Intimate partner violence and breastfeeding: a systematic review

Abstract

ObjectiveThe association between intimate partner violence (IPV) and breastfeeding is unclear. We conducted a systematic review to summarise the evidence of breastfeeding outcomes following exposure to IPV.DesignSystematic review.MethodsWe searched for published studies without study design or language restrictions (up to July 2019) in the following databases: PubMed, Embase, SCOPUS and The Global Health Library. Studies assessing various breastfeeding outcomes (initiation, duration and exclusive breastfeeding) in women exposed to IPV in any form (physical, psychological or sexual) and at any stage (1 year pre-pregnancy, during or post-pregnancy) were included. Two authors independently selected the studies and conducted the quality appraisal by use of the Newcastle–Ottawa Scale. Results were summarised taking precision and quality into account.ResultsA total of 16 studies (participants n=414 393) were included and they adjusted for a total of 48 different confounders. The majority of studies were cross-sectional (n=11) and most studies were judged to be fair/low quality. Four out of seven studies found that IPV exposure shortened breastfeeding duration (adjusted ORs/aORs=0.22 (95% CI: 0.05–0.85), 1.18 (95% CI: 1.01–1.37), 5.92 (95% CI: 1.72–27.98), 1.28 (95% CI: 1.18–1.39)). Further, 5/10 studies found that IPV led to early termination of exclusive breastfeeding (aORs=1.53 (95% CI: 1.01–23.1), 0.83 (95% CI: 0.71–0.96), 1.35 (95% CI: 1.07–1.71), 0.17 (95% CI: 0.07–0.4), 1839 (95% CI: 1.61–2911)) and 2/6 studies found that IPV significantly reduced breastfeeding initiation (aORs=2.00 (95% CI: 1.2–3.3), 0.81 (95% CI: 0.7–0.93)).ConclusionIPV exposure appears to associate negatively with some breastfeeding outcomes. Individual patient data meta-analysis is required to quantify the magnitude of the association for specific IPV-outcome combinations. More high-quality studies and definition of core confounders are warranted.PROSPERO registration numberCRD42019129353.

Caring for Mothers: A Narrative Review on Interpersonal Violence and Peripartum Mental Health

“…There is agreement that the mental health of pregnant women should be paid more attention [ 12 ]. The risk of suicide is a major concern for depressed mothers in the perinatal period [ 24 , 25 , 26 , 27 , 28 ]. As for preventive measures to protect mothers, all considered studies agree in emphasizing the importance of providing access to perinatal care to early detect and address domestic violence [ 5 , 26 , 29 ].…”

“…It has been shown that intimate partner violence is associated with a lower likelihood of exclusively breastfeeding infants in the first six months of life. Intimate partner violence may affect breastfeeding directly, through sore nipples and difficulty in relaxing for adequate let-down, but also indirectly, through lack of support or depression, self-doubt, body negativity, and anxiety [ 28 ]. In a sample of 779 mothers, psychological intimate partner violence was reported by one in five women, and the results show that this type of violence during peripartum, on average, doubles the avoidance of breastfeeding [ 29 ].…”

Violence and adversity among pregnant women and new mothers in central Vietnam

“…Postpartum depression, posttraumatic stress disorder, and insufficient social support may mediate the effect of IPV on sub-optimal breastfeeding; in turn, this can exacerbate marital and family conflicts, and impair mother-child attachment (Kendall-Tackett, 2007). Furthermore, although the relationship between IPV exposure during pregnancy and breastfeeding have been documented in 16 studies, the vast majority of studies were single-shot studies (n=11) and most studies were conducted with fair/ low quality (Normann et al, 2020). Thus, future studies, using the prospective longitudinal study design, will provide comprehensive insights into complex pathways between prenatal IPV and maternal mental disorder and perinatal nutrition practice after childbirth.…”

Influência da violência perpetrada por parceiro íntimo na prática do aleitamento materno

“…Pesquisas recentes demonstram associação entre a violência perpetrada por parceiro e as práticas inadequadas de AM (Chaves et al, 2019;Kjerulff Madsen et al, 2019;Normann et al, 2020). A violência praticada por parceiro íntimo se configura como condutas que provocam danos físicos, sexuais ou psicológicos à mulher, incluindo comportamento controlador.…”

“…A violência por parceiro íntimo (VPI) pode interferir de forma direta no aleitamento materno de várias maneiras, como dificuldade de relaxamento para descida em quantidade adequada do leite e dores na região do mamilo. Além disso, pode contribuir de forma indireta, por meio de falta de apoio emocional, depressão, psicose, ansiedade e até mesmo por descontentamento com o próprio corpo (Normann et al, 2020).…”