Intimate partner violence and early interruption of exclusive breastfeeding in the first three months of life

Hasselmann, Maria Helena; Lindsay, Ana Cristina; Surkan, Pamela J.; Vianna, Gabriela Vasconcellos de Barros; Werneck, Guilherme Loureiro

doi:10.1590/0102-311x00017816

Cited by 12 publications

(15 citation statements)

References 11 publications

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“…This is in line with previous publications that have found an association between low education, lower maternal age, and early complementary feeding [14,15,[30][31][32]. Domestic violence, particularly from an intimate partner, has been studied as a risk factor for inadequate breastfeeding practices [7][8][9][10], and such practices are related to the introduction of complementary feeding. We found that, following a multivariate analysis, exclusive breastfeeding at 90 days was a protective factor against early complementary feeding.…”

Section: Discussionsupporting

confidence: 87%

“…Breastfeeding duration and practices may be influenced by many factors, including maternal age, education, stress, and depressive symptoms [7]. A number of studies have found that mothers who suffer domestic violence have lower breastfeeding intention and initiation [7], as well as earlier cessation of exclusive breastfeeding, than those who do not [7][8][9][10]. The prevalence of exclusive breastfeeding in children under 6 months is 41.6% worldwide [11].…”

Section: Introductionmentioning

confidence: 99%

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Does domestic violence during pregnancy influence the beginning of complementary feeding?

Caprara

Bernardi

Bosa

et al. 2020

BMC Pregnancy Childbirth

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Background: This study investigate the influence of domestic violence against pregnant women on early complementary feeding and associated factors. Methods: A longitudinal observational study was conducted with a convenience sample recruited from three public hospitals in Porto Alegre, Rio Grande do Sul, Brazil. Data on maternal age, education, marital status, breastfeeding, introduction of complementary feeding and domestic violence during pregnancy were investigated at four follow-ups points. Data on domestic violence was collected through a self-report questionnaire based on the Abuse Assessment Screen. The early introduction of complementary feeding, characterized as occurring before or at 3 months of life, was verified through a questionnaire prepared by the research group. Data analysis involved Student's t-test, the chi-square test and Cox regression and was carried out in Statistical Package for the Social Sciences program. The significance level was set at 5%. Results: A total of 232 mother-infant pairs participated in the analyses, and 15.1% of the mothers reported suffering some form of violence. Domestic violence was directly associated with maternal education, marital status, and health status during pregnancy. Domestic violence was not associated with maternal age or breastfeeding at 3 months after delivery. In the univariate analysis, domestic violence during pregnancy was associated with early complementary feeding (RR = 1.74; CI: 1.01-2.98). This effect disappeared after the model was adjusted in multivariate analysis. Conclusions: There was no relationship between domestic violence during pregnancy and early complementary feeding.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Does domestic violence during pregnancy influence the beginning of complementary feeding?

Caprara

Bernardi

Bosa

et al. 2020

BMC Pregnancy Childbirth

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“…Of these, 8 reported lower breastfeeding intention, breastfeeding initiation, and exclusive breastfeeding during the first 6 months of the child’s life, and a higher likelihood of early termination of exclusive breastfeeding, among mothers who experienced IPV. Only 6 studies were from LMICs [13–18], and of these only 2 measured a mother’s exposure to emotional violence. Early initiation of breastfeeding (within 1 hour after birth) was measured in few studies [15,18].…”

Section: Introductionmentioning

confidence: 99%

Maternal exposure to intimate partner violence and breastfeeding practices in 51 low-income and middle-income countries: A population-based cross-sectional study

et al. 2019

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BackgroundIntimate partner violence (IPV) against women is a major global health issue, particularly in low- and middle-income countries (LMICs), that is associated with poor physical and mental health, but its association with breastfeeding practices is understudied. Both the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) recommend that children initiate breastfeeding within the first hour of birth and be exclusively breastfed for the first 6 months of life. Breastfeeding within the first hour of birth is critical to newborn survival, and exclusive breastfeeding for 6 months is recognised to offer significant health benefits to mothers and their infants. We examined the association of maternal exposure to IPV with early initiation of breastfeeding (within 1 hour of birth) and exclusive breastfeeding in the first 6 months.Methods and findingsWe assessed population-based cross-sectional Demographic and Health Surveys (DHS) from 51 LMICs. Data from the most recent DHS in each country (conducted between January 2000 and January 2019) with data available on IPV and breastfeeding practices were used. By WHO region, 52.9% (27/51) were from Africa, 11.8% (6/51) from the Americas, 7.8% (4/51) from the Eastern Mediterranean, 11.8% (6/51) from Europe, 11.8% (6/51) from South-East Asia, and 3.9% (2/51) from the Western Pacific. We estimated multilevel logistic regression models for any IPV and each type of IPV separately (physical violence, sexual violence, and emotional violence), accounting for demographic and socioeconomic factors. Depending on specification, the sample size varied between 95,320 and 102,318 mother–infant dyads. The mean age of mothers was 27.5 years, and the prevalence of any lifetime exposure to IPV among mothers was 33.3% (27.6% for physical violence, 8.4% for sexual violence, and 16.4% for emotional violence). Mothers exposed to any IPV were less likely to initiate breastfeeding early (adjusted odds ratio [AOR]: 0.88 [95% CI 0.85–0.97], p < 0.001) and breastfeed exclusively in the first 6 months (AOR: 0.87 [95% CI 0.82–0.92], p < 0.001). The associations were similar for each type of IPV and were overall consistent across infant’s sex and WHO regions. After simultaneously adjusting for all 3 types of IPV, all 3 types of IPV were independently associated with decreased likelihood of early breastfeeding initiation, but only exposure to physical violence was independently associated with a decreased likelihood of exclusively breastfeeding in the first 6 months. The main limitations of this study included the use of cross-sectional datasets, the possibility of residual confounding of the observed associations by household wealth, and the possibility of underreporting of IPV experiences attenuating the magnitude of observed associations.ConclusionsOur study indicates that mothers exposed to any form of IPV (physical, sexual, or emotional violence) were less likely to initiate breastfeeding early and breastfeed exclusively in the first 6 months. These findings may inform the...

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“…[3] Few studies have investigated the effect of IPV on breastfeeding. Most studies are from America [14, 15, 17–20] or Asia. [13, 21–23] A systematic review from 2017[24] showed that just one African study has been published.…”

Section: Introductionmentioning

confidence: 99%

Intimate partner violence and subsequent premature termination of exclusive breastfeeding: A cohort study

Madsen

Holm-Larsen

et al. 2019

PLoS ONE

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Objective The objective of this study was to examine whether exposure to Intimate Partner Violence (IPV) is associated with premature termination of Exclusive Breastfeeding (EB). Per WHO recommendations, this was defined as ceasing breastfeeding or supplementing with other foods or liquids before the child was 6 months old. Method It is a prospective cohort study set in Moshi, Tanzania consisting of 1128 pregnant women with live singleton births. Women were enrolled during pregnancy and followed up with interviews during pregnancy, after birth and 2–3 years postpartum, using structured questionnaires. Emotional, physical and sexual IPV exerted by the current partner was assessed at 34 weeks gestational age with WHO questionnaires. Months of EB was assessed 2–3 years postpartum. Premature termination of EB was defined as less than 6 months of EB. Analyses were made using a logistic regression model adjusted for maternal age, education, HIV-status, alcohol use during pregnancy and parity. Confounding variables were determined using a theoretical framework approach, i.e. a Directed Acyclic Graph model to minimize bias. Results Women who were exposed to IPV had more than 50% higher odds of terminating EB before the child was 6 months old compared to women who were not exposed (aOR = 1.62, 95%CI: 1.27–2.06). Women exposed to all three types of IPV had twice the odds of early termination of EB (aOR = 1.95, 1.12; 3.37). Furthermore, the odds were tripled if exposure happened specifically during the index pregnancy (aOR = 2.93 95%CI: 1.3; 6.6). Stratified analyses showed the most severely affected groups were the mothers older than 30 and those who gave birth to girls. Conclusions The results indicated that exposure to IPV is associated with increased risk of premature termination of EB. The odds increase with multiple types of the IPV, especially when exposed during the index pregnancy.

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Intimate partner violence and early interruption of exclusive breastfeeding in the first three months of life

Cited by 12 publications

References 11 publications

Does domestic violence during pregnancy influence the beginning of complementary feeding?

Does domestic violence during pregnancy influence the beginning of complementary feeding?

Maternal exposure to intimate partner violence and breastfeeding practices in 51 low-income and middle-income countries: A population-based cross-sectional study

Intimate partner violence and subsequent premature termination of exclusive breastfeeding: A cohort study

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