Prenatal management, adjusting to parenthood and breastfeeding are among the topics updated in an AAP clinical report on caring for adolescents and their children.
Teen parents, defined as those ages 15 to 19 years, have unique challenges and are at high risk for repeat births. Pediatricians can positively influence the long-term health and lifelong trajectories for adolescent parents and their children by creating a supportive, educational environment.
The overall teen birth rate is 18.8 per 1,000 live births. The rate has declined 51% since 2007 and 67% since 1991 but remains higher than in many other resource-rich countries. American Indian/Alaska Native teens have the highest birth rate (32.9 per 1,000), followed by Hispanic (28.9), Black (27.5) and White teens (13.2).
The report, Care of Adolescent Parents and Their Children, from the Committee on Adolescence and the Council on Early Childhood, is updated from 2012. It is available at https://doi.org/10.1542/peds.2021-050919 and will be published in the May issue of Pediatrics.
The report also discusses how to manage mental health, assess social determinants of health including poverty, address toxic stressors and promote cognitive and social development of children born to teen parents.
Pediatricians can help mitigate some of the effects of teen pregnancy by encouraging early prenatal care. They also can provide anticipatory guidance to strengthen a family’s social supports and provide resources for transportation, medical insurance, housing and food.
Other key roles for pediatricians are encouraging the use of positive parenting techniques.
The report states that coverage of, access to and coordination of services among medical providers need to be priorities for payers to assist pregnant and parenting adolescents.
Guidance for pediatricians includes the following:
- Create a patient-centered home for adolescent parents and their children. Involve partners and families in the newborn period and infancy, supporting their involvement in their children’s care.
- Tap community resources, such as nurse home visitation programs, to provide a comprehensive and multidisciplinary approach to caring for parenting teens.
- Promote breastfeeding.
- Provide contraception counseling during the pre- and postnatal periods in partnership with obstetricians and in subsequent health visits. Offer access to the full range of contraceptive services, including long-acting reversible contraceptives.
- Use a validated tool to screen for postpartum depression and refer to mental health resources when indicated.
- Screen for intimate partner violence and substance use.
- Emphasize the importance of completing high school and pursuing higher education or vocational training.
- Recognize all forms of parenting, including coparenting, and support the role of the adolescent father or partner.