Does intimate partner violence impact on women's initiation and duration of breastfeeding?

Jennifer P James, Angela Taft, Lisa H Amir, Paul Agius
Breastfeeding Review: Professional Publication of the Nursing Mothers' Association of Australia 2014, 22 (2): 11-9

BACKGROUND: Intimate Partner Violence (IPV) is prevalent among recent mothers and negatively impacts their physical and emotional health. Furthermore, the negative influence of IPV on parenting capacity and children's development is well described. However, it is unclear whether there is any relationship between IPV and method of infant feeding. Little is known about how women who are subjected to IPV make decisions about infant feeding or whether living in this context impacts on their experience of breastfeeding. With what is known about the importance of breastfeeding, particularly for vulnerable populations, research is essential to inform clinical practice and to develop appropriate community support strategies.

METHODS: This paper describes an analysis of data from a pragmatic cluster randomised controlled trial: Improving maternal and child health nurse care for vulnerable mothers (MOVE). The MOVE trial was conducted in the north-western suburbs of Melbourne, Australia from April 2010-April 2011 and involved 80 maternal and child health centres, 160 nurses and 2621 women who completed a survey. Intimate partner violence was measured using the Composite Abuse Scale.

RESULTS: Ninety-six per cent (n = 2111) of participating women initiated breastfeeding, with 80% (n = 1776) and 74% (n = 1537) indicating 'any' breastfeeding at 3 and 6 months respectively. Respondents tended to be older, well-educated with a household income > $70,000 per annum compared to the general population. The characteristics of women from the IPV and non-IPV groups were similar and together were comparable to all women who gave birth in north-west Melbourne. The reported prevalence of IPV in this survey was 6.3% (n = 138), which may be an underestimate. Breastfeeding rates did not significantly differ between IPV and non-IPV groups.

CONCLUSIONS: Our findings suggest that women who experience IPV are just as likely to breastfeed as the broader population of women. While this analysis provide's a snapshot of breastfeeding rates for this group of women, it does not capture women's experience of IPV as it relates to feeding a baby. In order to better identify infant feeding in the context of IPV, qualitative research is also necessary to investigate in a way that fully engages victims/survivors, giving them the opportunity to give voice to their experiences.

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