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.
['Eagen-Torkko|Meghan|M|', 'Low|Lisa Kane|LK|', 'Zielinski|Ruth|R|', 'Seng|Julia S|JS|']
D000328:Adult D054523:Adult Survivors of Child Abuse D001942:Breast Feeding D002648:Child D002649:Child Abuse D005260:Female D006801:Humans D007223:Infant D007231:Infant, Newborn D000068097:Maternal Health D015146:Midwestern United States D009034:Mother-Child Relations D009035:Mothers D011237:Predictive Value of Tests D011247:Pregnancy D015995:Prevalence D011446:Prospective Studies D018570:Risk Assessment D013313:Stress Disorders, Post-Traumatic
breastfeeding childhood abuse childhood maltreatment trauma CMT posttraumatic stress disorder PTSD