Breastfeeding continuation at 6-weeks postpartum remediates the negative effects of prenatal IPV on infant temperament

• In Event: 1-195 - The impact of maternal trauma exposure and caregiving among low-income, ethnic minority infants and preschoolers

Integrative Statement

Background: Research highlights the detrimental effects of prenatal IPV for both mothers and infants. Very little work, however, has examined potential buffering effects in the link between prenatal IPV and infant adjustment, especially factors present in the first critical weeks following delivery. The current study aimed to evaluate the protective role of breastfeeding in the relationship between prenatal IPV and infant temperament at 4-months.

Methods: Pregnant women (n=82) were recruited from a low-income clinic and were interviewed during pregnancy and at 6-weeks and 4-months postpartum. Most women (63%) were of ethnic minority background. It was hypothesized that (1) prenatal IPV would predict infant temperament outcomes at the 4-month post-partum visit, and (2) breastfeeding continuation at 6-weeks act as a protective factor such that breastfed infants will be less affected by the risk posed by prenatal IPV.

Results: Results indicated IPV exposure during pregnancy predicted significantly lower levels of infant positive affectivity/surgency at 4-months postpartum (β=-.27, p<.01). Prenatal IPV also was associated with orienting/regulatory capacity at 4-months postpartum, but only at p<.10 (β=-.20, p=.07). The addition of the hypothesized moderating effect of breastfeeding on the relationship between IPV and infant temperament improved overall model variance explained (R2=0.44, ΔR2=0.13, f2=0.23) with a medium effect size. There were also significant improvements in variance explained for both positive affectivity/surgency (R2=0.31, ΔR2=0.12; f2=0.14) and orienting/regulatory capacity (R2=0.18, ΔR2=0.16; f2=0.23), at small-to-medium and medium effect sizes, respectively. The variance explained for negative emotionality was unchanged and small (R2=0.04; ΔR2=0.00). Results indicated breastfeeding significantly moderated the relationship between prenatal IPV exposure and infant adjustment for both positive affectivity/surgency and orienting/regulatory capacity (β=1.06, p<.01; β=1.10, p<.01, respectively; See Figure 1). Simple slopes analyses indicated mothers who were not breastfeeding at 6-weeks postpartum demonstrated the expected negative relationship between prenatal IPV exposure and infant adjustment, such that higher rates of IPV were associated with lower levels of positive affectivity/surgency and orienting/regulatory capacity (t=-3.86, p<.01, t=-3.44, p<.01, respectively). In contrast, the relationship between IPV exposure and infant positive affectivity/surgency and orienting/regulatory capacity was not significantly different from zero for women who were still breastfeeding at 6-weeks.

Conclusions: Results indicate that exposure did not exert a negative effect on infant temperament at 4-months if mothers were still breastfeeding at 6-weeks postpartum. These findings highlight the importance of targeted breastfeeding supports for IPV-exposed women. The protective role of breastfeeding is a particularly promising area of intervention given that breastfeeding education and support is already embedded in numerous health systems women might engage with during their pregnancy. During pregnancy, many women regularly interact prenatal care providers, learn about breastfeeding options, and have opportunities to understand and develop practices to protect infants’ health and wellbeing. Consequently, costs of this preventative measure are relatively inconsequential – compared to either more intensive parenting interventions in pregnancy or postpartum mental health supports for women and children. It is important to recognize, however, IPV-exposed women may require more tailored breastfeeding support attending to their particular concerns and difficulties in breastfeeding.

Authors

• Laura Miller-Graff, University of Notre Dame
  Presenting Author

• Caroline Scheid, University of Notre Dame
  Non-Presenting Author