Prevalence and Predictors of Breastfeeding After Childhood Abuse.

OBJECTIVE

To describe the prevalence and predictors of breastfeeding intent and outcomes in women with histories of childhood maltreatment trauma (CMT), including those with posttraumatic stress disorder (PTSD).

DESIGN

Secondary analysis of a prospective observational cohort study of the effects of PTSD on perinatal outcomes.

SETTING

Prenatal clinics in three health systems in the Midwestern United States.

PARTICIPANTS

Women older than 18 years expecting their first infants, comprising three groups: women who experienced CMT but did not have PTSD (CMT-resilient), women with a history of CMT and PTSD (CMT-PTSD), and women with no history of CMT (CMT-nonexposed).

METHODS

Secondary analysis of an existing data set in which first-time mothers were well-characterized on trauma history, PTSD, depression, feeding plans, feeding outcomes, and several other factors relevant to odds of breastfeeding success.

RESULTS

Intent to breastfeed was similar among the three groups. Women in the CMT-resilient group were twice as likely to breastfeed exclusively at 6 weeks (60.5%) as women in the CMT-PTSD group (31.1%). Compared with women in the CMT-nonexposed group, women in the CMT-resilient group were more likely to exclusively breastfeed. Four factors were associated with increased likelihood of any breastfeeding at 6 weeks: prenatal intent to breastfeed, childbirth education, partnered, and a history of CMT. Four factors were associated with decreased odds of breastfeeding: African American race, PTSD, major depression, and low level of education (high school or less).

CONCLUSION

Posttraumatic stress disorder is more important than childhood maltreatment trauma history in determining likelihood of breastfeeding success. Further research on the promotion of breastfeeding among PTSD-affected women who have experienced CMT is indicated.