Intimate partner violence around the time of pregnancy: association with breastfeeding behavior.

OBJECTIVE: To assess associations of experiences of intimate partner violence (IPV) and breastfeeding behaviors among a large, population-based sample of U.S. women.

METHODS: Data were collected from women giving birth to live infants in 26 U.S. states and participating in the 2000-2003 Pregnancy Risk Assessment Monitoring System (PRAMS) (n = 118,579). Logistic regression analyses were conducted to assess the relations of experiences of IPV in the year prior to and during pregnancy to initiation and early cessation of breastfeeding.

RESULTS: Approximately 1 in 17 (5.8%) women delivering liveborn infants reported IPV either during or in the year prior to pregnancy. In crude logistic regression analyses, women who reported IPV in the year prior to pregnancy but not during pregnancy (OR 1.45, CI 1.26- 1.66), IPV during pregnancy but not in the year prior to pregnancy (OR 1.35, CI 1.11-1.64), and women reporting experiencing IPV across both periods (OR 1.52, CI 1.34-1.72) were significantly less likely to breastfeed the infants born subsequent to this pregnancy. Similarly, women reporting IPV around the time of pregnancy who initiated breastfeeding were more likely to cease breastfeeding by 4 weeks postpartum (ORs 1.41-1.71). In analyses adjusted for demographics and current smoking, however, experiences of IPV did not relate to women's risk for either outcome.

CONCLUSIONS: Although other factors beyond experiences of IPV may better predict a woman's decision or ability to breastfeed, abused women are overrepresented among mothers who do not or prematurely cease to breastfeed and should be identified and referred to appropriate services.