Breastfeeding avoidance following psychological intimate partner violence during pregnancy: a cohort study and multivariate analysis.

Objective: To evaluate if the experience of psychological intimate partner violence (IPV) adversely affects breastfeeding rates.
Design: A cohort study.
Setting: Maternities in 15 public hospitals, drawn using cluster sampling of obstetric services in Andalusia, Spain.
Population: A total of 779 consecutive mothers receiving antenatal care including ultrasound and giving birth during February-June 2010.
Methods: Trained midwives gathered IPV data using the Index of Spouse Abuse validated in the Spanish language (score ranges: 0-100, higher scores reflect more severe IPV; cut-off: psychological IPV = 25). Sociodemographic data including lack of kin support, and obstetric and neonatal outcomes were collected. Multivariate logistic regression estimated adjusted odds ratios (aOR), with 95% confidence intervals (CI), of the relationship between psychological IPV and breastfeeding, controlling for sociodemographic characteristics and obstetric complications.
Main Outcome Measure: Breastfeeding avoidance defined as lack of breastfeeding or pumping of breast milk to feed the new baby in the immediate post-partum period.
Results: Response rate was 92.2%. A total of 70% (n = 545) of women initiated breastfeeding. Psychological IPV, reported by 21.0% (n = 151), increased the odds of breastfeeding avoidance (aOR = 2.0; 95% CI = 1.2-3.3) adjusting for the presence of obstetric complications (aOR = 1.6; 95% CI = 1.0-2.4).
Conclusions: Mothers with psychological IPV avoid breastfeeding. Clinicians should be aware of the risks to infant arising from this deficiency due to IPV in pregnancy.
Tweetable Abstract: Psychological intimate partner violence, reported by one in five mothers in this study, on average doubles the avoidance of breastfeeding.
(© 2018 Royal College of Obstetricians and Gynaecologists.)