Breastfeeding is a complex relational act within the context of women’s lives and histories, which can include childhood maltreatment trauma (CMT) and its sequelae, including PTSD. There is little known about how a history of abuse and/or PTSD affects breastfeeding outcomes. In this study, I consider breastfeeding outcomes using public health and woman-centered outcome measures, and a trauma-informed theoretical approach to history of CMT and PTSD. This was a secondary analysis of 519 women, with data collected three times in the perinatal year, from a larger study conducted from 2006-2008.
In addition to comparing breastfeeding rates at 6 weeks postpartum, I developed a woman-centered adjunct outcome measurement of breastfeeding success, called concordance, referring to the degree to which a woman’s intended feeding method matches her actual feeding method. Concordance centers the woman and her optimal approach to feeding her infant. Positive concordance was defined as whether the woman breastfed at least as much as intended.
In this study, women with a history of CMT (with and without PTSD) are more likely to intend to breastfeed than those without. Women with a history of CMT who did not have PTSD are more likely to breastfeed their infants than were other women. There were no significant differences in the woman-centered outcome between groups. However, most women did not have concordant outcomes, suggesting there are issues between intent and outcome for most women.
Women with a history of both CMT and PTSD are significantly less likely to be breastfeeding their infants at 6 weeks, even though they are equally likely to intend to breastfeed when compared to other women. Women with a history of only CMT and not PTSD are more likely to be breastfeeding their infants, which suggests that PTSD, not abuse itself, is the salient factor. This finding supports the development of trauma-informed breastfeeding education and policies for perinatal care.PhDNursingUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/111601/1/eagen_1.pd
