379 - The Impact of Intimate Partner Violence on Breastfeeding: Disparities by Infant Gestational Age and Maternal Sociodemographic and Socioeconomic Characteristics

Publication Number: 3366.379

Grace Fjermedal, Rush Medical College of Rush University Medical Center, Chicago, IL, United States; Chuka N.. Emezue, Rush Medical College of Rush University Medical Center, Chicago, IL, United States; Tricia J.. Johnson, Rush University, Chicago, IL, United States; Katherine Bean, Rush Medical College of Rush University Medical Center, Chicago, IL, United States

Background: Breastfeeding plays a critical role in promoting maternal and infant health and development; yet, disparities in breastfeeding initiation and continuation persist. Intimate Partner Violence (IPV) is a pervasive form of physical, psychological, and sexual abuse and trauma affecting 1 in 4 US women of childbearing age in their lifetime. IPV before or during pregnancy can undermine a mother’s ability or decision to initiate and continue breastfeeding. However, little is known about how IPV impacts breastfeeding behaviors across infant gestational age (GA) and how sociodemographic factors may compound this risk.

Objective: This study examines the impact of IPV on mothers’ breastfeeding initiation and continuation at 12 weeks postpartum by infant birth GA (early preterm ≤33 weeks, late preterm 34-36 weeks, and term ≥37 weeks).

Design/Methods: We conducted a cross-sectional analysis of 149,770 postpartum women from the 2017-2021 Pregnancy Risk Assessment Monitoring System (PRAMS), a CDC population-based survey. Chi-square analysis was used to examine how IPV before or during pregnancy impacts breastfeeding initiation and continuation at 12 weeks by infant GA.

Results: Within the PRAMS study population, IPV prevalence was highest among teen mothers < 19 years old compared to 25-34 years old (7.6% vs 2.7%), Black and Hispanic mothers compared to White mothers (4.9% and 3.5% vs 2.8%), and mothers with lower education levels compared to a bachelor degree or higher (5% vs 1%), (p <.001). Mothers exposed to IPV who delivered ≤33 weeks GA had significantly lower breastfeeding initiation (82.9% vs 89.1%, p=.017) and continuation (38.6% vs 58.1%, p<.001) than unexposed mothers. Among late preterm deliveries, only continuation differed significantly (42.3% vs 60.8%, p<.001). For term deliveries, IPV exposure was linked to lower initiation (82.8% vs 88.3%, p<.001) and continuation (52.9% vs 71.1%, p<.001).

Conclusion(s): IPV exposure was associated with decreased rates of breastfeeding initiation and continuation, with the strongest effects in preterm infants at the highest developmental risk. Moreover, socioeconomically vulnerable mothers face compounded and intersecting vulnerabilities and are disproportionately affected by IPV. These disparities in IPV exposure and breastfeeding outcomes underscore the need for trauma- and violence-informed prenatal IPV screening and tailored lactation support to advance maternal and infant health in vulnerable populations. Future research should investigate effective breastfeeding support for populations impacted by IPV, particularly within high-risk sociodemographic groups.

IPV Exposure by Sociodemographic Characteristics
Table 1.pdf

Percent of Mothers Exposed to IPV by Infant Gestational Age
Table 2.pdf

Association Between IPV Exposure and Breastfeeding Outcomes by Infant Gestational Age
Table 3.pdf