Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, USA.
Int Breastfeed J. 2021 Feb 18;16(1):20. doi: 10.1186/s13006-021-00365-5.
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.
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.
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)].
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.
尽管母乳喂养的做法普遍不够理想，而且母亲也经历过亲密伴侣暴力（IPV），但 IPV 和母乳喂养做法之间的关联仍不清楚。本研究调查了马拉维、坦桑尼亚和赞比亚的母亲经历身体、性、情感暴力和控制行为与母乳喂养做法之间的关联。
数据包括马拉维（n=1878）、坦桑尼亚（n=3184）和赞比亚（n=3879）最近的人口与健康调查中的母婴对子。亲密伴侣暴力（身体、性和情感）使用修订后的冲突策略量表进行测量。母乳喂养做法包括出生后 1 小时内早期开始母乳喂养、在过去 24 小时内纯母乳喂养和持续母乳喂养。评估了经历身体、性或情感暴力或控制行为与母乳喂养做法之间的关联，以及 IPV 发生频率与母乳喂养做法之间的关联。
马拉维和赞比亚有许多母亲（77.6%和 67.7%）和超过一半（53.6%）的坦桑尼亚母亲在出生后 1 小时内开始母乳喂养。在赞比亚和马拉维，纯母乳喂养率分别为 70.6%和 60.1%，而 55.0%的坦桑尼亚母亲进行纯母乳喂养。至少持续母乳喂养 1 年的比例在马拉维为 92.2%，坦桑尼亚为 93.4%，赞比亚为 95.0%。坦桑尼亚（79.1%）、赞比亚（78.9%）和马拉维（73.9%）的大多数母亲报告了 IPV 经历。经历性 IPV 的母亲明显更有可能延迟母乳喂养（马拉维 [AOR 1.55（1.14，2.10）]；坦桑尼亚 [AOR 1.30（1.04，1.62）]；和赞比亚 [AOR 1.28（1.06，1.54）]）。马拉维和赞比亚的性 IPV 与不进行纯母乳喂养的可能性更大相关（马拉维 [AOR 1.90（1.05，3.45）]；赞比亚 [AOR 1.75（1.15，2.67）]）。坦桑尼亚经历过 IPV 的母亲经常或有时不太可能在分娩后一年进行母乳喂养 [AOR 2.23（1.09，4.57）]。
在调查的三个国家中，母亲经历 IPV 与母乳喂养做法不理想有关。针对改善母乳喂养做法的政策和方案应考虑在产前和产后护理期间筛查暴力经历，并支持减少 IPV 的举措。
