Abstract
Research suggests that breastfeeding may reduce child maltreatment risk. Alaska has high rates of both breastfeeding initiation and maltreatment reports to Child Protective Services (CPS). The present study assessed any and exclusive breastfeeding duration and child maltreatment reports to CPS among Alaskan mother-infant dyads, controlling for demographics and shared risk factors. We used a prospective, population-representative dataset linking 2009–2011 Alaska Pregnancy Risk Assessment Monitoring System (PRAMS) data with 2009–2016 Alaska CPS and administrative state data (n = 3,459). Breastfeeding duration was derived from PRAMS breastfeeding questions and categorized as never, < 1 weeks, 1—9 weeks, and ≥ 10 weeks. Age at first report of maltreatment to Alaska CPS included physical or sexual abuse, neglect, or mental injury. Hazard ratios and 95% confidence intervals (CI) were calculated using Cox proportional hazard models, adjusting for confounders. There was no increase in risk of maltreatment report among children never breastfed compared to those breastfed for ≥ 10 weeks. Risk of maltreatment report during the observation period was 1.7 times as high among children breastfed for < 1 week (CI: 1.06, 2.73), and 1.5 times as high among those breastfed for 1–9 weeks (CI: 1.17, 1.80), compared to those breastfed for ≥ 10 weeks. Estimates were attenuated for exclusive breastfeeding. Feeding method did not predict maltreatment reports in this population. Among mothers who initiated breastfeeding, shorter duration was associated with elevated risk of maltreatment reports. Addressing factors that facilitate or prohibit sustained breastfeeding may reduce risk of child maltreatment reports.
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Acknowledgements
We extend special thanks to LCDR Letisha Secret, MSN, RN, Heather Anderson MJ, RN, and Dr. Denise Dillard of Southcentral Foundation, Dr. Carla Britton of the Alaska Native Tribal Health Consortium, and Dr. Matthew Hirshfeld from the Alaska Native Medical Center for consultation and support during the writing of this manuscript. We thank Kathy Perham-Hester of the Alaska Division of Public Health MCH-Epidemiology Unit for managing the PRAMS program and reviewing draft manuscripts. We also thank Dr. Maureen Lahiff of the School of Public Health at University of California, Berkeley for analytic support.
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All authors contributed to the study conception and design. Material preparation, data collection, and analyses were performed by Helena J. Hutchins, Jared Parrish, and Jordyn Wallenborn. The first draft of the manuscript was written by Helena J. Hutchins and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Hutchins, H.J., Harley, K.G., Wallenborn, J.T. et al. Breastfeeding Duration and Reported Child Maltreatment in a Population-based Alaskan Birth Cohort. J Fam Viol 37, 1137–1146 (2022). https://doi.org/10.1007/s10896-021-00327-9
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DOI: https://doi.org/10.1007/s10896-021-00327-9