of Result Research adolescent health and pregnancy. aims to assess the systematic available evidence review Association breastfeeding and understand quantitative EBF among adolescent mothers and their determinants in the Health and Demographic Surveillance System (HDSS) service area of the International Center Diarrheal Disease Research. Bangladesh . (ISA) (GSA) in rural Matlab. Bangladesh. Journal Educational of Nursing (JEN) Vol. 9 No. Eighteen studies met the inclusion criteria. Breastfeeding for a duration equal to or greater than three or four months appears conduct disorder and total behavior in its association with Only four conduct disorder in when an association was found, it was likely positive. The appears to be more exclusive or nonexclusive. trend toward lower EBF in ISA compared to GSA was observed in However, variables. EBF status in GSA was 15% lower than in ISA (HR: 0. 85, 95% CI: 72Ae0. Paternal education differed between the two In both study areas. EBF adolescent mothers was lower than the Wulan Wijaya | Breastfeeding Problems in Teenage Mothers : A Scoping Review Title/Author/Year Country Effect of Amerika on Serikat symptoms among young adult mother. (Spisma et al. To describe the breastfeeding and symptoms among mothers and to Breastfeeding prevalence . (Suarez Catelo et , 2. To determine the level of maternal knowledge about breastfeeding and the introduction of baby food at weeks 6 and 16, as well as at 6 Spanyol Aim Journal Educational of Nursing (JEN) Vol. 9 No. Type Of Result Research . % vs. 65%). quantitative Postpartum symptoms were not breastfeeding at 6 Early association between breastfeeding at 6 Among young mothers still breastfeeding at 6 who reported no early breastfeeding difficulties had the scores, and mothers who reported early difficulties had the highest depression scores at 6 months. quantitative This study involved women, of whom 4% intended to babies, but only beyond six months. Knowledge relatively consistent influence newborn making it a crucial factor to consider strategies aimed at Wulan Wijaya | Breastfeeding Problems in Teenage Mothers : A Scoping Review Title/Author/Year Association United Kingdom breastfeeding and cohort study . (Wang et al. , 2. To determine the breastfeeding and Breastfeeding during infancy and 16year follow-up of PROBIT cluster-randomized trial . (Yang et al. , 2. Adolescent girlsAo low-income South Africa . (Zweigenthal et al. United Kingdom Afrika Selatan adolescent girls' breastfeeding in two low-income peri-urban communities in South Africa. Country Aim Journal Educational of Nursing (JEN) Vol. 9 No. Type Of Result Research breastfeeding rates. quantitative The prevalence of decreased from 36% in children aged 1 year to 18% in children aged 10Ae17 Breastfeeding was not associated with current eczema. Compared children who had never been breastfed, the adjusted odds ratio for current eczema at all ages . % confidence interval 90Ae1. children who had been breastfed for 0Ae . 82Ae1. for 4Ae6 months, and 98 . 85Ae1. for for >6 months. RCT Children who were exclusively breastfed for 3 . ersus <. months had 3. % CI 0. higher verbal function, but no observed in other quantitative Participants arguments for and against breastfeeding and formula feeding, occurs soon after Despite the strong emphasis on education, exclusive breastfeeding is seen Wulan Wijaya | Breastfeeding Problems in Teenage Mothers : A Scoping Review Title/Author/Year Country Aim Results And Discussion Based on the characteristics of the articles obtained, 19 articles were suitable for use in this scoping review using the method with articles from developing countries, namely Brazil with 6 articles, the United Kingdom Type Of Result Research Congruent educational policies and infant feeding policies/guidelines must address the adolescent mothers. with 2 articles, the United States with 3 articles. Thailand with 1 article. Turkey with 1 article. Nigeria with 1 article. Iran with 1 article. China with 1 article. Spain with 1 article. Bangladesh with 1 article. South Africa with 1 article. Ar t icles by Co u nt r y 10% 10% 10% Turkey Brazil United Kingdom Amerika Serikat Thailand Turki Nigeria Iran Spanyol Bangladesh Afrika Selatan China Figure 1. Articles by Country Discussion The results of the review of 19 articles found 3 themes, namely low levels of education, lack of support for breastfeeding mothers and mothers' lack of knowledge about Low Education Research conducted in Brazil. Turkey. Thailand. China, and Spain . , . , . , . , . , . , . , . , . indicates that low education levels can impact adolescent mothers' knowledge about breastfeeding. This is evident in the findings that lack of breastfeeding experience and low education levels in primiparous adolescent mothers are associated with low self-efficacy, which can lead to mothers not breastfeeding their Low education levels are closely related to adolescent mothers' knowledge Especially during adolescence, when adolescents should still be searching for their identity or identifying their character, they are also expected to become mothers. Journal Educational of Nursing (JEN) Vol. 9 No. Wulan Wijaya | Breastfeeding Problems in Teenage Mothers : A Scoping Review primarily by providing breast milk or nursing their babies . Adolescent breastfeeding mothers are a vulnerable group in breastfeeding practices, especially if they have a low level of education. Education plays a crucial role in shaping knowledge, attitudes, and health behaviors, including decision-making regarding maternal and infant health. Low levels of education among adolescent breastfeeding mothers often result in a lack of knowledge about the importance of exclusive breastfeeding during the first six months of a baby's life. Adolescents with low levels of education tend to lack comprehensive health susceptible to myths, traditional beliefs, or This can lead to suboptimal introducing complementary foods too early, using formula without medical indications, or stopping breastfeeding early . Furthermore, limited education also impacts adolescent mothers' ability to techniques, such as proper positioning and Incorrect breastfeeding techniques can lead to various problems, including sore nipples, breast pain, engorgement, and the perception of insufficient milk These conditions can lower adolescent mothers' self-confidence and lead to failure in exclusive breastfeeding . Adolescent breastfeeding mothers with low levels of education also tend to have limited access to health services and evidence-based information. A lack of understanding of the importance of postpartum visits, lactation counseling, and infant growth monitoring prevents mothers from receiving optimal support during breastfeeding. However, support midwives, is crucial for improving breastfeeding success in adolescents. The long-term impact of low education among adolescent breastfeeding mothers is felt not only by the mothers but also by their babies. Babies who are not exclusively breastfed are at higher risk of Therefore, maternal education is a crucial determinant in efforts to improve maternal and child health. The role of midwives and other health workers is strategic in addressing this issue through ongoing health education, communication approaches appropriate to the age and level of understanding of adolescent mothers, and empowering mothers to make informed decisions Simple education, using visual media, and intensive support have proven effective in improving breastfeeding knowledge and skills among adolescent mothers with low levels of education. Mother's knowledge about breast milk Research conducted in the United Kingdom. Nigeria. Bangladesh, and South Africa by . , . , . , . , . , . indicates that breastfeeding mothers' knowledge about breastfeeding is lacking. This is evident in the findings that adolescent mothers lack experience in the new role of parenting and carrying out caregiving functions. Therefore, their decision to breastfeed is heavily influenced by family members. Many adolescent mothers lack knowledge about breastfeeding, which sometimes leads to Breastfeeding. The knowledge that mothers have is part of a belief of teenage mothers regarding the risk or non-risk of problems or diseases or health problems and their perception of understanding how to take action to avoid bad things that might happen to their baby's condition, so that it will influence their readiness to take action . The knowledge of adolescent mothers is closely related to how people learn something after sensing a particular Sensing occurs through the senses of sight, hearing, smell, taste, and touch. This is reinforced by the recommendation to breastfeed until six months of age, followed by supplementary feeding until Journal Educational of Nursing (JEN) Vol. 9 No. Wulan Wijaya | Breastfeeding Problems in Teenage Mothers : A Scoping Review two years of age. Based on the theory proposed by Notoatmodjo . , it explains that many teenage mothers have knowledge about People something after they sense a particular Sensing occurs through the senses of sight, hearing, smell, taste, and touch. Lack of Support from Breastfeeding Mothers Research conducted in the United States and Iran by . , . , . found that one factor contributing to adolescent mothers not breastfeeding their babies is a lack of support from family members. Support reflects whether breastfeeding is accepted by all family members, such as parents, husbands, the community, and health professionals. The support a person receives from others who understand, care for, and pay attention to them can lead to feelings of appreciation, love, acceptance, and attention. Adolescent breastfeeding mothers are a vulnerable group to breastfeeding failure, partly due to a lack of breastfeeding Breastfeeding support includes emotional, informational, instrumental, and appraisal support provided by family, partners, healthcare providers, and the social For adolescent mothers, this support is often suboptimal due to limited experience, dependence on parents, and immature psychosocial conditions. Lack of family support, particularly from partners and parents, is a major factor affecting breastfeeding success in adolescent mothers. Many adolescent mothers still live with their parents, so decisions regarding infant care, including breastfeeding, are often dominated by older family members. If families lack knowledge or still believe myths, such as the belief that breast milk is insufficient or that babies need supplementary feeding from an early age, adolescent mothers tend to follow these decisions, even if they conflict with the principles of exclusive breastfeeding . In addition to family support, limited support from health professionals also plays a role in low breastfeeding success in adolescent mothers. Adolescent mothers need more intensive support, empathetic communication, and education tailored to their level of understanding and emotional well-being. Social support from peers is also often Adolescent mothers may experience social stigma, shame, or psychological stress due to their young This can reduce motivation to breastfeed and lead mothers to choose alternatives, such as formula, which are perceived as more practical and socially Lack of emotional support can increase the risk of stress and anxiety, which ultimately negatively impact breast milk production and sustainability . Lack of breastfeeding support for teenage mothers directly impacts the health of both mothers and babies. Babies are at risk of not being exclusively breastfed, making them more susceptible to infections, growth and developmental disorders, and nutritional problems. Meanwhile, teenage mothers are at risk of breastfeeding failure, low self-confidence as mothers, and increased psychological burden during the postpartum period. Therefore, the active role of midwives and health workers is essential in breastfeeding support system for teenage These efforts include lactation education and counseling from pregnancy, family involvement in the education process, and ongoing emotional support. In the practice of breastfeeding, encouragement from husbands and family is essential, as this can motivate mothers to breastfeed their babies, especially as parents who always help and support them Furthermore, surrounding environment is thought to be able to change adolescent mothers' breastfeeding behavior. Acknowledgement Thank you to all family members who helped in the preparation of this scientific article. This article was completed successfully and published, making it useful for readers. Further research is needed regarding breastfeeding problems that occur among Journal Educational of Nursing (JEN) Vol. 9 No. Wulan Wijaya | Breastfeeding Problems in Teenage Mothers : A Scoping Review adolescents, such as the surrounding culture and the influence of peers or the environment in the residential area. References