COMPARISON OF POSTPARTUM BONDING, MATERNAL BLUES, AND PERCEIVED INSUFFICIENT MILK SUPPLY IN ADOLESCENT AND ADULT MOTHERS

Abstract

Objective: This study was conducted to compare the levels of postpartum bonding, maternal blues and insufficient milk perception in adolescent and adult mothers and to examine the relationships between these variables. Method: This descriptive and cross-sectional study was conducted with a total of 160 mothers, including 44 adolescents and 116 adults, who attended postpartum check-ups at an education and research hospital in eastern Turkey. Data were collected using an introductory information form, the Inadequate Milk Perception Scale, the Postpartum Bonding Scale, and the Maternal Blues Scale. Descriptive statistics, intergroup comparison tests, and correlation analyses were used in the analysis of the data; effect sizes were calculated. Findings: It was determined that adolescent mothers had lower levels of education and income, and higher rates of living in rural areas, unplanned pregnancies, premature births, and lack of breastfeeding education (p<0.05). Adolescent mothers' milk adequacy perception scores were found to be lower than those of adult mothers, while their postpartum bonding problems and maternal blues scores were found to be significantly higher (p<0.05). Correlation analysis between the scales revealed that as milk adequacy perception increased, bonding problems and maternal blues levels decreased. When effect sizes were evaluated, differences between groups were found to be more pronounced, particularly in psychological variables. Conclusion: Research findings indicate that adolescent mothers are a more vulnerable group in terms of psychological adjustment during the postpartum period. Therefore, it is recommended that breastfeeding education and psychosocial support programmes for adolescent mothers be strengthened.

Keywords

• postpartum bonding.
• Adolescent mother
• adolescent pregnancy
• perception of insufficient milk supply
• maternal blues

Adölesan ve Yetişkin Annelerde Doğum Sonrası Bağlanma, Annelik Hüznü ve Algılanan Yetersiz Süt Miktarının Karşılaştırılması

Abstract

Amaç: Bu araştırma adölesan ve yetişkin annelerde, doğum sonrası bağlanma, annelik hüznü ve yetersiz süt algısı düzeylerini karşılaştırmak ve bu değişkenler arasındaki ilişkileri incelemek amacıyla yapılmıştır. Yöntem: Tanımlayıcı ve kesitsel tipte olan bu araştırma Türkiye’nin doğusunda bir eğitim ve araştırma hastanesinde doğum sonrası kontrole gelen 44 adölesan ve 116 yetişkin olmak üzere toplam 160 anne ile yürütülmüştür. Veriler tanıtıcı bilgi formu, Yetersiz Süt Algısı Ölçeği, Doğum Sonrası Bağlanma Ölçeği ve Annelik Hüznü Ölçeği kullanılarak toplanmıştır. Verilerin analizinde tanımlayıcı istatistikler, gruplar arası karşılaştırma testleri ve korelasyon analizleri kullanılmış; etki büyüklükleri hesaplanmıştır. Bulgular: Adölesan annelerin eğitim ve gelir düzeylerinin daha düşük olduğu, kırsal bölgelerde yaşama, plansız gebelik, erken doğum ve emzirme eğitimi almama oranlarının daha yüksek olduğu saptanmıştır (p<0,05). Adölesan annelerin yetersiz süt algısı puanları yetişkin annelere göre daha düşük bulunurken, doğum sonrası bağlanma sorunları ve annelik hüznü puanları anlamlı düzeyde daha yüksek bulunmuştur (p<0,05). Ölçekler arasında yapılan korelasyon analizinde, süt yeterlilik algısı arttıkça bağlanma sorunları ve annelik hüznü düzeylerinin azaldığı belirlenmiştir. Etki büyüklükleri değerlendirildiğinde, gruplar arasındaki farkların özellikle psikolojik değişkenlerde daha belirgin olduğu görülmüştür. Sonuç: Araştırma bulguları, adölesan annelerin doğum sonrası dönemde psikolojik uyum açısından daha kırılgan bir grup olduğunu göstermektedir. Bu nedenle adölesan annelere yönelik emzirme eğitimi ve psikososyal destek programlarının güçlendirilmesi önerilir.

Keywords

• doğum sonrası bağlanma
• adölesan anne
• adölesan gebelik
• yetersiz süt algısı
• annelik hüznü

References

1. 1. World Health Organization. Adolescent health. 2022. Accessed October 21, 2025. https://www.who.int/health-topics/adolescent-health#tab=tab_1
2. 2. Riva Crugnola C, Ierardi E, Gazzotti S, Albizzati A. Motherhood in adolescent mothers: maternal attachment, mother-infant styles of interaction and emotion regulation at three months. Infant Behav Dev. 2014;37(1):44-56.
3. 3. Akçay EA, Özbek H, Çakır D. Determining the postpartum functional status of adolescents. J Health Prof Res. 2025;7(1):1-11.
4. 4. Arslan Akgül H. Postpartum Blues (Maternal Blues) and Depression Assessment, Its Relationship with Demographic Characteristics, Life Events, and Social Support [Master's thesis]. İnönü University; 2019.
5. 5. Diabelková J, Rimárová K, Dorko E, et al. Adolescent pregnancy outcomes and risk factors. Int J Environ Res Public Health. 2023;20(5):4113.
6. 6. Islam MM, Islam MK, Hasan MS, Hossain MB. Adolescent motherhood in Bangladesh: trends and determinants. PLoS One. 2017;12(11):e0188294.
7. 7. Chakole S, Akre S, Sharma K, et al. Unwanted teenage pregnancy and its complications: a narrative review. Cureus. 2022;14(12):e32662.
8. 8. Firk C, Konrad K, Herpertz-Dahlmann B, et al. Cognitive development in children of adolescent mothers: the impact of socioeconomic risk and maternal sensitivity. Infant Behav Dev. 2018;50:238-46.

9. 9. Yas A, Karimi FZ, Khadivzadeh T. Breastfeeding needs in adolescent mothers: a systematic review. Sultan Qaboos Univ Med J. 2024;24(3):306-16.
10. 10. Sasayama D, Owa T, Kudo T, et al. Postpartum maternal depression, mother-to-infant bonding, and their association with child difficulties in sixth grade. Arch Womens Ment Health. 2025;28(5):1283-94.
11. 11. SmithBattle L, Freed P. Teen mothers' mental health. MCN Am J Matern Child Nurs. 2016;41(1):31-6.
12. 12. Cantin CM, Peterson WE, Agarwal A, et al. Evaluating breastfeeding self-efficacy in adolescents attending a co-designed breastfeeding program: a prospective pilot cohort study. Int J Environ Res Public Health. 2025;22(8):1271.
13. 13. Arga Z. Comparison of Maternal Attachment, Breastfeeding Self-Efficacy and Perceived Milk Insufficiency in Adolescent and Non-Adolescent Mothers [Doctoral dissertation]. Atatürk University; 2019.
14. 14. Çınaklı Ş, Arslantaş H. Childhood traumas, postpartum depression, and maternal attachment in adolescent and non-adolescent mothers. Cukurova Med J. 2021;46(2):789-800.
15. 15. Işık C, Küğcümen G. An analysis of insufficient milk perception among mothers during the lactation period from the perspective of different variables. Samsun J Health Sci. 2021;6(3):491-506.
16. 16. McCarter-Spaulding DE, Kearney MH. Parenting self-efficacy and perception of insufficient breast milk. J Obstet Gynecol Neonatal Nurs. 2001;30(5):515-22.
17. 17. Gökçeoğlu E, Küçükoğlu S. An Investigation of the Relationship Between Breastfeeding Self-Efficacy and Perceived Milk Sufficiency [Master's thesis]. Erzurum; 2014.
18. 18. Brockington IF, Oates J, George S, et al. A screening questionnaire for mother-infant bonding disorders. Arch Womens Ment Health. 2001;3(1):133-40.
19. 19. Yalçın SS, Örün E, Özdemir P, et al. Reliability of postnatal attachment scales in Turkish mothers. J Child Health Dis. 2014;57:246-51.
20. 20. Küçük And B, Cesur B. Postpartum motherhood blues assessment scale: development and validation. Anatolian J Health Res. 2025;6(1):60-5.
21. 21. Smith PH, Coley SL, Labbok MH, et al. Early breastfeeding experiences of adolescent mothers: a qualitative prospective study. Int Breastfeed J. 2012;7(1):13.
22. 22. Gipson JD, Koenig MA, Hindin MJ. The effects of unintended pregnancy on infant, child, and parental health: a review of the literature. Stud Fam Plann. 2008;39(1):18-38.
23. 23. Rusanen E, Vierikko E, Kojo T, et al. Prenatal expectations and other psycho-social factors as risk factors of postnatal bonding disturbance. Infant Ment Health J. 2021;42(5):655-71.
24. 24. Camarneiro APF, de Miranda Justo JMR. Prenatal attachment and sociodemographic and clinical factors in Portuguese couples. J Reprod Infant Psychol. 2017;35(3):212-22.
25. 25. Yarcheski A, Mahon NE, Yarcheski TJ, et al. A meta-analytic study of predictors of maternal-fetal attachment. Int J Nurs Stud. 2009;46(5):708-15.
26. 26. Mangeli M, Rayyani M, Cheraghi MA, Tirgari B. Exploring the challenges of adolescent mothers from their life experiences in the transition to motherhood: a qualitative study. J Family Reprod Health. 2017;11(3):165-72.
27. 27. World Health Organization. Adolescent pregnancy. 2024. Accessed April 24, 2026. https://www.who.int/news-room/fact-sheets/detail/adolescent-pregnancy
28. 28. Yakubu I, Salisu WJ. Determinants of adolescent pregnancy in sub-Saharan Africa: a systematic review. Reprod Health. 2018;15(1):15.
29. 29. Kassa GM, Arowojolu AO, Odukogbe AA, Yalew AW. Prevalence and determinants of adolescent pregnancy in Africa: a systematic review and meta-analysis. Reprod Health. 2018;15(1):195.
30. 30. Barto HH, Lambert SF, Kardes PE. Adolescent mothers’ career development: a 25-year review of the professional literature. J Employ Couns. 2015;52(2):64-75.
31. 31. Iacobelli S, Robillard PY, Gouyon JB, et al. Obstetric and neonatal outcomes of adolescent primiparous singleton pregnancies: a cohort study in the South of Reunion Island, Indian Ocean. J Matern Fetal Neonatal Med. 2012;25(12):2591-6.
32. 32. Yildirim F, Abukan B, Oztas D. From early marriage to adolescent pregnancy in Turkey: a review study in socio-cultural context. In: Socio-Cultural Influences on Teenage Pregnancy and Contemporary Prevention Measures. 2019:77-94.
33. 33. Sully EA, Biddlecom A, Daroch J, et al. Adding It Up: Investing in Sexual and Reproductive Health 2019. Guttmacher Institute; 2020.
34. 34. Darroch J, Woog V, Bankole A, Ashford LS. Additionally: The Costs and Benefits of Meeting Adolescents' Contraceptive Needs. Guttmacher Institute; 2016.
35. 35. Chen CW, Tsai CY, Sung FC, et al. Adverse birth outcomes among pregnancies of teen mothers: age-specific analysis of national data in Taiwan. Child Care Health Dev. 2010;36(2):232-40.
36. 36. de Vienne CM, Creveuil C, Dreyfus M. Does young maternal age increase the risk of adverse obstetric, fetal and neonatal outcomes: a cohort study. Eur J Obstet Gynecol Reprod Biol. 2009;147(2):151-6.
37. 37. Ganchimeg T, Ota E, Morisaki N, et al. Pregnancy and childbirth outcomes among adolescent mothers: a World Health Organization multicountry study. BJOG. 2014;121(suppl 1):40-8.
38. 38. Fahim SH, Kazemi F, Masoumi SZ, Refaei M. The effect of midwife-oriented breastfeeding counseling on self-efficacy and performance of adolescent mothers: a clinical trial study. BMC Pregnancy Childbirth. 2023;23(1):672.
39. 39. Grassley JS. Adolescent mothers' breastfeeding social support needs. J Obstet Gynecol Neonatal Nurs. 2010;39(6):713-22.
40. 40. Ranjbar A, Jahromi MS, Boujarzadeh B, et al. Pregnancy, childbirth and neonatal outcomes associated with adolescent pregnancy. Gynecol Obstet Clin Med. 2023;3(2):100-5.
41. 41. Khamaysa EB, Masri H, Hassan S. Adverse obstetric and perinatal outcomes among Palestinian adolescent mothers in the West Bank: a retrospective cohort study. Front Glob Womens Health. 2025;6:1732760.
42. 42. Zanardo V, Svegliado G, Cavallin F, et al. Elective cesarean delivery: does it have a negative effect on breastfeeding? Birth. 2010;37(4):275-9.
43. 43. Hobbs AJ, Mannion CA, McDonald SW, et al. The impact of caesarean section on breastfeeding initiation, duration and difficulties in the first four months postpartum. BMC Pregnancy Childbirth. 2016;16(1):90.
44. 44. Maduka NR, Nnoli US. Preference and disclosure of fetal gender to pregnant women during prenatal ultrasonography in South South Nigeria. Niger J Clin Pract. 2024;27(4):460-6.
45. 45. Gavalas V, Rontos K, Nagopoulos N. Sex ratio at birth in twenty-first century Greece: the role of ethnic and social groups. J Biosoc Sci. 2015;47(3):363-75.
46. 46. Arnold F, Kishor S, Roy TK. Sex‐selective abortions in India. Popul Dev Rev. 2002;28(4):759-85.