Although the adolescent pregnancy rate is declining in the United States, there are still a substantial portion of infants born to women aged 15 to 19 years (Centers for Disease Control and Prevention [CDC], 2019). In 2017, 194,377 infants were born to women in this age-group for a birth rate of 18.8 per 1,000 (CDC). The U.S. adolescent pregnancy rate is substantially higher than in other western industrialized nations and there continue to be racial/ethnic and geographic disparities in adolescent birth rates (CDC).

Adolescents are at risk for less optimal breastfeeding outcomes including breastfeeding initiation, exclusivity, and duration. For over a decade, students enrolled in my undergraduate semester-long course on human milk and breastfeeding have been working with the adolescents in the Philadelphia public school system to teach them about breastfeeding. In Philadelphia, we have a program that is part of a state initiative called Education Leading to Employment and Career Training (ELECT). The program is an initiative through the Pennsylvania Department of Education that is funded by the Department of Human Services (ELECT, 2019). The goal of ELECT is to enable school districts to help pregnant and parenting teens earn a diploma or high school equivalency certificate in order to become better parents and make the transition to employment, career training, or higher education (ELECT).

The School District of Philadelphia (2018) expanded and adopted Policy 234 to protect the rights of pregnant, parenting, and married students. Each building is required to designate a Teen Parent Student Liaison to help the student navigate the system and be aware of their rights. A critical component of Policy 234 is that students are able to express milk during the school day if they are away from their infants (The School District of Philadelphia). Students who participate in the ELECT program in Philadelphia also have the opportunity to participate in a variety of educational sessions during schooltime. During these educational sessions, students can earn "Baby Buck$" toward the "purchase" of personal care items or items for their newborn.

Through a partnership between the ELECT program and the University of Pennsylvania School of Nursing, we have worked to improve breastfeeding education of students and access to pump technology. With a generous donation by Medela corporation, we were able to acquire hospital-grade Symphony^(R) pumps for the ELECT program. The pumps are stored at the main office for the ELECT program and will be deployed to the school when a parent has returned and is continuing to chest/breastfeed their child. The school district's ELECT program is providing additional supplies such as the pump kits and milk storage bags for the parents. This will allow the adolescent parent to be able to attend school with relative ease of not having to transport a breast pump and have to take that pump through the security checkpoint. The student will express milk more efficiently with the Symphony^(R) pump thus having less time away from class.

The ELECT service provider will arrange to have the hospital-grade Symphony^(R) pump available and which will be used in preidentified lactation spaces at each ELECT site. My students at the University of Pennsylvania will continue to partner with ELECT to provide educational programming about breastfeeding as part of the ELECT program. We will also start to track the number of students who are using the pumps and the number of uses per day. We believe this is a model program and encourage other school districts to protect the rights of adolescent parents. Nurses play an important role in helping teen mothers meet their breastfeeding goals.

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