The association between childhood trauma and breastfeeding for a sample of women from Hamilton, Ontario, Canada Público

Abstract

Purpose: The goal of this research was to examine the association between childhood trauma (sexual, physical and emotional abuse) and breastfeeding outcomes (initiation, exclusive breastfeeding at 3 months and 6 months and any breastfeeding at 3, 6 and 12 months).
Methods: 257 women from Hamilton, Ontario, Canada were enrolled in a prospective study to assess their maternal and infant behaviors. Mothers were enrolled prenatally and were visited at home at 3, 6, 12, 18 and 24 months. Abuse was determined during the screening assessment at 12-18 weeks gestation. Women were screened for the three forms of abuse using the Childhood Trauma Questionnaire (CTQ). Breastfeeding initiation, exclusivity and duration were assessed at 6 and 12 months postpartum. The association between abuse and breastfeeding was examined using multivariate logistic regression models. Adjustments were made for maternal age, race, education, living with their partner, depression and if the pregnancy was unwanted.
Findings: Childhood physical abuse was significantly associated (at the p<0.05 level) with any breastfeeding at 3months [2.6, (1.145, 6.174)], 6 months [2.3 (1.009, 5.171)] and 12 months [5.4 (1.212, 23.839)]. Childhood sexual abuse was significantly associated with any breastfeeding at 6 months [2.437, (1.087, 5.461)]. In all cases the association was that those who were not abused were more likely to still be breastfeeding at those time points when compared to women who were abused. When adjustments were made for the covariates the associations were attenuated and there was no statistical association between abuse and infant feeding practices.
Conclusion: More attention should be paid to associations between childhood abuse and breastfeeding in general, especially the association between childhood physical abuse and later breastfeeding practices. In addition, maternity care professionals need to be educated on this topic to learn how to identify women who may have been abused and provide care to them in a way that is sensitive in order to foster successful breastfeeding when possible.

Table of Contents

Chapter 1: Introduction - 1

Chapter 2: Literature Review - 4

Chapter 3: Methodology and Results - 24

Chapter 4: Discussion, Conclusion and Recommendations -33

References - 40

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Palabra Clave	childhood trauma infant feeding child abuse breastfeeding
Committee Chair / Thesis Advisor	Girard, Amy Webb, Emory University
Partnering Agencies	University, college or educational institution (other than Emory)

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