Research Article: Intimate partner violence and subsequent premature termination of exclusive breastfeeding: A cohort study

Date Published: June 10, 2019

Publisher: Public Library of Science

Author(s): Frederikke Kjerulff Madsen, Christina Elise Holm-Larsen, Chunsen Wu, Jane Rogathi, Rachel Manongi, Declare Mushi, Dan Wolf Meyrowitsch, Tine Gammeltoft, Geofrey Nimrody Sigalla, Vibeke Rasch, Sandra Jacobson.


The objective of this study was to examine whether exposure to Intimate Partner Violence (IPV) is associated with premature termination of Exclusive Breastfeeding (EB). Per WHO recommendations, this was defined as ceasing breastfeeding or supplementing with other foods or liquids before the child was 6 months old.

It is a prospective cohort study set in Moshi, Tanzania consisting of 1128 pregnant women with live singleton births. Women were enrolled during pregnancy and followed up with interviews during pregnancy, after birth and 2–3 years postpartum, using structured questionnaires. Emotional, physical and sexual IPV exerted by the current partner was assessed at 34 weeks gestational age with WHO questionnaires. Months of EB was assessed 2–3 years postpartum. Premature termination of EB was defined as less than 6 months of EB. Analyses were made using a logistic regression model adjusted for maternal age, education, HIV-status, alcohol use during pregnancy and parity. Confounding variables were determined using a theoretical framework approach, i.e. a Directed Acyclic Graph model to minimize bias.

Women who were exposed to IPV had more than 50% higher odds of terminating EB before the child was 6 months old compared to women who were not exposed (aOR = 1.62, 95%CI: 1.27–2.06).

The results indicated that exposure to IPV is associated with increased risk of premature termination of EB. The odds increase with multiple types of the IPV, especially when exposed during the index pregnancy.

Partial Text

Breastfeeding is a vital factor in maternal and child health. [1, 2] The World Health Organization (WHO) recommends initiating breastfeeding within 1 hour of birth, exclusive breastfeeding (EB) for 6 months and continued supplemental breastfeeding for 2 years.[3] Child benefits are reduced mortality, lower rates of infectious diseases and diabetes,[2, 4] and improved neurological and cognitive development.[5, 6] However, only 37% of children worldwide are exclusively breastfed for 6 months or more.[2]

A total of 1300 women fulfilled the inclusion criteria and 1128 (96.3%) mothers and their babies were included in the study (Fig 2).

The present study provided strong evidence to support that exposure to IPV increases the odds of terminating EB before the recommended 6 months. This calls for initiatives and policies to prevent IPV and help the women affected.