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Bhatt Carreno S, Orjuela-Grimm M, Vahedi L, Roesch E, Heckman C, Beckingham A, Gayford M, Meyer SR. Linkages between maternal experience of intimate partner violence and child nutrition outcomes: A rapid evidence assessment. PLoS One 2024; 19:e0298364. [PMID: 38498450 PMCID: PMC10947923 DOI: 10.1371/journal.pone.0298364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 01/24/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND A strong evidence base indicates that maternal caregivers' experience of intimate partner violence [IPV] impacts children's health, cognitive development, and risk-taking behaviors. Our objective was to review peer-reviewed literature describing the associations between a child's indirect exposure to IPV and corresponding nutrition outcomes, with a particular focus on fragile settings in low and middle-income countries [LMICs]. METHODS We conducted a rapid evidence assessment to synthesize quantitative associations between maternal caregivers' IPV experience and children's nutrition/growth outcomes (birthweight, feeding, and growth indicators). We included peer-reviewed research, published in English or Spanish after the year 2000, conducted in fragile settings in LMICs. RESULTS We identified 86 publications that fit inclusion criteria. Amongst all associations assessed, a maternal caregiver's experience of combined forms of IPV (physical, sexual and emotional) or physical IPV only, were most consistently associated with lower birthweight, especially during pregnancy. Women of child-bearing age, including adolescents, exposed to at least one type of IPV showed a decreased likelihood of following recommended breastfeeding practices. Lifetime maternal experience of combined IPV was significantly associated with stunting among children under 5 years of age in the largest study included, though findings in smaller studies were inconsistent. Maternal experience of physical or combined IPV were inconsistently associated with underweight or wasting in the first five years. Maternal experience of sexual IPV during pregnancy appeared to predict worsened lipid profiles among children. CONCLUSION Maternal caregivers' experience of IPV is significantly associated with low birthweight and suboptimal breastfeeding practices, whereas studies showed inconsistent associations with child growth indicators or blood nutrient levels. Future research should focus on outcomes in children aged 2 years and older, investigation of feeding practices beyond breastfeeding, and examination of risk during time periods physiologically relevant to the outcomes. Programmatic implications include incorporation of GBV considerations into nutrition policies and programming and integrating GBV prevention and response into mother and child health and nutrition interventions in LMIC contexts.
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Affiliation(s)
- Silvia Bhatt Carreno
- Department of Epidemiology, Columbia University, New York City, New York, United States of America
| | - Manuela Orjuela-Grimm
- Department of Epidemiology and Pediatrics, Columbia University Irving Medical Center, New York City, New York, United States of America
| | - Luissa Vahedi
- Brown School, Washington University in St. Louis, St. Louis, Missouri, United States of America
| | | | | | | | - Megan Gayford
- UNICEF, New York City, New York, United States of America
| | - Sarah R. Meyer
- Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians-Universität, Munich, Germany
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Kopp SJ, Kelly EA, DeFranco EA. Influence of social determinants of health on breastfeeding intent in the United States. Birth 2023; 50:858-867. [PMID: 37395480 DOI: 10.1111/birt.12740] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 05/25/2023] [Accepted: 06/09/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND Breastfeeding rates in the United States are suboptimal despite public health recommendations that infants are fed breastmilk for their first year of life. This study aimed to characterize the influence of social determinants of health on intended breastfeeding duration. METHODS This case-control study analyzed breastfeeding intent in 421 postpartum women. Data on social determinants and medical history were obtained from medical records and participant self-report. Logistic regression estimated the influence of demographic factors and social determinants on intent to breastfeed for durations of <6 months, 6-12 months, and at least 1 year. RESULTS Thirty-five percent of mothers intended to breastfeed for at least 6 months, and 15% for 1 year. Social determinants that negatively predicted breastfeeding intent included not owning transportation and living in a dangerous neighborhood (p < 0.05). Women were more likely to intend to breastfeed for 12 months if they had knowledge of breastfeeding recommendations (adjusted odds ratio [aOR] 6.19, 95% confidence interval [CI 2.67-14.34]), an identifiable medical provider (aOR 2.64 [CI 1.22-5.72]), familial support (aOR 2.80 [CI 1.01-7.80]), or were married (aOR 2.55 [CI 1.01-6.46]). Sociodemographic factors that negatively influenced breastfeeding intent included non-Hispanic Black race, no high school diploma, cigarette use, income below $20,000, fewer than five prenatal visits, and WIC or Medicaid enrollment (p < 0.05). CONCLUSIONS Women who lack familial support, an identifiable healthcare provider, or knowledge of breastfeeding guidelines are less likely to intend to breastfeed. Public health initiatives should address these determinants to improve breastfeeding and infant outcomes.
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Affiliation(s)
- Sarah J Kopp
- University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Elizabeth A Kelly
- Division of General Obstetrics and Gynecology, Department of Clinical Obstetrics and Gynecology, Women's Community Health Services, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Emily A DeFranco
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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Stockman D, Haney L, Uzieblo K, Littleton H, Keygnaert I, Lemmens G, Verhofstadt L. An ecological approach to understanding the impact of sexual violence: a systematic meta-review. Front Psychol 2023; 14:1032408. [PMID: 37292501 PMCID: PMC10244654 DOI: 10.3389/fpsyg.2023.1032408] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 05/08/2023] [Indexed: 06/10/2023] Open
Abstract
Aim A systematic meta-review was conducted to examine (1) the broad range of negative and positive individual and interpersonal changes following adult sexual violence, as well as (2) the risk/protective factors at multiple levels of the social ecology (e.g., individual, assault, and micro/meso/exo/macro/chronosystem factors)-influencing the impact of sexual violence. Methods Searches of Web of Science, Pubmed, and ProQuest resulted in inclusion of 46 systematic reviews or meta-analyses. Review findings were extracted for summary and a deductive thematic analysis was conducted. Results Experiencing sexual violence is associated with many negative individual and sexual difficulties as well as revictimization risk. Only a limited number of reviews reported on interpersonal and positive changes. Factors at multiple levels of the social ecology play a role in the intensity of these changes. Reviews including macrolevel factors were non-existent, however. Conclusion Reviews on sexual violence are fragmented in nature. Although the use of an ecological approach is often lacking, adopting such a perspective in research is necessary for a fuller understanding of the multiple influences on survivor outcomes. Future research should evaluate the occurrence of social and positive changes following sexual violence, as well as the role of macrolevel factors in influencing post-assault outcomes.
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Affiliation(s)
- Dagmar Stockman
- Department of Experimental Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Laura Haney
- Department of Psychology, East Carolina University, Greenville, NC, United States
| | - Kasia Uzieblo
- Department of Criminology, Vrije Universiteit Brussel, Brussel, Belgium
- Forensic Care Specialists, Van der Hoeven Clinic, Utrecht, Netherlands
| | - Heather Littleton
- Lyda Hill Institute for Human Resilience, University of Colorado Colorado Springs, Colorado Springs, CO, United States
| | - Ines Keygnaert
- International Centre for Reproductive Health, Ghent University, Ghent, Belgium
| | - Gilbert Lemmens
- Department of Head and Skin, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Lesley Verhofstadt
- Department of Experimental Clinical and Health Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
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Kanichy (Makah) M, Schmidt L, Anderson R, Njau G, Stiffarm (Aaniiih) A, Schmidt M, Stepanov A, Williams A. Examining the Role of Interpersonal Violence in Racial Disparities in Breastfeeding in North Dakota (ND PRAMS 2017-2019). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085445. [PMID: 37107727 PMCID: PMC10138366 DOI: 10.3390/ijerph20085445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/01/2023] [Accepted: 04/07/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND The 2019 overall breastfeeding initiation rate in the US was 84.1%, yet only 76.6% of American Indian (AI) women initiated breastfeeding. In North Dakota (ND), AI women have greater exposure to interpersonal violence than other racial/ethnic groups. Stress associated with interpersonal violence may interfere with processes important to breastfeeding. We explored whether interpersonal violence partially explains racial/ethnic disparities in breastfeeding in ND. METHODS Data for 2161 women were drawn from the 2017-2019 ND Pregnancy Risk Assessment Monitoring System. Breastfeeding questions in PRAMS have been tested among diverse populations. Breastfeeding initiation was self-report to "Did you ever breastfeed or pump breast milk to feed your new baby, even for a short period?" (yes/no). Breastfeeding duration (2 months; 6 months) was self-reported how many weeks or months of breastmilk feeding. Interpersonal violence for both 12 months before and during pregnancy based on self-report (yes/no) of violence from a husband/partner, family member, someone else, or ex-husband/partner. An "Any violence" variable was created if participants reported "yes" to any violence. Logistic regression models estimated crude and adjusted odds ratios (OR) and 95% confidence intervals (95% CI) for breastfeeding outcomes among AI and Other Race women compared to White women. Sequential models were adjusted for interpersonal violence (husband/partner, family member, someone else, ex-husband/partner, or any). RESULTS AI women had 45% reduced odds of initiating breastfeeding (OR: 0.55, 95% CI: 0.36, 0.82) compared to white women. Including interpersonal violence during pregnancy did not change results. Similar patterns were observed for all breastfeeding outcomes and all interpersonal violence exposures. DISCUSSION Interpersonal violence does not explain the disparity in breastfeeding in ND. Considering cultural ties to the tradition of breastfeeding and the role of colonization may provide a better understanding of breastfeeding among AI populations.
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Affiliation(s)
- MichaeLynn Kanichy (Makah)
- Public Health Program, Department of Population Health, School of Medicine & Health Sciences, The University of North Dakota, 1301 North Columbia Road Stop 9037, Grand Forks, ND 58202, USA
| | - Lexie Schmidt
- Public Health Program, Department of Population Health, School of Medicine & Health Sciences, The University of North Dakota, 1301 North Columbia Road Stop 9037, Grand Forks, ND 58202, USA
| | - RaeAnn Anderson
- Department of Psychology, University of North Dakota, 501 North Columbia Road Stop 8380, Grand Forks, ND 58202, USA
| | - Grace Njau
- North Dakota Department of Health & Human Services, 600 East Boulevard Ave, Department 325, Bismarck, ND 58505, USA
| | - Amy Stiffarm (Aaniiih)
- Department of Indigenous Health, School of Medicine & Health Sciences, University of North Dakota, 1301 North Columbia Road Stop 9037, Grand Forks, ND 58202, USA
| | - Matthew Schmidt
- North Dakota Department of Health & Human Services, 600 East Boulevard Ave, Department 325, Bismarck, ND 58505, USA
| | - Anastasia Stepanov
- North Dakota Department of Health & Human Services, 600 East Boulevard Ave, Department 325, Bismarck, ND 58505, USA
| | - Andrew Williams
- Public Health Program, Department of Population Health, School of Medicine & Health Sciences, The University of North Dakota, 1301 North Columbia Road Stop 9037, Grand Forks, ND 58202, USA
- Department of Indigenous Health, School of Medicine & Health Sciences, University of North Dakota, 1301 North Columbia Road Stop 9037, Grand Forks, ND 58202, USA
- Correspondence:
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Maleki A, Asghari-Jafarabadi M, Youseflu S. A Systematic Review of the Correlation Between Marital Relationship and Breastfeeding Self-Efficacy, and Duration of Breastfeeding. Breastfeed Med 2023; 18:86-96. [PMID: 36800333 DOI: 10.1089/bfm.2022.0210] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Background: Breastfeeding as an important key to sustainable development strategies is the best nutrition for ensuring healthy growth and development in the first 1,000 days of life. Objective: The current systematic review and meta-analysis were conducted to evaluate the correlation between marital relationship satisfaction and breastfeeding self-efficacy and duration of breastfeeding. Method: A systematical search was carried out in main electronic databases (PubMed, Scopus, Embase, ProQuest, and Web of Science) and gray literature until June 2022. The study's risk of bias was assessed using the Newcastle-Ottawa risk-of-bias tool. Publication bias was evaluated using a funnel plot, and Begg's and Egger's tests. The degree of heterogeneity was assessed using the I2 test. To estimate common effect size r coefficient (r) and confidence intervals (95% CIs), random-effect models were fitted, and the results were presented using forest plots. Results: In total, 13 studies with 5,843 subjects were included in the meta-analysis. Overall, the pool estimates show a positive correlation between marital relationship satisfaction, and breastfeeding self-efficacy (r = 0.27, 95% CI (0.09-0.50), p = 0.024), but this relationship was not found in the term of breastfeeding duration (r = 0.11, 95% CI [-0.01 to 0.23], p = 0.079). The heterogeneity of studies was high (I2 = 95.2%) Conclusion: Our finding confirms a positive and moderate level of correlation between marital relationship satisfaction and breastfeeding self-efficacy. It is suggested to conduct more studies to reach appropriate conclusions regarding marital relationship satisfaction and breastfeeding duration.
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Affiliation(s)
- Azam Maleki
- Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mohamamd Asghari-Jafarabadi
- Cabrini Research, Cabrini Health, Victoria, Australia.,Faculty of Medicine, Nursing and Health Sciences, School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia.,Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Samaneh Youseflu
- Department of Midwifery and Reproductive Health, Isfahan University of Medical Sciences, Isfahan, Iran
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6
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Eidelman AI. The Effect of Intimate Partner Violence on Breastfeeding Behavior. Breastfeed Med 2022; 17:467-468. [PMID: 35613382 DOI: 10.1089/bfm.2022.29212.aie] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Obioha CU, Costa R, Del Pino Espejo MJ, Villalba K, Martin MP. Intimate Partner Violence and Breastfeeding Behaviors: Does the Source of Breastfeeding Information Affect the Associations Between Prepregnancy or Prenatal IPV and Breastfeeding Behaviors of Women in the United States? A PRAMS 2018 Study. Breastfeed Med 2022; 17:528-536. [PMID: 35324347 DOI: 10.1089/bfm.2021.0282] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Most countries do not meet World Health Organization's breastfeeding recommendations, and exposure to intimate partner violence (IPV) hinders positive breastfeeding behaviors. One in four U.S. women (43.6 million women) experiences IPV. This study aims to assess relationships between IPV, and breastfeeding initiation, duration, and early cessation among women in 42 U.S. states; and to evaluate possible modifying effect(s) of different breastfeeding information sources. Methods: Centers for Disease Control and Prevention's 2016-2018 Pregnancy Risk Assessment Monitoring System data (n = 105,230) were used to assess relationships between prepregnancy/prenatal IPV and breastfeeding initiation, duration, and early cessation; and modify effects of various breastfeeding information sources on study associations using multilogistic regression models. Results: About 1.4% of women experienced prenatal IPV with reduced odds of breastfeeding for 6 months or more (odds ratio [OR] = 0.74; 95% confidence interval = 0.58-0.94). Receiving breastfeeding information from baby's doctor modified early cessation (0.37 [0.18-0.78]) (p for interaction = 0.009) with prenatal IPV exposure. Among women exposed to prenatal IPV, breastfeeding initiation was stronger in women who received breastfeeding information from family/friends (2.46, [1.24-4.88]) (p for interaction = 0.010) or from breastfeeding support groups (3.03 [1.17-7.88]) (p for interaction = 0.023) compared to those who did not. Breastfeeding information from family/friends modified association between prepregnancy IPV and breastfeeding duration (0.67 [0.45-0.99]) (p for interaction = 0.042). Conclusions: Prenatal IPV is a risk factor for short-duration breastfeeding. Receiving information from doctors, nurses, support groups, and family/friends may improve breastfeeding behavior among IPV-exposed women. Interventions promoting breastfeeding information dissemination by family/friends, support groups, and doctors/nurses during hospital visits are encouraged.
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Affiliation(s)
- Chinedu U Obioha
- College of Nursing and Public Health, Adelphi University, Garden City, New York, USA
| | - Rosann Costa
- College of Nursing and Public Health, Adelphi University, Garden City, New York, USA
| | | | - Karina Villalba
- Department of Population Health Sciences, Violence Against Women Faculty Cluster, College of Medicine, University of Central Florida, Orlando, Florida, USA
| | - Maria Pilar Martin
- College of Nursing and Public Health, Adelphi University, Garden City, New York, USA
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8
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Aristizábal LYG, Theme Filha MM. Physical violence against women by their intimate partner during pregnancy and its relationship with breastfeeding. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2022. [DOI: 10.1590/1806-9304202200020004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract Objectives: to estimate the association between physical violence against women by their intimate partner during pregnancy and breastfeeding. Methods: the data source is the 2010 National Demographic and Health Survey (DHS) conducted in Colombia, and 11,416 mother-child dyads were analysed. The relationship between physical violence against women by their partner during pregnancy and breastfeeding indicators was carried out using the weighted propensity score from the Inverse Probability of Treatment Weighting (IPTW). Variables for adjustment were selected through the Directed Acyclic Diagram (DAG) and performed a sensitivity analysis to identify the strength of hidden bias. Results: according to the data, 6.4% (730) of the women suffered physical violence by their partner during their pregnancy. The median time of exclusive breastfeeding was 1.0 month. No statistically significant relationship was observed with any of the breastfeeding indicators analysed: exclusive breastfeeding (OR=1.17; CI95%=0.82-1.67); breastfeeding at any time (OR=1.61; CI95%=0.58-2.60); and initiation of breastfeeding (OR=1.07; CI95%=0.74-1.2) Conclusion: although the association between violence against women committed during pregnancy and breastfeeding indicators was not found, the suboptimal breastfeeding practices and high prevalence of violence against women by the partner are two major public health issues in Colombia. Prenatal care professionals can change this scenario by identifying women exposed to intimate partner violence and offering tailored support for breastfeeding practices.
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Dirirsa DE, Desta AA, Geleta TA, Gemmechu MM, Melese GT, Abebe ST. Intimate partner violence in the postpartum period and its associated factors among women attending a postnatal clinic in Central Ethiopia. SAGE Open Med 2022; 10:20503121221100136. [PMID: 35646358 PMCID: PMC9130815 DOI: 10.1177/20503121221100136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 04/25/2022] [Indexed: 12/02/2022] Open
Abstract
Objective: Intimate partner violence may affect women at any stage of their lives,
including during pregnancy and after childbirth, and can have major health
consequences for both the mother and the child. Therefore, the study was
aimed to assess Intimate partner violence against postpartum women and its
associated factors among women attending the postpartum clinic in Central
Ethiopia, 2021. Methods: The hospital based cross-sectional study design was implemented among
postpartum women attending Sendafa Beke Hospital from September to October
2021. Systematic random sampling procedure was used to select 414 eligible
postpartum women. Data were collected using a structured interviewer
administered questionnaire. The data were entered into Epi Info and exported
to SPSS version 24 for analysis. All variables with p-value < 0.05 under
adjusted odds ratio were taken as statistical significant associated factors
with postpartum intimate partner violence. Results: A total of 414 postpartum women participated in the study with a 97% of
response rate. The prevalence of postpartum intimate partner violence was
31.4%. The study identified that monthly income 1000–5000 birr (adjusted
odds ratio = 3.4; 95% confidence interval = 1.08, 10.5), partners’ alcohol
consumption (adjusted odds ratio = 0.17, 95% confidence interval = 0.06,
0.45), decision-maker of household affairs (adjusted odds ratio = 4.8; 95%
confidence interval = 1.5, 15.1), and infant’s sex (adjusted odds
ratio = 0.03; 95% confidence interval = 0.02, 0.063) were significantly
associated with postpartum intimate partner violence. Conclusion: According to the findings of this study, nearly one-third of postpartum women
were violated by their intimate partner after childbirth. Postpartum
intimate partner violence was found to be associated with monthly income,
partners’ alcohol intake, decision-maker of household affairs, and infant’s
sex. To reduce the magnitude of the problem, different efforts should
require from health professional, community, and government. The policy
makers, planners and other concerned bodies establish appropriate strategy
to prevent and control violence against women.
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Affiliation(s)
- Dejene Edosa Dirirsa
- Department of Midwifery, College of Health and Medical Sciences, Salale University, Fiche, Ethiopia
| | - Adugna Alemu Desta
- Department of Midwifery, College of Health and Medical Sciences, Salale University, Fiche, Ethiopia
| | - Tinsae Abeya Geleta
- Department of Public Health, College of Health and Medical Sciences, Salale University, Fiche, Ethiopia
| | | | - Girma Tufa Melese
- Department of Midwifery, College of Health and Medical Sciences, Bule Hora University, Bule Hora, Ethiopia
| | - Shimellis Tadese Abebe
- Department of Midwifery, College of Health and Medical Sciences, Mettu University, Metu, Ethiopia
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Yalçın SU, Özaslan ZZ, Dinç S, Bilgin H. AN EXAMINATION OF EFFECTS OF INTIMATE PARTNER VIOLENCE ON CHİLDREN: A CROSS-SECTIONAL STUDY CONDUCTED IN PEDIATRIC EMERGENCY UNIT IN TURKEY. J Nurs Manag 2022; 30:1648-1657. [PMID: 35560694 DOI: 10.1111/jonm.13673] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 02/24/2022] [Accepted: 05/09/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Intimate Partner Violence (IPV) against women causes inadequate and unbalanced nutrition in children aged 0-5 years and adversely affects their growth. AIM To examine the impact of intimate partner violence on a child's growth regarding the medical diagnosis in paediatric patients under 5-year-old, growth of the child, and mother's exposure to intimate partner violence. METHODS This descriptive cross-sectional study included 166 children, admitted to the paediatric emergency department, and their mothers. RESULTS Women exposed to emotional violence and controlling behaviour during pregnancy had children prone to being overweight and obese. Mothers' lifetime exposure to physical violence had an adverse effect on their children's wasting and moderate wasting. In contrast, mothers' exposure to emotional violence had a direct impact on childs' wasting and moderate wasting. CONCLUSION The lifetime effect of domestic violence may begin at birth. This vulnerability leads to negative outcomes in both children and women regarding biopsychosocial development. Implications for nursing management Nurses and midwives in primary healthcare services and one-on-one care should be trained to evaluate prospective mothers and children aged 0-5 regarding violence and its effects on the child's growth.
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Affiliation(s)
- Suna Uysal Yalçın
- Kocaeli Health and Technology University, Psychiatric and Mental Health Nursing Department, Kocaeli, Turkey
| | - Zeynep Zonp Özaslan
- University of Michigan, School of Nursing, Ann Arbor, USA;Kocaeli University, Psychiatric and Mental Health Nursing Department, Kocaeli, Turkey
| | - Sermin Dinç
- Istanbul University-Cerrahpaşa Florence Nightingale Faculty of Nursing, Child Health and Diseases Nursing, İstanbul, Turkey
| | - Hülya Bilgin
- Istanbul University-Cerrahpaşa Florence Nightingale Faculty of Nursing, Psychiatric and Mental Health Nursing Department, İstanbul, Turkey
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Tran LM, Nguyen PH, Naved RT, Menon P. Intimate partner violence is associated with poorer maternal mental health and breastfeeding practices in Bangladesh. Health Policy Plan 2021; 35:i19-i29. [PMID: 33165581 PMCID: PMC7649668 DOI: 10.1093/heapol/czaa106] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2020] [Indexed: 12/03/2022] Open
Abstract
Exposure to intimate partner violence (IPV) can have profound adverse consequences on maternal and child health. This study aimed to: (1) identify factors associated with IPV during pregnancy and postpartum in Bangladesh; and (2) assess the associations between IPV and maternal mental health and breastfeeding practices. We used data from a cross-sectional survey of 2000 mothers with children <6 months in four districts in Bangladesh. We applied multivariable logistic regression models to examine factors associated with IPV and structural equation modelling to assess the inter-relationships between IPV, maternal common mental disorders (CMD, measured by Self-reporting Questionnaire ≥7) and breastfeeding practices. Overall, 49.7% of mothers experienced violence during the last 12 months and 28% of mothers had high levels of CMD. Only 54% of women reported early initiation of breastfeeding and 64% reported exclusive breastfeeding. Women were more likely to experience IPV if living in food-insecure households, being of low socio-economic status, having low autonomy or experiencing inequality in education compared with husbands (OR ranged from 1.6 to 2.8). Women exposed to IPV were 2–2.3 times more likely to suffer from high levels of CMD and 28–34% less likely to breastfeed their babies exclusively. The indirect path (the indirect effects of IPV on breastfeeding through CMD) through maternal CMD accounted for 14% of the relationship between IPV on breastfeeding practice. In conclusion, IPV is pervasive in Bangladesh and is linked to increased risks of CMD and poor breastfeeding practices. Integrating effective interventions to mitigate IPV, along with routine maternal and child health services and involving men in counselling services, could help both to reduce exposure to IPV among women and to contribute to better health outcomes for women and children.
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Affiliation(s)
- Lan Mai Tran
- Alive &Thrive, FHI360,18 Ly Thuong Kiet Street, Hanoi, Vietnam
| | - Phuong Hong Nguyen
- Poverty, Health and Nutrition Division, International Food Policy Research Institute, Washington, DC, USA
| | - Ruchira Tabassum Naved
- Health System and Population Studies Division, ICDDR, GPO Box 128, Dhaka 1000, Bangladesh
| | - Purnima Menon
- Poverty, Health and Nutrition Division, International Food Policy Research Institute, Washington, DC, USA
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12
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Walters CN, Rakotomanana H, Komakech JJ, Stoecker BJ. Maternal experience of intimate partner violence is associated with suboptimal breastfeeding practices in Malawi, Tanzania, and Zambia: insights from a DHS analysis. Int Breastfeed J 2021; 16:20. [PMID: 33602285 PMCID: PMC7890985 DOI: 10.1186/s13006-021-00365-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 02/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite widespread suboptimal breastfeeding practices and maternal experiences of intimate partner violence (IPV), the association of IPV and breastfeeding practices remains unclear. This study investigated the associations between maternal experience of physical, sexual, emotional violence, and controlling behaviors with suboptimal breastfeeding practices in Malawi, Tanzania, and Zambia. METHODS Data included mother-infant dyads from the most recent Demographic and Health Surveys for Malawi (n = 1878), Tanzania (n = 3184), and Zambia (n = 3879). Intimate partner violence (physical, sexual, and emotional) was measured using the Revised Conflict Tactics Scale. Breastfeeding practices were early initiation of breastfeeding (within 1 h of birth), exclusive breastfeeding (in previous 24 h), and continued breastfeeding. Associations between experience of physical, sexual, or emotional violence or controlling behaviors and breastfeeding practices, as well as associations between the frequency of IPV and breastfeeding practices were assessed. RESULTS Many Malawian (77.6%) and Zambian (67.7%) and just over half (53.6%) of Tanzanian mothers, initiated breastfeeding within 1 h of birth. Exclusive breastfeeding was 70.6% in Zambia and 60.1% in Malawi, while 55.0% of Tanzanian mothers breastfed exclusively. Continued breastfeeding to at least 1 year was high in Malawi 92.2%, Tanzania 93.4%, and Zambia 95.0%. Most mothers reported experiences of IPV in Tanzania 79.1%, Zambia 78.9%, and Malawi 73.9%. Mothers who experienced sexual IPV were significantly more likely to delay breastfeeding (Malawi [AOR 1.55 (1.14, 2.10)]; Tanzania [AOR 1.30 (1.04, 1.62)]; and Zambia [AOR 1.28 (1.06, 1.54)]). Sexual IPV in Malawi and Zambia was associated with greater odds of not exclusively breastfeeding (Malawi [AOR 1.90 (1.05, 3.45)]; Zambia [AOR 1.75 (1.15, 2.67)]). Tanzanian mothers who experienced IPV often or sometimes were two times more likely not to breastfeed at one-year post-delivery [AOR 2.23 (1.09,4.57)]. CONCLUSIONS In the three countries investigated maternal experience of IPV was associated with suboptimal breastfeeding practices. Policies and programs targeting improved breastfeeding practices should consider screening during antenatal and postnatal care for experience of violence and support initiatives to reduce IPV.
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Affiliation(s)
- Christine N Walters
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA.
| | - Hasina Rakotomanana
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Joel J Komakech
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
| | - Barbara J Stoecker
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA
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Normann AK, Bakiewicz A, Kjerulff Madsen F, Khan KS, Rasch V, Linde DS. Intimate partner violence and breastfeeding: a systematic review. BMJ Open 2020; 10:e034153. [PMID: 33130559 PMCID: PMC7783610 DOI: 10.1136/bmjopen-2019-034153] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 08/11/2020] [Accepted: 09/21/2020] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE The association between intimate partner violence (IPV) and breastfeeding is unclear. We conducted a systematic review to summarise the evidence of breastfeeding outcomes following exposure to IPV. DESIGN Systematic review. METHODS We searched for published studies without study design or language restrictions (up to July 2019) in the following databases: PubMed, Embase, SCOPUS and The Global Health Library. Studies assessing various breastfeeding outcomes (initiation, duration and exclusive breastfeeding) in women exposed to IPV in any form (physical, psychological or sexual) and at any stage (1 year pre-pregnancy, during or post-pregnancy) were included. Two authors independently selected the studies and conducted the quality appraisal by use of the Newcastle-Ottawa Scale. Results were summarised taking precision and quality into account. RESULTS A total of 16 studies (participants n=414 393) were included and they adjusted for a total of 48 different confounders. The majority of studies were cross-sectional (n=11) and most studies were judged to be fair/low quality. Four out of seven studies found that IPV exposure shortened breastfeeding duration (adjusted ORs/aORs=0.22 (95% CI: 0.05-0.85), 1.18 (95% CI: 1.01-1.37), 5.92 (95% CI: 1.72-27.98), 1.28 (95% CI: 1.18-1.39)). Further, 5/10 studies found that IPV led to early termination of exclusive breastfeeding (aORs=1.53 (95% CI: 1.01-23.1), 0.83 (95% CI: 0.71-0.96), 1.35 (95% CI: 1.07-1.71), 0.17 (95% CI: 0.07-0.4), 1839 (95% CI: 1.61-2911)) and 2/6 studies found that IPV significantly reduced breastfeeding initiation (aORs=2.00 (95% CI: 1.2-3.3), 0.81 (95% CI: 0.7-0.93)). CONCLUSION IPV exposure appears to associate negatively with some breastfeeding outcomes. Individual patient data meta-analysis is required to quantify the magnitude of the association for specific IPV-outcome combinations. More high-quality studies and definition of core confounders are warranted. PROSPERO REGISTRATION NUMBER CRD42019129353.
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Affiliation(s)
- Anne Katrine Normann
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Aleksandra Bakiewicz
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | - Khalid Saeed Khan
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Granada, Spain
| | - Vibeke Rasch
- Obstetrics and Gynaecology, Odense Universitetshospital, Odense, Denmark
- Institute of Clinical Research, Syddansk Universitet, Odense, Denmark
| | - Ditte Søndergaard Linde
- Obstetrics and Gynaecology, Odense Universitetshospital, Odense, Denmark
- Institute of Clinical Research, Syddansk Universitet, Odense, Denmark
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14
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Ribeiro MRC, Batista RFL, Schraiber LB, Pinheiro FS, Santos AMD, Simões VMF, Confortin SC, Aristizabal LYG, Yokokura AVCP, Silva AAMD. Recurrent Violence, Violence with Complications, and Intimate Partner Violence Against Pregnant Women and Breastfeeding Duration. J Womens Health (Larchmt) 2020; 30:979-989. [PMID: 32936043 DOI: 10.1089/jwh.2020.8378] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Few studies have investigated the association between violence against pregnant women in terms of recurrence, complications, and perpetrators of violence, and breastfeeding duration. This study verifies whether recurrent violence, violence with pregnancy complications, and intimate partner violence (IPV) against pregnant women are associated with shorter exclusive breastfeeding up to the infant's 6th month and breastfeeding up to the 12th month of life. Materials and Methods: A cohort study with a convenience sample of 1,146 pregnant women was performed. Follow-up assessments were conducted at birth, and at 12-36 months. Survival analysis was used to verify whether recurrent violence, violence with pregnancy complications, and IPV were associated with reduced duration of exclusive breastfeeding and breastfeeding. Results: The adjusted Cox regression revealed no difference regarding exclusive breastfeeding duration among mothers exposed or not exposed to violence and according to who perpetrated the violence. The risk of an infant not being breastfed within the first 12 months of life increased in cases of violence before/during pregnancy (95% confidence interval [CI] = 1.03-1.88), recurrent psychological/physical/sexual violence during pregnancy (95% CI = 1.11-1.92), recurrent psychological violence (95% CI = 1.05-1.96), and recurrent physical/sexual violence (95% CI = 1.01-2.39). Violence with pregnancy complications (95% CI = 0.94-2.22) was not associated with breastfeeding interruption. Similar risks of breastfeeding interruption were observed for IPV (95% CI = 0.96-1.87) and violence perpetrated by other family members (95% CI = 0.83-1.89). Conclusions: We observed a shorter breastfeeding duration up to 12 months of life in cases of recurrent violence.
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Affiliation(s)
| | | | | | | | | | | | - Susana Cararo Confortin
- Postgraduation Program in Collective Health, Federal University of Maranhão, São Luís, Brazil
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15
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Caprara GL, Bernardi JR, Bosa VL, da Silva CH, Goldani MZ. Does domestic violence during pregnancy influence the beginning of complementary feeding? BMC Pregnancy Childbirth 2020; 20:447. [PMID: 32758170 PMCID: PMC7404913 DOI: 10.1186/s12884-020-03144-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 07/30/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study investigate the influence of domestic violence against pregnant women on early complementary feeding and associated factors. METHODS A longitudinal observational study was conducted with a convenience sample recruited from three public hospitals in Porto Alegre, Rio Grande do Sul, Brazil. Data on maternal age, education, marital status, breastfeeding, introduction of complementary feeding and domestic violence during pregnancy were investigated at four follow-ups points. Data on domestic violence was collected through a self-report questionnaire based on the Abuse Assessment Screen. The early introduction of complementary feeding, characterized as occurring before or at 3 months of life, was verified through a questionnaire prepared by the research group. Data analysis involved Student's t-test, the chi-square test and Cox regression and was carried out in Statistical Package for the Social Sciences program. The significance level was set at 5%. RESULTS A total of 232 mother-infant pairs participated in the analyses, and 15.1% of the mothers reported suffering some form of violence. Domestic violence was directly associated with maternal education, marital status, and health status during pregnancy. Domestic violence was not associated with maternal age or breastfeeding at 3 months after delivery. In the univariate analysis, domestic violence during pregnancy was associated with early complementary feeding (RR = 1.74; CI: 1.01-2.98). This effect disappeared after the model was adjusted in multivariate analysis. CONCLUSIONS There was no relationship between domestic violence during pregnancy and early complementary feeding.
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Affiliation(s)
- Gabriele Luiza Caprara
- Center for Child and Adolescent Health Studies – Hospital de Clínicas de Porto Alegre – Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, Porto Alegre, RS 90035-903 Brazil
| | - Juliana Rombaldi Bernardi
- Center for Child and Adolescent Health Studies – Hospital de Clínicas de Porto Alegre – Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, Porto Alegre, RS 90035-903 Brazil
| | - Vera Lúcia Bosa
- Center for Child and Adolescent Health Studies – Hospital de Clínicas de Porto Alegre – Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, Porto Alegre, RS 90035-903 Brazil
| | - Clécio Homrich da Silva
- Center for Child and Adolescent Health Studies – Hospital de Clínicas de Porto Alegre – Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, Porto Alegre, RS 90035-903 Brazil
| | - Marcelo Zubaran Goldani
- Center for Child and Adolescent Health Studies – Hospital de Clínicas de Porto Alegre – Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2350, Porto Alegre, RS 90035-903 Brazil
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16
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Baraldi NG, Lettiere-Viana A, Carlos DM, Salim NR, Pimentel DTR, Stefanello J. The meaning of the social support network for women in situations of violence and breastfeeding. Rev Lat Am Enfermagem 2020; 28:e3316. [PMID: 32696921 PMCID: PMC7365605 DOI: 10.1590/1518-8345.3313.3316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 04/06/2020] [Indexed: 11/22/2022] Open
Abstract
Objective: to understand the meanings attributed to the social support network of women
breastfeeding and in situations of violence by an intimate partner. Method: a qualitative study, carried out with 21 women, through semi-structured
interviews and data analyzed by the Method of Interpretation of the Senses
in the light of the conceptual framework of Social Support Network. Results: all women suffered violence by the partner in the puerperium and only one of
them maintained exclusive breastfeeding until 180 days postpartum. In the
analysis, the category entitled “The action of the social support network in
the face of breastfeeding in the context of intimate partner violence”
emerged, with two subcategories: “Interpersonal support network” and
“Institutional support network”. In the interpersonal network, the partner
was little mentioned, on the other hand, there was a greater participation
of other women. In the institutional network, non-resolution and actions
centered on biological character were evident. Conclusions: the search for help in the interpersonal network stood out in comparison to
the institutional network, both with regard to the issue of violence and
breastfeeding and the actions related to it, mostly ineffective,
characterized by counseling and referrals.
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Affiliation(s)
- Nayara Girardi Baraldi
- Escola de Artes, Ciências e Humanidades, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Angelina Lettiere-Viana
- PAHO/WHO Collaborating Centre at the Nursing Research Development, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Diene Monique Carlos
- Departamento de Enfermagem, Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Natália Rejane Salim
- Departamento de Enfermagem, Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Daniela Taysa Rodrigues Pimentel
- PAHO/WHO Collaborating Centre at the Nursing Research Development, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Juliana Stefanello
- PAHO/WHO Collaborating Centre at the Nursing Research Development, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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Young MF, Nguyen P, Kachwaha S, Tran Mai L, Ghosh S, Agrawal R, Escobar-Alegria J, Menon P, Avula R. It takes a village: An empirical analysis of how husbands, mothers-in-law, health workers, and mothers influence breastfeeding practices in Uttar Pradesh, India. MATERNAL AND CHILD NUTRITION 2019; 16:e12892. [PMID: 31773869 PMCID: PMC7083414 DOI: 10.1111/mcn.12892] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 06/17/2019] [Accepted: 08/29/2019] [Indexed: 12/03/2022]
Abstract
Evidence on strategies to improve infant and young child feeding in India, a country that carries the world's largest burden of undernutrition, is limited. In the context of a programme evaluation in two districts in Uttar Pradesh, we sought to understand the multiple influences on breastfeeding practices and to model potential programme influence on improving breastfeeding. A cross‐sectional survey was conducted among 1,838 recently delivered women, 1,194 husbands, and 1,353 mothers/mothers‐in‐law. We used bivariate and multivariable logistic regression models to examine the association between key determinants (maternal, household, community, and health services) and breastfeeding outcomes [early initiation of breastfeeding (EIBF)], prelacteal feed, and exclusive breastfeeding (EBF). We used population attributable risk analysis to estimate potential improvement in breastfeeding practices. Breastfeeding practices were suboptimal: EIBF (26.3%), EBF (54%), and prelacteal feeding (33%). EIBF was positively associated with maternal knowledge, counselling during pregnancy/delivery, and vaginal delivery at a health facility. Prelacteal feeds were less likely to be given when mothers had higher knowledge, beliefs and self‐efficacy, delivered at health facility, and mothers/mothers‐in‐law had attended school. EBF was positively associated with maternal knowledge, beliefs and self‐efficacy, parity, and socio‐economic status. High maternal stress and domestic violence contributed to lower EBF. Under optimal programme implementation, we estimate EIBF can be improved by 25%, prelacteal feeding can be reduced by 25%, and EBF can be increased by 23%. A multifactorial approach, including maternal‐, health service‐, family‐, and community‐level interventions has the potential to lead to significant improvements in breastfeeding practices in Uttar Pradesh.
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Affiliation(s)
- Melissa F Young
- Hubert Department of Global Health, Emory University, Atlanta, GA, USA
| | - Phuong Nguyen
- Poverty, Health and Nutrition Division, International Food Policy Research Institute (IFPRI), Washington, DC, USA
| | - Shivani Kachwaha
- Poverty, Health and Nutrition Division, International Food Policy Research Institute (IFPRI), Washington, DC, USA
| | | | | | | | | | - Purnima Menon
- Poverty, Health and Nutrition Division, International Food Policy Research Institute (IFPRI), Washington, DC, USA
| | - Rasmi Avula
- Poverty, Health and Nutrition Division, International Food Policy Research Institute (IFPRI), Washington, DC, USA
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18
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Caleyachetty R, Uthman OA, Bekele HN, Martín-Cañavate R, Marais D, Coles J, Steele B, Uauy R, Koniz-Booher P. Maternal exposure to intimate partner violence and breastfeeding practices in 51 low-income and middle-income countries: A population-based cross-sectional study. PLoS Med 2019; 16:e1002921. [PMID: 31574100 PMCID: PMC6771984 DOI: 10.1371/journal.pmed.1002921] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 08/27/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Intimate partner violence (IPV) against women is a major global health issue, particularly in low- and middle-income countries (LMICs), that is associated with poor physical and mental health, but its association with breastfeeding practices is understudied. Both the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) recommend that children initiate breastfeeding within the first hour of birth and be exclusively breastfed for the first 6 months of life. Breastfeeding within the first hour of birth is critical to newborn survival, and exclusive breastfeeding for 6 months is recognised to offer significant health benefits to mothers and their infants. We examined the association of maternal exposure to IPV with early initiation of breastfeeding (within 1 hour of birth) and exclusive breastfeeding in the first 6 months. METHODS AND FINDINGS We assessed population-based cross-sectional Demographic and Health Surveys (DHS) from 51 LMICs. Data from the most recent DHS in each country (conducted between January 2000 and January 2019) with data available on IPV and breastfeeding practices were used. By WHO region, 52.9% (27/51) were from Africa, 11.8% (6/51) from the Americas, 7.8% (4/51) from the Eastern Mediterranean, 11.8% (6/51) from Europe, 11.8% (6/51) from South-East Asia, and 3.9% (2/51) from the Western Pacific. We estimated multilevel logistic regression models for any IPV and each type of IPV separately (physical violence, sexual violence, and emotional violence), accounting for demographic and socioeconomic factors. Depending on specification, the sample size varied between 95,320 and 102,318 mother-infant dyads. The mean age of mothers was 27.5 years, and the prevalence of any lifetime exposure to IPV among mothers was 33.3% (27.6% for physical violence, 8.4% for sexual violence, and 16.4% for emotional violence). Mothers exposed to any IPV were less likely to initiate breastfeeding early (adjusted odds ratio [AOR]: 0.88 [95% CI 0.85-0.97], p < 0.001) and breastfeed exclusively in the first 6 months (AOR: 0.87 [95% CI 0.82-0.92], p < 0.001). The associations were similar for each type of IPV and were overall consistent across infant's sex and WHO regions. After simultaneously adjusting for all 3 types of IPV, all 3 types of IPV were independently associated with decreased likelihood of early breastfeeding initiation, but only exposure to physical violence was independently associated with a decreased likelihood of exclusively breastfeeding in the first 6 months. The main limitations of this study included the use of cross-sectional datasets, the possibility of residual confounding of the observed associations by household wealth, and the possibility of underreporting of IPV experiences attenuating the magnitude of observed associations. CONCLUSIONS Our study indicates that mothers exposed to any form of IPV (physical, sexual, or emotional violence) were less likely to initiate breastfeeding early and breastfeed exclusively in the first 6 months. These findings may inform the argument for antenatal screening for IPV in LMICs and the provision of services to not only improve mothers' safety and well-being, but also support them in adopting recommended breastfeeding practices.
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Affiliation(s)
- Rishi Caleyachetty
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
- * E-mail:
| | | | - Hana Nekatebeb Bekele
- World Health Organization Inter-Country Support Team, Zimbabwe WHO Country Office, Harare, Zimbabwe
| | | | - Debbie Marais
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Jennifer Coles
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Briony Steele
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Ricardo Uauy
- School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Peggy Koniz-Booher
- JSI Research & Training Institute, Arlington, Virginia, United States of America
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Kjerulff Madsen F, Holm-Larsen CE, Wu C, Rogathi J, Manongi R, Mushi D, Meyrowitsch DW, Gammeltoft T, Sigalla GN, Rasch V. Intimate partner violence and subsequent premature termination of exclusive breastfeeding: A cohort study. PLoS One 2019; 14:e0217479. [PMID: 31181090 PMCID: PMC6557484 DOI: 10.1371/journal.pone.0217479] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 05/13/2019] [Indexed: 12/19/2022] Open
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.
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Affiliation(s)
- Frederikke Kjerulff Madsen
- Research Unit of Gynaecology and Obstetrics, University of Southern Denmark, Odense, Denmark
- OPEN, Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark
- Psychiatric Research Academy Odense, Odense, Denmark
- * E-mail:
| | - Christina Elise Holm-Larsen
- Research Unit of Gynaecology and Obstetrics, University of Southern Denmark, Odense, Denmark
- OPEN, Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark
- Psychiatric Research Academy Odense, Odense, Denmark
| | - Chunsen Wu
- Research Unit of Gynaecology and Obstetrics, University of Southern Denmark, Odense, Denmark
| | - Jane Rogathi
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Rachel Manongi
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Declare Mushi
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | | | - Tine Gammeltoft
- Department of Anthropology, University of Copenhagen, Copenhagen, Denmark
| | - Geofrey Nimrody Sigalla
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Vibeke Rasch
- Research Unit of Gynaecology and Obstetrics, University of Southern Denmark, Odense, Denmark
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Bovbjerg ML. Current Resources for Evidence-Based Practice, January 2019. J Obstet Gynecol Neonatal Nurs 2019; 48:99-111. [DOI: 10.1016/j.jogn.2018.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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