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

Abstract

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.

Intimate partner violence during pregnancy and maternal and child health outcomes: a scoping review of the literature from low-and-middle income countries from 2016 - 2021

“…In terms of breastfeeding , high odds of not being breastfed in the first year of life was reported for babies whose mother had been exposed to violence (by partners/family members) before/during pregnancy compared to unexposed mothers [ 30 ]. This finding is in keeping with a prospective cohort study from Tanzania which suggests exposure to IPV during either pregnancy or the postpartum period increased the odds of breastfeeding cessation before the child turned 6 months old [ 68 ].…”

Intimate partner violence and breastfeeding: a systematic review

“…Of the five cohort studies, one study was judged as ‘good quality’, 32 three studies was judged as ‘fair quality’ 20 33 35 and one study was judged as ‘poor quality’. 34 Of the 11 cross-sectional studies, six were judged as having ‘good’ quality, 21–23 26 28 30 one was judged as ‘satisfactory’ 31 and three studies were judged as ‘unsatisfactory’.…”

“…A total of 16 studies met the inclusion criteria of which 11 were cross-sectional [20][21][22][23][24][25][26][27][28][29][30][31] and 5 were cohort studies. [32][33][34][35] The studies were published between 2006 and 2019. Four studies were conducted in the USA, 20 22 25 31 four in India, 21 23 26 29 two in Brazil, 28 34 one in Tanzania, 32 one in Spain, 33 one in Sweden, 24 one in Norway, 35 one in Australia 27 and one in Hong Kong.…”

“…[32][33][34][35] The studies were published between 2006 and 2019. Four studies were conducted in the USA, 20 22 25 31 four in India, 21 23 26 29 two in Brazil, 28 34 one in Tanzania, 32 one in Spain, 33 one in Sweden, 24 one in Norway, 35 one in Australia 27 and one in Hong Kong. 30 Population age ranged from 14 to 49 years and was reported as means (n=3) or in intervals (n=13).…”

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.…”