Disparities in Breastfeeding Among Military Veterans

Abstract

Background: Although breastfeeding is a major public health priority and provides numerous benefits, women veterans encounter many barriers to initiating and sustaining breastfeeding. Women veterans are a growing population with unique health care needs related to exposures and injuries experienced during military service. These military experiences are linked to health diagnoses known to impact postpartum health behaviors, such as breastfeeding. Research aim: The aim of this study was to identify factors associated with breastfeeding at 4 weeks postpartum among women veterans. Methods: We used 2016-to-2018 survey data from women veterans ( N = 420), interviewed before and after delivery, who were enrolled in maternity care coordination at a national sample of Veterans Health Administration facilities. Using the social ecological model, logistic regression was employed to explore the relationship between breastfeeding at least 4 weeks and postpartum and maternal/infant characteristics, interpersonal dynamics, community influences, and system factors. Results: The rate of breastfeeding at 4 weeks postpartum was 78.6% among this sample of veterans. Self-employed participants were 2.8 times more likely to breastfeed than those who were employed outside the home. Participants who had been deployed at any point in their military career were twice as likely to breastfeed compared with those who never deployed. In this study sample, race independently predicted lower rates of breastfeeding, with African American participants being 48% less likely to breastfeed as compared with white participants. Conclusion: Our analysis suggests significant racial disparities in breastfeeding within veteran populations utilizing Veterans Health Administration, despite access to multiple sources of support from both the Veterans Health Administration and the community.

An Injustice to the Justice-Involved

“…Not only does TBI impact mothers, it is also strongly associated with fetal outcomes such as delayed cognitive development, chronic ailments, and adverse childhood outcomes (Iverson & Pogoda, 2015; Narad et al, 2019; Tawfik et al, 2015). In a study that examined the maternal health of mothers who were veterans, mothers with TBI were significantly less likely to breastfeed at 1 month (Keddem, 2019). This may pose as a disadvantage to the infant's long-term health, as breastfeeding has been shown to reduce the likelihood of babies acquiring chronic diseases, such as obesity, hypertension, and multiple cancers (Binns et al, 2016).…”

“…▪ Mother and Child Health After Maternal TBI Subgroups of women (e.g., incarcerated women and women veterans) are disproportionately affected by TBI (Keddem, 2019). Not only does TBI impact mothers, it is also strongly associated with fetal outcomes such as delayed cognitive development, chronic ailments, and adverse childhood outcomes (Iverson & Pogoda, 2015;Narad et al, 2019;Tawfik et al, 2015).…”

Unique health stressors impacting female veterans

“…Sustaining breastfeeding following active duty can be difficult. Exposures and injuries sustained during military service impact postpartum health behaviors 19. Recognizing the needs of military members who are breastfeeding, the US military has allocated private areas for pumping in domestic and international military bases 19…”