Is Intimate Partner Violence a Barrier to Breastfeeding? An Analysis of the 2015 Indian National Family Health Survey

Abstract

Women in India experience high rates of intimate partner violence (IPV) and low rates of adherence to World Health Organization (WHO) breastfeeding guidelines, contributing to poor maternal and child health outcomes. However, there is little evidence for how IPV might influence ability to adhere to these guidelines in India. This study examines how different forms and severity levels of IPV are associated with current infant feeding behavior throughout the first year of life in an effort to begin to fill this gap in the literature and provide information to improve infant feeding programs. Data are analyzed from the 2015 Indian National Family Health Survey. The sample comprised women who reported initiating breastfeeding in the past 12 months and who were selected for the Domestic Violence Module (n = 6812). Two outcome variables were created to measure current adherence to the WHO breastfeeding guidelines for mothers of 1) infants 6 months and younger and 2) infants 7 to 12 months. Two logistic regression models were fit to measure associations between the outcome variables and non-severe physical violence, severe physical violence, and sexual violence. Less than one-third of women reported adhering to WHO breastfeeding guidelines. Only severe physical violence was significantly associated with lower odds of current exclusive breastfeeding among mothers of infants 0 to 6 months. This analysis advances the understanding of how IPV is associated with suboptimal breastfeeding behavior by categorizing the severity of violence and including infants through the first year of life. The results suggest it may be crucial to focus intervention efforts on mothers with younger infants if the negative health effects of early weaning are to be avoided. Additional study of IPV in mothers of older infants should focus on the temporality of violence, which may elucidate additional findings regarding IPV and breastfeeding in this population.