Elfgen Constanze, Hagenbuch Niels, Görres Gisela, Block Emina, Leeners Brigitte
1 Breast Centre, University Hospital Zürich, Zürich, Switzerland.
2 Department of Biostatistics, University of Zürich, Zürich, Switzerland.
J Hum Lact. 2017 Feb;33(1):119-127. doi: 10.1177/0890334416680789. Epub 2017 Jan 12.
Childhood sexual abuse (CSA) can have a serious effect on general and obstetric health. Breastfeeding includes several triggers for memories of abuse experiences, which will likely influence decisions about breastfeeding and its implementation in daily life. This is important since breastfeeding improves maternal well-being and bonding with the child. Research aim: As breastfeeding strongly influences the long-term health of children, we investigated experiences with breastfeeding in women with a history of CSA.
Data on breastfeeding were collected within a research project designed to compare labor and delivery experiences in women with a history of CSA to women without such antecedents. Data from 85 women having experienced CSA and 170 controls pair-matched for maternal age, children's age, and nationality were evaluated. The clinical record of pregnancy and a self-administered questionnaire were used to collect data.
Although the prevalence of breastfeeding was similar in women with and without CSA experiences (96.5% vs. 90.6%), women exposed to CSA more often described complications associated with breastfeeding (77.7% vs. 67.1%, p = .08). Mastitis (49.4% vs. 27.6%, p < .01) and pain (29.4% vs. 18.8%, p = .15) were reported significantly more often by women after CSA. For 20% of women after CSA, breastfeeding was a trigger for memories of CSA. Furthermore, 58% of women with CSA reported dissociation when breastfeeding.
In addition to the growing list of potential health consequences of CSA experience, this experience seems to be associated with an increased number of problems when breastfeeding. However, most women with a history of CSA intend to breastfeed despite particular challenges related to CSA. A support protocol tailored to the specific needs of these women during pregnancy and the lactation period may help to improve breastfeeding and the early mother-child relationship.
儿童期性虐待（CSA）会对总体健康和产科健康产生严重影响。母乳喂养包含多种引发虐待经历记忆的因素，这可能会影响母乳喂养的决策及其在日常生活中的实施。这一点很重要，因为母乳喂养能改善母亲的幸福感并增进与孩子的情感联结。研究目的：由于母乳喂养对儿童的长期健康有重大影响，我们调查了有CSA病史女性的母乳喂养经历。
在一个研究项目中收集了母乳喂养的数据，该项目旨在比较有CSA病史的女性与无此类病史的女性的分娩经历。对85名有CSA经历的女性和170名在母亲年龄、孩子年龄和国籍方面配对匹配的对照组的数据进行了评估。使用妊娠临床记录和一份自我管理的问卷来收集数据。
尽管有CSA经历和无CSA经历的女性中母乳喂养的发生率相似（96.5%对90.6%），但有CSA经历的女性更常描述与母乳喂养相关的并发症（77.7%对67.1%，p = 0.08）。CSA后女性报告乳腺炎（49.4%对27.6%，p < 0.01）和疼痛（29.4%对18.8%，p = 0.15）的情况明显更多。对于20%有CSA经历后的女性，母乳喂养是CSA记忆的触发因素。此外，58%有CSA经历的女性报告在母乳喂养时有解离现象。
除了CSA经历潜在的健康后果不断增加外，这种经历似乎与母乳喂养时出现更多问题有关。然而，大多数有CSA病史的女性尽管面临与CSA相关的特殊挑战，仍打算进行母乳喂养。在孕期和哺乳期针对这些女性的特定需求制定支持方案，可能有助于改善母乳喂养和早期母婴关系。
