Breastfeeding and Exposure to Past, Current, and Neighborhood Violence

Abstract

Objectives Breastfeeding has short- and long-term health benefits for children and mothers, but US breastfeeding rates are suboptimal. Exposure to violence may contribute to these low rates, which vary by race/ethnicity. We studied: (1) whether patterns of violence exposure differ by race/ethnicity and (2) whether these patterns are associated with breastfeeding outcomes. Methods We conducted a secondary analysis of data drawn from self-report surveys completed by a convenience sample of low-income postpartum women (n = 760) in upstate New York. Latent class analysis was used to identify groups of women with similar responses to seven violence measures, including childhood physical and/or sexual violence, experience of partner violence during or just after pregnancy (physical, emotional, verbal), and neighborhood violence (perceived or by ZIP code). Logistic regression and survival analysis were utilized to determine if classes were associated with breastfeeding initiation, duration, and exclusivity, controlling for demographics. Results Exposure to at least one form of violence was high in this sample (87%). We identified 4 classes defined by violence exposure (combining current and historical exposures). Violence exposure patterns differed between racial/ethnic groups, but patterns were inconsistently associated with breastfeeding plans or outcomes. For White women, history of violence exposure increased the likelihood of earlier breastfeeding cessation. By contrast, among Black women, history of violence exposure increased the likelihood of having a breastfeeding plan and initiating breastfeeding. Conclusions for Practice Some differences between violence exposure classes are likely due to the correlation between race/ethnicity and socioeconomic status in the community studied. Additional studies are warranted to better understand how exposure to violence is related to breastfeeding and how best to support women making decisions about intention, initiation, and duration of breastfeeding.

Intimate partner violence and breastfeeding: a systematic review

“… 34 Of the 11 cross-sectional studies, six were judged as having ‘good’ quality, 21–23 26 28 30 one was judged as ‘satisfactory’ 31 and three studies were judged as ‘unsatisfactory’. 25 27 29 One cross-sectional study was not assessed using NOS for cross-sectional studies, since the study was embedded from a cohort, 24 hence, NOS for cohort studies was used to assess the quality and it was judged as of ‘poor quality’ 24 ( figure 2 ).…”

Breastfeeding Among Mothers Who Have Experienced Childhood Maltreatment: A Review

“…Table 2 summarizes many of the characteristics of the reviewed studies. Four (75%) of the authors of the reviewed articles reported results from secondary data analyses (Coles et al, 2016;Eagen-Torkko et al, 2017;Elfgen et al, 2017;Holland et al, 2018). Two (25%) used a cross-sectional survey (Bowman et al, 2009;Islam et al, 2018).…”

“…The two (25%) qualitative research teams relied on in-depth individual interviews of participants (Coles, 2009;Wood & Van Esterik, 2010). For analysis, most of the quantitative researchers conducted a logistic regression (Coles et al, 2016;Eagen-Torkko et al, 2017;Elfgen et al, 2017;Holland et al, 2018;Islam et al, 2018). One (12.5%) study reported Spearman's rho and Mann-Whitney U calculations (Bowman et al, 2009).…”

“…Table 3 summarizes our analysis of the original contributions and the implications for each research study as it relates to breastfeeding. The strengths of the selected quantitative studies included sample sizes appropriate to analyses conducted (Coles et al, 2016;Eagen-Torkko et al, 2017;Elfgen et al, 2017;Holland et al, 2018;Islam et al, 2018) and the use of valid and reliable measures (Bowman et al, 2009;Coles et al, 2016;Eagen-Torkko et al, 2017;Holland et al, 2018). Researchers who did not use a previously validated measure conducted pilot testing of the instrument in their target population (Elfgen et al, 2017;Islam et al, 2018).…”

“…Limitations of the reviewed studies included the use of convenience sampling (Bowman et al, 2009;Holland et al, 2018) and small sample size, which limited the analytic power of sub-analyses (Bowman et al, 2009). Researchers conducted most studies with adult participants who were asked to recall CM, which could be biased (Coles et al, 2016;Elfgen et al, 2017;Holland et al, 2018;Islam et al, 2018); one was conducted when participants were an average of 10 years postpartum (Elfgen et al, 2017). Two (25%) research teams lacked information on the racial and ethnic backgrounds of their participants (Coles et al, 2016;Elfgen et al, 2017).…”