Ithaca College

Amy Frith, associate professor of nutrition, recently published a paper in the journal Public Health Nutrition entitled:  Breastfeeding counseling mitigates the negative association of domestic violence on exclusive breastfeeding duration in rural Bangladesh. The MINIMat randomized trial. This is the first work that documents a positive effect of a public health nutrition intervention for infant feeding in women who are victims of domestic violence. Dr. Frith published this work with colleagues, Shirin Ziaei and Eva-Charlotte Ekström from the International Maternal and Child Health Unit (IMCH), at the University Hospital, Uppsala University, Uppsala, Sweden, and with Ruchira Naved, Ashraful Islam Khan, Iqbal Kabir from the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b),  Dhaka, Bangladesh.

Abstract

Objective:  To determine if exclusive breastfeeding counselling modifies the association of experience of any lifetime or specific forms of domestic violence (DV) on duration of exclusive breastfeeding (EBF).

Design:  In the MINIMat trial pregnant women were randomized to receive either usual health messages (UHM) or usual health messages with breastfeeding counselling (BFC) in 8 visits. During pregnancy (30 wk), lifetime experience of any or specific form of DV was measured. Infant feeding practice information was collected from 0-6 months for 15 day intervals.

Setting:  Matlab, Bangladesh

Subjects:  3186 pregnant and postpartum women and their infants

Results:  Among women in UHM group, those who had experienced any lifetime DV exclusively breastfed for a shorter duration than women who did not experience any lifetime DV (P = 0.02). There was no difference, however, in duration of EBF among women in BFC group based on their experience of any lifetime DV exposure (P = 0.48). Using Cox regression analysis, there was an interaction of exposure to any lifetime DV, sexual violence, and controlling behavior, and counselling group with duration of breastfeeding at or before 6 months (P-interactions ≤ 0.08). Among the UHM group, experience of any lifetime DV, sexual DV, or controlling behavior was associated with fewer days of EBF (P < 0.05). In contrast, among the BFC group, experience of DV was not associated with duration of EBF.

Conclusion:  The experience of DV compromises EBF, and the support of breastfeeding counselling programs could assist this vulnerable group towards better infant feeding practices